LeukemiaPhase 2NCT00074282
Pentostatin, Cyclophosphamide, and Rituximab Followed By Campath-1H in Patients With Relapsed or Refractory B-Cell CLL
A Phase 2 study testing rituximab, cyclophosphamide and pentostatin in people with Leukemia, run by Eastern Cooperative Oncology Group at 143 sites in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as pentostatin, cyclophosphamide, and CAMPATH-1H work in different ways to stop cancer cells from dividing so they stop growing or die. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Leukemia
- What is being tested?
- rituximab, cyclophosphamide and pentostatin
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 102 participants
- Where
- 143 sitesUnited States
- Study dates
- 14 Apr 2005to 6 May 2018
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of B-cell chronic lymphocytic leukemia (CLL) meeting the following criteria:
- Peripheral blood absolute lymphocyte count greater than 5,000/mm^3
- Lymphocytosis must comprise small to moderate size lymphocytes with no greater than 55% prolymphocytes, atypical lymphocytes, or lymphoblasts morphologically
- Phenotypically characterized CLL defined by the following:
- Predominant population of cells share B-cell antigens with CD5 in the absence of other pan-T-cell markers (CD3 or CD2)
- B cell expresses either kappa or lambda light chains
Show all 30Show fewer
- Surface immunoglobulin with low cell surface density expression
- Requires chemotherapy, as indicated by any of the following:
- Disease-related symptoms
- Weight loss of 10% or more within the past 6 months
- Extreme fatigue
- Fevers greater than 100.5°F for 2 weeks without evidence of infection
- Night sweats without evidence of infection
- Evidence of progressive marrow failure manifested by the development of or worsening anemia (hemoglobin no greater than 10 g/dL) and/or thrombocytopenia (platelet count no greater than 100,000/mm^3)
- Massive (i.e., greater than 6 cm below left costal margin) or progressive splenomegaly
- Massive nodes or clusters (i.e., greater than 10 cm in longest diameter) or progressive adenopathy
- Progressive lymphocytosis with an increase of greater than 50% over a 2-month period OR an anticipated doubling time of less than 6 months
- Demonstrated progression after at least 1 course of either an alkylating agent-based or purine nucleoside-based (e.g., fludarabine) regimen OR failed to achieve a meaningful response OR relapsed after prior therapy
- Patients who have relapsed after a pentostatin-based regimen are eligible provided the response was greater than 12 months prior to study entry
- 18 and over
- ECOG Performance Status 0-2
- Bilirubin no greater than 2 mg/dL (unless secondary to tumor, hemolysis, or Gilbert syndrome)
- Creatinine no greater than 2.0 mg/dL
- Creatinine clearance ≥ 30 mL/min
- Negative pregnancy test
- Fertile patients must use 2 methods of effective contraception (including 1 barrier method) for at least 28 days before starting lenalidomide, while participating in the study, and for at least 28 days after discontinuation/stopping lenalidomide
- At least 8 weeks since prior rituximab
- At least 6 weeks since prior chemotherapy
- At least 1 year since prior pentostatin, cyclophosphamide, and rituximab (PCR) therapy
- PCR therapy at least 1 year prior to study entry allowed
Who cannot join
- Bone marrow dysplasia related to prior therapy
- New York Heart Association class III or IV heart failure
- Prior lenalidomide
- Other malignancy within the past 2 years except squamous cell or basal cell skin cancer or carcinoma in situ of the cervix
- Pregnant or nursing
- Concurrent oral or IV antibiotics for active infection
Trial locations and contacts
143 sites in 1 country.
