search
Back to results

Ofatumumab In Older Patients With Untreated Low Or Intermediate Risk Indolent B-Cell Lymphomas

Primary Purpose

Lymphoma, Non-Hodgkin, Lymphoma, Follicular, Lymphoma, B-Cell, Marginal Zone

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Ofatumumab
Sponsored by
UNC Lineberger Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma, Non-Hodgkin focused on measuring Follicular Lymphoma, Marginal Zone Lymphoma, Non-Hodgkins Lymphoma, Elderly, Newly Diagnosed, Lineberger Comprehensive Cancer Center, University of North Carolina, Ofatumumab, Arzerra, Phase 2, Geriatric, Lymphoma

Eligibility Criteria

70 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Stage II, III, or IV follicular or marginal zone B-cell CD20+ lymphomas not previously treated with systemic therapy
  • Low/intermediate risk grade 1 or 2 follicular NHL or marginal zone lymphoma defined by 2004 Follicular Lymphoma International Prognostic Index (FLIPI) scores
  • Measurable disease as assessed by 2 dimensional measurement by CT and/or by bone marrow histopathology.
  • Age ≥ 70 years at time of informed consent
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
  • Life expectancy of at least 3 months
  • Documented negative serologic testing for human immunodeficiency virus (HIV)
  • Documented negative serologic testing for Hepatitis B (HB); this is defined as negative for HBsAg;
  • If negative for HBsAg but HBcAb positive (regardless of HBsAb status), an hepatitis B virus (HBV) DNA test will be performed and must be negative for eligibility. Those with negative HBV DNA may be included but must undergo HBV DNA PCR testing every 2 months (see Time and Events table). Prophylactic antiviral therapy may be initiated at the discretion of the investigator in these patients.
  • Adequate bone marrow function (without transfusion support within four weeks of screening) as demonstrated by:

    • Hemoglobin ≥ 8 g/dL
    • Absolute neutrophil count (ANC) ≥ 1,000 cells/mm3
    • Platelet count ≥ 50,000/mm3
  • Adequate hepatic and renal function as demonstrated by:

    • Aspartate aminotransferase (AST/ALT) ≤ 2.5 × upper limit of normal (ULN)
    • Total serum bilirubin ≤ 1.5 × ULN
    • Alkaline phosphatase ≤ 2.5 × ULN
    • Serum creatinine ≤ 1.5 × ULN
  • If sexually active male with female partner of reproductive capability, has agreed to use a medically accepted form of contraception from time of enrollment to completion of initial follow-up study visit. Adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method, or total abstinence.
  • Signed an institutional review board (IRB)-approved informed consent document for this protocol

Exclusion Criteria:

  • Prior therapies for lymphoma except involved field radiation therapy
  • Prior anti-CD20 monoclonal antibody or alemtuzumab within 3 months prior to first infusion of ofatumumab for any reason
  • Evidence of transformation to aggressive lymphoma
  • More than 10 x 109/L circulating CD20+ lymphoma cells
  • History of previous allergic reactions to compounds of similar biological or chemical composition as ofatumumab
  • Medical or other condition that would represent an inappropriate risk to the patient or would likely compromise achievement of the primary study objective
  • Other past or current malignancies with the exception of:

    • Patients who have been free of malignancy for at least 5 years
    • Completely resected, non-melanoma skin cancer
    • Successfully treated in situ carcinoma
  • Patients who have current active hepatic or biliary disease (with exception Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment)
  • Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to first infusion of ofatumumab, whichever is longer, or currently participating in any other interventional clinical study
  • Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C.
  • History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae
  • Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to first infusion of ofatumumab, congestive heart failure (NYHA III-IV), and arrhythmia (unless controlled by therapy), with the exception of extra systoles or minor conduction abnormalities.
  • Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease which in the opinion of the investigator may represent a risk for the patient.
  • Positive serology for Hepatitis B (HB) defined as a positive test for HBsAg. In addition, if negative for HBsAg but HBcAb positive (regardless of HBsAb status), a HBV DNA test will be performed and if positive the patient will be excluded.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Ofatumumab

    Arm Description

    Outcomes

    Primary Outcome Measures

    To determine overall response rates (ORR) following ofatumumab treatment in older (≥ 70 years old) patients with previously untreated low or intermediate risk indolent NHL
    The ORR will be evaluated as the rate of complete responses (CR) + partial responses (PR) as defined by the Revised Response Criteria for Malignant Lymphoma (RRCML)

    Secondary Outcome Measures

    To determine the complete response rate (CR) following ofatumumab treatment in older patients without prior systemic therapy for low or intermediate risk indolent NHL
    To evaluate the toxicity and tolerability of ofatumumab treatment in the study population
    Estimate progression free survival (PFS) at 2 years after ofatumumab treatment
    PFS is defined as the time from study entry until lymphoma progression or death as a result of any cause.
    Evaluate molecular response to ofatumumab therapy by performing PCR analysis for BCL2/IgH from the peripheral blood at baseline and 3 months from initiation of treatment
    Molecular response is defined as the percentage of patients with detectable BCL2 PCR at baseline who convert from BCL2 PCR-detectable to undetectable disease status in the peripheral blood.

