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Fludarabine Followed by Alemtuzumab in Treating Patients With Chronic Lymphocytic Leukemia

1. juli 2016 oppdatert av: Alliance for Clinical Trials in Oncology

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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

86

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Alabama
      • Birmingham, Alabama, Forente stater, 35233-1996
        • Veterans Affairs Medical Center - Birmingham
    • California
      • La Jolla, California, Forente stater, 92093-0658
        • University of California San Diego Cancer Center
      • San Francisco, California, Forente stater, 94121
        • Veterans Affairs Medical Center - San Francisco
      • San Francisco, California, Forente stater, 94143-0128
        • UCSF Cancer Center and Cancer Research Institute
    • Delaware
      • Wilmington, Delaware, Forente stater, 19899
        • CCOP - Christiana Care Health Services
    • District of Columbia
      • Washington, District of Columbia, Forente stater, 20307-5000
        • Walter Reed Army Medical Center
      • Washington, District of Columbia, Forente stater, 20007
        • Lombardi Cancer Center
    • Florida
      • Miami Beach, Florida, Forente stater, 33140
        • CCOP - Mount Sinai Medical Center
    • Illinois
      • Chicago, Illinois, Forente stater, 60612
        • Veterans Affairs Medical Center - Chicago (Westside Hospital)
      • Chicago, Illinois, Forente stater, 60637-1470
        • University of Chicago Cancer Research Center
      • Chicago, Illinois, Forente stater, 60612
        • University of Illinois at Chicago Health Sciences Center
    • Iowa
      • Iowa City, Iowa, Forente stater, 52242-1009
        • Holden Comprehensive Cancer Center at the University of Iowa
    • Maine
      • Togus, Maine, Forente stater, 04330
        • Veterans Affairs Medical Center - Togus
    • Maryland
      • Baltimore, Maryland, Forente stater, 21201
        • Marlene & Stewart Greenebaum Cancer Center, University of Maryland
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02115
        • Dana-Farber Cancer Institute
      • Worcester, Massachusetts, Forente stater, 01655
        • University of Massachusetts Memorial Medical Center
    • Minnesota
      • Minneapolis, Minnesota, Forente stater, 55417
        • Veterans Affairs Medical Center - Minneapolis
      • Minneapolis, Minnesota, Forente stater, 55455
        • University of Minnesota Cancer Center
    • Missouri
      • Columbia, Missouri, Forente stater, 65201
        • Veterans Affairs Medical Center - Columbia (Truman Memorial)
      • Columbia, Missouri, Forente stater, 65203
        • Ellis Fischel Cancer Center - Columbia
      • Saint Louis, Missouri, Forente stater, 63110
        • Barnes-Jewish Hospital
    • Nebraska
      • Omaha, Nebraska, Forente stater, 68198-3330
        • University of Nebraska Medical Center
    • Nevada
      • Las Vegas, Nevada, Forente stater, 89106
        • CCOP - Southern Nevada Cancer Research Foundation
    • New Hampshire
      • Lebanon, New Hampshire, Forente stater, 03756-0002
        • Norris Cotton Cancer Center
    • New York
      • Buffalo, New York, Forente stater, 14263-0001
        • Roswell Park Cancer Institute
      • Buffalo, New York, Forente stater, 14215
        • Veterans Affairs Medical Center - Buffalo
      • Manhasset, New York, Forente stater, 11030
        • CCOP - North Shore University Hospital
      • Manhasset, New York, Forente stater, 11030
        • North Shore University Hospital
      • New Hyde Park, New York, Forente stater, 11040
        • Long Island Jewish Medical Center
      • New York, New York, Forente stater, 10021
        • Memorial Sloan-Kettering Cancer Center
      • New York, New York, Forente stater, 10021
        • New York Presbyterian Hospital - Cornell Campus
      • New York, New York, Forente stater, 10029
        • Mount Sinai Medical Center, NY
      • Syracuse, New York, Forente stater, 13210
        • State University of New York - Upstate Medical University
      • Syracuse, New York, Forente stater, 13210
        • Veterans Affairs Medical Center - Syracuse
      • Syracuse, New York, Forente stater, 13217
        • CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
    • North Carolina
      • Chapel Hill, North Carolina, Forente stater, 27599-7295
        • Lineberger Comprehensive Cancer Center, UNC
      • Durham, North Carolina, Forente stater, 27705
        • Veterans Affairs Medical Center - Durham
      • Durham, North Carolina, Forente stater, 27710
        • Duke Comprehensive Cancer Center
      • Winston-Salem, North Carolina, Forente stater, 27104-4241
        • CCOP - Southeast Cancer Control Consortium
      • Winston-Salem, North Carolina, Forente stater, 27157-1082
        • Comprehensive Cancer Center at Wake Forest University
    • Ohio
      • Columbus, Ohio, Forente stater, 43210-1240
        • Arthur G. James Cancer Hospital - Ohio State University
    • Rhode Island
      • Providence, Rhode Island, Forente stater, 02903
        • Rhode Island Hospital
    • South Carolina
      • Charleston, South Carolina, Forente stater, 29425-0721
        • Medical University of South Carolina
    • Tennessee
      • Memphis, Tennessee, Forente stater, 38103
        • University of Tennessee, Memphis Cancer Center
      • Memphis, Tennessee, Forente stater, 38104
        • Veterans Affairs Medical Center - Memphis
    • Vermont
      • Bennington, Vermont, Forente stater, 05201
        • CCOP - Southwestern Vermont Regional Cancer Center
      • Burlington, Vermont, Forente stater, 05401-3498
        • Vermont Cancer Center
      • White River Junction, Vermont, Forente stater, 05009
        • Veterans Affairs Medical Center - White River Junction
    • Virginia
      • Richmond, Virginia, Forente stater, 23298-0037
        • MBCCOP - Massey Cancer Center
      • Richmond, Virginia, Forente stater, 23249
        • Veterans Affairs Medical Center - Richmond

