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CompletedNCT00274989Updated May 23, 2019

Bendamustine and Rituximab in Treating Patients With Previously Untreated or Relapsed Chronic Lymphocytic Leukemia

A Phase 2 interventional study of Bendamustine and Rituximab in Chronic Lymphocytic Leukemia, sponsored by German CLL Study Group. Completed at 58 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-05-23.

Sponsored by German CLL Study Group · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
195
Allocation
Not applicable
Ages
18 Years and older
Sex
All
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Study summary

CLL2M is a phase 2, multicenter, open label study to investigate the possible therapeutic benefits of using bendamustine in combination with rituximab for the treatment of patients with previously untreated or relapsed CLL.

Read the detailed description

Conventional chemotherapy and also high dose chemotherapy with autologous stem cell transplantation are not curative treatment options in B-CLL; nearly all patients will eventually relapse. Also monoclonal antibodies are not curative for B-CLL patients in monotherapy, their impact on survival in combination with conventional chemotherapy is currently validated. In addition, there is no standard combination therapy for patients with relapsed CLL. Therefore there is an urgent medical need to identify new strategies.

The combination of rituximab (monoclonal antibody) and bendamustine (chemotherapy) has shown encouraging activity in patients with relapsed/refractory NHL or mantle cell lymphoma. In vitro studies have been used to investigate the effects of bendamustine and rituximab on programmed cell death (apoptosis) and have shown synergistic effects of both drugs. The mechanisms of action of these two active drugs may provide a treatment with good therapeutic potential in CLL. However, though bendamustine has been used for over 30 years there is still a need to define a standard regimen for the use of bendamustine in combination with monoclonal antibodies (mAb) especially in the treatment of CLL.

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Conditions studied

  • Chronic Lymphocytic Leukemia

Keywords

  • B-cell chronic lymphocytic leukemia
  • relapsed refractory chronic lymphocytic leukemia
  • previously untreated chronic lymphocytic leukemia
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In context

Leukemia

5,441 studies on the registry are indexed under Leukemia; 636 are open to participants now.

This study's enrollment of 195 is above the median of 38 across 4,247 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

German CLL Study Group is the lead sponsor of 36 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older
  • Diagnosis of B-CLL in need of treatment

    • Previously untreated Binet stage C or Binet B with need of treatment according to NCI-criteria
    • Relapsed or refractory disease after at least one but not more than 3 prior regimens. Patients who previously received bendamustine must have had at least a partial response with duration of response of at least six months.
  • World Health Organization performance status of 0-2
  • Life expectancy >12 weeks
  • Anti-cancer therapy, major surgery, or irradiation was completed >3 weeks before registration in this study. Patient must have recovered from the acute side effects incurred as a result of previous therapy.
  • Serum creatinine ≤1.5 the institutional upper limit of normal (ULN) or Creatinine clearance >30 ml/min/1.73 m²
  • Adequate liver function as indicated by a total bilirubin, AST, and ALT ≤2 the institutional ULN value, unless directly attributable to the patient's tumor.
  • Female patients with childbearing potential must have a negative serum pregnancy test within two weeks of first dose of study drug(s). Male and female patients must agree to use an effective contraceptive method while on study treatment and for a minimum of six months following study therapy.
  • Signed, written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Previously treated with >3 prior regimens for B-CLL.
  • Known central nervous system (CNS) involvement with B-CLL.
  • Patients who have progressed with more aggressive B-cell cancers such as Richter's syndrome.
  • History of anaphylaxis following exposure to monoclonal antibodies.
  • Known to be human immunodeficiency virus (HIV), hepatitis B, or C positive.
  • Active infection or history of severe infection (grade 4) within 3 months prior to study registration.
  • Medical condition requiring prolonged use of oral corticosteroids (> 1 month).
  • Use of investigational agents within 30 days prior to study randomization.
  • Active secondary malignancy.
  • ANC \<1.5x109/L or platelet count \<75x109/L, unless due to bone marrow involvement of CLL.
  • Other severe, concurrent diseases, including tuberculosis, mental disorders, serious cardiac functional capacity (Class III or IV as defined by the New York Heart Association Classification), severe diabetes, severe hypertension, pulmonary disease (chronic obstructive pulmonary disease [COPD] with hypoxemia), or major organ malfunction (liver, kidney) that could interfere with the patient's ability to participate in the study.
  • Pregnant or nursing women.
  • Any circumstance at the time of study entry that would preclude completion of the study or the required follow-up.
  • Participation in another clinical trial
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
195 participants (actual)

Study arms

  • Experimental
    Bendamustine plus Rituximab

    Drug: Bendamustine · Biological: Rituximab

Interventions

  • DrugBendamustine

    First-Line Therapy: Bendamustine i.v. 90 mg/m² day 1-2, q4wks, cycle 1 to 6 2nd to 4th -Line Therapy: Bendamustine i.v. 70 mg/m² day 1-2 q4wks, cycle 1 to 6