    Full Information

    First Posted
    December 16, 2010
    Last Updated
    October 8, 2015
    Sponsor
    UNC Lineberger Comprehensive Cancer Center
    Collaborators
    GlaxoSmithKline
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT01263418
    Brief Title
    Ofatumumab In Older Patients With Untreated Low Or Intermediate Risk Indolent B-Cell Lymphomas
    Official Title
    A Phase II Trial Of Ofatumumab In Older (≥70 Years) Patients With Previously Untreated Low Or Intermediate Risk Indolent B-Cell Lymphomas
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2015
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    No patients enrolled and funding has been withdrawn.
    Study Start Date
    June 2011 (undefined)
    Primary Completion Date
    January 2016 (Anticipated)
    Study Completion Date
    January 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    UNC Lineberger Comprehensive Cancer Center
    Collaborators
    GlaxoSmithKline

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This research study will only include two types of non-Hodgkin Lymphoma (NHL), follicular lymphoma or marginal zone lymphoma and participants will be age 70 or older. The purpose of this research study is to learn about the safety of the treatment with the drug ofatumumab to find out what effects, both good and bad this treatment has on lymphoma. Ofatumumab is a monoclonal antibody. Monoclonal antibodies are being used to treat some types of cancer. Monoclonal antibodies are a type of protein made in a laboratory that can bind substances in the body including cancer cells. Ofatumumab binds to the protein called CD20, which is found on B-cells and lymphoma cells. The study drug, Ofatumumab, is approved by the United States Food and Drug Administration (FDA) for treatment of other types of blood cancer and is not approved for use in patients with non-Hodgkin Lymphoma. The use of ofatumumab in this study is considered investigational. In addition to learning about ofatumumab, the researchers are interested in learning about how this cancer treatment affects daily activities. Participants will be asked to complete a Geriatric Assessment (GA). GAs are designed to gather information on memory, nutritional status, mental health, and level of social support. This assessment will help the health care team understand a participant's "functional age" as compared to a participant's actual age. The researchers also want to collect blood samples to study molecules in follicular lymphoma cells called 'biomarkers' to learn about how the lymphoma responds to therapy. A biomarker is a molecule (for example, DNA or protein) found in the blood or tissues that is a marker for disease. In this study, the investigators will measure the changes of the biomarker called bcl-2. This biomarker research will only be in subjects with follicular lymphoma.
    Detailed Description
    This multicenter Phase II clinical study will investigate the overall response rate (ORR) after 2 months of therapy with weekly ofatumumab in older (≥70 years of age) patients with previously untreated low or intermediate risk indolent NHL (n=37). Secondary objectives include progression free survival (PFS) at 2 years, and an evaluation of the toxicity and tolerability of ofatumumab in this population. We will also evaluate molecular response to ofatumumab by performing PCR analysis for BCL2/IgH from the peripheral blood. We will conduct an exploratory analysis of the minimum observed serum concentration (Cmin) of ofatumumab prior to the last dose and correlate this level with ORR. This trial includes administration of a Geriatric Assessment (GA) tool which patients will be asked to complete serially during the trial.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Lymphoma, Non-Hodgkin, Lymphoma, Follicular, Lymphoma, B-Cell, Marginal Zone, Lymphoma, Low-Grade, Lymphoma, Intermediate-Grade
    Keywords
    Follicular Lymphoma, Marginal Zone Lymphoma, Non-Hodgkins Lymphoma, Elderly, Newly Diagnosed, Lineberger Comprehensive Cancer Center, University of North Carolina, Ofatumumab, Arzerra, Phase 2, Geriatric, Lymphoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Ofatumumab
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Ofatumumab
    Other Intervention Name(s)
    ARZERRA, (BLA) 125326
    Intervention Description
    Intravenous; Dosage: 1000mg; Frequency: one time per week; Duration: 8 weeks
    Primary Outcome Measure Information:
    Title
    To determine overall response rates (ORR) following ofatumumab treatment in older (≥ 70 years old) patients with previously untreated low or intermediate risk indolent NHL
    Description
    The ORR will be evaluated as the rate of complete responses (CR) + partial responses (PR) as defined by the Revised Response Criteria for Malignant Lymphoma (RRCML)
    Time Frame
    2 years
    Secondary Outcome Measure Information:
    Title
    To determine the complete response rate (CR) following ofatumumab treatment in older patients without prior systemic therapy for low or intermediate risk indolent NHL
