A Pilot Study of Decitabine and Vorinostat With Chemotherapy for Relapsed ALL

Stopped early · Phase 1/Phase 2

Conditions studied: Acute Lymphoblastic Leukemia, Precursor B-Cell Lymphoblastic Leukemia, Precursor T-Cell Lymphoblastic Leukemia

In brief

This is a pilot study using decitabine and vorinostat before and during chemotherapy with vincristine, dexamethasone, mitoxantrone, and peg-asparaginase in pediatric patients with acute lymphoblastic leukemia (ALL).

Key facts

Study ID: NCT01483690
Run by: Therapeutic Advances in Childhood Leukemia Consortium
People needed: 23
Starts: 2011-12-01
Expected to finish: 2015-07-31
Last updated by the study team: 2020-10-27

Who can join

Age: 1 and older, up to 21. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Patients must be ≥1 and ≤ 21 years of age when originally diagnosed with ALL.
Diagnosis
Patients must have a diagnosis of acute lymphoblastic leukemia (ALL) with ≥ 25% blasts in the bone marrow (M3), with or without extramedullary disease.
Patients may have CNS 1, 2 or 3 disease.
Karnofsky > 50% for patients > 16 years of age and Lansky > 50% for patients ≤ 16 years of age.
Prior Therapy
Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study.
Patients must have had 2 or more prior therapeutic attempts defined as:
Relapse after going into remission from re-induction for the first or subsequent relapse (ie: 2nd , 3rd, 4th…relapse), OR
Refractory disease after first or greater relapse and a re-induction attempt, OR
Failing to go into remission from original diagnosis after 2 previous induction attempts.
Hematopoietic Stem Cell Transplant: Patients who have experienced their relapse after a HSCT are eligible, provided they have no evidence of Graft-versus-Host Disease (GVHD) and are at least 60 days post-transplant at the time of enrollment.
Prior anthracycline exposure: Patients must have less than 400 mg/m2 lifetime exposure of anthracycline chemotherapy. (See Appendix II for calculation worksheet)
Hematopoietic grow factors: It must have been at least 7 days since the completion of therapy with GCSF or other growth factors at the time of enrollment. It must have been at least 14 days since the completion of therapy with pegfilgrastim (Neulasta®).
Biologic (anti-neoplastic) therapy: It must be at least 7 days after last does of biologic agent. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur. The duration of this interval must be discussed with the study chair
Monoclonal antibodies: At least 3 half-lives of the antibody must have elapsed after the last dose of monoclonal antibody. (ie. Rituximab=66 days, Epratuzumab=69 days)
Immunotherapy: At least 42 days after the completion of any type of immunotherapy, e.g. tumor vaccines.
Renal and Hepatic Function
Patient's serum creatinine must be ≤ 1.5 x institutional upper limit of normal (ULN) according to age. If the serum creatinine is greater than 1.5 times normal, the patient must have a calculated creatinine clearance or radioisotope GRF ≥ 70mL/min/1.73m2.
Patient's ALT and AST must be < 5 x institutional upper limit of norm ULN. The hepatic requirements are waived for patients with known or suspected liver involvement who would otherwise be eligible after consultation with the Study Chair or Vice Chair.
Patient's total bilirubin must be ≤ 1.5 x ULN. The hepatic requirements are waived for patients with known or suspected liver involvement who would otherwise be eligible.
Cardiac Function:
Patient must have a shortening fraction ≥ 27% by Echo or an ejection fraction ≥ 50% by MUGA.
Reproductive Function
Female patients of childbearing potential must have a negative urine or serum pregnancy test confirmed prior to enrollment.

You may not qualify if…

Patients will be excluded if they are receiving Valproic Acid (VPA) therapy.
Patients will be excluded if they have a known allergy to any of the drugs used in the study.
Patients will be excluded if they have a systemic fungal, bacterial, viral or other infection that is exhibiting ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics or other treatment.
Patients will be excluded if there is a plan to administer non-protocol chemotherapy, radiation therapy, or immunotherapy during the study period.
Patients will be excluded if they have significant concurrent disease, illness, psychiatric disorder or social issue that would compromise patient safety or compliance with the protocol treatment or procedures, interfere with consent, study participation, follow up, or interpretation of study results.
Patients will be excluded if they have had any positive fungal culture in the last 30 days prior to enrollment.

Where it is running

Childrens Hospital Los Angeles — Los Angeles, California, United States
CHOC — Orange, California, United States
UCSF School of Medicine — San Francisco, California, United States
The Children's Hospital, University of Colorado — Aurora, Colorado, United States
Children's National Medical Center — Washington D.C., District of Columbia, United States
University of Miami Cancer Center — Miami, Florida, United States
Children's Healthcare of Atlanta, Emory University — Atlanta, Georgia, United States
Lurie Children's Hospital — Chicago, Illinois, 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
University of Minnesota Children's Hospital — Minneapolis, Minnesota, United States
Children's Mercy Hospitals and Clinics — Kansas City, Missouri, United States
New York University Medical Center — New York, New York, 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
Nationwide Childrens Hospital — Columbus, Ohio, United States
Oregon Health and Science University — Portland, Oregon, United States
Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States
St. Jude — Memphis, Tennessee, 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
Seattle Children's Hospital — Seattle, Washington, United States

Full record on ClinicalTrials.gov

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