143 sites in 1 country
United States143 sites
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
Aurora Presbyterian Hospital
Aurora, Colorado, 80012
Ochsner Health Center - Bluebonnet
Baton Rouge, Louisiana, 70809
MeritCare Bemidji
Bemidji, Minnesota, 56601
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
Boise, Idaho, 83706
Boulder Community Hospital
Boulder, Colorado, 80301-9019
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
Chicago, Illinois, 60611-3013
Hematology and Oncology Associates
Chicago, Illinois, 60611
Marshfield Clinic - Chippewa Center
Chippewa Falls, Wisconsin, 54729
Case Comprehensive Cancer Center
Cleveland, Ohio, 44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical Center
Cleveland, Ohio, 44109
Penrose Cancer Center at Penrose Hospital
Colorado Springs, Colorado, 80933
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Ochsner Health Center - Covington
Covington, Louisiana, 70433
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
St. Anthony Central Hospital
Denver, Colorado, 80204
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
St. Joseph Hospital
Denver, Colorado, 80218
Rose Medical Center
Denver, Colorado, 80220
CCOP - Colorado Cancer Research Program
Denver, Colorado, 80222
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Veterans Affairs Medical Center - East Orange
East Orange, New Jersey, 07018-1095
Marshfield Clinic Cancer Care at Regional Cancer Center
Eau Claire, Wisconsin, 54701
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Elkhart General Hospital
Elkhart, Indiana, 46515
Union Hospital of Cecil County
Elkton, Maryland, 21921
Swedish Medical Center
Englewood, Colorado, 80110
CCOP - MeritCare Hospital
Fargo, North Dakota, 58122
Roger Maris Cancer Center at MeritCare Hospital
Fargo, North Dakota, 58122
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
Cancer Center of Kansas - Fort Scott
Fort Scott, Kansas, 66701
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
North Colorado Medical Center
Greeley, Colorado, 80631
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54307-3508
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
Hartford, Connecticut, 06105
Geisinger Hazleton Cancer Center
Hazleton, Pennsylvania, 18201
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
Kellogg Cancer Care Center
Highland Park, Illinois, 60035
Hinsdale Hematology Oncology Associates
Hinsdale, Illinois, 60521
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
Foote Memorial Hospital
Jackson, Michigan, 49201
Baptist Cancer Institute - Jacksonville
Jacksonville, Florida, 32207
Borgess Medical Center
Kalamazoo, Michigan, 49001
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Provena St. Mary's Regional Cancer Center - Kankakee
Kankakee, Illinois, 60901
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Howard Community Hospital
Kokomo, Indiana, 46904
Center for Cancer Therapy at LaPorte Hospital and Health Services
La Porte, Indiana, 46350
Lakeland Regional Cancer Center at Lakeland Regional Medical Center
Lakeland, Florida, 33805
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Tunnell Cancer Center at Beebe Medical Center
Lewes, Delaware, 19958
Lewistown Hospital
Lewistown, Pennsylvania, 17044
Cancer Center of Kansas, PA - Liberal
Liberal, Kansas, 67901
North Shore Oncology and Hematology Associates, Limited - Libertyville
Libertyville, Illinois, 60048
St. Rita's Medical Center
Lima, Ohio, 45801
Littleton Adventist Hospital
Littleton, Colorado, 80122
St. Mary Mercy Hospital
Livonia, Michigan, 48154
Sky Ridge Medical Center
Lone Tree, Colorado, 80124
Hope Cancer Care Center at Longmont United Hospital
Longmont, Colorado, 80501
McKee Medical Center
Loveland, Colorado, 80539
Holy Family Memorial Medical Center Cancer Care Center
Manitowoc, Wisconsin, 54221-1450
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology - Maplewood
Maplewood, Minnesota, 55109
Bay Area Cancer Care Center at Bay Area Medical Center
Marinette, Wisconsin, 54143
Marshfield Clinic - Marshfield Center
Marshfield, Wisconsin, 54449
Saint Joseph's Hospital
Marshfield, Wisconsin, 54449
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, 53226
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Marshfield Clinic - Lakeland Center
Minocqua, Wisconsin, 54548
Saint Joseph Regional Medical Center
Mishawaka, Indiana, 46545-1470
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus
Moline, Illinois, 61265
New Orleans Cancer Institute at Memorial Medical Center
New Orleans, Louisiana, 70115
Ochsner Cancer Institute at Ochsner Clinic Foundation
New Orleans, Louisiana, 70121
New Ulm Medical Center
New Ulm, Minnesota, 56073
Beth Israel Medical Center - Petrie Division
New York, New York, 10003-3803
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Cancer Care and Hematology Specialists of Chicagoland - Niles
Niles, Illinois, 60714
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
St. Joseph Mercy Oakland
Pontiac, Michigan, 48341-2985
Mercy Regional Cancer Center at Mercy Hospital
Port Huron, Michigan, 48060
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
St. Mary - Corwin Regional Medical Center
Pueblo, Colorado, 81004
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center
Reading, Pennsylvania, 19612-6052
Ministry Medical Group at Saint Mary's Hospital
Rhinelander, Wisconsin, 54501
Marshfield Clinic - Indianhead Center
Rice Lake, Wisconsin, 54868
Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
Swedish-American Regional Cancer Center
Rockford, Illinois, 61104-2315
Seton Cancer Institute at Saint Mary's - Saginaw
Saginaw, Michigan, 48601
Lakeland Regional Cancer Care Center - St. Joseph
Saint Joseph, Michigan, 49085
Lakeside Cancer Specialists, PLLC
Saint Joseph, Michigan, 49085
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, 55416
Park Nicollet Cancer Center
Saint Louis Park, Minnesota, 55416
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67401
Mayo Clinic Scottsdale
Scottsdale, Arizona, 85259-5499
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
St. Nicholas Hospital
Sheboygan, Wisconsin, 53081
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
Mercy Medical Center - Sioux City
Sioux City, Iowa, 51102
St. Luke's Regional Medical Center
Sioux City, Iowa, 51104
Sanford Cancer Center at Sanford USD Medical Center
Sioux Falls, South Dakota, 57117-5039
Hematology Oncology Associates - Skokie
Skokie, Illinois, 60076
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, 46601
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, 16801
Mount Nittany Medical Center
State College, Pennsylvania, 16803
Marshfield Clinic at Saint Michael's Hospital
Stevens Point, Wisconsin, 54481
Saint Michael's Hospital Cancer Center
Stevens Point, Wisconsin, 54481
Lakeview Hospital
Stillwater, Minnesota, 55082
North Suburban Medical Center
Thornton, Colorado, 80229
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
Ridgeview Medical Center
Waconia, Minnesota, 55387
St. John Macomb Hospital
Warren, Michigan, 48093
Marshfield Clinic - Wausau Center
Wausau, Wisconsin, 54401
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Diagnostic and Treatment Center
Weston, Wisconsin, 54476
Marshfield Clinic - Weston Center
Weston, Wisconsin, 54476
Exempla Lutheran Medical Center
Wheat Ridge, Colorado, 80033
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Medical Arts Tower
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Wichita
Wichita, Kansas, 67214
CCOP - Wichita
Wichita, Kansas, 67214
Via Christi Cancer Center at Via Christi Regional Medical Center
Wichita, Kansas, 67214
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
Marshfield Clinic - Wisconsin Rapids Center
Wisconsin Rapids, Wisconsin, 54494
Minnesota Oncology - Woodbury
Woodbury, Minnesota, 55125
About this study
Official title: Phase II Trial of Pentostatin, Cyclophosphamide and Rituximab (PCR) Followed by Campath-1H for Previously Treated Relapsed or Refractory Patients With Chronic Lymphocytic Leukemia
RATIONALE: Drugs used in chemotherapy, such as pentostatin, cyclophosphamide, and CAMPATH-1H work in different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies, such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Combining chemotherapy with monoclonal antibody therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well pentostatin, cyclophosphamide, rituximab, and CAMPATH-1H work in treating patients with relapsed or refractory B-cell chronic lymphocytic leukemia.
Read the detailed description
OBJECTIVES:
Primary
- Determine the objective response rate (complete remission, partial remission [PR], or nodular PR) in patients with relapsed or refractory B-cell chronic lymphocytic leukemia (CLL) treated with pentostatin, cyclophosphamide, and rituximab (PCR) followed by CAMPATH-1H .
- Determine the presence of minimal residual disease in patients treated with this regimen who achieve a CR or nPR
Secondary
- Determine the toxicity of this regimen in these patients.
- Determine the overall and progression-free survival of patients treated with this regimen.
- Evaluate the number of patients who after PCR (or during PCR for PD), only achieve a PR, SD, or PD and who subsequently convert to a higher response category after CAMPATH-1H .
Exploratory
- Assess the angiogenic profile (i.e., secretion levels of pro- versus anti-angiogenic molecules) of CLL B cell clones as well as bone marrow angiogenesis (i.e., vascular density by immunohistochemistry) at baseline, after PCR, after CAMPATH-1H, every six months (serum only), and at time of response assessment (marrow).
