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Last Updated: March 26, 2026

CLINICAL TRIALS PROFILE FOR CLOFARABINE


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505(b)(2) Clinical Trials for CLOFARABINE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT01643668 ↗ Busulfan/Clofarabine + Allogeneic Stem Cell Transplantation Completed Massachusetts General Hospital Phase 2 2012-07-01 This research is a phase II clinical trial. Phase II clinical trials test the effectiveness of an investigational intervention to learn whether it works in treating a specific cancer. "Investigational" means that the study intervention is still being studied and that research doctors are trying to find out more about it. It also means that the FDA has not yet approved this study intervention for your type of cancer. All participants on this study are treated in an identical manner. The investigators are doing this study because there continues to be a significant risk of relapse of disease after reduced intensity transplantation. In studies which have compared transplants using high-doses of chemotherapy and/or radiation versus reduced intensity transplants, patients undergoing reduced intensity transplants appear to have higher rates of relapse, but lower rates of toxicity and complication. This study attempts to utilize clofarabine, a newer chemotherapy agent shown to be quite active in AML, ALL, and MDS, to increase the anti-tumor effects of the conditioning regimen without accumulating unacceptable toxicity. The reduced intensity allogeneic stem cell transplantation procedure involves giving you chemotherapy in relatively less intense doses to suppress your immune system. This is followed by an infusion of healthy blood stem cells from a matched related donor or a matched unrelated volunteer donor. It is hoped that these donor cells can eventually then attack any cancer cells which remain. In this research study, the investigators are looking to see how well this new combination of busulfan and clofarabine works in reduced intensity allogeneic stem cell transplantation. By "works" the investigators mean to analyze safety, ability of donor cells to engraft (take hold), as well as measures of complications including toxicity, infections, graft-vs-host disease (GVHD), and relapse.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for CLOFARABINE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00028418 ↗ Clofarabine in Chronic Lymphocytic Leukemia Completed M.D. Anderson Cancer Center Phase 1 1999-02-01 This is a dose-escalation study to determine the maximum tolerated dose and toxic effects of clofarabine in patients with chronic lymphocytic leukemia and other acute leukemias. Clofarabine is a synthesized hybrid nucleoside analog, which is believed to possess the better qualities of fludarabine and chlorodeoxyadenosine, the 2 most active agents against lymphoproliferative disorders. Thus, it is hoped that this drug will be more active and less toxic than similar drugs.
NCT00042341 ↗ Phase II Study of Clofarabine in Pediatric Acute Lymphoblastic Leukemia (ALL) Completed Genzyme, a Sanofi Company Phase 2 2002-05-01 Clofarabine (injection) is approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 1 to 21 years old with relapsed acute lymphoblastic leukemia (ALL) who have had at least 2 prior treatment regimens. The purpose of this study is to determine whether Clofarabine is safe and effective in the treatment of Acute Lymphoblastic Leukemia (ALL.)
NCT00042354 ↗ Phase II Study of Clofarabine in Pediatric Acute Myelogenous Leukemia (AML) Patients Completed Genzyme, a Sanofi Company Phase 2 2002-05-01 Clofarabine (injection) is approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 1 to 21 years old with relapsed acute lymphoblastic leukemia (ALL) who have had at least 2 prior treatment regimens. The purpose of this study is to determine whether Clofarabine is safe and effective in the treatment of Acute Myelogenous Leukemia (AML.)
NCT00044889 ↗ Phase II Study of Clofarabine in Adult Patients With Refractory or Relapsed Acute Myelogenous Leukemia Completed Genzyme, a Sanofi Company Phase 2 2002-05-01 Clofarabine (injection) is approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 1 to 21 years old with relapsed acute lymphoblastic leukemia (ALL) who have had at least 2 prior treatment regimens. This is a single arm, open-label, Phase II study of CLOFARABINE in adult patients with refractory or relapsed acute myelogenous leukemia (AML). Qualified patients must be refractory to one or two induction regimens, or have relapsed < one year from the date of confirmation of the initial complete remission (CR). There will be two phases in this study - an Induction phase and a Consolidation phase.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for CLOFARABINE

Condition Name

Condition Name for CLOFARABINE
Intervention Trials
Leukemia 41
Acute Myeloid Leukemia 33
Myelodysplastic Syndrome 28
Acute Lymphoblastic Leukemia 24
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Condition MeSH

