A Phase II Trial of Alemtuzumab and Rituximab in Patients With Previously Untreated CLL

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Bayer
Information provided by (Responsible Party):
Northwestern University
ClinicalTrials.gov Identifier:
NCT00858117
First received: March 6, 2009
Last updated: March 20, 2014
Last verified: March 2014
  Purpose

RATIONALE: Monoclonal antibodies, such as alemtuzumab and rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Giving alemtuzumab together with rituximab may kill more cancer cells.

PURPOSE: This phase II trial is studying the side effects of giving alemtuzumab together with rituximab and to see how well it works in treating patients with previously untreated B-cell chronic lymphocytic leukemia.


Condition Intervention Phase
Leukemia
Biological: Alemtuzumab
Biological: Rituximab
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial of Alemtuzumab (Campath-1H) and Rituximab (Rituxan) in Patients With Previously Untreated CLL

Resource links provided by NLM:


Further study details as provided by Northwestern University:

Primary Outcome Measures:
  • To determine the response rate to the study medications, Alemtuzumab and Rituximab [ Time Frame: At 9 weeks (during therapy), 18 weeks (at the completion of therapy), and 30 weeks ] [ Designated as safety issue: No ]
    Response rate to the study medications, Alemtuzumab and Rituximab, will be measured at 9 weeks, 18 weeks, and 30 weeks, by physical examination and evaluation of peripheral blood and bone marrow through lab tests.

  • Collect data on the toxicity of the study medications, Alemtuzumab and Rituximab [ Time Frame: Every 2 weeks while on treatment and then monthly for 6 months, then every 3 months for 4.5 years (54 months) ] [ Designated as safety issue: Yes ]
    Toxicity data of the study medications, Alemtuzumab and Rituximab will be evaluated by blood tests every 2 weeks while on treatment and then monthly for 6 months, then every 3 months for 4.5 years (54 months)


Enrollment: 30
Study Start Date: March 2005
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Alemtuzumab and Rituximab
Administration of Alemtuzumab combined with Rituximab to test the feasibility of combining these two monoclonal antibodies as a first line therapy in patients with B-cell chronic lymphocytic leukemia.
Biological: Alemtuzumab
Alemtuzumab administered subcutaneously 30mg per day, 3 days per week for 18 weeks
Other Name: Campath-1H
Biological: Rituximab
Rituximab administered intravenously at 375mg/m2 every 2 weeks for 18 weeks
Other Name: Rituxan

Detailed Description:

OBJECTIVES:

  • To determine the response rate in patients with previously untreated B-cell chronic lymphocytic leukemia treated with alemtuzumab and rituximab.
  • To evaluate the toxicity of alemtuzumab and rituximab in these patients.

OUTLINE: Patients receive alemtuzumab subcutaneously on days 1, 3, and 5 in weeks 1-18 and rituximab IV on day 1 in weeks 3, 5, 7, 9, 11, 13, 15, and 17 in the absence of disease progression or unacceptable toxicity.

Peripheral blood and bone marrow samples are collected periodically for laboratory biomarker studies. Samples are analyzed for surface markers (e.g., CD3, CD4, CD8, CD10, CD19, CD20, CD25, CD38, CD52, Zap-70) and IgVH by PCR, flow cytometry, and FISH. Samples are also analyzed for alemtuzumab and anti-alemtuzumab antibody levels by flow cytometry.

After completion of study treatment, patients are followed periodically for 5 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of B-cell chronic lymphocytic leukemia (CLL)*, as defined by the following criteria:

    • Peripheral blood absolute lymphocyte count > 5,000/mm³
    • Small- to moderate-size lymphocytes with < 55% prolymphocytes, atypical lymphocytes, or lymphoblasts
    • Phenotypically characterized B-CLL expressing CD20 and CD52, as defined by the following:

      • Predominant population of cells share B-cell antigens with CD-5 in the absence of other pan-T-cell markers (e.g., CD-3, CD-2)
      • B-cell expresses either lambda or kappa light chains
      • Surface immunoglobulin with low-cell surface density expression NOTE: *Presence of splenomegaly, hepatomegaly, or lymphadenopathy are not required for the diagnosis of CLL
  • Requires therapy, as indicated by ≥ 1 of the following criteria:

    • Unintentional weight loss > 10% within the past 6 months
    • Extreme fatigue (i.e., ECOG performance status 2)
    • Fevers > 100.5°F for 2 weeks without evidence of infection
    • Night sweats without evidence of infection
    • Evidence of progressive marrow failure as manifested by the development of or worsening of anemia (hemoglobin < 10 g/dL) and/or thrombocytopenia (platelet count < 100,000/mm³)
    • Massive (i.e., > 6 cm below left costal margin) or progressive splenomegaly
    • Massive nodes/clusters (> 5 cm), progressive symptomatic adenopathy, or adenopathy resulting in end-organ damage
    • Progressive lymphocytosis with an increase of > 50% over 2 months or an anticipated doubling time < 6 months
  • Marked hypogammaglobulinemia or the development of a monoclonal protein in the absence of any of the above criteria for active disease is not sufficient for eligibility

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • ANC ≥ 1,000/mm³*
  • Platelet count ≥ 50,000/mm³*
  • Hemoglobin ≥ 10 g/dL*
  • Serum creatinine ≤ 2.0 mg/dL OR creatinine clearance > 40 mL/min
  • Bilirubin < 2 mg/dL
  • AST and ALT ≤ 2 times normal (unless secondary to tumor infiltration/lymphadenopathy)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after completion of study treatment
  • No active autoimmune anemia or thrombocytopenia
  • No active infection requiring oral or intravenous antibiotics
  • No second malignancy, other than basal cell carcinoma of the skin or in situ carcinoma of the cervix, unless curatively treated ≥ 2 years ago NOTE: *If cytopenias are due to degree of bone marrow involvement, patient may be eligible at the discretion of the principal investigator.

PRIOR CONCURRENT THERAPY:

  • Prior corticosteroid therapy allowed
  • No prior cytotoxic therapy (other than corticosteroids)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00858117

Locations
United States, Illinois
Northwestern University, Northwestern Medical Faculty Foundation
Chicago, Illinois, United States, 60611
Sponsors and Collaborators
Northwestern University
Bayer
Investigators
Principal Investigator: Olga Frankfurt, MD Northwestern University
  More Information

No publications provided

Responsible Party: Northwestern University
ClinicalTrials.gov Identifier: NCT00858117     History of Changes
Other Study ID Numbers: NU 04H6, NU 04H6, STU00004494
Study First Received: March 6, 2009
Last Updated: March 20, 2014
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by Northwestern University:
B-cell chronic lymphocytic leukemia
stage I chronic lymphocytic leukemia
stage II chronic lymphocytic leukemia
stage III chronic lymphocytic leukemia
stage IV chronic lymphocytic leukemia

Additional relevant MeSH terms:
Leukemia
Neoplasms by Histologic Type
Neoplasms
Alemtuzumab
Rituximab
Campath 1G
Antibodies, Neoplasm
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents

ClinicalTrials.gov processed this record on April 16, 2014