Escalating Doses of Torisel in Combination With Three Chemotherapies Regimens: R-CHOP, R-FC or R-DHA for Patients With Relapsed/Refractory Mantle Cell Lymphoma (MCL). (T³)
Primary Purpose
Mantle Cell Lymphoma Refractory
Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Torisel dose 15 mg and R-CHOP
Torisel dose 15 mg and R-FC
Torisel dose 15 mg and R-DHA
Torisel dose 25 mg and R-CHOP
Torisel dose 50 mg and R-CHOP
Torisel dose 75 mg and R-CHOP
Torisel dose 25 mg and R-FC
Torisel dose 50 mg and R-FC
Torisel dose 75 mg and R-FC
Torisel dose 25 mg and R-DHA
Torisel dose 50 mg and R-DHA
Torisel 75 mg and R-DHA
Sponsored by
About this trial
This is an interventional treatment trial for Mantle Cell Lymphoma Refractory
Eligibility Criteria
Inclusion Criteria:
- Patients with histologically or cytologically confirmed refractory or relapsed Mantle Cell Lymphoma (at initial diagnosis or relapse),
- Ann Arbor Stage I-IV with at least one tumor site measurable,
- Patients who received prior therapy (at least one but no more than three lines therapies) for Mantle Cell Lymphoma (MCL),
- Aged ≥ 18 years,
- ECOG performance status 0, 1 or 2,
Adequate hepatic and renal function :
- Serum Glutamic Oxaloacetic Transaminase (SGOT)/AST or Serum Glutamic Pyruvic TransaminaseSGPT/ALT ≤ 3.0 x upper limit of normal (ULN),
- Serum Total Bilirubin ≤ 1.5 mg/dL (26 μmol/L) except in case of hemolytic anemia,
- Serum Creatinine ≤ 2 mg/dL (177 μmol/L) or calculated Creatinine Clearance (Cock-croft-Gault formula) of ≥ 50 mL /min
Adequate bone marrow reserve :
- Absolute neutrophil count (ANC) ≥ 1 G/L (1,000 cells/mm³)
- Platelets count ≥ 50 G/L
- Hemoglobin ≥ 9.0 g/dL,
- Signed and date informed consent,
- Life expectancy of ≥ 90 days (3 months)
Exclusion Criteria:
- Other types of lymphomas, e.g. B-cell lymphoma,
- Contraindication to any drug contained in the three chemotherapy regimens (R-CHOP, R-FC, R-DHA),
- Tested positive for HIV,
- Active Hepatitis B and/or C,
- Exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited, to active systemic fungal infection, diagnosis of fever and neutropenia,
- Any serious active disease or co-morbid medical condition (according to investigator's decision),
- Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form,
- Received a biological agent for anti-neoplastic intent within 30 days prior to the first dose of study drug,
- Use of any standard or experimental anti-cancer drug therapy within 30 days prior to the first dose of study drug,
- Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) unless the subject has been free of the disease for ≥ 3 years,
- Left Ventricular Ejection Fraction < 45% (calculated by echocardiographic or scintigraphic method),
- Pregnancy or breast feeding women,
- Women of childbearing potential who not willing to use an adequate method of birth controls for the duration of the study and for twelve months after the end of treatment,
- Male patient whose sexual partner(s) are WOCBP who are not willing to use adequate contraception, during the study and for twelve months after the end of treatment.
Sites / Locations
- CHU de Grenoble MICHALLON
- Hôtel Dieu - Université de Nantes
- Hôpital Henri Mondor
- CHU de Dijon
- Hôpital Saint-Eloi
- Hôpital Saint Louis
- Hôpital Necker
- Groupe hospitalier Sud Hôpital Haut-Lévêque
- Centre Hospitalier Lyon Sud
- CHU Pontchaillou
- CHU de Tours - Hôpital Bretonneau
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Experimental
Arm Label
Torisel 15 mg
Torisel 25 mg
Torisel 50 mg
Torisel 75 mg
Arm Description
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 15 mg
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 25 mg
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 50 mg
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 75 mg
Outcomes
Primary Outcome Measures
Incidence of Dose Limiting Toxicities (DLT)
The evaluable for DLT population is the subset of patients from all treated population with a DLT assessment at the two first cycles.
Secondary Outcome Measures
Complete Response Rate(CR) after 4 cycles and at the end of treatment
Response at the end of treatment will be assessed after four cycles and at the end of complete treatment if the patient received all planned cycles or at withdrawal. Patients without response assessments (due to whatever reason) will be considered non-responders. A descriptive analysis will also be performed considering as non-responders all patients who relapsed or died during the treatment phase even if they were prematurely withdrawn as responders.
