- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00004857
Fludarabine Followed by Alemtuzumab in Treating Patients With Chronic Lymphocytic Leukemia
A Phase II Study of Fludarabine Induction Followed by CAMPATH-1H Consolidation in Untreated Patients With B-Cell Chronic Lymphocytic Leukemia
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies such as alemtuzumab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells.
PURPOSE: Phase II trial to study the effectiveness of fludarabine followed by alemtuzumab in treating patients who have chronic lymphocytic leukemia.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
OBJECTIVES: I. Determine the overall response rate of previously untreated patients with stage I, II, III, or IV B-cell chronic lymphocytic leukemia when treated with fludarabine induction followed by alemtuzumab consolidation. II. Determine the infectious toxic effects and feasibility of this regimen in this patient population. III. Determine the treatment-related toxic effects, including infection and injection site reactions, of subcutaneous vs intravenous alemtuzumab in patients treated with this regimen. IV. Determine the progression-free and overall survival of patients treated with this regimen. V. Determine the immunologic effects of this regimen in these patients.
OUTLINE: Patients receive fludarabine IV over 30 minutes 5 days a week. Treatment repeats every 28 days for 4 courses in the absence of disease progression. Patients undergo clinical staging after completion of course 4 of fludarabine followed by 2 months of observation. Patients with stable or responding disease receive alemtuzumab subcutaneously 3 days a week for 6 weeks. Patients undergo clinical staging again after completion of 6 weeks of alemtuzumab followed by 2 more months of observation. Patients are followed every 3 months for 1 year and then every 6 months for 8 years.
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
-
-
Alabama
-
Birmingham, Alabama, Spojené státy, 35233-1996
- Veterans Affairs Medical Center - Birmingham
-
-
California
-
La Jolla, California, Spojené státy, 92093-0658
- University of California San Diego Cancer Center
-
San Francisco, California, Spojené státy, 94121
- Veterans Affairs Medical Center - San Francisco
-
San Francisco, California, Spojené státy, 94143-0128
- UCSF Cancer Center and Cancer Research Institute
-
-
Delaware
-
Wilmington, Delaware, Spojené státy, 19899
- CCOP - Christiana Care Health Services
-
-
District of Columbia
-
Washington, District of Columbia, Spojené státy, 20307-5000
- Walter Reed Army Medical Center
-
Washington, District of Columbia, Spojené státy, 20007
- Lombardi Cancer Center
-
-
Florida
-
Miami Beach, Florida, Spojené státy, 33140
- CCOP - Mount Sinai Medical Center
-
-
Illinois
-
Chicago, Illinois, Spojené státy, 60612
- Veterans Affairs Medical Center - Chicago (Westside Hospital)
-
Chicago, Illinois, Spojené státy, 60637-1470
- University of Chicago Cancer Research Center
-
Chicago, Illinois, Spojené státy, 60612
- University of Illinois at Chicago Health Sciences Center
-
-
Iowa
-
Iowa City, Iowa, Spojené státy, 52242-1009
- Holden Comprehensive Cancer Center at the University of Iowa
-
-
Maine
-
Togus, Maine, Spojené státy, 04330
- Veterans Affairs Medical Center - Togus
-
-
Maryland
-
Baltimore, Maryland, Spojené státy, 21201
- Marlene & Stewart Greenebaum Cancer Center, University of Maryland
-
-
Massachusetts
-
Boston, Massachusetts, Spojené státy, 02115
- Dana-Farber Cancer Institute
-
Worcester, Massachusetts, Spojené státy, 01655
- University of Massachusetts Memorial Medical Center
-
-
Minnesota
-
Minneapolis, Minnesota, Spojené státy, 55417
- Veterans Affairs Medical Center - Minneapolis
-
Minneapolis, Minnesota, Spojené státy, 55455
- University of Minnesota Cancer Center
-
-
Missouri
-
Columbia, Missouri, Spojené státy, 65201
- Veterans Affairs Medical Center - Columbia (Truman Memorial)
-
Columbia, Missouri, Spojené státy, 65203
- Ellis Fischel Cancer Center - Columbia
-
Saint Louis, Missouri, Spojené státy, 63110
- Barnes-Jewish Hospital
-
-
Nebraska
-
Omaha, Nebraska, Spojené státy, 68198-3330
- University of Nebraska Medical Center
-
-
Nevada
-
Las Vegas, Nevada, Spojené státy, 89106
