Trial Outcomes & Findings for Cediranib Maleate in Treating Patients With Relapsed, Refractory, or Untreated Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome (NCT NCT00475150)

NCT ID: NCT00475150

Last Updated: 2017-02-15

Results Overview

Complete Response (CR) requires a repeat bone marrow with \< 5% myeloblasts, hemoglobin ≥ 11 g/dl, neutrophils ≥ 1000/mm3, platelets ≥ 100,000/mm3, and no circulating blasts. Partial Response (PR) requires a bone marrow blast reduction of 50% or more, hemoglobin ≥ 11 g/dl, neutrophils ≥ 1000/mm3, platelets ≥ 100,000/mm3, and no circulating blasts. Hematologic Improvement (HI) requires one of the following: 1. RBC transfusion independent participants are required to have \>1.5 g/dL increase in hemoglobin, 2. RBC transfusion-dependent participants are required to be transfusion independent, 3. A 100% increase, and an absolute increase over 500mm\^3 in Absolute Neutrophil Count, 4. Participants with a pretreatment platelet count over 20,000/mm3 require an absolute increase of 30,000/mm\^3 or more, 5. Participants with platelet count below 20,000/mm3 require an increase over 20,000/mm\^3 and by at least 100%.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

39 participants

Primary outcome timeframe

At the end of cycles 1 and 3 and every 3 cycles thereafter up to 26 cycles

Results posted on

2017-02-15

Participant Flow

Between June 2008 and June 2011, 39 participants were accrued to this study.

A total of 23 AML (7 at 45 mg; 16 at 30 mg) and 16 MDS (all at 30 mg) were enrolled. The AML and MDS groups were analyzed for the primary endpoint separately.

Participant milestones

Participant milestones
Measure
Acute Myeloid Leukemia (AML)
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Overall Study
STARTED
23
16
Overall Study
COMPLETED
23
16
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Cediranib Maleate in Treating Patients With Relapsed, Refractory, or Untreated Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Acute Myeloid Leukemia (AML)
n=23 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
n=16 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Total
n=39 Participants
Total of all reporting groups
Age, Continuous
70 years
n=99 Participants
73 years
n=107 Participants
72 years
n=206 Participants
Gender
Female
12 Participants
n=99 Participants
6 Participants
n=107 Participants
18 Participants
n=206 Participants
Gender
Male
11 Participants
n=99 Participants
10 Participants
n=107 Participants
21 Participants
n=206 Participants
Region of Enrollment
United States
23 participants
n=99 Participants
16 participants
n=107 Participants
39 participants
n=206 Participants

PRIMARY outcome

Timeframe: At the end of cycles 1 and 3 and every 3 cycles thereafter up to 26 cycles

Population: All participants were evaluable for this endpoint.

Complete Response (CR) requires a repeat bone marrow with \< 5% myeloblasts, hemoglobin ≥ 11 g/dl, neutrophils ≥ 1000/mm3, platelets ≥ 100,000/mm3, and no circulating blasts. Partial Response (PR) requires a bone marrow blast reduction of 50% or more, hemoglobin ≥ 11 g/dl, neutrophils ≥ 1000/mm3, platelets ≥ 100,000/mm3, and no circulating blasts. Hematologic Improvement (HI) requires one of the following: 1. RBC transfusion independent participants are required to have \>1.5 g/dL increase in hemoglobin, 2. RBC transfusion-dependent participants are required to be transfusion independent, 3. A 100% increase, and an absolute increase over 500mm\^3 in Absolute Neutrophil Count, 4. Participants with a pretreatment platelet count over 20,000/mm3 require an absolute increase of 30,000/mm\^3 or more, 5. Participants with platelet count below 20,000/mm3 require an increase over 20,000/mm\^3 and by at least 100%.

