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ON 01910

Protein Kinase Inhibitors

Enzyme Inhibitors

1800 mg/day of ON 01910.Na administered as a 24-hour continuous intravenous infusion on days 1, 2 and 3 of 14-day cycle.

1800 mg/day as a 24-hour continuous intravenous infusion administered three times a week every 2 weeks

ON 01910.Na

Azra Raza, MD

The primary objective of this study is to evaluate the efficacy and safety of ON 01910.Na Concentrate when it is administered as an intravenous continuous infusion (IVCI) over 72 hours once every 2 weeks in a broad population of MDS patients. Rationale for this study is based on the activity observed in another study with ON 01910.Na in patients with refractory anemia with excess blasts (RAEB) 1 and 2 MDS. This study will examine ON 01910.Na in a broader population of MDS and AML patients. This phase I/II study will establish the Maximum Tolerated Dose (MTD) starting with a dose of 800 mg/m2 per day administered over 24 hours for 2 consecutive days as a continuous intravenous infusion, once a week for 3 weeks of a 4-week cycle and examine the efficacy and safety profile at the MTD.

The primary objective of this study is to evaluate the efficacy and safety of ON 01910.Na CIV 24-hour infusion administered three times a week every other week in achieving by week 25 a complete or partial response as defined per the 2000 International Working Group (IWG) Criteria in patients with MDS or as defined by Cheson et al. \[JCO 21:4642 (2003)\] in patients with AML.

The secondary objectives are to assess:

* Time and duration of response
* Blastic response in bone marrow
* Improvement of dyspoiesis as evaluated by the change in aneuploidy in bone marrow
* Change in International Prognostic Scoring System (IPSS) in MDS patients
* Major and minor responses in absolute neutrophil count, according to IWG 2000 criteria
* Major and minor responses in platelet count, according to IWG 2000 criteria
* Major and minor erythroid response, according to IWG 2000 criteria
* Time to progression
* Overall survival at 25 and 50 weeks
* Proportion of MDS patients transitioning to acute myeloid leukemia (AML) at 25 and 50 weeks

This is a phase 1/2 single arm study in which six to thirty-five patients with MDS or AML who meet all other inclusion/exclusion criteria will receive ON 01910.Na as an intravenous continuous infusion (IVCI) over 72 hours once a week every other week.

In the phase 1 portion of the study, a traditional dose escalation rule, also known as the "3+3" rule, will be used. Three patients will be treated at the 800 mg/m2/day dose level. If none of the patients experience a DLT during cycle 1, the next group of 3 patients will receive 1500 mg/m2/day. If no DLT is seen at the 1500 mg/m2/day dose level, then the dose used in the phase 2 portion of the study will be 1500 mg/m2/day. If there is DLT in one of the first three patients at the 800 mg/m2/day dose level, this dose level will be expanded to 6 patients. If ≤ 1 patient out of 6 experience DLT, then the dose will be escalated to the 1500 mg/m2/day dose level. If ≥ 2 patients experience DLT at the 800 mg/m2/day dose level, a full safety review will determine if further enrollment of patients will proceed. If there is DLT in one of the first three patients at the 1500 mg/m2/day dose level, this dose level will be expanded to 6 patients. If ≤ 1 patient out of 6 experience DLT at the 1500 mg/m2/day dose level, then 1500 mg/m2/day dose level will be considered the MTD. If ≥ 2 patients experience DLT at the 1500 mg/m2/day dose level, then 800 mg/m2/day will be designated as the MTD.

The total study duration is 29 weeks, which includes a 2-week screening phase, a 23-week dosing phase, and a 4-week follow-up phase that begins after the last dose of ON 01910.Na. Beginning at week 4, and every 2 weeks thereafter, patients will be assessed for response and followed up.

Patients who achieve by week 25 a complete or partial response or stabilization of their disease are eligible to receive an additional 24 weeks of ON 01910.Na 1800 mg/24 h for 72 h once a week every 2 weeks and will be followed up.

Study of 72-Hour Infusion of ON 01910.Na in Patients With MDS or AML

A Phase 1/2, Single-Arm Study To Assess The Efficacy and Safety Of 72-Hour Continuous Intravenous Dosing Of ON 01910.Na Administered Every Other Week in Patients With Myelodysplastic Syndrome (MDS) or Acute Myeloid Leukemia (AML)

Traws Pharma, Inc.

