Vorinostat, Azacitidine, and Gemtuzumab Ozogamicin for Older Patients With Relapsed or Refractory AML

Not Recruiting

Trial ID: NCT00895934


The purpose of this study is to test the safety of vorinostat (Zolinza) and azacitidine (Vidaza) when combined with gemtuzumab ozogamicin (GO) at different dose levels. These drugs increase the effect of GO against leukemia cells in the test tube, but we don't know yet whether they also increase the anti-leukemia effect of GO in people.

Official Title

A Phase 1/2 Study of Vorinostat (Zolinza®) in Combination With Gemtuzumab Ozogamicin (Mylotarg®) and Azacitidine (Vidaza®) in Patients 50 Years of Age and Older With Relapsed/Refractory Non-APL Acute Myeloid Leukemia (AML)

Stanford Investigator(s)

Jason Gotlib

Professor of Medicine (Hematology)


Inclusion Criteria:

   - Prior morphological diagnosis of acute myeloid leukemia (AML) other then acute
   promyelocytic leukemia (APL) according to the 2001 WHO criteria; patients with
   biphenotypic AML are eligible

   - Need for first salvage chemotherapy for persistent or relapsing disease, defined by
   standard criteria, after at least one course of conventional chemotherapy

   - A bone marrow biopsy is not required but should be obtained if the aspirate is dilute,
   hypocellular, or not aspirable; outside marrow exams performed within the stipulated
   time period are acceptable if the slides are reviewed at the study institution

   - Flow cytometric analysis of the marrow aspirate per institutional practice guidelines

   - Duration of first complete remission (CR1) < 12 months (or primary resistant disease)

   - Patients with prior autologous or allogeneic hematopoietic cell transplantation (HCT)
   if relapse occurs 6-12 months post-transplant

   - ECOG/WHO/Zubrod performance status of 0-3 within 14 days prior to registration

   - Off any active therapy for AML except hydroxyurea for at least 14 days prior to study
   registration, with resolution of all grade 3 and 4 non-hematological toxicities

   - Willingness to discontinue taking any medications known to cause a risk of Torsades de

   - Bilirubin =< 1.5 x Institutional Upper Limit of Normal (IULN) unless elevation is due
   to hepatic infiltration by AML, Gilbert's syndrome, or hemolysis (within 7 days prior
   to registration)

   - SGOT (AST) and SGPT (ALT) =< 1.5 x IULN unless elevation is due to hepatic
   infiltration by AML (within 7 days prior to registration)

   - Serum creatinine =< 1.5 x IULN (within 7 days prior to registration)

   - No clinical or radiographical evidence of heart failure

   - white blood cell (WBC) < 25,000/uL within 3 days prior to registration

   - Patients with symptoms/signs of hyperleukocytosis or WBC > 100,000/uL can be treated
   with leukapheresis prior to enrollment

   - Collection of bone marrow and peripheral blood specimens for correlative studies prior
   to study treatment is highly recommended; peripheral blood only is acceptable if the
   peripheral blast count is > 5,000/uL and > 50% of total WBC

   - Must agree to use adequate contraception prior to and during the study

   - Can understand and sign a written informed consent document; a legally authorized
   representative can provide consent if the patient is unable

Exclusion Criteria:

   - Remission or second or later relapse

   - Diagnosis of another malignancy, unless diagnosed at least 2 years earlier and
   disease-free for at least 6 months after completion of curative intent therapy except:

      - Treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial
      neoplasia, if definitive treatment has been completed

      - Organ-confined prostate cancer with no evidence of recurrent or progressive
      disease based on prostate-specific antigen (PSA) values if hormonal therapy has
      been initiated or a radical prostatectomy was performed

   - Refractory/relapsing blast crisis of chronic myeloid leukemia (CML)

   - Prior anti-AML treatment with GO, histone deacetylase (HDAC) inhibitor (including the
   use of valproic acid for control of seizure activity or other purposes), or
   demethylating agent

   - Known hypersensitivity to GO, vorinostat, azacitidine, or mannitol

   - Possible central nervous system (CNS) involvement with leukemia unless a lumbar
   puncture confirms no leukemic blasts in the cerebralspinal fluid (CSF)

   - HIV-positive patients with cluster of differentiation (CD)4 count is < 200 cells/uL or
   if AIDS-related complications

   - Pregnancy; breastfeeding should be discontinued if the mother is treated with
   vorinostat, azacitidine, and GO

   - Uncontrolled systemic infection, despite appropriate antibiotics or other treatment)

   - Receipt of any other investigational agents


drug: azacitidine

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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