Trial Outcomes & Findings for Low-Intensity Chemotherapy and Blinatumomab in Treating Patients With Philadelphia Chromosome Negative Relapsed or Refractory Acute Lymphoblastic Leukemia (NCT NCT03518112)

NCT ID: NCT03518112

Last Updated: 2022-11-04

Results Overview

Time from date of treatment start until the date of first objective documentation of disease-relapse. Relapse and resistant disease will be defined based on morphological assessment of bone marrow and peripheral blood. Complete Remission (CR): Normalization of the peripheral blood and bone marrow with 5% or less blasts in normocellular or hypercellular marrow with a granulocyte count of 1 x 10\^9/L or above, and platelet count of 100 x 10\^9/L. Complete resolution of all sites of extramedullary disease is required for CR. Complete remission without recovery of counts (CRi): Peripheral blood and marrow results as for CR, but with incomplete recover of counts (platelets \< 100 x 10\^9/L; neutrophils \< 1 x 10\^9/L). Partial Response (PR): As above for CR except for the presence of 6-25% marrow blasts.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

6 participants

Primary outcome timeframe

Time from the first day of treatment assessed up to 3 years, 1 month

Results posted on

2022-11-04

Participant Flow

Recruitment Period: April 2018 to May 2021

Participant milestones

Participant milestones
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Overall Study
STARTED
6
Overall Study
COMPLETED
5
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Overall Study
Withdrawal by Subject
1

Baseline Characteristics

Low-Intensity Chemotherapy and Blinatumomab in Treating Patients With Philadelphia Chromosome Negative Relapsed or Refractory Acute Lymphoblastic Leukemia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=6 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Age, Categorical
<=18 years
0 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
5 Participants
n=99 Participants
Age, Categorical
>=65 years
1 Participants
n=99 Participants
Age, Continuous
47 years
n=99 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
Sex: Female, Male
Male
4 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=99 Participants
Race (NIH/OMB)
White
4 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Region of Enrollment
United States
6 participants
n=99 Participants

PRIMARY outcome

Timeframe: Time from the first day of treatment assessed up to 3 years, 1 month

Time from date of treatment start until the date of first objective documentation of disease-relapse. Relapse and resistant disease will be defined based on morphological assessment of bone marrow and peripheral blood. Complete Remission (CR): Normalization of the peripheral blood and bone marrow with 5% or less blasts in normocellular or hypercellular marrow with a granulocyte count of 1 x 10\^9/L or above, and platelet count of 100 x 10\^9/L. Complete resolution of all sites of extramedullary disease is required for CR. Complete remission without recovery of counts (CRi): Peripheral blood and marrow results as for CR, but with incomplete recover of counts (platelets \< 100 x 10\^9/L; neutrophils \< 1 x 10\^9/L). Partial Response (PR): As above for CR except for the presence of 6-25% marrow blasts.

Outcome measures

Outcome measures
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=5 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Event Free Survival (EFS) Where Events Defined as no Response, Loss of Response, or Death
5.7 Months
Interval 1.4 to 34.7

SECONDARY outcome

Timeframe: Up to 3 years

Minimal Residual Disease (MRD) was assessed by flow cytometry. MRD negativity: Absence of detectable leukemia using multiparameter flow cytometry with a sensitivity of \</= 0.01%.

Outcome measures

Outcome measures
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=4 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Number of Participants Negative for Minimal Residual Disease (MRD)
4 Participants

SECONDARY outcome

Timeframe: Time from the first day of treatment assessed up to 3 years, 1 month

Response date to loss of response or last follow up. Complete Remission (CR): Normalization of the peripheral blood and bone marrow with 5% or less blasts in normocellular or hypercellular marrow with a granulocyte count of 1 x 10\^9/L or above, and platelet count of 100 x 10\^9/L. Complete resolution of all sites of extramedullary disease is required for CR. Complete remission without recovery of counts (CRi): Peripheral blood and marrow results as for CR, but with incomplete recover of counts (platelets \< 100 x 10\^9/L; neutrophils \< 1 x 10\^9/L). Partial Response (PR): As above for CR except for the presence of 6-25% marrow blasts.

