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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04285567
Registration number
NCT04285567
Ethics application status
Date submitted
25/02/2020
Date registered
26/02/2020
Titles & IDs
Public title
A Study to Compare the Efficacy and Safety of a Combined Regimen of Venetoclax and Obinutuzumab Versus Fludarabine, Cyclophosphamide, and Rituximab (FCR)/ Bendamustine And Rituximab (BR) in FIT Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL) Without DEL (17P) or TP53 Mutation
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Scientific title
A Prospective, Open-Label, Multicenter Randomized Phase III Study to Compare The Efficacy and Safety of A Combined Regimen of Venetoclax and Obinutuzumab Versus Fludarabine, Cyclophosphamide, and Rituximab (FCR)/Bendamustine and Rituximab (BR) in FIT Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL) Without DEL(17P) or TP53 Mutation
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Secondary ID [1]
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2019-003327-37
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Secondary ID [2]
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CO41685
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Universal Trial Number (UTN)
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Trial acronym
CRISTALLO
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Lymphocytic Leukemia (CLL)
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Obinutuzumab
Treatment: Drugs - Venetoclax
Treatment: Drugs - Fludarabine
Treatment: Drugs - Cyclophosphamide
Treatment: Drugs - Rituximab
Treatment: Drugs - Bendamustine
Experimental: VEN + G - Participants will receive 12 cycles of treatment (each cycle is 28 days). Venetoclax (VEN) will be administered orally, daily, with a 5-week ramp-up period, starting on Cycle 1, Day 22 and administration will continue until the end of Cycle 12. Obinutuzumab (G) will be administered intravenously (IV) on Days 1 (and 2), 8, and 15 of Cycle 1 and on Day 1 of Cycles 2-6.
Active comparator: FCR/BR - Participants will receive 6 cycles of Fludarabine + Cyclophosphamide + Rituximab (FCR) consisting of a single cycle of a single infusion of rituximab on Day 1 and fludarabine and cyclophosphamide infusions on Days 1-3 of each 28-day cycle or bendamustine (B) as infusions on Days 1 and 2 and a single cycle of rituximab on Day 1 of each 28-day cycle.
Treatment: Drugs: Obinutuzumab
Obinutuzumab 1000 milligrams (mg) will be administered IV on Days 1 (and 2), 8, and 15 of Cycle 1 and on Day 1 of Cycles 2-6.
Treatment: Drugs: Venetoclax
Venetoclax 20 mg will be administered orally, once daily starting on Day 22 of Cycle 1 for 7 days, then ramp up from 50 to 400 mg/day during Cycle 2 and continue at 400 mg/day from Day 1 of Cycle 3 till end of Cycle 12.
Treatment: Drugs: Fludarabine
Fludarabine will be administered in a dosage of 25 milligram per meter squared (mg/m\^2), IV, on days 1, 2, and 3 of Cycles 1-6.
Treatment: Drugs: Cyclophosphamide
Cyclophosphamide will be administered in a dosage of 250 mg/m\^2, IV, on Days 1, 2, and 3 Cycles 1-6.
Treatment: Drugs: Rituximab
Rituximab will be administered at a dose of 375 mg/m\^2, IV, on Cycle 1, Day 1 followed by 500 mg/m\^2 on Day 1 of Cycles 2-6.
