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Phase II Study of Tipifarnib in Patients With Poor-Risk Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndromes in First Complete Remission After Induction and Consolidation Chemotherapy
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Published Results Trial Contact Information Registry Information
Alternate Title
Tipifarnib in Treating Patients With Acute Myeloid Leukemia or
Myelodysplastic Syndrome in Complete Remission
Basic Trial Information
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Phase II

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Completed

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18 and over

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JHOC-J0252 MSGCC-0150, NCI-5689, NCT00045396, 5689

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Objectives - Determine the duration of disease-free survival and overall survival of patients with poor-risk acute myeloid leukemia or high-risk myelodysplastic syndromes in early first complete remission treated with tipifarnib.
- Determine the tolerability and toxic effects of this drug in these patients.
Entry Criteria Disease Characteristics:
- Histologically confirmed diagnosis of 1 of the following:
- Poor-risk acute myeloid leukemia (AML), defined as any of the following:
- Antecedent hematologic disorder
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AML arising from myelodysplastic syndromes (MDS)
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Therapy-related AML
- 60 years of age or over (in absence of favorable cytogenetics)
- Adverse cytogenetics (e.g., -5/5q, -7/7q, 20q-, or 11q23 abnormalities or
complex karyotype)
- Hyperleukocytosis at diagnosis (e.g., blasts at least 50,000/mm3 in absence
of favorable cytogenetics)
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No acute promyelocytic leukemia (FAB M3 subtype)
- High-risk myelodysplastic syndromes (MDS),
defined as any of the following:
- Chronic myelomonocytic leukemia with more than 5% marrow blasts
- Therapy-related MDS
- Refractory anemia with excess blasts (RAEB) with IPSS score at least 1.5
- RAEB in transformation with IPSS score at least 1.5
- In early first complete remission after completing induction and consolidation chemotherapy
- No more than 21-35 days since hospital discharge after marrow recovery from consolidation
therapy
- No more than 120 days since initiation of the final course of consolidation therapy
- No presence of residual AML (more than 5% marrow blasts) or MDS by morphology,
flow cytometry, and/or cytogenetics
- No active CNS leukemia
- No presence of (8;21) translocation or inversion 16 genotype as sole
abnormality
- Ineligible for curative allogeneic stem cell transplantation
Prior/Concurrent Therapy:
Biologic therapy - No concurrent immunotherapy
Chemotherapy - See Disease Characteristics
- No concurrent chemotherapy
Endocrine therapy Radiotherapy - No concurrent radiotherapy
Surgery Other - No prior tipifarnib
- No concurrent participation in another phase II or phase III study in which
disease-free survival and overall survival are primary endpoints
Patient Characteristics:
Age - See Disease Characteristics
- 18 and over
Performance status Life expectancy Hematopoietic - Polymorphonuclear cell count at least 1,000/mm3
- Platelet count at least 30,000/mm3*
- Hemoglobin at least 9 g/dL*
- Hematocrit at least 27%*
[Note: *Unsupported] Hepatic - Bilirubin no greater than 1.5 times normal
- AST and ALT no greater than 2.5 times normal
- Alkaline phosphatase no greater than 2.5 times normal
Renal - Creatinine no greater than 2.0 mg/dL
OR
- Creatinine clearance at least 40 mL/min
Cardiovascular - No disseminated intravascular coagulation
- LVEF at least 25%
Other - No active uncontrolled infection
- No known allergy to imidazole drugs (e.g., ketoconazole or miconazole)
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
Expected Enrollment 44A total of 14-44 patients will be accrued for this study within 11-15 months. Outcomes Primary Outcome(s)6-month disease-free survival
Secondary Outcome(s)Tolerability and toxicity
Outline This is a multicenter study.
Patients receive oral tipifarnib twice daily on days 1-14. Treatment repeats every 21 days for up to 16 courses in the absence of disease progression or unacceptable toxicity.
Published ResultsKarp JE, Smith BD, Gojo I, et al.: Phase II trial of tipifarnib as maintenance therapy in first complete remission in adults with acute myelogenous leukemia and poor-risk features. Clin Cancer Res 14 (10): 3077-82, 2008.[PUBMED Abstract]
Trial Contact Information
Trial Lead Organizations Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins  |  |  | | Judith Karp, MD, Protocol chair |  | |  |
| Registry Information |  | | Official Title | | A Phase II Study Of The Farnesyltransferase Inhibitor ZANESTRA (R115777, NSC #702818, IND #58,359) In Complete Remission Following Induction And/Or Consolidation Chemotherapy In Adults With Poor-Risk Acute Myelogenous Leukemia (AML) And High-Risk Myelodysplasia (MDS) |  | | Trial Start Date | | 2002-08-21 |  | | Registered in ClinicalTrials.gov | | NCT00045396 |  | | Date Submitted to PDQ | | 2002-06-28 |  | | Information Last Verified | | 2006-04-08 |  | | NCI Grant/Contract Number | | CA69854, CA06973 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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