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LeukemiaPhase 1/2NCT01088984

Study of Bendamustine Hydrochloride for the Treatment of Pediatric Patients With Relapsed or Refractory Acute Leukemia

A Phase 1/2 study testing Bendamustine in people with Leukemia, run by Teva Branded Pharmaceutical Products R&D, Inc. at 50 sites in 12 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of phase 1 of this study is to establish the recommended phase II dose (RP2D). The primary objective of phase 2 of this study is to evaluate the safety and efficacy of bendamustine at the recommended pediatric dose for the treatment of pediatric patients with relapsed or refractory acute leukemia. Read more about this study

Who is it for?
Ages 1 year to 20 years
Conditions the study is for
Leukemia
What is being tested?
Bendamustine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
50 sitesin 12 countries
Study dates
Aug 2010to Aug 2011
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 year to 20 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • The patient has histologically proven acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) that has relapsed or is refractory to the last regimen, and the patient is without alternative curative therapy.
  • The patient's last myelosuppression therapy ended at least 2 weeks before the first dose of study drug.
  • Nonhematologic acute toxic effects of prior therapy have resolved to grade 2 or less according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE).
  • The patient has adequate liver function with bilirubin values less than or equal to 1.5 times the upper limit of normal (ULN) and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values less than or equal to 5 times the age-appropriate ULN.
  • The patient has adequate renal function with serum creatinine values less than 2 times ULN.
  • The patient has Karnofsky or Lansky performance status of 60 or greater. Patients older than 16 years of age will be scored according to the Karnofsky scale and patients 16 years of age or younger will be scored according to the Lansky scale.
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  • The patient may have had hematopoietic stem cell transplantation.
  • Women of childbearing potential (not surgically sterile) must use a medically accepted method of contraception and must agree to continue use of this method for the duration of treatment and for 30 days after the end of treatment.
  • Men not surgically sterile or who are capable of producing offspring must practice abstinence or use a barrier method of birth control, and must agree to continue use of this method for the duration of treatment and for 30 days after the end of treatment.
  • The patient must be willing and able to comply with study restrictions and to remain at the clinic for the required duration during the study period, and willing to return to the clinic for the follow-up evaluation as specified in this protocol.

Who cannot join

  • The patient has any active, uncontrolled systemic infection, severe concurrent disease, or symptomatic untreated central nervous system (CNS) involvement.
  • The patient has evidence of active graft versus host disease.
  • The patient has a known human immunodeficiency virus (HIV) infection.
  • The patient has active hepatitis B or hepatitis C infection.
  • The patient is a pregnant or lactating woman. Any women becoming pregnant during the study will be withdrawn from the study immediately.
  • The patient has any serious uncontrolled medical or psychological disorder that would impair the ability of the patient to receive study drug.
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  • The patient has any condition that places the patient at unacceptable risk or confounds the ability of the investigators to interpret study data.
  • The patient has received any other investigational agent within 30 days of study entry.
  • The patient has known hypersensitivity to bendamustine or mannitol.

Trial locations and contacts

50 sites in 12 countries.