Outcome measures

Outcome measures
Measure
Acute Myeloid Leukemia (AML)
n=23 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
n=16 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
The Number of Confirmed Disease Response: Complete Response (CR), Partial Response (PR), and Hematologic Improvement (HI). A Confirmed Response is Defined to be an Objective Status of CR, PR, or HI Noted on 2 Consecutive Evaluations.
Partial Response (PR)
0 participants
0 participants
The Number of Confirmed Disease Response: Complete Response (CR), Partial Response (PR), and Hematologic Improvement (HI). A Confirmed Response is Defined to be an Objective Status of CR, PR, or HI Noted on 2 Consecutive Evaluations.
Complete Response (CR)
0 participants
0 participants
The Number of Confirmed Disease Response: Complete Response (CR), Partial Response (PR), and Hematologic Improvement (HI). A Confirmed Response is Defined to be an Objective Status of CR, PR, or HI Noted on 2 Consecutive Evaluations.
Hematologic Improvement
0 participants
1 participants

SECONDARY outcome

Timeframe: Every cycle during treatment and every 6 months for up to 2 years after completion of study treatment

Population: All participants were evaluable for this endpoint.

Defined as the time from date of registration to date of death due to any cause or date last known alive. The distribution of survival time will be estimated using the method of Kaplan-Meier.

Outcome measures

Outcome measures
Measure
Acute Myeloid Leukemia (AML)
n=23 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
n=16 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Overall Survival
3.71 months
Interval 2.2 to 5.75
4.66 months
Interval 1.97 to 10.81

SECONDARY outcome

Timeframe: Every 3 courses during treatment and then at 3 months and every 6 months for up to 2 years after completion of study treatment

Population: All participants are evaluable for this primary endpoint.

Defined as the time from date of registration to date that disease progression was documented, death, or last date that progression-free status was documented, whichever comes first. Estimated using the method of Kaplan-Meier. Disease progression is defined as one of the following: * A ≥ 50% increase in bone marrow blasts from the best response, or * A 50% or greater decrement from maximum remission/response levels in neutrophils or platelets, or * A reduction in hemoglobin concentration by at least 1.5 g/dl, or * Transfusion dependence (without alternative explanation and sustained for at least 2 weeks).

Outcome measures

Outcome measures
Measure
Acute Myeloid Leukemia (AML)
n=23 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
n=16 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Progression-free Survival
2.82 months
Interval 1.15 to 5.35
4.30 months
Interval 1.97 to 7.72

SECONDARY outcome

Timeframe: Every 3 courses up to 26 courses

Population: This endpoint was not analyzed due to lack of response.

Measured from the time criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented. Estimated using the method of Kaplan-Meier.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Continuously during treatment up to 26 courses

Population: All participants were analyzed for this endpoint.

Graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. All adverse events determined to be possibly, probably, or definately related to AZD2171 are included in this analysis.

Outcome measures

Outcome measures
Measure
Acute Myeloid Leukemia (AML)
n=23 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
Myelodysplastic Syndrome (MDS)
n=16 Participants
Patients receive 30 mg oral cediranib maleate QD on days 1-28. Treatment repeats every 28 days for up to 26 courses in the absence of disease progression or unacceptable toxicity.
The Number of Patients That Report Adverse Events Possibly, Probably, or Definitely Related to AZD2171.
Grade 3 or Higher
14 participants
11 participants
The Number of Patients That Report Adverse Events Possibly, Probably, or Definitely Related to AZD2171.
Grade 4 or Higher
7 participants
5 participants
The Number of Patients That Report Adverse Events Possibly, Probably, or Definitely Related to AZD2171.
Grade 5
0 participants
0 participants

