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Brief Title: Gemtuzumab Ozogamicin in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia
Official Title: Gemtuzumab Ozogamicin (GO) Monotherapy Versus Standard Supportive Care for Previously Untreated AML in Elderly Patients Who Are Not Eligible for Intensive Chemotherapy: A Randomized Phase II/III Trial (AML-19) of the EORTC-LG and GIMEMA-ALWP
Study ID: NCT00091234
Brief Summary: RATIONALE: Monoclonal antibodies such as gemtuzumab ozogamicin can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. It is not yet known whether gemtuzumab ozogamicin is more effective than standard supportive care in treating older patients who have acute myeloid leukemia. PURPOSE: This randomized phase II/III trial is studying two different gemtuzumab ozogamicin regimens to see how well they work compared to standard supportive care in treating older patients with previously untreated acute myeloid leukemia.
Detailed Description: OBJECTIVES: * Compare the feasibility, toxicity, and antileukemic activity of two different dosing regimens of gemtuzumab ozogamicin (GO) vs standard supportive care in older patients with previously untreated acute myeloid leukemia who are not candidates for intensive chemotherapy. (phase II) * Compare the efficacy and toxicity of the best dosing regimen of GO selected from phase II vs standard supportive care, in terms of overall survival, in these patients. (phase III) OUTLINE: This is a randomized, open-label, multicenter phase II study followed by a phase III study. Patients are stratified according to age (61 to 75 vs 76 to 80 vs 81 and over), CD33-positivity of bone marrow blasts (\< 20% vs 20-80% vs \> 80% vs unknown), initial WBC before hydroxyurea administration (\< 30,000/mm\^3 vs ≥ 30,000/mm\^3), WHO performance status (0-1 vs 2 vs 3-4), and participating center. * Phase II: Patients are randomized to 1 of 3 treatment arms. * Arm I: Patients receive gemtuzumab ozogamicin (GO) IV over 2 hours on days 1 and 8. Patients with stable or responding disease at day 36 receive GO IV over 2 hours every 4 weeks for up to 8 courses in the absence of disease progression or unacceptable toxicity. * Arm II: Patients receive GO IV over 2 hours on days 1, 3, and 5. Patients with stable or responding disease at day 36 receive GO IV over 2 hours every 4 weeks for up to 8 courses in the absence of disease progression or unacceptable toxicity. * Arm III: Patients receive standard supportive care. * Phase III: Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive the selected treatment (arm I or arm II) from phase II. * Arm II: Patients receive standard supportive care. Patients who receive GO treatment are followed monthly for 1 year and then every 3 months thereafter. Patients who receive standard supportive care are followed at least every 4 weeks. PROJECTED ACCRUAL: A total of 259 patients (75 for phase II \[25 per treatment arm\] and 184 for phase III \[92 per treatment arm\]) will be accrued for this study within 2.5 years.
Minimum Age: 61 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp, , Belgium
AZ Sint-Jan, Brugge, , Belgium
Institut Jules Bordet, Brussels, , Belgium
Hopital Universitaire Erasme, Brussels, , Belgium
Universitair Ziekenhuis Antwerpen, Edegem, , Belgium
CHU Liege - Domaine Universitaire du Sart Tilman, Liege, , Belgium
Centre Hospitalier Peltzer-La Tourelle, Verviers, , Belgium
Ospedale S Donato, USL-8, Arezzo cap, , Italy
Universita Degli Studi di Bari, Bari, , Italy
Universita Di Brescia, Brescia, , Italy
Ospedale Binaghi, Cagliari, , Italy
Ospedale Oncologico A. Businco, Cagliari, , Italy
Ospedale Regionale A Pugliese, Cantanzaro, , Italy
Ospedale Ferrarotto, Catania, , Italy
Ospedale Regionale A. Pugliese, Catanzaro, , Italy
Universita di Ferrara, Ferrara, , Italy
Azienda Ospedaliera Vito Fazzi, Lecce, , Italy
Azienda Ospedaliera - Universitaria di Modena, Modena, , Italy
Ospedale Di Montefiascone, Montefiascone, , Italy
Azienda Ospedaliera di Rilievo Nazionale A.Cardarelli, Naples, , Italy
Ospedale Maggiore della Carita, Novara, , Italy
Azienda Ospedaliera Policlinico Paolo Giaccone, Palermo, , Italy
Ospedale La Maddalena - Palermo, Palermo, , Italy
Azienda Ospedaliera Di Parma, Parma, , Italy
Policlinico Monteluce, Perugia, , Italy
Ospedale San Salvatore, Pesaro, , Italy
Ospedale Civile Pescara, Pescara, , Italy
Ospedale San Carlo, Potenza, , Italy
Ospedale Sta. Maria Delle Croci, Ravenna, , Italy
Ospedale Sant'Andrea, Roma, , Italy
Azienda Ospedaliera Universitaria Policlinico Tor Vergata, Rome, , Italy
Ospedale Sant' Eugenio, Rome, , Italy
Libero Istituto Universitario Campus Bio-Medico, Rome, , Italy
Azienda Policlinico Umberto Primo, Rome, , Italy
Istituto Regina Elena, Rome, , Italy
Policlinico A. Gemelli - Universita Cattolica del Sacro Cuore, Rome, , Italy
H. San Giovanni-Addolorata Hospital, Rome, , Italy
Universita Degli Studi "La Sapeinza", Rome, , Italy
Istituto di Ematologia Universita - University di Sassari, Sassari, , Italy
Universita di Siena, Siena, , Italy
Ospedale Maggiore dell' Universita, Trieste, , Italy
Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, , Netherlands
Onze Lieve Vrouwe Gasthuis, Amsterdam, , Netherlands
Leiden University Medical Center, Leiden, , Netherlands
Universitair Medisch Centrum St. Radboud - Nijmegen, Nijmegen, , Netherlands
Name: Sergio Amadori, MD
Affiliation: EORTC - AZIENDA OSPEDALLERA UNIVERSITARIA - POLICLINICO TOR VERGATA, IT
Role: PRINCIPAL_INVESTIGATOR
Name: Giuliana Alimena
Affiliation: GIMEMA - Universita Degli Studi "La Sapeinza"
Role: PRINCIPAL_INVESTIGATOR