E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic Lymphocytic Leukaemia |
Chronická lymfocytární leukémie |
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E.1.1.1 | Medical condition in easily understood language |
Leukemia, Cancer of white blood cells |
Leukémie, nádorové onemocnění z buněk bílé krevní řady |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to evaluate progression-free-survival of ofatumumab added to chlorambucil therapy vs. chlorambucil therapy for the treatment of previously untreated (frontline) CLL. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives are to evaluate clinical benefit, safety, tolerability, changes in patient reported outcome measures (PRO) and pharmacokinetics of subjects treated with ofatumumab added to chlorambucil.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Diagnosis of CLL defined by:
• Circulating lymphocytes ≥5,000/uL for a duration of at least 3 months*
AND
• Flow cytometry confirmation of immunophenotype with CD5, CD19, CD20, CD23, CD79b, and surface Ig prior to Visit 2
* CLL might be suspected in otherwise healthy adults who have an absolute increase in B-cells but who have less than 5,000/microL blood lymphocytes (defined as monoclonal B-lymphocytosis, MBL). The presence of a cytopenia caused by a typical marrow infiltrate defines the diagnosis of CLL regardless of the number of peripheral B-lymphocytes or of the lymph node involvement.
2. Active disease and indication for treatment based on modified NCI-WG guidelines [Hallek, 2008] defined by presenting at least any one of the following conditions:
• Evidence of progressive marrow failure as manifested by development or worsening of anemia and/or thrombocytopenia
• Massive (i.e. > 6cm below the left costal margin) or progressive or symptomatic splenomegaly
• Massive nodes (i.e. > 10cm in longest diameter) or progressive or symptomatic lymphadenopathy
• Progressive lymphocytosis with an increase of more than 50% over a two month period or an lymphocyte doubling time of less than 6 months
• A minimum of any one of the following disease-related symptoms must be present:
a) Unintentional Weight loss ≥10% within the previous six months
b) Fevers > 100.5oF (38.0oC) for ≥ 2 weeks without evidence of infection
c) Night sweats for more than 1 month without evidence of infection
3. Not been previously treated for CLL (prior autoimmune hemolytic anemia treatment permitted)
4. ECOG Performance Status of 0-2
5. Life expectancy of at least 6 months
6. Age ≥ 18 years
7. Signed written informed consent prior to performing any study-specific procedures
French subjects: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.
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E.4 | Principal exclusion criteria |
1. Prior immuno- or chemotherapy for CLL with any agent except corticosteroids used to treat autoimmune hemolytic anemia
2. Previous autologous or allogeneic stem cell transplantation
3. Active autoimmune hemolytic anemia (AIHA) requiring corticosteroid therapy > 100mg equivalent to hydrocortisone, or chemotherapy
4. Known transformation of CLL (e.g. Richter)
5. Known CNS involvement of CLL
6. Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C.
7. Other past or current malignancy. Subjects who have been free of malignancy for at least 5 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible.
8. Clinically significant cardiac disease including unstable angina, acute myocardial infarction within 6 months prior to Visit 1, congestive heart failure, and arrhythmia requiring therapy, with the exception of extra systoles or minor conduction abnormalities
9. History of significant cerebrovascular disease or event with significant symptoms or sequelae
10. Glucocorticoid use, unless given in doses ≤ 100mg/day hydrocortisone (or equivalent dose of other glucocorticoid) for <7 days for exacerbations other than CLL (e.g. asthma)
11. Known HIV positive
12. Positive serology for Hepatitis B (HB) defined as a positive test for HBsAg. In addition, if negative for HBsAg but HBcAb positive and HBsAb negative, a HB DNA test will be performed and if positive the subject will be excluded. Note: If HBcAb positive and HBsAb positive, which is indicative of a past infection, the subject can be included.
13. Screening laboratory values:
• Creatinine > 2.0 times upper normal limit (unless normal creatinine clearance)
• Total bilirubin > 2.0 times upper normal limit (unless due to liver involvement of CLL)
• alanine transaminase (ALT) > 3.0 times upper normal limit (unless due to liver involvement of CLL)
14. Previous treatment or known or suspected hypersensitivity to ofatumumab
15. Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to Visit 1, whichever is longer or currently participating in any other interventional clinical study
16. Known or suspected inability to comply with study protocol
17. Lactating women, women with a positive pregnancy test at Visit 1 or women (of childbearing potential) as well as men with partners of childbearing potential, who are not willing to use adequate contraception from study start through one year following last treatment dose. Adequate contraception is defined as abstinence, oral hormonal birth control, hormonal birth control injections, implants of levonorgestrel, estrogenic vaginal ring, percutaneous contraceptive patches, intrauterine device, and male partner sterilization if male partner is sole partner for that subject. The double barrier method can be used in regions where considered acceptable and adequate (condom or occlusive cap plus spermicidal agent).
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E.5 End points |
E.5.1 | Primary end point(s) |
• Progression free survival (PFS), defined as the interval between randomization until disease progression or death. |
Doba do progrese |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Overall response rate, Overall survival, Changes in patient reported
outcome measures, Number of complete remissions, Time to response,
duration of response, Time to progression, time to next therapy,
Improvement of ECOG PS, Improvement in B-symptoms, Incidence and
severity of AEs, SAEs and other safety parameters,Human Anti Human
Antibodies (HAHA), CIRS |
Overall response rate, Overall survival, Changes in patient reported
outcome measures, Number of complete remissions, Time to response,
duration of response, Time to progression, time to next therapy,
Improvement of ECOG PS, Improvement in B-symptoms, Incidence and
severity of AEs, SAEs and other safety parameters,Human Anti Human
Antibodies (HAHA), CIRS |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At primary endpoint analysis (26-May-2011) and at end of study (16-Jun-2022) |
V době analýzy primárního endpointu (26-May-2011) a v závěru studie (16-Jun-2022) |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
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 | Yes |
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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 107 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Belgium |
Brazil |
Canada |
Czech Republic |
France |
Germany |
Greece |
India |
Ireland |
Italy |
Netherlands |
Poland |
Russian Federation |
Spain |
Sweden |
United Kingdom |
United States |
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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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End of trial is LSLV but there is two LSLV, one is for the primary
endpoint (which is event driven) and one is for end of study (which is
driven by treatment duration) |
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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 | 8 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 21 |
E.8.9.2 | In all countries concerned by the trial years | 8 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 21 |