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Brief Title: A Study of Clofarabine and Cytarabine for Older Patients With Relapsed or Refractory Acute Myelogenous Leukemia (AML)(CLASSIC I)
Official Title: A Phase III Randomized, Double-blind, Controlled Study Comparing Clofarabine and Cytarabine Versus Cytarabine Alone in Adult Patients 55 Years and Older With Acute Myelogenous Leukemia (AML) Who Have Relapsed or Are Refractory After Receiving up to Two Prior Induction Regimens
Study ID: NCT00317642
Brief Summary: Clofarabine (injection) is approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 1 to 21 years old with relapsed acute or refractory lymphoblastic leukemia (ALL) who have had at least 2 prior treatment regimens. There is no recommended standard treatment for relapsed or refractory acute myelogenous leukemia in older patients. Cytarabine is the most commonly used drug to treat these patients. This study will determine if there is benefit by combining clofarabine with cytarabine. Patients will be randomized to receive up to 3 cycles of treatment with either placebo in combination with cytarabine or clofarabine in combination with cytarabine. Randomization was stratified by remission status following the first induction regimen (no remission \[i.e., CR1 = refractory\] or remission \<6 months vs CR1 = remission ≥6 months). CR1 is defined as remission after first pre-study induction regimen. The safety and tolerability of clofarabine in combination with cytarabine and cytarabine alone will be monitored throughout the study.
Detailed Description: After screening and eligibility assessment, patients were randomized (in a 1:1 ratio) to receive either clofarabine or matching placebo, in addition to cytarabine. Randomization was stratified by remission status following the first induction regimen (CR1): no remission \[i.e., CR1 = refractory\] or remission \<6 months vs remission ≥6 months. During randomization by interactive voice response system (IVRS), there were 10 participants misclassified to the CR1 \<6 months stratum and 12 participants misclassified to CR1 ≥6 months stratum. The error did not affect the participants' treatment, only the stratification. Due to the misclassification, outcomes that used strata in their analysis were analyzed twice: once with the 'randomized stratification' which includes the misclassification and once with the 'calculated stratification' in which participants appear in the 'correct' strata. Two clinical study reports were written for this study. 1. Clinical study report dated 7 April 2011 includes the entire treatment period of all participants plus much of the follow-up. At that time, 33 participants in the Clofarabine+cytarabine group and 29 participants in the placebo+cytarabine group were still being follow-up post treatment. Results were reported on clinicaltrials.gov in August 2011. Outcomes that used strata reported the 'calculated strata' on clinicaltrials.gov. 2. Clinical study report dated 9 July 2012 includes all patient treatment experience plus all long-term follow-up (a minimum of 2 years from the end of treatment or until the patient died). The study was completed at that time. Outcomes that used strata reported the 'randomized strata' on clinicaltrials.gov. AE records on clinicaltrials.gov reflect the final database. Outcomes that changed between the two clinical study reports due to the additional long-term follow-up data are reported twice on clinicaltrials.gov (once from each clinical study report) and the appropriate report date is included in the outcome description. Outcomes from the 9 July 2012 report represent more complete data.
Minimum Age: 55 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Mayo Clinical Hospital, Scottsdale, Arizona, United States
Arizona Cancer Center, Tucson, Arizona, United States
University of Arkansas for Medical Sciences, Arkansas Cancer Research Center, Little Rock, Arkansas, United States
Scripps Cancer Center, La Jolla, California, United States
UCLA School of Medicine, Los Angeles, California, United States
University of Southern California, Kenneth Norris Cancer Center, Los Angeles, California, United States
Stanford Comprehensive Cancer Center, Stanford, California, United States
University of Colorado Health Science Center, Aurora, Colorado, United States
Rocky Mountain Cancer Center, Denver, Colorado, United States
Cancer Center of Central Connecticut, Southington, Connecticut, United States
Northwestern University, Chicago, Illinois, United States
Rush University Medical Center, Chicago, Illinois, United States
Evanston Northwestern Healthcare, Evanston, Illinois, United States
University of Kansas Medical Center, Kansas City, Kansas, United States
University of Kentucky, Markey Cancer Center, Lexington, Kentucky, United States
Louisiana State University Health Science Center, Shreveport, Louisiana, United States
Harold Alfond Center for Cancer Care, Augusta, Maine, United States
Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Josephine Ford Cancer Center, Detroit, Michigan, United States
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, United States
The Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States
Roswell Park Cancer Center, Buffalo, New York, United States
Mt. Sinai School of Medicine, New York, New York, United States
New York Medical Center, Valhalla, New York, United States
Mecklenburg Medical Group, Charlotte, North Carolina, United States
Duke University Medical Center, Durham, North Carolina, United States
Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Gabrail Cancer Center, Canton, Ohio, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Oregon Health Science University, Portland, Oregon, United States
Medical University of South Carolina, Charleston, South Carolina, United States
University of Tennessee Medical Center, Knoxville, Tennessee, United States
Sarah Cannon Research Institute, Nashville, Tennessee, United States
Vanderbilt University Medical Center, Nashville, Tennessee, United States
UT Southwestern Medical Center, Simmons Comprehensive Cancer Center, Dallas, Texas, United States
MD Anderson Cancer Center, Houston, Texas, United States
Cancer Care Centers of South Texas, San Antonio, Texas, United States
University of Texas Health Sciences Center, San Antonio, Texas, United States
University of Utah - Huntsman Cancer Institute, Salt Lake City, Utah, United States
West Virginia University Hospitals, Mary Babb Randolph Cancer Center, Morgantown, West Virginia, United States
Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Saint John Regional Hospital, Saint John, New Brunswick, Canada
Juravinski Cancer Center, Hamilton, Ontario, Canada
Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
Service Maladies du Sang, CHU Angers, Angers Cedex 01, , France
Hopital Claude Huriez CHRU de Lille, Lille, , France
Hopital Edouard Herriot, Lyon, , France
Institut Paoli Calmettes, Marseille, , France
Hopital Hotel Dieu, Nantes, , France
Hopital Purpan, Toulouse, , France
Medizinische Hochschule Hannover, Zentrum fur Innere Medizin, Abt. Haematologie / Onkologie, Hannover, , Germany
Medizinische Klinik der Technischen, Universität München, Munich, , Germany
Universitatsklinikum Ulm, Ulm, , Germany
Ospedali Riuniti Bergamo, Bergamo, , Italy
A.O Ospedale Niguarda Ca'Granda, Milano, , Italy
N.O. San Gerardo, Monza, , Italy
Azienda Ospedaliera "Antonio Cardarelli", Napoli, , Italy
Name: Medical Monitor
Affiliation: Genzyme, a Sanofi Company
Role: STUDY_DIRECTOR