- Determine the V_H gene mutation status and CD38 expression of the B-CLL clones at study entry and at the end of the therapy and assess the association between the VH gene mutation status and CD38 expression and clinical outcome.
- Determine surface phenotype (by flow cytometry) and genetic defects (by CLL FISH panel) information on CLL-B cell clones and associate with clinical outcome.
- Monitor the T-cell status by repertoire and flow cytometry analysis to determine the nature and extent of T-cell deficiency induced by the PCR and CAMPATH-1H treatment and assess any association with clinical outcome and toxicities.
- Conditions
- Leukemia
- Being tested
- rituximab, cyclophosphamide, pentostatin, Alemtuzumab
- Keywords
- refractory chronic lymphocytic leukemia, B-cell chronic lymphocytic leukemia
- Medical subject headings
- Leukemia, Leukemia, Lymphocytic, Chronic, B-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rituximabBiological
Also called Rituxan
cyclophosphamideDrug
Also called Cytoxan
pentostatinDrug
Also called deoxycoformycin, Nipent
AlemtuzumabDrug
Also called Campath, Campath-1H
| Study group | Role | What they receive |
|---|---|---|
| Arm A (PCR) | Experimental | Treatment consisted of 6 cycles of pentostatin, cyclophosphamide, and rituximab (PCR) given every 28 days.
Rituximab administered as follows: For the first infusion, all patients receive 100 mg dose (regardless of weight/BSA). For subsequent infusions, all patients receive rituximab 375 mg/m2.
Pentostatin and cyclophosphamide administered as follows: Pentostatin given at 4 mg/m2 either as an IV push or IV over 10-30 minutes in 250 mL NS or D5W on day 1 every 4 weeks of cycles 1-6. Cyclophosphamide given at 600 mg/m2 IV over 30-60 minutes in 250 mL NS on day 1 every 4 weeks of cycle 1-6. Receives: Biological: rituximab; Drug: cyclophosphamide; Drug: pentostatin |
| Arm B (Alemtuzumab: CR, nPR) | Experimental | Patients who achieved a confirmed CR or nPR, were registered to receive Alemtuzumab (Arm B). When the patient was registered to Arm B, the drug was administered three times a week for four weeks. The dose was 30 mg per dose. A twelve-week treatment-free period had to elapse before CAMPATH-1H began following completion of PCR for Arm B patients Receives: Drug: Alemtuzumab |
| Arm C (Alemtuzumab: PR, <PR, PD) | Experimental | For those patients not achieving a CR or nPR (thus patients either achieved PR, SD, or PD), Alemtuzumab (Arm C) was administered three times a week for eighteen weeks at a dose of 30 mg TIW. For PR, SD and PD patients, the timing of CAMPATH-1H was left to the discretion of the investigator, and treatment could begin earlier but no less than two weeks and no longer than eight weeks after the completion of the last PCR course. Patients determined to have PD during treatment with PCR did not need to complete all 6 cycles of PCR to go on to Arm C, however, completing a minimum of 2 cycles was required. Receives: Drug: Alemtuzumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Response Rate
Percent with response (CR, nPR, PR) with two-stage 90% confidence interval
Measured: 8 weeks after Cycle 6
Molecular Complete Remission (MCR) Rate
Percent of patients who have MCR (clinical CR with flow negative and RT-PCR negative)
Measured: 3 months post alemtuzumab
Secondary outcomes (3)
Overall Survival (OS)
OS is defined as the time from registration until death from any cause.
Measured: Up to 5 years from registration
Progression-free Survival (PFS)
PFS is defined as the time from registration until induction failure, institution of non-protocol therapy, relapse or death from any cause in the absence of relapse.
