ISRCTN01844152进行中（未招募）未知
FLAIR: Front-Line therapy in CLL: Assessment of Ibrutinib-containing Regimes: a randomised controlled trial
niversity of Leeds (UK)0 个研究点目标入组 1,576 人开始时间: 2014年8月8日最近更新:
适应症
试验速览
- 阶段
- 未知
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 1,576
研究概览
简要总结
2017 Protocol article in https://www.ncbi.nlm.nih.gov/pubmed/28830517 protocol 2021 Protocol article in https://pubmed.ncbi.nlm.nih.gov/33419469/ protocol update (added 11/01/2021) 2023 Interim results article in https://pubmed.ncbi.nlm.nih.gov/37142374/ interim results (added 09/05/2023) 2023 Results article in https://pubmed.ncbi.nlm.nih.gov/38078508/ (added 19/12/2023)
研究设计
- 研究类型
- Interventional
入排标准
- 性别
- All
入选标准
- •Current inclusion criteria as of 13/11/2023:
- •For standard-risk pathway:
- •1. At least 18 years old. Maximum age of 75 years old.
- •2. B-CLL with a characteristic immunophenotype, including small lymphocytic lymphoma
- •3. Binet's Stages C, B or Progressive Stage A
- •4. Requiring therapy by the IWCLL criteria in that they must have at least one of the following:
- •4.1. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anaemia and/or thrombocytopenia.
- •4.2. Massive (i.e. 6 cm below the left costal margin) or progressive or symptomatic splenomegaly
- •4.3. Massive nodes (i.e. 10 cm in longest diameter) or progressive or symptomatic lymphadenopathy
- •4.4. Progressive lymphocytosis with an increase of more than 50% over a 2-month period or lymphocyte doubling time (LDT) of less than 6 months as long as the lymphocyte count is over 30 x 10^9/L
- •4.5. A minimum of any one of the following disease-related symptoms must be present:
- •4.5.1. Unintentional weight loss more than or equal to 10% within the previous 6 months.
- •4.5.2. Significant fatigue (i.e. Eastern Cooperative Oncology Group PS 2 or worse; cannot work or unable to perform usual activities)
- •4.5.3. Fevers of greater than 38.0°C for 2 or more weeks without other evidence of infection
- •4.5.4. Night sweats for more than 1 month without evidence of infection
- •5. Considered fit for treatment with FCR as determined by the treating clinician
- •6. World Health Organisation (WHO) performance status (PS) of 0, 1 or 2
- •7. Able to provide written informed consent
- •8. Biochemical values must be within the following limits within 14 days prior to randomization and at baseline:
- •8.1. Alanine aminotransferase (ALT) 3 x upper limit of normal (ULN). Aspartate aminotransferase (AST) 3 x ULN.
- •8.2. Total bilirubin = 1.5 x ULN, unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin
- •For the genetically high-risk pathway
- •1. TP53 abnormality confirmed by central laboratory
- •2. At least 18 years old (no upper limit)
- •3. Meeting all the inclusion criteria for the standard risk pathway stated, with the exception of ‘considered fit for treatment with FCR as determined by the treating clinician’
- •Previous inclusion criteria:
- •1. At least 18 years old. Maximum age of 75 years old.
- •2. B-CLL with a characteristic immunophenotype, including small lymphocytic lymphoma
- •3. Binet?s Stages C, B or Progressive Stage A
- •4. Requiring therapy by the IWCLL criteria in that they must have at least one of the following:
- •4.1. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anaemia and/or thrombocytopenia.
- •4.2. Massive (i.e. 6 cm below the left costal margin) or progressive or symptomatic splenomegaly
- •4.3. Massive nodes (i.e. 10 cm in longest diameter) or progressive or symptomatic lymphadenopathy
- •4.4. Progressive lymphocytosis with an increase of more than 50% over a 2-month period or lymphocyte doubling time (LDT) of less than 6 months as long as the lymphocyte count is over 30 x 10^9/L
- •4.5. A minimum of any one of the following disease-related symptoms must be present:
- •4.5.1. Unintentional weight loss more than or equal to 10% within the previous 6 months.
- •4.5.2. Significant fatigue (i.e. Eastern Cooperative Oncology Group PS 2 or worse; cannot work or unable to perform usual activities)
- •4.5.3. Fevers of greater than 38.0°C for 2 or more weeks without other evidence of infection
- •4.5.4. Night sweats for more than 1 month without evidence of infe
排除标准
- •Current exclusion criteria as of 07/09/2018:
- •1. Prior therapy for CLL
- •2. History or current evidence of Richter?s transformation
- •3. Major surgery within 4 weeks prior to randomisation
- •4. Active infection
- •5. Above 20% P53 deletion, determined by FISH
- •6. Past history of anaphylaxis following exposure to rat or mouse derived CDR-grafted humanised monoclonal antibodies
- •7. Concomitant warfarin or equivalent vitamin K inhibitor - added 29/06/2017: or other oral anticoagulant treatment; anyone requiring anticoagulation treatment for greater than 6 months is not eligible for trial entry
- •8. Pregnancy, lactation or women of child-bearing potential unwilling to use medically approved contraception whilst receiving treatment and for 12 months after treatment with rituximab has finished, or 30 days after treatment with ibrutinib has finished, whichever is latest. Women must agree to not donate eggs (ova, oocytes) for the purposes of assisted reproduction
- •9. Men whose partners are capable of having children but who are not willing to use appropriate medically approved contraception whilst receiving treatment and for 12 months after treatment with rituximab has finished, or 3 months after treatment with ibrutinib has finished, whichever is latest, unless they are surgically sterile
- •10. CNS involvement with CLL
- •11. Symptomatic cardiac failure not controlled by therapy, or unstable angina not adequately controlled by current therapy (in patients with a significant cardiac history the left ventricular function should be assessed and patients with severe impairment should be excluded)
- •12. Respiratory impairment (bronchiectasis or moderate COPD)
- •13. Other severe, concurrent diseases or mental disorders that could interfere with their ability to participate in the study
- •14. Inability to swallow oral medication
- •15. Disease significantly affecting gastrointestinal function and/or inhibiting small intestine absorption (malabsorption syndrome, resection of the small bowel, poorly controlled inflammatory bowel disease etc)
- •16. Known HIV positive
- •17. Positive serology for Hepatitis B (HB) defined as a positive test for HBsAg. In addition, if negative for HBsAg but HBcAb positive (regardless of HBsAb status), a HB DNA test will be performed and if positive the subject will be excluded
- •18. Positive serology for Hepatitis C (HC) defined as a positive test for HCAb, in which case reflexively perform a HC RIBA immunoblot assay on the same sample to confirm the result
- •19. History of prior malignancy, with the exception of the following:
- •19.1. Malignancy treated with curative intent and with no evidence of active disease present for more than 3 years prior to screening and felt to be at low risk for recurrence by treating physician
- •19.2. Adequately treated non-melanomatous skin cancer or lentigo maligna melanoma without current evidence of disease
- •19.3. Adequately treated cervical carcinoma in situ without current evidence of disease
- •20. Persisting severe pancytopenia (neutrophils <0.5 x 10^9/l or platelets <50 x 10^9/l) unless due to direct marrow infiltration by CLL
- •21. Current treatment with prednisolone of >10 mg/day
- •22. Active haemolysis (patients with haemolysis controlled with prednisolone at a dose 10 mg or less per day can be entered into the trial)
- •23. Patients with a creatinine clearance of less than 30 ml/min (either measured or derived by the Cockcroft Gault formula or alternative locally approved formula)
- •24. History of stroke or intracranial hemorrhage wi
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