Lenalidomide for the Treatment of CLL Patients With High-Risk Disease
18 Years
N/A
Both
B-cell Chronic Lymphocytic Leukemia, Stage III Chronic Lymphocytic Leukemia, Stage IV Chronic Lymphocytic Leukemia
Trial Information
Lenalidomide for the Treatment of CLL Patients With High-Risk Disease
PRIMARY OBJECTIVES:
I. To determine the time to progression in patients with high-risk chronic lymphocytic
leukemia (CLL) treated with lenalidomide.
SECONDARY OBJECTIVES:
I. To determine the clinical response (complete and partial response) in treatment-naïve
patients with high-risk CLL treated with single-agent lenalidomide.
II. To determine the incidence of immune-mediated flare reaction. III. To determine the
toxicity profile of single-agent lenalidomide in previously untreated patients with
high-risk CLL.
IV. To conduct correlative studies in bone marrow, peripheral blood, and/or lymph nodes of
patients treated with lenalidomide.
OUTLINE:
Patients receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days
for 8 courses in the absence of disease progression or unacceptable toxicity. Patients who
achieve complete response (by morphological criteria but have persistent minimal residual
disease by molecular criteria) or partial response may continue treatment beyond 8 courses.
Patients may undergo bone marrow, peripheral blood, and/or lymph node sample collection at
baseline and periodically during study for correlative studies.
After completion of study therapy, patients are followed up every 3 months for a maximum of
5 years.
Inclusion Criteria:
- Definitive diagnosis of B-cell chronic lymphocytic leukemia (B-CLL) as defined by the
International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria
- Must have high-risk B-CLL as defined by ≥ one of the following:
- High-risk cytogenetics (either 17p deletion and/or 11q deletion)
- Unmutated immunoglobulin heavy chain gene rearrangement
- Zap-70 and CD38 expression on leukemic cells will not be used as eligibility
criteria for enrollment into the clinical trial
- No prior treatment for the management of B-CLL
- Patients must have B-CLL requiring therapy as defined by the IWCLL criteria
- Must have measurable disease meeting one of the following criteria:
- Absolute lymphocyte count > 5,000/μL
- Measurable lymphadenopathy or organomegaly
- No tumor lysis syndrome (TLS) by Cairo-Bishop definition
- Patients with correction of electrolyte abnormalities allowed
- ECOG performance status 0-2
- ANC ≥ 1,500/mm³
- Platelet count ≥ 75,000/mm³
- Creatinine clearance ≥ 30 mL/min
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 3 times ULN (≤ 5 times ULN if hepatic metastases are present)
- Uric acid normal
- Patients with elevated uric acid allowed provided it is corrected with
appropriate pharmacologic measures
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must commit to continued abstinence from heterosexual intercourse or
use 2 acceptable methods of contraception (1 highly effective method and 1 additional
effective method) ≥ 28 days prior to, during, and for ≥ 28 days after discontinuing
lenalidomide
- Able to adhere to the study visit schedule and other protocol requirements
- No serious medical condition, laboratory abnormality, or psychiatric illness that
would prevent the patient from signing the informed consent form
- No condition, including the presence of laboratory abnormalities, that would place
the patient at unacceptable risk if he/she were to participate in the study or
confounds the ability to interpret data from the study
- No known hypersensitivity to thalidomide or lenalidomide
- No history of erythema nodosum characterized by a desquamating rash while taking
thalidomide or similar drugs
- No history of any other cancer except non-melanoma skin cancer or carcinoma in-situ
of the cervix or cancer for which the patient is in complete remission and off
therapy for > 3 years
- No cardiac arrest within the past 6 months
- No known history of hepatitis B infection, positive hepatitis B surface antigen, or
positive hepatitis C antibody
- No other concurrent anti-cancer agents or treatments
- More than 28 days since any prior experimental drug or therapy
- Aspirin (81 or 325 mg) or warfarin sodium daily as prophylactic anticoagulation
required
- No prior lenalidomide
Type of Study:
Interventional
Study Design:
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
Time to progression
Outcome Time Frame:
From the start of lenalidomide therapy to time of disease progression, assessed up to 24 months
Safety Issue:
No
Principal Investigator
Asher Chanan-Khan
Investigator Role:
Principal Investigator
Investigator Affiliation:
Roswell Park Cancer Institute
Authority:
United States: Food and Drug Administration
Study ID:
NCI-2011-02568
NCT ID:
NCT01271283
Start Date:
December 2010
Completion Date:
Related Keywords:
- B-cell Chronic Lymphocytic Leukemia
- Stage III Chronic Lymphocytic Leukemia
- Stage IV Chronic Lymphocytic Leukemia
- Leukemia
- Leukemia, Lymphocytic, Chronic, B-Cell
- Leukemia, Lymphoid
Name | Location |
|---|---|
| Roswell Park Cancer Institute | Buffalo, New York 14263 |