Measured: Up to 5 years from registration
Number of Patients Who After PCR (or During PCR for PD), Only Achieve a PR, SD, or PD and Who Subsequently Convert to a Higher Response Category After Campath-1H
Measured: From re-registration up to 5 years (followed for response until progression)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Dec 2003 (estimated)
- Study start14 Apr 2005
- Primary completion9 Dec 2017
- Study completion6 May 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for LeukemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 102 participants (actual)
Sponsor and investigators
- Lead sponsor
- Eastern Cooperative Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Sanford J. Kempin, MD, Study chair, Beth Israel Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00074282
- Sponsor's protocol ID
- CDR0000343796
- Other IDs
- E2903
- Status last verified
- Jun 2023
- First submitted
- 10 Dec 2003
- Last updated
- 29 Jun 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Kay NE, Kim HT, Kempin S, et al.: Predictors of clinical outcome to pentostatin, cyclophosphamide and rituximab (PCR) followed by campath for relapsed/refractory CLL : a study of the Eastern Cooperative Oncology Group, E2903. [Abstract] Blood 112 (11): A-1057, 2008.
Kempin S, Kay NE, Sun Z, et al.: Early results of pentostatin, cytoxan, rituximab (PCR) followed by CAMPATH-H (CA) for the treatment of relapse/refractory chronic lymphocytic leukemia (CLL) in ECOG protocol E2903. [Abstract] Blood 110 (11): A-3109, 2007.
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Trial of Pentostatin, Cyclophosphamide and Rituximab (PCR) Followed by Campath-1H for Previously Treated Relapsed or Refractory Patients With Chronic Lymphocytic Leukemia
- ClinicalTrials.gov ID
- NCT00074282
- Acronym / sponsor ID
- CDR0000343796
- Conditions
- Leukemia
- Keywords
- refractory chronic lymphocytic leukemia, B-cell chronic lymphocytic leukemia
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 102 participants (actual)
- Lead sponsor
- Eastern Cooperative Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- 14 Apr 2005 (actual)
- Primary completion
- 9 Dec 2017 (actual)
- Study completion
- 6 May 2018 (actual)
- First posted
- 11 Dec 2003 (estimated)
- Results
- Posted 27 Feb 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as pentostatin, cyclophosphamide, and CAMPATH-1H work in different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies, such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Combining chemotherapy with monoclonal antibody therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well pentostatin, cyclophosphamide, rituximab, and CAMPATH-1H work in treating patients with relapsed or refractory B-cell chronic lymphocytic leukemia.
Detailed description
OBJECTIVES:
Primary
- Determine the objective response rate (complete remission, partial remission [PR], or nodular PR) in patients with relapsed or refractory B-cell chronic lymphocytic leukemia (CLL) treated with pentostatin, cyclophosphamide, and rituximab (PCR) followed by CAMPATH-1H .
- Determine the presence of minimal residual disease in patients treated with this regimen who achieve a CR or nPR
Secondary
- Determine the toxicity of this regimen in these patients.
- Determine the overall and progression-free survival of patients treated with this regimen.
- Evaluate the number of patients who after PCR (or during PCR for PD), only achieve a PR, SD, or PD and who subsequently convert to a higher response category after CAMPATH-1H .
Exploratory
- Assess the angiogenic profile (i.e., secretion levels of pro- versus anti-angiogenic molecules) of CLL B cell clones as well as bone marrow angiogenesis (i.e., vascular density by immunohistochemistry) at baseline, after PCR, after CAMPATH-1H, every six months (serum only), and at time of response assessment (marrow).
- Determine the V_H gene mutation status and CD38 expression of the B-CLL clones at study entry and at the end of the therapy and assess the association between the VH gene mutation status and CD38 expression and clinical outcome.
- Determine surface phenotype (by flow cytometry) and genetic defects (by CLL FISH panel) information on CLL-B cell clones and associate with clinical outcome.
