NCT00557193

Combination Chemotherapy With or Without Lestaurtinib in Treating Younger Patients With Newly Diagnosed Acute Lymphoblastic Leukemia

Official Title:

A Phase III Study of Risk Directed Therapy for Infants With Acute Lymphoblastic Leukemia (ALL): Randomization of Highest Risk Infants to Intensive Chemotherapy +/- FLT3 Inhibition (CEP-701, Lestaurtinib; NSC#617807)

Summary

This phase III trial studies combination chemotherapy with or without lestaurtinib with to see how well they work in treating younger patients with newly diagnosed acute lymphoblastic leukemia. Drugs used in chemotherapy work in different ways to stop the growth of stop cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Lestaurtinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether combination chemotherapy is more effective with or without lestaurtinib in treating acute lymphoblastic leukemia.

Eligibility

Inclusion Criteria:

* Patients must be enrolled on a Children's Oncology Group (COG) ALL Classification Study (AALL08B1) prior to enrollment on AALL0631
* Patients must be \< 366 days of age at the time of diagnosis; for neonates in the first month of life, patients must be \> 36 weeks gestational age at the time of diagnosis
* Patients must be newly diagnosed with acute lymphoblastic leukemia (ALL) or acute undifferentiated leukemia (AUL); patients with T-cell ALL are eligible; patients with bilineage or biphenotypic acute leukemia are eligible, provided the morphology and immunophenotype are predominately lymphoid
* Patients must be previously untreated with the exception of steroids and intrathecal chemotherapy; no other systemic chemotherapy may have been administered; patients receiving prior steroid therapy are eligible for study; any amount of steroid pretreatment will not affect initial induction assignment as long as the patient meets all other eligibility criteria; IT chemotherapy per protocol is allowed for patient convenience at the time of the diagnostic bone marrow or venous line placement to avoid second lumbar puncture; (note: the central nervous system \[CNS\] status must be determined based on a sample obtained prior to administration of any systemic or intrathecal chemotherapy, except for steroid pretreatment); systemic chemotherapy must begin within 72 hours of this IT therapy
* All patients and/or their parents or legal guardians must sign a written informed consent
* All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
* Patients with mature B-cell ALL or acute myelogenous leukemia (AML) are NOT eligible
* Patients with Down syndrome are NOT eligible

Disease(s) and\or Condition(s)

Acute Lymphoblastic Leukemia

Acute Undifferentiated Leukemia

Childhood T Acute Lymphoblastic Leukemia

Primary Purpose
  • TREATMENT
Intervention/Treatment
    • Type: DRUG
    • Name: Asparaginase
    • Description: Given IV, IM, or PO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: PROCEDURE
    • Name: Biospecimen Collection
    • Description: Undergo blood sample collection
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: PROCEDURE
    • Name: Bone Marrow Biopsy
    • Description: Undergo bone marrow biopsy
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Cyclophosphamide
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Cytarabine
    • Description: Given IV or IT
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Daunorubicin Hydrochloride
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Dexamethasone
    • Description: Given IV or PO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: PROCEDURE
    • Name: Echocardiography
    • Description: Undergo ECHO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Etoposide
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: BIOLOGICAL
    • Name: Filgrastim
    • Description: Given IV or SC
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: OTHER
    • Name: Laboratory Biomarker Analysis
    • Description: Correlative studies
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Lestaurtinib
    • Description: Given PO
    • Arm Group Labels: Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Leucovorin Calcium
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Mercaptopurine
    • Description: Given PO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Methotrexate
    • Description: Given IV, IT, or PO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Methylprednisolone
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: PROCEDURE
    • Name: Multigated Acquisition Scan
    • Description: Undergo MUGA
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Pegaspargase
    • Description: Given IM
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: OTHER
    • Name: Pharmacological Study
    • Description: Correlative studies
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Prednisone
    • Description: Given PO
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Therapeutic Hydrocortisone
    • Description: Given IT
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
    • Type: DRUG
    • Name: Vincristine Sulfate
    • Description: Given IV
    • Arm Group Labels: Arm A (standard risk MLL-G), Arm B (IR/HR MLL-R chemotherapy), Arm C (IR/HR MLL-R chemotherapy and lestaurtinib)
Sponsor
  • Children's Oncology Group