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Dose Escalation Study of Revlimid With Fludarabine-Rituximab for CLL/SLL

26 maj 2016 uppdaterad av: Jennifer R. Brown, MD, PhD, Dana-Farber Cancer Institute

A Phase I Dose Escalation Study of Lenalidomide (Revlimid) in Combination With Fludarabine-Rituximab (Rituxan) for Previously Untreated CLL/SLL

The purpose of this study is to determine the safety of lenalidomide (revlimid) in combination with fludarabine and rituximab and to determine the highest dose of lenalidomide that can safely be given in that combination. Lenalidomide is a drug that alters the immune system and may also interfere with the the development of tiny blood vessels that help support tumor growth. Lenalidomide is approved by the FDA for the treatment of two different blood cancers called myelodysplastic syndrome and multiple myeloma. Lenalidomide has also been studied in subjects with relapsed CLL. In this research study we are adding lenalidomide to a well-established initial therapy for CLL/SLL.

Studieöversikt

Detaljerad beskrivning

  • Participants will be treated in groups (cohorts) of three to six subjects per cohort. The dose of lenalidomide or fludarabine will be increased from one cohort to the next. Regardless of the treatment cohort, participants will receive treatment in cycles lasting 28 days.
  • For the first 3-5 days (depending on the group), participants will be treated on an outpatient basis in the infusion room at the Dana-Farber Clinic, with fludarabine and rituximab. Fludarabine is given intravenously for 3-5 days. Rituximab is given intravenously on day 1 of each 28-day cycle. Lenalidomide is given orally once per day for 3 weeks, followed by 1 week of rest.
  • Participants will be monitored very closely during the study treatment. During the first 28 day period (cycle 1), a physical exam and routine blood tests will be performed weekly. All participants in a group must finish the first 28-day treatment period before we proceed with the next group. Once started on study treatment, participants will continue for six cycles (a cycle is 28 days) of combination therapy with all three drugs. During that period they will have a physical exam and routine blood tests on day 1 of each treatment cycle, and additional blood tests on day 15 of each cycle.
  • When participants complete 6 cycles of combination therapy, they will proceed with two additional months of the lenalidomide alone, for 21 out of 28 days.
  • Disease response will be evaluated after 2, 6, and 8 months of study treatment. The following tests and procedures will be performed: Physical exam; blood tests; CT scans to evaluate lymph nodes; skin testing; and bone marrow biopsy if all other tests show no evidence of any remaining CLL and if the baseline bone marrow biopsy was positive
  • Participants will have a physical exam and lab work every 3 months as long as their disease remains in remission.

Studietyp

Interventionell

Inskrivning (Faktisk)

9

Fas

  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02115
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Förenta staterna, 02114
        • Massachusetts General Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • 18 years of age or older
  • Diagnosed with B-CLL/SLL based on the standard histologic and immunophenotypic criteria described in the WHO classification
  • No prior systemic therapy for CLL/SLL, including chemotherapy or antibody therapy
  • Currently needs therapy based on 1996 NCI-WG criteria
  • Measurable disease
  • ECOG Performance Status of 0-2
  • Laboratory test results within parameters outlined in protocol
  • Able to take aspirin daily as prophylactic anticoagulation

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent document
  • Pregnant or breast-feeding females
  • Any condition, including the presence of abnormal laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study
  • Use of any other experimental drug or therapy within 28 days of baseline
  • Known hypersensitivity to thalidomide
  • Development of erythema nodosum characterized by a desquamating rash while taking thalidomide or similar drugs
  • Prior use of lenalidomide
  • Concurrent use of other anti-cancer agents or treatments
  • Known positive for HIV
  • Chronic active Hep B patients not on prophylactic lamivudine
  • Diagnosis of Mantle Cell Lymphoma

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Lenalidomide, fludarabine and rituximab
Lenalidomide-Dose level will depend upon time the participant enrolls on the study: Given orally once a day for 3 weeks followed by a one week rest period fludarabine- Dose level will vary depending upon when participant enters the trial: Given intravenously for 3-5 days Rituximab- Given intravenously on Day 1 of each 28 day cycle
Dose level will depend upon time the participant enrolls on the study: Given orally once a day for 3 weeks followed by a one week rest period
Andra namn:
  • Revlimid
Dose level will vary depending upon when participant enters the trial: Given intravenously for 3-5 days
Given intravenously on Day 1 of each 28 day cycle

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
To evaluate the safety of lenalidomide in combination with fludarabine-rituximab (FR) and to determine the maximum tolerated dose in subjects with previously untreated CLL/SLL.
Tidsram: 2 years
2 years

Sekundära resultatmått

Resultatmått
Tidsram
To determine the objective response rate and progression-free survival following lenalidomide/FR in this patient population
Tidsram: 2 years
2 years
To determine the improvement in ORR following two months of consolidation lenalidomide after completion of combination therapy
Tidsram: 2 years
2 years
To assess effects on immune function as measured by cytokine levels, T and NK cell subsets, T cell activation during therapy and DTH vaccine responses.
Tidsram: 2 years
2 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Jennifer R. Brown, MD, PhD, Dana-Farber Cancer Institute

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 oktober 2007

Primärt slutförande (Faktisk)

1 juni 2009

Avslutad studie (Faktisk)

1 december 2012

Studieregistreringsdatum

Först inskickad

10 oktober 2007

Först inskickad som uppfyllde QC-kriterierna

10 oktober 2007

Första postat (Uppskatta)

12 oktober 2007

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

27 maj 2016

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 maj 2016

Senast verifierad

1 maj 2016

Mer information

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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