Outcome measures

Outcome measures
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=4 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Duration of Response
4.4 Months
Interval 1.2 to 34.7

SECONDARY outcome

Timeframe: Up to 3 years

defined as the percentage of patients achieving complete response (CR) or CR with inadequate count recovery (CRi). Complete Remission (CR): Normalization of the peripheral blood and bone marrow with 5% or less blasts in normocellular or hypercellular marrow with a granulocyte count of 1 x 10\^9/L or above, and platelet count of 100 x 10\^9/L. Complete resolution of all sites of extramedullary disease is required for CR. Complete remission without recovery of counts (CRi): Peripheral blood and marrow results as for CR, but with incomplete recover of counts (platelets \< 100 x 10\^9/L; neutrophils \< 1 x 10\^9/L).

Outcome measures

Outcome measures
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=5 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Participants With a Response
4 Participants

SECONDARY outcome

Timeframe: Time from the first day of treatment assessed up to 3 years, 1 month

Time from date of treatment start until date of death due to any cause or last Follow-up.

Outcome measures

Outcome measures
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=5 Participants
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
Overall Survival
16.7 Months
Interval 6.9 to 37.0

Adverse Events

Treatment (Blinatumomab, Combination Chemotherapy)

Serious events: 0 serious events
Other events: 5 other events
Deaths: 1 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Treatment (Blinatumomab, Combination Chemotherapy)
n=6 participants at risk
See detailed description. Blinatumomab: Given IV Cyclophosphamide: Given IV Cytarabine: Given IT or IV Dexamethasone: PO or IV Filgrastim: Given SC Laboratory Biomarker Analysis: Correlative studies Leucovorin Calcium: Given IV Mercaptopurine: Given PO Methotrexate: Given IT or IV Pegfilgrastim: Given SC Rituximab: Given IV Vincristine Sulfate: Given IV
General disorders
Fever
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
General disorders
Headache
50.0%
3/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Psychiatric disorders
Insomnia
33.3%
2/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Nervous system disorders
Concentration Impairment
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
General disorders
Fatigue
50.0%
3/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
General disorders
Night Sweats
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
General disorders
Edema Legs
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Injury, poisoning and procedural complications
Infusion Related Reaction
16.7%
1/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Investigations
Thrombocytopenia
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Blood and lymphatic system disorders
Anemia
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Blood and lymphatic system disorders
Neutopenia
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Metabolism and nutrition disorders
Hyponatremia
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Musculoskeletal and connective tissue disorders
Muscle Spasms
16.7%
1/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Metabolism and nutrition disorders
Hypophosphatemia
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
General disorders
Chills
33.3%
2/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Metabolism and nutrition disorders
Hypokalemia
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Musculoskeletal and connective tissue disorders
Arthralgia
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Blood and lymphatic system disorders
Decreased White Blood Count
33.3%
2/6 • Number of events 3 • Time from the first day of treatment assessed up to 3 years, 1 month
Immune system disorders
Cytokine Release Syndrome
33.3%
2/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Cardiac disorders
Ventricular Tachycardia
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Metabolism and nutrition disorders
Hyperglycemia
33.3%
2/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Investigations
Alanine Aminotransferase Increased
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Blood and lymphatic system disorders
Febrile Neutropenia
33.3%
2/6 • Number of events 2 • Time from the first day of treatment assessed up to 3 years, 1 month
Nervous system disorders
Tremor
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Psychiatric disorders
Confusion
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Gastrointestinal disorders
Mucositis
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Cardiac disorders
Steroid Myopathy
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Gastrointestinal disorders
Nausea
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month
Nervous system disorders
Dysgeusia
16.7%
1/6 • Number of events 1 • Time from the first day of treatment assessed up to 3 years, 1 month

Additional Information

Dr. Elias Joseph Jabbour MD/Professor

The University of Texas MD Anderson Cancer Center

Phone: 713-792-4764

Results disclosure agreements

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