- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne 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.
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Szczegółowy opis
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 studiów
Zapisy (Rzeczywisty)
Faza
- Faza 2
Kontakty i lokalizacje
Lokalizacje studiów
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Alabama
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Birmingham, Alabama, Stany Zjednoczone, 35233-1996
- Veterans Affairs Medical Center - Birmingham
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California
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La Jolla, California, Stany Zjednoczone, 92093-0658
- University of California San Diego Cancer Center
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San Francisco, California, Stany Zjednoczone, 94121
- Veterans Affairs Medical Center - San Francisco
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San Francisco, California, Stany Zjednoczone, 94143-0128
- UCSF Cancer Center and Cancer Research Institute
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Delaware
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Wilmington, Delaware, Stany Zjednoczone, 19899
- CCOP - Christiana Care Health Services
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District of Columbia
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Washington, District of Columbia, Stany Zjednoczone, 20307-5000
- Walter Reed Army Medical Center
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Washington, District of Columbia, Stany Zjednoczone, 20007
- Lombardi Cancer Center
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Florida
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Miami Beach, Florida, Stany Zjednoczone, 33140
- CCOP - Mount Sinai Medical Center
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Illinois
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Chicago, Illinois, Stany Zjednoczone, 60612
- Veterans Affairs Medical Center - Chicago (Westside Hospital)
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Chicago, Illinois, Stany Zjednoczone, 60637-1470
- University of Chicago Cancer Research Center
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Chicago, Illinois, Stany Zjednoczone, 60612
- University of Illinois at Chicago Health Sciences Center
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Iowa
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Iowa City, Iowa, Stany Zjednoczone, 52242-1009
- Holden Comprehensive Cancer Center at the University of Iowa
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Maine
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Togus, Maine, Stany Zjednoczone, 04330
- Veterans Affairs Medical Center - Togus
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Maryland
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Baltimore, Maryland, Stany Zjednoczone, 21201
- Marlene & Stewart Greenebaum Cancer Center, University of Maryland
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Massachusetts
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Boston, Massachusetts, Stany Zjednoczone, 02115
- Dana-Farber Cancer Institute
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Worcester, Massachusetts, Stany Zjednoczone, 01655
- University of Massachusetts Memorial Medical Center
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Minnesota
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Minneapolis, Minnesota, Stany Zjednoczone, 55417
- Veterans Affairs Medical Center - Minneapolis
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Minneapolis, Minnesota, Stany Zjednoczone, 55455
- University of Minnesota Cancer Center
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Missouri
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Columbia, Missouri, Stany Zjednoczone, 65201
- Veterans Affairs Medical Center - Columbia (Truman Memorial)
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Columbia, Missouri, Stany Zjednoczone, 65203
- Ellis Fischel Cancer Center - Columbia
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Saint Louis, Missouri, Stany Zjednoczone, 63110
- Barnes-Jewish Hospital
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Nebraska
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Omaha, Nebraska, Stany Zjednoczone, 68198-3330
- University of Nebraska Medical Center
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Nevada
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Las Vegas, Nevada, Stany Zjednoczone, 89106
- CCOP - Southern Nevada Cancer Research Foundation
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New Hampshire
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Lebanon, New Hampshire, Stany Zjednoczone, 03756-0002
- Norris Cotton Cancer Center
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New York
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Buffalo, New York, Stany Zjednoczone, 14263-0001
- Roswell Park Cancer Institute
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Buffalo, New York, Stany Zjednoczone, 14215
- Veterans Affairs Medical Center - Buffalo
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Manhasset, New York, Stany Zjednoczone, 11030
- CCOP - North Shore University Hospital
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Manhasset, New York, Stany Zjednoczone, 11030
- North Shore University Hospital
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New Hyde Park, New York, Stany Zjednoczone, 11040
- Long Island Jewish Medical Center
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New York, New York, Stany Zjednoczone, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Stany Zjednoczone, 10021
