Moffitt Cancer Center: Clinical Trial 20042

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Clinical Trial 20042

Cancer Type: Malignant Hematology
Study Type: Treatment
NCT#: NCT04620681

Phase: Phase I/II
Prinicipal Investigator: Hany Elmariah

Call 813-745-6100
or 1-800-679-0775 Learn More

Overview

Study Title

CD8 Depleted, Non-Engrafting, HLA Mismatched Unrelated Donor Lymphocyte Infusion in Patients with MDS and Secondary AML

Summary

The purpose of the study is to determine the safety of an investigational treatment for myelodysplastic syndrome (MDS) after the first therapy (such as azacitidine or decitabine) stops working or after progression of MDS to acute myeloid leukemia (AML).

Objective

1. Determine the maximum tolerated dose (MTD) of CD8-depleted non-engrafting human leukocyte antigen (HLA) mismatched unrelated donor lymphocyte infusion (NE-DLI) in patients with myeloid malignancies. 2. Estimate the response rate to therapy with CD8-depleted NE-DLI in patients with myelodysplastic syndrome (MDS) who have failed therapy with hypomethylating agents (HMAs) or untreated patients with acute myeloid leukemia (AML) secondary to an antecedent hematologic disease (sAML).

Treatments

Therapies

Medications

Inclusion Criteria

Myelodysplastic Syndrome (MDS) having failed hypomethylating agent (HMA) therapy cohort:

Age 18-79 years, inclusive

Pathologically confirmed MDS

IPSS-R score intermediate, high or very high

Must have failed therapy with an HMA (defined as progression by International Working Group criteria (1) or intolerance of the drug)

Secondary Acute Myeloid Leukemia (sAML) cohort:

Pathologically confirmed AML according to World Health Organization (WHO) criteria

Evidence of an antecedent hematologic disorder (AHD) prior to acute leukemia including a diagnosis of myelodysplastic/MPNs or data suggestive of an AHD such as cytopenias, fibrosis, macrocytic anemia, cellular or dysplasia at or prior to the time of diagnosis. > If available, MDS-defining karyotypes (-7/del(7q), -5/del(5q), del(13q), del(11q), del(12p), t(12p), del(9q), idic(X)(q13), t(17p) (unbalanced translocations) or i(17q) (ie, loss of 17p), t(11;16)(q23;p13.3), t(3;21)(q26.2;q22.1), t(1;3)(p36.3;q21), t(2;11)(p21;q23), inv(3)(q21q26.2), t(6;9)(p23;q34)) or somatic mutations in multiple genes including SRSF2, SF3B1, U2AF1, ZRSR2, ASXL1, EZH2, BCOR, or STAG2 would also confirm eligibility.

Age 60-79 years, inclusive

Must not have received any prior therapy for AML with the exception of hydroxyurea for increased blast count or leukapheresis for leukocytosis. Patients who have received a limited and short-term exposure of ATRA while acute promyelocytic leukemia was being ruled out, and which has been discontinued, will be eligible.

For both cohorts:

Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

Deemed eligible to receive cytotoxic chemotherapy

Creatinine clearance (CrCl)>50ml/min

Total bilirubin > Left Ventricular Ejection Fraction > 50%

Willing and able to participate in study assessments

Exclusion Criteria

Patients who have had systemic chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier. Intrathecal chemotherapy within this time frame is permitted. Intrathecal chemotherapy may be continued during protocol therapy in order to consolidate or maintain a central nervous system (CNS) remission, but not to treat active CNS disease

Acute promyelocytic leukemia, or the presence of t(15;17)

Patients receiving any other investigational agents

Uncontrolled concurrent illness including, but not limited to, ongoing and uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

Pregnant women are excluded from this study because there is an unknown but potential risk for adverse events in the fetus. Breastfeeding should be discontinued if the mother is treated. These potential risks may also apply to other agents used in this study

Patients who have any debilitating medical or psychiatric illness that would preclude their giving informed consent or their receiving optimal treatment and follow-up

Patients with a poor functional status of ECOG 3-4, or otherwise deemed unfit to tolerate induction chemotherapy.

Age > 80 years

Patients with blastic transformation of chronic myelogenous leukemia are ineligible

Exposure to a humanized mouse chimeric antibody, as this could sensitize patients to components of the CD8 depletion column that may be present in small amounts in the cell product

If you are interested in learning more about clinical trials, our clinical trial navigators can discuss your options and recommend opportunities that may be suitable for you. Call 813-745-6100 or 1-800-679-0775 (toll-free) or submit a clinical trials inquiry form.