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Assessment of Efficacy and Safety of Front-line Fludarabine, Cyclophoshamide and Ofatumumab Chemoimmunotherapy in Young Patients With Chronic Lymphocytic Leukemia. (CLL0911)

Primary Purpose

B-cell Lymphoid Leukemia, Young Patients

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Cyclophosphamide
Fludarabine
Ofatumumab
Sponsored by
Gruppo Italiano Malattie EMatologiche dell'Adulto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Lymphoid Leukemia focused on measuring CLL, Fludarabine, Cyclophosphamide, Ofatumumab

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • B-cell CLL diagnosis by 2008 revised IWCLL criteria.
  • Treatment requirement according to the 2008 revised IWCLL criteria.
  • No previous treatment.
  • Age > 18 year and . 65 years.
  • ECOG performance status of 0-1 at study entry and CIRS score .6.
  • Adequate renal function (creatinine clearance.60 ml/min estimated using the Cockcroft-Gaultequation) .
  • For male and female subjects of childbearing potential, agreement to use effective contraception.
  • Signed written informed const according to ICH/EU/GCP and national local laws.

Exclusion Criteria:

  • Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease and/or laboratory abnormality which in the opinion of the investigator may represent a risk for the patient and/or that would prevent the subject from signing the informed consent form.
  • Pregnant or lactating females.
  • Known positive serology for HIV.
  • Positive serology for Hepatitis B (HBV) defined as a positive test for HBsAg and HBV-DNA.
  • HCV-RNA positive.
  • Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection, tuberculosis and active hepatitis.
  • History of tuberculosis within the last five years or recent exposure to tuberculosis equal to or less than 6 months.
  • Known presence of alcohol and/or drug abuse.
  • Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to the inclusion in the study, congestive heart failure (NYHA III-IV), arrhythmia unless controlled by therapy.. grade 2 neuropathy; history of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae.
  • Uncontrolled autoimmune hemolytic anemia or thrombocytopenia.
  • One or more laboratory abnormalities:

    1. Calculated creatinine clearance (Cockroft-Gault)<60mL/min.
    2. Absolute granulocyte count <1500/ƒÊL not disease related.
    3. Platelet count < 75000/ƒÊL not disease related.
    4. GOT, GPT, GT, alkaline phosphatase > 1,5 x upper limit of normal value unless due to disease involvement); serum bilirubin >1.5mg/dL, subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones)
  • Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to enrollment, whichever is longer, or currently participating in any other interventional clinical study
  • Other past or current malignancy. Subjects who have been free of malignancy for at least 5 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible.

Sites / Locations

  • S.O.C. di Ematologia - Azienda Ospedaliera - SS. Antonio e Biagio e Cesare Arrigo
  • Dipartimento Area Medica - Presidio Ospedaliero "C. e G.Mazzoni"
  • S.O.C. di Medicina Interna B - Ospedale - Cardinal Massaia di Asti
  • ASL12 - Biella Ospedale degli Infermi - Dip. di Medicina e Geriatria - Struttura Complessa di Medicina Interna
  • Azienda Ospedaliera Pugliese Ciaccio - Presidio Ospedaliero A.Pugliese - Unità Operativa di Ematologia
  • Sezione di Ematologia e Fisiopatologia delle Emostasi - Azienda Ospedaliera - Arcispedale S. Anna
  • RCCS_AOU San Martino-IST-Ematologia 1-Monoblocco 11°piano- lato ponente
  • ASL Le/1 P.O. Vito Fazzi - U.O. di Ematologia ed UTIE
  • Azienda Ospedaliera Universitaria - Policlinico G. Martino Dipartimento di Medicina Interna - U.O. Messina
  • Ospedale Niguarda " Ca Granda"
  • S.C.D.U. Ematologia - DIMECS e Dipartimento Oncologico - Università del Piemonte Orientale Amedeo Avogadro
  • Divisione di Ematologia con trapianto di midollo - A.U. Policlinico "Paolo Giaccone"
  • Cattedra di Ematologia CTMO Università degli Studi di Parma
  • Dipartimento Emato-Oncologia A.O."Bianchi-Melacrino-Morelli"
  • Unità Operativa Complessa di Ematologia - Arcispedale S. Maria Nuova
  • Padiglione Cesalpino - I piano - Divisione di Ematologia - Ospedale S. Camillo
  • Policlinico Umberto I, Hematology Department - Sapienza
  • U.O.C. Ematologia - Ospedale S.Eugenio
  • U.O.C. Ematologia e Trapianti - A.O. Senese - Policlinico " Le Scotte"
  • SS.C. di Oncoematologia - Dipartimento di Medicina Clinica e Sperimentale - Azienda Ospedaliera - S. Maria Di Terni
  • Div. di Ematologia Ospedale "S.Giovanni Battista"
  • Clinica Ematologica - Policlinico Universitario

