Phase 3
N=3,154
Dexamethasone Compared With Prednisone During Induction Therapy and Methotrexate With or Without Leucovorin During Maintenance Therapy in Treating Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia
Acute Lymphoblastic Leukemia · Adult B Acute Lymphoblastic Leukemia · Childhood B Acute Lymphoblastic Leukemia
Bottom Line
View on ClinicalTrials.gov: NCT00075725 ↗Enrolled (actual)
3,154
Serious AEs
11.1%
Results posted
Aug 2015
Primary outcome: Primary: Comparison of the Increase in Cure Rate of High Risk ALL Without Causing More Serious Side Effects Between Interventions — 83.2; 81.6; 69.1; 91.2 percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Cyclophosphamide (Drug); Cytarabine (Drug); Daunorubicin Hydrochloride (Drug); Dexamethasone (Drug); Doxorubicin Hydrochloride (Drug); Leucovorin Calcium (Drug); Mercaptopurine (Drug); Methotrexate (Drug); Pegaspargase (Drug); Prednisone (Drug); Radiation Therapy (Radiation); Thioguanine (Drug); Vincristine Sulfate (Drug)
- Age
- Pediatric, Adult · 1+ yrs
- Sex
- All
- Sponsor
- Children's Oncology Group
- Primary completion
- Dec 2010
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Comparison of the Increase in Cure Rate of High Risk ALL Without Causing More Serious Side Effects Between Interventions |
83.2; 81.6; 69.1; 91.2; 82.1; 73.5 | — |
| SECONDARY Correlation of Minimal Residual Disease (MRD) Positive With Overall Survival (OS) |
79.2; 69.9; 65.6; 86.2; 93.8; 63.1 | — |
| SECONDARY Correlation of Minimal Residual Disease (MRD) Negative With Overall Survival (OS). |
95.4; 92.9; 87.4; 98.1; 93.3; 90.2 | — |
| SECONDARY Correlation of Early Marrow Response Status With MRD Positive. |
26; 12; 43; 14; 16; 95 | — |
| SECONDARY Correlation of Early Marrow Response Status With MRD Negative. |
182; 72; 198; 188; 195; 471 | — |
| SECONDARY Correlation of Minimal Residual Disease (MRD) Positive With Event Free Survival (EFS) |
66.5; 43.3; 35.4; 80; 34.7; 39 | — |
| SECONDARY Correlation of Minimal Residual Disease (MRD) Negative With Event Free Survival (EFS). |
86.4; 93.6; 80.5; 93.1; 86.5; 83.4 | — |
Summary
This randomized phase III trial is studying dexamethasone to see how well it works compared to prednisone during induction therapy. This trial is also studying methotrexate and leucovorin calcium to see how well they work compared to methotrexate alone during maintenance therapy in treating patients with newly diagnosed acute lymphoblastic leukemia (ALL). Drugs used in chemotherapy, such as dexamethasone, prednisone, methotrexate, and leucovorin calcium, work in different ways to stop cancer cells from dividing so they stop growing or die. Giving more than one drug may kill more cancer cells. It is not yet known which combination chemotherapy regimen is more effective in treating acute lymphoblastic leukemia.
Eligibility Criteria
Inclusion Criteria
- Must be eligible for and enrolled on classification study COG-AALL03B1
- Newly diagnosed B-precursor acute lymphoblastic leukemia
- WBC > 50, 000/mm^3 for patients age 1 to 9
- Any WBC for patients age 10 to 30 OR patients who have received prior steroid therapy OR patients with testicular disease
- Whit blood cell (WBC) criteria:
- Age 1 - 9 years: WBC >= 50,000/uL
- Age 10 - 30 years: any WBC
- Prior steroid therapy: any WBC
- Testicular disease: any WBC
- Patients shall have had no other prior cytotoxic chemotherapy with the exception of steroids and intrathecal cytarabine
- Patients receiving prior steroid therapy (as described in AALL03B1) are eligible for study; the dose and duration of previous steroid therapy should be carefully documented
- All patients and/or their parents or legal guardians must sign a written informed consent
- All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion Criteria
- Patients with Down syndrome are ineligible to enroll onto this study
Data sourced from ClinicalTrials.gov (NCT00075725). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.