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clofarabine

Phase 3

Acute Myelogenous Leukemia | Small molecule | Oncology |Sanofi|Last Updated: Apr 14, 2014

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindCONTROLLEDDMCBiomarker
Total Trials4
Total Enrollment496
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00317642A Study of Clofarabine and Cytarabine for Older Patients With Relapsed or Refractory Acute Myelogenous Leukemia (AML)(CLASSIC I)PHASE3 COMPLETED 326Aug 1, 2006Jan 1, 2012Apr 14, 201457 United States, Canada +3
NCT00373529A Study of Clofarabine for Older Patients With Newly Diagnosed Acute Myelogenous Leukemia (AML) (CLASSIC II)PHASE2 COMPLETED 116Oct 1, 2006May 1, 2010Apr 14, 201420 United States
NCT00044889Phase II Study of Clofarabine in Adult Patients With Refractory or Relapsed Acute Myelogenous LeukemiaPHASE2 COMPLETED 40May 1, 2002Mar 1, 2003Mar 19, 201412 United States
NCT01090167A Study of Clofarabine in Japanese Patients With Acute Myeloid Leukemia (AML)PHASE1 COMPLETED 14Feb 1, 2010Apr 1, 2011Mar 19, 20146 Japan
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Study Endpoints
Primary Endpoints
Overall Survival - Overall and by Calculated Strata (CSR 7-April-11)
Day 1 (randomization) up to approximately 4 years

Overall survival (OS) for the Full Analysis Set (FAS) and for the 2 calculated strata. OS was defined as the number of months from date of randomization until date of death due to any cause.

Overall Survival - Overall and by Randomized Strata (CSR 9-July-12)
Day 1 (randomization) up to approximately 4 years

Overall survival (OS) for the Full Analysis Set (FAS) and for the 2 randomized strata. OS was defined as the number of months from date of randomization until date of death due to any cause.

Percentage of Participants Achieving Overall Remission (OR) After No More Than Two Cycles (Approximately Month 2)
approximately Month 2

Best response was assessed by the Independent Response Review Panel(IRRP) after two cycles of treatment. Overall remission(OR) is the sum of complete remission(CR) and complete remission in the absence of platelet recovery(CRp). CR includes normal values for peripheral blood cell counts (absolute neutrophil and platelet) and leukemic blast cells from bone marrow biopsy or aspirate, and absence of extramedullary disease. Partial remission(PR) includes recovery of peripheral blood cells with improved but still abnormal values in leukemic blast cells.

Maximum Tolerated Dose (MTD) as determined by Dose Limiting Toxicities (DLTs)
28 days (1st cycle)
Safety as measured by number of patients with at least one adverse events (incidence)
50 days
Safety as measured by severity of adverse events
50 days
Safety as measured by duration of adverse events
50 days
Safety as measured by causality of adverse events
50 days
Safety as measured by seriousness of adverse events
50 days
Safety as measured by type of adverse event
50 days
Safety as measured by number of deaths
50 days
Safety as measured by number of serious adverse events
50 days
Safety as measured by number of patients who discontinue due to adverse events
50 days
Safety as measured by clinically significant changes in hematology
50 days
Safety as measured by clinically significant changes in chemistry parameters (i.e. serum chemistry)
50 days
Pharmacokinetic (PK) parameters (Cmax, Tmax, AUC)
6 days
Secondary Endpoints
Best Response Per Independent Response Review Panel (IRRP) Assessment - Overall and by Calculated Strata (CSR 7-April-11)
Day 12 up to approximately 6 months
Duration of Remission (DOR) Per IRRP Assessment-Overall and by Calculated Strata (CSR 7-April-11)
Day 12 to approximately 4 years
Duration of Remission (DOR) Per IRRP Assessment-Overall and by Randomized Strata (CSR 9-July-12)
Day 12 to approximately 4 years
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
clofarabine (IV formulation) and cytarabineEXPERIMENTALParticipants received clofarabine (40 mg/m\^2) administered as a 1-hour infusion followed 3 hours later (from end of infusion) by cytarabine 1 g/m\^2 administered as a 2-hour infusion. Participants could receive up to 3 cycles of treatment (induction, re-induction, and consolidation) Complete induction cycle = 5 consecutive days of treatment Re-induction cycle = 5 consecutive days of treatment at the original or modified dose Consolidation cycle = 4 consecutive days of treatment at the original or modified dose
placebo and cytarabineEXPERIMENTALParticipants received placebo administered as a 1-hour infusion followed 3 hours later (from end of infusion) by cytarabine 1 g/m\^2 administered as a 2-hour infusion. Patients could receive up to 3 cycles of treatment (induction, re-induction, and consolidation)
ClofarabineEXPERIMENTALParticipants received an induction cycle of clofarabine 30 mg/m\^2/day intravenous infusion for 5 consecutive days. Participants could then receive up to 5 additional cycles, repeated minimally every 28 days, of clofarabine 20 mg/m\^2/day intravenous infusion for 5 consecutive days.
Interventions
NameTypeDescription
clofarabine (IV formulation)DRUGclofarabine (IV formulation) infusion 40mg/m\^2 / day up to 3 cycles
placeboDRUGplacebo (sodium Chloride) 1-hour IV infusion
cytarabineDRUGcytarabine IV infusion 1g/m\^2/day for up to 3 cycles
clofarabineDRUGInduction cycle 1: cycle 1 of clofarabine 30 mg/m\^2/day as a 1-hour intravenous infusion for 5 consecutive days. Reinduction (cycle 2) and/or Consolidation cycles (cycles 2-6): cycles repeated minimally every 28 days, of clofarabine 20 mg/m\^2/day as a 1-hour intravenous infusion for 5 consecutive days.
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Eligibility Criteria
Age Range55 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites57

Inclusion Criteria: * Have a diagnosis of Acute Myelogenous Leukemia (AML) according to World Health Organization (WHO) classification * Relapsed after receiving up to 2 prior induction regimens (i.e. first or second relapse)or are refractory to not more than one prior combination chemotherapy indu...

Countries:United StatesCanadaFranceGermanyItalyJapan
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