A Phase II Randomized Trial Comparing Standard and Low Dose Rituximab: Initial Treatment of Progressive Chronic Lymphocytic Leukemia in Elderly Patients Using Alemtuzumab, and Rituximab
OBJECTIVES:
Primary
- To compare the rate of complete and overall response in elderly patients with
progressive chronic lymphocytic leukemia (CLL) treated with one of two doses of
rituximab combined with alemtuzumab to determine if the use of modified-dose rituximab
significantly affects outcome.
Secondary
- To monitor and assess toxicity of these regimens.
- To determine the overall and progression-free survival, time to clinical response, time
to next treatment, and duration of response in patients treated with these regimens
- To assess the correlation between risk stratification prognostic markers (i.e., CD38,
ZAP-70, FISH, and IgVH mutation) and clinical outcome.
- To assess response to these regimens using both the NCI-WG 96 criteria and an expanded
definition of response for patients in complete remission, including
immunohistochemical examination of the bone marrow and sensitive flow cytometry (4-6
color) of blood for minimal residual disease and CT scans for residual adenopathy.
- To determine the mechanism of action of rituximab and alemtuzumab and to determine
mechanisms of resistance of a subpopulation of CLL cells to these drugs.
OUTLINE: This is a multicenter study. Patients are stratified according to FISH risk (low
[13q14-] vs intermediate [12+, no abnormality, all other abnormalities] vs high
[17p13-,11q22-]). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive alemtuzumab subcutaneously (SC) on days 1-3, 6, 8, 10, 13, 15,
17, 20, 22, 24, 27, 29, and 31 and standard-dose rituximab IV on days 8, 15, 22, and 29
in course 1. In courses 2 and 3, patients receive alemtuzumab SC on days 1, 3, 5, 8,
10, 12, 15, 17, 19, 22, 24, and 26 and standard-dose rituximab IV on days 3, 10, 17,
and 24. Treatment repeats every 28 days for up to 3 courses in the absence of disease
progression or unacceptable toxicity.
- Arm II: Patients receive alemtuzumab as in arm I. Patients also receive low-dose
rituximab IV on days 6, 8, 10, 13, 15, 17, 20, 22, 24, 27, 29, and 31 in course 1 and
on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22, 24, and 26 in courses 2 and 3. Treatment
repeats every 28 days for up to 3 courses in the absence of disease progression or
unacceptable toxicity.
Blood and bone marrow samples are collected periodically for cytogenetic and biomarker
analysis.
After completion of study therapy, patients are followed up periodically for 5 years.
Interventional
Allocation: Randomized, Primary Purpose: Treatment
Rate of complete and overall response
No
Clive S. Zent, MD
Study Chair
Mayo Clinic
Unspecified
CDR0000659098
NCT01013961
October 2010
Name | Location |
---|---|
Mayo Clinic Scottsdale | Scottsdale, Arizona 85259 |
Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
University of Chicago Cancer Research Center | Chicago, Illinois 60637 |
CCOP - Mount Sinai Medical Center | Miami Beach, Florida 33140 |
CCOP - Illinois Oncology Research Association | Peoria, Illinois 61602 |
CCOP - Carle Cancer Center | Urbana, Illinois 61801 |
Rush-Copley Cancer Care Center | Aurora, Illinois 60507 |
Cedar Rapids Oncology Associates | Cedar Rapids, Iowa 52403 |
Mercy Medical Center - Sioux City | Sioux City, Iowa 51104 |
Siouxland Hematology-Oncology Associates, LLP | Sioux City, Iowa 51101 |
St. Luke's Regional Medical Center | Sioux City, Iowa 51104 |
Bronson Methodist Hospital | Kalamazoo, Michigan 49007 |
West Michigan Cancer Center | Kalamazoo, Michigan 49007-3731 |
Borgess Medical Center | Kalamazooaa, Michigan 49001 |
Aultman Cancer Center at Aultman Hospital | Canton, Ohio 44710-1799 |
St. Rita's Medical Center | Lima, Ohio 45801 |
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center | Madison, Wisconsin 53792-6164 |
Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
CCOP - Cancer Research for the Ozarks | Springfield, Missouri 65807 |
CCOP - Dayton | Kettering, Ohio 45429 |
Mercy Hospital Cancer Center - Scranton | Scranton, Pennsylvania 18501 |
Hulston Cancer Center at Cox Medical Center South | Springfield, Missouri 65807 |
St. John's Regional Health Center | Springfield, Missouri 65804 |
Lewistown Hospital | Lewistown, Pennsylvania 17044 |
Mount Nittany Medical Center | State College, Pennsylvania 16803 |
Wayne Memorial Hospital, Incorporated | Goldsboro, North Carolina 27534 |
Swedish-American Regional Cancer Center | Rockford, Illinois 61104-2315 |
Tulane Cancer Center Office of Clinical Research | Alexandria, Louisiana 71315-3198 |
CCOP - Nevada Cancer Research Foundation | Las Vegas, Nevada 89109-2306 |
Gundersen Lutheran Center for Cancer and Blood | La Crosse, Wisconsin 54601 |
