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Acute Lymphoblastic LeukemiaPhase 1NCT03571321

Ruxolitinib and Chemotherapy in Adolescents and Young Adults With Ph-like Acute Lymphoblastic Leukemia

A Phase 1 study testing Ruxolitinib, Cyclophosphamide and Cytarabine in people with Acute Lymphoblastic Leukemia and ALL, Childhood, run by University of Chicago at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study will test if adding ruxolitinib to standard multi-drug chemotherapy regimen will be safe and tolerated in adolescents and young adults with newly diagnosed Ph-like acute lymphoblastic leukemia (ALL). Read more about this study

Who is it for?
Ages 18 to 39 years
Conditions the study is for
Acute Lymphoblastic Leukemia, ALL, Childhood, ALL
What is being tested?
Ruxolitinib, Cyclophosphamide and Cytarabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
2 sitesUnited States
Study dates
28 May 2019to 5 Sep 2027
Phase
Phase 1
Are there results?
Not yet: the study is under way

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 18 to 39 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Newly diagnosed de novo B-precursor acute lymphoblastic leukemia (ALL) as determined by World Health Organization (WHO) criteria. Patients must have unequivocal diagnosis of precursor B ALL. This includes an institutional immunophenotyping report that is to assign B-lineage or T-lineage.
  • "Ph-like" signature, as determined by low density micro-array (LDA) card
  • Jak-targetable genetic signature as defined by any of the following:
  • Cytokine receptor-like factor 2 (CRLF2) rearranged (JAK2 mutant or wild-type)
  • JAK2 or erythropoietin receptor (EPOR) fusions.
  • Other JAK pathway alterations at the discretion of the principle investigator including, but not limited to:
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  • SH2B adaptor protein 3 (SH2B3) deletions
  • Interleukin-7 receptor subunit alpha (IL7RA) mutations
  • Prior therapy
  • Prior to starting ruxolitinib, patients must have completed a 4-drug induction regimen with intrathecal chemotherapy (modified aBFM regimen or equivalent) as per the institutional standard of care. Recommended induction treatment is outlined in Section 5.1.2.
  • No additional prior therapy for acute leukemia except emergency therapy (corticosteroids or hydroxyurea) for blast cell crisis, superior vena cava syndrome, or renal failure due to leukemic infiltration of the kidneys. When indicated, leukapheresis or exchange transfusion is recommended to reduce the white blood cell count (WBC).
  • Screening may occur at any point prior to or during induction therapy
  • Age ≥ 18 years and < 40 years. Because this is specifically a study of the adolescent and young adult population and no adverse event data are currently available on the use of this pediatric-based chemotherapy regimen in patients ≥ 40 years of age, older adults are excluded from this study, but may be eligible for future trials.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤2 (Karnofsky ≥ 60%)
  • Platelet count > 25,000/uL.
  • Patients must have normal organ function as defined below:
  • total bilirubin ≤ 2 mg/dL
  • aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ≤ 2.5 × institutional upper limit of normal
  • creatinine within normal institutional limits OR creatinine clearance ≥ 60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
  • Because the therapeutic agents used in this study are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation.
  • Ability to understand and the willingness to sign a written informed consent document.

Who cannot join

  • Patients who are receiving any other investigational agent.
  • Patients with a "currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are free of disease for ≥ 3 years.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ruxolitinib or other agents used in study.
  • Use of any potent cytochrome P450 (CYP) 3A4 inhibitor or inducer within 5 half-lives before the first dose of the study drug. Potent inhibitors of CYP3A4 include systemic ketoconazole, posaconazole, voriconazole, clarithromycin, itraconazole, nefazodone, and telithromycin. At the fluconazole dose of 200mg daily used this regimen, there is minimal inhibition of CYP3A4 [36] and therefore fluconazole is not prohibited on this trial and no dose modifications should be made in the presence of fluconazole.
  • Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated list such as http://medicine.iupui.edu/clinpharm/ddis/table.aspx; medical reference texts such as the Physicians' Desk Reference may also provide this information. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
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  • Pregnant women are excluded from this study because ruxolitinib is a class C agent with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ruxolitinib breastfeeding should be discontinued if the mother is treated with ruxolitinib. These potential risks may also apply to other agents used in this study.
  • Down Syndrome due to the likelihood of excessive toxicity resulting. These patients should be treated in consultation with a pediatric oncologist.
  • Burkitt type leukemia
  • Ph+ ALL at time of diagnosis

