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Sorafenib in Treating Patients With Relapsed Chronic Lymphocytic Leukemia
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: University of Chicago
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00303966
  Purpose

RATIONALE: Sorafenib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer.

PURPOSE: This phase II trial is studying how well sorafenib works in treating patients with relapsed chronic lymphocytic leukemia.


Condition Intervention Phase
Leukemia
Drug: sorafenib tosylate
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Sorafenib Sorafenib tosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase 2 Study of BAY 43-9006 in Relapsed Chronic Lymphocytic Leukemia

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Objective overall response rate [ Designated as safety issue: No ]
  • Time to progression [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]

Estimated Enrollment: 37
Study Start Date: November 2005
Estimated Primary Completion Date: December 2007 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the objective response rate in patients with recurrent chronic lymphocytic leukemia (CLL) treated with sorafenib.
  • Determine the toxicity in patients treated with sorafenib.

Secondary

  • Correlate bone marrow angiogenesis, CLL tumor cell expression of vascular endothelial growth factor (VEGF), VEGF receptors (flt-1, KDR, flt-4 and neuropilin-1), basic fibroblast growth factor, and plasma interleukin-8 levels with response.

OUTLINE: This is a multicenter study.

Patients receive oral sorafenib twice daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

PROJECTED ACCRUAL: Approximately 40 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed chronic lymphocytic leukemia (CLL) by NCI-WG immunophenotype and blood criteria

    • Documentation of current or prior peripheral blood (PB) or bone marrow (BM) immunophenotype compatible with CLL

      • Patients who currently do not have > 5,000/mm³ absolute lymphocytosis are eligible if they have previously met PB lymphocytosis criteria and have a current immunophenotype documenting monoclonal B lymphocytosis morphologically and immunophenotypically compatible with CLL
  • Intermediate-risk (Rai stage I or II) or high-risk (Rai stage III or IV) disease, including any of the following:

    • Rai stage I disease with lymphocytosis and enlarged nodes
    • Rai stage II disease with lymphocytosis plus splenomegaly and/or hepatomegaly (nodes positive or negative)
    • Rai stage III disease with lymphocytosis plus anemia
    • Rai stage IV disease with lymphocytosis and thrombocytopenia
  • Must require treatment with active disease, experiencing disease related symptoms, or having deterioration of blood counts, meeting ≥ 1 of the following criteria:

    • Presence of ≥ 1 of the following disease-related symptoms:

      • Weight loss > 10% within the past 6 months
      • Extreme fatigue (i.e., ECOG performance status 2: cannot work or unable to perform usual activities)
      • Fever > 100.5°F for 2 weeks without evidence of infection
      • Night sweats without evidence of infection
    • Evidence of progressive marrow failure, as manifested by worsening of anemia (hemoglobin < 10 g/dL), thrombocytopenia (platelet count < 100,000/mm³), and/or neutropenia (neutrophil count < 2,000/mm³)
    • Massive (i.e., > 6 cm below left costal margin) or progressive splenomegaly or discomfort from splenomegaly
    • Massive nodes or clusters (i.e., > 10 cm in longest diameter), progressive adenopathy, or discomfort from lymphadenopathy
    • Deterioration of blood counts and/or progressive lymphocytosis, with an increase of ≥ 10% documented over a 2-month period OR an anticipated doubling time < 6 months
  • Relapsed disease

    • Must receive at least 1, but no more than 3, prior chemotherapy regimens with any cytotoxic agent or antibody therapy

      • No fludarabine refractory disease

        • Responded to prior fludarabine without relapse or disease progression for at least 6 months
  • Patients with a history of Coombs-positive hemolytic anemia are eligible provided recovery from treatment of hemolysis and off steroids
  • No stage 0 CLL
  • No known CNS involvement

PATIENT CHARACTERISTICS:

  • Life expectancy > 6 months
  • ECOG performance status 0-2 OR Karnofsky performance status 70-100%
  • Absolute neutrophil count ≥ 1,000/mm³
  • Platelets ≥ 30,000/mm³
  • Bilirubin ≤ 2 mg/dL
  • AST/ALT ≤ 2.5 times upper limit of normal (ULN)
  • Creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min (for patients with creatinine levels above normal)
  • No currently active second malignancy
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patient must use effective contraception prior to and during study participation
  • No uncontrolled hypertension, defined as blood pressure (BP) > 150/100 mm Hg on 2 different measurements at least 1 day apart with either systolic or diastolic number meeting this definition

    • Patients may later enter the study, if they have achieved stable BP (i.e., < 140/90 mm Hg) on a regimen of ≤ 2 drugs after 6-8 weeks of therapy
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to sorafenib
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:

    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would limit compliance with the study requirements
  • No active infection requiring systemic antibiotics
  • No evidence of bleeding diathesis
  • No evidence of bowel perforation or obstruction risk
  • No swallowing dysfunction leading to difficulty taking the study drug

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior therapy
  • At least 2 weeks since prior antibiotic therapy
  • At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or radiotherapy
  • At least 12 weeks since prior monoclonal antibody
  • Concurrent warfarin for anticoagulation allowed provided all of the following are met:

    • On a stable therapeutic dose
    • INR ≤ 3
    • No active bleeding or pathological condition that carries high risk of bleeding
  • No prior MAPK signaling inhibitor agents or anti-angiogenesis agents
  • No concurrent combination anti-retroviral therapy for HIV-positive patients
  • No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (phenytoin, carbamazepine, or phenobarbital), rifampin, or Hypericum perforatum (St. John's wort)
  • No other concurrent investigational agents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00303966

Locations
United States, Illinois
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, United States, 60153
Central Illinois Hematology Oncology Center
Springfield, Illinois, United States, 62701
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, United States, 62526
Evanston Northwestern Healthcare - Evanston Hospital
Evanston, Illinois, United States, 60201-1781
Simmons Cooper Cancer Institute
Springfield, Illinois, United States, 62794-9677
Joliet Oncology-Hematology Associates, Limited - West
Joliet, Illinois, United States, 60435
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, United States, 61615-7828
Ingalls Cancer Care Center at Ingalls Memorial Hospital
Harvey, Illinois, United States, 60426
University of Chicago Cancer Research Center
Chicago, Illinois, United States, 60637-1470
United States, Indiana
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, United States, 46601
Fort Wayne Medical Oncology and Hematology
Fort Wayne, Indiana, United States, 46885-5099
United States, Maryland
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, United States, 21201
United States, Michigan
Oncology Care Associates, PLLC
Saint Joseph, Michigan, United States, 49085
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, United States, 48109-0942
United States, Missouri
David C. Pratt Cancer Center at St. John's Mercy
Saint Louis, Missouri, United States, 63141
United States, Wisconsin
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, United States, 53226
Sponsors and Collaborators
University of Chicago
Investigators
Principal Investigator: John E. Godwin, MD, MS Simmons Cooper Cancer Institute
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000462339, UCCRC-14194B, NCI-7071
Study First Received: March 15, 2006
Last Updated: October 22, 2008
ClinicalTrials.gov Identifier: NCT00303966  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
refractory chronic lymphocytic leukemia
stage I chronic lymphocytic leukemia
stage II chronic lymphocytic leukemia
stage III chronic lymphocytic leukemia
stage IV chronic lymphocytic leukemia

Study placed in the following topic categories:
Chronic lymphocytic leukemia
Lymphatic Diseases
Leukemia
Leukemia, Lymphoid
Immunoproliferative Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-cell, chronic
Lymphoproliferative Disorders
Leukemia, B-Cell
Sorafenib

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009