Intervention: Tipifarnib
Trial phase: Phase 3
SMILES: Cn1cncc1[C@@](N)(c1ccc(Cl)cc1)c1ccc2c(c1)c(-c1cccc(Cl)c1)cc(=O)n2C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 72
Group description: Patients receive tipifarnib PO BID on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Eligibility criteria:
Inclusion Criteria:

Patients eligible to enter this study must fall into one of these categories:

Patients in first remission following primary induction failure
Patients must have received at least two chemotherapy induction regimens
Patients in second or subsequent remission
Patients > 60 years old in first remission

Patients must be in complete remission (CR) or morphologic remission (MR) by blood counts and bone marrow studies to enter the study

Confirmatory bone marrow must be performed =< 2 weeks prior to randomization

Patients must have morphologic proof (from bone marrow aspirate, smears or touch preps of marrow biopsy) that they had AML of one of the following types prior to achievement of CR/MR

Acute myeloblastic leukemia, minimal differentiation (French-American-British [FAB] M0)
Acute myeloblastic leukemia without differentiation (FAB M1)
Acute myeloblastic leukemia with maturation (FAB M2)
Acute myelomonocytic leukemia (FAB M4)
Acute monocytic leukemia (FAB M5)
Acute erythroleukemia (FAB M6)
Acute megakaryocytic leukemia (FAB M7)
Refractory anemia with excess blasts in transformation (RAEB-T)
AML by World Health Organization (WHO) criteria
Acute myeloid leukemia with multilineage dysplasia
Patients with acute promyelocytic leukemia (FAB M3) are not eligible

Patients must be registered within 60 days of completion of therapy for the current remission; patients are eligible if they meet any of the criteria below:

Within 60 days of remission (CR or MR) by peripheral blood counts following induction therapy or
Within 60 days of discharge from the hospital following induction therapy or
Within 60 days of discharge from the hospital following post-remission therapy or
Within 60 days of recovery of blood counts following last dose of chemotherapy

All of the patients below are eligible for study entry:

Patients who have received consolidation therapy
Patients who have not received any consolidation or post remission therapy
Patients who have had an autologous stem cell transplant
Patients who have received an allogeneic transplant (bone marrow transplant [BMT] or peripheral stem cell transplant [PSCT]) in their current remission are ineligible; patients who have had an allogeneic transplant in a previous remission and are currently in remission after subsequent relapse are eligible
Patients with a history of extramedullary disease are eligible if they are in complete remission at the time of study entry and no longer requiring therapy for their extramedullary disease
Patients must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study < 2 weeks prior to randomization to rule out pregnancy
Women of childbearing potential and sexually active males are strongly advised to use an accepted and effective method of contraception
Patients must not be known to have an allergy to imidazole drugs, such as clotrimazole ketoconazole, miconazole, econazole, or terconazole; this does not include fluconazole, voriconazole, or itraconazole
Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2
Patients must not have active cardiac or pulmonary disease; but patient will be eligible if disease is medically controlled
Patients must not have active renal disease; creatinine must be =< 1.5 x upper limit of normal
Patients must not have active hepatic disease; total or direct bilirubin must be < 2 mg/dl
Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) must be =< 2.5 times the upper limit of normal
Absolute neutrophil count (ANC) >= 1000/mm^3
Platelet count >= 50,000/mm^3
Patients must not be taking a hepatic enzyme-inducing anti-convulsant; a patient will not be eligible for the study if the patient is currently taking one of these agents and cannot be switched to a non-hepatic enzyme-inducing anti-convulsant