  • BiologicalRituximab

    First-Line Therapy: Rituximab i.v. 375 mg/m² day 0, q4wks, cycle 1; Rituximab i.v. 500 mg/m² day 1, q4wks, cycle 2-6 2nd to 4th -Line Therapy: Rituximab i.v. 375 mg/m² day 0, q4wks, cycle 1; Rituximab i.v. 500 mg/m² day 1, q4wks, cycle 2-6

    Also known as: MabThera, Rituxan

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What researchers measure

Primary outcomes

  1. Overall response rate

    Response will be assessed using clinical examination, hematology, bone marrow examination, plain radiograph of the chest (chest X-ray), ultrasound or CT of the abdomen, and MRD testing (for the molecular response rate only).

    Time frame: 56 days after the last of six cycles

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Study locations

58 sites
  • Internistische Praxis - Arnstadt
    Arnstadt, 99310, Germany
  • Klinikum Augsburg
    Augsburg, D-86156, Germany
  • HELIOS Klinikum Bad Saarow
    Bad Saarow, 15526, Germany
  • Internistische Gemeinschaftspraxis - Berlin
    Berlin, 13347, Germany
  • Charite - Campus Charite Mitte
    Berlin, D-10117, Germany
  • Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
    Berlin, D-12200, Germany
  • Charite University Hospital - Campus Virchow Klinikum
    Berlin, D-13353, Germany
  • Augusta-Kranken-Anstalt gGmbH
    Bochum, D-44791, Germany
  • Marienhospital Bottrop gGmbH
    Bottrop, D-46236, Germany
  • DIAKO Ev. Diakonie Krankenhaus gGmbH
    Bremen, D-28239, Germany
  • Medizinische Universitaetsklinik I at the University of Cologne
    Cologne, D-50924, Germany
  • Klinikum Darmstadt
    Darmstadt, D-64283, Germany
  • Krankenhaus Benrath
    Dusseldorf, 40593, Germany
  • Helios Klinikum Erfurt
    Erfurt, 99012, Germany
  • Universitaetsklinikum Essen
    Essen, D-45122, Germany
  • Staedtische Kliniken Esslingen
    Esslingen, D-73730, Germany
  • Klinikum Frankfurt (Oder) GmbH
    Frankfurt (Oder), D-15236, Germany
  • Klinikum Garmisch - Partenkirchen GmbH
    Garmisch-Partenkirchen, D-82467, Germany
  • Internistische Praxisgemeinschaft
    Germering, 82110, Germany
  • Universitaetsklinikum Goettingen
    Goettingen, D-37075, Germany
  • Klinik Fuer Innere Medizin, Hematology/Oncology, Ernst Moritz Armdt Universitaet
    Greifswald, D-17475, Germany
  • Allgemeines Krankenhaus Hagen
    Hagen, D-58095, Germany
  • Praxis fur Innere Medizin - Hamburg
    Hamburg, 22457, Germany
  • Hamatologische/Onkologische - Hamburg
    Hamburg, 22767, Germany
  • Asklepios Klinik St. Georg
    Hamburg, D-20099, Germany
  • Evangelische Krankenhaus Hamm
    Hamm, DOH-59063, Germany
  • Universitaetsklinikum des Saarlandes
    Homburg, D-66424, Germany
  • Westpfalz-Klinikum GmbH
    Kaiserslautern, D-67653, Germany
  • Staedtisches Klinikum Karlsruhe gGmbH
    Karlsruhe, 76133, Germany
  • University Hospital Schleswig-Holstein - Kiel Campus
    Kiel, D-24116, Germany
  • Onkologische Schwerpunktpraxis - Leer
    Leer, D-26789, Germany
  • Klinikum Lippe - Lemgo
    Lemgo, D-32657, Germany
  • Gemeinschaftspraxis - Ludwigshafen
    Ludwigshafen, 67061, Germany
  • Kreiskrankenhaus Luedenscheid
    Luedenscheid, 58515, Germany
  • Staedtisches Klinikum Magdeburg
    Magdeburg, D-39130, Germany
  • Krankenhaus Maria Hilf GmbH
    Moenchengladbach, D-41063, Germany
  • Haematologisch - Onkologische Gemeinschaftspraxis - Muenster
    Muenster, D-48149, Germany
  • Klinikum der Universitaet Muenchen - Grosshadern Campus
    Munich, D-81377, Germany
  • Onkologische Schwerpunktpraxis Dr. Schmidt
    Neunkirchen, D-66538, Germany
  • Klinikum Oldenburg
    Oldenburg, D-26133, Germany
  • Paracelsus Karankenhaus Ruit
    Ostfildern, 73760, Germany
  • Gemeinschaftspraxis - Pinneberg
    Pinnebeg, 25421, Germany
  • Klinikum Ernst Von Bergmann
    Potsdam, D-14467, Germany
  • Scherpunktpraxis fur Hematologie und Onkologie
    Regensburg, 93053, Germany
  • Klinikum der Universitaet Regensburg
    Regensburg, D-93042, Germany
  • Krankenhaus Barmherzige Brueder Regensburg
    Regensburg, D-93049, Germany
  • Internistische Praxis Dres. Hempel und Hochdorfer
    Rehling, 86508, Germany
  • Klinik und Poliklinik fuer Innere Medizin - Universitaet Rostock
    Rostock, D-18057, Germany
  • Caritasklinik St. Theresia
    Saarbrucken, D-66113, Germany
  • Schwerpunktpraxis fur Hamatologie und Onkologie
    Siegburg, 53721, Germany
  • St. Marien - Krankenhaus Siegen GMBH
    Siegen, D-57072, Germany
  • Hanse-Klinikum Stralsund - Krankenhaus West
    Stralsund, D-18437, Germany
  • Haematologische Praxis
    Stuttgart, D-70173, Germany
  • Krankenanstalt Mutterhaus der Borromaerinnen
    Trier, D-54290, Germany
  • Universitaetsklinikum Tuebingen
    Tuebingen, D-72076, Germany
  • Comprehensive Cancer Center Ulm at Universitaetsklinikum Ulm
    Ulm, D-89081, Germany
  • St. Marienhospital - Vechta
    Vechta, D-49377, Germany
  • Heinrich-Braun-Krankenhaus Zwickau
    Zwickau, 08060, Germany
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References and documents

