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临床试验/NCT00086580
NCT00086580已完成3 期

A Phase III Randomized Trial to Evaluate the Efficacy and Safety of Second-Line Therapy With Fludarabine Plus Alemtuzumab vs. Fludarabine Alone in Patients With B-Cell Chronic Lymphocytic Leukemia

Genzyme, a Sanofi Company96 个研究点 分布在 15 个国家目标入组 335 人开始时间: 2004年7月1日最近更新:
适应症
干预措施

试验速览

阶段
3 期
状态
已完成
发起方
入组人数
335
试验地点
96
主要终点
Kaplan-Meier Estimates for Progression-free Survival (PFS) Based on Independent Response Review Panel (IRRP) Assessment

研究概览

简要总结

This is a Phase 3, prospective, multicenter, open-label, randomized, controlled study to evaluate and compare the efficacy and safety of fludarabine plus alemtuzumab versus fludarabine alone as second-line therapy for patients with relapsed or refractory B-cell chronic lymphocytic leukemia (B-CLL). Patients who meet all eligibility criteria and sign the informed consent document may be entered on the study.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • A diagnosis of B-cell chronic lymphocytic leukemia (B-CLL); according to the National Cancer Institute Working Group (NCI WG) criteria.
  • Relapsed or refractory disease after 1 prior regimen except patients who were refractory to (i.e., progressed on) fludarabine or alemtuzumab therapy. Patients who previously responded (complete response or partial response) to fludarabine or alemtuzumab therapy, but who have relapsed at the time of study entry, may be eligible but response to fludarabine or alemtuzumab therapy must have lasted >12 months (i.e., >12 months from a documented response to a documented relapse).
  • Binet stage A, stage B, or stage C or Rai Stage I through IV disease with evidence of progression as evidenced by the presence of one or more of the following:
  • I. Evidence of progressive marrow failure as manifested by: 1) a decrease in hemoglobin to <11g/dL, or 2) a decrease in platelet count to <100 x 10^9/L within the previous 6 months, or 3) a decrease in absolute neutrophil count (ANC) to <1.0 X 10^9/L.
  • II. Progressive splenomegaly to >2 cm below the left costal margin or other organomegaly.
  • III. Progressive lymphadenopathy.
  • IV. Progressive lymphocytosis with an increase of 50% over a 2-month period, or an anticipated doubling time of less than 6 months.
  • World Health Organization (WHO) performance status (PS) of 0 or
  • Life expectancy >12 weeks.
  • Anti-cancer therapy, major surgery, or irradiation was completed >3 weeks before randomization in this study. Patient must have recovered from the acute side effects incurred as a result of previous therapy.
  • Serum creatinine less than or equal to 2.0 x institutional upper limits of normal (ULN) and calculated creatinine clearance (CrCl) greater than or equal to 30mL/min using the Cockroft and Gault formula.
  • Adequate liver function as indicated by a total bilirubin, AST, and ALT less than or equal to 2 x the institutional ULN value, unless directly attributable to the patient's tumor.
  • Female patients with childbearing potential must have a negative serum pregnancy test with 2 weeks of first dose of study drug(s). Male and female patients must agree to use an effective contraceptive method while on study treatment, if appropriate, and for a minimum of 6 months following study therapy.
  • Signed, written informed consent.

排除标准

  • Previously treated with >1 prior regimen for B-CLL.
  • Previously treated with a fludarabine plus alemtuzumab (FluCAM) regimen for B-CLL.
  • Positive Coombs test and actively hemolyzing.
  • Absolute neutrophil count (ANC) <1.5 x 10^9/L or platelet count <75 x 10^9/L, unless due to bone marrow involvement.
  • Medical condition requiring chronic use of pharmacologic doses of oral corticosteroids, i.e. anything other than replacement dose levels.
  • History of anaphylaxis following exposure to monoclonal antibodies.
  • Use of investigational agents within 6 weeks prior to study randomization.
  • Active infection or history of severe infection (grade 4) within 3 months prior to study randomization.
  • Known to be human immunodeficiency virus (HIV) positive.
  • Autoimmune thrombocytopenia.
  • Active second malignancy.
  • Known central nervous system (CNS) involvement with B-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.
  • Patients that have progressed with more aggressive B-cell cancers such as Richter's syndrome.
  • Active hepatitis or a history of prior viral hepatitis B or hepatitis C, or positive hepatitis B serologies without prior immunization.

研究组 & 干预措施

Combination Arm (FluCAM)

Experimental

干预措施: FluCAM [Fludara + Campath] (Biological)

结局指标

主要结局

Kaplan-Meier Estimates for Progression-free Survival (PFS) Based on Independent Response Review Panel (IRRP) Assessment

时间窗: Up to 6 years

Progression-free survival was defined as the number of days from the date of randomization to the date of first objective documentation of progressive disease (PD) as determined by the treatment-blinded IRRP, or death due to any cause. Results are expressed in months.

次要结局

  • Participant Best Response to Treatment Assessed by the Independent Response Review Panel (IRRP)(Up to 9 months)
  • Mean EQ-5D™ Index Scores to Measure Quality of Life at End of Treatment(up to month 6 (end of treatment))
  • Kaplan-Meier Estimates of Overall Survival Time(Up to 6 years)
  • Kaplan Meier Estimates for Time to Disease Progression Assessed by the Independent Response Review Panel (IRRP)(Up to 6 years)
  • Kaplan-Meier Estimates for Duration of Response Assessed by the Independent Response Review Panel (IRRP)(Up to 6 years)
  • Mean EuroQol Visual Analogue Scale (EQ-VAS) Scores to Measure Quality of Life at Baseline(Day 0 (baseline))
  • Kaplan-Meier Estimates for Time to Alternative Therapy(Up to 6 years)
  • Mean EQ-5D™ Index Scores to Measure Quality of Life at Baseline(Day 0 (baseline))
  • Mean EuroQol Visual Analogue Scale (EQ-VAS) Scores to Measure Quality of Life at End of Treatment(up to month 6 (end of treatment))
  • Summary of Participants With Adverse Experiences (AEs)(Up to 6 years)
  • Mean Systemic Clearance (CL) of Fludarabine(month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion))
  • Total Volume of Distribution (Vss) of Fludarabine(month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion))
  • Maximum Plasma Concentration (Cmax) of Fludarabine(month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion))
  • Area Under the Curve (AUC) of Fludarabine From (AUC 0-tau)(month 4 (cycle 4): first day of dosing (pre-dose, 0.5 hr end of infusion), second day of dosing (pre-dose, 0.5 hr end of infusion), third day of dosing (pre-dose, 0.25 hr, 0.5 hr end of infusion, 1,2,3,4,6,24,48,72 hr after start of fludarabine infusion))
  • Participants With Minimal Residual Disease (MRD)(up to 9 months)

研究者

发起方
Genzyme, a Sanofi Company
申办方类型
Industry
责任方
Sponsor

研究点 (96)

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