Chronic Lymphocytic Leukemia Clinical Trial
A Study to Evaluate the Benefit of Venetoclax Plus Rituximab Compared With Bendamustine Plus Rituximab in Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL)
Summary
The purpose of this open-label, multicenter, randomized, Phase III study is to evaluate the benefit of venetoclax in combination with rituximab compared with bendamustine in combination with rituximab in participants with relapsed or refractory leukemia-cll/" >CLL. Participants will be randomly assigned in 1:1 ratio to receive either venetoclax + rituximab (Arm A) or bendamustine + rituximab (Arm B).
Eligibility Criteria
Inclusion Criteria:
Diagnosis of CLL per diagnostic criteria for relapsed or refractory CLL per the international workshop on chronic lymphocytic leukemia (iwCLL) guidelines
Previously treated with 1-3 lines of therapy (example: completed greater than or equal to [>/=] 2 treatment cycles per therapy), including at least one standard chemotherapy-containing regimen
Participants previously treated with bendamustine only if their duration of response was >/= 24 months
Eastern Cooperative Oncology Group (ECOG) performance score of less than or equal to (=) 1
Adequate bone marrow function
Adequate renal and hepatic function
Participants must use effective birth control throughout study until at least 30 days after study treatment or 1 year after rituximab treatment, whichever is later; female participants must not be pregnant or breast-feeding
For participants with the 17p deletion, previously treated with 1-3 lines of therapy, including at least one prior standard chemotherapy-containing regimen or at least one prior alemtuzumab-containing therapy
Inclusion Criteria R/C Substudy:
Participants randomized to Arm A or Arm B with a confirmed disease progression of CLL per iwCLL criteria
Participants who have not received new anti-CLL therapy following disease progression in Arm A or Arm B
Adequate renal and hepatic function per laboratory reference range
Exclusion Criteria:
Transformation of CLL to aggressive non-Hodgkin lymphoma or central nervous system (CNS) involvement by CLL
Undergone an allogenic stem cell transplant
A history of significant renal, neurologic, psychiatric, endocrine, metabolic, immunologic, cardiovascular or hepatic disease
Hepatitis B or C or known human immunodeficiency virus (HIV) positive
Receiving warfarin treatment
Received an anti-CLL monoclonal antibody within 8 weeks prior to the first dose of study drug
Received any anti-cancer or investigational therapy within 28 days prior to the first dose of study drug or has not recovered to less than Grade 2 clinically significant adverse effect(s)/toxicity(ies) of any previous therapy
Received cytochrome P450 3A4 (CYP3A4) inhibitors (such as fluconazole, ketoconazole and clarithromycin) or inducers (such as rifampin, carbamazapine, phenytoin, St. John's Wort) within 7 days prior to the first dose of venetoclax
History of prior venetoclax treatment
Participants with another cancer, history of another cancer considered uncured on in complete remission for <5 years, or currently under treatment for another suspected cancer except non-melanoma skin cancer or carcinoma in situ of the cervix that has been treated or excised and is considered resolved
Malabsorption syndrome or other condition that precludes enteral route of administration
Other clinically significant uncontrolled condition(s) including, but not limited to, systemic infection (viral, bacterial or fungal)
Vaccination with a live vaccine within 28 days prior to randomization
Consumed grapefruit or grapefruit products, seville oranges (including marmalade containing seville oranges), or star fruit within 3 days prior to the first dose of study treatment
A cardiovascular disability status of New York Heart Association Class >/=3. Class 3 is defined as cardiac disease in which participants are comfortable at rest but have marked limitation of physical activity due to fatigue, palpitations, dyspnea, or anginal pain
Major surgery within 30 days prior to the first dose of study treatment
A participant who is pregnant or breastfeeding
Known allergy to both xanthine oxidase inhibitors and rasburicase
Exclusion Criteria R/C Substudy:
Transformation of CLL to aggressive NHL (e.g., Richter's transformation, prolymphocytic leukemia, or DLBCL) or CNS involvement by CLL
Evidence of other clinically significant uncontrolled condition(s) including, but not limited to, uncontrolled systemic infection (viral, bacterial, or fungal)
Development of other malignancy since enrollment into the study, with the exception of curatively treated basal cell carcinoma or squamous cell carcinoma of the skin or carcinoma in situ of the cervix
Uncontrolled autoimmune hemolytic anemia or immune thrombocytopenia
History of severe (i.e., requiring permanent discontinuation of prior rituximab therapy) prior allergic or anaphylactic reactions to rituximab
Known HIV positivity
Positive test results for chronic hepatitis B infection (defined as positive hepatitis B surface antigen [HbsAg] serology)
