Clinical trial

A Randomized Multi-Center Treatment Study (COALL 08-09) to Improve the Survival of Children With Acute Lymphoblastic Leukemia on Behalf of the German Society of Pediatric Hematology and Oncology

Name
CDR0000686545
Description
RATIONALE: 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 more than once drug (combination chemotherapy) may kill more cancer cells. Radiation therapy uses high-energy x-rays to kill cancer cells. It is not yet known whether giving clofarabine or high-dose cytarabine, pegaspargase, and combination chemotherapy followed by daunorubicin hydrochloride or doxorubicin hydrochloride is more effective in treating young patients with acute lymphoblastic leukemia. PURPOSE: This randomized phase II/III trial is studying the side effects of giving clofarabine compared with giving high-dose cytarabine, pegaspargase, and combination chemotherapy followed by daunorubicin hydrochloride or doxorubicin hydrochloride and to see how well it works in treating young patients with T-cell acute lymphoblastic leukemia or precursor B-cell acute lymphoblastic leukemia.
Trial arms
Trial start
2010-10-01
Estimated PCD
2019-12-01
Trial end
2024-12-01
Status
Active (not recruiting)
Phase
Early phase I
Treatment
Amsacrine
one block amsacrine together with etoposide and methylprednisolone for very high risk patients
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine)
Clofarabine
one block clofarabine with Asparaginase for MRD positive patients after induction
Arms:
Arm II intensification (clofarabine)
Cyclophosphamide
together wit MTX and ASP in consolidation and together with cytarabine and 6-TG in reinduction
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Cytarabine
part of different chemotherapy blocks in consolidation and reinduction
Arms:
Arm I intensification (cytarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Daunorubicin hydrochloride
part of induction and reinduction therapy
Arms:
Arm II intensification (clofarabine), Arm IV reinduct.(daunorubicin hydrochl.)
Dexamethasone
part of reinduction therapy
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Doxorubicin hydrochloride
part of reinduction therapy
Arms:
Arm III reinduct.(doxorubicin hydrochl.)
Etoposide phosphate
part of different chemotherapy blocks
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine)
Mercaptopurine
part of different chemotherapy blocks
Arms:
Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Methotrexate
part of different chemotherapy blocks
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Methylprednisolone
part of different chemotherapy blocks
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine)
Pegaspargase
part of different chemotherapy blocks
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Thioguanine
part of different chemotherapy blocks
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine)
Vincristine sulfate
part of intravenous chemotherapy
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine), Arm III reinduct.(doxorubicin hydrochl.), Arm IV reinduct.(daunorubicin hydrochl.)
Whole-brain radiation therapy
patients with initial cns involvement receive cranial irradiation
Arms:
Arm I intensification (cytarabine), Arm II intensification (clofarabine)
Size
745
Primary endpoint
Safety and efficacy of clofarabine combined with pegaspargase (phase II)
at day 21 after chemotherapy
Eligibility criteria
Inclusion criteria: diagnosis after the first and before the 18th birthday AND confirmed diagnosis of acute B-precursor or or T-cell leukemia AND parents or guardians/patients give consent for inclusion in the study and transmission of data AND if none of exclusion criteria is accomplished Exclusion criteria: BCR/ABL rearrangement positive OR prior cytostatic treatment lasting \> 7 days or prior treatment with cytostatic drugs other than vincristine, daunorubicin and prednisone OR prior severe illnesses which make treatment per the protocol impossible from the outset (BUT trisomy 21 is not an exclusion criterion) OR absence of the baseline data required for assignment to a risk group in accordance with the protocol (BUT patients for whom the MRD value could not be determined for technical reasons will be treated as protocol patients) OR the disease is a secondary malignancy or relapse OR death before the start of treatment
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE2', 'PHASE3'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 745, 'type': 'ACTUAL'}}
Updated at
2024-01-09

1 organization

12 products

2 drugs

1 indication

Product
Amsacrine
Indication
Leukemia
Product
Cytarabine
Product
Etoposide