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

  1. 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.
  2. Prior Treatment: No prior therapy for CLL including corticosteroids for autoimmune complications that have developed since the initial diagnosis of CLL.
  3. No medical condition requiring chronic use of oral corticosteroids.
  4. Age ≥18 years.
  5. Performance Status 0 - 2.
  6. No HIV disease. Due to alterations in host immunity, patients with HIV may not be enrolled.
  7. 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.
  8. Initial Required Laboratory Values:

Creatinine <1.5 x upper limit of institutional normal value Coomb's Testing NEGATIVE

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Fludarabine + Campath-1H
Standard of care induction with fludarabine followed by consolidation antibody therapy
Biologisk: alemtuzumab
30 mg subQ injection tiw for 6 weeks
Andre navn:
  • campath-1H
Legemiddel: fludarabine phosphate
25mg/sq m/day IV infusion x 5 days Wks 1, 5, 9, and 13

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Response
Tidsramme: 2 months post consolidation
2 months post consolidation

Sekundære resultatmål

Resultatmål
Tidsramme
Toxicity
Tidsramme: 2 months post consolidation
2 months post consolidation

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Alliance for Clinical Trials in Oncology

Samarbeidspartnere

National Cancer Institute (NCI)

Etterforskere

  • Studiestol: Kanti R. Rai, MD, Long Island Jewish Medical Center

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2000

Primær fullføring (Faktiske)

1. mars 2003

Studiet fullført (Faktiske)

1. februar 2010

Datoer for studieregistrering

Først innsendt

7. mars 2000

Først innsendt som oppfylte QC-kriteriene

10. desember 2003

Først lagt ut (Anslag)

11. desember 2003

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

6. juli 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. juli 2016

Sist bekreftet

1. juli 2016

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CALGB-19901
  • U10CA031946 (U.S. NIH-stipend/kontrakt)
  • CDR0000067506 (Registeridentifikator: NCI Physician Data Query)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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