Treatment: Drugs: Bendamustine
Bendamustine will be administered at a dose of 90 mg/m\^2, IV, on 2 consecutive days of Cycles 1-6.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Minimal Residual Disease (MRD) Response Rate Using Next-generation Sequencing (NGS)
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Assessment method [1]
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Timepoint [1]
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At Month 15
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Secondary outcome [1]
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Progression-free Survival (PFS)
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Assessment method [1]
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Timepoint [1]
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From randomization up to the first occurrence of disease progression (PD), or death from any cause (up to 74 months)
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Secondary outcome [2]
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MRD Response Rate in Peripheral Blood (PB) at the End of Treatment Response Visit
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Assessment method [2]
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Timepoint [2]
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At end of treatment response visit (up to approximately 15 months in Arm VEN + G and 9 months in Arm FCR/BR
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Secondary outcome [3]
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MRD Response Rate in Bone Marrow (BM) at the End of Treatment Response Visit
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Assessment method [3]
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Timepoint [3]
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At end of treatment response visit (up to approximately 15 months in Arm VEN + G and 9 months in Arm FCR/BR
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Secondary outcome [4]
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Objective Response Rate (ORR)
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Assessment method [4]
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Timepoint [4]
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At Month 15
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Secondary outcome [5]
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Complete Response (CR) Rate
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Assessment method [5]
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Timepoint [5]
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At Month 15
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Secondary outcome [6]
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MRD Response Rate in PB of Participant With a CR/CR With Incomplete Blood Count (CRi) at Month 15
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Assessment method [6]
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Timepoint [6]
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At Month 15
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Secondary outcome [7]
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MRD Response Rate in the BM of Participants With a CR/CRi at the End of Treatment Visit
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Assessment method [7]
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Timepoint [7]
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At end of treatment response visit (up to approximately 15 months in Arm VEN + G and 9 months in Arm FCR/BR
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Secondary outcome [8]
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Duration of Objective Response (DOR)
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Assessment method [8]
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Timepoint [8]
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From time of first response until PD, or death from any cause (up to 74 months)
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Secondary outcome [9]
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Best Overall Response
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Assessment method [9]
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Timepoint [9]
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Up to and including the assessment at Month 15
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Secondary outcome [10]
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Event-free Survival (EFS)
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Assessment method [10]
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Timepoint [10]
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From randomization up to PD /relapse, death, or start of a new anti-leukemic therapy (up to 74 months)
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Secondary outcome [11]
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Overall Survival (OS)
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Assessment method [11]
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Timepoint [11]
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From randomization up to death due to any cause (up to 74 months)
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Secondary outcome [12]
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Arm VEN + G: Tumor Lysis Syndrome (TLS) Risk Reduction Rate
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Assessment method [12]
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Timepoint [12]
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At screening and Cycle 1 Day 22 (cycle length= 28 days)
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Secondary outcome [13]
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Arm VEN + G: Reduction in Mandatory Hospitalisations During Venetoclax Ramp-up
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Assessment method [13]
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Timepoint [13]
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On Cycle 1 Day 22 (cycle length= 28 days)
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Secondary outcome [14]
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Change From Baseline in M.D. Anderson Symptom Inventory-CLL (MDASI-CLL) Score
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Assessment method [14]
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The MDASI-CLL is a questionnaire of 25 items related to CLL specific symptoms that a participant may have experienced in the past 24 hours. Participants were asked to rate the severity of 13 symptoms called mean core symptom severity (i.e., pain, fatigue, nausea, disturbed sleep, distressed, shortness of breath, remembering things, lack of appetite, drowsy, dry mouth, sadness, vomiting, and numbness or tingling), 6 disease-specific symptoms called mean module symptom severity (night sweats, fevers and chills, lymph node swelling, diarrhea, easy bruising or bleeding, and constipation) and 6 mean interference on life questions (i.e., general activity, walking, work, mood, relations with other people, and enjoyment of life) on a scale from 0 to 10 with 0 indicating that the symptom is "not present" or "did not interfere" with the participant's activities and 10 indicating "as bad as you can imagine" or "interfered completely".
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Timepoint [14]
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Arm VEN + G: Day 1 of Cycle 1-12, Day 28 after treatment completion/early termination (TC/ET), follow up (FU) visits; Arm FCR/BR: Day 1 of Cycle 1-6, Day 28 after TC/ET, end of combination treatment response visit and FU visit (up to 74 months)
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Secondary outcome [15]
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Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQC-30)
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Assessment method [15]
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The EORTC QLQ-C30 is a validated and reliable self-report measure consisting of 30 questions incorporated into five functional scales (physical, role, cognitive, emotional, and social scales), three symptom scales (fatigue, pain, nausea, and vomiting scales), and a global health status/global quality-of-life scale. The remaining single items (dyspnea, appetite loss, sleep disturbance, constipation, and diarrhea) assess the additional symptoms experienced by patients with cancer and the perceived financial burden of treatment. The 28 function and symptom items were scored on a 4-point scale that ranged from "not at all" to "very much," and the 2 global health status/global quality-of-life items were scored on a 7-point scale that ranged from "very poor" to "excellent." Raw average scale scores were linearly transformed to range 0-100 with higher scores indicating higher response levels (i.e., higher functioning, higher symptom severity).
