This trial is active, not recruiting.

Condition chronic lymphocytic leukemia
Treatment rituximab
Phase phase 2
Target CD20
Sponsor Institut Paoli-Calmettes
Start date December 2011
End date June 2015
Trial size 35 participants
Trial identifier NCT01521689, LLCR lowdoz / IPC 2009-004


Chronic Lymphocytic Leukemia (CLL) is still an incurable disease. However recent advances have established correlation between the quality of the response (in particular achievement of negativity of minimal residual disease (MRD) and progression free and overall survival. That is why MRD negative complete remission (CR) is the current goal in CLL treatment.

The association of Rituximab fludarabine cyclophosphamide leads to the best response rate with 52 to 72% CR in "medically" fit untreated CLL patients. MRD results in this setting are still preliminary and around 50%. However many other situations (unfit, elderly, relapse, haematological toxicity leading to early interruption of treatment…) are associated with much lower response rate that would be improved by consolidation treatment.

Monoclonal antibodies are the treatment of choice for consolidation because of sparing marrow and targeting CLL cells. Alemtuzumab has been used for this purpose and results confirm improvement of CR and MRD negative responses but alemtuzumab induced immunodeficiency lead to unacceptable infectious complications. Rituximab monotherapy induces low response rate at standard dose regimen. This is at least partially due to shaving of CD20, mechanism by which CD20 is lost from the leukemic cells but these cells are not cleared. Using low doses of rituximab reduced shaving and allowed CLL cells clearance by the mononuclear phagocytic system. Such low doses of rituximab can be administered subcutaneously.

The investigators then propose subcutaneous low dose rituximab in consolidation to CLL patients responding after induction but having not achieved MRD negative CR.

United States No locations recruiting
Other countries No locations recruiting

Study Design

Endpoint classification efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment
Consolidation treatment with sub cutaneaous low doses of Rituximab
rituximab Rituximab
Low doses of sub cutaneaous rituximab

Primary Outcomes

Residual disease
time frame: up to 3 month after the end of treatment

Secondary Outcomes

overall survival
time frame: From date of inclusion until date of death, assessed up to 10 years
Adverse events
time frame: up to 3 months
-Quality of life
time frame: up to 3 months after the end of treatment
Immune functions
time frame: up to 3 months after the end of treatment
- Progression free survival
time frame: up to time of progression assessed up to 10 years
treatment free survival
time frame: up to time of new treatment assessed up to 10 years

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - CLL (Matutes 4 or 5) in CR after induction treatment with negative MRD or PR - age>18 - performance status<=2 - signed informed consent Exclusion Criteria: - cytopenia - other malignant affection - HIV or HBV positive - steroids treatment - richter syndrome - pregnant or breastfeeding women

Additional Information

Official title Phase II Study of Tolerance and Efficacy of Subcutanous Low Doses Rituximab Given as Consolidation Treatment to Chronic Lymphocytic Leukaemia (CLL) Patients Responding to Induction Therapy
Principal investigator Thérèse AURRAN, MD
Description Objective(s) of the clinical study Main objective: - To improve the minimal residual disease (MRD) negative complete response (CR) rate after consolidation using subcutaneous low dose of rituximab Secondary objectives: - Progression free survival, treatment free survival, overall survival, - MRD follow-up, - Safety - Medico-economic study - Quality of life study - Immune functions study (ancillary study) Main assessment criteria: MRD negative CR rate, established by peripheral blood 4colour flow cytometry according to international consensus on CLL MRD study, at the end of the consolidation treatment. Experimental plan: Inclusion of patients after the evaluation of response to induction treatment according to NCI-ICLLWG criteria and MRD analysis (2 to 3 months after induction completion): patients having not achieved MRD negative CR. Consolidation treatment by subcutaneous rituximab given at 20 mg/m²/d thrice weekly during 12 weeks. Evaluation of the response 3 months after completion of the consolidation treatment. Subjects number: 35 patients will be needed to accept the hypothesis of an augmentation of CR with negative MRD >=40%, excluding the hypothesis that this rate is < 20%. This ensure us an alpha risk at 5% with a 80% power, taking into account that non evaluable patients will be < 5%. Brief description of the ancillary study: Immune functions study before and after consolidation treatment by rituximab
Trial information was received from ClinicalTrials.gov and was last updated in March 2015.
Information provided to ClinicalTrials.gov by Institut Paoli-Calmettes.