- New York Presbyterian Hospital - Cornell Campus
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New York, New York, Stany Zjednoczone, 10029
- Mount Sinai Medical Center, NY
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Syracuse, New York, Stany Zjednoczone, 13210
- State University of New York - Upstate Medical University
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Syracuse, New York, Stany Zjednoczone, 13210
- Veterans Affairs Medical Center - Syracuse
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Syracuse, New York, Stany Zjednoczone, 13217
- CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
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North Carolina
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Chapel Hill, North Carolina, Stany Zjednoczone, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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Durham, North Carolina, Stany Zjednoczone, 27705
- Veterans Affairs Medical Center - Durham
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Durham, North Carolina, Stany Zjednoczone, 27710
- Duke Comprehensive Cancer Center
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Winston-Salem, North Carolina, Stany Zjednoczone, 27104-4241
- CCOP - Southeast Cancer Control Consortium
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Winston-Salem, North Carolina, Stany Zjednoczone, 27157-1082
- Comprehensive Cancer Center at Wake Forest University
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Ohio
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Columbus, Ohio, Stany Zjednoczone, 43210-1240
- Arthur G. James Cancer Hospital - Ohio State University
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Rhode Island
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Providence, Rhode Island, Stany Zjednoczone, 02903
- Rhode Island Hospital
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South Carolina
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Charleston, South Carolina, Stany Zjednoczone, 29425-0721
- Medical University of South Carolina
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Tennessee
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Memphis, Tennessee, Stany Zjednoczone, 38103
- University of Tennessee, Memphis Cancer Center
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Memphis, Tennessee, Stany Zjednoczone, 38104
- Veterans Affairs Medical Center - Memphis
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Vermont
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Bennington, Vermont, Stany Zjednoczone, 05201
- CCOP - Southwestern Vermont Regional Cancer Center
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Burlington, Vermont, Stany Zjednoczone, 05401-3498
- Vermont Cancer Center
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White River Junction, Vermont, Stany Zjednoczone, 05009
- Veterans Affairs Medical Center - White River Junction
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Virginia
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Richmond, Virginia, Stany Zjednoczone, 23298-0037
- MBCCOP - Massey Cancer Center
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Richmond, Virginia, Stany Zjednoczone, 23249
- Veterans Affairs Medical Center - Richmond
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Nielosowe
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Eksperymentalny: Fludarabine + Campath-1H
Standard of care induction with fludarabine followed by consolidation antibody therapy
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30 mg subQ injection tiw for 6 weeks
Inne nazwy:
25mg/sq m/day IV infusion x 5 days Wks 1, 5, 9, and 13
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Ramy czasowe |
|---|---|
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Response
Ramy czasowe: 2 months post consolidation
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2 months post consolidation
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Miary wyników drugorzędnych
Miara wyniku |
Ramy czasowe |
|---|---|
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Toxicity
Ramy czasowe: 2 months post consolidation
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2 months post consolidation
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Współpracownicy i badacze
Współpracownicy
Śledczy
- Krzesło do nauki: Kanti R. Rai, MD, Long Island Jewish Medical Center
Publikacje i pomocne linki
Publikacje ogólne
- 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.
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów
Zakończenie podstawowe (Rzeczywisty)
Ukończenie studiów (Rzeczywisty)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Oszacować)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Oszacować)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby układu odpornościowego
- Nowotwory według typu histologicznego
- Nowotwory
- Zaburzenia limfoproliferacyjne
- Choroby limfatyczne
- Zaburzenia immunoproliferacyjne
- Białaczka, komórki B
- Białaczka
- Białaczka, Limfocytowa, Przewlekła, B-Cell
- Białaczka, układ limfatyczny
- Fizjologiczne skutki leków
- Molekularne mechanizmy działania farmakologicznego
- Antymetabolity, przeciwnowotworowe
- Antymetabolity
- Środki przeciwnowotworowe
- Środki immunosupresyjne
- Czynniki immunologiczne
- Środki przeciwnowotworowe, immunologiczne
- Fludarabina
- Fosforan fludarabiny
- Alemtuzumab
Inne numery identyfikacyjne badania
- CALGB-19901
- U10CA031946 (Grant/umowa NIH USA)
- CDR0000067506 (Identyfikator rejestru: NCI Physician Data Query)
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