E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Intravenous azacitidine 100 mg/m2, Days 1 to 7 of a 28-day cycle for up to 3 cycles initially.
In case of decline of MRD during azacitidine treatment additional cycles are allowed (maximum 6 cycles).
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E.1.1.1 | Medical condition in easily understood language |
Infusion of azacitidine (study drug) to the patient up to 6 times. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the effect of azacitidine treatment in AML subjects at molecular relapse after CR1 with regard to molecular response prior to further treatment (reinduction / HSCT) |
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E.2.2 | Secondary objectives of the trial |
To assess safety of azacytidine treatment in children and adolescents with a molecular relapse of AML. Disease free and overall survival post molecular relapse; quality of life (questionnaire, AE reports). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Aged 3 months to <21 years with documented diagnosis of AML according to WHO classification with at least one quantitative genetic maker, e.g. one of the following aberrations:
• t(8;21); RUNX1/RUNX1T1 • inv(16); CBFb/MYH11 • t(9;11); MLL/AF9 • t(10;11); MLL/AF10 • NPM1 • WT1; etc.
2. Molecular remission confirmed at the start of last consolidation course or within 1 month after completion of consolidation treatment
3. Detection of a confirmed molecular relapse of an AML
4. Understand and voluntarily provide permission (subjects and when applicable, parental/legal representative(s)) to the ICF prior to conducting any study related assessments/procedures
5. Able to adhere to the study visit schedule and other protocol requirements
6. Lansky performance score at least equal to 50; or Karnofsky performance status at least equal to 50, whichever is applicable
7. Negative serum pregnancy tests for females of child bearing potential within 10 days prior to treatment
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E.4 | Principal exclusion criteria |
1. Concomitant treatment with any other anticancer therapy except those specified in protocol
2. HSCT within previous 3 months
3. Treated by any investigational agent in a clinical study within previous 4 weeks
4. Pregnancy or lactating
5. FAB type M3 leukemia (acute promyelocytic leukemia)
6. Therapy-related AML
7. AML of Down syndrome or other congenital syndromes giving rise to leukemia or treatment complications
8. Symptomatic cardiac disorders (CTCAE 4.0 Grade 3 or 4)
9. Evidence of invasive fungal infection or other severe systemic infection requiring treatment doses of systemic/parenteral therapy including known active viral infection with human immunodeficiency virus (HIV) or Hepatitis Type B and C
10. Any other organ dysfunction (CTCAE 4.0 Grade 3 or 4) that will interfere with the administration of the therapy according to this protocol
11. Ongoing severe toxicities (CTCAE 4.0 Grade 3 or 4) of prior chemotherapy/stem cell transplantation
12. Hypersensitivity to azacitidine
13. Abnormal liver function: • serum bilirubin > 3 x ULN • ALT or AST > 5 times ULN
14. Symptomatic CNS-involvement or isolated extramedullary disease at initial diagnosis
15. Female and male subjects with child bearing potential who avoid to use secure anti-conceptive measurements
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint based on molecular response will be assessed at the end of the azacitidine treatment. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• Toxicities • Event-free-survival • Disease free survival • Overall-survival • Quality of life
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 35 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Austria |
Belgium |
Czech Republic |
Denmark |
European Union |
Finland |
France |
Germany |
Italy |
Netherlands |
Norway |
Poland |
Slovakia |
Sweden |
Switzerland |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS + 28 days safety follow up |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |