E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic Lymphocytic Leukemia |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Bone marrow response (change in percentage of infiltration) after 6 months of Bevacizumab |
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E.2.2 | Secondary objectives of the trial |
Clinical complete response, partial response, nodal partial response rate Molecular complete response Progression Free Survival Time to next treatment Safety and Toxicity Scientific accompanying programme |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patient's written informed consent • B-CLL (as determined by CD23+, CD5+, CD19+, CD20+) • Treatment not yet indicated as defined by NCI Workshop Criteria, but with ≥1 risk factors (unfavourable molecular cytogenetics [17p and/or 11q and/or trisomy 12]; increased CD-38 level; increased ZAP70 expression; unmutated IgVH gene; or predicted lymphocyte doubling time shorter than 12 months) • Signs of advanced tumor mass or disease dynamics (fatigue or weight loss below NCI-definition, increase in bone marrow infiltration of more than 20% or absolute bone marrow infiltration rate of greater 70%, cytopenias due to splenomegaly below NCI criteria, lymph nodes above 3 cm or progressive lymphadenopathy below 50% in 6 month, leukocytosis greater than 100.000/µl) • Age ≥18 • ECOG performance status 0-2 • No previous treatment of the CLL by chemotherapy, radiotherapy or immunotherapy • Life expectancy > 6 months • Patient using a reliable means of contraception (e.g. physical barrier, contraceptive pill or patch, spermicide and barrier, or IUD) for the duration of the treatment including 1 year thereafter • Adequate renal function as documented by: - a serum creatinine level < 2 mg/dL (177 μmol/L) - urine dipstick for proteinuria < 2+. If urine dipstick is ≥ 2+, 24 hrs urine collection must demonstrate ≤ 1 g protein secretion in 24 hours • Adequate hepatic function (total bilirubin ≤ 1.5 x ULN, transaminases < 2.5 x ULN [or < 5 x ULN in the presence of CLL involvement of the liver]) • The use of full dose oral or parenteral anticoagulants is permitted as long as the INR, or other monitoring test as appropriate, is within therapeutic limits and the patient has been on a stable dose of anticoagulants for at least 2 weeks at the time of enrolment. Patients not receiving anticoagulant medication must have an INR ≤ 1.5 and an aPTT ≤ 1.5 x ULN within 7 days of enrolment.
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E.4 | Principal exclusion criteria |
Uncontrolled viral, bacterial or fungal infection • History of solid organ transplantation • Pregnant or nursing females • CNS involvement by CLL or any evidence of spinal cord compression. Brain CT/MRI is only mandatory (within 4 weeks prior to enrolment) in case of clinical suspicion of CNS involvement by CLL. • CT scan based evidence of tumor invading major blood vessels (putting patients at risk for bleeding during study treatment) • Gastrointestinal tract involvement by CLL (test only upon clincal suspicion) • Prior malignancy (except adequately treated basal cell carcinoma of the skin, in situ cervical cancer, or any other cancer for which the patient has been in remission for at least 5 years) • Known hypersensitivity to study drug or its ingredients (i.e., hypersensitivity to Polysorbate 20, CHO cell products, or recombinant human antibodies) • Seizures requiring permanent anticonvulsant therapy • Severe chronic obstructive pulmonary disease with hypoxemia • Uncontrolled diabetes mellitus • Uncontrolled hypertension, CVA/stroke (≤ 6 months prior to enrolment), myocardial infarction (≤ 6 months prior to enrolment), unstable angina (≥ NYHA Grade IV), thrombosis within 6 months before enrolment, NYHA ≥ Grade II CHF, or serious cardiac arrhythmia requiring ongoing medication • Clinically significant, active peripheral vascular disease, serious non healing wound/ulcer, bone fracture, bleeding diathesis (history or evidence of inherited bleeding diathesis) or coagulopathy • Major surgery, open biopsy or trauma within 28 days before enrolment (lymph node biopsies are not considered major surgery), or the need for major surgery during the course of study treatment • History of active ulcer (within 1 year prior to enrolment), abdominal fistula, gastrointestinal perforation, or intra abdominal abscess or concurrent therapy for treatment/prevention of ulcer • Current or recent (within the 30 days prior to starting study treatment) treatment with another investigational drug or participation in another investigational therapeutic study • Evidence of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug, or patient at high risk from treatment complications • Any co-existing medical or psychological condition that would compromise ability to give informed consent
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E.5 End points |
E.5.1 | Primary end point(s) |
Bone marrow response after 6 months of Bevacizumab |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
explorative proof of concept trial |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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date of last follow-up visit of the last patient indcluded |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |