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Phase I/II Multicenter Study of Arsenic Trioxide in Patients with Myelodysplastic Syndromes Protocole CTI 1061 Analyse Mars 2004. Rouen, Juin 2004. Dose regimen. Week 3. Week 2. Week 16+. Week 1. Week 4. ATO 0.30 mg/kg x 5 days and 0.25 mg/kg twice a week for at least 15 weeks.
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Phase I/II Multicenter Study of Arsenic Trioxide in Patients with Myelodysplastic SyndromesProtocole CTI 1061Analyse Mars 2004 Rouen, Juin 2004
Dose regimen Week 3 Week 2 Week 16+ Week 1 Week 4 ATO 0.30 mg/kg x 5 days and 0.25 mg/kg twice a week for at least 15 weeks
Phase I/II Multicenter Study of Arsenic Trioxide in Patients with Myelodysplastic Syndromes Primary Objective - lower-risk MDS: % of patients who will achieve major hematologic improvement - higher-risk MDS: % of patients who will achieve complete (CR) or partial remission (PR) • Secondary Objective • Durability of any responses observed • Duration of overall and progression-free survival • Quality of life (QOL) during therapy • Toxicity profile of ATO in this patient population • Pharmacokinetic profile of ATO with this dosing schedule
Eligibility criteria • Confirmed diagnosis of MDS by standard FAB criteria: RA, RARS, RAEB, RAEB-t, or CMML • Age 18 years; life expectancy 3 months • Serum creatinine 1.5 x ULN; bilirubin, SGPT and SGOT 2.5 x ULN • QTc interval <460 msec with serum K+ >4.0 mEq/L and Mg2+ >1.8 mg/dL • No growth factors or treatment with cytotoxic or experimental agents within 30 days before study dosing
Response by IPSS Risk Category IPSS Risk Category Lineage (baseline High Risk Patients (n = Low Risk Patients (n = 39) 62) values) Minor Major Minor Major response response response response Erythroid lineage 7 (includin g 3 4 2 response (Hgb 1 CR) <11g/dL) Platelet lineage 1 1 1 6 response 9 (<100x10 /L) Neutrophil lineage 0 0 0 7 response 9 (<1.5x10 /L) Lineage responses (some pts had 4 5 3 20 responses in more than one lineage) All: 9/39 (23%) Al l: 18/62 (29%) Total PATIENTS with response Major: 5/39 (13%) Major: 16/62 (26%) All: 27/101 (27%) Total response rate Major: 21/101 (21%) ³ *Responses by modified IWG criteria: response must be maintained 56 days. Efficacy assessment
Conclusions • Étude arrêtée avec objectif de recrutement atteint (n=110) • Taux de réponse global: 27% • 21% de réponses majeures, • 50% des répondeurs obtiennent indépendance transfusionnelle • Taux de réponse > quand excès de blastes • Études d’arsenic en combinaison sont à faire