This phase II trial studies how well duvelisib on an intermittent (irregular) dosing schedule works in treating patients with chronic lymphocytic leukemia or small lymphocytic lymphoma. Duvelisib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving duvelisib on an intermittent schedule may result in similar effectiveness with less amount of severe side effects.
PRIMARY OBJECTIVE: I. To evaluate the efficacy of duvelisib (induction followed by maintenance \[intermittent dosing\]) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), as measured by the progression free survival (PFS). SECONDARY OBJECTIVES: I. To evaluate safety of duvelisib induction and maintenance (by intermittent dosing) in relapsed/refractory CLL. II. To evaluate clinical benefits to duvelisib treatment. EXPLORATORY OBJECTIVE: I. To evaluate T-cell populations in patients with CLL treated with duvelisib. OUTLINE: INDUCTION: Patients receive duvelisib orally (PO) twice daily (BID) on days 1-28. Cycles repeat every 28 days for 12 weeks in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients receive duvelisib PO BID on days 1-2, 8-9, 15-16, and 22-23. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 3 months for up to 12 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Given PO
City of Hope Medical Center
Duarte, California, United States
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
OHSU Knight Cancer Institute
Portland, Oregon, United States
Progression Free Survival (PFS) at 12 Months
Progression is defined using IWCLL 2018 guidelines (Section 5.3 of Hallek et al, 2018). Proportion of subjects achieving 12-month PFS were estimated along with a two-sided exact Clopper-Pearson 95% confidence interval. PFS was estimated from start of duvelisib treatment until death, time of progression, start of new therapy, or end of follow-up, whichever occurs first. PFS was censored at the start of new therapy or end of follow-up, whichever occurs first.
Time frame: First dose of duvelisib until death, time of progression, start of new therapy, or 12 months from start of therapy, whichever occurs first
Objective Response Rate (ORR) (Including Complete Response [CR] and Partial Response [PR])
Treatment responses were defined by using IWCLL 2018 guidelines (Hallek et al, 2018). Overall Response (OR) = CR + PR. Probability of having ORR was measured and reported with 95% exact confidence interval.
Time frame: First dose of duvelisib up to 12 months after discontinuation of duvelisib
Median Progression-Free Survival (PFS)
Progression is defined using IWCLL 2018 guidelines (Section 5.3 of Hallek et al, 2018). Estimated distribution of the PFS was plotted using Kaplan Meier curves and reported with median PFS and 95% confidence intervals.
Time frame: First dose of duvelisib until death, time of progression, or start of new therapy, whichever occurs first, assessed up to 12 months after discontinuation of duvelisib
Percentage of the Participants With 12-month Duration of Response (DOR)
Duration of response (DOR), for participants who responded to the study intervention, was measured from the time of first documented objective response (i.e., CR or PR/PR-L) until evidence of progressive disease, start of new therapy, death, or end of follow-up. DOR was censored at the start of new therapy or end of follow-up, whichever occurs first. Proportion of the participants achieving 12-month DOR and the 95% confidence interval were reported.
Time frame: From time of ORR until death, time of progression, start of new therapy, or end of follow-up, whichever occurs first, assessed up to 12 months after discontinuation of duvelisib
Percentage of Participants With Grade 3 4 5 Toxicity Related to Duvelisib
Percentage of participants, that received at least one dose of duvelisib, had developed grade 3 4 5 toxicities at least possibly related to duvelisib. The 95% confidence interval was calculated by the Clopper-Pearson (exact) method.
Time frame: From first dose of duvelisib until 3 months post-discontinuation of duvelisib
Number of Administrated Cycles of the Study Treatment
Number of study treatment cycles that participants received from the first dose of study drug until therapy was discontinued for any reason.
Time frame: From first dose of duvelisib until time of duvelisib discontinuation up to 5 years.
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