Chronic Lymphocytic Leukemia Clinical Trial
Official title:
Ibrutinib Monotherapy in Early Stage Chronic Lymphocytic Leukemia (CLL) Without IWCLL/NCI-WG 2008 Treatment Indications But With High-Risk Features for Disease Progression
The standard approach to managing chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL) is to wait until you have symptoms before treatment is given. The goal of this clinical research study is to learn if providing earlier treatment for CLL or SLL with ibrutinib in patients who do not have symptoms will be more effective than waiting until symptoms develop. This is an investigational study. Ibrutinib is FDA approved and commercially available for the treatment of patients with CLL or SLL. It is considered investigational to give ibrutinib to CLL and SLL patients before symptoms develop. The study doctor can describe how the study drug is designed to work. Up to 50 participants will be enrolled in this study. All will take part at MD Anderson.
Study Drug Administration: If you are found to be eligible to take part in this study, you will take ibrutinib by mouth 1 time every day. Each dose should be taken with about 1 cup (8 ounces) of water. If you miss a dose of ibrutinib, it can be taken as soon as possible on the same day. You should take your next dose as scheduled. If you forget to take a dose, do not take extra capsules on the next day to "make up" the missed dose. You will be given standard drugs, such as allopurinol or valacyclovir, to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks. If you have side effects, your dose of ibrutinib may be lowered or temporarily stopped until you recover from the side effects. Length of Treatment: You may take ibrutinib for up to 2 years (24 cycles). If at the end of 2 years you are benefitting from ibrutinib and the study doctor thinks it is in your best interest to continue taking it, other treatment options will be discussed with you to allow you to continue to take ibrutinib. You will no longer be able to take the study drug if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions. Study Visits: Each cycle is 28 days. On Day 28 of Cycles 1-3 and then every 3 cycles after that until Cycle 24 (Cycles 6, 9, 12, and so on): - Blood (about 2 tablespoons) will be drawn for routine tests. - You will have a physical exam. - You will have an EKG. On Day 28 of Cycles 1, 3, 6, 12, and 24, blood (about 3 tablespoons) will be drawn to test for genetic mutations related to the disease. At Months 3, 6, and 12, additional blood (about 8 teaspoons) will be drawn for immune system testing. On Day 28 of Cycles 6, 12, 18 and 24, you will have CT, MRI or PET/CT scan to check the status of the disease. Depending on the results of the CT, MRI or PET/CT scans, you may not need to have these scans repeated. The doctor will discuss this with you. On Day 28 of Cycles 6, 12 and 24, you will have a bone marrow biopsy to check the status of the disease. If the doctor thinks it is needed or if the disease gets worse, some tests/procedures, such as physical exams and blood draws for routine tests, may be repeated more often. Long-term follow-up: Every 3 months, during a regularly scheduled clinic visit (if you are still receiving care at MD Anderson) or by phone (if you are receiving care outside of MD Anderson), you will be asked how you are doing, if you are still taking ibrutinib, and if you have any side effects. If called, this call should last about 5-10 minutes. ;
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