Progression-free survival (PFS)
Progression-Free Survival will be measured from the date of inclusion to the date of first documented disease progression, relapse or death from any cause, according to the Cheson 2007 criteria. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.
Duration of Response
Duration of response will be measured from the date of first documentation of a response (CR or PR at the end of treatment) to the date of first documented evidence of progression/relapse or death from any cause, according to the Cheson 2007 criteria. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.
Overall Response at the end of treatment
The same disease response assessment used for complete response rate will be considered to determine the Overall Response Rate. A Patient will be defined as a responder if he/she has a complete response (CR/CRu) or partial response (PR) after four cycles and at the end of treatment. A descriptive analysis will also be performed considering as non-responders all patients who relapsed or died during treatment phase even if they were prematurely withdrawn as responders.
Overall Survival (OS)
Overall survival will be measured from the date of inclusion to the date of death from any cause. Patients who are alive at the time of analysis will be censored at the date of the last contact.
Safety of association Temsirolimus with the three chemotherapy regimens
All subjects who received at least one dose of Temsirolimus (Torisel™) will be considered evaluable and will be included in the safety analysis.
Analysis of safety will be performed by summarizing adverse events, laboratory data, vital signs and ECOG per-formance status. When applicable, a summary of safety data will also be performed by cycle.
Full Information
NCT ID
NCT01389427
First Posted
July 4, 2011
Last Updated
March 8, 2017
Sponsor
The Lymphoma Academic Research Organisation
Collaborators
French Innovative Leukemia Organisation
1. Study Identification
Unique Protocol Identification Number
NCT01389427
Brief Title
Escalating Doses of Torisel in Combination With Three Chemotherapies Regimens: R-CHOP, R-FC or R-DHA for Patients With Relapsed/Refractory Mantle Cell Lymphoma (MCL).
Acronym
T³
Official Title
A Multicenter Phase IB Dose Escalation Study to Evaluate the Safety, Feasibility and Efficacy of the Torisel-Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (T-R-CHOP), Torisel-Rituximab-Fludarabine-Cyclophosphamide (T-R-FC) and Torisel-Rituximab-Aracytine High Dose-Dexamethasone (T-R-DHA) for the Treatment of Patients in Relapsed/Refractory Mantle Cell Lymphoma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
November 2011 (Actual)
Primary Completion Date
May 2015 (Actual)
Study Completion Date
September 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Lymphoma Academic Research Organisation
Collaborators
French Innovative Leukemia Organisation
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a multicenter, open label, three arms, Phase IB study.
A dose escalation phase of Temsirolimus (Torisel™) administered in intravenous (IV) at day 2, day 8 and day 15 in combination with three chemotherapies regimens for patients in relapsed/refractory Mantle Cell Lymphoma (MCL):
Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (R-CHOP) administered every 3 weeks for 6 cycles,
Rituximab-Fludarabine-Cyclophosphamide (R-FC) administered every 4 weeks for 6 cycles,
Rituximab-Aracytine high dose-Dexamethasone (R-DHA) administered every 4 weeks for 6 cycles.
Detailed Description
This is a three arms trial that investigates Temsirolimus (Torisel™) in combination with three chemotherapy regimens (R-CHOP, R-FC or R-DHA).
Primary Objective:
- To assess the feasibility of these three chemotherapy regimens in combination with Temsirolimus (Torisel™) and to assess the incidence of dose limiting toxicities (DLT) during the two first cycles of Temsirolimus (Torisel™) in combination with three chemotherapy regimens in order to determine the maximal tolerate dose (MTD) in a dose escalating study design in a population of patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Secondary objectives:
To assess the safety of the association Temsirolimus with the three chemotherapy regimens,
To determine the efficacy of the association of Temsirolimus (Torisel™) and these three chemotherapy regimens after 4 cycles and after 6 cycles at the end of treatment: response rate and complete response rate (CR), progression-free survival (PFS), response duration (RD) and overall survival (OS).