- CCOP - Southern Nevada Cancer Research Foundation
-
-
New Hampshire
-
Lebanon, New Hampshire, Spojené státy, 03756-0002
- Norris Cotton Cancer Center
-
-
New York
-
Buffalo, New York, Spojené státy, 14263-0001
- Roswell Park Cancer Institute
-
Buffalo, New York, Spojené státy, 14215
- Veterans Affairs Medical Center - Buffalo
-
Manhasset, New York, Spojené státy, 11030
- CCOP - North Shore University Hospital
-
Manhasset, New York, Spojené státy, 11030
- North Shore University Hospital
-
New Hyde Park, New York, Spojené státy, 11040
- Long Island Jewish Medical Center
-
New York, New York, Spojené státy, 10021
- Memorial Sloan-Kettering Cancer Center
-
New York, New York, Spojené státy, 10021
- New York Presbyterian Hospital - Cornell Campus
-
New York, New York, Spojené státy, 10029
- Mount Sinai Medical Center, NY
-
Syracuse, New York, Spojené státy, 13210
- State University of New York - Upstate Medical University
-
Syracuse, New York, Spojené státy, 13210
- Veterans Affairs Medical Center - Syracuse
-
Syracuse, New York, Spojené státy, 13217
- CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
-
-
North Carolina
-
Chapel Hill, North Carolina, Spojené státy, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
-
Durham, North Carolina, Spojené státy, 27705
- Veterans Affairs Medical Center - Durham
-
Durham, North Carolina, Spojené státy, 27710
- Duke Comprehensive Cancer Center
-
Winston-Salem, North Carolina, Spojené státy, 27104-4241
- CCOP - Southeast Cancer Control Consortium
-
Winston-Salem, North Carolina, Spojené státy, 27157-1082
- Comprehensive Cancer Center at Wake Forest University
-
-
Ohio
-
Columbus, Ohio, Spojené státy, 43210-1240
- Arthur G. James Cancer Hospital - Ohio State University
-
-
Rhode Island
-
Providence, Rhode Island, Spojené státy, 02903
- Rhode Island Hospital
-
-
South Carolina
-
Charleston, South Carolina, Spojené státy, 29425-0721
- Medical University of South Carolina
-
-
Tennessee
-
Memphis, Tennessee, Spojené státy, 38103
- University of Tennessee, Memphis Cancer Center
-
Memphis, Tennessee, Spojené státy, 38104
- Veterans Affairs Medical Center - Memphis
-
-
Vermont
-
Bennington, Vermont, Spojené státy, 05201
- CCOP - Southwestern Vermont Regional Cancer Center
-
Burlington, Vermont, Spojené státy, 05401-3498
- Vermont Cancer Center
-
White River Junction, Vermont, Spojené státy, 05009
- Veterans Affairs Medical Center - White River Junction
-
-
Virginia
-
Richmond, Virginia, Spojené státy, 23298-0037
- MBCCOP - Massey Cancer Center
-
Richmond, Virginia, Spojené státy, 23249
- Veterans Affairs Medical Center - Richmond
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Specific Diagnosis of B-Cell CLL
1.1 An absolute lymphocytosis of > 5,000/µl
1.1.1 Morphologically, the lymphocytes must appear mature with < 55% prolymphocytes.
1.1.2 Bone marrow examination must include at least a unilateral aspirate and biopsy. The aspirate smear must show > 30% of all nucleated cells to be lymphoid or the bone marrow core biopsy must show lymphoid infiltrates compatible with marrow involvement by CLL. The overall cellularity must be normocellular or hypercellular.
1.1.3 Local institution lymphocyte phenotype must reveal a predominant B-cell monoclonal population sharing a B-cell marker (CD19, CD20, CD23, CD24) with the CD5 antigen, in the absence of other pan-T-cell markers. Additionally, the B-cells must be monoclonal with regard to expression of either κ or λ and have surface immunoglobulin expression of low density. Patients with bright surface immunoglobulin levels must have CD23 co-expression.
1.2 Staging
1.2.1 Patients must be in the intermediate- or high-risk categories of the modified three-stage Rai staging system (i.e., stages I, II, III, or IV) per the protocol.
1.2.2 Patients in the intermediate-risk group must have evidence of active disease as demonstrated by at least one of the following criteria:
- Massive or progressive splenomegaly and/or lymphadenopathy
- Presence of weight loss > 10% over the preceding 6 month period;
- Grade 2 or 3 fatigue
- Fevers > 100.5°C or night sweats for greater than 2 weeks without evidence of infection
- Progressive lymphocytosis with an increase of > 50% over a 2 month period or an anticipated doubling time of less than 6 months.
