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Follicular Lymphoma IV/SC Rituximab Therapy (FLIRT) (FLIRT)

Primary Purpose

Follicular Lymphoma

Status
Completed
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Rituximab IV
Rituximab SC
Sponsored by
The Lymphoma Academic Research Organisation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Follicular Lymphoma focused on measuring LNH, CD20+, follicular

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically confirmed follicular lymphoma CD20+ grade 1, 2 and 3a by biopsy within 4 months before signing informed consent
  • Have a bone marrow biopsy within 4 months before the first study drug administration
  • Have no prior therapy except surgery for diagnosis
  • Aged 18 years or more with no upper age limit
  • ECOG performance status 0-2
  • Ann Arbor Stage II, III or IV
  • Bi-dimensionally measurable disease defined by at least one single node or tumor lesion > 1.5 cm assessed by CT scan and/or clinical examination
  • With low-tumor burden defined as:

    • Nodal or extra-nodal tumor mass with diameter less than 7 cm in its greater diameter
    • And involvement of less than 3 nodal or extra nodal sites with diameter greater than 3 cm
    • And absence of B symptoms
    • And no symptomatic splenomegaly
    • And no compression syndrome (ureteral, orbital, gastrointestinal…)
    • And no pleural or peritoneal serous effusion
    • And no cytopenia, with hemoglobin > 10 g/dL (6.25mmol/L) and absolute neutrophil count> 1.5 G/L and platelets > 100 G/L within 28 days before the randomization
    • And LDH < ULN within 28 days before the randomization
    • And β2 microglobulin < ULN within 28 days before the randomization
  • Have signed an informed consent
  • Must be covered by a social security system

Exclusion Criteria:

  • Grade 3b follicular lymphoma
  • Ann Arbor Stage I
  • Seropositive for or active viral infection with hepatitis B virus (HBV) HBs Ag positive HBs Ag negative, anti-HBs antibody positive and/or anti-HBc antibody positive and detectable viral DNA

Note:

Patients who are HBs Ag negative, anti-HBs positive and/or anti-HBc positive but viral DNA negative are eligible Patients who are seropositive due to a history of hepatitis B vaccine are eligible

  • Known seropositive for, or active viral infection with hepatitis C virus (HCV)
  • Known seropositive for, or active viral infection with Human Immunodeficiency Virus (HIV)
  • Any of the following laboratory abnormalities within 28 days before the randomization:

Total bilirubin or GGT or AST or ALT > 3 ULN. Calculated creatinine clearance (Cockcroft and Gault formula) < 60 mL /min

  • Presence or history of CNS involvement by lymphoma
  • 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
  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Patient with mental deficiency preventing proper understanding of the informed consent and the requirements of treatment.
  • Adult under law-control
  • Adult under tutelage
  • Contraindication to use rituximab or known sensitivity or allergy to murine products
  • Pregnant or lactating females.
  • Concomitant disease requiring prolonged use of corticosteroids or corticosteroids administration for lymphoma within 28 days before the first study drug administration.
  • Male and female patients of childbearing potential who cannot or do not wish to use an effective method of contraception, during the study treatment and for 12 months thereafter.

Sites / Locations

  • CH de Pays d'Aix
  • CHU Angers
  • CH d'Avignon - Hôpital Henri Duffaut
  • Hôpital de Bayonnes
  • CH de BLOIS
  • Hôpital d'Avicenne
  • Institut Bergonié
  • Polyclinique Bordeaux Nord Aquitaine
  • IHBN - CHU de Caen
  • Clinique du Parc
  • CH de Chambéry
  • Chu Estaing
  • Hôpital Pasteur
  • Hôpital Henri Mondor
  • CHU Dijon - Hôpital d'Enfants
  • Hôpital Albert Michallon
  • CH Départemental Vendée
  • Hôpital St Louis
  • Hôpital André Mignot
  • Clinique Victor Hugo
  • CHRU de Lille - Hôpital Claude Hurriez
  • Centre Léon Bérard
  • Hôpital de la Conception
  • Hôpital Mercy
  • Hôpital Saint-Eloi
  • Hôpital Emile Muller
  • CHU de Nantes - Hôtel Dieu
  • Institut de Cancérologie du Gard Hématologie clinique
  • CHR de la Source
  • Hôpital Cochin
  • Hôpital Necker
  • Hôpital Saint Jean
  • Hôpital Haut Lévêque - Centre François Magendie
  • CHU Lyon Sud
  • CH René Dubos
  • Centre Hospitalier Annecy-Genevois
  • Hôpital Robert Debré
  • Hôpital Pontchaillou
  • Hôpital Victor Provo
  • Centre Henri Becquerel
  • Institut de Cancérologie de l'Ouest René Gauducheau
  • Institut de Cancérologie Lucien Neuwirth
  • Hôpital Yves Le Foll
  • Hôpital de Hautepierre
  • IUCT Oncopole
  • Hôpital Bretonneau
  • CH de TROYES
  • CH de Valenciennes
  • CHU Nancy - Hôpital de Brabois
  • CH Bretagne Atlantique

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Am A : Rituximab IV

Arm B: Rituximab SC

Arm C : Rituximab SC first cycle

Arm Description

4 infusions of intravenous rituximab (375mg/m²) at Day 1, Day 8, Day 15 and D22

1 infusion of intravenous rituximab (375mg/m²) at Day 1, and 7 administrations of sub-cutaneous rituximab (1400mg) at Day 8, Day15, Day 22, Month 3, Month 5, Month 7 and Month 9.

