Dasatinib in Relapsed Chronic Lymphocytic Leukemia

Phase 2

Completed

Brief Summary: The purpose of this research study is to see if Dasatinib is effective and safe to give to people with relapsed chronic lymphocytic leukemia (CLL) and to determine the effects of the drug on LYN kinase activity in blood and bone marrow. Recent research shows that a key enzyme in CLL cells is responsible for cell survival. This enzyme is called LYN kinase. Laboratory studies show that inhibition of LYN kinase in CLL cells results in the death to CLL cells. Dasatinib has the ability to inhibit LYN kinase and, therefore, should have some effect on CLL cells.

Detailed Description: * After the screening procedures confirm that the participant is eligible and willing to participate in the research study, they will have the following tests and procedures.

* Dasatinib is given orally once daily. Each participant will have a pill diary to record doses and any missed doses. All necessary drug refills will be given during clinic appointments, at which time the pill diary and any unused study drug will be returned.

* During the first month of study treatment the participant will come to the clinic at the following intervals: Day 1: An EKG will be performed two hours after the first dose of medication; Days 3-8: Blood samples will be drawn once between days 3-8; Weeks 2-4: A physical examination, EKG and blood samples will be drawn once a week.

* Beginning with the second month of study treatment, participants will come to the clinic monthly for up to two years. The following tests and procedures will be done; physical examination (monthly), blood work (monthly), pregnancy test (monthly), EKG (monthly for 6 months, then when medically indicated), CT of the neck, chest and abdomen (every 2 months for 6 months, then once every 6 months), at the end of month 2, additional blood will be drawn for research testing.

* Participants can continue to take the study drug for up to two years as long as their disease does not progress and they are not experiencing any serious side effects.

Recruitment & Eligibility

Inclusion Criteria

18 years of age or older
CLL/SLL with cells positive by flow cytometry (or immunostaining) for CD19, CD23 and CD. Patients may be CD23 negative as long as they are also cyclin D1 negative.
Must have failed at least 1 prior fludarabine containing regimen or have failed at least 2 non-fludarabine containing regimens or have a contraindication to fludarabine use
ECOG performance status of 2 or better
Adequate organ function to tolerate chemotherapy
Adequate method of contraception

Exclusion Criteria

Pregnant or breast-feeding women
Uncontrolled angina within 3 months
Diagnosed or suspected congenital long QT syndrome
History of clinically significant ventricular arrhythmias
Prolonged QTc interval on pre-entry electrocardiogram
Uncontrolled hypertension
Drugs that are generally accepted to have a risk of causing Torsades de Pointes
Patient known to be HIV positive
Known significant bleeding disorder unrelated to CLL
Drugs that interfere with platelet function or coagulation must be stopped at least 7 days prior to entry

Arm && Interventions

Group	Intervention	Description
Dasatinib treatment	Dasatinib	All patients were treated with dasatinib pills by mouth as treatment.

Primary Outcome Measures

Name	Time	Method
Overall Objective Response	2 years	Overall objective response rate in terms of complete response, nodular partial response, and partial response to treatment. Objective response is when a biopsy shows. In general response is defined as the following (not complete criteria): Complete response (CR) requires all of the following for a period of at least 2 months: * Absence of lymphadenopathy * No hepatomegaly or splenomegaly * Absence of constitutional symptoms * Normal complete blood count Nodular partial response (nPR): Met the criteria for CR, but had residual bone marrow biopsy nodules as the only evidence of disease Partial response (PR): requires at least the following: * 50% decrease in peripheral blood lymphocyte count * 50% reduction in lymphadenopathy * 50% reduction in the size of the liver and/or spleen

Secondary Outcome Measures

Name	Time	Method
Median Time to Disease Progression	1 year	The median time to disease progression, measured from the start of treatment.
Median Overall Survival	3 years	The median survival time, as measured from the start of treatment until death from any cause.
Complete Response Rate	1 year	The number of participants with a 100% reduction in nodal mass.

Locations (2): Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Dana-Farber Cancer Institute
🇺🇸
Boston, Massachusetts, United States