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Fludara Plus Alemtuzumab (Campath, MabCampath) vs Fludara Alone in B-Cell Chronic Lymphocytic Leukemia (B-CLL) Patients
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Genzyme
Bayer Healthcare Pharmaceuticals, Inc./Bayer Schering Pharma
Information provided by: Genzyme
ClinicalTrials.gov Identifier: NCT00086580
  Purpose

This is a Phase III, prospective, multicenter, open-label, randomized, controlled study to evaluate and compare the efficacy and safety of Fludara plus alemtuzumab versus Fludara alone as second-line therapy for patients with relapsed or refractory B-cell chronic lymphocytic leukemia (B-CLL). Patients who meet all eligibility criteria and sign the informed consent document may be entered on the study.


Condition Intervention Phase
B-Cell Lymphocytic Leukemia
Biological: alemtuzumab (Campath, MabCampath); FluCAM [Fludara + Campath]
Biological: fludarabine phosphate (Fludara)
Phase III

MedlinePlus related topics: Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Fludarabine Fludarabine monophosphate Alemtuzumab Campath
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study
Official Title: Phase III Randomized Trial to Evaluate the Efficacy and Safety of Second-Line Therapy With Fludara Plus Alemtuzumab (Campath, MabCampath) Versus Fludara Alone in Patients With B-Cell Chronic Lymphocytic Leukemia

Further study details as provided by Genzyme:

Primary Outcome Measures:
  • Compare efficacy of FluCAM (Fludara+Campath) versus Fludara alone based on the PFS (Progression Free Survival) for the two treatment groups [ Time Frame: Up to 6 yrs but variable based on time to disease progression ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Comparison of overall response rates complete response [CR] + partial response [PR] between FluCam (Fludara+Campath) and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare the complete response rate between FluCam (Fludara+Campath) and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare the overall survival time and 3-year survival between FluCam and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • To compare the TTP (Time to Progression) between the two treatment arms (Flucam and Fludara alone) [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare duration of response between FluCAM and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare time to alternative therapy between FluCAM and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Determine the incidence of MRD negativity for FluCAM and Fludara alone by flow cytometry analysis of bone marrow and peripheral blood [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare the health related quality of life between FluCAM and Fludara alone using the EQ-5D [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]
  • Compare safety parameters using the NCI CTCAE by analyzing the frequency, severity, duration, and relationship of adverse events for FluCAM and Fludara alone [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: Yes ]
  • To compare the pharmacokinetics of Fludarabine alone to the pharmacokinetics of Fludarabine when concomitantly administered with Campath [ Time Frame: Up to 6 years but variable based on time to disease progression ] [ Designated as safety issue: No ]

Estimated Enrollment: 335
Study Start Date: July 2004
Estimated Study Completion Date: January 2010
Arms Assigned Interventions
ARM 1 - Combination Arm(Fludara + Campath): Active Comparator Biological: alemtuzumab (Campath, MabCampath); FluCAM [Fludara + Campath]

Phase A: Escalating Doses of Campath Alone (Arm 1):

Day 1 Campath 3 mg IV over 2 hours.

Day 2 Campath 10 mg IV over 2 hours if 3 mg as tolerated, else repeat 3 mg daily until tolerated.

Day 3 Campath 30 mg IV over 2 hours if 10 mg was tolerated, else repeat 10 mg daily until tolerated.

Phase B: FluCAM (Fludara + Campath) (Arm 1):

For Cycle 1 Fludara is administered at 30 mg/m2 over 30 minutes IV, Day 1, 2, 3 followed immediately (within 1 hour) by Campath 30 mg IV over 2 hours, Day 1, 2, 3. A similar schedule is set for Cycles 2 through 6; lengths of the infusions vary.

ARM 2 - Fludara Alone: Active Comparator Biological: fludarabine phosphate (Fludara)
For patients randomized to Arm 2, Fludara is administered at a dose of 25 mg/m2 intravenously (IV) over 15 to 30 minutes daily for 5 consecutive days (days 1 through 5) every 28 days (per package instructions). Each 28-day period is 1 cycle. The dose of Fludara will be based on the patient's BSA as calculated at the beginning of each cycle

  Eligibility

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

Inclusion Criteria:

