Phase III Study of CPX-351 Versus 7+3 in Patients 60-75 Years Old With Untreated High Risk (Secondary) Acute Myeloid Leukemia

Not Recruiting

Trial ID: NCT01696084


To confirm the efficacy of CPX-351 compared to 7+3 as first line therapy in elderly patients (60-75 yrs) with high risk (secondary) Acute Myeloid Leukemia. The primary efficacy endpoint will be overall survival.

Official Title

Phase III, Multicenter, Randomized, Trial of CPX-351 (Cytarabine:Daunorubicin) Liposome Injection Versus Cytarabine and Daunorubicin in Patients 60-75 Years of Age With Untreated High Risk (Secondary) AML


Inclusion Criteria:

   - Ability to understand and voluntarily give informed consent

   - Age 60-75 years at the time of diagnosis of AML

   - Pathological diagnosis of AML according to WHO criteria (with at least 20% blasts in
   the peripheral blood or bone marrow)

   - Confirmation of:

      - Therapy related AML: t-AML must have a documented history of prior cytotoxic
      therapy or ionizing radiotherapy for an unrelated disease

      - AML with a history of myelodysplasia: MDSAML must have bone marrow documentation
      of prior MDS

      - AML with a history of CMMoL: CMMoLAML must have bone marrow documentation of
      prior CMMoL

      - De novo AML with karyotypic abnormalities characteristic of MDS: de novoAML must
      have cytogenetics with abnormalities per WHO.

   - Eastern Cooperative Oncology Group (ECOG) performance status 0-2

   - Able to adhere to the study visit schedule and other protocol requirements

   - Laboratory values fulfilling the following:

      - Serum creatinine < 2.0 mg/dL

      - Serum total bilirubin < 2.0 mg/dL, patients with Gilbert's Syndrome should
      contact the medical monitor

      - Serum alanine aminotransferase or aspartate aminotransferase < 3 times the ULN
      Note: If elevated liver enzymes, above the ULN, are related to disease; contact
      medical monitor to discuss.

   - Cardiac ejection fraction ≥ 50% by echocardiography or MUGA

   - Patients with second malignancies in remission may be eligible if there is clinical
   evidence of disease stability for a period of greater than 6 months off cytotoxic
   chemotherapy, documented by imaging, tumor marker studies, etc., at screening.
   Patients maintained on long-term non-chemotherapy treatment, e.g., hormonal therapy,
   are eligible.

Exclusion Criteria:

   - Except for CMMoL, patients with history of myeloproliferative neoplasms (MPN) (defined
   as a history of essential thrombocytosis or polycythemia vera, or idiopathic
   myelofibrosis prior to the diagnosis of AML) or combined MDS/MPN are not eligible.

   - Acute promyelocytic leukemia [t(15;17)] or favorable cytogenetics, including t(8;21)
   or inv16 if known at the time of randomization.

   - Clinical evidence of active CNS leukemia

   - Patients with active (uncontrolled, metastatic) second malignancies are excluded.

   - Prior treatment intended for induction therapy of AML; only hydroxyurea is permitted
   for control of blood counts. For example, a patient with MDS that changes HMA dose and
   schedule after the diagnosis of AML is excluded. AML-type therapy, such as cytarabine
   alone (>1g/m2/day) or cytarabine plus an anthracycline as well as prior HSCT are also

   - Administration of any therapy for MDS (conventional or investigational) must be
   completed by 2 weeks prior to of the first dose of study drug; in the event of rapidly
   proliferative disease use of hydroxyurea is permitted until 24 hours before the start
   of study treatment. Toxicities associated with prior MDS therapy must have recovered
   to grade 1 or less prior to start of treatment.

   - Any major surgery or radiation therapy within four weeks.

   - Patients with prior cumulative anthracycline exposure of greater than 368 mg/m2
   daunorubicin (or equivalent).

   - Any serious medical condition, laboratory abnormality or psychiatric illness that
   would prevent obtaining informed consent

   - Patients with myocardial impairment of any cause (e.g. cardiomyopathy, ischemic heart
   disease, significant valvular dysfunction, hypertensive heart disease, and congestive
   heart failure) resulting in heart failure by New York Heart Association Criteria
   (Class III or IV staging)

   - Active or uncontrolled infection. Patients with an infection receiving treatment
   (antibiotic, antifungal or antiviral treatment) may be entered into the study but must
   be afebrile and hemodynamically stable for ≥72 hrs.

   - Current evidence of invasive fungal infection (blood or tissue culture); patients with
   recent fungal infection must have a subsequent negative cultures to be eligible; known
   HIV (new testing not required) or evidence of active hepatitis B or C infection (with
   rising transaminase values)

   - Hypersensitivity to cytarabine, daunorubicin or liposomal products

   - History of Wilson's disease or other copper-metabolism disorder


drug: 7+3 (cytarabine and daunorubicin)

drug: CPX-351

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305

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