Refractory Chronic Lymphocytic Leukemia Clinical Trial
Official title:
A Phase II Study of Fludarabine (F), Rituxan (R) and Avastin (A) Followed by RA Maintenance in Patients With Relapsed/Refractory B-cell Chronic Lymphocytic Leukemia (CLL)
RATIONALE: Drugs used in chemotherapy, such as fludarabine phosphate, work in different ways
to stop the growth of cancer cells, either by killing the cells or by stopping them from
dividing. Monoclonal antibodies, such as rituximab and bevacizumab, can block cancer growth
in different ways. Some block the ability of cancer cells to grow and spread. Others find
cancer cells and help kill them or carry cancer-killing substances to them. Giving
fludarabine phosphate together with rituximab and bevacizumab may kill more cancer cells.
PURPOSE: This phase II trial is studying how well giving fludarabine phosphate together with
rituximab and bevacizumab works in treating patients with B-cell chronic lymphocytic
leukemia that has relapsed or not responded to treatment.
PRIMARY OBJECTIVES:
I. To estimate PFS at 2 years after FR plus Avastin (A) induction followed by Rituximab plus
Avastin (RA) maintenance therapy for relapsed/refractory CLL patients.
SECONDARY OBJECTIVES:
I. To evaluate response rates after FR-A induction and RA maintenance therapy. II. To
eliminate residual disease (documented by flow cytometry and/or PCR) in patients who have
achieved a CR after FR-A.
III. To estimate the rate of conversion of PR to CR after FR-A. IV. To determine the safety
and pharmacokinetics of FR-A and RA maintenance.
OUTLINE:
INDUCTION THERAPY: Patients receive fludarabine phosphate IV over 20-30 minutes once daily
on days 1-5 and rituximab IV once daily on days 4 or 5. Treatment repeats every 35 days for
6 courses in the absence of disease progression or unacceptable toxicity. Beginning on day 8
of course 1, patients also receive bevacizumab IV over 30 minutes. Treatment repeats every
21 days for 9 courses in the absence of disease progression or unacceptable toxicity.
Patients achieving complete response, partial response, or nodular partial response proceed
to maintenance therapy.
MAINTENANCE THERAPY: Beginning 2 months after completion of induction treatment, patients
receive rituximab IV every 3 months and bevacizumab IV over 30 minutes every 3 weeks.
Treatment continues for 2 years in the absence of disease progression or unacceptable
toxicity.
After completion of study treatment, patients are followed up every 3 months for 2 years,
every 6 months for 3 years, and annually thereafter.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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