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Bendamustine and Rituximab in Treating Patients With Previously Untreated or Relapsed Chronic Lymphocytic Leukemia

Primary Purpose

Chronic Lymphocytic Leukemia

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Bendamustine
Rituximab
Sponsored by
German CLL Study Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Lymphocytic Leukemia focused on measuring B-cell chronic lymphocytic leukemia, relapsed refractory chronic lymphocytic leukemia, previously untreated chronic lymphocytic leukemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 18 years of age or older Diagnosis of B-CLL in need of treatment Previously untreated Binet stage C or Binet B with need of treatment according to NCI-criteria Relapsed or refractory disease after at least one but not more than 3 prior regimens. Patients who previously received bendamustine must have had at least a partial response with duration of response of at least six months. World Health Organization performance status of 0-2 Life expectancy >12 weeks Anti-cancer therapy, major surgery, or irradiation was completed >3 weeks before registration in this study. Patient must have recovered from the acute side effects incurred as a result of previous therapy. Serum creatinine ≤1.5 the institutional upper limit of normal (ULN) or Creatinine clearance >30 ml/min/1.73 m² Adequate liver function as indicated by a total bilirubin, AST, and ALT ≤2 the institutional ULN value, unless directly attributable to the patient's tumor. Female patients with childbearing potential must have a negative serum pregnancy test within two weeks of first dose of study drug(s). Male and female patients must agree to use an effective contraceptive method while on study treatment and for a minimum of six months following study therapy. Signed, written informed consent. Exclusion Criteria: Previously treated with >3 prior regimens for B-CLL. Known central nervous system (CNS) involvement with B-CLL. Patients who have progressed with more aggressive B-cell cancers such as Richter's syndrome. History of anaphylaxis following exposure to monoclonal antibodies. Known to be human immunodeficiency virus (HIV), hepatitis B, or C positive. Active infection or history of severe infection (grade 4) within 3 months prior to study registration. Medical condition requiring prolonged use of oral corticosteroids (> 1 month). Use of investigational agents within 30 days prior to study randomization. Active secondary malignancy. ANC <1.5x109/L or platelet count <75x109/L, unless due to bone marrow involvement of CLL. Other severe, concurrent diseases, including tuberculosis, mental disorders, serious cardiac functional capacity (Class III or IV as defined by the New York Heart Association Classification), severe diabetes, severe hypertension, pulmonary disease (chronic obstructive pulmonary disease [COPD] with hypoxemia), or major organ malfunction (liver, kidney) that could interfere with the patient's ability to participate in the study. Pregnant or nursing women. Any circumstance at the time of study entry that would preclude completion of the study or the required follow-up. Participation in another clinical trial