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States2 sites, 1 recruiting
  • University of Chicago Medical Center

    Chicago, Illinois, 60637

    Howie Weiner, (773) 702-2084, hweiner@medicine.bsd.uchicago.edu

    Wendy Stock, MD

    Recruiting
  • The University of Texas Southwestern Medical Center

    Dallas, Texas, 75390

    Active, not recruiting

Other trials in United States

About this study

Official title: Phase I Trial of Ruxolitinib in Combination With a Pediatric Based-regimen for Adolescents and Young Adults (AYAs) With Ph-like Acute Lymphoblastic Leukemia (ALL)

This study will test if adding ruxolitinib to standard multi-drug chemotherapy regimen will be safe and tolerated in adolescents and young adults with newly diagnosed Ph-like acute lymphoblastic leukemia (ALL).

Being tested
Ruxolitinib, Cyclophosphamide, Cytarabine, Mercaptopurine, Vincristine
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma

What participants receive

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

  • RuxolitinibDrug

    Also called Jakafi

    Participants will receive one of 3 doses [taken by mouth] (30 mg, 40 mg, or 50 mg) depending on when they are enrolled to the study.

    Remission consolidation regimen:

    • Days 1-14 and 29-43

    Interim maintenance regimen:

    • Days 1-14 and 29-43

    Delayed Intensification regimen:

    • Days 1-14 and 29-43
  • CyclophosphamideDrug

    Remission consolidation regimen:

    • 1000 mg/m2 by intravenous infusion (IV) on Day 1 and Day 29

    Delayed Intensification regimen:

    • 1000 mg/m2 IV on Day 29
  • CytarabineDrug

    Remission consolidation regimen:

    • 75 mg/m2/day IV or subcutaneously (SC) on Days 1-4 (i.e., 4 doses), 8-11, 29-32, and 36-39

    Delayed Intensification regimen:

    • 75 mg/m2/day IV or SC on Days 29-32 and 36-39
  • MercaptopurineDrug

    Taken by mouth.

    Remission consolidation regimen:

    • 60 mg/m2 on Days 1-14 and 29-42

    Maintenance Therapy:

    • 75 mg/m2 on Days 1-84
  • VincristineDrug

    Remission consolidation regimen:

    • 1.5 mg/m2 (maximum 2 mg) IV once per week on Days 15, 22, 43, and 50

    Interim maintenance regimen:

    • 1.5 mg/m2 (maximum 2 mg) IV on Days 1, 11, 21, 31, and 41

    Delayed Intensification regimen:

    • 1.5 mg/m2 (maximum 2 mg) IV on Days 1, 8, 15, 43, and 50

    Maintenance Therapy:

    • 1.5 mg/m2 (maximum 2 mg) IV on Days 1, 29, and 57
  • PegaspargaseDrug

    Remission consolidation regimen:

    • 2500 IU/m2 given by intramuscular (IM) injection or IV on Days 15 and 43

    Interim maintenance regimen:

    • 2500 IU/m2 IM or IV on Days 2 and 22

    Delayed Intensification regimen:

    • 2500 IU/m2 IM or IV on Day 4 (OR Day 5 OR Day 6) AND Day 43.
  • RituximabDrug

    For patients that have cluster of differentiation antigen 20 positive (CD20+) disease only.

    Remission consolidation regimen:

    • 375 mg/m2 IV on Days 1, 8, 29 and 36

    Interim maintenance regimen:

    • 375 mg/m2 IV on Days 1 and 11

    Delayed Intensification regimen:

    • 375 mg/m2 IV on Days 1 and 8
  • Methotrexate (Intrathecal Administration)Drug

    Drug is given through a needle which is inserted in one of the spaces between the bones in the lower back (intrathecal [IT] administration).