Positive test results for hepatitis C virus (HCV; HCV antibody serology testing)
Requires the use of warfarin (due to potential drug interactions that may potentially increase the exposure of warfarin)
Has not recovered to less than Grade 2 clinically significant adverse effect(s)/toxicity(ies) of any previous therapy
Received potent CYP3A4 inhibitors (such as fluconazole, ketoconazole, and clarithromycin) within 7 days prior to the first dose of study treatment
Received potent CYP3A4 inducers (such as rifampin, carbamazepine, phenytoin, St. John's wort) within 7 days prior to the first dose of study treatment
Consumed grapefruit or grapefruit products, Seville oranges (including marmalade containing Seville oranges), or star fruit within 3 days prior to the first dose of study treatment
A cardiovascular disability status of New York Heart Association Class >/= 3
A significant history of renal, neurologic, psychiatric, endocrine, metabolic, immunologic, cardiovascular, or hepatic disease that, in the opinion of the investigator, would adversely affect the participants's participation in this study or interpretation of study outcomes
Major surgery within 30 days prior to the first dose of study treatment
A participant who is pregnant or breastfeeding
Malabsorption syndrome or other condition that precludes enteral route of administration
Known allergy to both xanthine oxidase inhibitors and rasburicase
Vaccination with a live vaccine within 28 days prior to randomization
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There are 107 Locations for this study
La Jolla California, 92093, United States
Detroit Michigan, 48202, United States
New York New York, 10021, United States
New York New York, 10032, United States
Salt Lake City Utah, 84112, United States
Garran Australian Capital Territory, 2065, Australia
Concord New South Wales, 2139, Australia
Kogarah, New South Wales New South Wales, 2217, Australia
Woolloongabba Queensland, 4102, Australia
Adelaide South Australia, 5000, Australia
Bedford Park South Australia, 5042, Australia
Hobart Tasmania, 7000, Australia
Frankston Victoria, 3199, Australia
Melbourne Victoria, 3168, Australia
Mount Waverley Victoria, 3149, Australia
North Melbourne Victoria, 3051, Australia
Parkville Victoria, 3050, Australia
Nedlands Western Australia, 6009, Australia
Innsbruck , 6020, Austria
Salzburg , 5020, Austria
Wien , 1090, Austria
Wien , 1160, Austria
Antwerpen , 2060, Belgium
Bruxelles , 1200, Belgium
Kortrijk , 8500, Belgium
Leuven , 3000, Belgium
Mont-godinne , 5530, Belgium
Roeselare , 8800, Belgium
Calgary Alberta, T2N 2, Canada
Hamilton Ontario, L8N 3, Canada
Montreal Quebec, H3T 1, Canada
Saskatoon Saskatchewan, S7N 4, Canada
Brno , 613 0, Czechia
Hradec Kralove , 500 0, Czechia
Olomouc , 775 2, Czechia
Ostrava - Poruba , 708 5, Czechia
Praha 2 , 128 0, Czechia
Praha , 100 3, Czechia
Herlev , 2730, Denmark
København Ø , 2100, Denmark
Odense C , 5000, Denmark
Roskilde , 4000, Denmark
Vejle , 7100, Denmark
Brest , 29609, France
La Roche sur Yon , 85925, France
Lille , 59037, France
Montpellier , 34295, France
Nantes , 44093, France
Paris , 75019, France
Pierre Benite , 69495, France
Poitiers , 86000, France
Rennes , 35033, France
Rouen , 76038, France
Toulouse , 31059, France
Tours , 37044, France
Vandoeuvre-les-nancy , 54511, France
Dresden , 01307, Germany
Freiburg , 79106, Germany
Tübingen , 72076, Germany
Budapest , 1088, Hungary
Budapest , 1122, Hungary
Debrecen , 4012, Hungary
Pecs , 7624, Hungary
Szeged , 6720, Hungary
Torino Abruzzo, 10126, Italy
Genova Liguria, 16132, Italy
Bergamo Lombardia, 24127, Italy
Milano Lombardia, 20132, Italy
Milano Lombardia, 20162, Italy
Torrette Di Ancona Marche, 60126, Italy
Bari Puglia, 70124, Italy
Florence Toscana, 50134, Italy
Padova Veneto, 35128, Italy
Seongnam-si , 463-7, Korea, Republic of
Seoul , 03722, Korea, Republic of
Seoul , 05030, Korea, Republic of
Seoul , 6591, Korea, Republic of
Amsterdam , 1081 , Netherlands
Amsterdam , 1105 , Netherlands
Dordrecht , 3318 , Netherlands
Enschede , 7512 , Netherlands
Leiden , 2333 , Netherlands
Rotterdam , 3000 , Netherlands
Utrecht , 3508, Netherlands
Auckland , 1309, New Zealand
Auckland , , New Zealand
Christchurch , 8011, New Zealand
Mount Wellington , 1060, New Zealand
Chorzow , 41-50, Poland
Gdansk , , Poland
Lodz , 93-51, Poland
Opole , 45-06, Poland
Warszawa , 02-10, Poland
Zabrze , 44803, Poland
Moscow Moskovskaja Oblast, 11547, Russian Federation
Sankt-peterburg Sankt Petersburg, 19102, Russian Federation
St. Petersburg Sankt Petersburg, 19734, Russian Federation
Kemerovo , 65006, Russian Federation
Omsk , 64401, Russian Federation
Pamplona Navarra, 31008, Spain
Barcelona , 08035, Spain
Barcelona , 08036, Spain
Madrid , 28041, Spain
Salamanca , 37007, Spain
Lund , 221 8, Sweden
Uppsala , 751 8, Sweden
Taipei , 10002, Taiwan
Bristol , BS2 8, United Kingdom
Manchester , M20 4, United Kingdom
Southampton , SO16 , United Kingdom
Swansea , SA2 8, United Kingdom
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