CLL-Irl Study. CTRIAL-IE (ICORG) 07-01, V7
An Open-label Phase II Study of the Efficacy and Safety of the Combination of Fludarabine, Cyclophosphamide and Rituximab in Patients With Chronic Lymphocytic Leukaemia Who Are Newly Diagnosed, Have Relapsed or Are Resistant to First-Line Treatment
RATIONALE: Drugs used in chemotherapy, such as fludarabine and cyclophosphamide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Giving fludarabine together with cyclophosphamide and rituximab may kill more cancer cells.
PURPOSE: This phase II trial is studying giving fludarabine together with cyclophosphamide and rituximab to see how well it works in treating patients with chronic lymphocytic leukemia.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
- Drug: cyclophosphamide
- Genetic: gene expression analysis
- Genetic: protein expression analysis
- Other: laboratory biomarker analysis
- Genetic: mutation analysis
- Drug: fludarabine phosphate
- Biological: rituximab
- Other: flow cytometry
- Genetic: cytogenetic analysis
- Biological: pegfilgrastim
- Genetic: fluorescence in situ hybridization
Detailed Description
OBJECTIVES:
Primary
- Evaluate the efficacy, in terms of complete remission rate, of fludarabine phosphate, cyclophosphamide, and rituximab in patients with chronic lymphocytic leukemia.
Secondary
- Determine the time to treatment failure (TTF) in these patients.
- Determine the overall survival of these patients until 10th January 2019.
- Assess the predictive value of immunophenotype, hypermutation analysis, and FISH in determining TTF and OS in these patients.
- Determine the safety profile of this regimen.
OUTLINE: This is a multicenter study.
Patients receive fludarabine IV over 30 minutes or orally and cyclophosphamide IV or orally on days 1-3 and pegfilgrastim subcutaneously on day 4. Starting on course 2, patients receive rituximab IV on day 1. Treatment repeats every 28 days for up to 6* courses in the absence of disease progression or unacceptable toxicity.
NOTE: *Patients achieving negative minimal residual disease receive 4 courses of treatment.
Blood samples are collected periodically for biomarker analysis. Samples are analyzed for protein expression (i.e., CD38, CD20, and ZAP70) by flow cytometry; quantitative immunoglobulins, β2-microglobulin, and T-cell subsets by electrophoresis; IgVH mutation status; and cytogenetics (i.e., +12, del 13q, del 11q, and del 17p) by FISH.
After completion of study therapy, patients are followed every 6 months for 5 years and then annually until 10th January 2019.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Dublin, Ireland, 8
- St. James's Hospital
-
Galway, Ireland
- University College Hospital
-
Limerick, Ireland, 0009
- University Hospital Limerick
-
Tullamore, Ireland
- Midland Regional Hospital at Tullamore
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Waterford, Ireland
- Waterford Regional Hospital
-
-
Leinster
-
Dublin, Leinster, Ireland
- Tallaght University Hospital
-
-
Munster
-
Cork, Munster, Ireland
- Cork University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
DISEASE CHARACTERISTICS:
Diagnosis of chronic lymphocytic leukemia
- Stage I-IV disease (Binet stage progressive A, B, C)
- CD5 and CD23 positive
- Untreated OR relapsed/resistant disease after combination chemotherapy or rituximab
- No 17p deletion
PATIENT CHARACTERISTICS:
- WHO performance status 0-2
- Life expectancy > 1 year
- Creatinine clearance ≥ 50 mL/min
- HIV negative
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No other concurrent malignancy except for noninvasive cervical cancer or localized nonmelanomatous skin cancer
- No history of anaphylaxis to mouse-derived humanized monoclonal antibody
- No other severe concurrent (e.g., cardiac or pulmonary) diseases or mental disorders that could interfere with ability to participate in the study
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
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: Fludarabine, Cylophosphamide and Rituximab
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Complete remission rate by NCI response criteria and minimal residual disease (MRD) analysis
Time Frame: A formal assessment of response by NCI Criteria (Appendix 3) with the addition of assessment of minimal residual disease in the marrow and if relevant assessment of bulky disease by CT scanning will be made after 4 +/-6 courses of therapy.
|
A formal assessment of response by NCI Criteria (Appendix 3) with the addition of assessment of minimal residual disease in the marrow and if relevant assessment of bulky disease by CT scanning will be made after 4 +/-6 courses of therapy.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to treatment failure (TFF)
Time Frame: A clinical assessment of response will be made after 4 courses of therapy, Patients with evidence of progressive disease will stop therapy and will be deemed to have failed treatment.
|
A clinical assessment of response will be made after 4 courses of therapy, Patients with evidence of progressive disease will stop therapy and will be deemed to have failed treatment.
|
|
|
Overall survival
Time Frame: Until 10th January 2019
|
Until 10th January 2019
|
|
|
Predictive value of immunophenotype, FISH, and hypermutation analysis in determining TTF and OS
Time Frame: See description
|
Timing and type of response assessment During chemotherapy. A clinical assessment of response will be made after 4 courses of therapy. Patients with evidence of progressive disease will stop therapy and will be deemed to have failed treatment. A formal assessment of response by NCI Criteria (Appendix 3) with the addition of assessment of minimal residual disease in the marrow and if relevant assessment of bulky disease by CT scanning will be made after 4 +/-6 courses of therapy. Following chemotherapy. Disease assessment after the end of therapy will involve a history(recording B-symptoms), complete physical examination, full blood count and blood MRD analysis every 6 months for 5 years and then annually until 10th of January 2019 or until disease progression. |
See description
|
|
Acute and chronic toxicity as assessed by NCI criteria
Time Frame: A formal assessment of response by NCI Criteria (Appendix 3) with the addition of assessment of minimal residual disease in the marrow and if relevant assessment of bulky disease by CT scanning will be made after 4 +/-6 courses of therapy.
|
A formal assessment of response by NCI Criteria (Appendix 3) with the addition of assessment of minimal residual disease in the marrow and if relevant assessment of bulky disease by CT scanning will be made after 4 +/-6 courses of therapy.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Elisabeth Vandenberghe, MD, St. James's Hospital, Ireland
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
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 (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Chronic Disease
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Hematologic Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Leukemia, B-Cell
- Leukemia, Lymphoid
- Leukemia
- Leukemia, Lymphocytic, Chronic, B-Cell
- Antineoplastic Agents, Immunological
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Rituximab
- Cyclophosphamide
- Fludarabine
- Fludarabine phosphate
Other Study ID Numbers
Other Study ID Numbers
- CTRIAL-IE (ICORG) 07-01
- 2008-001250-40
- EU-20898
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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