A Phase II Trial to Evaluate the Efficacy and Safety of Subcutaneously Administered Alemtuzumab (CAMPATH®, MabCampath®) in Patients With Previously Treated B-Cell Chronic Lymphocytic Leukemia
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- B-Cell Chronic Lymphocytic Leukemia (B-CLL)
- Sponsor
- Genzyme, a Sanofi Company
- Enrollment
- 86
- Locations
- 21
- Primary Endpoint
- Percentage of Participants Who Had an Overall Response (OR) as Determined by the Independent Response Review Panel (IRRP)
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
This is a Phase II, open-label, prospective, multicenter study to evaluate the efficacy and safety of subcutaneously administered alemtuzumab (CAMPATH, MabCampath) as therapy for patients with relapsed or refractory B-CLL who have been previously treated.
Investigators
Eligibility Criteria
Inclusion Criteria
- •A diagnosis of B-cell chronic lymphocytic leukemia (B-CLL); according to the National Cancer Institute Working Group (NCI WG) Criteria.
- •World Health Organization (WHO) performance status of 0, 1, or
- •Life expectancy ≥ 12 weeks.
- •Previous therapy with at least one but no more than 5 regimens (single agent or combination regimen). One therapy regimen is defined as consecutive, contiguous cycles of the same drug(s) with no treatment interruptions lasting \> 3 months.
- •Patient requires treatment for CLL per the following criteria: -Rai stage III or IV; -Rai stage 0-II with at least one of the following - evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia; Massive (i.e. greater than 6 cm below the left costal margin) or progressive splenomegaly; Progressive lymphocytosis with an increase of greater than 50% over a 2-month period or an anticipated doubling time of less than 6 months; Lymphocyte count \> 100\*10\^9/L; B symptoms.
- •More than 3 weeks since prior chemotherapy. Patient must have recovered from the acute side effects incurred as a result of previous therapy.
- •More than 3 weeks since using investigational agents. Patient must have recovered from the acute side effects incurred as a result of previous therapy.
- •Serum creatinine and conjugated (direct) bilirubin less than or equal to 2 times the institutional upper limit of normal (ULN) unless secondary to direct infiltration of the liver with CLL.
- •Female patients with childbearing potential must have a negative pregnancy test (serum or urine) within 2 weeks of first dose of study drug(s). All 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 (in the US, includes The Health Insurance Portability and Accountability Act of 1996 (HIPAA) authorization)
Exclusion Criteria
- •Positive Coombs test and evidence of active hemolysis.
- •Platelet count less than 50\*10\^9/L without splenomegaly.
- •History of anaphylaxis following exposure to rat or mouse derived CDR-grafted humanized monoclonal antibodies.
- •Previously treated with CAMPATH.
- •Previous bone marrow transplant.
- •Known central nervous system (CNS) involvement with B-CLL
- •Active infection, including human immunodeficiency virus (HIV) positive.
- •Active second malignancy.
- •Recent documented history (within 2 years) of active tuberculosis (TB), current active TB infection, currently receiving anti-tuberculous medication (e.g., INH, rifampin, streptomycin, pyrazinamide, or others).
- •Active hepatitis or a history of prior viral hepatitis B or hepatitis C, or positive hepatitis B serologies. Patients with a positive hepatitis B surface antibody (HBsAb) test with a documented history of prior hepatitis B immunization are eligible as long as other criteria are met (i.e. negative tests for: hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb) and hepatitis C virus antibody (HCVAb)).
Outcomes
Primary Outcomes
Percentage of Participants Who Had an Overall Response (OR) as Determined by the Independent Response Review Panel (IRRP)
Time Frame: up to 44 weeks
Participants were evaluated by the IRRP according to National Cancer Institute (NCI) 1996 response criteria. The percentage of participants whose best response observed during the study was either a Complete Response (CR) or a Partial Response (PR). Overall Response (OR) = CR + PR. A Complete Response (CR) exhibits a normal physical exam, marrow cells and blood values. A Partial Response (PR) has a \>= 50% decrease from baseline in lymphocytes, lymphadenopathy and liver or spleen exam.
Number of Participants With Best Disease Response as Determined by the Independent Response Review Panel (IRRP)
Time Frame: up to 44 weeks
Participants were evaluated by the IRRP according to National Cancer Institute (NCI) 1996 response criteria. The best response observed during the study is summarized. Response categories include Complete Response (CR) with normal physical exam, marrow cells and blood values, Partial Response (PR) with a \>= 50% decrease from baseline in lymphocytes, lymphadenopathy and liver or spleen exam, Stable Disease (SD) without significant progression from baseline, or Progressive Disease (PD) with increased size/number of nodes, size of liver or spleen, increase in lymphocytes, aggressive histology.
Secondary Outcomes
- Kaplan-Meier Estimates of Progression Free Survival as Determined by the Independent Response Review Panel (IRRP)(up to 5 years)
- Kaplan-Meier Estimates of Duration of Response as Determined by the Independent Response Review Panel (IRRP)(up to 5 years)
- Participants With Treatment-Emergent Adverse Events (TEAE)(up to 18 weeks of treatment plus 45 days)
- Kaplan-Meier Estimates of Overall Survival(up to 5 years)
- Participants With a Minimal Residual Disease (MRD) Status of Negative(44 weeks)