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A comparatiVe Study on Efficacy and Safety of Lipegfilgrastim in Comparison to Pegfilgrastim in Elderly Patients With Aggressive B Cell Non-HOdgkin Lymphomas at hIgh Risk for R-CHOP-21-inDuced Neutropenia (AVOID)

Primary Purpose

Aggressive B Cell Non-Hodgkin Lymphomas at High Risk for R-CHOP-21-induced Neutropenia

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
lipegfilgrastim
pegfilgrastim
Sponsored by
Teva Branded Pharmaceutical Products R&D, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aggressive B Cell Non-Hodgkin Lymphomas at High Risk for R-CHOP-21-induced Neutropenia focused on measuring Neutropenia, NHL, Non-Hodgkin lymphomas, R-CHOP-21

Eligibility Criteria

65 Years - 85 Years (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed and dated Independent Ethics Committee (IEC)-approved written informed consent
  2. Age ≥65 years and ≤85 years
  3. Histological documentation of aggressive B cell NHL
  4. Planned to receive systemic anticancer therapy with at least 6 cycles of R-CHOP-21, according to local standards
  5. ECOG score ≤2
  6. Life expectancy of at least 3 months
  7. Adequate bone marrow, renal and hepatic function within 14 days before start of chemotherapy
  8. The patient is capable of understanding and complying with parameters as outlined in the protocol
  9. Women of childbearing potential (not surgically sterile or 2 years postmenopausal) must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the treatment and for 30 days after discontinuation of study drug.
  10. The patient, if a man, is surgically sterile, or, if capable of producing offspring, is currently using an approved method of birth control and agrees to continued use of this method for the duration of the treatment (and for 90 days after taking the last dose of study

    • Other Criteria apply, please contact the investigator for more information

Exclusion Criteria:

  1. Participation in a clinical study within 30 days before randomization
  2. Any chemotherapy within the last 3 months before start of chemotherapy. A prephase to reduce tumor burden prior to start of R-CHOP is allowed.
  3. The patient is a pregnant or lactating woman. (Any woman becoming pregnant during the study will be withdrawn from the study.)
  4. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of chemotherapy.
  5. Active cardiac disease
  6. Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within the 6 months before start of chemotherapy.
  7. Ongoing infection, known history of human immunodeficiency virus (HIV) infection, tuberculosis, or chronic hepatitis B or C.
  8. Patients with evidence or history of bleeding diathesis.
  9. Non-healing wound, ulcer or bone fracture.
  10. Renal failure requiring hemo- or peritoneal dialysis.
  11. Any conditions that may interfere with the patient's participation in the study or evaluation of the study results.
  12. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation.
  13. Any illness or medical conditions that are unstable or could jeopardize the safety of the patient and his/her compliance in the study.
  14. Treatment with lithium at screening or planned during the study.

    • Other Criteria apply, please contact the investigator for more information

Sites / Locations

  • Teva Investigational Site 32284
  • Teva Investigational Site 32314
  • Teva Investigational Site 32267
  • Teva Investigational Site 32277
  • Teva Investigational Site 32292
  • Teva Investigational Site 32400
  • Teva Investigational Site 32318
  • Teva Investigational Site 32294
  • Teva Investigational Site 32282
  • Teva Investigational Site 32269
  • Teva Investigational Site 32303
  • Teva Investigational Site 32308
  • Teva Investigational Site 32302
  • Teva Investigational Site 32276
  • Teva Investigational Site 32293
  • Teva Investigational Site 32290
  • Teva Investigational Site 32322
  • Teva Investigational Site 32320
  • Teva Investigational Site 32273
  • Teva Investigational Site 32296
  • Teva Investigational Site 32319
  • Teva Investigational Site 32272
  • Teva Investigational Site 32295
  • Teva Investigational Site 32270
  • Teva Investigational Site 32401
  • Teva Investigational Site 32279
  • Teva Investigational Site 32297
  • Teva Investigational Site 32310
  • Teva Investigational Site 32280
  • Teva Investigational Site 32275
  • Teva Investigational Site 32309
  • Teva Investigational Site 32287
  • Teva Investigational Site 32289
  • Teva Investigational Site 32313
  • Teva Investigational Site 32311
  • Teva Investigational Site 32278
  • Teva Investigational Site 32281
  • Teva Investigational Site 32301
  • Teva Investigational Site 32274
  • Teva Investigational Site 32306
  • Teva Investigational Site 32304
  • Teva Investigational Site 32291
  • Teva Investigational Site 32315
  • Teva Investigational Site 32300
  • Teva Investigational Site 32288
  • Teva Investigational Site 32268
  • Teva Investigational Site 32321
  • Teva Investigational Site 32305
  • Teva Investigational Site 32266
  • Teva Investigational Site 32317
  • Teva Investigational Site 32286
  • Teva Investigational Site 30061
  • Teva Investigational Site 30059
  • Teva Investigational Site 30063
  • Teva Investigational Site 30062
  • Teva Investigational Site 31074
  • Teva Investigational Site 31071
  • Teva Investigational Site 31070
  • Teva Investigational Site 31073
  • Teva Investigational Site 31072