Adverse Events

All Patients Receiving Cediranib Maleate

Serious events: 23 serious events
Other events: 39 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
All Patients Receiving Cediranib Maleate
n=39 participants at risk
All patients receiving oral cediranib maleate, regardless of diagnosis were analyzed for toxicity.
Blood and lymphatic system disorders
Febrile neutropenia
5.1%
2/39 • Number of events 2
Blood and lymphatic system disorders
Hemoglobin decreased
10.3%
4/39 • Number of events 6
Gastrointestinal disorders
Diarrhea
5.1%
2/39 • Number of events 2
Gastrointestinal disorders
Dyspepsia
2.6%
1/39 • Number of events 2
Gastrointestinal disorders
Lower gastrointestinal hemorrhage
5.1%
2/39 • Number of events 2
Gastrointestinal disorders
Mucositis oral
2.6%
1/39 • Number of events 1
Gastrointestinal disorders
Upper gastrointestinal hemorrhage
2.6%
1/39 • Number of events 1
General disorders
Fatigue
17.9%
7/39 • Number of events 7
Infections and infestations
Infection
2.6%
1/39 • Number of events 1
Infections and infestations
Pneumonia
5.1%
2/39 • Number of events 2
Infections and infestations
Sepsis
2.6%
1/39 • Number of events 1
Infections and infestations
Urinary tract infection
2.6%
1/39 • Number of events 2
Investigations
INR increased
2.6%
1/39 • Number of events 1
Investigations
Leukocyte count decreased
7.7%
3/39 • Number of events 4
Investigations
Lymphocyte count decreased
2.6%
1/39 • Number of events 1
Investigations
Neutrophil count decreased
17.9%
7/39 • Number of events 10
Investigations
Platelet count decreased
20.5%
8/39 • Number of events 10
Investigations
Weight loss
2.6%
1/39 • Number of events 1
Metabolism and nutrition disorders
Anorexia
2.6%
1/39 • Number of events 1
Metabolism and nutrition disorders
Dehydration
2.6%
1/39 • Number of events 1
Metabolism and nutrition disorders
Serum potassium decreased
5.1%
2/39 • Number of events 2
Musculoskeletal and connective tissue disorders
Chest wall pain
2.6%
1/39 • Number of events 1
Musculoskeletal and connective tissue disorders
Joint pain
2.6%
1/39 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscle weakness
5.1%
2/39 • Number of events 2
Musculoskeletal and connective tissue disorders
Muscle weakness lower limb
2.6%
1/39 • Number of events 1
Nervous system disorders
Intracranial hemorrhage
2.6%
1/39 • Number of events 1
Renal and urinary disorders
Bladder hemorrhage
2.6%
1/39 • Number of events 1
Renal and urinary disorders
Protein urine positive
5.1%
2/39 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Dyspnea
10.3%
4/39 • Number of events 4
Respiratory, thoracic and mediastinal disorders
Hypoxia
2.6%
1/39 • Number of events 1
Skin and subcutaneous tissue disorders
Petechiae
2.6%
1/39 • Number of events 1
Vascular disorders
Hypertension
7.7%
3/39 • Number of events 3
Vascular disorders
Hypotension
2.6%
1/39 • Number of events 1

