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Cyclophosphamide, Fludarabine, Alemtuzumab, and Rituximab (CFAR) for Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL)
This study has been completed.
Sponsor:
M.D. Anderson Cancer Center
Collaborator:
Bayer
Information provided by (Responsible Party):
M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:
NCT01082939
First received: March 5, 2010
Last updated: February 17, 2012
Last verified: February 2012
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Purpose
The goal of this clinical research study is to learn if the combination of fludarabine, cyclophosphamide, alemtuzumab, and rituximab is effective in treating chronic lymphocytic leukemia in patients who have already been treated with chemotherapy.
Primary Objectives:
Evaluate the therapeutic efficacy, including the complete remission (CR), nodular partial remission (NPR), and partial remission (PR) rates (overall response) of combined cyclophosphamide, fludarabine, alemtuzumab, and rituximab (CFAR) in previously treated patients with Chronic Lymphocytic Leukemia (CLL).
Second Objectives:
- Assess the toxicity profile of CFAR in previously treated patients with CLL.
- Monitor for infection and determine incidence and etiology of infection including cytomegalovirus in patients treated with CFAR.
- Evaluate molecular remission by polymerase chain reaction (PCR) for the clonal immunoglobulin heavy chain variable gene in responding patients treated with CFAR.
- Assess immune parameters, including pretreatment, during treatment, and post-treatment blood T-cell counts and subset distribution and serum immunoglobulin levels in patients treated with CFAR.
| Condition | Intervention | Phase |
|---|---|---|
| Chronic Lymphocytic Leukemia | Drug: Fludarabine Drug: Cyclophosphamide Drug: Alemtuzumab Drug: Rituximab | Phase 2 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study of Cyclophosphamide, Fludarabine, Alemtuzumab, and Rituximab (CFAR) in Previously Treated Patients With Chronic Lymphocytic Leukemia (CLL) |
Resource links provided by NLM:
Drug Information available for:
Cyclophosphamide
Fludarabine
Fludarabine phosphate
Rituximab
Alemtuzumab
Genetic and Rare Diseases Information Center resources:
Chronic Lymphocytic Leukemia
Leukemia, B-cell, Chronic
U.S. FDA Resources
Further study details as provided by M.D. Anderson Cancer Center:
Primary Outcome Measures:
- Number of Participants With an Overall Response [ Time Frame: 6 cycles of treatment (28 days per cycle) ]Overall (OR) is the total number of participants with any response: Complete remission (CR), is defined as > 30% lymphocytes in the bone marrow, recovery of blood counts and no clinical symptoms; Nodular partial remission (NPR), is the same as CR but with nodules; Partial remission (PR) is > 50% decrease of clinical symptoms from baseline and recovery from blood counts.
| Enrollment: | 80 |
| Study Start Date: | December 2002 |
| Study Completion Date: | January 2011 |
| Primary Completion Date: | January 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: CFAR
CFAR: Cyclophosphamide 250 mg/m^2/day intravenous (IV) Days 3-5, Fludarabine 25 mg/m^2/day IV Days 3-5, Alemtuzumab 30 mg IV Days 1, 3 and 5 over 2-4 hours, repeated every four weeks for a total of 6 planned cycles, and Rituximab Cycle 1 (Week 1): 375 mg/m^2/day IV Day 2 over 4- 6 hours, Cycle 2 - 6 (Week 1): 500 mg/m^2/day IV Day 2 over 4- 6 hours.
|
Drug: Fludarabine
25 mg/m^2/day IV on Days 3-5; repeated every four weeks for a total of 6 planned cycles.
Other Names:
Drug: Cyclophosphamide
250 mg/m^2/day IV on Days 3-5; repeated every four weeks for a total of 6 planned cycles.
Other Names:
Drug: Alemtuzumab
30 mg IV on Days 1, 3 and 5 over 2-4 hours; repeated every four weeks for a total of 6 planned cycles.
Other Names:
Drug: Rituximab
Cycle 1 (Week 1): 375 mg/m^2/day IV on Day 2 over 4- 6 hours Cycle 2 - 6 (Week 1): 500 mg/m^2/day IV on Day 2 over 4- 6 hours Other Name: Rituxan
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | Child, Adult, Senior |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- All patients must have been diagnosed with CLL by immunophenotyping and flow cytometry analysis of blood or bone marrow demonstrating a monoclonal population of CD5 and CD19 positive cells.
- All patient must have been previously treated with chemotherapy.
- All patients with Rai stage III-IV are eligible for treatment with this protocol. - OR - All patients with Rai stage 0-II who meet one or more indication for treatment as defined by the NCI-sponsored Working Group are eligible for treatment with this protocol.
- All patients must have a Zubrod performance status of 0-3.
- All patients must have adequate renal and hepatic function (serum creatinine <2mg/dL; total bilirubin <2.5mg/dL). Patients with renal or liver dysfunction due to organ infiltration by lymphocytes may be eligible after discussion with the Principle Investigator and appropriate dose adjustment considered.
- Patients may not receive concurrent chemotherapy, radiotherapy, or immunotherapy. Localized radiotherapy to an area not compromising bone marrow function does not apply, nor do hematopoietic growth factors such as erythropoietin, Granulocyte colony-stimulating factor (G-CSF or GCSF, GM-CSF etc).
- Patients must not have untreated or uncontrolled life-threatening infection.
- Patients must sign informed consent.
Exclusion Criteria:
1. None
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01082939
Please refer to this study by its ClinicalTrials.gov identifier: NCT01082939
Locations
| United States, Texas | |
| UT MD Anderson Cancer Center | |
| Houston, Texas, United States, 77030 | |
Sponsors and Collaborators
M.D. Anderson Cancer Center
Bayer
Investigators
| Study Chair: | William G. Wierda, MD, PhD, BS | UT MD Anderson Cancer Center |
More Information
Additional Information:
| Responsible Party: | M.D. Anderson Cancer Center |
| ClinicalTrials.gov Identifier: | NCT01082939 History of Changes |
| Other Study ID Numbers: |
DM02-593 |
| Study First Received: | March 5, 2010 |
| Results First Received: | July 26, 2011 |
| Last Updated: | February 17, 2012 |
Keywords provided by M.D. Anderson Cancer Center:
|
Chronic lymphocytic leukemia Refractory CLL CFAR Alemtuzumab Campath-1H Campath Cyclophosphamide Cytoxan |
Neosar Fludarabine Fludara Fludarabine Phosphate Rituximab Rituxan CLL |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Lymphoid Leukemia, Lymphocytic, Chronic, B-Cell Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Leukemia, B-Cell Cyclophosphamide Fludarabine phosphate Rituximab Fludarabine Alemtuzumab |
Vidarabine Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Myeloablative Agonists Antimetabolites, Antineoplastic Antimetabolites Antiviral Agents Anti-Infective Agents |
ClinicalTrials.gov processed this record on June 28, 2017