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study therapy

Arm Description

Outcomes

Primary Outcome Measures

Number of complete responses.
The complete response (CR) rate after FCO2 front-line treatment.

Secondary Outcome Measures

Number of overall responses.
Overall Response (OR) rate after FCO2 front-line treatment.
Number of patients in progression-free survival.
Progression-free survival (PFS) calculated from the date of first treatment dose - induction phase - until the date of the first documentation of progressive disease or until death (whatever the cause), whichever occurs first. Patients still alive and known to be progression free will be censored at the moment of last follow-up.
Number of patients needing a new CLL Treatment.
Time to a new CLL treatment (TTT) will be calculated from the date of last treatment dose until date of a new treatment received for CLL, where death occurred before the new treatment will be considered as competing risk. Patients still alive without receiving a new treatment will be censored at the time of the last follow-up.
Number of patients in overall survival
Overall survival (OS): defined as the time interval between the date of first treatment dose - induction phase- and the date of death for any cause; patients still alive will be censored at the moment of last follow-up.
Number of toxic events.
Toxicity of treatment according the last NCI criteria.
Outcome of patients according to clinical and biologica variables.
Outcome of patients (response, PFS OS) according to clinical and biologic variables (age; size of nodes, 2-microglobulin, lymphocyte count, stage, IgVH, p53, FISH, ZAP-70, CD38, FLCs).

Full Information

First Posted
January 4, 2013
Last Updated
October 12, 2020
Sponsor
Gruppo Italiano Malattie EMatologiche dell'Adulto
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1. Study Identification

Unique Protocol Identification Number
NCT01762202
Brief Title
Assessment of Efficacy and Safety of Front-line Fludarabine, Cyclophoshamide and Ofatumumab Chemoimmunotherapy in Young Patients With Chronic Lymphocytic Leukemia.
Acronym
CLL0911
Official Title
Phase 2 Multicenter, Study to Assess the Efficacy and the Safety of Front-line Fludarabine, Cyclophoshamide and Ofatumumab (FCO2) Chemoimmunotherapy in Young (≤65 Yrs) Patients With Chronic Lymphocytic Leukemia (CLL).
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
November 5, 2013 (Actual)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
October 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gruppo Italiano Malattie EMatologiche dell'Adulto

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Assessment of safety and efficacy of with fludarabine and cyclophosphamide (FC) combined with ofatumumab (FCO2) in previously untreated "young" patients with Chronic Lymphocytic Leukemia (CLL).
Detailed Description
Given that: rituximab, fludarabine and cyclophosphamide (FCR) front-line treatment was associated with a high OR rate, superior PFS and OS as compared to fludarabine and cyclophosphamide regimen; a direct relationship between the dose of rituximab and the response rate has been reported; ofatumumab, as single agent, proved activity in CLL patients with refractory disease; ofatumumab, fludarabine and cylophosphamide (O-FC) front-line treatment has been associated with a high complete response (CR) rate; the expected grade 3-4 granulocytopenia could led to reduce the dose intensity of study drugs (FC) and increase the infection rate; a schedule combining FC with an increased dose of ofatumumab associated to primary phrophylaxis of granulocytopenia could be associated with an improvement in the CR rate. The purpose of this study is to determine whether we could improve the CR rate of the golden standard treatment for fit patients with CLL , the FCR regimen, with a chemoimmunotherapy including FC combined with an increased dose of the monoclonal antibody ofatumumab, given every other week (FCO2) associated with a primary prophylaxis of granulocytopenia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Lymphoid Leukemia, Young Patients
Keywords
CLL, Fludarabine, Cyclophosphamide, Ofatumumab

