Brief Title
Rasburicase and Allopurinol in Treating Patients With Hematologic Malignancies
Official Title
Efficacy and Safety of Two Comparable Single Low Doses of Rasburicase Followed by Allopurinol in Adult Patients With Malignancy
Brief Summary
This randomized phase II trial studies how well giving rasburicase together with allopurinol works in treating patients with hematologic malignancies. Rasburicase may reduce the level of uric acid in the blood. Allopurinol may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known which dose of rasburicase is more effective in treating hematologic malignancies when given together with or without allopurinol.
Detailed Description
PRIMARY OBJECTIVES: I. To prospectively evaluate the efficacy, as defined by uric acid response rate, of 2 different single low doses of rasburicase followed by allopurinol in 2 treatment arms. SECONDARY OBJECTIVES: I. To estimate the proportion of patients requiring additional doses of rasburicase to maintain a uric acid level =< 7.5mg/dL on day 2 through day 6. II. To identify differential characteristics of the patients who do not respond to treatment. III. To measure the area under the plasma uric acid concentration-time curve (AUC) from baseline (day 1) to day 7, time to plasma uric acid level less than or equal to 7.5mg/dL. IV. To evaluate the rate of patients requiring hemodialysis (HD) V. To evaluate the safety of low single-doses of rasburicase. VI. To evaluate the rate of patients expressing a doubling of serum creatinine. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive 1.5mg of rasburicase intravenously (IV) over 30 minutes on day 1* and allopurinol orally (PO) once daily (QD) on days 1-6. ARM II: Patients receive 3 mg of rasburicase IV over 30 minutes on day 1* and allopurinol PO QD on days 1-6. NOTE: *Patients with serum uric acid >= 7.5mg/dl also receive rasburicase IV on days 2-3. After completion of study treatment, patients are followed up at 30 days.
Study Phase
Phase 2
Study Type
Interventional
Primary Outcome
Probability of Obtaining a Uric Acid Level =< 7.5mg/dL
Secondary Outcome
Number of Patients Requiring Additional Doses of Rasburicase to Maintain a Uric Acid Level =< 7.5mg/dL
Condition
Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
Intervention
rasburicase
Study Arms / Comparison Groups
Arm I (1.5mg rasburicase)
Description: Patients receive 1.5mg of rasburicase IV over 30 minutes on day 1 and allopurinol PO QD on days 1-6.
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
24
Start Date
September 29, 2011
Completion Date
May 28, 2016
Primary Completion Date
May 28, 2015
Eligibility Criteria
Inclusion Criteria: - Eastern Cooperative Oncology Group (ECOG) status of 0-3 - Active leukemia and Burkitt leukemia/lymphoma treated in-house that puts them at risk for tumor lysis syndrome (TLS) - Serum uric acid level >= 7.5mg/dL and high risk for TLS as defined by: - A diagnosis of acute myeloid leukemia (AML), or - A diagnosis of blast-phase chronic myeloid leukemia (CML), or - A diagnosis of high-grade myelodysplastic syndrome (MDS) with >= 10% blast bone marrow blast involvement, or - Acute lymphoblastic leukemia (ALL), or - Burkitt leukemia/lymphoma - Patient or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure Exclusion Criteria: - History of asthma - History of severe or life threatening atopic allergy - Hypersensitivity to uricases - Known prior sensitivity to allopurinol - Known glucose-6-phosphate dehydrogenase (G6PD) deficiency - Recent prior history of uricolytic therapy defined as therapy within the last 7 days
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Eunice Wang, MD, ,
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT01564277
Organization ID
I 197711
Secondary IDs
NCI-2011-03231
Responsible Party
Sponsor
Study Sponsor
Roswell Park Cancer Institute
Collaborators
National Cancer Institute (NCI)
Study Sponsor
Eunice Wang, MD, Principal Investigator, Roswell Park Cancer Institute
Verification Date
December 2017