©2022 Stanford Medicine
Nilotinib and Imatinib Mesylate After Donor Stem Cell Transplant in Treating Patients With ALL or CML
Not Recruiting
Trial ID: NCT00702403
Purpose
This phase I/II trial is studying the side effects and best way to give nilotinib when given
alone or sequentially after imatinib mesylate after donor stem cell transplant in treating
patients with acute lymphoblastic leukemia or chronic myelogenous leukemia. Nilotinib and
imatinib mesylate may stop the growth of cancer cells by blocking some of the enzymes needed
for cell growth.
Official Title
A Multicenter Phase I/II Study of the Prophylactic Inhibition of BCR-ABL Tyrosine Kinase by Tasigna ® (Nilotinib) After Hematopoietic Cell Transplantation for Philadelphia Chromosome-Positive Leukemias.
Stanford Investigator(s)
Laura Johnston
Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)
Robert Negrin
Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)
Wen-Kai Weng, MD, PhD
Associate Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy) and, by courtesy, of Dermatology
Robert Lowsky
Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)
Sally Arai
Associate Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)
Judith Shizuru
Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy) and of Pediatrics (Stem Cell Transplantation)
Eligibility
Inclusion Criteria:
- Body surface area >= 1 m^2
- Allogeneic HCT
- Acute lymphocytic leukemia (ALL) or chronic myelogenous leukemia (CML) characterized
by the p190 and/or p210 BCR/ABL gene rearrangement
- CML in accelerated phase, blast crisis, or blast crisis remission as defined by World
Health Organization (WHO) criteria
- CML in chronic phase if patient age =< 17 years or a patient of any age with CML in
second chronic phase or beyond
- Patients with minimal residual disease (MRD) that is not declining in response to
tyrosine kinase inhibitor therapy must be screened for the T315I and other mutations
- An appropriately matched related or unrelated donor
- Signed informed consent
- Patient must have a life expectancy of at least 2 months
- Stated willingness of the patient to comply with study procedures and reporting
requirements
- Creatinine =< 2.0 x upper limit normal (ULN)
- Platelets > 20 x 10^9 /L
- Serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 3 x ULN,
conjugated bilirubin < 3 x ULN
- Serum potassium phosphorus, magnesium, and calcium >= lower limit normal (LLN) or
correctable with supplements prior to first dose of study drug; calcium levels may be
corrected for hypoalbuminemia
- Serum amylase and lipase < 1.5 x ULN
- Female patients of childbearing potential must have negative pregnancy test within 7
days before initiation of study drug dosing; postmenopausal women must be amenorrheic
for at least 12 months to be considered of non-childbearing potential; male and female
patients of reproductive potential must agree to employ an effective barrier method of
birth control throughout the study and for up to 3 months following discontinuation of
study drug
- Careful rationalization with a view to discontinuing or considering alternatives to
any concomitant medications that have potential to prolong the QT interval
Exclusion Criteria:
- Autologous transplant
- Non-myeloablative transplant
- Patient age > 17 years with CML in first chronic phase
- Aberrant antigen expression on marrow leukemic blasts >= 5% by multidimensional flow
cytometric assay immediately before conditioning (CML patients in chronic phase exempt
from flow cytometry screening)
- Ph+ ALL without complete cytogenetic remission immediately before conditioning
- Known T315I mutation
- Hypersensitivity to Gleevec or Tasigna
- Patients who are Tasigna-resistant or intolerant
- Central nervous system (CNS) involvement with leukemia at baseline (pre-imatinib
therapy); CML chronic phase (CP), accelerated phase (AP) patients exempt from CNS
involvement screening
- Female patients who are pregnant, breast-feeding, or of childbearing potential without
a negative serum pregnancy test at screening; male or female patients of childbearing
potential unwilling to use effective contraceptive precautions throughout the trial;
post-menopausal women must be amenorrheic for at least 12 months to be considered of
non-childbearing potential
- Life expectancy severely limited by diseases other than leukemia
- Myocardial infarction within one year prior to starting nilotinib
- Other clinically significant heart disease (e.g. congestive heart failure,
uncontrolled hypertension, unstable angina)
- Absolute neutrophil count (ANC) less than 1500 per microliter at study entry despite
the use of filgrastim (G-CSF)
- Impaired cardiac function, including any one of the following:
- Complete left bundle branch block or bifascicular block (right bundle branch
block plus left anterior hemiblock) or use of ventricular-paced pacemaker
- Congenital long QT syndrome or a family history of long QT syndrome
- History of or presence of significant ventricular or atrial tachyarrhythmias
- Clinically significant resting bradycardia (< 50 beats per minute)
- Corrected QT interval (QTc) > 450 milliseconds on screening electrocardiogram (ECG);
if QTc > 450 and electrolytes are not within normal ranges, electrolytes should be
corrected and then the patient rescreened for QTc
Intervention(s):
other: pharmacological study
drug: imatinib mesylate
drug: nilotinib
Not Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
Physician Referrals
6507230822