RATIONALE: Drugs used in chemotherapy, such as fludarabine, cyclophosphamide, and bendamustine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. It is not yet known whether giving fludarabine and cyclophosphamide together with rituximab is more effective than giving bendamustine together with rituximab in treating chronic lymphocytic leukemia. PURPOSE: This randomized phase III trial is studying fludarabine, cyclophosphamide, and rituximab to see how well they work compared with bendamustine and rituximab in treating patients with previously untreated B-cell chronic lymphocytic leukemia.
OBJECTIVES: * To compare the therapeutic efficacy of fludarabine phosphate, cyclophosphamide, and rituximab vs bendamustine hydrochloride and rituximab in patients with previously untreated B-cell chronic lymphocytic leukemia. * To compare the incidence of major side effects (e.g., myelosuppression) associated with these regimens in these patients. * To compare the rate of infections and secondary neoplasias in patients treated with these regimens. OUTLINE: This is a multicenter study. Patients are stratified according to country and disease stage. Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive fludarabine phosphate IV and cyclophosphamide IV on days 1-3. Patients also receive rituximab IV on day 0 of course 1 and on day 1 of courses 2-6. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. * Arm II: Patients receive bendamustine hydrochloride IV on days 1 and 2. Patients also receive rituximab as in arm I. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity. Patients complete quality of life questionnaires (EORTC-C30 and EURO-QOL) at baseline and then at 12, 24, 36, 48, and 60 months. After completion of study therapy, patients are followed every 3 months for 2 years, every 6 months for 3 years, and then once a year thereafter.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
564
cycle 1: 375 mg/m² i.v., day 0, q28d cycle 2-6: 500 mg/m² i.v., day 1, q28d
cycle 1-6: 90mg/m² i.v., day 1-2, q28d
cycle 1-6: 250 mg/m² i.v., days 1-3, q28d
cycle 1-6: 25 mg/m² i.v., days 1-3, q28d
Medizinische Universitaetsklinik I at the University of Cologne
Cologne, Germany
Progression-free survival rate after 24 months
estimated time point when 198 needed events for the final analysis(PD or deaths) have occured.
Time frame: 2008-2015
Minimal residual disease, complete response rates, and partial response rates
done within the final analysis
Time frame: 2008-2015
Duration of remission
done within the final analysis
Time frame: 2008-2015
Event-free survival
done within the final analysis
Time frame: 2008-2015
Overall survival
done within the final analysis
Time frame: 2008-2015
Overall response rate
done within the final analysis
Time frame: 2008-2015
Response rates in and survival times in biological subgroups
done within the final analysis
Time frame: 2008-2015
Toxicity rates
done within the final analysis
Time frame: 2008-2015
Quality of life
done within the final analysis
Time frame: 2008-2015
Standard safety analysis
done within the final analysis
Time frame: 2008-2015
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.