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Timepoint [15]
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Arm VEN + G: Day 1 of Cycle 1-12, Day 28 after treatment completion/early termination (TC/ET), follow up (FU) visits; Arm FCR/BR: Day 1 of Cycle 1-6, Day 28 after TC/ET, end of combination treatment response visit and FU visit (up to 74 months)
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Secondary outcome [16]
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Number of Participants With Adverse Events (AEs)
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Assessment method [16]
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Timepoint [16]
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Up to 28 days after last dose of study drug or until initiation of another anti-cancer therapy (up to 74 months)
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Eligibility
Key inclusion criteria
* Ability to comply with the study protocol, in the investigator's judgment
* Aged 18 years or older
* Have previously untreated documented Chronic Lymphocytic Leukemia (CLL) according to the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria
* CLL requiring treatment according to the iwCLL criteria
* Cumulative Illness Rating Scale (CIRS) score = 6 and creatinine clearance (CrCl) = 70 mL/min
* Hematology values within the following limits, unless cytopenia is caused by the underlying disease (i.e., no evidence of additional bone marrow (BM) dysfunction; e.g., myelodysplastic syndrome, hypoplastic BM):
* Absolute neutrophil count = 1.0 x 109/L, unless there is BM involvement
* Platelet count = 75 x 109/L and more than 7 days since last transfusion, or = 30 x 109/L if there is BM involvement
* Adequate liver function as indicated by a total bilirubin, aspartate aminotransferase, and Alanine transaminase = 2 times the institutional upper limit of normal (ULN) value, unless directly attributable to the participant's CLL
* Life expectancy >6 months
* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception and agreement to refrain from donating eggs
* For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods, and agreement to refrain from donating sperm
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Transformation of CLL to aggressive Non-Hodgkin's Lymphoma (NHL)
* Participants with Small Lymphocyclic Lymphoma (SLL) only
* Known central nervous system involvement
* Participants with a history of confirmed progressive multifocal leukoencephalopathy (PML)
* Detected del(17p) or TP53 mutation (valid test within 6-months from screening is required for randomisation)
* An individual organ/system impairment score of 4 as assessed by the Cumulative Illness Rating Scale (CIRS) definition limiting the ability to receive the treatment regimen of this trial with the exception of eyes, ears, nose, throat organ system
* Participants with uncontrolled autoimmune hemolytic anemia or immune thrombocytopenia
* History of prior malignancy
* Participants with infections requiring IV treatment (Grade 3 or 4) within the last 8 weeks prior to enrollment
* Evidence of other clinically significant uncontrolled conditions including but not limited to active or uncontrolled systemic infection (e.g., viral, bacterial, or fungal)
* History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products
* Hypersensitivity to fludarabine, bendamustine, cyclophosphamide, rituximab, obinutuzumab, or venetoclax or to any of the excipients (e.g., trehalose)
* Pregnant women and nursing mothers
* Vaccination with a live vaccine = 28 days prior to randomization
* Prisoners or participants who are institutionalized by regulatory or court order or persons who are in dependence to the Sponsor or an investigator
* History of illicit drug or alcohol abuse within 12 months prior to screening, in the investigator's judgment
* Positive test results for chronic hepatitis B virus (HBV) infection (defined as positive hepatitis B surface antigen [HBsAg] serology)
* Positive test result for hepatitis C (hepatitis C virus [HCV] antibody serology testing)
* Participants with known infection with HIV or Human T-Cell Leukemia Virus 1 (HTLV-1)
* Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the participant's safe participation in and completion of the study
* Received any of the following agents within 28 days prior to the first dose of study treatment:
* Immunotherapy
* Radiotherapy
* Hormone therapy
* Any therapies intended for the treatment of lymphoma/leukemia whether approved or experimental
* Participants who have received the following agents:
* Strong and moderate CYP3A inhibitors/inducers within 7 days prior to the initiation of study treatment
* Steroid therapy for anti-neoplastic intent with the exception of inhaled steroids for asthma, topical steroids, or replacement/stress corticosteroids within 7 days prior to the first dose of study drug administration
* Consumed grapefruit, grapefruit products, Seville oranges(including marmalade containing Seville oranges), or star fruit within 3 days prior to the first dose of study drug and throughout venetoclax administration
* Inability to swallow a large number of tablets.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
28/05/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/07/2026
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Actual
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Sample size
Target
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Accrual to date
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Final
166
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,TAS,VIC
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Recruitment hospital [1]
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Canberra Hospital; Haematology Department - Canberra
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Recruitment hospital [2]
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Liverpool Hospital; Haematology - Liverpool
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Recruitment hospital [3]
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Port Macquarie Base Hospital - Port Macquarie
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Royal North Shore Hospital; Haematology Department - St. Leonards
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Recruitment hospital [5]
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Royal Hobart Hospital - Hobart
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Recruitment hospital [6]
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The Northern Hospital - Epping
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Recruitment hospital [7]
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Peter MacCallum Cancer Centre; Department of Haematology - Melbourne
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Recruitment hospital [8]
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Monash Medical Centre; Haematology - Melbourne
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Recruitment postcode(s) [1]
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2605 - Canberra
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Recruitment postcode(s) [2]
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2170 - Liverpool
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Recruitment postcode(s) [3]
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2444 - Port Macquarie
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Recruitment postcode(s) [4]
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2065 - St. Leonards
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Recruitment postcode(s) [5]
