Sequential Regimen of Bendamustin-Debulking Followed by Ofatumumab and Ibrutinib in CLL Patients (CLL2-BIO)

German CLL Study Group (Other)
Overall Status
Completed ID
Gilead Sciences (Industry), Novartis Pharmaceuticals (Industry)

Study Details

Study Description

Brief Summary

A prospective, open-label, multicentre phase-II trial to evaluate the efficacy and safety of a sequential regimen of bendamustine followed by ofatumumab and ibrutinib followed by ibrutinib and ofatumumab maintenance in CLL patients.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

In the CLL2-BIO trial an allcomer CLL population with indication for treatment will be included.

Patient will receive 2 cycles of debulking treatment with bendamustin unless contraindications are existing or debulking is not indicated. Afterwards 6 cycles of induction therapy with ofatumumab and ibrutinib will be applied, each with a duration of 28 days. Primary endpoint overall Response rate will be assessed at final restaging.

Patients benefitting from BIO treatment will enter the maintenance phase of the trial. Maintenance treatment will be continued if no unacceptable toxicity occurs until three months after negativity of minimal residual disease (MRD) is achieved in peripheral blood in patients with (clinical) complete response (CR) or (clinical) incomplete complete response (CRi) confirmed by 2 consecutive testings of MRD within 3 months, progression of CLL, start of a subsequent therapy or up to 8 cycles of maintenance (each cycle with a duration of 84 calendar days = 3 months), whichever occurs first.

Study Design

Study Type:
Actual Enrollment :
66 participants
Intervention Model:
Single Group Assignment
None (Open Label)
Primary Purpose:
Official Title:
Prospective, Open-label, Multicentre Phase-II Trial to Evaluate Efficacy and Safety of a Sequential Regimen of Bendamustine Followed by Ofatumumab and Ibrutinib Followed by Ibrutinib and Ofatumumab Maintenance in CLL Patients
Actual Study Start Date :
Feb 4, 2016
Actual Primary Completion Date :
Jul 13, 2017
Actual Study Completion Date :
Feb 6, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Bendamustine + Ofatumumab + Ibrutinib

Bendamustine: 70mg/m² i.v. Ofatumumab: 1000 mg i.v. Ibrutinib: 420 mg po

Drug: Bendamustine
Debulking: Cycles 1 - 2, d1 & 2: 70 mg/m2 i.v.

Drug: Ofatumumab
Induction: Cycle 1: Day 1 300 mg i.v.; Day 8 1000 mg i.v.; Day 15 1000 mg i.v. Cycle 2-6: Day 1 1000 mg i.v. Maintenance: After the induction ofatumumab iv 1000 mg every three months will be continued. Cycle 1-8: Day 1 1000 mg i.v.

Drug: Ibrutinib
Induction: Cycle 2-6: d1-28: 420 mg p.o. Maintenance: After the induction ibrutinib p.o. 420 mg daily will be continued. Cycle 1-8: d1-84: 420 mg p.o.

Outcome Measures

Primary Outcome Measures

  1. Overall response rate (ORR) [84 days after first dose of last induction cycle]

    Proportion of patients responding according to international working Group on chronic lymphocytic leukemia criteria

Secondary Outcome Measures

  1. Safety: Adverse events (AEs) and adverse events of special interest (AESI) [up to 48 months after first dose of study drug]

    Type, frequency, and severity of adverse events (AEs) and adverse events of special interest (AESI) and their relationship to study treatment.

  2. minimal residual disease (MRD) [up to 48 months after first dose of study drug]

    Rate of MRD responses in peripheral blood measured by immunophenotyping

Eligibility Criteria


Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Inclusion Criteria:
  1. Documented CLL requiring treatment (irrespective if first- or relapse treatment) according to International Working Group on CLL (iwCLL) criteria

In case of previously treated patients, these must have recovered from acute toxicities and treatment regimen must be stopped within the following time periods before start of the study treatment in the CLL2-BIO trial:

  • chemotherapy within ≥ 28 days

  • antibody treatment within ≥ 14 days

  • kinase inhibitors, Bcl-2-antagonists or immunomodulatory agents within ≥ 3 days

