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Open Label, Uncontrolled, Pilot, Phase II Study of Histone-deacetylase Inhibitor ITF2357 Administered Orally to Subjects With Chronic Lymphocytic Leukemia (CLL) Refractory/Relapsed After Conventional Chemotherapy or Relapsed After Autologous Bone Marrow Transplantation


Phase 2
18 Years
75 Years
Not Enrolling
Both
Chronic Lymphocytic Leukemia

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Trial Information

Open Label, Uncontrolled, Pilot, Phase II Study of Histone-deacetylase Inhibitor ITF2357 Administered Orally to Subjects With Chronic Lymphocytic Leukemia (CLL) Refractory/Relapsed After Conventional Chemotherapy or Relapsed After Autologous Bone Marrow Transplantation


CLL is the most frequent type of leukemia in the western world and affects mainly elderly
individuals, although about one third of patients are less than 60 years of age at
diagnosis.

CLL is a heterogeneous disease characterised by a surprisingly diverse clinical course with
patients that may have an overall survival time ranging from months to decades.

CLL accounts for approximately 7000 new cases and 4500 deaths per year in the US.

Chemotherapeutic treatment of CLL is largely ineffective and despite new emerging
therapies, CLL still remains an incurable disease.

ITF 2357 is a novel and proprietary molecule synthesized by Italfarmaco S.p.A. Research
Laboratories, provided with an established and powerful HDAC-inhibitory activity (see below
for further details). It is being developend for a range of possible clinical applications
both in oncohaematological conditions and in chronic inflammatory diseases. The former
application is consistent with the well known antitumor pharmacological properties of
HDAC-inhibitors as a family (i.e. cell-cycle arrest, pro-apoptotic and cell-differentiating
effects); the latter application (chronic inflammation) is based of the demonstrated
anticytokine effect of ITF 2357.


Inclusion Criteria:



- Confirmed diagnosis of CLL according to the NCI Working Group criteria.

- Male and female patients of age >18 and ≤75 years

- Patients relapsed/refractory within 1 month after conventional chemotherapy (>1
polychemotherapy regimen) or relapsed within 3 months after autologous bone marrow
transplantation

- ECOG performance score of ≤2

- Limphocytes ≥10.0x10^9/L and platelets >75.0x10^9/L after recovery from a previous
therapy

- Percentage of CD19+/CD5+ leukemic cells >50%

- Adequate cardiac, pulmonary and renal function, as defined by LVEF >45%, FEV >50%
and creatinine ≤1.5 ULN or creatinine clearance ≥50ml/min

- Serum bilirubine <1.5xULN, AST and ALT <2.5xULN

- Serum potassium, phosphorus, total calcium, magnesium >LLN

- Normal values for FT4 and TSH (patients may be on thyroid hormone replacement)

- Negative test for beta-HCG for women in fertile age

- Documentation of written informed consent to participate in the trial

- Willingness and ability to comply with scheduled visits, treatment plan, laboratory
tests and other study procedures.

Exclusion Criteria:

- Patients with Autoimmune haemolytic anaemia, Autoimmune Thrombocytopenic Purpura and
Fischer Evans Syndrome.

- Patients with other autoimmune diseases.

- Patients with a marked baseline prolongation of QTc interval (e.g. repeated
demonstration of a QTc interval >450 ms).

- Patients with history of additional risk factors for torsade de pointes (e.g. hearth
failure, family history of Long QT Syndrome)

- The use of concomitant medications with potential risk of torsade de pointes and/or
that can prolong QTc interval

- Prior treatment with an HDAC inhibitor.

- Treatment with Rituximab or Alemtuzumab within 90 days prior to study therapy.

- Patients HIV positive, patients with active EBV, HBV, HCV infection or liver
cirrhosis

- Patients with active uncontrolled viral or bacterial or mycotic infection.

- Major surgeries within 4 weeks from study start or not fully recovered from any
previous surgical procedure.

- Presence of any medical or psychiatric condition which may limit full compliance with
the study or increase the risk associated with study participation or study drug
administration.

- Patients in treatment with corticosteroids within 1 month before study start

- Significant cardiovascular disease (i.e., uncontrolled arrhythmias, unstable angina),
or a major thromboembolic event (myocardial infarction, stroke, transient ischemic
attack, pulmonary embolism, or non-catheter-related deep-vein thrombosis) in the last
6 months.

- Uncontrolled hypertension.

- Malabsorption syndromes.

- Breast feeding women

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

To determine overall response-rate, complete response (CR) or partial response (PR) to ITF2357 given at 100 mg x 2/die for up to three months

Outcome Time Frame:

13 weeks

Safety Issue:

No

Principal Investigator

Massimo Martelli, MD

Investigator Role:

Study Director

Investigator Affiliation:

Department of Internal Medicine and Public Health, University of Perugia

Authority:

Italy: Ministry of Health

Study ID:

DSC/06/2357/21

NCT ID:

NCT00792831

Start Date:

February 2008

Completion Date:

April 2009

Related Keywords:

  • Chronic Lymphocytic Leukemia
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid

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