Publications

  • Al-Sawaf O, Robrecht S, Bahlo J, Fink AM, Cramer P, von Tresckow J, Maurer C, Bergmann M, Seiler T, Lange E, Kneba M, Stilgenbauer S, Dohner H, Kiehl MG, Jager U, Wendtner CM, Fischer K, Goede V, Hallek M, Eichhorst B, Hopfinger G. Impact of gender on outcome after chemoimmunotherapy in patients with chronic lymphocytic leukemia: a meta-analysis by the German CLL study group. Leukemia. 2017 Oct;31(10):2251-2253. doi: 10.1038/leu.2017.221. Epub 2017 Jul 12. No abstract available. PubMed 28745332 ↗
  • Sachanas S, Pangalis GA, Fink AM, Bahlo J, Fischer K, Levidou G, Kyrtsonis MC, Bartzi V, Vassilakopoulos TP, Kalpadakis C, Koulieris E, Moschogiannis M, Yiakoumis X, Tsirkinidis P, Angelopoulou MK, Eichhorst B, Hallek M. Small Lymphocytic Lymphoma: Analysis of Two Cohorts Including Patients in Clinical Trials of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG) or in "Real-Life" Outside of Clinical Trials. Anticancer Res. 2019 May;39(5):2591-2598. doi: 10.21873/anticanres.13382. PubMed 31092457 ↗
  • Fischer K, Cramer P, Busch R, Stilgenbauer S, Bahlo J, Schweighofer CD, Bottcher S, Staib P, Kiehl M, Eckart MJ, Kranz G, Goede V, Elter T, Buhler A, Winkler D, Kneba M, Dohner H, Eichhorst BF, Hallek M, Wendtner CM. Bendamustine combined with rituximab in patients with relapsed and/or refractory chronic lymphocytic leukemia: a multicenter phase II trial of the German Chronic Lymphocytic Leukemia Study Group. J Clin Oncol. 2011 Sep 10;29(26):3559-66. doi: 10.1200/JCO.2010.33.8061. Epub 2011 Aug 15. PubMed 21844497 ↗
  • Fischer K, Cramer P, Busch R, Bottcher S, Bahlo J, Schubert J, Pfluger KH, Schott S, Goede V, Isfort S, von Tresckow J, Fink AM, Buhler A, Winkler D, Kreuzer KA, Staib P, Ritgen M, Kneba M, Dohner H, Eichhorst BF, Hallek M, Stilgenbauer S, Wendtner CM. Bendamustine in combination with rituximab for previously untreated patients with chronic lymphocytic leukemia: a multicenter phase II trial of the German Chronic Lymphocytic Leukemia Study Group. J Clin Oncol. 2012 Sep 10;30(26):3209-16. doi: 10.1200/JCO.2011.39.2688. Epub 2012 Aug 6. PubMed 22869884 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 23, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00274989
Lead sponsor
German CLL Study Group
Collaborators
University of Cologne
Responsible party
Sponsor
First posted
Jan 11, 2006
Start date
Nov 2005
Primary completion
Mar 2008
Completion
Mar 2011
Last update
May 23, 2019

Study contacts

Clemens M. Wendtner
study chair · Medizinische Universitaetsklinik I at the University of Cologne

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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