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Activity & Safety Study of Lenalidomide & Rituximab as Non-chemotherapy Based Therapy on Chronic Lymphocytic Leukemia (LLC-LENAR-08)

27. september 2013 opdateret af: MD Anderson International Spain SA

Phase I Study of the Activity and Safety of Lenalidomide and Rituximab as Non-chemotherapy Therapy for Patients With Recurrent and Refractory Chronic Lymphocytic Leukemia

The rationale for combining lenalidomide with rituximab derives from preclinical observations suggesting that lenalidomide may enhance the ADCC (antigen-dependent cellular cytotoxicity) triggered by monoclonal antibodies such as rituximab. Lenalidomide augments NK cytotoxicity by increasing CD56dimCD3 subset, in addition to inducing IL-2 in T cells. These results provide the cellular and molecular basis for the use of lenalidomide as an adjuvant in immunotherapeutic strategies of monoclonal antibodies (mAb)-based therapies. The combination lenalidomide-rituximab was tested in lymphoma cell lines but not specifically on CLL cell lines. However the observed synergism was attributed to NK cells expansion, thus lending support to the notion that this synergism may operate in other B-cell lymphoproliferative malignancies.

The objective was to develop a non-cytotoxic and effective treatment for CLL that would fulfill an unmet medical need, as a significant proportion of CLL patients are elderly and frail. These patients experience an excess in chemotherapy induced toxicity, often preventing the completion of the planned treatment.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

25

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Spanien
      • Córdoba, Spanien, 14004
        • Hospital Universitario Reina Sofía
      • Madrid, Spanien, 28046
        • Hospital Universitario La Paz
      • Madrid, Spanien, 28033
        • MD Anderson Internacional España
      • Salamanca, Spanien, 37007
        • Hospital Clínico de Salamanca
      • Sevilla, Spanien, 41013
        • Hospital Virgen del Rocío
      • Valencia, Spanien, 46010
        • Hospital Clínico Universitario de Valencia
      • Zaragoza, Spanien, 50009
        • Hospital Universitario Miguel Servet

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Recurrent and refractory CLL patients that have received at least one previous treatment with purine analogs.
  • Adequate liver function and renal function.
  • ECOG performance status ≤ 2.
  • Signed informed consent
  • Male and female patients who are fertile agree to use an effective barrier method of birth control to avoid pregnancy.

Exclusion Criteria:

  • Positive serological markers for hepatitis B with the exception of HBsAc in previously vaccinated patients
  • Pregnant patients
  • HIV infection
  • Concurrent chemotherapy or immunotherapy
  • Other malignancy within the last 2 years, except for localized cutaneous carcinoma
  • Neurological impairment precluding understanding of protocol and the entailed visits and procedures.
  • Patients with Renal insufficiency that requires dialysis.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Lenalidomida, Rituximab
Phase I: Lenalidomide will be administered from day 1 to 21 of 28 days cycles, escalating doses (from 2,5mg to 25 mg).Rituximab dose will be administered at the standard (375 mg/m2 in the first cycle and 500 mg/m2 in successive cycles).
Medicin: Lenalidomida and Rituximab

Lenalidomide: Oral use. It will be administered from day 1 to 21 of 28 days cycles in a total of 6 cycles.

Rituximab, intravenous use. The dose will be administered at the standard (375 mg/m2 in the first cycle and 500 mg/m2 in successive cycles).

In the first cycle Rituximab will be administered in two divided doses:100mg/m2 total on day 1 and the rest up to 375mg/m2 on day 2.

If lenalidomide treatment starts on day 1, Rituximab will be administered, in this first cycle, on days -2 (100 mg/m2) and -1 (275 mg/m2).

In the second and subsequent cycles, 500 mg/m2 of Rituximab will be administered on day -1.

Andre navne:
  • Lenalidomide: REVLIMID
  • Rituximab: MABTHERA

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Phase I: To determine Starting Recommended Dose for the first cycle and the subsequent cycles (Maximal Tolerated Dose)in relapsed B-cell CLL patients.
Tidsramme: 5 months
6 treatment cycles followed by an evaluation visit (between 60-90 days after last dosing) and quarterly follow up visits, until disease progression. Module I: patients on every cohort will have the same dose during treatment, except if they experiment DLT, in which case dose will be decreased (unless they are on the first dose level).
5 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
To determine the toxicity profile of LenRtx.
Tidsramme: 5 months
Phase II: patients will be followed during 6 cycles, safety assessment visit and quarterly follow up visits
5 months
To determine the time to treatment failure.
Tidsramme: 5 months
Phase II: patients will be followed during 6 cycles, safety assessment visit and quarterly follow up visits
5 months
To determine the molecular response rate.
Tidsramme: 5 months
Phase II: patients will be followed during 6 cycles, safety assessment visit and quarterly follow up visits
5 months
To determine the clinical response rate (combined morphological and flow cytometry criteria).
Tidsramme: 5 months
6 treatment cycles followed by an evaluation visit (between 60-90 days after last dosing) and quarterly follow up visits, until disease progression
5 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

MD Anderson International Spain SA

Samarbejdspartnere

Celgene Corporation

Efterforskere

  • Ledende efterforsker: José F Tomas, MD, MD Anderson Internacional España

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. april 2009

Primær færdiggørelse (Faktiske)

1. december 2012

Studieafslutning (Faktiske)

1. september 2013

Datoer for studieregistrering

Først indsendt

17. december 2009

Først indsendt, der opfyldte QC-kriterier

18. august 2010

Først opslået (Skøn)

19. august 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

30. september 2013

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. september 2013

Sidst verificeret

1. september 2013

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • LLC-LENAR-08 (Anden identifikator: Fundación MD Anderson Internacional. España)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Kronisk lymfatisk leukæmi

Kliniske forsøg med Lenalidomida and Rituximab

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