Pacritinib and Chemotherapy in Treating Patients With Acute Myeloid Leukemia and FLT3 Mutations

• Status: Completed
• Trial end date: 2018-07-12
• Target enrollment: 0
• Participant gender: All

Summary

This phase I trial studies the side effects and best dose of pacritinib when given together with chemotherapy in treating patients with acute myeloid leukemia that have an abnormal change (mutation) in the fms-related tyrosine kinase 3 (FLT3) gene. Pacritinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cytarabine, daunorubicin hydrochloride, and decitabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving pacritinib and chemotherapy may be a better treatment for acute myeloid leukemia with FLT3 mutations.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Bhavana Bhatnagar
• Collaborator: CTI BioPharma
• Treatments: Azacitidine; Cytarabine; Daunorubicin; Decitabine

Criteria

Inclusion Criteria:

• Patients with AML and the presence of FLT3 mutation

• Patients with secondary AML or therapy related disease (t-AML) are eligible

• If the patient has co-morbid medical illness, life expectancy attributed to this must be greater than 6 months

• Eastern Cooperative Oncology Group (ECOG) performance status =< 2

• Total bilirubin < 2.0mg/dL unless due to Gilbert's disease

• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 X institutional upper limit of normal

• Creatinine (Cr) clearance > 50 mL/min by Cockcroft-Gault calculation

• New York Heart Association (NYHA) congestive heart failure (CHF) class II or better

• Cardiac ejection fraction >= 50% for Arm A, >= 40% for Arm B

• Female patients of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening, and male patients must use an effective barrier method of contraception if sexually active with a female of child-bearing potential; acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal; for both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose

• Ability to understand and willingness to sign the written informed consent document

• Human immunodeficiency virus (HIV) infection without history of acquired immune deficiency syndrome (AIDS) and sufficiently high cluster of differentiation (CD)4 cells (> 400/mm^3) and low HIV viral loads (< 30,000 copies/ml plasma) not requiring anti-HIV therapy are eligible

Exclusion Criteria:

• Patients with core-binding factor AML (inv[16], t[8;21]) or t(15;17)

• Patients who have had chemotherapy or radiotherapy within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study; treatment with hydroxyurea is permitted during cycle 1 to maintain white blood cell (WBC) < 40,000/uL

• Patients receiving any other investigational agents or patients that have received other investigational agents within 14 days of enrollment

• Patients with active central nervous system (CNS) malignancy

• Major surgery within 2 weeks before day 1

• Uncontrolled active infection; patients with infection requiring parenteral antibiotics are eligible if the infection is controlled

• Patients with significantly diseased or obstructed gastrointestinal tract

• Uncontrolled intercurrent illness including, but not limited to, symptomatic congestive heart failure (New York Heart Association [NYHA] class III or IV), unstable angina pectoris, myocardial infarction within 6 months prior to enrollment, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities; prior to study entry, any electrocardiogram (ECG) abnormality at screening has to be documented by the investigator as not medically relevant

• Patients with serious medical or psychiatric illness likely to interfere with participation in this clinical study

• Pregnant women or women who are breastfeeding are excluded from this study; confirmation that the subject is not pregnant must be established by a negative serum beta-human chorionic gonadotropin (beta-hCG) pregnancy test result obtained during screening; pregnancy testing is not required for post-menopausal or surgically sterilized women

• Patients with advanced malignant solid tumors

• Patients who are not able to swallow capsules or tablets

• Patients with baseline corrected QT (QTc) > 500 ms