Vorinostat and Gemtuzumab Ozogamicin in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia

Not Recruiting

Trial ID: NCT00673153


RATIONALE: Vorinostat may stop the growth of cancer cells by interfering with various proteins needed for cell growth. Monoclonal antibodies, such as gemtuzumab ozogamicin (GO), can block cancer growth in different ways. GO finds cancer cells and helps kill them by carrying a cancer-killing substance to them. Giving vorinostat together with gemtuzumab ozogamicin may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving vorinostat together with gemtuzumab ozogamicin works in treating older patients with previously untreated acute myeloid leukemia.

Official Title

Phase II Trial of Vorinostat (Suberoylanilide Hydroxamic Acid or SAHA; Zolinza™) in Combination With Gemtuzumab Ozogamicin (Mylotarg™) as Induction and Post-Remission Therapy in Older Patients With Previously Untreated Non-M3 Acute Myeloid Leukemia

Stanford Investigator(s)

Jason Gotlib

Professor of Medicine (Hematology)


Inclusion Criteria:

   - Morphological diagnosis of AML other then acute promyelocytic leukemia (FAB M3)
   according to WHO diagnostic criteria; diagnosis of AML must be based on bone marrow or
   peripheral blood studies obtained within 28 days prior to study registration or start
   of hydroxyurea (for patients presenting with WBC >= 10,000/uL), and no potentially
   anti-leukemic therapy (with the exception of hydroxyurea) must have been given between
   AML diagnosis and study registration; a bone marrow biopsy is not routinely required
   but should be obtained if the aspirate is dilute, hypocellular, or inaspirable;
   outside bone marrows performed within the stipulated time period are acceptable as
   long as the slides are reviewed at a study institution

   - Cytogenetic analysis on bone marrow or peripheral blood specimen is available; based
   on the result from the first interim analysis, patients stratified into the good-risk
   group are only eligible if their AML has favorable cytogenetics (core-binding factor
   AML) or has a normal karyotype; patients stratified into the poor-risk group are
   eligible independent of the cytogenetic analysis

   - Pretreatment bone marrow and peripheral blood specimens for correlative studies are
   available; if bone marrow was performed at an outside facility, submission of
   peripheral blood only is acceptable as long as the peripheral blast count is >
   5,000/uL and > 50% of total WBC

   - Patients with a history of antecedent MDS are eligible, if prior treatment did not
   include intensive chemotherapy; patients may have received hematopoietic growth
   factors, thalidomide/lenalidomide, 5-azacytidine/decitabine, arsenic trioxide, signal
   transduction inhibitors, or low dose cytarabine (< 100 mg/m2/day) for treatment of
   MDS; patients must be off prior therapy for MDS at least 30 days prior to study
   registration, and all non-hematologic toxicities must have resolved to < grade 2

   - ECOG/WHO/Zubrod performance status of 0-3

   - Bilirubin =< 2.5 x Institutional Upper Limit of Normal (IULN) unless elevation is
   thought to be due to hepatic infiltration by AML, Gilbert's syndrome, or hemolysis
   (assessed within 14 days prior to registration)

   - SGOT (AST) and SPGT (ALT) =< 1.5 x IULN unless elevation is thought to be due to
   hepatic infiltration by AML (assessed within 14 days prior to registration)

   - Serum creatinine =< 1.5 x IULN (assessed within 14 days prior to registration)

   - Left ventricular ejection fraction >= 40% and no clinical evidence of congestive heart
   failure (assessed within 28 days prior to registration, e.g. by MUGA scan or

   - Men of reproductive potential must use an effective contraceptive method throughout
   the study and for a period of at least 3 months after the study

   - Women must be postmenopausal; a postmenopausal woman is defined as a woman who has
   experienced amenorrhea > 12 consecutive months or a woman on hormone replacement
   therapy with documented FSH level > 35 mIU/mL (women of childbearing potential must
   have a pregnancy test within 28 days prior to registration, and must use an adequate
   method of contraception to avoid pregnancy throughout the study and for a period of at
   least 3 months after the study)

   - Provide signed written informed consent

   - Willingness to undergo bone marrow examination on day 8 of first induction cycle

   - WBC < 10,000/uL (patients with WBC >= 10,000/uL must undergo cytoreduction with
   hydroxyurea prior to enrollment and will not be enrolled if the WBC remains >=
   10,000/uL (of note, patients with symptoms/signs of hyperleukocytosis or WBC >
   100,000/uL can be treated with leukapheresis prior to enrollment)

Exclusion Criteria:

   - Diagnosis of another malignancy, unless the patient was diagnosed at least 2 years
   earlier and has been disease-free for at least 6 months following the completion of
   curative intent therapy; there should be no plan to begin therapy for the prior
   malignancy at the time of study registration; prior treatment with AML induction-type
   chemotherapy is not allowed (note the following exceptions: patients with treated
   non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia,
   regardless of the disease-free duration, are eligible for this study if definitive
   treatment for the condition has been completed; patients with organ-confined prostate
   cancer with no evidence of recurrent or progressive disease based on prostate-specific
   antigen [PSA] values are also eligible for this study if hormonal therapy has been
   initiated or a radical prostatectomy has been performed; concurrent hormonal therapy
   is allowed)

   - Myeloid blast crisis of chronic myelogenous leukemia (CML)

   - Prior systemic chemotherapy for AML with the exception of hydroxyurea

   - Prior treatment with AML induction-type chemotherapy, GO, HDAC inhibitors, or high
   dose chemotherapy with hematopoietic stem cell support

   - Treatment with HDAC inhibitors during the last 3 years prior to registration,
   including the use of valproic acid for seizure activity or other purposes

   - Known hypersensitivity to hydroxyurea, GO, or vorinostat

   - Clinical evidence suggestive of central nervous system (CNS) involvement with leukemia
   unless a lumbar puncture confirms the absence of leukemic blasts in the cerebrospinal
   fluid (CSF)

   - Prior positive test for the human immunodeficiency virus (HIV)

   - Breastfeeding

   - Uncontrolled systemic fungal, bacterial, viral, or other infection (defined as
   exhibiting ongoing signs/symptoms related to the infection and without improvement,
   despite appropriate antibiotics or other treatment)


other: laboratory biomarker analysis

drug: gemtuzumab ozogamicin

drug: vorinostat

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Cancer Clinical Trials Office

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