Immune System Diseases

Neoplasm Metastasis

Lymphoma

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Leukemia, Lymphoid

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive

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Chronic Myeloproliferative Disorders

Myelodysplastic Syndrome With Excess Blasts

Lymphoma, Large-cell, Immunoblastic

Chronic Neutrophilic Leukemia

Patients receiving umbilical cord blood transplantation.

The graft will be given by slow injection into each posterior iliac crest.

umbilical cord blood transplantation

John E. Wagner, MD

Rationale: Giving chemotherapy and total-body irradiation before a donor umbilical cord blood transplant helps stop the growth of cancer and abnormal cells and helps stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells from the donor's umbilical cord blood are injected into the patient's bone marrow they may help make stem cells, red blood cells, white blood cells, and platelets.

Purpose: This phase I/II trial is studying the side effects of donor umbilical cord blood transplant when given directly into the bone marrow and to see how well it works in treating patients with hematologic cancer.

Objectives:

Primary

* Determine the safety, in terms of infusional toxicity, of myeloablative unrelated donor double-unit umbilical cord blood (UCB) transplantation via intra-bone marrow injection (IBMI) in patients with advanced or high-risk hematologic malignancy.
* Determine whether treatment with this regimen improves the time to neutrophil engraftment (compared to historical controls) in these patients.

Secondary

* Determine the incidence of sustained donor engraftment in patients treated with this regimen.
* Determine the relative contribution of each UCB unit to initial and sustained donor engraftment in these patients.
* Determine the incidence of grade II-IV and grade III-IV acute graft-vs-host disease (GVHD) and chronic GVHD in patients treated with this regimen.
* Determine the incidence of day 100 and 180 transplant-related mortality in patients treated with this regimen.
* Determine the probability of survival at 100 days and 1 year post-transplantation in these patients.

Outline: This is a nonrandomized study.

Patients receive a myeloablative conditioning regimen. Patients also receive immunosuppression, growth factor, and supportive care as in protocol MT2005-10 (NCT00309842).

Patients receive 2 units of donor umbilical cord blood (UCB) by intra-bone marrow injection (IBMI) over 10 minutes each on day 0. If the IBMI procedure is not possible, then the UCB units are given intravenously (IV.)

After completion of study therapy, patients are followed periodically for 5 years.

Projected Accrual: A total of 36 patients will be accrued for this study.

Donor Umbilical Cord Blood Transplant By Injection Into the Bone Marrow in Treating Patients With Hematologic Cancer

A Phase I/II Study of Double Unit Umbilical Cord Blood (UCB) Transplantation Utilizing Graft Administration Via Intra-Bone Marrow Injection (Companion Protocol to MT2000-25)

Number of days to neutrophil recovery observed in recipients of two umbilical cord blood units (UCB)administered i.v. Neutrophil recovery is defined as first of 3 consecutive days with ANC (absolute neutrophil count) greater than or equal to 500/ul.

Number of patients with sustained neutrophil recovery with chimerism (evidence of engraftment of both cord blood transplants) at 6 months.

Number of patients who received both cord blood units and achieved sustained donor engraftment

Number of patients who exhibited grade II-IV acute GVHD at 100 days post umbilical cord blood transplant.

Number of patients who were deceased at days 100 and 180 from any cause other than relapse.

Overall survival of patients-Number of patients who were alive at Day 100 and 1 year post transplant.

Number of umbilical cord blood transplant patients developing severe GVHD at 100 days post transplant.

Number of umbilical cord blood transplant patients with limited and extensive chronic GVHD.

Masonic Cancer Center, University of Minnesota

Patients with high-risk hematologic malignancy transplanted with umbilical cord blood via direct marrow injection.

Umbilical Cord Blood Transplant Patients

Age, Categorical

Age, Continuous

Sex: Female, Male

United States

Region of Enrollment

This study was terminated early based on interim statistical analysis that indicated time to engraftment will not be improved compared to historical controls. While safe, lack of faster marrow recovery supports early discontinuation.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Study of 72-Hour Infusion of ON 01910.Na in Patients With MDS or AML	NCT00854945	Myelodysplastic... Acute Myeloid L...	ON 01910.Na	18 Years -	Traws Pharma, Inc.
Donor Umbilical Cord Blood Transplant By Injection Into the Bone Marrow in Treating Patients With Hematologic Cancer	NCT00295880	Myeloproliferat... Leukemia Lymphoma Myelodysplastic...	umbilical cord ...	12 Years - 45 Years	Masonic Cancer Center, University of Minnesota

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