Dasatinib Combination for Chronic Lymphocytic Leukemia(CLL) With Refractory Disease (D'ACCORD)
Recruitment status was: Recruiting
Patients with chemo refractory CLL have a poor prognosis. 2 independent mechanisms are attributed to the development of chemoresistance in CLL. The first is a shift in the balance between pro- and anti-apoptotic regulators. The second mechanism is based on acquired mutations resulting in a dysfunctional p53 response. Recent studies indicate that the tyrosine kinase inhibitor dasatinib acts synergistically with both purine analogies and alkylating agents. Also, dasatinib has the potency to restore the apoptotic balance of CLL cells.
Hypothesis: Dasatinib will be clinically active in chemo-refractory CLL patients and will act synergistically with the purine-analogue fludarabine.
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Dasatinib Combination for Chronic Lymphocytic Leukemia Patients With Chemo Refractory Disease|
- response rate and response quality [ Time Frame: At 32 weeks of either dasatinib monotherapy or after 6 cycles of fludarabine and dasatinib combination ]
- overall safety profile of these treatment approaches, event free survival, progression free survival, relapse or death, disease free survival [ Time Frame: 3 years ]
|Study Start Date:||October 2008|
|Estimated Study Completion Date:||January 2016|
|Estimated Primary Completion Date:||January 2013 (Final data collection date for primary outcome measure)|
Patients will be treated with dasatinib monotherapy 100mg daily. At four weeks patients will be re-evaluated. Patients with less than a partial response will receive fludarabine (orally 40mg/daily for 3 days q28) in addition to dasatinib.
Chemo-refractory CLL patients will be treated with dasatinib monotherapy 100mg daily.Patients with less than a partial response at 4 weeks will receive fludarabine (orally 40mg/daily for 3 days q28) in addition to dasatinib for a maximum of 6 cycles. Patients with at least a partial response will continue dasatinib monotherapy. Patients that receive monotherapy after the initial 28 days and that develop progressive disease will 'cross-over' to the combination treatment.
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01051115
|Maastricht university medical center|
|Maastricht, Limburg, Netherlands, 6229 HX|
|Academic Medical Center|
|Amsterdam, NH, Netherlands, 1105 AZ|
|Erasmus MC-Daniel den Hoed Cancer Center|
|Rotterdam, ZH, Netherlands, 3015 CE|
|University Medical Center Groningen|
|Groningen, Netherlands, 9713 GZ|
|Principal Investigator:||Arnon P kater, MD, PhD||Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)|
|Principal Investigator:||Marinus HJ van Oers, MD, PhD||Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)|