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

lipegfilgrastim.

pegfilgrastim

Arm Description

subcutaneous (SC) injection of 6 mg lipegfilgrastim

SC injection of 6 mg pegfilgrastim

Outcomes

Primary Outcome Measures

Duration of severe neutropenia (DSN) ANC <0.5 * 10^9/L
Grade 4 neutropenia measured in days

Secondary Outcome Measures

Incidence of febrile neutropenia (FN) (strict definition)
Body temperature of >38.5°C for at least one hour and ANC<1*10^9/L
Incidence of FN
A single temperature of ≥38.3°C or ≥38.0°C for at least one hour and ANC <1 * 10^9/L
Incidence of very severe neutropenia
The occurrence of at least one incidence of ANC <0.1 * 10*9/L
Incidence of infections
Incidence and severity of infections
Time to ANC recovery
The time in days from start of chemotherapy administration until the ANC increases to ≥1.0 x 109/L, ≥1.5 x 109/L, and ≥2.0 x 109/L after the expected nadir
Summary of participants with adverse events

Full Information

First Posted
January 21, 2014
Last Updated
June 6, 2022
Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02044276
Brief Title
A comparatiVe Study on Efficacy and Safety of Lipegfilgrastim in Comparison to Pegfilgrastim in Elderly Patients With Aggressive B Cell Non-HOdgkin Lymphomas at hIgh Risk for R-CHOP-21-inDuced Neutropenia
Acronym
AVOID
Official Title
A Randomized, Phase IIIB, Open-label, Two-arm, Multicenter, comparatiVe Study on Efficacy and Safety of Lipegfilgrastim (Lonquex, TEVA) in Comparison to Pegfilgrastim (Neulasta(R), Amgen) in Elderly Patients With Aggressive B Cell Non-HOdgkin Lymphomas at hIgh Risk for R-CHOP-21-inDuced Neutropenia - AVOID Neutropenia
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Completed
Study Start Date
March 31, 2014 (Actual)
Primary Completion Date
August 29, 2017 (Actual)
Study Completion Date
April 24, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of the study is to demonstrate non-inferiority of lipegfilgrastim to pegfilgrastim for the duration of severe neutropenia in the first cycle of chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aggressive B Cell Non-Hodgkin Lymphomas at High Risk for R-CHOP-21-induced Neutropenia
Keywords
Neutropenia, NHL, Non-Hodgkin lymphomas, R-CHOP-21

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
101 (Actual)