50 sites in 12 countries

United States19 sites
  • Teva Investigational Site 8

    Baltimore, Maryland

  • Teva Investigational Site 16

    Boston, Massachusetts

  • Teva Investigational Site 3

    Dallas, Texas

  • Teva Investigational Site 9

    Detroit, Michigan

  • Teva Investigational Site 4

    Fort Worth, Texas

  • Teva Investigational Site 11

    Hershey, Pennsylvania

  • Teva Investigational Site 13

    Houston, Texas

  • Teva Investigational Site 1

    Jackson, Mississippi

  • Teva Investigational Site 5

    Kansas City, Missouri

  • Teva Investigational Site 19

    Memphis, Tennessee

  • Teva Investigational Site 6

    Milwaukee, Wisconsin

  • Teva Investigational Site 15

    New York, New York

  • Teva Investigational Site 17

    Orange, California

  • Teva Investigational Site 7

    Philadelphia, Pennsylvania

  • Teva Investigational Site 18

    Portland, Oregon

  • Teva Investigational Site 12

    San Diego, California

  • Teva Investigational Site 2

    Seattle, Washington

  • Teva Investigational Site 14

    St Louis, Missouri

  • Teva Investigational Site 10

    St. Petersburg, Florida

Other trials in United States

Brazil8 sites
  • Teva Investigational Site 615

    Barretos-SP

  • Teva Investigational Site 616

    Caxias do Sul

  • Teva Investigational Site 613

    Curitiba-PR

  • Teva Investigational Site 612

    Porto Alegre

  • Teva Investigational Site 614

    Porto Alegre

  • Teva Investigational Site 610

    São Paulo

  • Teva Investigational Site 611

    São Paulo

  • Teva Investigational Site 617

    Sao Paulo-SP

Other trials in Brazil

Mexico4 sites
  • Teva Investigational Site 603

    Guadalajara

  • Teva Investigational Site 600

    Mexico City

  • Teva Investigational Site 601

    Mexico City

  • Teva Investigational Site 602

    Monterrey

Other trials in Mexico

South Korea4 sites
  • Teva Investigational Site 330

    Seoul

  • Teva Investigational Site 331

    Seoul

  • Teva Investigational Site 332

    Seoul

  • Teva Investigational Site 333

    Seoul

Other trials in South Korea

Australia3 sites
  • Teva Investigational Site 300

    Herston

  • Teva Investigational Site 301

    Parkville

  • Teva Investigational Site 302

    Randwick

Other trials in Australia

Israel3 sites
  • Teva Investigational Site 501

    Jerusalem

  • Teva Investigational Site 503

    Petah Tikva

  • Teva Investigational Site 502

    Ramat Gan

Other trials in Israel

Poland3 sites
  • Teva Investigational Site 531

    Bialystok

  • Teva Investigational Site 530

    Lublin

  • Teva Investigational Site 532

    Warsaw

Other trials in Poland

Russia2 sites
  • Teva Investigational Site 511

    Moscow

  • Teva Investigational Site 510

    Saint Petersburg

Other trials in Russia

Belarus1 site
  • Teva Investigational Site 520

    Minsk

Other trials in Belarus

Canada1 site
  • Teva Investigational Site 100

    Toronto

Other trials in Canada

New Zealand1 site
  • Teva Investigational Site 303

    Auckland

Other trials in New Zealand

Singapore1 site
  • Teva Investigational Site 320

    Singapore

Other trials in Singapore

About this study

Official title: An Open-Label Study of Bendamustine Hydrochloride for the Treatment of Pediatric Patients With Relapsed or Refractory Acute Leukemia

The primary objective of phase 1 of this study is to establish the recommended phase II dose (RP2D). The primary objective of phase 2 of this study is to evaluate the safety and efficacy of bendamustine at the recommended pediatric dose for the treatment of pediatric patients with relapsed or refractory acute leukemia.

Conditions
Leukemia
Being tested
Bendamustine
Medical subject headings
Leukemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01088984
Study groupRoleWhat they receive
BendamustineExperimentalBendamustine 90 or 120 mg/m^2 administered as an intravenous (IV) infusion over 60 minutes on Days 1 and 2 of each 21-day cycle (maximum of 12 total cycles), with delays up to 2 weeks for neutrophil and platelet count recovery, for up to a 35-day cycle.
Receives: Drug: Bendamustine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recommended Phase II Dose (RP2D) of Bendamustine

    RP2D was determined by a traditional 3+3 dose escalation design, with the following restrictions: only doses of 60, 90, 120, and 150 mg/m^2 were explored, and escalation to 150 mg/m^2 would only occur if the 120 mg/m^2 dose was deemed safe and pharmacokinetic data indicate subtherapeutic exposure as compared with adults. The first cohort was administered bendamustine at the 90 mg/m^2 dose; de-escalation to the 60 mg/m^2 dose would only occur if the starting dose led to dose-limiting toxicity (DLT) in 2 or more participants. A DLT was defined as any study drug-related nonhematologic adverse event (AE) that was grade 4 for toxicity by National Cancer Institute's Common Toxicity Criteria for AEs, version 4. In addition, grade 3 or above allergic reaction or skin rash were considered DLTs. Hematologic AEs were not considered DLTs. The dose level at which at least 2 of 3 or 2 of 6 participants had a DLT was considered as exceeding the RP2D. The RP2D was the dose 1 step below that level.

    Measured: Induction Cycle (21- to 35-day cycle)

  2. Overall Response Rate (ORR)

    ORR was calculated as follows: number of participants in the primary analysis set achieving a best overall response of complete remission without platelet recovery (CRp) or complete remission (CR), divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A CR required no evidence of circulating blasts or extramedullary disease, an M1 marrow (≤ 5% bone marrow blasts), and recovery of peripheral counts (platelets ≥ 100 × 10^9/L and absolute neutrophil count ≥ 1.0 × 10^9/L). A CR without platelet recovery (CRp) required all of the criteria for a CR with the exception of platelet recovery.