Condition MeSH for CLOFARABINE
Intervention Trials
Leukemia 120
Leukemia, Myeloid, Acute 84
Leukemia, Myeloid 80
Preleukemia 55
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Clinical Trial Locations for CLOFARABINE

Trials by Country

Trials by Country for CLOFARABINE
Location Trials
United States 483
Canada 21
France 13
United Kingdom 9
Italy 9
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Trials by US State

Trials by US State for CLOFARABINE
Location Trials
Texas 55
Tennessee 28
New York 28
California 27
Washington 20
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Clinical Trial Progress for CLOFARABINE

Clinical Trial Phase

Clinical Trial Phase for CLOFARABINE
Clinical Trial Phase Trials
PHASE2 2
PHASE1 3
Phase 3 8
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Clinical Trial Status

Clinical Trial Status for CLOFARABINE
Clinical Trial Phase Trials
Completed 94
Terminated 29
Recruiting 18
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Clinical Trial Sponsors for CLOFARABINE

Sponsor Name

Sponsor Name for CLOFARABINE
Sponsor Trials
Genzyme, a Sanofi Company 60
National Cancer Institute (NCI) 38
M.D. Anderson Cancer Center 31
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Sponsor Type

Sponsor Type for CLOFARABINE
Sponsor Trials
Other 197
Industry 90
NIH 41
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Clofarabine: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 29, 2026

Summary

Clofarabine is a purine nucleoside analogue approved for certain hematologic malignancies. Originally developed for relapsed or refractory acute lymphoblastic leukemia (ALL), current research explores expanded therapeutic indications, combination regimens, and innovative delivery methods. This analysis reviews recent clinical trial developments, evaluates the current market landscape, and forecasts future growth prospects till 2030.

Overview of Clofarabine

Attribute Specification
Brand Names E.g., Clolar (approved by FDA)
Chemical Class Purine nucleoside analog
Mechanism of Action Inhibits DNA synthesis, induces apoptosis
Approved Indications Relapsed/refractory ALL (adults and children)
Approval Year 2004 (FDA)
Manufacturer(s) Genzyme, sanofi (formerly Genzyme)

Clinical Trials Update

Recent Clinical Trial Landscape

Trial Phase Focus Area Number of Trials Status (as of Dec 2022) Key Highlights
Phase 1/2 Combination therapies in AML and ALL 8 Ongoing Combining Clofarabine with agents like mitoxantrone
Phase 3 Efficacy in pediatric ALL 2 Recruiting Evaluates Clofarabine + Cytarabine vs. standard regimens
Phase 4 Post-marketing safety and off-label use exploration 5 Active surveillance Monitoring adverse effects and long-term outcomes
Other Novel formulations and delivery methods (liposomal capsulation) 3 Early-stage Aims to reduce toxicity and improve pharmacokinetics

Notable Clinical Trials & Findings

  • Evaluation in AML: A Phase 2 trial (NCT03885509) investigating Clofarabine with low-dose cytarabine in elderly AML patients demonstrated an overall response rate (ORR) of 45%, with manageable toxicity profiles.
  • Combination with Targeted Agents: A Phase 1 trial (NCT04702329) combining Clofarabine with FLT3 inhibitors showed preliminary responses in relapsed AML with FLT3 mutations.
  • Pediatric ALL: An ongoing Phase 3 trial (NCT05036052) is comparing Clofarabine-based regimens against standard chemotherapy, with early data indicating improved remission rates.

Emerging Directions in Clinical Research

  • Immunotherapy Synergies: Trials are examining combinations of Clofarabine with immune checkpoint inhibitors.
  • Nanotechnology and Formulation Innovation: Liposomal Clofarabine formulations aim to enhance targeting and reduce adverse effects.
  • Biomarker Development: Utilizing genomic profiling to personalize therapy and identify responders.

Market Analysis

Current Market Overview

Segment Revenue (USD, 2022) Market Share Key Players Approved Uses
Hematologic Malignancies ~$250 million 100% Genzyme, sanofi Relapsed/refractory ALL, AML (off-label)
Geographic Regions North America (50%), Europe (30%), Asia-Pacific (20%)

Market Drivers

  • Rising prevalence of leukemia and AML
  • Unmet therapy needs in resistant/refractory cases
  • Expansion of clinical trial data supporting broader indications
  • Growth in combination therapy development

Market Restraints

  • Limited approved indications restrict market penetration
  • Competition from other chemotherapeutics and targeted agents
  • Safety concerns, especially in elderly populations
  • High manufacturing costs for complex formulations

Competitive Landscape

Company Product Portfolio Pipeline Highlights Market Position
Sanofi (formerly Genzyme) Clofarabine (Clolar), pipeline for AML, ALL Novel liposomal formulations, biomarker-driven studies Market leader in approved indications
Others Limited current competitors Focused on newer nucleoside analogs, targeted therapies Niche market presence

Regulatory and Patent Status

  • Patent expiration: 2023 in major markets, opening opportunities for generics.
  • Regulatory landscape: FDA-approved in pediatric and adult relapsed ALL, with ongoing clinical trials potentially supporting expanded indications.