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Study therapy
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Type
Drug
Intervention Name(s)
Ofatumumab
Primary Outcome Measure Information:
Title
Number of complete responses.
Description
The complete response (CR) rate after FCO2 front-line treatment.
Time Frame
After 8 months from study entry.
Secondary Outcome Measure Information:
Title
Number of overall responses.
Description
Overall Response (OR) rate after FCO2 front-line treatment.
Time Frame
After 8 months from study entry.
Title
Number of patients in progression-free survival.
Description
Progression-free survival (PFS) calculated from the date of first treatment dose - induction phase - until the date of the first documentation of progressive disease or until death (whatever the cause), whichever occurs first. Patients still alive and known to be progression free will be censored at the moment of last follow-up.
Time Frame
After 32 months from study entry.
Title
Number of patients needing a new CLL Treatment.
Description
Time to a new CLL treatment (TTT) will be calculated from the date of last treatment dose until date of a new treatment received for CLL, where death occurred before the new treatment will be considered as competing risk. Patients still alive without receiving a new treatment will be censored at the time of the last follow-up.
Time Frame
After 32 months from study entry.
Title
Number of patients in overall survival
Description
Overall survival (OS): defined as the time interval between the date of first treatment dose - induction phase- and the date of death for any cause; patients still alive will be censored at the moment of last follow-up.
Time Frame
After 32 months from study entry.
Title
Number of toxic events.
Description
Toxicity of treatment according the last NCI criteria.
Time Frame
After 32 months from study entry.
Title
Outcome of patients according to clinical and biologica variables.
Description
Outcome of patients (response, PFS OS) according to clinical and biologic variables (age; size of nodes, 2-microglobulin, lymphocyte count, stage, IgVH, p53, FISH, ZAP-70, CD38, FLCs).
Time Frame
After 32 months from study entry.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: B-cell CLL diagnosis by 2008 revised IWCLL criteria. Treatment requirement according to the 2008 revised IWCLL criteria. No previous treatment. Age > 18 year and . 65 years. ECOG performance status of 0-1 at study entry and CIRS score .6. Adequate renal function (creatinine clearance.60 ml/min estimated using the Cockcroft-Gaultequation) . For male and female subjects of childbearing potential, agreement to use effective contraception. Signed written informed const according to ICH/EU/GCP and national local laws. Exclusion Criteria: Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease and/or laboratory abnormality which in the opinion of the investigator may represent a risk for the patient and/or that would prevent the subject from signing the informed consent form. Pregnant or lactating females. Known positive serology for HIV. Positive serology for Hepatitis B (HBV) defined as a positive test for HBsAg and HBV-DNA. HCV-RNA positive. Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection, tuberculosis and active hepatitis. History of tuberculosis within the last five years or recent exposure to tuberculosis equal to or less than 6 months. Known presence of alcohol and/or drug abuse. Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to the inclusion in the study, congestive heart failure (NYHA III-IV), arrhythmia unless controlled by therapy.. grade 2 neuropathy; history of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae. Uncontrolled autoimmune hemolytic anemia or thrombocytopenia. One or more laboratory abnormalities: Calculated creatinine clearance (Cockroft-Gault)<60mL/min. Absolute granulocyte count <1500/ƒÊL not disease related. Platelet count < 75000/ƒÊL not disease related. GOT, GPT, GT, alkaline phosphatase > 1,5 x upper limit of normal value unless due to disease involvement); serum bilirubin >1.5mg/dL, subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones) Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to enrollment, whichever is longer, or currently participating in any other interventional clinical study Other past or current malignancy. Subjects who have been free of malignancy for at least 5 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roberto Foà, Pr.
Organizational Affiliation
Policlinico Umberto I, Hematology Department.
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Francesca R. Mauro
Organizational Affiliation
Policlinico Umberto I, Hematology Department.
Official's Role
Study Director
Facility Information:
Facility Name
S.O.C. di Ematologia - Azienda Ospedaliera - SS. Antonio e Biagio e Cesare Arrigo
City
Alessandria
Country
Italy
Facility Name
Dipartimento Area Medica - Presidio Ospedaliero "C. e G.Mazzoni"
City
Ascoli Piceno
Country
Italy
Facility Name
S.O.C. di Medicina Interna B - Ospedale - Cardinal Massaia di Asti
City
Asti
Country
Italy
Facility Name
ASL12 - Biella Ospedale degli Infermi - Dip. di Medicina e Geriatria - Struttura Complessa di Medicina Interna
City
Biella
Country
Italy
Facility Name
Azienda Ospedaliera Pugliese Ciaccio - Presidio Ospedaliero A.Pugliese - Unità Operativa di Ematologia
City
Catanzaro
Country
Italy
Facility Name
Sezione di Ematologia e Fisiopatologia delle Emostasi - Azienda Ospedaliera - Arcispedale S. Anna
City
Ferrara
Country
Italy
Facility Name
RCCS_AOU San Martino-IST-Ematologia 1-Monoblocco 11°piano- lato ponente
City
Genova
Country
Italy
Facility Name
ASL Le/1 P.O. Vito Fazzi - U.O. di Ematologia ed UTIE
City
Lecce
Country
Italy
Facility Name
Azienda Ospedaliera Universitaria - Policlinico G. Martino Dipartimento di Medicina Interna - U.O. Messina
City
Messina
Country
Italy
Facility Name
Ospedale Niguarda " Ca Granda"
City
Milano
Country
Italy
Facility Name
S.C.D.U. Ematologia - DIMECS e Dipartimento Oncologico - Università del Piemonte Orientale Amedeo Avogadro
City
Novara
Country
Italy
Facility Name
Divisione di Ematologia con trapianto di midollo - A.U. Policlinico "Paolo Giaccone"
City
Palermo
Country
Italy
Facility Name
Cattedra di Ematologia CTMO Università degli Studi di Parma
City
Parma
Country
Italy
Facility Name
Dipartimento Emato-Oncologia A.O."Bianchi-Melacrino-Morelli"
City
Reggio Calabria
Country
Italy
Facility Name
Unità Operativa Complessa di Ematologia - Arcispedale S. Maria Nuova
City
Reggio Emilia
Country
Italy
Facility Name
Padiglione Cesalpino - I piano - Divisione di Ematologia - Ospedale S. Camillo
City
Roma
Country
Italy
Facility Name
Policlinico Umberto I, Hematology Department - Sapienza
City
Roma
Country
Italy
Facility Name
U.O.C. Ematologia - Ospedale S.Eugenio
City
Roma
Country
Italy
Facility Name
U.O.C. Ematologia e Trapianti - A.O. Senese - Policlinico " Le Scotte"
City
Siena
Country
Italy
Facility Name
SS.C. di Oncoematologia - Dipartimento di Medicina Clinica e Sperimentale - Azienda Ospedaliera - S. Maria Di Terni
City
Terni
Country
Italy
Facility Name
Div. di Ematologia Ospedale "S.Giovanni Battista"
City
Torino
Country
Italy
Facility Name
Clinica Ematologica - Policlinico Universitario
City
Udine
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
http://www.gimema.it
Description
GIMEMA Foundation website

Learn more about this trial

Assessment of Efficacy and Safety of Front-line Fludarabine, Cyclophoshamide and Ofatumumab Chemoimmunotherapy in Young Patients With Chronic Lymphocytic Leukemia.

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