  • A diagnosis of B-CLL; according to the NCI WG Criteria.
  • Relapsed or refractory disease after 1 prior regimen except patients who were refractory to (i.e., progressed on) Fludara or CAMPATH therapy. Patients who previously responded (CR or PR) to Fludara or CAMPATH therapy, but who have relapsed at the time of study entry, may be eligible but response to Fludara or CAMPATH therapy must have lasted >12 months (i.e., >12 months from a documented response to a documented relapse).
  • Binet stage A, stage B, or stage C or Rai Stage I through IV disease with evidence of progression as evidenced by the presence of one or more of the following: I.Disease-related B symptoms (fever of greater than 38C [100.5F] for greater than or equal to 2 weeks without evidence of infection, night sweats without evidence of infection, weight loss >10%). II.Evidence of progressive marrow failure as manifested by: 1) a decrease in hemoglobin to <11g/dL, or 2) a decrease in platelet count to <100 x 10^9/L within the previous 6 months, or 3) a decrease in absolute neutrophil count (ANC) to <1.0 X 10^9/L. III.Progressive splenomegaly to >2 cm below the left costal margin or other organomegaly. IV.Progressive lymphadenopathy. V.Progressive lymphocytosis with an increase of 50% over a 2-month period, or an anticipated doubling time of less than 6 months.
  • World Health Organization (WHO) performance status(PS)of 0 or 1.
  • Life expectancy >12 weeks.
  • Anti-cancer therapy, major surgery, or irradiation was completed >3 weeks before randomization in this study. Patient must have recovered from the acute side effects incurred as a result of previous therapy.
  • Serum creatinine less than or equal to 2.0 x institutional upper limits of normal (ULN) and calculated creatinine clearance (CrCl) greater than or equal to 30mL/min using the Cockroft and Gault formula.
  • Adequate liver function as indicated by a total bilirubin, AST, and ALT greater than or equal to 2 x the institutional ULN value, unless directly attributable to the patient's tumor.
  • Female patients with childbearing potential must have a negative serum pregnancy test with 2 weeks of first dose of study drug(s). Male and female patients must agree to use an effective contraceptive method while on study treatment, if appropriate, and for a minimum of 6 months following study therapy.
  • Signed, written informed consent (in the USA, includes HIPAA authorization).

Exclusion Criteria:

  • Previously treated with >1 prior regimen for B-CLL.
  • Previously treated with a fludarabine plus CAMPATH (FluCAM) regimen for B-CLL.
  • Positive Coombs test and actively hemolyzing.
  • ANC <1.5 x 10^9/L or platelet count <75 x 10^9/L, unless due to bone marrow involvement.
  • Medical condition requiring chronic use of pharmacologic doses of oral corticosteroids, i.e. anything other than replacement dose levels.
  • History of anaphylaxis following exposure to monoclonal antibodies.
  • Use of investigational agents within 6 weeks prior to study randomization.
  • Active infection or history of severe infection (grade 4) within 3 months prior to study randomization.
  • Known to be human immunodeficiency virus (HIV) positive.
  • Autoimmune thrombocytopenia.
  • Active secondary malignancy.
  • Known central nervous system (CNS) involvement with B-CLL.
  • Other severe, concurrent diseases, including tuberculosis, mental disorders, serious cardiac functional capacity (Class III or IV as defined by the New York Heart Association Classification), severe diabetes, severe hypertension, pulmonary disease (chronic obstructive pulmonary disease [COPD] with hypoxemia), or major organ malfunction (liver, kidney) that could interfere with the patient's ability to participate in the study.
  • Pregnant or nursing women.
  • Patients that have progressed with more aggressive B-cell cancers such as Richter's syndrome.
  • Active hepatitis or a history of prior viral hepatitis B or hepatitis C, or positive hepatitis B serologies without prior immunization.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00086580

  Show 61 Study Locations
Sponsors and Collaborators
Genzyme
Bayer Healthcare Pharmaceuticals, Inc./Bayer Schering Pharma
  More Information

Responsible Party: Genzyme Corporation ( Medical Monitor )
Study ID Numbers: CAM314
Study First Received: July 6, 2004
Last Updated: October 10, 2008
ClinicalTrials.gov Identifier: NCT00086580  
Health Authority: United States: Food and Drug Administration;   Austria: Federal Ministry for Health and Women;   Bulgaria: Bulgarian Drug Agency or Ministry of Health;   Canada: Health Canada;   Croatia: Ministry of Health and Social Care;   Czech Republic: State of Institute for Drug control;   France: Agence Francaise de Securite Sanitaire des Produits de Sante (AFSSAPS) - French health Products Safety Agency;   Germany: Feeral Institute for Drugs and Medical Devices;   Greece: National Organization for Medicines;   Italy: Ministry of Health;   Poland: Office for Registration of Medicinal Products, Medical Devices and Biocidal products or Main Pharmaceutical Inspectorate;   Portugal: National Pharmacy and Medicines Institute (IFARMED);   Romania: National Medicines Agency;   Russian Federation: Ministry of Health and Social Development of the Russian Federation;   Sweden: Medical Products Agency (MPA);   Ukraine: State Pharmacological Center - Ministry of Health

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

Additional relevant MeSH terms:
Antimetabolites
Neoplasms
Antimetabolites, Antineoplastic
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Immunosuppressive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 15, 2009