- Prior Treatment: No prior therapy for CLL including corticosteroids for autoimmune complications that have developed since the initial diagnosis of CLL.
- No medical condition requiring chronic use of oral corticosteroids.
- Age ≥18 years.
- Performance Status 0 - 2.
- No HIV disease. Due to alterations in host immunity, patients with HIV may not be enrolled.
- Non-pregnant and non-nursing. Due to the unknown teratogenic potential of Campath-1H, pregnant or nursing women may not be enrolled. Women and men of reproductive potential should agree to use an effective means of birth control.
- Initial Required Laboratory Values:
Creatinine <1.5 x upper limit of institutional normal value Coomb's Testing NEGATIVE
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Nerandomizované
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Fludarabine + Campath-1H
Standard of care induction with fludarabine followed by consolidation antibody therapy
|
30 mg subQ injection tiw for 6 weeks
Ostatní jména:
25mg/sq m/day IV infusion x 5 days Wks 1, 5, 9, and 13
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Časové okno |
|---|---|
|
Response
Časové okno: 2 months post consolidation
|
2 months post consolidation
|
Sekundární výstupní opatření
Měření výsledku |
Časové okno |
|---|---|
|
Toxicity
Časové okno: 2 months post consolidation
|
2 months post consolidation
|
Spolupracovníci a vyšetřovatelé
Spolupracovníci
Vyšetřovatelé
- Studijní židle: Kanti R. Rai, MD, Long Island Jewish Medical Center
Publikace a užitečné odkazy
Obecné publikace
- Rai KR, Freter CE, Mercier RJ, Cooper MR, Mitchell BS, Stadtmauer EA, Santabarbara P, Wacker B, Brettman L. Alemtuzumab in previously treated chronic lymphocytic leukemia patients who also had received fludarabine. J Clin Oncol. 2002 Sep 15;20(18):3891-7. doi: 10.1200/JCO.2002.06.119.
- Morrison VA, Peterson BL, Rai KR, et al.: Alemtuzumab increases serious infections in patients with previously untreated chronic lymphocytic leukemia (CLL) receiving fludarabine-based therapy: a comparative analysis of 3 Cancer and Leukemia Group B studies (CALGB 9011, 9712, 19901). [Abstract] Blood 110 (11): A-756, 2007.
- Byrd JC, Peterson BL, Rai KR, Hurd D, Hohl R, Perry MC, Gockerman J, Nattam S, Larson RA. Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901. Leuk Lymphoma. 2009 Oct;50(10):1589-96. doi: 10.1080/10428190903150839.
- Rai KR, Byrd JC, Peterson B: Subcutaneous alemtuzumab following fludarabine for previously untreated patients with chronic lymphocytic leukemia (CLL): CALGB study 19901. [Abstract] Blood 102 (11 Pt 1): A-2506, 2003.
- Rai KR, Byrd JC, Peterson BL, et al.: A phase II trial of fludarabine followed by alemtuzumab (Campath-1H) in previously untreated chronic lymphocytic leukemia (CLL) patients with active disease: Cancer and Leukemia Group B (CALGB) study 19901. [Abstract] Blood 100 (11 Pt 1): A-772, 2002.
- Jones JA, Ruppert AS, Zhao W, Lin TS, Rai K, Peterson B, Larson RA, Marcucci G, Heerema NA, Byrd JC. Patients with chronic lymphocytic leukemia with high-risk genomic features have inferior outcome on successive Cancer and Leukemia Group B trials with alemtuzumab consolidation: subgroup analysis from CALGB 19901 and CALGB 10101. Leuk Lymphoma. 2013 Dec;54(12):2654-9. doi: 10.3109/10428194.2013.788179. Epub 2013 May 9.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Onemocnění imunitního systému
- Novotvary podle histologického typu
- Novotvary
- Lymfoproliferativní poruchy
- Lymfatická onemocnění
- Imunoproliferativní poruchy
- Leukémie, B-buňka
- Leukémie
- Leukémie, lymfocytární, chronická, B-buňky
- Leukémie, lymfoidní
- Fyziologické účinky léků
- Molekulární mechanismy farmakologického působení
- Antimetabolity, Antineoplastika
- Antimetabolity
- Antineoplastická činidla
- Imunosupresivní látky
- Imunologické faktory
- Antineoplastická činidla, Imunologická
- Fludarabin
- Fludarabin fosfát
- Alemtuzumab
Další identifikační čísla studie
- CALGB-19901
- U10CA031946 (Grant/smlouva NIH USA)
- CDR0000067506 (Identifikátor registru: NCI Physician Data Query)
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .