Trial Outcomes & Findings for Pentostatin, Cyclophosphamide, Rituximab, and Mitoxantrone in Treating Patients With Chronic Lymphocytic Leukemia or Other Low-Grade B-Cell Cancer (NCT NCT00546377)

NCT ID: NCT00546377

Last Updated: 2016-05-12

Results Overview

Complete response (CR): Absence of lymphadenopathy, hepatomegaly or splenomegaly by physical examination and appropriate radiographic techniques (if abnormal pre-treatment): it is recognized that some patients with lymphoid malignancies who achieve a CR may have mild persistent abnormalities on CT Scan. Such abnormalities if stable on subsequent scanning will not be viewed as persistent disease in patients who otherwise meet the criteria for CR. Response will be assessed on an ongoing basis, but at a minimum of prior to cycle four and following completion of all therapy. Patients who are removed from study early will have response status determined at time of removal from study. The major criteria for determination of response to therapy in patients with CLL include physical examination and examination of the peripheral blood and bone marrow. Radiographic studies are not required but those that were abnormal pre-treatment, will be repeated to document the degree of maximal response.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

50 participants

Primary outcome timeframe

3 years

Results posted on

2016-05-12

Participant Flow

Participant milestones

Participant milestones
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Overall Study
STARTED
50
Overall Study
COMPLETED
43
Overall Study
NOT COMPLETED
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Overall Study
Deemed ineligible
1
Overall Study
Adverse Event
6

Baseline Characteristics

Pentostatin, Cyclophosphamide, Rituximab, and Mitoxantrone in Treating Patients With Chronic Lymphocytic Leukemia or Other Low-Grade B-Cell Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
n=43 Participants
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
31 Participants
n=5 Participants
Age, Categorical
>=65 years
12 Participants
n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
Sex: Female, Male
Male
35 Participants
n=5 Participants
Region of Enrollment
United States
43 participants
n=5 Participants

PRIMARY outcome

Timeframe: 3 years

Complete response (CR): Absence of lymphadenopathy, hepatomegaly or splenomegaly by physical examination and appropriate radiographic techniques (if abnormal pre-treatment): it is recognized that some patients with lymphoid malignancies who achieve a CR may have mild persistent abnormalities on CT Scan. Such abnormalities if stable on subsequent scanning will not be viewed as persistent disease in patients who otherwise meet the criteria for CR. Response will be assessed on an ongoing basis, but at a minimum of prior to cycle four and following completion of all therapy. Patients who are removed from study early will have response status determined at time of removal from study. The major criteria for determination of response to therapy in patients with CLL include physical examination and examination of the peripheral blood and bone marrow. Radiographic studies are not required but those that were abnormal pre-treatment, will be repeated to document the degree of maximal response.

Outcome measures

Outcome measures
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
n=43 Participants
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Overall Response
Complete Response
11 participants
Overall Response
Partial Response
23 participants
Overall Response
Stable Disease
4 participants
Overall Response
Progression of Disease
5 participants

PRIMARY outcome

Timeframe: 2 years

The MTD is defined as the highest dose studied for which the incidence of DLT is less than 33%. In the phase I portion of the trial, cohorts of 3-6 pts will receive pentostatin, cyclophosphamide and rituximab along with one of three potential dose levels of mitoxantrone. The following dose escalation scheme will be followed: If none of the initial three pts in a cohort experience a dose-limiting toxicity (grade 4 infection, or grade ≥ 3 non-hematologic toxicity that persists for 7 days or more) then a new cohort of three pts will be treated at the next higher dose level. If one of the three pts in a cohort experiences DLT, then up to three additional pts will be treated at the same dose level. If two or more pts in a cohort experience DLT, then the maximum tolerated dose (MTD) will have been exceeded, and no further dose escalation will occur. The previous dose level will be considered as the MTD.

Outcome measures

Outcome measures
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
n=43 Participants
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Maximum Tolerated Dose (MTD) of Mitoxantrone
10 mg/m2