Sites / Locations

  • Internistische Praxis - Arnstadt
  • Klinikum Augsburg
  • HELIOS Klinikum Bad Saarow
  • Internistische Gemeinschaftspraxis - Berlin
  • Charite - Campus Charite Mitte
  • Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
  • Charite University Hospital - Campus Virchow Klinikum
  • Augusta-Kranken-Anstalt gGmbH
  • Marienhospital Bottrop gGmbH
  • DIAKO Ev. Diakonie Krankenhaus gGmbH
  • Medizinische Universitaetsklinik I at the University of Cologne
  • Klinikum Darmstadt
  • Krankenhaus Benrath
  • Helios Klinikum Erfurt
  • Universitaetsklinikum Essen
  • Staedtische Kliniken Esslingen
  • Klinikum Frankfurt (Oder) GmbH
  • Klinikum Garmisch - Partenkirchen GmbH
  • Internistische Praxisgemeinschaft
  • Universitaetsklinikum Goettingen
  • Klinik Fuer Innere Medizin, Hematology/Oncology, Ernst Moritz Armdt Universitaet
  • Allgemeines Krankenhaus Hagen
  • Praxis fur Innere Medizin - Hamburg
  • Hamatologische/Onkologische - Hamburg
  • Asklepios Klinik St. Georg
  • Evangelische Krankenhaus Hamm
  • Universitaetsklinikum des Saarlandes
  • Westpfalz-Klinikum GmbH
  • Staedtisches Klinikum Karlsruhe gGmbH
  • University Hospital Schleswig-Holstein - Kiel Campus
  • Onkologische Schwerpunktpraxis - Leer
  • Klinikum Lippe - Lemgo
  • Gemeinschaftspraxis - Ludwigshafen
  • Kreiskrankenhaus Luedenscheid
  • Staedtisches Klinikum Magdeburg
  • Krankenhaus Maria Hilf GmbH
  • Haematologisch - Onkologische Gemeinschaftspraxis - Muenster
  • Klinikum der Universitaet Muenchen - Grosshadern Campus
  • Onkologische Schwerpunktpraxis Dr. Schmidt
  • Klinikum Oldenburg
  • Paracelsus Karankenhaus Ruit
  • Gemeinschaftspraxis - Pinneberg
  • Klinikum Ernst Von Bergmann
  • Scherpunktpraxis fur Hematologie und Onkologie
  • Klinikum der Universitaet Regensburg
  • Krankenhaus Barmherzige Brueder Regensburg
  • Internistische Praxis Dres. Hempel und Hochdorfer
  • Klinik und Poliklinik fuer Innere Medizin - Universitaet Rostock
  • Caritasklinik St. Theresia
  • Schwerpunktpraxis fur Hamatologie und Onkologie
  • St. Marien - Krankenhaus Siegen GMBH
  • Hanse-Klinikum Stralsund - Krankenhaus West
  • Haematologische Praxis
  • Krankenanstalt Mutterhaus der Borromaerinnen
  • Universitaetsklinikum Tuebingen
  • Comprehensive Cancer Center Ulm at Universitaetsklinikum Ulm
  • St. Marienhospital - Vechta
  • Heinrich-Braun-Krankenhaus Zwickau

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bendamustine plus Rituximab

Arm Description

Outcomes

Primary Outcome Measures

Overall response rate
Response will be assessed using clinical examination, hematology, bone marrow examination, plain radiograph of the chest (chest X-ray), ultrasound or CT of the abdomen, and MRD testing (for the molecular response rate only).

Secondary Outcome Measures

Full Information

First Posted
January 10, 2006
Last Updated
May 21, 2019
Sponsor
German CLL Study Group
Collaborators
University of Cologne
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1. Study Identification

Unique Protocol Identification Number
NCT00274989
Brief Title
Bendamustine and Rituximab in Treating Patients With Previously Untreated or Relapsed Chronic Lymphocytic Leukemia
Official Title
Multicentre Phase II Trial of Bendamustine in Combination With Rituximab for Patients With Previously Untreated or Relapsed Chronic Lymphocytic Leukemia. CLL2M Protocol of the German CLL-Study Group (GCLLSG)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
November 2005 (undefined)
Primary Completion Date
March 2008 (Actual)
Study Completion Date
March 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
German CLL Study Group
Collaborators
University of Cologne

