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Efficacy and Safety of Idelalisib in Combination With Obinutuzumab Compared to Chlorambucil in Combination With Obinutuzumab for Previously Untreated Chronic Lymphocytic Leukemia

Phase 3TerminatedNCT01980875
Gilead Sciences57 enrolled

Overview

The primary objective of this study is to evaluate the effects of idelalisib with obinutuzumab versus the combination of chlorambucil and obinutuzumab on progression-free survival (PFS) in participants with previously untreated chronic lymphocytic leukemia (CLL). An increased rate of deaths and serious adverse events (SAEs) among participants with front-line CLL and early-line indolent non-Hodgkin lymphoma (iNHL) treated with idelalisib in combination with standard therapies was observed by the independent data monitoring committee (DMC) during regular review of 3 Gilead Phase 3 studies. Gilead reviewed the unblinded data and terminated those studies in agreement with the DMC recommendation and in consultation with the US Food and Drug Administration (FDA). All front-line studies of idelalisib, including this study, were also terminated.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

57

Conditions

Chronic Lymphocytic Leukemia

Interventions

IdelalisibDRUG

150 mg tablet administered orally twice daily

ChlorambucilDRUG

2 mg tablets administered at a dose of 0.5 mg/kg orally every other week for a total of 12 doses

ObinutuzumabDRUG

1000 mg/40 mL single-use vials administered intravenously for a total of 8 doses over 21 weeks

Eligibility

Sex: ALLMin age: 18 Years
Medical Language ↔ Plain English
Key Inclusion Criteria: * Not a candidate for fludarabine therapy based on either: 1. creatinine clearance \< 70 mL/min, or 2. Cumulative Illness Rating Scale score \> 6, by assessment of the investigator * Diagnosis of B-cell CLL, with diagnosis established according to International Workshop on Chronic Lymphocytic Leukemia (IWCLL) * No prior therapy for CLL other than corticosteroids for disease complications. * CLL that warrants treatment * Presence of measurable lymphadenopathy * Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2 Key Exclusion Criteria: * Known histological transformation from CLL to an aggressive lymphoma (ie, Richter transformation) * Known presence of myelodysplastic syndrome * Evidence of ongoing systemic bacterial, fungal, or viral infection at the time of randomization * Ongoing liver injury * Ongoing drug-induced pneumonitis * Ongoing inflammatory bowel disease * History of prior allogeneic bone marrow progenitor cell or solid organ transplantation * Ongoing immunosuppressive therapy other than corticosteroids * Concurrent participation in another therapeutic clinical trial * Undergone major surgery within 30 days prior to randomization * Known hypersensitivity or intolerance to any of the active substances or excipients in the formulations for idelalisib, obinutuzumab, or chlorambucil * History of non-infectious pneumonitis * Received last dose of study drug on another therapeutic clinical trial within 30 days prior to randomization Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Locations (18)

Sansum Clinic

Santa Barbara, California, United States

UCLA Jonsson Comprehensive Cancer Center

Santa Monica, California, United States

Innovative Clinical Research Institute

Whittier, California, United States

Cancer Center of Central Connecticut

Southington, Connecticut, United States

Gabrail Cancer Center Research

Canton, Ohio, United States

Saint Francis Cancer Center

Greenville, South Carolina, United States

St Vincent Hospital, Sydney

Darlinghurst, New South Wales, Australia

UZ Ghent- hematology

Ghent, Belgium

Royal Victoria Regional Health Centre - Simcoe Musk

Barrie, Ontario, Canada

Centre Hospitalier du Mans

Le Mans, France

...and 8 more locations

Outcomes

Primary Outcomes

Progression-Free Survival

Progression-free survival (PFS) is defined as the interval from randomization to the first documentation of definitive disease progression or death from any cause. Definitive disease progression is CLL progression based on standard criteria, excluding lymphocytosis alone. PFS was to be assessed by an independent review committee (IRC).

Time frame: Up to 11 months

Secondary Outcomes

Overall Response Rate

Overall response rate (ORR) is defined as the proportion of participants who achieve a confirmed complete or partial response. ORR was to be assessed by an IRC.

Time frame: Up to 11 months

Nodal Response Rate

Nodal response rate is defined as the proportion of participants who achieve a 50% decrease from baseline in the sum of the products of the greatest perpendicular diameters of index lesions. Nodal response rate was to be assessed by an IRC.

Time frame: Up to 11 months

Complete Response Rate

Complete response rate is defined as the proportion of participants who achieve a confirmed complete response. Complete response rate was to be assessed by an IRC.

Time frame: Up to 11 months

Overall Survival

Overall survival is defined as the interval from randomization to death from any cause. Overall survival was to be assessed by an IRC.

Time frame: Up to 11 months

Minimal Residual Disease Negativity Rate at Week 36

Minimal residual disease (MRD) negativity rate is defined as the proportion of participants with MRD \< 10\^-4 assessed by flow cytometry in bone marrow at Week 36 after therapy initiation. For participants receiving the final dose of obinutuzumab after the original scheduled date, the MRD assessment was performed no less than 12 weeks after the last dose of obinutuzumab. MRD negativity rate was to be assessed by an IRC.

Time frame: Up to 11 months

Data from ClinicalTrials.gov

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