    Time Frame
    2 years
    Title
    To evaluate the toxicity and tolerability of ofatumumab treatment in the study population
    Time Frame
    2 years
    Title
    Estimate progression free survival (PFS) at 2 years after ofatumumab treatment
    Description
    PFS is defined as the time from study entry until lymphoma progression or death as a result of any cause.
    Time Frame
    4 years
    Title
    Evaluate molecular response to ofatumumab therapy by performing PCR analysis for BCL2/IgH from the peripheral blood at baseline and 3 months from initiation of treatment
    Description
    Molecular response is defined as the percentage of patients with detectable BCL2 PCR at baseline who convert from BCL2 PCR-detectable to undetectable disease status in the peripheral blood.
    Time Frame
    3 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Stage II, III, or IV follicular or marginal zone B-cell CD20+ lymphomas not previously treated with systemic therapy Low/intermediate risk grade 1 or 2 follicular NHL or marginal zone lymphoma defined by 2004 Follicular Lymphoma International Prognostic Index (FLIPI) scores Measurable disease as assessed by 2 dimensional measurement by CT and/or by bone marrow histopathology. Age ≥ 70 years at time of informed consent Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 Life expectancy of at least 3 months Documented negative serologic testing for human immunodeficiency virus (HIV) Documented negative serologic testing for Hepatitis B (HB); this is defined as negative for HBsAg; If negative for HBsAg but HBcAb positive (regardless of HBsAb status), an hepatitis B virus (HBV) DNA test will be performed and must be negative for eligibility. Those with negative HBV DNA may be included but must undergo HBV DNA PCR testing every 2 months (see Time and Events table). Prophylactic antiviral therapy may be initiated at the discretion of the investigator in these patients. Adequate bone marrow function (without transfusion support within four weeks of screening) as demonstrated by: Hemoglobin ≥ 8 g/dL Absolute neutrophil count (ANC) ≥ 1,000 cells/mm3 Platelet count ≥ 50,000/mm3 Adequate hepatic and renal function as demonstrated by: Aspartate aminotransferase (AST/ALT) ≤ 2.5 × upper limit of normal (ULN) Total serum bilirubin ≤ 1.5 × ULN Alkaline phosphatase ≤ 2.5 × ULN Serum creatinine ≤ 1.5 × ULN If sexually active male with female partner of reproductive capability, has agreed to use a medically accepted form of contraception from time of enrollment to completion of initial follow-up study visit. Adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method, or total abstinence. Signed an institutional review board (IRB)-approved informed consent document for this protocol Exclusion Criteria: Prior therapies for lymphoma except involved field radiation therapy Prior anti-CD20 monoclonal antibody or alemtuzumab within 3 months prior to first infusion of ofatumumab for any reason Evidence of transformation to aggressive lymphoma More than 10 x 109/L circulating CD20+ lymphoma cells History of previous allergic reactions to compounds of similar biological or chemical composition as ofatumumab Medical or other condition that would represent an inappropriate risk to the patient or would likely compromise achievement of the primary study objective Other past or current malignancies with the exception of: Patients who have been free of malignancy for at least 5 years Completely resected, non-melanoma skin cancer Successfully treated in situ carcinoma Patients who have current active hepatic or biliary disease (with exception Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment) Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to first infusion of ofatumumab, whichever is longer, or currently participating in any other interventional clinical study Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C. History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to first infusion of ofatumumab, congestive heart failure (NYHA III-IV), and arrhythmia (unless controlled by therapy), with the exception of extra systoles or minor conduction abnormalities. Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease which in the opinion of the investigator may represent a risk for the patient. Positive serology for Hepatitis B (HB) defined as a positive test for HBsAg. In addition, if negative for HBsAg but HBcAb positive (regardless of HBsAb status), a HBV DNA test will be performed and if positive the patient will be excluded.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Steven Park, MD
    Organizational Affiliation
    UNC Lineberger Comprehensive Cancer Center
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Links:
    URL
    http://unclineberger.org/
    Description
    UNC Lineberger Comprehensive Cancer Center website

    Learn more about this trial

    Ofatumumab In Older Patients With Untreated Low Or Intermediate Risk Indolent B-Cell Lymphomas

    We'll reach out to this number within 24 hrs