Ofatumumab for Patients With Previously Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
Status: | Active, not recruiting |
---|---|
Conditions: | Blood Cancer, Lymphoma |
Therapuetic Areas: | Oncology |
Healthy: | No |
Age Range: | 18 - Any |
Updated: | 4/21/2016 |
Start Date: | July 2010 |
End Date: | November 2016 |
Phase II Trial of Ofatumumab for Older Patients and Patients Who Refuse Fludarabine-Based Regimens With Previously Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
The risk of immunosuppression deters many patients from receiving fludarabine, while
combination chemotherapy regimens are poorly tolerated by elderly or infirm chronic
lymphocytic leukemia (CLL) patients. Previous studies by our group and others have shown
that rituximab is safe and well tolerated when used as a single agent in patients with CLL.
In addition, maintenance therapy with rituximab was well tolerated by CLL patients, with
probable prolongation of progression-free survival (Hainsworth et al. 2003). Based on pre
clinical and clinical studies indicating possible increased efficacy of ofatumumab in
patients with CLL, we wish to develop an antibody-only regimen for older patients and
patients who refuse fludarabine-based regimens.
combination chemotherapy regimens are poorly tolerated by elderly or infirm chronic
lymphocytic leukemia (CLL) patients. Previous studies by our group and others have shown
that rituximab is safe and well tolerated when used as a single agent in patients with CLL.
In addition, maintenance therapy with rituximab was well tolerated by CLL patients, with
probable prolongation of progression-free survival (Hainsworth et al. 2003). Based on pre
clinical and clinical studies indicating possible increased efficacy of ofatumumab in
patients with CLL, we wish to develop an antibody-only regimen for older patients and
patients who refuse fludarabine-based regimens.
Inclusion Criteria:
1. CD20+ B-cell chronic lymphocytic leukemia (B-CLL) or small lymphocytic lymphoma
according to NCI criteria (see Appendix B).
2. Previously untreated CLL or small lymphocytic lymphoma (SLL).
3. Patients must require treatment according to NCI-Working Group guidelines (see
Appendix C).
4. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of ≤2 (see Appendix
A).
5. Laboratory values as follows ≤7 days of initiation of treatment:
- Creatinine <3.0 mg/dL
- Aspartate amino transferase (AST) or alanine amino transferase (ALT) and
alkaline phosphatase (ALP) must be <3 x upper limit of normal (ULN)
- Total bilirubin <1.5 x the institutional ULN
6. Patients must be hepatitis B sAg negative. Note: Patients who are HepB sAg negative
but are HepB cAb positive (regardless of HepB sAb status) will NOT be allowed.
7. Women of childbearing potential must have a negative serum pregnancy test performed
≤7 days prior to start of treatment. Women of childbearing potential or men with
partners of childbearing potential must use effective birth control measures during
treatment. If a woman becomes pregnant or suspects she is pregnant while
participating in this study, she must agree to inform her treating physician
immediately.
8. Patients ≤ 65 years of age, or patients 18-64 years of age who have declined
fludarabine-based regimens, are eligible.
9. Patient must be accessible for treatment and follow-up.
10. Patients must be able to understand the nature of this study, give written informed
consent prior to study entry, and comply with study requirements.
Exclusion Criteria:
1. Previous therapy for CLL/SLL. (Patients who have received steroids or IVIG for
autoimmune complications of CLL are eligible).
2. Current active hepatic or biliary disease (with the exception of patients with
Gilbert's syndrome, asymptomatic gallstones, liver metastases, or stable chronic
liver disease, per assessment by the treating physician).
3. Active bacterial or viral infection, or infection requiring intravenous antibiotic
treatment at the time of accrual.
4. Central nervous system lymphoma/CLL.
5. Transformation of CLL to aggressive non-Hodgkin lymphoma (NHL) (i.e., Richters
transformation).
6. History of other malignancy within 2 years of study entry which could affect
compliance with the protocol or interpretation of results. Patients with a history of
curatively treated basal or squamous cell carcinoma of the skin or in situ carcinoma
of the cervix, low grade, early-stage, localized prostate cancer treated surgically
with curative intent, ductal carcinoma in situ (DCIS) of the breast treated with
curative intent, are generally eligible. These cases should be discussed with the
study chair or study co-chair prior to enrollment.
7. Patients who are HepB sAg positive and/or HepB cAb positive.
8. Concurrent severe, intercurrent illness including, but not limited to, ongoing or
active infection, or psychiatric illness/social situations that would limit
compliance with study requirements.
9. Any condition that would prevent patient comprehension of the nature of, and risk
associated with, the study.
10. A serious underlying medical condition that would impair the ability of the patient
to receive protocol treatment.
11. A major surgical procedure, open biopsy, or significant traumatic injury ≤28 days of
beginning treatment, or anticipation of the need for major surgery during the course
of the study.
12. Treatment with any known non-marketed drug substance or experimental therapy within 5
terminal half lives or 4 weeks prior to visit 1, whichever is longer. Patients may
not receive any other investigational or anti-cancer treatments while participating
in this study.
We found this trial at
13
sites
Ohio State University The Ohio State University’s main Columbus campus is one of America’s largest...
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166 Stoneridge Drive
Columbia, South Carolina 29210
Columbia, South Carolina 29210
803-461-3000
South Carolina Oncology Associates, PA South Carolina Oncology Associates (SCOA) is the only comprehensive cancer...
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Oncology Hematology Care Our more than 60 physicians and advanced practice providers throughout neighborhood offices...
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Northeast Georgia Medical Center Northeast Georgia Health System (NGHS) is a not-for-profit community health system...
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Tennessee Oncology, PLLC Since 1976 Tennessee Oncology has been providing quality cancer care. In 2013,...
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