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
CLL2M is a phase 2, multicenter, open label study to investigate the possible therapeutic benefits of using bendamustine in combination with rituximab for the treatment of patients with previously untreated or relapsed CLL.
Detailed Description
Conventional chemotherapy and also high dose chemotherapy with autologous stem cell transplantation are not curative treatment options in B-CLL; nearly all patients will eventually relapse. Also monoclonal antibodies are not curative for B-CLL patients in monotherapy, their impact on survival in combination with conventional chemotherapy is currently validated. In addition, there is no standard combination therapy for patients with relapsed CLL. Therefore there is an urgent medical need to identify new strategies. The combination of rituximab (monoclonal antibody) and bendamustine (chemotherapy) has shown encouraging activity in patients with relapsed/refractory NHL or mantle cell lymphoma. In vitro studies have been used to investigate the effects of bendamustine and rituximab on programmed cell death (apoptosis) and have shown synergistic effects of both drugs. The mechanisms of action of these two active drugs may provide a treatment with good therapeutic potential in CLL. However, though bendamustine has been used for over 30 years there is still a need to define a standard regimen for the use of bendamustine in combination with monoclonal antibodies (mAb) especially in the treatment of CLL.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia
Keywords
B-cell chronic lymphocytic leukemia, relapsed refractory chronic lymphocytic leukemia, previously untreated chronic lymphocytic leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
195 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bendamustine plus Rituximab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Intervention Description
First-Line Therapy: Bendamustine i.v. 90 mg/m² day 1-2, q4wks, cycle 1 to 6 2nd to 4th -Line Therapy: Bendamustine i.v. 70 mg/m² day 1-2 q4wks, cycle 1 to 6
Intervention Type
Biological
Intervention Name(s)
Rituximab
Other Intervention Name(s)
MabThera, Rituxan
Intervention Description
First-Line Therapy: Rituximab i.v. 375 mg/m² day 0, q4wks, cycle 1; Rituximab i.v. 500 mg/m² day 1, q4wks, cycle 2-6 2nd to 4th -Line Therapy: Rituximab i.v. 375 mg/m² day 0, q4wks, cycle 1; Rituximab i.v. 500 mg/m² day 1, q4wks, cycle 2-6
Primary Outcome Measure Information:
Title
Overall response rate
Description
Response will be assessed using clinical examination, hematology, bone marrow examination, plain radiograph of the chest (chest X-ray), ultrasound or CT of the abdomen, and MRD testing (for the molecular response rate only).
Time Frame
56 days after the last of six cycles

