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A Phase II Study of EL625 in Patients in Persistent Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma


Phase 2
18 Years
N/A
Not Enrolling
Both
Lymphoma, Small Lymphocytic, Leukemia, Lymphocytic, Chronic

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Trial Information

A Phase II Study of EL625 in Patients in Persistent Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma


Chronic lymphocytic leukemia (CLL) and small B-cell lymphocytic lymphoma (SLL) are thought
to be different manifestations of the same disease. Treatment options for CLL/SLL range from
a watch and wait approach to bone marrow transplant. Currently there is no consensus on the
best treatment regimen and new approaches to treatment are needed.

EL625 is a 20-mer antisense molecule which binds to a coding region of exon 10 in p53 RNA
transcripts. It can bind to both mutant and wild type p53. p53 is involved in regulating
apoptosis and DNA repair in cells. When genetic damage occurs p53 is upregulated. As the
expression of p53 increases in normal cells they are more likely to undergo apoptosis rather
than cell cycle arrest and DNA repair. However in malignant cells, for a given level of DNA
damage they are more likely to undergo cell cycle arrest and repair rather than apoptosis.
Because EL625 is theorized to increase response to chemotherapy, we propose adding EL625 to
a combination of fludarabine, cyclophosphamide and rituximab.


Inclusion Criteria:



- Patients with a diagnosis of CLL/SLL who have received at least one prior treatment
regimen and have persistent disease (i.e. any evidence of active disease). Patients
with a chromosome 17 abnormality or a p53 mutation of any type may be enrolled
without having received prior treatment.

- Patients must be 18 years of age or older.

- Patient has an estimated or measured creatinine clearance ≥30 ml/min at study
enrollment.

- AST, ALT, total bilirubin < than 2.5 times the upper limit of normal.

- WBC > 1.5; ANC >500; Plt >50,000 unless documented as due to disease

- ECOG performance status of 0-2.

- Voluntary written informed consent before performance of any study-related procedure
not part of normal medical care.

- Female subject is either post-menopausal or surgically sterilized or willing to use
an acceptable method of birth control (i.e., a hormonal contraceptive, intra-uterine
device, diaphragm with spermicide, condom with spermicide, or abstinence) for 2 weeks
after administration of the study drug.

- Male subject agrees to use an acceptable method for contraception for the duration of
the study therapy and for 2 weeks after administration of study drug.

Exclusion Criteria:

- Female who is pregnant or lactating.

- Serious medical or psychiatric illness likely to interfere with participation in this
clinical study.

- Patients with another malignancy within the last three years (from documentation of
remission) other than basal or squamous cell skin cancer, resected early stage
prostate cancer not requiring systemic treatment or CIS of the cervix or fully
treated early stage prostate cancer.

- Significant cardiac or vascular events within 6 months: acute MI, unstable angina,
severe peripheral vascular disease (ischemic pain at rest class 3 or worse,
non-healing ulcers/wounds, congestive heart failure (NYHA class ≥ 2), uncontrolled
cardiac arrhythmias, and disseminated intravascular coagulation.

- Patients who are unable to refrain from taking acetaminophen

- Investigational agent within 14 days of enrolling on the study.

- Patients unable or unwilling to refrain from antioxidants including vitamin A,
vitamin C, vitamin E, lycopene, lutein, grape seed extract, pycnogenol, green tea
extract, and the like.

- Patients who have received a prior allogenic stem cell transplant and have at least
2.5% donor cells still evident on engraftment studies.

Type of Study:

Interventional

Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Number of Patients With an Overall Response (Complete Response + Partial Response)

Outcome Description:

Overall Response is the total number of participants with a Complete (CR) or Partial (PR) response. CR requires the absence of lymphadenopathy, hepatomegaly or splenomegaly and constitutional symptoms and a normal CBC; bone marrow must be at least normocellular for age, with less than 30% nucleated cells being lymphocytes with no lymphoid nodules. Partial Response: requires ≥ 50% decrease in one of the following: peripheral blood lymphocyte count, lymphadenopathy, enlargement of liver and/or spleen, or bone marrow involvement by CLL AND at least one hematologic parameter met for 2 months.

Outcome Time Frame:

every 3 cycles

Safety Issue:

No

Principal Investigator

David Rizzieri, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Duke University

Authority:

United States: Food and Drug Administration

Study ID:

Pro00001363

NCT ID:

NCT00636155

Start Date:

February 2008

Completion Date:

May 2012

Related Keywords:

  • Lymphoma, Small Lymphocytic
  • Leukemia, Lymphocytic, Chronic
  • Small Lymphocytic Lymphoma
  • Chronic Lymphocytic Leukemia
  • EL625
  • cenersen
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid
  • Lymphoma

Name

Location

Duke University Medical Center Durham, North Carolina  27710