Protocol
RELHEM: A Pilot Pharmacokinetic, Pharmacodynamic, and Feasibility Study of Sorafenib in
Combination with Cytarabine and Clofarabine in Patients with Refractory or Relapsed
Hematologic Malignancies
Diseases
Leukemias / Lymphomas : Acute myeloid leukemia (AML), acute promyelocytic leukemia (APL), acute lymphoblastic leukemia (ALL), infantile leukemia (both AML and ALL), AML w/prior myelodysplastic syndrome (MDS), myelodysplastic / myeloproliferative neoplasms, biphenotypic leukemia
Description
This is a preliminary study to describe the qualities of the toxicity profile of the drug sorafenib and to determine the maximum tolerated dose of sorafenib and clofarabine when given in combination with cytarabine and determine the feasibility of administering this drug combination. Participants in this study have relapsed (disease has returned) or refractory (disease is not responding to treatment) hematologic malignancies including acute myeloid leukemia (AML), acute promyelocytic leukemia (APL), acute lymphoblastic leukemia (ALL), infantile leukemia (both AML and ALL), AML with prior myelodysplastic syndrome (MDS), myelodysplastic/myeloproliferative neoplasms, and biphenotypic leukemia.
Relapse is defined as the reappearance (in a patient who has previously achieved remission) of leukemic blasts in the peripheral blood or ≥5% blasts in the bone marrow, not attributable to any other cause (e.g., bone marrow regeneration).
Refractory disease is defined by the persistence of leukemic blasts after 1 or more courses of induction chemotherapy.
Objectives
- To determine a tolerable dose of sorafenib, cytarabine and clofarabine in patients with relapsed or refractory hematologic malignancies including acute myeloid leukemia (AML), acute promyelocytic leukemia (APL), acute lymphoblastic leukemia (ALL), infantile leukemia (both AML and ALL), AML with prior myelodysplastic syndrome (MDS), myelodysplastic/myeloproliferative neoplasms, and biphenotypic leukemia.
- To characterize the pharmacokinetics of sorafenib on days 1 and 7.
- To estimate the overall response rate of sorafenib given sequentially with cytarabine and clofarabine in patients with relapsed or refractory hematologic malignancies.
Eligibility
Patients must have a diagnosis of acute myeloid leukemia (AML), acute promyelocytic leukemia (APL), acute lymphoblastic leukemia (ALL), infantile leukemia (either AML or ALL), AML with prior myelodysplastic syndrome (MDS), myelodysplastic/myeloproliferative neoplasms, or biphenotypic leukemia. Patients with treatment-related AML (t-AML) will be eligible, provided they meet all other eligibility criteria. Current disease status must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life. Patients must meet one of the following criteria:
- First or greater relapse
- Refractory to 1 or more courses of induction or reinduction chemotherapy
- First or greater relapse after allogeneic hematopoietic stem cell transplantation (HSCT).
For the current eligibility status of this clinical study, referring physicians must contact St. Jude Children's Research Hospital at 1-866-2ST-JUDE (1-866-278-5833).
Contact
Hiroto Inaba, MD, PhD
St. Jude Children’s Research Hospital
262 Danny Thomas Place
Memphis, TN 38105 USA
Voice: 1-866-2ST-JUDE (1-866-278-5833)
FAX: 901-521-9005
Referring or consulting physicians only: protocolinfo@stjude.org
For all other inquiries about St. Jude Children's Research Hospital studies: info@stjude.org
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