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years of age or older Diagnosis of B-CLL in need of treatment Previously untreated Binet stage C or Binet B with need of treatment according to NCI-criteria Relapsed or refractory disease after at least one but not more than 3 prior regimens. Patients who previously received bendamustine must have had at least a partial response with duration of response of at least six months. World Health Organization performance status of 0-2 Life expectancy >12 weeks Anti-cancer therapy, major surgery, or irradiation was completed >3 weeks before registration in this study. Patient must have recovered from the acute side effects incurred as a result of previous therapy. Serum creatinine ≤1.5 the institutional upper limit of normal (ULN) or Creatinine clearance >30 ml/min/1.73 m² Adequate liver function as indicated by a total bilirubin, AST, and ALT ≤2 the institutional ULN value, unless directly attributable to the patient's tumor. Female patients with childbearing potential must have a negative serum pregnancy test within two weeks of first dose of study drug(s). Male and female patients must agree to use an effective contraceptive method while on study treatment and for a minimum of six months following study therapy. Signed, written informed consent. Exclusion Criteria: Previously treated with >3 prior regimens for B-CLL. Known central nervous system (CNS) involvement with B-CLL. Patients who have progressed with more aggressive B-cell cancers such as Richter's syndrome. History of anaphylaxis following exposure to monoclonal antibodies. Known to be human immunodeficiency virus (HIV), hepatitis B, or C positive. Active infection or history of severe infection (grade 4) within 3 months prior to study registration. Medical condition requiring prolonged use of oral corticosteroids (> 1 month). Use of investigational agents within 30 days prior to study randomization. Active secondary malignancy. ANC <1.5x109/L or platelet count <75x109/L, unless due to bone marrow involvement of CLL. Other severe, concurrent diseases, including tuberculosis, mental disorders, serious cardiac functional capacity (Class III or IV as defined by the New York Heart Association Classification), severe diabetes, severe hypertension, pulmonary disease (chronic obstructive pulmonary disease [COPD] with hypoxemia), or major organ malfunction (liver, kidney) that could interfere with the patient's ability to participate in the study. Pregnant or nursing women. Any circumstance at the time of study entry that would preclude completion of the study or the required follow-up. Participation in another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clemens M. Wendtner
Organizational Affiliation
Medizinische Universitaetsklinik I at the University of Cologne
Official's Role
Study Chair
Facility Information:
Facility Name
Internistische Praxis - Arnstadt
City
Arnstadt
ZIP/Postal Code
99310
Country
Germany
Facility Name
Klinikum Augsburg
City
Augsburg
ZIP/Postal Code
D-86156
Country
Germany
Facility Name
HELIOS Klinikum Bad Saarow
City
Bad Saarow
ZIP/Postal Code
15526
Country
Germany
Facility Name
Internistische Gemeinschaftspraxis - Berlin
City
Berlin
ZIP/Postal Code
13347
Country
Germany
Facility Name
Charite - Campus Charite Mitte
City
Berlin
ZIP/Postal Code
D-10117
Country
Germany
Facility Name
Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
City
Berlin
ZIP/Postal Code
D-12200
Country
Germany
Facility Name
Charite University Hospital - Campus Virchow Klinikum
City
Berlin
ZIP/Postal Code
D-13353
Country
Germany
Facility Name
Augusta-Kranken-Anstalt gGmbH
City
Bochum
ZIP/Postal Code
D-44791
Country
Germany
Facility Name
Marienhospital Bottrop gGmbH
City
Bottrop
ZIP/Postal Code
D-46236
Country
Germany
Facility Name
DIAKO Ev. Diakonie Krankenhaus gGmbH
City
Bremen
ZIP/Postal Code
