The following info and data is provided "as is" to help patients around the globe.
We do not endorse or review these studies in any way.
Brief Title: A Phase I Study of 5-Azacytidine in Combination With Chemotherapy for Children With Relapsed or Refractory ALL or AML
Official Title: A Phase I Study of 5-Azacytidine in Combination With Chemotherapy for Children With Relapsed or Refractory ALL or AML
Study ID: NCT01861002
Brief Summary: This is a Phase I study with a conditional cohort expansion phase to evaluate the feasibility of, and to obtain preliminary efficacy data about, pretreatment with Azacytidine (AZA) for 5 days followed by fludarabine/cytarabine chemotherapy regimen in pediatric acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) patients who are refractory to primary treatment or who relapsed.
Detailed Description: Growing evidence indicates that aberrant DNA hypermethylation is associated with leukemia development, drug resistance, and relapse. It has been shown that pretreating leukemia cells with AZA or decitabine could partially reverse the aberrant DNA methylation, restore the expression of tumor suppressor gene important for apoptosis, and sensitize cells to subsequent killing by cytotoxic agent. Since cytarabine and decitabine share the same mechanisms of resistance, we use AZA to test the novel epigenetic "priming" approach. This is a phase I clinical study with expansion phase, using hypomethylating agent, 5-azacytidine (AZA), in sequential with chemotherapy to evaluate whether epigenetic "priming" can reverse aberrant DNA methylation, overcome drug resistance, and increase response in relapsed/refractory AML. The chemotherapy regimen to be used in this study is fludarabine and cytarabine. This regimen has substantial activity in leukemia and has been widely used in treating pediatric patients with relapsed/refractory AML and ALL in the past several decades. In BFM relapsed AML 2001/01 study, FLAG (fludarabine, cytarabine and G-CSF) chemotherapy regimen showed significant activity in AML with 4 year OS around 36%. Since the use of G-CSF in conjunction with fludarabine/cytarabine didn't improve the overall survival of patient in a randomized trial, only fludarabine and cytarabine will be used in this study to decrease the incidence of leukocytosis related complications. This regimen is very similar to the chemotherapy regimen proposed for the next relapsed AML trial within the Children's Oncology Group (COG). If this trial proves to be safe and active, it will provide the foundation and smooth transition to larger statistically powered nationwide phase II clinical trials by COG.
Minimum Age: 1 Year
Eligible Ages: CHILD, ADULT
Sex: ALL
Healthy Volunteers: No
Childrens Hospital Los Angeles, Los Angeles, California, United States
UCSF School of Medicine, San Francisco, California, United States
Children's National Medical Center, Washington, District of Columbia, United States
Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, United States
Johns Hopkins University, Baltimore, Maryland, United States
Dana Farber, Boston, Massachusetts, United States
C.S. Mott Children's Hospital, Ann Arbor, Michigan, United States
Childrens Hospital & Clinics of Minnesota, Minneapolis, Minnesota, United States
Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
Children's Hospital New York-Presbyterian, New York, New York, United States
Levine Children's Hospital at Carolinas Medical Center, Charlotte, North Carolina, United States
Rainbow Babies & Children's Hospital, Cleveland, Ohio, United States
Nationwide Childrens Hospital, Columbus, Ohio, United States
Vanderbilt Children's Hospital, Nashville, Tennessee, United States
University of Texas at Southwestern, Dallas, Texas, United States
Cook Children's Medical Center, Fort Worth, Texas, United States
Primary Children's Medical Center, Salt Lake City, Utah, United States
Seattle Children's Hospital, Seattle, Washington, United States
Children's Hospital of Wisconsin, Milwaukee, Wisconsin, United States
Sydney Children's Hospital, Randwick, New South Wales, Australia
Children's Hospital at Westmead, Westmead, New South Wales, Australia
British Columbia Children's Hospital, Vancouver, British Columbia, Canada
Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Name: Weili Sun, MD, PhD
Affiliation: Children's Hospital Los Angeles
Role: STUDY_CHAIR