Chemoimmunotherapy for patients with chronic lymphocytic leukemia (CLL).
| Study . | Treatment . | Prior Treatment . | No. Evaluable . | % CR . | % OR . |
|---|---|---|---|---|---|
| Abbreviations: A, alemtuzumab; R, rituximab; F, fludarabine; C, cyclophosphamide; P, pentostatin; d, day; c, course; wks, weeks; IV, intravenous; PO, oral; PD, progressive disease; SD, stable disease; SQ, subcutaneous; TIW, thrice weekly | |||||
| *Refractory to both fludarabine and alemtuzumab | |||||
| **Refractory to fludarabine | |||||
| Kennedy41 | Concurrent (4wk course) F – 25 mg/m2 IV d 1–3 A – 30 mg IV TIW × 12 wks | Ref* | 6 | 17 | 83 |
| Elter42 | Concurrent (4wk course) F – 30 mg/m2 d 1–3, c 1–6 A – 30 mg d 1–3, c 1–6 | Yes | 36 | 30 | 83 |
| MDACC - FCR | Concurrent (4wk course) F – 25 mg/m2 IV d 2–4, c 1; d 1–3, c 2–6 C – 250 mg/m2 IV d 2–4, c 1; d 1–3, c 2–6 R – 375–500 mg/m2 IV d 1, c 1–6 | No37 Yes38 | 224 177 | 70 25 | 95 73 |
| CALGB 971235 | Randomized | ||||
| Concurrent (4 wk course) F – 25 mg/m2 IV d 1–5, c 1–6 R – 375 mg/m2 IV d 1,4, c 1; d 1, c 2–6 2 months observation then R – 375 mg/m2 IV weekly × 4 | No | 51 | 47 | 90 | |
| Sequential (4 wk course) F – 25 mg/m2 IV d1–5, c1–6 2 months observation then R – 375 mg/m2 IV weekly × 4 | No | 53 | 28 | 77 | |
| Kay39 | Concurrent (3 wk course) P – 2 mg/m2 IV d 1, c1–6 C – 600 mg/m2 IV d 1, c1–6 R – 375 mg/m2 IV d 1, c2–6 | No | 33 | 33 | 97 |
| Lamanna40 | Concurrent (3 wk course) P – 4 mg/m2 IV d 1, c1–6 C – 600 mg/m2 IV d 1, c1–6 R – 375 mg/m2 IV d 1, c2–6 | Yes | 32 | 25 | 75 |
| UKCLL0260 | Concurrent A – 30 mg SQ TIW x 24 wks add F – 40 mg/m2 PO d 1–3, q 4 wks for PD, SD (4 courses) | Ref** | 36 | 11 | 44 |
| Wierda61 - CFAR | Concurrent (4 wk course) C – 250 mg/m2 IV d 3–5, c 1–6 F – 25 mg/m2 IV d 3–5, c 1–6 A – 30 mg IV d 1,3,5 c1–6 R – 375–500 mg/m2 IV d 2, c 1–6 | Yes | 44 | 27 | 65 |
| Study . | Treatment . | Prior Treatment . | No. Evaluable . | % CR . | % OR . |
|---|---|---|---|---|---|
| Abbreviations: A, alemtuzumab; R, rituximab; F, fludarabine; C, cyclophosphamide; P, pentostatin; d, day; c, course; wks, weeks; IV, intravenous; PO, oral; PD, progressive disease; SD, stable disease; SQ, subcutaneous; TIW, thrice weekly | |||||
| *Refractory to both fludarabine and alemtuzumab | |||||
| **Refractory to fludarabine | |||||
| Kennedy41 | Concurrent (4wk course) F – 25 mg/m2 IV d 1–3 A – 30 mg IV TIW × 12 wks | Ref* | 6 | 17 | 83 |
| Elter42 | Concurrent (4wk course) F – 30 mg/m2 d 1–3, c 1–6 A – 30 mg d 1–3, c 1–6 | Yes | 36 | 30 | 83 |
| MDACC - FCR | Concurrent (4wk course) F – 25 mg/m2 IV d 2–4, c 1; d 1–3, c 2–6 C – 250 mg/m2 IV d 2–4, c 1; d 1–3, c 2–6 R – 375–500 mg/m2 IV d 1, c 1–6 | No37 Yes38 | 224 177 | 70 25 | 95 73 |
| CALGB 971235 | Randomized | ||||
| Concurrent (4 wk course) F – 25 mg/m2 IV d 1–5, c 1–6 R – 375 mg/m2 IV d 1,4, c 1; d 1, c 2–6 2 months observation then R – 375 mg/m2 IV weekly × 4 | No | 51 | 47 | 90 | |
| Sequential (4 wk course) F – 25 mg/m2 IV d1–5, c1–6 2 months observation then R – 375 mg/m2 IV weekly × 4 | No | 53 | 28 | 77 | |
| Kay39 | Concurrent (3 wk course) P – 2 mg/m2 IV d 1, c1–6 C – 600 mg/m2 IV d 1, c1–6 R – 375 mg/m2 IV d 1, c2–6 | No | 33 | 33 | 97 |
| Lamanna40 | Concurrent (3 wk course) P – 4 mg/m2 IV d 1, c1–6 C – 600 mg/m2 IV d 1, c1–6 R – 375 mg/m2 IV d 1, c2–6 | Yes | 32 | 25 | 75 |
| UKCLL0260 | Concurrent A – 30 mg SQ TIW x 24 wks add F – 40 mg/m2 PO d 1–3, q 4 wks for PD, SD (4 courses) | Ref** | 36 | 11 | 44 |
| Wierda61 - CFAR | Concurrent (4 wk course) C – 250 mg/m2 IV d 3–5, c 1–6 F – 25 mg/m2 IV d 3–5, c 1–6 A – 30 mg IV d 1,3,5 c1–6 R – 375–500 mg/m2 IV d 2, c 1–6 | Yes | 44 | 27 | 65 |