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7000 - Hobart
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Recruitment postcode(s) [6]
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VIC 3076 - Epping
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Recruitment postcode(s) [7]
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3002 - Melbourne
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Recruitment postcode(s) [8]
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3168 - Melbourne
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Colorado
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United States of America
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State/province [2]
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Maryland
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United States of America
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Montana
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United States of America
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Tennessee
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United States of America
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Texas
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United States of America
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Utah
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Country [7]
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United States of America
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State/province [7]
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Virginia
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France
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State/province [8]
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Caen
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France
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State/province [9]
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Creteil
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France
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State/province [10]
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Le Mans
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France
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State/province [11]
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Lille
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Country [12]
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France
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State/province [12]
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Perpignan
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France
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State/province [13]
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Pessac
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France
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State/province [14]
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Pierre Benite
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France
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State/province [15]
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Poitiers
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France
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State/province [16]
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Reims
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France
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State/province [17]
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Toulon
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France
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State/province [18]
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TOURS Cedex
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Italy
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State/province [19]
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Emilia-Romagna
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Italy
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State/province [20]
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Lazio
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Italy
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State/province [21]
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Liguria
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Italy
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State/province [22]
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Lombardia
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Italy
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State/province [23]
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Piemonte
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Italy
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State/province [24]
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Puglia
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Italy
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Umbria
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Spain
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Barcelona
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Spain
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Navarra
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Spain
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State/province [28]
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Tenerife
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Spain
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State/province [29]
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Madrid
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Spain
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State/province [30]
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Murcia
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Spain
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State/province [31]
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Sevilla
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Spain
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State/province [32]
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Toledo
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Hoffmann-La Roche
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This study will evaluate the efficacy and safety of venetoclax and obinutuzumab (VEN + G) compared with fludarabine + cyclophosphamide + rituximab or bendamustine + rituximab (FCR/BR) in FIT participants (FIT is defined by a cumulative illness rating scale \[CIRS\]/score of =6 and a normal creatinine clearance of =70 mL/min) with previously untreated CLL without DEL(17P) or TP53 mutation requiring treatment. Eligible participants will be randomly assigned in a 1:1 ratio to receive either VEN + G (Arm A) or FCR/BR (Arm B).
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Trial website
https://clinicaltrials.gov/study/NCT04285567
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Clinical trial
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Address
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Hoffmann-La Roche
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers may request access to individual patient level data through the request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/).
For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/innovation/process/clinical-trials/data-sharing).
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04285567