Fludarabine (Fludara®) Plus Alemtuzumab (CAMPATH®, MabCampath®) vs Fludarabine Alone in B-Cell Chronic Lymphocytic Leukemia (B-CLL) Patients
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| Study Type: | Interventional |
|---|---|
| Study Design: | Allocation: Randomized; Endpoint Classification: Safety/Efficacy Study; Intervention Model: Parallel Assignment; Masking: Open Label; Primary Purpose: Treatment |
| Condition: |
B-Cell Chronic Lymphocytic Leukemia |
| Interventions: |
Biological: FluCAM [Fludara + Campath] Biological: fludarabine phosphate |
Baseline Characteristics
Reporting Groups
| Description | |
|---|---|
| Combination Arm (FluCAM) | Participants received both fludarabine (Fludara) and alemtuzumab (Campath) intravenously. Initial escalation of alemtuzumab from 3 to 30 mg (escalation can take up to 14 days). Up to six cycles of fludarabine 30 mg/m^2 intravenous (IV) followed by alemtuzumab 30 mg IV on the first 3 days of each 28 day cycle. |
| Fludarabine Alone | Participants received fludarabine monotherapy 25 mg/m^2 IV daily for the first 5 days of each 28 day cycle for up to 6 cycles. |
| Total | Total of all reporting groups |
Baseline Measures
| Combination Arm (FluCAM) | Fludarabine Alone | Total | |
|---|---|---|---|
|
Number of Participants
[units: participants] |
168 | 167 | 335 |
|
Age
[units: years] Mean ± Standard Deviation |
60.0 ± 9.25 | 60.8 ± 9.34 | 60.4 ± 9.29 |
|
Gender
[units: participants] |
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| Female | 59 | 59 | 118 |
| Male | 109 | 108 | 217 |
|
Race/Ethnicity, Customized
[units: participants] |
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| White | 167 | 167 | 334 |
| Other | 1 | 0 | 1 |
|
Height
[units: centimeters] Mean ± Standard Deviation |
169.0 ± 8.88 | 169.4 ± 9.30 | 169.2 ± 9.08 |
|
Body Surface Area (BSA)
[units: meters^2] Mean ± Standard Deviation |
1.87 ± 0.213 | 1.90 ± 0.218 | 1.88 ± 0.216 |
|
Maximum Lymph Node Size
[1] [units: participants] |
|||
| <5 centimeters | 134 | 136 | 270 |
| >= 5 centimeters | 34 | 31 | 65 |
|
World Health Organization (WHO) Performance Status
[2] [units: participants] |
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| WHO Performance Status = 0 | 81 | 72 | 153 |
| WHO Performance Status = 1 | 87 | 95 | 182 |
|
Rai Stage Group
[3] [units: participants] |
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| Rai Stage 0 | 2 | 2 | 4 |
| Rai Stage I - II | 104 | 102 | 206 |
| Rai Stage III - IV | 62 | 63 | 125 |
|
Binet Stage
[4] [units: participants] |
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| Binet Stage A | 27 | 25 | 52 |
| Binet Stage B | 89 | 89 | 178 |
| Binet Stage C | 52 | 53 | 105 |
|
Disease Status
[5] [units: participants] |
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| Relapsed | 101 | 101 | 202 |
| Refractory | 67 | 66 | 133 |
|
Summary of Prior Therapy by Type of Therapy
[6] [units: participants] |
|||
| Fludarabine-containing therapy | 25 | 26 | 51 |
| Non-fludarabine-containing therapy | 143 | 141 | 284 |
| [1] | The number of participants whose largest lymph node by physical exam assessment during a baseline visit fell within two categories: <5 cm and >=5 cm. If there is no enlarged lymph node, then size is classified as <5 cm. |
|---|---|
| [2] | Per protocol, all participants had a WHO performance status of 0 or 1. A WHO performance status of 0 is defined as "patient is able to carry out all normal activity without restriction," and status of 1 is "patient is ambulatory and capable of all self-care but unable to carry out any work; up and about more than 50% of waking hours." |
| [3] | Rai staging is a way to categorize the disease progression of chronic lymphocytic leukemia (CLL); higher stages reflect increasing severity. Rai Stage 0: Lymphocytosis only, Rai Stage I: Lymphocytosis with lymphadenopathy, Rai Stage II: Lymphocytosis with hepatomegaly or splenomegaly, Rai Stage III: Lymphocytosis with anemia, Rai Stage IV: Lymphocytosis with thrombocytopenia. Per protocol, the 4 participants with Rai Stage 0 were eligible for the study because they had Binet Stage A. |
| [4] | Binet staging classifies CLL according to the number of lymphoid tissues involved, as well as the presence of low red blood cell count (anemia) or low number of blood platelets (thrombocytopenia). Binet Stage A: fewer than three areas of enlarged lymphoid tissue. Enlarged lymph nodes of the neck, underarms, and groin, as well as the spleen, are each considered "one group," whether unilateral (one-sided) or bilateral (on both sides). Binet Stage B: more than three areas of enlarged lymphoid tissue. Binet Stage C: anemia plus thrombocytopenia (platelets <100 x 10^3/dL). |
