A phase 1 clinical trial of flavopiridol consolidation in chronic lymphocytic leukemia patients following chemoimmunotherapy

Farrukh T. Awan, Jeffrey A. Jones, Kami Maddocks, Ming Poi, Michael R. Grever, Amy Johnson, John C. Byrd, Leslie A. Andritsos

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Patients with chronic lymphocytic leukemia (CLL) who receive chemoimmunotherapy and do not achieve complete remission experience significantly shortened progression-free interval (PFS). Additionally, the majority of patients treated for relapsed disease demonstrate evidence of measurable disease. Eradication of minimal residual disease (MRD) results in improved PFS and overall survival. Maintenance therapy might result in eradication of MRD and improve response duration but might be associated with an increase in incidence of infectious complications. Flavopiridol is a broad cyclin-dependent kinase (CDK) inhibitor with established safety and efficacy in patients with relapsed CLL, particularly patients with high-risk cytogenetic features. A pharmacologically derived schedule was utilized as consolidation therapy in this phase I study to assess the safety and feasibility of outpatient therapy with flavopiridol in patients with low tumor burden. Flavopiridol was administered as a 30-min loading dose of 30 mg/m2 followed by a 4-h infusion of 30 mg/m2 once weekly for 3 weeks every 5 weeks (1 cycle) for planned 2 cycles in ten patients. Therapy was extremely well tolerated and no patient developed acute tumor lysis syndrome. The most common toxicities were gastrointestinal. Of the patients, 22 % improved their response from a PR to CR. Eighty-eight percent experienced a reduction in tumor burden as measured by extent of bone marrow involvement including patients with del17p and complex karyotype. The study establishes the safety and efficacy of flavopiridol as consolidation therapy after chemoimmunotherapy for patients with CLL. Further evaluation is required in larger trials for the utility of CDK inhibitors as consolidation or maintenance strategies. Registration number at ClinicalTrials.gov: NCT00377104.

Original languageEnglish (US)
Pages (from-to)1137-1143
Number of pages7
JournalAnnals of Hematology
Volume95
Issue number7
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

alvocidib
Clinical Trials, Phase I
B-Cell Chronic Lymphocytic Leukemia
Cyclin-Dependent Kinases
Residual Neoplasm
Tumor Burden
Safety
Tumor Lysis Syndrome
Therapeutics

Keywords

  • Chronic lymphocytic leukemia
  • Flavopiridol

ASJC Scopus subject areas

  • Hematology

Cite this

A phase 1 clinical trial of flavopiridol consolidation in chronic lymphocytic leukemia patients following chemoimmunotherapy. / Awan, Farrukh T.; Jones, Jeffrey A.; Maddocks, Kami; Poi, Ming; Grever, Michael R.; Johnson, Amy; Byrd, John C.; Andritsos, Leslie A.

In: Annals of Hematology, Vol. 95, No. 7, 01.06.2016, p. 1137-1143.

Research output: Contribution to journalArticle

Awan, Farrukh T. ; Jones, Jeffrey A. ; Maddocks, Kami ; Poi, Ming ; Grever, Michael R. ; Johnson, Amy ; Byrd, John C. ; Andritsos, Leslie A. / A phase 1 clinical trial of flavopiridol consolidation in chronic lymphocytic leukemia patients following chemoimmunotherapy. In: Annals of Hematology. 2016 ; Vol. 95, No. 7. pp. 1137-1143.
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