Adverse Events

Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone

Serious events: 19 serious events
Other events: 43 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
n=43 participants at risk
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Immune system disorders
Allerg react/hypersens (incl drug fever)
2.3%
1/43 • Number of events 1 • 7 years
Immune system disorders
Allerg rhinitis (w sneez, nas stuff, postnas drip)
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Colitis
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Constipation
2.3%
1/43 • Number of events 1 • 7 years
Respiratory, thoracic and mediastinal disorders
Cough
2.3%
1/43 • Number of events 1 • 7 years
Skin and subcutaneous tissue disorders
Dermatology/Skin, other
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Diarrhea
2.3%
1/43 • Number of events 1 • 7 years
Nervous system disorders
Dizziness
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Dysphagia (Difficulty swallowing)
2.3%
1/43 • Number of events 1 • 7 years
Infections and infestations
Febrile neutropenia
16.3%
7/43 • Number of events 9 • 7 years
General disorders
Fever (in the absence of neutropenia)
11.6%
5/43 • Number of events 6 • 7 years
Endocrine disorders
Hot flashes/flushes
2.3%
1/43 • Number of events 1 • 7 years
Renal and urinary disorders
Incontinence, urinary
2.3%
1/43 • Number of events 1 • 7 years
Infections and infestations
Inf norm ANC/gr1/2 neut-Pneumonia(lung)
4.7%
2/43 • Number of events 2 • 7 years
Infections and infestations
Infection w/ Gr 3/4 neut, Colon
2.3%
1/43 • Number of events 1 • 7 years
Infections and infestations
Infection w/ Gr 3/4 neut, Sinus
2.3%
1/43 • Number of events 1 • 7 years
Infections and infestations
Infection w/ Gr 3/4 neut, Skin (cellulites)
2.3%
1/43 • Number of events 1 • 7 years
Infections and infestations
Infection, other
2.3%
1/43 • Number of events 1 • 7 years
Musculoskeletal and connective tissue disorders
Muscle weakness - Whole body/general
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Nausea
7.0%
3/43 • Number of events 4 • 7 years
Blood and lymphatic system disorders
Neutrophils/granulocytes (ANC/AGC)
2.3%
1/43 • Number of events 1 • 7 years
Investigations
Pain - Abdomen NOS
2.3%
1/43 • Number of events 1 • 7 years
Investigations
Pain - Head/headache
4.7%
2/43 • Number of events 3 • 7 years
Investigations
Pain - Neck
2.3%
1/43 • Number of events 1 • 7 years
Investigations
Pain - Pelvis
2.3%
1/43 • Number of events 1 • 7 years
Investigations
Pain - Throat/pharynx/larynx
2.3%
1/43 • Number of events 1 • 7 years
General disorders
Sweating (diaphoresis)
2.3%
1/43 • Number of events 1 • 7 years
Nervous system disorders
Syncope (fainting)
2.3%
1/43 • Number of events 1 • 7 years
Cardiac disorders
Vasovagal episode
2.3%
1/43 • Number of events 1 • 7 years
Eye disorders
Vision-photophobia
2.3%
1/43 • Number of events 1 • 7 years
Gastrointestinal disorders
Vomiting
4.7%
2/43 • Number of events 3 • 7 years

Other adverse events

Other adverse events
Measure
Pentostatin,Cyclophosphamide,Rituximab & Mitoxantrone
n=43 participants at risk
To determine the dose of mitoxantrone that can be safely administered with pentostatin, cyclosphosphamide, and rituximab in previously treated patient with CLL and other low grade B-cell malignancies.
Metabolism and nutrition disorders
ALT, SGPT
20.9%
9/43 • Number of events 50 • 7 years
Metabolism and nutrition disorders
AST, SGOT
16.3%
7/43 • Number of events 40 • 7 years
Metabolism and nutrition disorders
Albumin, low (hypoalbuminemia)
18.6%
8/43 • Number of events 40 • 7 years
Metabolism and nutrition disorders
Alkaline phosphatase
9.3%
4/43 • Number of events 50 • 7 years
Metabolism and nutrition disorders
Bilirubin (hyperbilirubinemia)
7.0%
3/43 • Number of events 10 • 7 years
Metabolism and nutrition disorders
Creatinine
11.6%
5/43 • Number of events 15 • 7 years
General disorders
Fever (in the absence of neutropenia)
4.7%
2/43 • Number of events 2 • 7 years
Metabolism and nutrition disorders
Glucose, high (hyperglycemia)
72.1%
31/43 • Number of events 50 • 7 years
Metabolism and nutrition disorders
Hemoglobin
72.1%
31/43 • Number of events 100 • 7 years
Blood and lymphatic system disorders
INR
4.7%
2/43 • Number of events 5 • 7 years
Blood and lymphatic system disorders
Leukocytes (total WBC)
72.1%
31/43 • Number of events 150 • 7 years
Blood and lymphatic system disorders
Lymphopenia
65.1%
28/43 • Number of events 150 • 7 years
Gastrointestinal disorders
Nausea
4.7%
2/43 • Number of events 2 • 7 years
Blood and lymphatic system disorders
Neutrophils/granulocytes (ANC/AGC)
72.1%
31/43 • Number of events 150 • 7 years
Metabolism and nutrition disorders
Phosphate, low (hypophosphatemia)
30.2%
13/43 • Number of events 50 • 7 years
Blood and lymphatic system disorders
Platelets
46.5%
20/43 • Number of events 150 • 7 years
Metabolism and nutrition disorders
Potassium, high (hyperkalemia)
4.7%
2/43 • Number of events 5 • 7 years
Metabolism and nutrition disorders
Potassium, low (hypokalemia)
4.7%
2/43 • Number of events 3 • 7 years
Gastrointestinal disorders
Vomiting
4.7%
2/43 • Number of events 2 • 7 years

Additional Information

Dr. Renier Brentjens, Associate Attending

Memorial Sloan Kettering Cancer Center

Phone: +1212-639-7053

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place