| [5] | Count of participants with refractory or relapsed disease at baseline (as reported by the investigator). |
| [6] | Count of participants who had prior therapy categorized by type of therapy: fludarabine-containing therapy or non-fludarabine-containing therapy. |
Outcome Measures
| 1. Primary: | Kaplan-Meier Estimates for Progression-free Survival (PFS) Based on Independent Response Review Panel (IRRP) Assessment [ Time Frame: Up to 6 years ] |
| 2. Secondary: | Participant Best Response to Treatment Assessed by the Independent Response Review Panel (IRRP) [ Time Frame: Up to 9 months ] |
| 3. Secondary: | Kaplan-Meier Estimates of Overall Survival Time [ Time Frame: Up to 6 years ] |
| 4. Secondary: | Kaplan Meier Estimates for Time to Disease Progression Assessed by the Independent Response Review Panel (IRRP) [ Time Frame: Up to 6 years ] |
| 5. Secondary: | Kaplan-Meier Estimates for Duration of Response Assessed by the Independent Response Review Panel (IRRP) [ Time Frame: Up to 6 years ] |
| 6. Secondary: | Kaplan-Meier Estimates for Time to Alternative Therapy [ Time Frame: Up to 6 years ] |
| 7. Secondary: | Mean EQ-5D™ Index Scores to Measure Quality of Life at Baseline [ Time Frame: Day 0 (baseline) ] |
| 8. Secondary: | Mean EQ-5D™ Index Scores to Measure Quality of Life at End of Treatment [ Time Frame: up to month 6 (end of treatment) ] |
| 9. Secondary: | Mean EuroQol Visual Analogue Scale (EQ-VAS) Scores to Measure Quality of Life at Baseline [ Time Frame: Day 0 (baseline) ] |
| 10. Secondary: | Mean EuroQol Visual Analogue Scale (EQ-VAS) Scores to Measure Quality of Life at End of Treatment [ Time Frame: up to month 6 (end of treatment) ] |
| 11. Secondary: | Summary of Participants With Adverse Experiences (AEs) [ Time Frame: Up to 6 years ] |
| 12. Secondary: | Mean Systemic Clearance (CL) of Fludarabine [ Time Frame: month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion) ] |
| 13. Secondary: | Total Volume of Distribution (Vss) of Fludarabine [ Time Frame: month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion) ] |
| 14. Secondary: | Area Under the Curve (AUC) of Fludarabine From (AUC 0-tau) [ Time Frame: month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion) ] |
| 15. Secondary: | Maximum Plasma Concentration (Cmax) of Fludarabine [ Time Frame: month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion) ] |
| 16. Secondary: | Participants With Minimal Residual Disease (MRD) [ Time Frame: up to 9 months ] |
| 17. Other Pre-specified: | Kaplan-Meier Estimates for Progression-free Survival (PFS) Based on Independent Response Review Panel (IRRP) for Participants With Rai Stage I-II [ Time Frame: Up to 6 years ] |
| 18. Other Pre-specified: | Kaplan-Meier Estimates for Progression-free Survival (PFS) Based on Independent Response Review Panel (IRRP) for Participants With Rai Stage III-IV [ Time Frame: Up to 6 years ] |
| 19. Other Pre-specified: | Kaplan-Meier Estimates of Overall Survival Time for Participants With Rai Stage I-II [ Time Frame: Up to 6 years ] |
| 20. Other Pre-specified: | Kaplan-Meier Estimates of Overall Survival Time for Participants With Rai Stage III-IV [ Time Frame: Up to 6 years ] |
More Information
| Principal Investigators are NOT employed by the organization sponsoring the study. | ||||||
| There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. | ||||||
The agreement is:
|
Limitations and Caveats
| Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data |
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Results Point of Contact:
Organization: Genzyme Corporation
phone: 800-745-4447
Publications of Results:
Publications automatically indexed to this study:
| Responsible Party: | Genzyme |
| ClinicalTrials.gov Identifier: | NCT00086580 History of Changes |
| Other Study ID Numbers: | CAM314, 2004-000149-39 |
| Study First Received: | July 6, 2004 |
| Results First Received: | June 13, 2011 |
| Last Updated: | August 21, 2012 |
| Health Authority: | United States: Food and Drug Administration Austria: Federal Ministry for Health and Women Bulgaria: Bulgarian Drug Agency Canada: Health Canada Croatia: Ministry of Health and Social Care Czech Republic: State Institute for Drug Control France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Germany: Federal Institute for Drugs and Medical Devices Greece: National Organization of Medicines Italy: Ministry of Health Poland: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products Portugal: National Pharmacy and Medicines Institute Romania: National Medicines Agency Russia: Ministry of Health of the Russian Federation Sweden: Medical Products Agency Ukraine: State Pharmacological Center - Ministry of Health |