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Lenalidomide and Obinutuzumab for Previously Untreated CLL

Primary Purpose

Chronic Lymphocytic Leukemia

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Lenalidomide
Obinutuzumab
Sponsored by
University of California, San Diego
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Lymphocytic Leukemia focused on measuring cancer, lenalidomide, obinutuzumab, CLL

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers
  • Main Inclusion Criteria:

    1. Clinical and phenotypic verification of B cell CLL or SLL and measurable disease.
    2. Prior therapy: no prior CLL therapy.
    3. Patients must have progressive disease based on 2008 iwCLL definition with one of the following:
  • Symptomatic or progressive splenomegaly
  • Symptomatic lymph nodes, nodal clusters, or progressive lymphadenopathy
  • Progressive anemia (hemoglobin ≤ 11 g/dL)
  • Progressive thrombocytopenia (platelets ≤ 100 x 109/L)
  • Weight loss > 10% body weight over the preceding 6 month period
  • Fatigue attributable to CLL
  • Fever or night sweats for > 2 weeks without evidence of infection
  • Progressive lymphocytosis with an increase of > 50% over a 2-month period or an anticipated doubling time of less than 6 months.
  • Able to take aspirin (81mg or 325mg) daily, warfarin, low molecular weight heparin, or equivalent anticoagulation as prophylactic medication.
  • All study participants must be registered into the mandatory Revlimid REMS program, and be willing and able to comply with the requirements of REMS.
  • Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to and again within 24 hours prior to starting Revlimid and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control.
  • Females of reproductive potential must adhere to the scheduled pregnancy testing as required in the Revlimid REMS program.
  • ECOG performance status of 0-2.
  • Adequate hematologic function
  • Adequate renal function
  • Adequate hepatic function

Exclusion Criteria:

  • Pregnant or breast-feeding women will not be entered on this study due to risks of fetal and teratogenic adverse events as seen in animal/human studies. Women for child-bearing age must obtain a pregnancy test and pregnant or breast feeding females are excluded.
  • Known hypersensitivity to thalidomide or lenalidomide (if applicable), including development of erythema nodosum or a desquamating rash while taking thalidomide or similar drugs.
  • Deep vein thrombosis or superficial thrombophlebitis of any cause on current anticoagulation therapy at the time of screening.
  • Patients who are currently receiving another investigational agent are excluded.
  • Current infection requiring parenteral antibiotics.
  • Known seropositive for or active viral infection with human immunodeficiency virus (HIV); or known active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) based on detectable viral load. Patients who are seropositive because of hepatitis B virus vaccine or passive immunization by intravenous immunoglobulin (IVIG) are eligible.
  • Active malignancy within the previous 2 years (other than completely resected non-melanoma skin cancer or carcinoma in situ).
  • Known central nervous system (CNS) involvement by malignancy.
  • Untreated autoimmunity such as autoimmune hemolytic anemia, or immune thrombocytopenia.
  • Insufficient recovery from surgical-related trauma or wound healing.
  • Impaired cardiac function

Sites / Locations

  • UC San Diego Moores Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lenalidomide-Obinutuzumab

Arm Description

All patients receive the combination of lenalidomide and obinutuzumab. There is no randomization or comparator arm.

Outcomes

Primary Outcome Measures

The incidence of dose limiting toxicity
For phase 1 portion of study
Complete Response Rate
For phase 2 portion of study: iwCLL 2008 defined complete response rate

Secondary Outcome Measures

Number of patients with adverse events associated with lenalidomide-obinutuzumab
Progression free survival rate
Progression free survival rate at completion of combination therapy, total progression free survival, and overall survival determined by International Working Group in CLL (iwCLL) criteria
Overall response rate
Overall response rate (Complete response + partial response) and stable disease rate (also based on 2008 iwCLL guidelines), also at the time of primary endpoint response assessment.

Full Information

First Posted
February 13, 2015
Last Updated
February 21, 2018
Sponsor
University of California, San Diego
Collaborators
Celgene Corporation, Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02371590
Brief Title
Lenalidomide and Obinutuzumab for Previously Untreated CLL
Official Title
A Phase 2 Clinical Trial To Evaluate Lenalidomide And Obinutuzumab For The Treatment Of Patients With Not Previously Treated Chronic Lymphocytic Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Study Not Activated Due to Contract Issues
Study Start Date
February 2018 (Anticipated)
Primary Completion Date
December 2019 (Anticipated)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of California, San Diego
Collaborators
Celgene Corporation, Genentech, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is phase 1/2 study for patients with CLL or (SLL) who have not been previously treated. This study will evaluate whether obinutuzumab and lenalidomide is safe and tolerable in this setting and induce complete clinical responses.
Detailed Description
This is phase 1/2 study for patients with CLL or (SLL) who have not been previously treated. The primary endpoint is to determine safety and tolerability of the regimen and determine complete response (CR) to therapy. The secondary endpoints will assess the impact of treatment on progression free and overall survival Eligible patients will receive obinutuzumab for 6 x 28 day cycles. Patients will also receive lenalidomide orally once daily on days 8-28 of each 28 day cycles. The starting dose for all patients is 5 mg PO daily. At the start of each cycle, there is intra-patient dose-escalation to a maximum of 25mg daily, as tolerated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia
Keywords
cancer, lenalidomide, obinutuzumab, CLL

