NCT00462605 · REGISTRY CONDITION SEARCH

MS-275 and GM-CSF in Treating Patients With Myelodysplastic Syndrome and/or Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphocytic Leukemia

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase: PHASE2
Status at capture: COMPLETED
Registry last update: 2017-07-18

This phase II trial is studying how well giving MS-275 together with GM-CSF works in treating patients with myelodysplastic syndrome and/or relapsed or refractory acute myeloid leukemia. MS-275 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer. Colony-stimulating factors, such as GM-CSF, may increase the number of immune cells found in bone marrow or peripheral blood. Giving MS-275 together with GM-CSF may be an effective treatment for myelodysplastic syndrome and acute myeloid leukemia

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

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baseline

Baseline characteristics

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outcome · POSTED

Response (Complete and Partial Response) in Patients With Myeloid Disorders

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outcome · POSTED

Clinical Activity Assessed by Change in Peripheral Blood Counts

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outcome · POSTED

Clinical Activity Assessed by Change in Transfusion Requirements

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outcome · POSTED

Changes in Detectable Chromosomal Abnormalities Measured by Fluorescent in Situ Hybridization (FISH)

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outcome · POSTED

Change in the Percentage of Cells With Normal and Abnormal Myeloid Phenotype Measured by Flow Cytometry

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adverse events

Adverse events

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more info

Limitations, agreements, and source contact

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Who could take part

eligibility Criteria: Inclusion Criteria: * Diagnosis of 1 of the following diseases by bone marrow aspiration and/or biopsy: * Myelodysplastic syndromes (MDS) meeting the following criteria: * Must have 1 of the following subtypes: * Refractory anemia (RA) (no RA with 5q-syndrome), * RA with ringed sideroblasts or * Refractory cytopenia with multilineage dysplasia * Myelodysplastic syndromes (MDS) meeting the following criteria: Must have 1 of the following subtypes: * Refractory cytopenia with multilineage dysplasia and ringed sideroblasts, * RA with excess blasts (RAEB)-1, RAEB-2, * Myelodysplastic syndromes, unclassified or * Chronic myelomonocytic leukemia * International Prognostic Scoring System score of intermediate-2 or high-risk * Acute myeloid leukemia (AML) meeting 1 of the following criteria: * Relapsed or refractory AML, including any of the following subtypes: * \* AML with recurrent cytogenetic abnormalities (i.e., AML with 11q23 \[MLL\] abnormalities) * AML with multilineage dysplasia * AML that is therapy-related * AML, not otherwise categorized (M0 \[minimally differentiated\], M1 \[without maturation\], M2 \[with maturation\], M4 \[myelomonocytic leukemia\], M5 \[monoblastic/monocytic leukemia\], M6 \[erythroid leukemia\], and M7 \[megakaryoblastic leukemia\]) * Untreated AML * Newly diagnosed patients are eligible provided they do not qualify for potentially curative intensive chemotherapeutic regimens * Acute lymphocytic leukemia (ALL) meeting 1 of the following criteria: * Relapsed or refractory ALL * Patients with any measurable residual disease are eligible, including cytogenetic abnormalities * Untreated ALL * Newly diagnosed patients are eligible provided they do not qualify for potentially curative intensive chemotherapeutic regimens, including any of the following: * Patients who have refused chemotherapy for untreated ALL * Patients who are deemed to be poor candidates medically for ALL induction chemotherapy * Relatively stable bone marrow function for \> 7 days prior to study entry * WBC count that has not doubled within the past 7 days * WBC =\<10,000/mm³ * No uncontrolled peripheral leukemia (i.e., blast count \> 30,000/mm³) * No active CNS disease * Lumbar puncture with negative cytology required for patients with clinical symptoms of active CNS disease * Not a candidate for a potentially curative allogeneic stem cell transplantation OR considered a poor candidate for such a procedure due to age, medical comorbidities, or lack of a suitable donor * Hemoglobin \>= 8 g/dL (transfusions allowed) * Creatinine =\< 2.0 mg/dL * Bilirubin =\< 1.6 mg/dL (unless secondary to hemolysis) * AST or ALT =\< 3 times upper limit of normal (unless disease-related) * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No untreated or progressive infections * No history of intolerance to sargramostim (GM-CSF) * Recovered from all treatment-related toxicities * More than 2 weeks since prior therapy for AML, ALL, or MDS, including chemotherapy, hematopoietic growth factors, or biologic therapy such as monoclonal antibodies * Concurrent hydroxyurea allowed during course 1 for control of leukocytosis if WBC \> 30,000/mm³ * ECOG performance status 0-2
healthy Volunteers: false
minimum Age: 18 Years
sex: ALL
std Ages: ADULT
OLDER_ADULT