  • corticosteroids may be applied until the start of the BIO-regimen, these have to be reduced to an equivalent of ≤ 20 mg prednisolone during treatment

  1. Adequate hematologic function as indicated by a platelet count ≥ 25 x 109/L, a neutrophil count ≥ 1,0 x 109/L and a hemoglobin value ≥ 8.0 g/dL, unless directly attributable to the patient´s CLL (e.g. bone marrow infiltration)

  2. Adequate renal function as indicated by a creatinine clearance ≥ 30ml/min calculated according to the modified formula of Cockcroft and Gault or directly measured with 24 hrs urine collection

  3. Adequate liver function as indicated by a total bilirubin ≤ 2x, aspartate aminotransferase (AST)/ alanin aminotransferase (ALT) ≤ 2.5x the institutional upper limit of normal (ULN) value, unless directly attributable to the patient's CLL or to Gilbert's Syndrome

  4. Negative serological testing for hepatitis B, negative testing for hepatitis-C RNA and negative HIV antibody test within 6 weeks prior to registration

  5. Age ≥ 18 years

  6. Eastern Cooperative Oncology Group (ECOG) Performance Status 0 to 2, ECOG 3 is only permitted if related to CLL (e.g. due to anemia or severe constitutional symptoms)

  7. Life expectancy ≥ 6 months

  8. Ability and willingness to provide written informed consent and to adhere to the study visit schedule and other protocol requirements

Exclusion Criteria:
  1. Transformation of CLL (i.e. Richter's transformation, pro-lymphocytic leukemia)

  2. Known central nervous system (CNS) involvement

  3. Patients with confirmed progressive multifocal leukoencephalopathy (PML)

  4. Malignancies other than CLL currently requiring systemic therapy

  5. Uncontrolled infection requiring systemic treatment

  6. Any comorbidity or organ system impairment rated with a cumulative illness rating scale (CIRS) score of 4, excluding the eyes/ears/nose/throat/larynx organ system or any other life- threatening illness, medical condition or organ system dysfunction that - in the investigator´s opinion - could compromise the patients safety or interfere with the absorption or metabolism of the study drugs (e.g, inability to swallow tablets or impaired resorption in the gastrointestinal tract)

  7. Use of investigational agents which might interfere with the study drug within 3 days prior to Registration

  8. Known hypersensitivity to ofatumumab, ibrutinib or any of the excipients Please note: Patients with a known hypersensitivity to bendamustine are allowed to participate but will not receive a debulking with bendamustine

  9. Requirement of treatment with strong CYP3A4-inhibitors/-inducers or anticoagulant with phenprocoumon (marcumar), warfarin, or other vitamin k antagonists

  10. History of stroke or intracranial hemorrhage within 6 months prior to registration

  11. Pregnant women and nursing mothers (a negative pregnancy test is required for all women of childbearing potential within 7 days before start of treatment and monthly during debulking, induction and maintenance therapy)

  12. Fertile men or women of childbearing potential unless:

  • surgically sterile or ≥ 2 years after the onset of menopause, or

  • willing to use two methods of reliable contraception including one highly effective (Pearl Index < 1) and one additional effective (barrier) method during study treatment and for 12 months after end of study treatment.

  1. Vaccination with a live vaccine ≤ 28 days prior to registration

  2. Legal incapacity

  3. Prisoners or subjects who are institutionalized by regulatory or court order

  4. Persons who are in dependence to the sponsor or an investigator

Contacts and Locations


Site City State Country Postal Code
1 German CLL Study Group Cologne Germany 50935

Sponsors and Collaborators

  • German CLL Study Group
  • Gilead Sciences
  • Novartis Pharmaceuticals


  • Principal Investigator: Paula Cramer,, German CLL Study Group

Study Documents (Full-Text)

None provided.

More Information

Additional Information:


None provided.
Responsible Party:
German CLL Study Group Identifier:
Other Study ID Numbers:
  • CLL2-BIO
  • 2014-000590-39
First Posted:
Feb 23, 2016
Last Update Posted:
Jun 11, 2020
Last Verified:
Jun 1, 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:
Keywords provided by German CLL Study Group
Additional relevant MeSH terms:

Study Results

No Results Posted as of Jun 11, 2020