An Australasian, phase II, multicentre, randomised, dose intensification study investigating oral fludarabine, oral cyclophosphamide and i.v. rituximab (poFCivR) tolerance in previously untreated elderly (≥ 65 years old) patients with chronic lymphocytic leukaemia (CLL05)

Funding

Commercial sector/Industry,Roche

Scientific enquiries

Prof Stephen Mulligan

Brief Summary

The trial is a randomised phase II open-label multicentre trial investigating oral fludarabine, cyclophosphamide and intravenous rituximab in previously untreated elderly (= 65 years old) patients with chronic lymphocytic leukaemia. The primary objective is to investigate the tolerability of each of three of these combination chemotherapies and the associated primary endpoint is the proportion of paitens able to complete 6 cycles of therapy.

Key Inclusion Criteria

1. B-CLL confirmed according to National Cancer Institute (NCI) Working Group Criteria. 2. Binet stage B or C, or progressive symptomatic stage A (see Protocol Appendix I). 3. Age = 65 years old. 4. Judged to be in need of systemic therapy (see Protocol Appendix II). 5. No previous treatment (chemotherapy, radiotherapy or immunotherapy) for CLL. 6. Alkaline phosphatase and transaminases = 2 x ULN.(Upper Limits of Normal) 7. Creatinine clearance = 50 ml/min (as calculated by (estimated Glomerular .... 1. B-CLL confirmed according to National Cancer Institute (NCI) Working Group Criteria. 2. Binet stage B or C, or progressive symptomatic stage A (see Protocol Appendix I). 3. Age = 65 years old. 4. Judged to be in need of systemic therapy (see Protocol Appendix II). 5. No previous treatment (chemotherapy, radiotherapy or immunotherapy) for CLL. 6. Alkaline phosphatase and transaminases = 2 x ULN.(Upper Limits of Normal) 7. Creatinine clearance = 50 ml/min (as calculated by (estimated Glomerular Filtration Rate) eGFR; eGFR also calculated by Cockcroft and Gault formula for final analysis; see Protocol Appendix III). 8. Females of childbearing potential or fertile males must take contraceptive measures during and at least 6 months after cessation of therapy. 9. (Eastern Cooperative Group) ECOG performance status 0-1. 10. Cumulative Illnes Rating Scale CIRS score < 6 (see Protocol Appendix IV). 11. Life expectancy > 6 months. 12. Patient’s written informed consent.
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Key Exclusion Criteria

1. Age < 65 years old. 2. Non-progressive or stable Binet stage A. 3. Clinically significant auto-immune cytopenia, Coombs-positive haemolytic anaemia (as discerned by treating physician). 4. Active second malignancy currently requiring treatment (except for non-melanoma skin cancer or cervical cancer in situ or tumour treated curatively by surgery > 5 years ago) 5. Concomitant disease requiring prolonged use of glucocorticoids (> 1 month). 6. Known hypersensitivity with anaphylactic reaction to .... 1. Age < 65 years old. 2. Non-progressive or stable Binet stage A. 3. Clinically significant auto-immune cytopenia, Coombs-positive haemolytic anaemia (as discerned by treating physician). 4. Active second malignancy currently requiring treatment (except for non-melanoma skin cancer or cervical cancer in situ or tumour treated curatively by surgery > 5 years ago) 5. Concomitant disease requiring prolonged use of glucocorticoids (> 1 month). 6. Known hypersensitivity with anaphylactic reaction to humanised monoclonal antibodies or any of the study drugs. 7. ECOG performance status 2-3. 8. Class III or IV cardiac disease defined by the NYHA. 9. Severe or debilitating pulmonary disease. 10. Severe or debilitating central nervous system disease or cerebral dysfunction. 11. Transformation to aggressive B-cell malignancy, e.g. diffuse large cell lymphoma, Richter’s syndrome or prolymphocytic leukaemia. 12. Active bacterial, viral or fungal infection; patients who have known Human Immunodeficiency Virus (HIV) infection or active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. 13. Total bilirubin > 2 x ULN. 14. Creatinine clearance < 50 ml/min (as calculated by eGFR). 15. Any coexisting medical or psychological condition that would preclude participation in the required study procedures. 16. Treatment with any other investigational agent, or participation in another clinical trial within 30 days prior to entering this study. 17. Pregnancy and lactation.
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