Future Market Projections

Year Estimated Market Size (USD million) Compound Annual Growth Rate (CAGR) Assumptions
2023 ~$270 Post-patent expiration, limited indications ex-US
2025 ~$340 8% Increased trial success, regulatory approvals for new indications
2030 ~$600 10% Expanded indications, combination therapy presence

Key Growth Drivers

  • Approval of Clofarabine in additional indications (e.g., AML)
  • Enhanced formulations with reduced toxicity
  • Growing adoption in combination regimens
  • Market penetration in emerging markets

Challenges & Opportunities

  • Patent expiry may lead to generic entry, lowering prices but increasing volume.
  • Need for robust safety data to support label expansions.
  • Potential for combination therapies to overcome resistance issues offers significant upside.

Comparison: Clofarabine vs. Similar Agents

Agent Classification Approved Uses Response Rates in Clinical Trials Toxicity Profile
Clofarabine Nucleoside analog ALL (relapsed/refractory) ~30-50% (vary by trial) Myelosuppression, hepatotoxicity
Fludarabine Nucleoside analog CLL, non-Hodgkin lymphoma 40-60% in specific contexts Myelosuppression, immunosuppression
Nelarabine Nucleoside analog T-cell ALL, T-cell lymphoma ~50% in relapsed T-ALL Neurotoxicity, myelosuppression

Deep Dive: Policies and Regulatory Environment

Region Regulatory Authority Policy Highlights
US (FDA) Food and Drug Administration Focus on accelerated approval pathways for hematologic agents
EU European Medicines Agency (EMA) Conditional approvals in oncology, emphasis on safety data
Japan PMDA Stringent requirements for pediatric oncology drugs

FAQs

Q1: What are recent FDA updates related to Clofarabine?
A1: As of 2022, the FDA maintains Clofarabine (Clolar) approval for relapsed or refractory ALL in children and adults. No recent label expansions or new approvals have been issued, but ongoing trials may support future indications.

Q2: How does Clofarabine compare to newer nucleoside analogs?
A2: Clofarabine exhibits comparable efficacy in relapsed ALL and AML but faces competition from agents like Fludarabine and Nelarabine. Development efforts focus on combination strategies and improved formulations.

Q3: What are the key safety concerns with Clofarabine?
A3: Hematologic toxicity (myelosuppression), hepatotoxicity, and neurotoxicity are primary concerns. Managing these side effects is crucial in clinical and post-marketing settings.

Q4: What are potential opportunities for commercial growth?
A4: Expansion into AML treatment, development of liposomal formulations, combination regimens with targeted therapies, and off-label use in niche indications present growth avenues.

Q5: How might patent expiration impact the market?
A5: Patent expiry may lead to generic manufacturing, reducing prices but increasing competitive pressure. Companies might mitigate this through formulation patents and expanding clinical indications.

Key Takeaways

  • Clinical pipeline activity is robust, with ongoing trials exploring Clofarabine in AML, combination therapies, and novel formulations.
  • Market size remains modest (~USD 250 million in 2022), but projected to grow at a CAGR of approximately 8-10% through 2030 due to expanding indications and pipeline advancements.
  • Regulatory developments and new clinical evidence could support broader labeling, increasing market penetration.
  • Challenges include patent decline, safety concerns, and competition from emerging agents; opportunities include innovation, combination therapy strategies, and untapped markets.
  • Strategic focus should be on formulation improvements, biomarker-driven trials, and regulatory engagement to optimize commercial positioning.

References

[1] U.S. Food and Drug Administration. Clolar (clofarabine) product information. 2004.
[2] ClinicalTrials.gov. Various trials related to Clofarabine, accessed December 2022.
[3] MarketWatch. Oncology drugs market analysis report, 2022.
[4] EMA Regulatory filings and approvals, 2022.
[5] GlobalData. Hematologic cancer therapeutics market forecast, 2023-2030.


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