D-28239
Country
Germany
Facility Name
Medizinische Universitaetsklinik I at the University of Cologne
City
Cologne
ZIP/Postal Code
D-50924
Country
Germany
Facility Name
Klinikum Darmstadt
City
Darmstadt
ZIP/Postal Code
D-64283
Country
Germany
Facility Name
Krankenhaus Benrath
City
Dusseldorf
ZIP/Postal Code
40593
Country
Germany
Facility Name
Helios Klinikum Erfurt
City
Erfurt
ZIP/Postal Code
99012
Country
Germany
Facility Name
Universitaetsklinikum Essen
City
Essen
ZIP/Postal Code
D-45122
Country
Germany
Facility Name
Staedtische Kliniken Esslingen
City
Esslingen
ZIP/Postal Code
D-73730
Country
Germany
Facility Name
Klinikum Frankfurt (Oder) GmbH
City
Frankfurt (Oder)
ZIP/Postal Code
D-15236
Country
Germany
Facility Name
Klinikum Garmisch - Partenkirchen GmbH
City
Garmisch-Partenkirchen
ZIP/Postal Code
D-82467
Country
Germany
Facility Name
Internistische Praxisgemeinschaft
City
Germering
ZIP/Postal Code
82110
Country
Germany
Facility Name
Universitaetsklinikum Goettingen
City
Goettingen
ZIP/Postal Code
D-37075
Country
Germany
Facility Name
Klinik Fuer Innere Medizin, Hematology/Oncology, Ernst Moritz Armdt Universitaet
City
Greifswald
ZIP/Postal Code
D-17475
Country
Germany
Facility Name
Allgemeines Krankenhaus Hagen
City
Hagen
ZIP/Postal Code
D-58095
Country
Germany
Facility Name
Praxis fur Innere Medizin - Hamburg
City
Hamburg
ZIP/Postal Code
22457
Country
Germany
Facility Name
Hamatologische/Onkologische - Hamburg
City
Hamburg
ZIP/Postal Code
22767
Country
Germany
Facility Name
Asklepios Klinik St. Georg
City
Hamburg
ZIP/Postal Code
D-20099
Country
Germany
Facility Name
Evangelische Krankenhaus Hamm
City
Hamm
ZIP/Postal Code
DOH-59063
Country
Germany
Facility Name
Universitaetsklinikum des Saarlandes
City
Homburg
ZIP/Postal Code
D-66424
Country
Germany
Facility Name
Westpfalz-Klinikum GmbH
City
Kaiserslautern
ZIP/Postal Code
D-67653
Country
Germany
Facility Name
Staedtisches Klinikum Karlsruhe gGmbH
City
Karlsruhe
ZIP/Postal Code
76133
Country
Germany
Facility Name
University Hospital Schleswig-Holstein - Kiel Campus
City
Kiel
ZIP/Postal Code
D-24116
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis - Leer
City
Leer
ZIP/Postal Code
D-26789
Country
Germany
Facility Name
Klinikum Lippe - Lemgo
City
Lemgo
ZIP/Postal Code
D-32657
Country
Germany
Facility Name
Gemeinschaftspraxis - Ludwigshafen
City
Ludwigshafen
ZIP/Postal Code
67061
Country
Germany
Facility Name
Kreiskrankenhaus Luedenscheid
City
Luedenscheid
ZIP/Postal Code
58515
Country
Germany
Facility Name
Staedtisches Klinikum Magdeburg
City
Magdeburg
ZIP/Postal Code
D-39130
Country
Germany
Facility Name
Krankenhaus Maria Hilf GmbH
City
Moenchengladbach
ZIP/Postal Code
D-41063
Country
Germany
Facility Name
Haematologisch - Onkologische Gemeinschaftspraxis - Muenster
City
Muenster
ZIP/Postal Code
D-48149
Country
Germany
Facility Name
Klinikum der Universitaet Muenchen - Grosshadern Campus
City
Munich
ZIP/Postal Code
D-81377
Country
Germany
Facility Name
Onkologische Schwerpunktpraxis Dr. Schmidt
City
Neunkirchen
ZIP/Postal Code
D-66538
Country
Germany
Facility Name
Klinikum Oldenburg
City
Oldenburg
ZIP/Postal Code
D-26133
Country
Germany
Facility Name
Paracelsus Karankenhaus Ruit
City
Ostfildern
ZIP/Postal Code
73760
Country
Germany
Facility Name
Gemeinschaftspraxis - Pinneberg
City
Pinnebeg
ZIP/Postal Code
25421
Country
Germany
Facility Name
Klinikum Ernst Von Bergmann
City
Potsdam
ZIP/Postal Code
D-14467
Country
Germany
Facility Name
Scherpunktpraxis fur Hematologie und Onkologie
City
Regensburg
ZIP/Postal Code
93053
Country
Germany
Facility Name
Klinikum der Universitaet Regensburg
City
Regensburg
ZIP/Postal Code
D-93042
Country
Germany
Facility Name
Krankenhaus Barmherzige Brueder Regensburg
City
Regensburg
ZIP/Postal Code
D-93049
Country
Germany
Facility Name
Internistische Praxis Dres. Hempel und Hochdorfer
City
