The rationale of the study is to explore the safety and efficacy of ofatumumab in combination with dexamethasone (O-dex regimen) in patients with refractory/relapsed CLL. Moreover, the hypothesis is that this approach will be able to achieve at least the same response rates compared with R-dex regimens (historical controls; manuscript submitted to Leukemia), while maintaining lower toxicity profile.
This is an open-label, multi-center, non-randomized, phase II study to evaluate the safety and efficacy of ofatumumab added to dexamethasone in subjects with relapsed or refractory chronic lymphocytic leukemia. The treatment will be given for a minimum of 3 cycles, until the best response, or up to a maximum of 6 cycles. After completion of the treatment phase in all patients, survival and disease status assessments will be performed in 1 month post treatment, and then every 2 months for 3 years. The patient will be followed-up in the study for 3 years if there is no progression. Dose and schedule Cycle 1: Ofatumumab: 300 mg as an i.v. infusion on day 1 of the cycle Ofatumumab: 2000 mg as an i.v. infusion on days 8, 15, 22; Dexamethasone: 40 mg/day p.o., days 1-4 and 15-18; Cycles 2 to 6 (cycles every 28 days): Ofatumumab: 1000 mg i.v. infusion on day 1, 8, 15 and 22 of the cycle; Dexamethasone: 40 mg/day p.o., days 1-4 and 15-18. Response will be assessed according to the IWCLL guidelines. The investigator assessment of response and progression will be considered primary for all endpoints described in the study. Safety of the treatment will be evaluated by: adverse events, laboratory tests, vital signs, electrocardiogram and performance status. Study Endpoints Primary Endpoint: Overall response rate (CR, CRi, PR rates) Secondary Endpoints: Toxicity, tolerability, adverse events (these events will be assessed by investigator and by the independent reviewers at the key time-points) Overall survival Progression-free survival Time to response and duration of response Time to progression and time to next therapy Other/Exploratory Endpoints: Exploratory molecular genetic, immunophenotypic, cytogenetic and pharmacologic markers
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
33
Dose and schedule Cycle 1: Ofatumumab: 300 mg as an i.v. infusion on day 1 of the cycle; Ofatumumab: 2000 mg as an i.v. infusion on days 8, 15, 22; Dexamethasone: 40 mg/day p.o., days 1-4 and 15-18 Cycles 2 to 6 (cycles every 28 days): Ofatumumab: 1000 mg i.v. infusion on day 1, 8, 15 and 22 of the cycle; Dexamethasone: 40 mg/day p.o., days 1-4 and 15-18
University Hospital Brno, Department of Internal Medicine - Hematology and Oncology
Brno, Czechia
University Hospital Hradec Králové, Department of clinical hematology
Hradec Králové, Czechia
University Hospital Královské Vinohrady, Department of clinical hematology
Prague, Czechia
Charles University in Prague and General University Hospital in Prague, 1st Department of medicine - Department of hematology
Prague, Czechia
Overall response rate (complete remission - CR, CRi; partial remission - PR)
The response (CR, CRi, PR rates) will be assessed at the end of therapy of every patient according to international guideline.
Time frame: Up to Week 24
Safety profile of the combination of ofatumumab and dexamethasone
Safety of the treatment will be evaluated by: adverse events, laboratory tests, vital signs, electrocardiogram and performance status. The safety analysis population will include all subjects who receive at least one dose/infusion and a baseline safety assessment.
Time frame: Up to Week 24
Time dependent parameters: progression-free survival (PFS); overall survival (OS).
PFS and OS will be summarized using Kaplan-Meier plots. Median and the corresponding 95% CI (using Greenwood's formula) will be provided as appropriate. In addition these will be compared with the corresponding plots of a previous study R-dex using one sample log-rank test as described in Finkelstein et al. (J Nat Cancer Inst, 2003).
Time frame: Year 3 after treatment completion
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