Treatment arms and interventions

arm Groups

description
Patients receive oral MS-275 on days 1, 8, 15, and 22. Patients also receive sargramostim (GM-CSF) subcutaneously once daily on days 1-42 in courses 3 and 5 and on days 1-35 in courses 1, 2, 4, and 6. Treatment repeats every 6 weeks for 2-6 courses in the absence of disease progression or unacceptable toxicity. After completion of 2 courses of study therapy, patients who achieve a complete or partial response may receive an additional 4 courses. Patients who maintain stable disease for more than 2 months after completion of 6 courses of study therapy may receive an additional 6 courses at the time of disease progression, provided they meet original eligibility criteria.
intervention Names
Drug: entinostat
Drug: sargramostim
label
Arm I
type
EXPERIMENTAL

interventions

arm Group Labels
Arm I
description
Given PO
name
entinostat
other Names
HDAC inhibitor SNDX-275
SNDX-275
type
DRUG
arm Group Labels
Arm I
description
Given SC
name
sargramostim
other Names
GM-CSF
Leukine
Prokine
type
DRUG

Study design

allocation

intervention Model

SINGLE_GROUP

masking Info

masking: NONE

primary Purpose

TREATMENT

Enrollment

count: 24
type: ACTUAL

Registered outcome plans (not posted results)

primary Outcomes

description
Response to treatment was assessed after two cycles, according to International Working Group (IWG) criteria. Cytogenetic responses were monitored in patients with abnormalities at baseline.
measure
Response (Complete and Partial Response) in Patients With Myeloid Disorders
time Frame
Up to 2 years

secondary Outcomes

measure
Clinical Activity Assessed by Change in Peripheral Blood Counts
time Frame
Baseline and after 2 cycles
measure
Clinical Activity Assessed by Change in Transfusion Requirements
time Frame
Baseline and after 2 cycles
measure
Changes in Detectable Chromosomal Abnormalities Measured by Fluorescent in Situ Hybridization (FISH)
time Frame
Baseline and 6, 12, 24, and 36 weeks
measure
Change in the Percentage of Cells With Normal and Abnormal Myeloid Phenotype Measured by Flow Cytometry
time Frame
Baseline and 6, 12, 24, and 36 weeks

Full study description

brief Summary: This phase II trial is studying how well giving MS-275 together with GM-CSF works in treating patients with myelodysplastic syndrome and/or relapsed or refractory acute myeloid leukemia. MS-275 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer. Colony-stimulating factors, such as GM-CSF, may increase the number of immune cells found in bone marrow or peripheral blood. Giving MS-275 together with GM-CSF may be an effective treatment for myelodysplastic syndrome and acute myeloid leukemia
detailed Description: PRIMARY OBJECTIVE: I. Determine clinical response in patients with myelodysplastic syndromes and/or relapsed or refractory acute myeloid leukemia or acute lymphocytic leukemia treated with MS-275 in combination with sargramostim (GM-CSF). SECONDARY OBJECTIVES: I. Determine the clinical activity of this regimen, in terms of changes in peripheral blood counts and changes in individual patient transfusion requirements, in these patients. II. Determine the biologic activity of this regimen, in terms of changes in the peripheral blood and bone marrow phenotype (i.e., induction of markers of myeloid differentiation or lymphoid differentiation) and changes in detectable cytogenetic abnormalities in the blood and marrow compartments, in these patients. III. Determine the toxicity profile of this regimen in these patients. OUTLINE: Patients receive oral MS-275 on days 1, 8, 15, and 22. Patients also receive sargramostim (GM-CSF) subcutaneously once daily on days 1-42 in courses 3 and 5 and on days 1-35 in courses 1, 2, 4, and 6. Treatment repeats every 6 weeks for 2-6 courses in the absence of disease progression or unacceptable toxicity. After completion of 2 courses of study therapy, patients who achieve a complete or partial response may receive an additional 4 courses. Patients who maintain stable disease for more than 2 months after completion of 6 courses of study therapy may receive an additional 6 courses at the time of disease progression, provided they meet original eligibility criteria. Patients undergo blood and bone marrow (BM) collection at baseline and periodically during study for biologic correlative studies. Peripheral blood and bone marrow samples are assessed for changes in progenitor phenotype and clonogenic growth by flow cytometry and for changes in cytogenetics (i.e., malignant:nonmalignant cell ratio in BM CD34-positive cells, peripheral blood monocytes, peripheral blood neutrophils, and bone marrow and peripheral blood lymphoblasts) by FISH. Terminal differentiation of CD34-positive progenitor cells is studied in vitro in long-term cultures. After completion of study therapy, patients are followed periodically for up to 2 years.

Source references

Source notices and limitations

Discovery and provenance

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Preserved source evidence · Not medical advice