All subjects who received at least one dose of Temsirolimus (Torisel™) will be considered evaluable and will be included in the safety analysis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mantle Cell Lymphoma Refractory
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
41 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Torisel 15 mg
Arm Type
Experimental
Arm Description
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 15 mg
Arm Title
Torisel 25 mg
Arm Type
Experimental
Arm Description
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 25 mg
Arm Title
Torisel 50 mg
Arm Type
Experimental
Arm Description
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 50 mg
Arm Title
Torisel 75 mg
Arm Type
Experimental
Arm Description
Chemotherapy (R-CHOP, R-DHA or R-FC) associated to Torisel 75 mg
Intervention Type
Drug
Intervention Name(s)
Torisel dose 15 mg and R-CHOP
Other Intervention Name(s)
Arm A cohort -1
Intervention Description
Torisel in association with Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (R-CHOP) administered every 3 weeks (21 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 15 mg and R-FC
Other Intervention Name(s)
Arm B cohort -1
Intervention Description
Torisel in association with Rituximab-Fludarabine-Cyclophosphamide (R-FC) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 15 mg and R-DHA
Other Intervention Name(s)
Arm C cohort -1
Intervention Description
Torisel in association with Rituximab-Aracytine (high dose)-Dexamethasone (R-DHA) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 25 mg and R-CHOP
Other Intervention Name(s)
Arm A cohort 1
Intervention Description
Torisel in association with Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (R-CHOP) administered every 3 weeks (21 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 50 mg and R-CHOP
Other Intervention Name(s)
Arm A cohort 2
Intervention Description
Torisel in association with Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (R-CHOP) administered every 3 weeks (21 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 75 mg and R-CHOP
Other Intervention Name(s)
Arm A cohort 3
Intervention Description
Torisel in association with Rituximab-Cyclophosphamide-Doxorubicin-Vincristine-Prednisone (R-CHOP) administered every 3 weeks (21 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 25 mg and R-FC
Other Intervention Name(s)
Arm B cohort 1
Intervention Description
Torisel in association with Rituximab-Fludarabine-Cyclophosphamide (R-FC) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 50 mg and R-FC
Other Intervention Name(s)
Arm B cohort 2
Intervention Description
Torisel in association with Rituximab-Fludarabine-Cyclophosphamide (R-FC) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 75 mg and R-FC
Other Intervention Name(s)
Arm B cohort 3
Intervention Description
Torisel in association with Rituximab-Fludarabine-Cyclophosphamide (R-FC) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 25 mg and R-DHA
Other Intervention Name(s)
Arm C cohort 1
Intervention Description
Torisel in association with Rituximab-Aracytine (high dose)-Dexamethasone (R-DHA) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel dose 50 mg and R-DHA
Other Intervention Name(s)
Arm C cohort 2
Intervention Description
Torisel in association with Rituximab-Aracytine (high dose)-Dexamethasone (R-DHA) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Intervention Type
Drug
Intervention Name(s)
Torisel 75 mg and R-DHA
Other Intervention Name(s)
Arm C cohort 3
Intervention Description
Torisel in association with Rituximab-Aracytine (high dose)-Dexamethasone (R-DHA) administered every 4 weeks (28 days) for 6 cycles for patients in relapsed/refractory Mantle Cell Lymphoma (MCL).
Primary Outcome Measure Information:
Title
Incidence of Dose Limiting Toxicities (DLT)
Description
The evaluable for DLT population is the subset of patients from all treated population with a DLT assessment at the two first cycles.
Time Frame
56 days
Secondary Outcome Measure Information:
Title
Complete Response Rate(CR) after 4 cycles and at the end of treatment
Description
Response at the end of treatment will be assessed after four cycles and at the end of complete treatment if the patient received all planned cycles or at withdrawal. Patients without response assessments (due to whatever reason) will be considered non-responders. A descriptive analysis will also be performed considering as non-responders all patients who relapsed or died during the treatment phase even if they were prematurely withdrawn as responders.
Time Frame
28 days up to 42 days after the last treatment dose
Title
Progression-free survival (PFS)
Description
Progression-Free Survival will be measured from the date of inclusion to the date of first documented disease progression, relapse or death from any cause, according to the Cheson 2007 criteria. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.
Time Frame
From the date of inclusion to the date of first documentated disease progression, relapse or death from any cause up to 3 years
Title
Duration of Response
Description
Duration of response will be measured from the date of first documentation of a response (CR or PR at the end of treatment) to the date of first documented evidence of progression/relapse or death from any cause, according to the Cheson 2007 criteria. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.
Time Frame
From the date of first documentation of a response to the date of first documented evidence of progression/relapse or death from any cause up to 3 years
Title
Overall Response at the end of treatment
Description
The same disease response assessment used for complete response rate will be considered to determine the Overall Response Rate. A Patient will be defined as a responder if he/she has a complete response (CR/CRu) or partial response (PR) after four cycles and at the end of treatment. A descriptive analysis will also be performed considering as non-responders all patients who relapsed or died during treatment phase even if they were prematurely withdrawn as responders.