    Remission consolidation regimen:

    • 15 mg on Days 1, 8, 15, and 22

    Interim maintenance regimen:

    • 15 mg on Days 1 and 31

    Delayed Intensification regimen:

    • 15 mg on Days 1, 29, and 36

    Maintenance Therapy:

    • 15 mg on Day 1
    • 15 mg on Day 29 (First 4 courses only)
  • Methotrexate (Intravenous Administration)Drug

    Interim maintenance regimen:

    • 100 mg/m2 IV on Days 1, 11, 21, 31, and 41
  • DexamethasoneDrug

    Taken by mouth or given by IV infusion.

    Delayed Intensification regimen:

    • 10 mg/m2 per day (divided into 2 doses) on Days 1-7 and 15-21

    Maintenance Therapy:

    • 6 mg/m2 per day (divided into 2 doses) on Days 1-5, 29-33, and 57-61
  • DoxorubicinDrug

    Delayed Intensification regimen:

    • 25 mg/m2 IV on Days 1, 8, 15
  • ThioguanineDrug

    Taken by mouth at least 1 hour after evening meal.

    Delayed Intensification regimen:

    • 60 mg/m2 on Days 29-42
  • Methotrexate Oral ProductDrug

    Taken by mouth.

    Maintenance Therapy:

    • 20 mg/m2 weekly (on Days 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78)
    • Not given on Day 29 of first 4 courses (on days when IT Methotrexate is given]
Study groups in NCT03571321
Study groupRoleWhat they receive
RuxolitinibExperimentalParticipants will receive ruxolitinib in addition to standard chemotherapy. Standard Chemotherapy Consists of: * Remission consolidation therapy (lasting 8 weeks) * Interim Maintenance (lasting 8 weeks) * Delayed Intensification (lasting 8 weeks * Maintenance Therapy (12 week courses/84 day cycles lasting 2-3 years) Prior to study entry, patients must have completed a 4-drug induction therapy regimen with intrathecal chemotherapy (modified Berlin-Frankfurt-Münster (aBFM) regimen or equivalent) as per the institution standard of care.
Receives: Drug: Ruxolitinib; Drug: Cyclophosphamide; Drug: Cytarabine; Drug: Mercaptopurine; Drug: Vincristine; Drug: Pegaspargase; Drug: Rituximab; Drug: Methotrexate (Intrathecal Administration); Drug: Methotrexate (Intravenous Administration); Drug: Dexamethasone; Drug: Doxorubicin; Drug: Thioguanine; Drug: Methotrexate Oral Product

What is being measured

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

  1. Feasibility of adding ruxolitinib to a standard-of-care pediatric-based chemotherapy regimen in adolescents and young adult patients as determined by rate of side effects seen when combination is given

    Determined by rate of side effects seen when combination is given

    Measured: 24 weeks

Secondary outcomes (3)
  1. Rate of participants that are minimal residual disease (MRD) negative at end of induction therapy

    Measured: 4 weeks

  2. Overall survival rate

    Measured: 2 years

  3. Event-free survival rate

    Measured: 2 years

Timeline

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

  1. First posted27 Jun 2018
  2. Study start28 May 2019
  3. Primary completion1 Sep 2026 (estimated)
  4. Study completion5 Sep 2027 (estimated)

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
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential
Masking
None (open label)
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03571321
Sponsor's protocol ID
IRB17-1110
Status last verified
Jan 2026
First submitted
22 Jun 2018
Last updated
29 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Ruxolitinib, Cyclophosphamide and Cytarabine in people with Acute Lymphoblastic Leukemia and ALL, Childhood, run by University of Chicago at 2 sites in United States.

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 21 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 29 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. 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 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.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Clinical Trials Office (1-855-702-8222, cancerclinicaltrials@bsd.uchicago.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of adding ruxolitinib to a standard-of-care pediatric-based chemotherapy regimen in adolescents and young adult patients as determined by rate of side effects seen when combination is given (time frame: 24 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 29 Jun 2026.

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