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Oxaliplatin, Fludarabine, Cytarabine, and Rituximab in Patients With Richter's Transformation and Leukemias
This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, November 2008
Sponsors and Collaborators: M.D. Anderson Cancer Center
Sanofi-Aventis
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00472849
  Purpose

The goal of this clinical research study is to find the highest tolerable dose of fludarabine and cytarabine that can be given in combination with oxaliplatin and rituximab in the treatment of chronic lymphocytic leukemia (CLL), prolymphocytic leukemia, or Richter's transformation. Once the highest tolerable dose for this drug combination is found, the next goal of the study will be to find out if this combination therapy is effective in shrinking or slowing the growth of these diseases.


Condition Intervention Phase
Richter's Transformation
Leukemia
Drug: Oxaliplatin
Drug: Fludarabine
Drug: Cytarabine
Drug: Rituximab
Phase I
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
Drug Information available for: Cytarabine Cytarabine hydrochloride Fludarabine Fludarabine monophosphate Rituximab Oxaliplatin
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Historical Control, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I-II Study of Oxaliplatin, Fludarabine, Cytarabine, and Rituximab in Patients With Richter's Transformation, Prolymphocytic Leukemia, Aggressive, Relapsed or Refractory B-Cell Chronic Lymphocytic Leukemia

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Phase 1: Determine maximum total tolerated dose of fludarabine & cytarabine in combination with oxaliplatin and rituximab. [ Time Frame: 2010 ] [ Designated as safety issue: Yes ]
  • Phase 2: Assess objective response rates, including complete and partial response rates, and define safety/toxicity profile of oxaliplatin, fludarabine, cytarabine and rituximab (OFAR). [ Time Frame: 2010 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To determine the duration of response, disease-free survival, and overall survival. [ Time Frame: 2010 ] [ Designated as safety issue: Yes ]
  • To determine the pharmacokinetics and pharmacodynamics of oxaliplatin administered alone and following infusion of fludarabine and cytarabine. [ Time Frame: 2010 ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 102
Study Start Date: May 2007
Estimated Study Completion Date: May 2010
Arms Assigned Interventions
1: Experimental
OFAR
Drug: Oxaliplatin
Oxaliplatin 30 mg/m2/day, over approximately 2 hours, before fludarabine is started, on days 1-4.
Drug: Fludarabine
Fludarabine 30 mg/m2 daily I.V., over approximately 30 minutes, on days 2-3, 2-4, or 2-5 until maximum tolerated dose is reached.
Drug: Cytarabine
Cytarabine 500 mg/m2 daily I.V., 2-hour infusion starting 4 hours after first fludarabine dose is started, on days 2-3, 2-4, or 2-5, until maximum tolerated dose is reached.
Drug: Rituximab
Rituximab 375 mg/m2 I.V. on day 3, course 1 (on day 1, subsequent courses).

  Show Detailed Description

  Eligibility

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

Inclusion Criteria:

  • All patients with histologically or cytologically confirmed Richter's transformation, prolymphocytic leukemia, aggressive, or relapsed/refractory B-cell chronic lymphocytic leukemia are eligible for this protocol.
  • Patients must be 18 years of age or older.
  • Patients must have a performance status of 0-2 (Zubrod scale).
  • Patients must have adequate renal function (serum creatinine <= 2 mg/dL or creatinine clearance > 50 mL/min). Patients with renal dysfunction due to organ infiltration by disease may be eligible after discussion with the P.I. and consideration of appropriate dose adjustments.
  • Patients must have adequate hepatic function (bilirubin <= 2 mg/dl; SGOT or SGPT < 2.5x the ULN for the reference lab unless due to leukemia or congenital hemolytic disorder [for bilirubin]). Patients with hepatic dysfunction due to organ infiltration by disease may be eligible after discussion with the P.I. and consideration of appropriate dose adjustments.
  • Female patients of childbearing potential (including those < 1 year post-menopausal) and male patients must agree to use contraception.
  • Patients must sign an informed consent indicating that they are aware of the investigational nature of this study.
  • Patients must have platelet counts > 20,000, unless lower counts are due to disease involvement or autoimmune disorders.

Exclusion Criteria:

  • Untreated or uncontrolled life-threatening infection.
  • Oxaliplatin, fludarabine, cytarabine or rituximab intolerance.
  • Pregnancy or lactation.
  • Chemotherapy and/or radiation therapy within 4 weeks.
  • Medical condition, including mental illness or substance abuse, deemed by the investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interfere with the interpretation of the results.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00472849

Contacts
Contact: William G. Wierda, M.D., PhD 713-745-0428

Locations
United States, Texas
The University of Texas M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Contact: William G. Wierda, M.D., PhD     713-745-0428        
Principal Investigator: William G. Wierda, M.D., PhD            
Sponsors and Collaborators
M.D. Anderson Cancer Center
Sanofi-Aventis
Investigators
Principal Investigator: William G. Wierda, M.D., PhD M.D. Anderson Cancer Center
  More Information

M.D. Anderson's internet website  This link exits the ClinicalTrials.gov site

Responsible Party: The University of Texas M. D. Anderson Cancer Center ( William Wierda, M.D./Associate Professor )
Study ID Numbers: 2006-1026
Study First Received: May 11, 2007
Last Updated: November 12, 2008
ClinicalTrials.gov Identifier: NCT00472849  
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
OFAR 2
Oxaliplatin
Fludarabine
Cytarabine
Ara-C
Rituximab
Richter's Transformation
Prolymphocytic Leukemia
B-Cell Chronic Lymphocytic Leukemia
Leukemia
CLL

Study placed in the following topic categories:
Chronic lymphocytic leukemia
Richter syndrome
Leukemia, Lymphoid
Immunoproliferative Disorders
Rituximab
Leukemia, B-cell, chronic
Fludarabine monophosphate
Leukemia
Lymphatic Diseases
Oxaliplatin
Leukemia, Prolymphocytic
Leukemia, Lymphocytic, Chronic, B-Cell
Prolymphocytic leukemia
Fludarabine
Aggression
Leukemia, B-Cell
Lymphoproliferative Disorders
Cytarabine

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

ClinicalTrials.gov processed this record on January 14, 2009