8. Arms, Groups, and Interventions

Arm Title
lipegfilgrastim.
Arm Type
Experimental
Arm Description
subcutaneous (SC) injection of 6 mg lipegfilgrastim
Arm Title
pegfilgrastim
Arm Type
Active Comparator
Arm Description
SC injection of 6 mg pegfilgrastim
Intervention Type
Drug
Intervention Name(s)
lipegfilgrastim
Other Intervention Name(s)
XM22
Intervention Description
6 mg
Intervention Type
Drug
Intervention Name(s)
pegfilgrastim
Other Intervention Name(s)
Neulasta®
Intervention Description
6 mg
Primary Outcome Measure Information:
Title
Duration of severe neutropenia (DSN) ANC <0.5 * 10^9/L
Description
Grade 4 neutropenia measured in days
Time Frame
3 weeks
Secondary Outcome Measure Information:
Title
Incidence of febrile neutropenia (FN) (strict definition)
Description
Body temperature of >38.5°C for at least one hour and ANC<1*10^9/L
Time Frame
18 weeks
Title
Incidence of FN
Description
A single temperature of ≥38.3°C or ≥38.0°C for at least one hour and ANC <1 * 10^9/L
Time Frame
18 weeks
Title
Incidence of very severe neutropenia
Description
The occurrence of at least one incidence of ANC <0.1 * 10*9/L
Time Frame
3 weeks
Title
Incidence of infections
Description
Incidence and severity of infections
Time Frame
18 weeks
Title
Time to ANC recovery
Description
The time in days from start of chemotherapy administration until the ANC increases to ≥1.0 x 109/L, ≥1.5 x 109/L, and ≥2.0 x 109/L after the expected nadir
Time Frame
3 weeks
Title
Summary of participants with adverse events
Time Frame
9 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated Independent Ethics Committee (IEC)-approved written informed consent Age ≥65 years and ≤85 years Histological documentation of aggressive B cell NHL Planned to receive systemic anticancer therapy with at least 6 cycles of R-CHOP-21, according to local standards ECOG score ≤2 Life expectancy of at least 3 months Adequate bone marrow, renal and hepatic function within 14 days before start of chemotherapy The patient is capable of understanding and complying with parameters as outlined in the protocol Women of childbearing potential (not surgically sterile or 2 years postmenopausal) must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the treatment and for 30 days after discontinuation of study drug. The patient, if a man, is surgically sterile, or, if capable of producing offspring, is currently using an approved method of birth control and agrees to continued use of this method for the duration of the treatment (and for 90 days after taking the last dose of study Other Criteria apply, please contact the investigator for more information Exclusion Criteria: Participation in a clinical study within 30 days before randomization Any chemotherapy within the last 3 months before start of chemotherapy. A prephase to reduce tumor burden prior to start of R-CHOP is allowed. The patient is a pregnant or lactating woman. (Any woman becoming pregnant during the study will be withdrawn from the study.) Major surgical procedure, open biopsy, or significant traumatic injury within 28 days before start of chemotherapy. Active cardiac disease Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within the 6 months before start of chemotherapy. Ongoing infection, known history of human immunodeficiency virus (HIV) infection, tuberculosis, or chronic hepatitis B or C. Patients with evidence or history of bleeding diathesis. Non-healing wound, ulcer or bone fracture. Renal failure requiring hemo- or peritoneal dialysis. Any conditions that may interfere with the patient's participation in the study or evaluation of the study results. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation. Any illness or medical conditions that are unstable or could jeopardize the safety of the patient and his/her compliance in the study. Treatment with lithium at screening or planned during the study. Other Criteria apply, please contact the investigator for more information
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Teva Medical Expert, MD
Organizational Affiliation
Teva Branded Pharmaceutical Products R&D, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Teva Investigational Site 32284
City
Aurich
ZIP/Postal Code
26603
Country
Germany
Facility Name
Teva Investigational Site 32314
City
Bad Soden Am Taunus
ZIP/Postal Code
65812
Country
Germany
Facility Name
Teva Investigational Site 32267
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Teva Investigational Site 32277
City
Berlin
ZIP/Postal Code
10707
Country
Germany
Facility Name
Teva Investigational Site 32292
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Teva Investigational Site 32400
City
Bonn
ZIP/Postal Code
53105
Country
Germany
Facility Name
Teva Investigational Site 32318
City
Bonn
ZIP/Postal Code
53113
Country
Germany
Facility Name
Teva Investigational Site 32294
City
Bottrop
ZIP/Postal Code
46236
Country
Germany
Facility Name
Teva Investigational Site 32282
City
Dresden
ZIP/Postal Code
01127
Country
Germany
Facility Name
Teva Investigational Site 32269
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Teva Investigational Site 32303
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Teva Investigational Site 32308
City
Frankfurt (Oder)
ZIP/Postal Code
15236
Country
Germany
Facility Name
Teva Investigational Site 32302
City
Frankfurt-Hochst