- Monitor the T-cell status by repertoire and flow cytometry analysis to determine the nature and extent of T-cell deficiency induced by the PCR and CAMPATH-1H treatment and assess any association with clinical outcome and toxicities.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm A (PCR) | Experimental | Biological: rituximab, Drug: cyclophosphamide, Drug: pentostatinTreatment consisted of 6 cycles of pentostatin, cyclophosphamide, and rituximab (PCR) given every 28 days. Rituximab administered as follows: For the first infusion, all patients receive 100 mg dose (regardless of weight/BSA). For subsequent infusions, all patients receive rituximab 375 mg/m2. Pentostatin and cyclophosphamide administered as follows: Pentostatin given at 4 mg/m2 either as an IV push or IV over 10-30 minutes in 250 mL NS or D5W on day 1 every 4 weeks of cycles 1-6. Cyclophosphamide given at 600 mg/m2 IV over 30-60 minutes in 250 mL NS on day 1 every 4 weeks of cycle 1-6. |
| Arm B (Alemtuzumab: CR, nPR) | Experimental | Drug: AlemtuzumabPatients who achieved a confirmed CR or nPR, were registered to receive Alemtuzumab (Arm B). When the patient was registered to Arm B, the drug was administered three times a week for four weeks. The dose was 30 mg per dose. A twelve-week treatment-free period had to elapse before CAMPATH-1H began following completion of PCR for Arm B patients |
| Arm C (Alemtuzumab: PR, <PR, PD) | Experimental | Drug: AlemtuzumabFor those patients not achieving a CR or nPR (thus patients either achieved PR, SD, or PD), Alemtuzumab (Arm C) was administered three times a week for eighteen weeks at a dose of 30 mg TIW. For PR, SD and PD patients, the timing of CAMPATH-1H was left to the discretion of the investigator, and treatment could begin earlier but no less than two weeks and no longer than eight weeks after the completion of the last PCR course. Patients determined to have PD during treatment with PCR did not need to complete all 6 cycles of PCR to go on to Arm C, however, completing a minimum of 2 cycles was required. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (30 listed)
- Diagnosis of B-cell chronic lymphocytic leukemia (CLL) meeting the following criteria:
- Requires chemotherapy, as indicated by any of the following:
- Demonstrated progression after at least 1 course of either an alkylating agent-based or purine nucleoside-based (e.g., fludarabine) regimen OR failed to achieve a meaningful response OR relapsed after prior therapy
- 18 and over
- ECOG Performance Status 0-2
Key exclusion criteria (6 listed)
- Bone marrow dysplasia related to prior therapy
- New York Heart Association class III or IV heart failure
- Prior lenalidomide
- Other malignancy within the past 2 years except squamous cell or basal cell skin cancer or carcinoma in situ of the cervix
- Pregnant or nursing
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| rituximabAlso: Rituxan | Biological | Arm A (PCR) |
| cyclophosphamideAlso: Cytoxan | Drug | Arm A (PCR) |
| pentostatinAlso: deoxycoformycin, Nipent | Drug | Arm A (PCR) |
| AlemtuzumabAlso: Campath, Campath-1H | Drug | Arm B (Alemtuzumab: CR, nPR), Arm C (Alemtuzumab: PR, <PR, PD) |
Primary outcome
Response Rate
Time frame: 8 weeks after Cycle 6
Percent with response (CR, nPR, PR) with two-stage 90% confidence interval
Molecular Complete Remission (MCR) Rate
Time frame: 3 months post alemtuzumab
Percent of patients who have MCR (clinical CR with flow negative and RT-PCR negative)
3 secondary outcomes
Overall Survival (OS)
Time frame: Up to 5 years from registration
Progression-free Survival (PFS)
Time frame: Up to 5 years from registration
Number of Patients Who After PCR (or During PCR for PD), Only Achieve a PR, SD, or PD and Who Subsequently Convert to a Higher Response Category After Campath-1H
Time frame: From re-registration up to 5 years (followed for response until progression)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jun 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publicationKay NE, Kim HT, Kempin S, et al.: Predictors of clinical outcome to pentostatin, cyclophosphamide and rituximab (PCR) followed by campath for relapsed/refractory CLL : a study of the Eastern Cooperative Oncology Group, E2903. [Abstract] Blood 112 (11): A-1057, 2008.
- Results publicationKempin S, Kay NE, Sun Z, et al.: Early results of pentostatin, cytoxan, rituximab (PCR) followed by CAMPATH-H (CA) for the treatment of relapse/refractory chronic lymphocytic leukemia (CLL) in ECOG protocol E2903. [Abstract] Blood 110 (11): A-3109, 2007.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sanford J. Kempin, MD study chair
Beth Israel Medical Center
143 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing rituximab, cyclophosphamide and pentostatin in people with Leukemia, run by Eastern Cooperative Oncology Group at 143 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 30 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 143 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 27 Feb 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Response Rate (time frame: 8 weeks after Cycle 6). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00074282, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2023.