Flavopiridol in Treating Patients With Chronic Lymphocytic Leukemia

Study Overview
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Brief Summary
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Phase II trial to study the effectiveness of flavopiridol in treating patients who have chronic lymphocytic leukemia that has not responded to treatment with fludarabine. Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die

Detailed Description
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OBJECTIVES: Determine the complete and partial response rate to flavopiridol in patients with fludarabine-refractory chronic lymphocytic leukemia. Assess the toxicity profile of this treatment in these patients. Examine progression-free survival and overall survival following this treatment in these patients. Determine the effects of flavopiridol on normal T-cell subsets and immunoglobulin levels in these patients. OUTLINE: This is an open label, multicenter study. Patients registered before 9/15/2000 receive flavopiridol IV continuously on days 1-3. Treatment repeats every 14 days for a total of 12 courses in the absence of disease progression or unacceptable toxicity. Patients registered after 9/15/2000 receive flavopiridol IV over 1 hour daily on days 1-3. Treatment repeats every 3 weeks for a total of 8 courses in the absence of disease progression or unacceptable toxicity. Patients are followed every 3 months for the first year and then every 6 months for 5 years.

Official Title
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A PHASE II STUDY OF FLAVOPIRIDOL (NSC # 649890) IN PATIENTS WITH PREVIOUSLY TREATED BCELL CHRONIC LYMPHOCYTIC LEUKEMIA

Conditions
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B-cell Chronic Lymphocytic Leukemia, Refractory Chronic Lymphocytic Leukemia, Stage I Chronic Lymphocytic Leukemia, Stage II Chronic Lymphocytic Leukemia, Stage III Chronic Lymphocytic Leukemia, Stage IV Chronic Lymphocytic Leukemia

Intervention / Treatment
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* Drug: alvocidib
* Other: laboratory biomarker analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically diagnosed intermediate risk (stage I or II) or high risk (stage III or IV) refractory B-cell chronic lymphocytic leukemia Intermediate risk group must have evidence of active disease as shown by at least one of the following: Massive or progressive splenomegaly and/or lymphadenopathy Weight loss of greater than 10% in the last 6 months CALGB grade 2-4 fatigue Fevers greater than 100.5 degree Fahrenheit OR night sweats for greater than2 weeks without evidence of infection Progressive lymphocytosis with an increase greater than 50% over a 2 month period or an anticipated doubling time of less than 6 months Refractory to fludarabine treatment OR relapsed within 6 months of fludarabine Lymphocytosis greater than 5000/mm3 at some time during disease Bilirubin no greater than 1.5 times upper limit of normal (ULN) Creatinine no greater than 1.5 times ULN Not pregnant or nursing Fertile patients must use effective contraception No more than 1 prior nonradiolabeled antibody treatment (e.g., Campath-1H or rituximab) At least 1, but no more than 3, prior chemotherapy regimens At least 1 prior chemotherapy regimen comprising fludarabine No other concurrent chemotherapy No concurrent chronic use of oral corticosteroids No concurrent hormone therapy except for non-disease related conditions No concurrent dexamethasone or other corticosteroid-based antiemetics No concurrent palliative radiotherapy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment (flavopiridol)<br>Patients registered before 9/15/2000 receive flavopiridol IV continuously on days 1-3. Treatment repeats every 14 days for a total of 12 courses in the absence of disease progression or unacceptable toxicity. Patients registered after 9/15/2000 receive flavopiridol IV over 1 hour daily on days 1-3. Treatment repeats every 3 weeks for a total of 8 courses in the absence of disease progression or unacceptable toxicity. | Drug: alvocidib<br>* Given IV<br>* Other names: L-868275;Other: laboratory biomarker analysis<br>* Correlative studies<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete + partial response rate | The CR + PR rate will be estimated with a 95% confidence interval, and the success of the study will be judged with the two-stage design given above. | Up to 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Toxicity profile of flavopiridol | Toxicities will be tabulated by type and grade | Up to 5 years | 
| Progression-free survival | Will be estimated using the Kaplan-Meier method. | From onstudy date to the date of progression or death, assessed up to 5 years | 
| Overall survival |  | From onstudy date to the date of death, assessed up to 5 years |