ZIP/Postal Code
65929
Country
Germany
Facility Name
Teva Investigational Site 32276
City
Frechen
ZIP/Postal Code
50226
Country
Germany
Facility Name
Teva Investigational Site 32293
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Teva Investigational Site 32290
City
Freiburg
ZIP/Postal Code
79110
Country
Germany
Facility Name
Teva Investigational Site 32322
City
Fulda
ZIP/Postal Code
36043
Country
Germany
Facility Name
Teva Investigational Site 32320
City
Furth
ZIP/Postal Code
90766
Country
Germany
Facility Name
Teva Investigational Site 32273
City
Goslar
ZIP/Postal Code
38642
Country
Germany
Facility Name
Teva Investigational Site 32296
City
Gutersloh
ZIP/Postal Code
33332
Country
Germany
Facility Name
Teva Investigational Site 32319
City
Halle
ZIP/Postal Code
06110
Country
Germany
Facility Name
Teva Investigational Site 32272
City
Hamburg
ZIP/Postal Code
22081
Country
Germany
Facility Name
Teva Investigational Site 32295
City
Heilbronn
ZIP/Postal Code
74078
Country
Germany
Facility Name
Teva Investigational Site 32270
City
Herne
ZIP/Postal Code
44623
Country
Germany
Facility Name
Teva Investigational Site 32401
City
Herne
ZIP/Postal Code
44625
Country
Germany
Facility Name
Teva Investigational Site 32279
City
Hof
ZIP/Postal Code
95028
Country
Germany
Facility Name
Teva Investigational Site 32297
City
Kaiserslautern
ZIP/Postal Code
67655
Country
Germany
Facility Name
Teva Investigational Site 32310
City
Kassel
ZIP/Postal Code
34119
Country
Germany
Facility Name
Teva Investigational Site 32280
City
Kiel
ZIP/Postal Code
24116
Country
Germany
Facility Name
Teva Investigational Site 32275
City
Koeln
ZIP/Postal Code
50674
Country
Germany
Facility Name
Teva Investigational Site 32309
City
Krefeld
ZIP/Postal Code
47805
Country
Germany
Facility Name
Teva Investigational Site 32287
City
Lahr
ZIP/Postal Code
77933
Country
Germany
Facility Name
Teva Investigational Site 32289
City
Langen
ZIP/Postal Code
63225
Country
Germany
Facility Name
Teva Investigational Site 32313
City
Lebach
ZIP/Postal Code
66822
Country
Germany
Facility Name
Teva Investigational Site 32311
City
Leer
ZIP/Postal Code
26789
Country
Germany
Facility Name
Teva Investigational Site 32278
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Teva Investigational Site 32281
City
Mulheim
ZIP/Postal Code
45468
Country
Germany
Facility Name
Teva Investigational Site 32301
City
Munchen
ZIP/Postal Code
D-81377
Country
Germany
Facility Name
Teva Investigational Site 32274
City
Oldenburg
ZIP/Postal Code
26121
Country
Germany
Facility Name
Teva Investigational Site 32306
City
Poessneck
ZIP/Postal Code
07381
Country
Germany
Facility Name
Teva Investigational Site 32304
City
Ravensburg
ZIP/Postal Code
88212
Country
Germany
Facility Name
Teva Investigational Site 32291
City
Rotenburg
ZIP/Postal Code
27356
Country
Germany
Facility Name
Teva Investigational Site 32315
City
Singen
ZIP/Postal Code
78224
Country
Germany
Facility Name
Teva Investigational Site 32300
City
Stade
ZIP/Postal Code
21680
Country
Germany
Facility Name
Teva Investigational Site 32288
City
Stolberg
ZIP/Postal Code
52222
Country
Germany
Facility Name
Teva Investigational Site 32268
City
Stuttgart
ZIP/Postal Code
70174
Country
Germany
Facility Name
Teva Investigational Site 32321
City
Stuttgart
ZIP/Postal Code
70376
Country
Germany
Facility Name
Teva Investigational Site 32305
City
Torgau
ZIP/Postal Code
04860
Country
Germany
Facility Name
Teva Investigational Site 32266
City
Villingen- Schwenningen
ZIP/Postal Code
78052
Country
Germany
Facility Name
Teva Investigational Site 32317
City
Villingen-Schwenningen
ZIP/Postal Code
78052
Country
Germany
Facility Name
Teva Investigational Site 32286
City
Weiden
ZIP/Postal Code
92637
Country
Germany
Facility Name
Teva Investigational Site 30061
City
Campobasso
ZIP/Postal Code
86100
Country
Italy
Facility Name
Teva Investigational Site 30059
City
Milano
ZIP/Postal Code
20162
Country
Italy
Facility Name
Teva Investigational Site 30063
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Teva Investigational Site 30062
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Teva Investigational Site 31074
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Teva Investigational Site 31071
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
Teva Investigational Site 31070
City
Madrid
ZIP/Postal Code
28222
Country
Spain
Facility Name
Teva Investigational Site 31073
City
Valencia
ZIP/Postal Code
46010
Country
Spain
Facility Name
Teva Investigational Site 31072
City
Valencia
ZIP/Postal Code
46026
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
32944800
Citation
Link H, Illerhaus G, Martens UM, Salar A, Depenbusch R, Kohler A, Engelhardt M, Mahlmann S, Zaiss M, Lammerich A, Bias P, Buchner A. Efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with aggressive B cell non-Hodgkin lymphoma (B-NHL): results of the randomized, open-label, non-inferiority AVOID neutropenia study. Support Care Cancer. 2021 May;29(5):2519-2527. doi: 10.1007/s00520-020-05711-7. Epub 2020 Sep 17.
Results Reference
derived

Learn more about this trial

A comparatiVe Study on Efficacy and Safety of Lipegfilgrastim in Comparison to Pegfilgrastim in Elderly Patients With Aggressive B Cell Non-HOdgkin Lymphomas at hIgh Risk for R-CHOP-21-inDuced Neutropenia

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