Ella Milbank Foshay Cancer Center at Jupiter Medical Center | Jupiter, Florida 33458 |
St. Joseph Medical Center | Bloomington, Illinois 61701 |
Graham Hospital | Canton, Illinois 61520 |
Memorial Hospital | Carthage, Illinois 62321 |
Eureka Community Hospital | Eureka, Illinois 61530 |
McDonough District Hospital | Macomb, Illinois 61455 |
BroMenn Regional Medical Center | Normal, Illinois 61761 |
Community Cancer Center | Normal, Illinois 61761 |
Community Hospital of Ottawa | Ottawa, Illinois 61350 |
Oncology Hematology Associates of Central Illinois, PC - Ottawa | Ottawa, Illinois 61350 |
Cancer Treatment Center at Pekin Hospital | Pekin, Illinois 61554 |
Oncology Hematology Associates of Central Illinois, PC - Peoria | Peoria, Illinois 61615 |
OSF St. Francis Medical Center | Peoria, Illinois 61637 |
Proctor Hospital | Peoria, Illinois 61614 |
Illinois Valley Community Hospital | Peru, Illinois 61354 |
St. Francis Hospital and Health Centers - Beech Grove Campus | Beech Grove, Indiana 46107 |
Mercy Regional Cancer Center at Mercy Medical Center | Cedar Rapids, Iowa 52403 |
Feist-Weiller Cancer Center at Louisiana State University Health Sciences | Shreveport, Louisiana 71130-3932 |
Upper Michigan Cancer Center at Marquette General Hospital | Marquette, Michigan 49855 |
Iredell Memorial Hospital | Statesville, North Carolina 28677 |
Samaritan North Cancer Care Center | Dayton, Ohio 45415 |
Grandview Hospital | Dayton, Ohio 45405 |
David L. Rike Cancer Center at Miami Valley Hospital | Dayton, Ohio 45409 |
Good Samaritan Hospital | Dayton, Ohio 45406 |
Blanchard Valley Medical Associates | Findlay, Ohio 45840 |
Charles F. Kettering Memorial Hospital | Kettering, Ohio 45429 |
Middletown Regional Hospital | Middletown, Ohio 45044 |
UVMC Cancer Care Center at Upper Valley Medical Center | Troy, Ohio 45373-1300 |
Ruth G. McMillan Cancer Center at Greene Memorial Hospital | Xenia, Ohio 45385 |
Danville Regional Medical Center | Danville, Virginia 24541 |
Mercy Cancer Center at Mercy Medical Center - North Iowa | Mason City, Iowa 50401 |
Missouri Baptist Cancer Center | St. Louis, Missouri 63131 |
Randolph Hospital | Asheboro, North Carolina 27203 |
Moses Cone Regional Cancer Center at Wesley Long Community Hospital | Greensboro, North Carolina 27401 |
Annie Penn Cancer Center | Reidsville, North Carolina 27320 |
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital | Fort Lauderdale, Florida 33308 |
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler | Savannah, Georgia 31405 |
Reid Hospital & Health Care Services | Richmond, Indiana 47374 |
McFarland Clinic, PC | Ames, Iowa 50010 |
Wayne Hospital | Greenville, Ohio 45331 |
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center | Hershey, Pennsylvania 17033-0850 |
Hematology and Oncology Associates of Northeastern Pennsylvania | Scranton, Pennsylvania 18510 |
UW Cancer Center Johnson Creek | Johnson Creek, Wisconsin 53038 |
Mid Dakota Clinic, PC | Bismarck, North Dakota 58501 |
Pardee Memorial Hospital | Hendersonville, North Carolina 28791 |
Kinston Medical Specialists | Kinston, North Carolina 28501 |
Phelps County Regional Medical Center | Rolla, Missouri 65401 |
Galesburg Clinic, PC | Galesburg, Illinois 61401 |
Illinois CancerCare - Bloomington | Bloomington%, Illinois 61701 |
Illinois CancerCare - Canton | Canton, Illinois 61520 |
Illinois CancerCare - Carthage | Carthage, Illinois 62321 |
Illinois CancerCare - Eureka | Eureka, Illinois 61530 |
Illinois CancerCare - Havana | Havana, Illinois 62644 |
Illinois CancerCare - Kewanee Clinic | Kewanee, Illinois 61443 |
Illinois CancerCare - Macomb | Macomb, Illinois 61455 |
OSF Holy Family Medical Center | Monmouth, Illinois 61462 |
Illinois CancerCare - Monmouth | Monmouth, Illinois 61462 |
Illinois CancerCare - Community Cancer Center | Normal, Illinois 61761 |
Illinois CancerCare - Pekin | Pekin, Illinois 61603 |
Illinois CancerCare - Peru | Peru, Illinois 61354 |
Illinois CancerCare - Princeton | Princeton, Illinois 61356 |
Illinois CancerCare - Spring Valley | Spring Valley, Illinois 61362 |
U.T. Medical Center Cancer Institute | Knoxville, Tennessee 37920-6999 |
Medcenter One Hospital Cancer Care Center | Bismarck, North Dakota 58501 |
St. Alexius Medical Center Cancer Center | Bismarck, North Dakota 58502 |
Hematology-Oncology Clinic | Baton Rouge, Louisiana 70808 |
Skaggs Cancer Center at Skaggs Regional Medical Center | Branson, Missouri 65616 |
Southeast Cancer Center | Cape Girardeau, Missouri 63703 |
Goldschmidt Cancer Center | Jefferson City, Missouri 65109 |
Riverview UW Cancer Center at Riverview Hospital | Wisconsin Rapids, Wisconsin 54494 |
Central Care Cancer Center at Carrie J. Babb Cancer Center | Bolivar, Missouri 65613 |
Mercy Clinic Cancer and Hematology - Rolla | Rolla, Missouri 65401 |