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Lenalidomide-Obinutuzumab
Arm Type
Experimental
Arm Description
All patients receive the combination of lenalidomide and obinutuzumab. There is no randomization or comparator arm.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
Revlimid
Intervention Description
Lenalidomide is administered orally once daily on Days 8-28 of each 28 day cycle. The starting dose for all patients is 5 mg PO daily. At the start of each cycle, there is intra-patient dose-escalation to a maximum of 25mg daily, as tolerated. The study consists of a 6 month treatment period with obinutuzumab and lenalidomide, and an indefinite period of treatment with lenalidomide for as long as it is helpful and tolerated by subject.
Intervention Type
Drug
Intervention Name(s)
Obinutuzumab
Other Intervention Name(s)
Gazyva
Intervention Description
Obinutuzumab is administered as follows: Cycle 1: 100mg IV on day 1, 900 mg IV on day 2, 1000mg day 8, 1000 mg on day 15. Cycles 2-6: 1000mg IV on day 1.
Primary Outcome Measure Information:
Title
The incidence of dose limiting toxicity
Description
For phase 1 portion of study
Time Frame
1 year
Title
Complete Response Rate
Description
For phase 2 portion of study: iwCLL 2008 defined complete response rate
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Number of patients with adverse events associated with lenalidomide-obinutuzumab
Time Frame
2 years
Title
Progression free survival rate
Description
Progression free survival rate at completion of combination therapy, total progression free survival, and overall survival determined by International Working Group in CLL (iwCLL) criteria
Time Frame
2 years
Title
Overall response rate
Description
Overall response rate (Complete response + partial response) and stable disease rate (also based on 2008 iwCLL guidelines), also at the time of primary endpoint response assessment.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Clinical and phenotypic verification of B cell CLL or SLL and measurable disease. Prior therapy: no prior CLL therapy. Patients must have progressive disease based on 2008 iwCLL definition with one of the following: Symptomatic or progressive splenomegaly Symptomatic lymph nodes, nodal clusters, or progressive lymphadenopathy Progressive anemia (hemoglobin ≤ 11 g/dL) Progressive thrombocytopenia (platelets ≤ 100 x 109/L) Weight loss > 10% body weight over the preceding 6 month period Fatigue attributable to CLL Fever or night sweats for > 2 weeks without evidence of infection Progressive lymphocytosis with an increase of > 50% over a 2-month period or an anticipated doubling time of less than 6 months. Able to take aspirin (81mg or 325mg) daily, warfarin, low molecular weight heparin, or equivalent anticoagulation as prophylactic medication. All study participants must be registered into the mandatory Revlimid REMS program, and be willing and able to comply with the requirements of REMS. Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to and again within 24 hours prior to starting Revlimid and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control. Females of reproductive potential must adhere to the scheduled pregnancy testing as required in the Revlimid REMS program. ECOG performance status of 0-2. Adequate hematologic function Adequate renal function Adequate hepatic function Exclusion Criteria: Pregnant or breast-feeding women will not be entered on this study due to risks of fetal and teratogenic adverse events as seen in animal/human studies. Women for child-bearing age must obtain a pregnancy test and pregnant or breast feeding females are excluded. Known hypersensitivity to thalidomide or lenalidomide (if applicable), including development of erythema nodosum or a desquamating rash while taking thalidomide or similar drugs. Deep vein thrombosis or superficial thrombophlebitis of any cause on current anticoagulation therapy at the time of screening. Patients who are currently receiving another investigational agent are excluded. Current infection requiring parenteral antibiotics. Known seropositive for or active viral infection with human immunodeficiency virus (HIV); or known active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) based on detectable viral load. Patients who are seropositive because of hepatitis B virus vaccine or passive immunization by intravenous immunoglobulin (IVIG) are eligible. Active malignancy within the previous 2 years (other than completely resected non-melanoma skin cancer or carcinoma in situ). Known central nervous system (CNS) involvement by malignancy. Untreated autoimmunity such as autoimmune hemolytic anemia, or immune thrombocytopenia. Insufficient recovery from surgical-related trauma or wound healing. Impaired cardiac function
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Choi, MD
Organizational Affiliation
UC San Diego Moores Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
UC San Diego Moores Cancer Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Lenalidomide and Obinutuzumab for Previously Untreated CLL

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