A Pilot Trial With Subcutaneous Alemtuzumab and Oral Fludarabinephosphate for the Determination of Safety, Efficacy and Molecular Profiling for the Prediction of Response
Subcutaneous MabCampath® (Alemtuzumab) and Oral Fludara® (Fludarabinephosphate) for the Treatment of Refractory or Relapsed Chronic Lymphocytic Leukemia in 2nd or 3rd Line of Treatment: A Pilot Trial (FLUSALEM) for the Determination of Safety, Efficacy and Molecular Profiling for the Prediction of Response
Open label multicenter, two-step, non-randomized (pilot) study to analyze the safety of 4 cycles of 3-day 40mg/m2 oral fludarabine with simultaneous thrice weekly application of 30mg alemtuzumab s.c. in patients with B-CLL disease in 1st and 2nd relapse after any primary treatment or with disease refractory to any therapy in 1st or 2nd line (including Fludarabine, ). This regimen is preceded by an escalation phase with 3-10-30 mg of alemtuzumab s.c.
After the first phase (completed treatment of 7 patients) an interim analysis of safety and efficacy will be performed. In case of a sufficient risk benefit assessment followed by the enrollment of further 21 patients. Final analysis of safety and preliminary efficacy will be based on all patients enrolled.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Feldkirch, Austria, A-6806
- Landeskrankenhaus Feldkirch
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Fürstenfeld, Austria, A-8280
- A.ö. Landeskrankenhaus Fürstenfeld
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Innsbruck, Austria, A-6020
- Universitätsklinik Innsbruck/ Klinik für Innere Medizin
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Leoben, Austria, A-8700
- A.ö. Landeskrankenhaus Leoben
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Linz, Austria, A-4020
- Krankenhaus der Stadt Linz
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Salzburg, Austria, A-5020
- St. Johanns LK
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St. Poelten, Austria, A-3100
- A.ö. Krankenhaus der Landeshauptstadt St. Pölten
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Wels, Austria, A-4600
- Klinikum Kreuzschwestern Wels GmbH
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male or female patients with CD23+, CD5+, CD19+, light chain monoclonal B CLL
- 1st or 2nd relapse after fludarabine or any other primary treatment regimen or refractory to primary or secondary treatment (including fludarabine) and simultaneously indication for treatment according to the NCI Workshop Criteria 1996
- Age 19-75
- WHO performance score 0-2
- Informed consent given by the patient
Exclusion Criteria:
- HIV positive or positive for Hepatitis B or C
- active uncontrolled infection
- child bearing age without adequate control of fertility, pregnant or lactating women
- intolerance towards any ingredient of either oral fludarabine or alemtuzumab
- allergy against foreign proteins
- previous treatment with alemtuzumab
- treatment with an experimental drug within the previous 2 months
- second malignant disease (non CLL)
- CLL in transformation (Richter syndrome)
- decreased kidney-function with creatinine-clearance < 30ml/min
- severe concomitant diseases or major organ dysfunctions
- patients who are unable to comply with the requirements of the protocol
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Overall study
The FLUSALEM protocol combines 4 cycles of oral fludarabine phosphate (40mg/m² d1-3; q 29d) and an intensive dose schedule of alemtuzumab (30mg sc.3 times weekly for 16 weeks) in an outpatient setting
|
orally, 40 mg/m2 d1-3 q4w, x4 cycles
Other Names:
subcutaneous, starting dose 3 mg and escalation to 10 mg, then 30 mg, followed by 30 mg thrice weekly for 16 weeks in escalated dose
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Safety and tolerability
Time Frame: within the duration of study
|
within the duration of study
|
|
Complete and overall response rate
Time Frame: within the duration of study
|
within the duration of study
|
|
Infections grade III, IV
Time Frame: within the duration of study
|
within the duration of study
|
|
Rate of CMV reactivation
Time Frame: within the duration of study
|
within the duration of study
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Time to retreatment
Time Frame: within duration of trial
|
within duration of trial
|
|
Overall survival
Time Frame: within duration of trial
|
within duration of trial
|
|
Response in lymphatic compartments
Time Frame: within duration of trial
|
within duration of trial
|
|
Molecular response/ immunologic MRD response
Time Frame: within duration of trial
|
within duration of trial
|
|
Quality of Life
Time Frame: within duration of trial
|
within duration of trial
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Richard Greil, MD, IIIrd Medical Department for Hematology, Oncology, Rheumatology, Infectiology and Hemostasiology at the Medical University of Salzburg
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Leukemia, B-Cell
- Leukemia
- Leukemia, Lymphocytic, Chronic, B-Cell
- Leukemia, Lymphoid
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Fludarabine
- Fludarabine phosphate
- Alemtuzumab
Other Study ID Numbers
Other Study ID Numbers
- FLUSALEM
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