| ID | Type | Description | Link |
|---|---|---|---|
| P30CA015083 | U.S. NIH Grant/Contract | View source | |
| 1155-05 | Other Identifier | Mayo Clinic IRB | |
| NCI-2009-01227 | Registry Identifier | NCI-CTRP | |
| MC0419 | Other Identifier | Mayo Clinic Cancer Center |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Green tea extract contains ingredients that may slow the growth of certain cancers.
PURPOSE: This phase I/II trial is studying the side effects and best dose of green tea extract and to see how well it works in treating patients with stage 0, stage I, or stage II chronic lymphocytic leukemia (CLL).
OBJECTIVES:
Phase I
Phase II
OUTLINE: This is a phase I, dose-escalation study of green tea extract (Polyphenon E) followed by a phase II study.
Cohorts of 3-6 patients receive escalating doses of green tea extract (Polyphenon E) until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.
After completion of study treatment, patients are followed periodically for up to 5 years.
PROJECTED ACCRUAL: A total of 73 patients will be accrued for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| polyphenon E | Experimental | Designed to assess toxicity, treatment response, and pertinent laboratory measurements in patients with previously untreated, asymptomatic, Rai Stage 0-II CLL. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Polyphenon E | Biological | Phase I Dose Escalation:. 400 mg orally twice a day to 2000 mg orally twice a day Phase II: 2000 mg orally twice a day |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With a Confirmed Response [Complete Response (CR) and Partial Response (PR)] on 2 Consecutive Evaluations at Least 4 Weeks Apart | National Cancer Institute working group criteria (NCIWG) was used to assess response.
| 6 months |
| Number of Participants With Biological Response (Bio-R) on 2 Consecutive Evaluations at Least 4 Weeks Apart | Bio-R: A reduction in the absolute lymphocyte count (ALC) of more than 20% from the pretreatment level for at least 2 months or a >= 30% reduction in all palpable lymphadenopathy without meeting the NCIWG criteria for PR was required | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With a Confirmed Complete Response (CR) | A confirmed complete response is a CR which is reported on 2 consecutive cycles at least 4 weeks apart. CR is defined in Primary Outcome Measure #1. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| 24 Month Treatment Free Survival Rate | Percentage of participants who were alive and treatment (for progressive CLL) free at 24 months. The 24 month treatment free survival, with 95% CI, was estimated using the Kaplan-Meier method. | 24 months (from registration) |
DISEASE CHARACTERISTICS:
Confirmed diagnosis of chronic lymphocytic leukemia (CLL)
Stage 0, I, or II disease
Previously untreated disease
Splenomegaly, hepatomegaly, or lymphadenopathy are not required for the diagnosis of CLL
Absolute lymphocyte count > 10,000/mm^3
Lymphocytosis must consist of small to moderate size lymphocytes, with ≤ 55% prolymphocytes, atypical lymphocytes, or lymphoblasts morphologically
Phenotypically characterized B-CLL defined by all of the following criteria:
Mantle cell lymphoma must be excluded by demonstrating the absence of the t(11:14) by FISH testing
Patients who require chemotherapy for treatment of CLL, based on any of the following criteria, are excluded:
CLL-related symptoms requiring treatment, including any of the following:
Evidence of progressive marrow failure due to CLL involvement of bone marrow as manifested by the development of worsening anemia (hemoglobin < 11 g/dl) and/or thrombocytopenia (platelet count < 100,000/mm^3)
Massive (i.e. > 6 cm below left costal margin) or progressive splenomegaly
Massive nodes or clusters (i.e., > 10 cm in longest diameter) or progressive adenopathy
Progressive lymphocytosis with an increase of > 50% over 2 month period, or an anticipated lymphocyte doubling time of < 6 months
PATIENT CHARACTERISTICS:
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Tait D. Shanafelt, MD | Mayo Clinic | Study Chair |
| Jose F Leis, MD | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic in Arizona | Scottsdale | Arizona | United States | |||
| Mayo Clinic |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19470922 | Result | Shanafelt TD, Call TG, Zent CS, LaPlant B, Bowen DA, Roos M, Secreto CR, Ghosh AK, Kabat BF, Lee MJ, Yang CS, Jelinek DF, Erlichman C, Kay NE. Phase I trial of daily oral Polyphenon E in patients with asymptomatic Rai stage 0 to II chronic lymphocytic leukemia. J Clin Oncol. 2009 Aug 10;27(23):3808-14. doi: 10.1200/JCO.2008.21.1284. Epub 2009 May 26. | |
| 22760587 | Result | Shanafelt TD, Call TG, Zent CS, Leis JF, LaPlant B, Bowen DA, Roos M, Laumann K, Ghosh AK, Lesnick C, Lee MJ, Yang CS, Jelinek DF, Erlichman C, Kay NE. Phase 2 trial of daily, oral Polyphenon E in patients with asymptomatic, Rai stage 0 to II chronic lymphocytic leukemia. Cancer. 2013 Jan 15;119(2):363-70. doi: 10.1002/cncr.27719. Epub 2012 Jul 3. |
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Thirty-six (36) and 37 patients recruited to the phase I and phase II portions, respectively. Three phase I patients were replaced and one patient was ineligible for evaluation. Per study design, the 36 eligible phase II participants along with the 6 phase I participants treated at the phase II dose level were evaluated (n=42).
A total of 73 participants were enrolled at the Mayo Clinic from August 2005 - October 2009.