Rehling
ZIP/Postal Code
86508
Country
Germany
Facility Name
Klinik und Poliklinik fuer Innere Medizin - Universitaet Rostock
City
Rostock
ZIP/Postal Code
D-18057
Country
Germany
Facility Name
Caritasklinik St. Theresia
City
Saarbrucken
ZIP/Postal Code
D-66113
Country
Germany
Facility Name
Schwerpunktpraxis fur Hamatologie und Onkologie
City
Siegburg
ZIP/Postal Code
53721
Country
Germany
Facility Name
St. Marien - Krankenhaus Siegen GMBH
City
Siegen
ZIP/Postal Code
D-57072
Country
Germany
Facility Name
Hanse-Klinikum Stralsund - Krankenhaus West
City
Stralsund
ZIP/Postal Code
D-18437
Country
Germany
Facility Name
Haematologische Praxis
City
Stuttgart
ZIP/Postal Code
D-70173
Country
Germany
Facility Name
Krankenanstalt Mutterhaus der Borromaerinnen
City
Trier
ZIP/Postal Code
D-54290
Country
Germany
Facility Name
Universitaetsklinikum Tuebingen
City
Tuebingen
ZIP/Postal Code
D-72076
Country
Germany
Facility Name
Comprehensive Cancer Center Ulm at Universitaetsklinikum Ulm
City
Ulm
ZIP/Postal Code
D-89081
Country
Germany
Facility Name
St. Marienhospital - Vechta
City
Vechta
ZIP/Postal Code
D-49377
Country
Germany
Facility Name
Heinrich-Braun-Krankenhaus Zwickau
City
Zwickau
ZIP/Postal Code
08060
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28745332
Citation
Al-Sawaf O, Robrecht S, Bahlo J, Fink AM, Cramer P, von Tresckow J, Maurer C, Bergmann M, Seiler T, Lange E, Kneba M, Stilgenbauer S, Dohner H, Kiehl MG, Jager U, Wendtner CM, Fischer K, Goede V, Hallek M, Eichhorst B, Hopfinger G. Impact of gender on outcome after chemoimmunotherapy in patients with chronic lymphocytic leukemia: a meta-analysis by the German CLL study group. Leukemia. 2017 Oct;31(10):2251-2253. doi: 10.1038/leu.2017.221. Epub 2017 Jul 12. No abstract available.
Results Reference
background
PubMed Identifier
31092457
Citation
Sachanas S, Pangalis GA, Fink AM, Bahlo J, Fischer K, Levidou G, Kyrtsonis MC, Bartzi V, Vassilakopoulos TP, Kalpadakis C, Koulieris E, Moschogiannis M, Yiakoumis X, Tsirkinidis P, Angelopoulou MK, Eichhorst B, Hallek M. Small Lymphocytic Lymphoma: Analysis of Two Cohorts Including Patients in Clinical Trials of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG) or in "Real-Life" Outside of Clinical Trials. Anticancer Res. 2019 May;39(5):2591-2598. doi: 10.21873/anticanres.13382.
Results Reference
background
PubMed Identifier
21844497
Citation
Fischer K, Cramer P, Busch R, Stilgenbauer S, Bahlo J, Schweighofer CD, Bottcher S, Staib P, Kiehl M, Eckart MJ, Kranz G, Goede V, Elter T, Buhler A, Winkler D, Kneba M, Dohner H, Eichhorst BF, Hallek M, Wendtner CM. Bendamustine combined with rituximab in patients with relapsed and/or refractory chronic lymphocytic leukemia: a multicenter phase II trial of the German Chronic Lymphocytic Leukemia Study Group. J Clin Oncol. 2011 Sep 10;29(26):3559-66. doi: 10.1200/JCO.2010.33.8061. Epub 2011 Aug 15.
Results Reference
result
PubMed Identifier
22869884
Citation
Fischer K, Cramer P, Busch R, Bottcher S, Bahlo J, Schubert J, Pfluger KH, Schott S, Goede V, Isfort S, von Tresckow J, Fink AM, Buhler A, Winkler D, Kreuzer KA, Staib P, Ritgen M, Kneba M, Dohner H, Eichhorst BF, Hallek M, Stilgenbauer S, Wendtner CM. Bendamustine in combination with rituximab for previously untreated patients with chronic lymphocytic leukemia: a multicenter phase II trial of the German Chronic Lymphocytic Leukemia Study Group. J Clin Oncol. 2012 Sep 10;30(26):3209-16. doi: 10.1200/JCO.2011.39.2688. Epub 2012 Aug 6.
Results Reference
result
Links:
URL
http://www.dcllsg.de/en/trial/cll2m/index.php
Description
Click here for more information about this study: CLL2M (German CLL Study Group)

Learn more about this trial

Bendamustine and Rituximab in Treating Patients With Previously Untreated or Relapsed Chronic Lymphocytic Leukemia

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