    Measured: Assessed at each treatment cycle (21 to 35 days), for a maximum of 12 cycles

Secondary outcomes (7)
  1. Best Overall Tumor Response Rate

    Biological activity of bendamustine was defined as achieving a best response of partial response (PR), CRp, or CR. Rate was calculated as follows: number of participants in the primary analysis set achieving a best overall response of PR, CRp, or CR, divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A PR had to meet the following criteria: complete disappearance of circulating blasts and an M2 marrow (≥ 5% and ≤ 25% bone marrow blasts) and appearance of normal progenitor cells or an M1 marrow that did not qualify for CR or CRp. See Outcome Measure 2 for full definitions for CRp and CR.

    Measured: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles

  2. Best Overall Tumor Response Rate, by Phase

    Biological activity of bendamustine was defined as achieving a best response of partial response (PR), CRp, or CR. Rate was calculated as follows: number of participants in the primary analysis set achieving a best overall response of PR, CRp, or CR, divided by the number of participants in the primary analysis set. The most positive response for each patient during the study was counted. The 95% CI was calculated using binomial parameter exact method. Response was determined by the investigator, and evaluated per Jeha et al, 2006: A PR had to meet the following criteria: complete disappearance of circulating blasts and an M2 marrow (≥ 5% and ≤ 25% bone marrow blasts) and appearance of normal progenitor cells or an M1 marrow that did not qualify for CR or CRp. See Outcome Measure 2 for full definitions for CRp and CR.

    Measured: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles

  3. Duration of Response (DOR)

    DOR was determined for the participants with CR or CRp in the primary analysis set, defined as the time from first achieving remission to the time when progression was diagnosed, the participant died, or the participant started receiving new antineoplastic therapy. Data from participants who do not progress were censored at the last valid assessments. Median DOR and its 95% confidence interval was determined based on the Kaplan-Meier method. Data from participants who received a transplant were censored at the time of the transplant.

    Measured: At each treatment cycle (21 to 35 days), for a maximum of 12 cycles

  4. Maximum Observed Plasma Drug Concentration (Cmax) for Bendamustine and Its Metabolites (M3 and M4)

    Measured: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.

  5. Time to Maximum Plasma Drug Concentration (Tmax) for Bendamustine and Its Metabolites (M3 and M4)

    Measured: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.

  6. Area Under the Plasma Drug Concentration by Time Curve From Time 0 Until the Last Measurable Plasma Concentration (AUC0-t) for Bendamustine and Its Metabolites (M3 and M4)

    Measured: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.

  7. Area Under the Plasma Drug Concentration by Time Curve From Time 0 Until 24 Hours After Study Drug Administration (AUC0-24) for Bendamustine and Its Metabolites (M3 and M4)

    Measured: Cycle 1, Day 1: before infusion, immediately following the infusion, and 3, 6, 10(±2), and 24 hours after the start of infusion. The 24-hour postinfusion sample was obtained before the start of the infusion on Day 2.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2010 (estimated)
  2. Study startAug 2010
  3. Primary completionAug 2011
  4. Study completionAug 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01088984
Sponsor's protocol ID
C18083/2046
Other IDs
2010-020768-40
Status last verified
Apr 2016
First submitted
16 Mar 2010
Last updated
23 May 2016

Publications

  • Fraser C, Brown P, Megason G, Ahn HS, Cho B, Kirov I, Frankel L, Aplenc R, Bensen-Kennedy D, Munteanu M, Weaver J, Harker-Murray P. Open-label bendamustine monotherapy for pediatric patients with relapsed or refractory acute leukemia: efficacy and tolerability. J Pediatr Hematol Oncol. 2014 May;36(4):e212-8. doi: 10.1097/MPH.0000000000000021.

    PubMed 24072240

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Bendamustine in people with Leukemia, run by Teva Branded Pharmaceutical Products R&D, Inc. at 50 sites in 12 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 May 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 50 sites in United States, Brazil, Mexico, South Korea, Australia and 7 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recommended Phase II Dose (RP2D) of Bendamustine (time frame: Induction Cycle (21- to 35-day cycle)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01088984, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2016.

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