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| ID | Title | Description |
|---|---|---|
| FG000 | Phase I Polyphenon E | Dose ranging from 400 to 1,800 mg orally twice a day for 6 months |
| FG001 | Phase II Polyphenon E | 2000mg orally twice daily for 6 months |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Phase I Polyphenon E | Dose ranging from 400 to 1,800 mg orally twice daily for 6 months |
| BG001 | Phase II Polyphenon E | 2000mg twice daily for 6 months |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With a Confirmed Response [Complete Response (CR) and Partial Response (PR)] on 2 Consecutive Evaluations at Least 4 Weeks Apart | National Cancer Institute working group criteria (NCIWG) was used to assess response.
| Phase II participants who satisfied all eligibility criteria, signed the consent form and started therapy were evaluated for this endpoint. | Posted | Number | participants | 6 months |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Phase II Polyphenon E | 2000mg orally twice daily for 6 months |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hemoglobin decreased | Blood and lymphatic system disorders | MedDRA 6 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Tait Shanafelt | Mayo Clinic | shanafelt.tait@mayo.edu |
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| ID | Term |
|---|---|
| D007938 | Leukemia |
| D015451 | Leukemia, Lymphocytic, Chronic, B-Cell |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| C472086 | polyphenon E |
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| Rochester |
| Minnesota |
| 55905 |
| United States |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Dose Level of Polyphenon E | Number | participants |
|
| Fluorescence In Situ Hybridization (FISH) Abnormalities | This test determines the presence of abnormalities in specific chromosomes of CLL cells, which are associated with more or less aggressive forms of cancer. Patients with abnormalities of chromosome 11 (deletion 11q23) and 17 (deletion 17p13) experience rapid progression of their CLL. | Number | participants |
|
| Rai Stage | Rai staging is a way to categorize the disease progression of chronic lymphocytic leukemia (CLL); higher stages reflect increasing severity. Rai Stage 0: Lymphocytosis only, Rai Stage I: Lymphocytosis and lymphadenopathy, Rai Stage II: Lymphocytosis and hepatomegaly +/- splenomegaly | Number | participants |
|
| ZAP-70 Status | This test is used to predict the rate of progression from diagnosis to need for treatment in CLL. Participants with positive ZAP-70 (>=20%) tend to experience a more aggressive course of CLL. | Number | participants |
|
| CD38 Status | This test is used to predict the rate of progression from diagnosis to need for treatment in CLL. Participants with positive CD38 (>=30%) tend to experience a more aggressive course of CLL. | Number | participants |
|
| Immunoglobulin Variable Heavy Chain (IGVH) Mutation Status | IGVH testing helps predict which patients will experience a more aggressive (if the gene is unmutated, <=2%) or less aggressive (if the gene is mutated, >2%) course of CLL. This technically complex test is only available at select medical institutions. | Number | participants |
|
2000mg twice daily for 6 months
|
|
| Primary | Number of Participants With Biological Response (Bio-R) on 2 Consecutive Evaluations at Least 4 Weeks Apart | Bio-R: A reduction in the absolute lymphocyte count (ALC) of more than 20% from the pretreatment level for at least 2 months or a >= 30% reduction in all palpable lymphadenopathy without meeting the NCIWG criteria for PR was required | Phase II participants who satisfied all eligibility criteria, signed the consent form and started therapy were evaluated for this endpoint. | Posted | Number | participants | 6 months |
|
|
|
| Secondary | Number of Participants With a Confirmed Complete Response (CR) | A confirmed complete response is a CR which is reported on 2 consecutive cycles at least 4 weeks apart. CR is defined in Primary Outcome Measure #1. | Phase II participants who satisfied all eligibility criteria, signed the consent form and started therapy were evaluated for this endpoint. | Posted | Number | participants | 6 months |
|
|
|
| Other Pre-specified | 24 Month Treatment Free Survival Rate | Percentage of participants who were alive and treatment (for progressive CLL) free at 24 months. The 24 month treatment free survival, with 95% CI, was estimated using the Kaplan-Meier method. | Phase II participants who satisfied all eligibility criteria, signed the consent form and started therapy were evaluated for this endpoint. | Posted | Number | 95% Confidence Interval | percentage of participants | 24 months (from registration) |
|
|
|
| 0 |
| 42 |
| 40 |
| 42 |
| Vision blurred | Eye disorders | MedDRA 6 | Systematic Assessment |
|
| Abdominal distension | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Esophageal ulcer | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Flatulence | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Mucositis oral | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
|
| Edema limbs | General disorders | MedDRA 6 | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA 6 | Systematic Assessment |
|
| Fever | General disorders | MedDRA 6 | Systematic Assessment |
|
| Flu-like symptoms | General disorders | MedDRA 6 | Systematic Assessment |
|
| Hypersensitivity | Immune system disorders | MedDRA 6 | Systematic Assessment |
|
| Infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
|
| Skin infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
|
| Upper respiratory infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
|
| Urinary tract infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Alkaline phosphatase increased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Aspartate aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Blood bilirubin increased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Creatinine increased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Neutrophil count decreased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Platelet count decreased | Investigations | MedDRA 6 | Systematic Assessment |
|
| Anorexia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Blood glucose increased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Dehydration | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Glucose intolerance | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Serum calcium decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Serum calcium increased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Serum potassium increased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Serum sodium decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Buttock pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA 6 | Systematic Assessment |
|
| Extrapyramidal disorder | Nervous system disorders | MedDRA 6 | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA 6 | Systematic Assessment |
|
| Peripheral sensory neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA 6 | Systematic Assessment |
|
| Alopecia | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Rash desquamating | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
|
| Sweating | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
|
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| D015448 | Leukemia, B-Cell |
| D007945 | Leukemia, Lymphoid |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |