Chronic Lymphocytic Leukemia Clinical Trial
Official title:
A Phase II Translational Study of Sorafenib for the Treatment of Chronic Lymphocytic Leukemia Patients
This is a Phase 2 trial to evaluate the activity of sorafenib in relapsed or refractory CLL
patients with an iwCLL-WG indication to receive therapy.
Sorafenib is an orally active multikinase inhibitor, which targets the RAF/MEK/ERK signaling
pathway as well as several receptor tyrosine kinases. It is FDA approved for the treatment
of hepatocellular carcinoma and renal cell carcinoma. Preclinical studies in the
investigators laboratory demonstrated that sorafenib is cytotoxic to CLL cells.
The primary objective of the study is to determine the overall response rate of Sorafenib in
previously treated CLL patients. All patients will receive sorafenib at 400 mg twice daily
continuously for three months and then assessed for response. Responding patients may elect
to continue on treatment for an additional 9 months.
The UCSD Moores Cancer is conducting a Phase 2 clinical trial to evaluate the activity of
sorafenib in relapsed or refractory CLL patients.
Sorafenib (BAY 43-9006) is an oral multi-kinase inhibitor with effects on tumor
proliferation and tumor angiogenesis. It was initially selected based on inhibition of the
serine/threonine kinases Raf-1 and wild-type B-Raf, which are pivotal components of the
Ras/Raf/MEK/ERK signaling pathway. CLL cells derive survival support from their
microenvironment, in part by activation of this pathway. Preclinical studies performed in
our lab demonstrated that sorafenib was cytotoxic to CLL cells, including those from
patients with more aggressive disease and from patients with chemotherapy (fludarabine)
resistant disease.
The purpose of this study is to evaluate for evidence of anti-leukemic activity / clinical
activity of sorafenib by assessing decrease in absolute lymphocyte count (ALC)/leukemia cell
counts, lymphadenopathy, splenomegaly, and leukemia infiltration of bone marrow and to
assess the impact of sorafenib on the CLL B cells through corollary studies. Patients will
continue treatment for up to 3 monthly cycles unless toxicity or progressive disease.
Patients with noted stable disease (or better) in the absence of significant toxicity will
be allowed to receive another 1-9 cycles of single agent sorafenib. All patients will be
assessed for response following 3 cycles of treatment and/or following all therapy per
iwCLL-WG 2008 guidelines.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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