Other adverse events

Other adverse events
Measure
All Patients Receiving Cediranib Maleate
n=39 participants at risk
All patients receiving oral cediranib maleate, regardless of diagnosis were analyzed for toxicity.
Blood and lymphatic system disorders
Hemoglobin decreased
7.7%
3/39 • Number of events 3
Cardiac disorders
Atrial fibrillation
2.6%
1/39 • Number of events 1
Cardiac disorders
Left ventricular failure
2.6%
1/39 • Number of events 1
Endocrine disorders
Hypothyroidism
5.1%
2/39 • Number of events 3
Gastrointestinal disorders
Constipation
15.4%
6/39 • Number of events 6
Gastrointestinal disorders
Diarrhea
53.8%
21/39 • Number of events 49
Gastrointestinal disorders
Dry mouth
2.6%
1/39 • Number of events 1
Gastrointestinal disorders
Dyspepsia
2.6%
1/39 • Number of events 1
Gastrointestinal disorders
Ear, nose and throat examination abnormal
5.1%
2/39 • Number of events 2
Gastrointestinal disorders
Lower gastrointestinal hemorrhage
10.3%
4/39 • Number of events 4
Gastrointestinal disorders
Mucositis oral
5.1%
2/39 • Number of events 2
Gastrointestinal disorders
Nausea
41.0%
16/39 • Number of events 22
Gastrointestinal disorders
Oral pain
2.6%
1/39 • Number of events 1
Gastrointestinal disorders
Rectal pain
2.6%
1/39 • Number of events 1
Gastrointestinal disorders
Vomiting
12.8%
5/39 • Number of events 9
General disorders
Edema limbs
12.8%
5/39 • Number of events 7
General disorders
Fatigue
89.7%
35/39 • Number of events 66
Infections and infestations
Bladder infection
2.6%
1/39 • Number of events 1
Infections and infestations
Colitis, infectious (e.g., Clostridium difficile)
2.6%
1/39 • Number of events 1
Infections and infestations
Skin infection
2.6%
1/39 • Number of events 2
Infections and infestations
Upper respiratory infection
2.6%
1/39 • Number of events 1
Infections and infestations
Urinary tract infection
2.6%
1/39 • Number of events 1
Injury, poisoning and procedural complications
Bruising
10.3%
4/39 • Number of events 4
Investigations
Alanine aminotransferase increased
2.6%
1/39 • Number of events 3
Investigations
Alkaline phosphatase increased
2.6%
1/39 • Number of events 1
Investigations
Aspartate aminotransferase increased
2.6%
1/39 • Number of events 1
Investigations
Bilirubin increased
2.6%
1/39 • Number of events 1
Investigations
Creatinine increased
5.1%
2/39 • Number of events 4
Investigations
INR increased
2.6%
1/39 • Number of events 2
Investigations
Laboratory test abnormal
2.6%
1/39 • Number of events 1
Investigations
Leukocyte count decreased
7.7%
3/39 • Number of events 3
Investigations
Neutrophil count decreased
30.8%
12/39 • Number of events 18
Investigations
Platelet count decreased
48.7%
19/39 • Number of events 36
Investigations
Weight loss
33.3%
13/39 • Number of events 23
Metabolism and nutrition disorders
Anorexia
17.9%
7/39 • Number of events 9
Metabolism and nutrition disorders
Blood glucose increased
7.7%
3/39 • Number of events 7
Metabolism and nutrition disorders
Dehydration
2.6%
1/39 • Number of events 2
Metabolism and nutrition disorders
Serum phosphate decreased
2.6%
1/39 • Number of events 3
Musculoskeletal and connective tissue disorders
Bone pain
5.1%
2/39 • Number of events 5
Musculoskeletal and connective tissue disorders
Chest wall pain
2.6%
1/39 • Number of events 1
Musculoskeletal and connective tissue disorders
Joint pain
2.6%
1/39 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscle weakness
28.2%
11/39 • Number of events 16
Musculoskeletal and connective tissue disorders
Myalgia
2.6%
1/39 • Number of events 1
Nervous system disorders
Ataxia
2.6%
1/39 • Number of events 1
Nervous system disorders
Dizziness
28.2%
11/39 • Number of events 15
Nervous system disorders
Headache
25.6%
10/39 • Number of events 15
Nervous system disorders
Peripheral sensory neuropathy
7.7%
3/39 • Number of events 6
Renal and urinary disorders
Hemorrhage urinary tract
2.6%
1/39 • Number of events 1
Renal and urinary disorders
Protein urine positive
48.7%
19/39 • Number of events 26
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
2.6%
1/39 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Cough
2.6%
1/39 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnea
69.2%
27/39 • Number of events 56
Respiratory, thoracic and mediastinal disorders
Hemorrhage nasal
5.1%
2/39 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Hypoxia
2.6%
1/39 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Voice alteration
20.5%
8/39 • Number of events 13
Skin and subcutaneous tissue disorders
Dry skin
2.6%
1/39 • Number of events 2
Skin and subcutaneous tissue disorders
Sweating
2.6%
1/39 • Number of events 1
Vascular disorders
Hypertension
64.1%
25/39 • Number of events 40
Vascular disorders
Hypotension
5.1%
2/39 • Number of events 2

Additional Information

Mark B. Juckett, MD

University of Wisconsin Comprehensive Cancer Center

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60