NCT01371981

Bortezomib and Sorafenib Tosylate in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia

Official Title:

A Phase III Randomized Trial for Patients With De Novo AML Using Bortezomib and Sorafenib (NSC# 681239, NSC# 724772) for Patients With High Allelic Ratio FLT3/ITD

Summary

This randomized phase III trial studies how well bortezomib and sorafenib tosylate work in treating patients with newly diagnosed acute myeloid leukemia. Bortezomib and sorafenib tosylate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving bortezomib and sorafenib tosylate together with combination chemotherapy may be an effective treatment for acute myeloid leukemia.

Eligibility

Inclusion Criteria:

* Patients must be newly diagnosed with de novo acute myelogenous leukemia
* Patients with previously untreated primary AML who meet the customary criteria for AML with \>= 20% bone marrow blasts as set out in the 2008 World Health Organization (WHO) Myeloid Neoplasm Classification are eligible

* Attempts to obtain bone marrow either by aspirate or biopsy must be made unless clinically prohibitive; in cases where it is clinically prohibitive, peripheral blood with an excess of 20% blasts and in which adequate flow cytometric and cytogenetics/fluorescent in situ hybridization (FISH) testing is feasible can be substituted for the marrow exam at diagnosis
* Patients with \< 20% bone marrow blasts are eligible if they have:

* A karyotypic abnormality characteristic of de novo AML (t(8;21)(q22;q22), inv(16)(p13q22) or t(16;16)(p13;q22) or 11q23 abnormalities
* The unequivocal presence of megakaryoblasts, or
* Biopsy proven isolated myeloid sarcoma (myeloblastoma; chloroma, including leukemia cutis)
* Patients with any performance status are eligible for enrollment
* Prior therapy with hydroxyurea, all-trans retinoic acid (ATRA), corticosteroids (any route), and IT cytarabine given at diagnosis is allowed; hydroxyurea and ATRA must be discontinued prior to initiation of protocol therapy; patients who have previously received any other chemotherapy, radiation therapy or any other antileukemic therapy are not eligible for this protocol

Exclusion Criteria:

* Patients with any of the following constitutional conditions are not eligible:

* Fanconi anemia
* Shwachman syndrome
* Any other known bone marrow failure syndrome
* Patients with constitutional trisomy 21 or with constitutional mosaicism of trisomy 21 Note: enrollment may occur pending results of clinically indicated studies to exclude these conditions
* Patients with any of the following oncologic diagnoses are not eligible:

* Any concurrent malignancy
* Juvenile myelomonocytic leukemia (JMML)
* Philadelphia chromosome positive AML
* Biphenotypic or bilineal acute leukemia
* Acute promyelocytic leukemia
* Acute myeloid leukemia arising from myelodysplasia
* Therapy-related myeloid neoplasms Note: enrollment may occur pending results of clinically indicated studies to exclude these conditions
* Pregnancy and breast feeding
* Female patients who are pregnant are ineligible
* Lactating females are not eligible unless they have agreed not to breastfeed their infants
* Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained
* Sexually active patients of reproductive potential are not eligible unless they have agreed to use an effective contraceptive method for the duration of their study participation

Disease(s) and\or Condition(s)

Acute Myeloid Leukemia

Leukemia Cutis

Myeloid Neoplasm

Myeloid Sarcoma

Primary Purpose
  • TREATMENT
Intervention/Treatment
    • Type: DRUG
    • Name: Asparaginase
    • Description: Given IM
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3)
    • Type: DRUG
    • Name: Bortezomib
    • Description: Given IV
    • Arm Group Labels: Arm B
    • Type: DRUG
    • Name: Cytarabine
    • Description: Given IT or IV
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: DRUG
    • Name: Daunorubicin Hydrochloride
    • Description: Given IV
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: DRUG
    • Name: Etoposide
    • Description: Given IV
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: OTHER
    • Name: Laboratory Biomarker Analysis
    • Description: Correlative studies
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: DRUG
    • Name: Mitoxantrone Hydrochloride
    • Description: Given IV
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3)
    • Type: OTHER
    • Name: Pharmacological Study
    • Description: Correlative studies
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: OTHER
    • Name: Quality-of-Life Assessment
    • Description: Ancillary studies
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: OTHER
    • Name: Questionnaire Administration
    • Description: Ancillary studies
    • Arm Group Labels: Arm A, Arm B, Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3), Arm D
    • Type: DRUG
    • Name: Sorafenib Tosylate
    • Description: Given PO
    • Arm Group Labels: Arm C (Cohort 1), Arm C (Cohort 2), Arm C (Cohort 3)
Sponsor
  • National Cancer Institute (NCI)