Time Frame
28 days up to 42 days after the last treatment dose
Title
Overall Survival (OS)
Description
Overall survival will be measured from the date of inclusion to the date of death from any cause. Patients who are alive at the time of analysis will be censored at the date of the last contact.
Time Frame
From the date of inclusion to the date of first documentated disease progression, relapse or death from any cause up to 3 years
Title
Safety of association Temsirolimus with the three chemotherapy regimens
Description
All subjects who received at least one dose of Temsirolimus (Torisel™) will be considered evaluable and will be included in the safety analysis.
Analysis of safety will be performed by summarizing adverse events, laboratory data, vital signs and ECOG per-formance status. When applicable, a summary of safety data will also be performed by cycle.
Time Frame
From the date of informed consent signature to 28 days after the last drug administration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with histologically or cytologically confirmed refractory or relapsed Mantle Cell Lymphoma (at initial diagnosis or relapse),
Ann Arbor Stage I-IV with at least one tumor site measurable,
Patients who received prior therapy (at least one but no more than three lines therapies) for Mantle Cell Lymphoma (MCL),
Aged ≥ 18 years,
ECOG performance status 0, 1 or 2,
Adequate hepatic and renal function :
Serum Glutamic Oxaloacetic Transaminase (SGOT)/AST or Serum Glutamic Pyruvic TransaminaseSGPT/ALT ≤ 3.0 x upper limit of normal (ULN),
Serum Total Bilirubin ≤ 1.5 mg/dL (26 μmol/L) except in case of hemolytic anemia,
Serum Creatinine ≤ 2 mg/dL (177 μmol/L) or calculated Creatinine Clearance (Cock-croft-Gault formula) of ≥ 50 mL /min
Adequate bone marrow reserve :
Absolute neutrophil count (ANC) ≥ 1 G/L (1,000 cells/mm³)
Platelets count ≥ 50 G/L
Hemoglobin ≥ 9.0 g/dL,
Signed and date informed consent,
Life expectancy of ≥ 90 days (3 months)
Exclusion Criteria:
Other types of lymphomas, e.g. B-cell lymphoma,
Contraindication to any drug contained in the three chemotherapy regimens (R-CHOP, R-FC, R-DHA),
Tested positive for HIV,
Active Hepatitis B and/or C,
Exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited, to active systemic fungal infection, diagnosis of fever and neutropenia,
Any serious active disease or co-morbid medical condition (according to investigator's decision),
Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form,
Received a biological agent for anti-neoplastic intent within 30 days prior to the first dose of study drug,
Use of any standard or experimental anti-cancer drug therapy within 30 days prior to the first dose of study drug,
Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) unless the subject has been free of the disease for ≥ 3 years,
Left Ventricular Ejection Fraction < 45% (calculated by echocardiographic or scintigraphic method),
Pregnancy or breast feeding women,
Women of childbearing potential who not willing to use an adequate method of birth controls for the duration of the study and for twelve months after the end of treatment,
Male patient whose sexual partner(s) are WOCBP who are not willing to use adequate contraception, during the study and for twelve months after the end of treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven LE GOUILL, Professor
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU de Grenoble MICHALLON
City
Grenoble Cedex 9
State/Province
Hôpital Nord 217
ZIP/Postal Code
38043
Country
France
Facility Name
Hôtel Dieu - Université de Nantes
City
Nantes cedex
State/Province
Place Alexis Ricordeau
ZIP/Postal Code
44093
Country
France
Facility Name
Hôpital Henri Mondor
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
CHU de Dijon
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
Hôpital Saint-Eloi
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Hôpital Saint Louis
City
Paris
ZIP/Postal Code
75475
Country
France
Facility Name
Hôpital Necker
City
Paris
ZIP/Postal Code
75743
Country
France
Facility Name
Groupe hospitalier Sud Hôpital Haut-Lévêque
City
Pessac
ZIP/Postal Code
33604
Country
France
Facility Name
Centre Hospitalier Lyon Sud
City
Pierre Benite
ZIP/Postal Code
69310
Country
France
Facility Name
CHU Pontchaillou
City
Rennes
ZIP/Postal Code
35003
Country
France
Facility Name
CHU de Tours - Hôpital Bretonneau
City
Tours
ZIP/Postal Code
37000
Country
France
12. IPD Sharing Statement
Learn more about this trial
Escalating Doses of Torisel in Combination With Three Chemotherapies Regimens: R-CHOP, R-FC or R-DHA for Patients With Relapsed/Refractory Mantle Cell Lymphoma (MCL).
We'll reach out to this number within 24 hrs