8 administrations of sub-cutaneous rituximab (1400mg) at Day 8, Day15, Day 22, Month 3, Month 5, Month 7 and Month 9.

Outcomes

Primary Outcome Measures

Progression Free Survival (PFS)
Time from randomization into the study to the first observation of documented disease progression or death due to any cause. If a subject has not progressed or died, PFS will be censored at the time of last visit with adequate assessment

Secondary Outcome Measures

Overall Survival (OS)
time from the date of randomization to the date of death from any cause. Alive patients will be censored at their last follow-up date.
Response Rates
Disease response evaluation, assessment will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma) according to Cheson 1999 (M3 and M12) and according to Cheson 2014 (M12 only). The response rates will be described for each modality (CR, CRu, PR, SD and PD) and the Overall response rates (CR+CRu+PR) will also be described at the two time points (M3 & M12).
Best Response Rate during the study
Best disease response, assessment of response will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma (Cheson, 1999)). The response rates will be described for each modality (CR, CRu, PR, SD and PD) and the Overall response rates (CR+CRu+PR) will also be described
Time to Next Anti-Lymphoma Treatment (TTNLT)
time from randomization to the date of first documented administration of any new anti-lymphoma treatment (chemotherapy, radiotherapy, radio-immunotherapy, immunotherapy…). Patients continuing in response or who are lost to follow-up will be censored on their last visit date. Patients who died (due to any cause) before having received a new anti-lymphoma treatment will be included in the statistical analysis with death being counted as an event.
Molecular Response
Bcl-2-IgH rearrangement

Full Information

First Posted
November 25, 2014
Last Updated
January 9, 2023
Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Roche Pharma AG
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1. Study Identification

Unique Protocol Identification Number
NCT02303119
Brief Title
Follicular Lymphoma IV/SC Rituximab Therapy (FLIRT)
Acronym
FLIRT
Official Title
A Randomized Phase III Trial Evaluating Two Strategies of Rituximab Administration for the Treatment of First Line/Low Tumor Burden Follicular Lymphoma (Follicular Lymphoma IV/SC Rituximab Therapy)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
February 2, 2015 (Actual)
Primary Completion Date
June 29, 2021 (Actual)
Study Completion Date
June 29, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Roche Pharma AG

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Patient will receive either one infusion of rituximab IV and seven administrations of rituximab SC (experimental arm) or four infusions of rituximab IV (standard arm). The hypothesis is that the use of rituximab by sub cutaneous route and the scheme of administration could: optimize rituximab exposure leading to improve response rate increase adaptative response and then improve long-term control disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Follicular Lymphoma
Keywords
LNH, CD20+, follicular

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Am A : Rituximab IV
Arm Type
Active Comparator
Arm Description
4 infusions of intravenous rituximab (375mg/m²) at Day 1, Day 8, Day 15 and D22
Arm Title
Arm B: Rituximab SC
Arm Type
Experimental
Arm Description
1 infusion of intravenous rituximab (375mg/m²) at Day 1, and 7 administrations of sub-cutaneous rituximab (1400mg) at Day 8, Day15, Day 22, Month 3, Month 5, Month 7 and Month 9.
Arm Title
Arm C : Rituximab SC first cycle
Arm Type
Experimental
Arm Description
8 administrations of sub-cutaneous rituximab (1400mg) at Day 8, Day15, Day 22, Month 3, Month 5, Month 7 and Month 9.
Intervention Type
Drug
Intervention Name(s)
Rituximab IV
Other Intervention Name(s)
MabThera IV
Intervention Description
intra-venous, 375 mg/m²
Intervention Type
Drug
Intervention Name(s)
Rituximab SC
Other Intervention Name(s)
MabThera SC
Intervention Description
sub-cutaneous, 1400 mg
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
Time from randomization into the study to the first observation of documented disease progression or death due to any cause. If a subject has not progressed or died, PFS will be censored at the time of last visit with adequate assessment
Time Frame
5.5 years
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
time from the date of randomization to the date of death from any cause. Alive patients will be censored at their last follow-up date.
Time Frame
5.5 years
Title
Response Rates
Description
Disease response evaluation, assessment will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma) according to Cheson 1999 (M3 and M12) and according to Cheson 2014 (M12 only). The response rates will be described for each modality (CR, CRu, PR, SD and PD) and the Overall response rates (CR+CRu+PR) will also be described at the two time points (M3 & M12).
Time Frame
M3 and M12
Title
Best Response Rate during the study
Description
Best disease response, assessment of response will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma (Cheson, 1999)). The response rates will be described for each modality (CR, CRu, PR, SD and PD) and the Overall response rates (CR+CRu+PR) will also be described
Time Frame
M3 and M12
Title
Time to Next Anti-Lymphoma Treatment (TTNLT)
Description
time from randomization to the date of first documented administration of any new anti-lymphoma treatment (chemotherapy, radiotherapy, radio-immunotherapy, immunotherapy…). Patients continuing in response or who are lost to follow-up will be censored on their last visit date. Patients who died (due to any cause) before having received a new anti-lymphoma treatment will be included in the statistical analysis with death being counted as an event.
Time Frame
5.5 years
Title
Molecular Response
Description
Bcl-2-IgH rearrangement
Time Frame
M3 and M12
Other Pre-specified Outcome Measures:
Title
Pharmacokinetic parameters of rituximab will be used to estimate individual area under the concentration curves of rituximab (AUC).
Description
The AUC will be used to describe the relationship between rituximab pharmacokinetics and clinical response (objective response, survival).
Time Frame
5.5 years
Title
Causes of death
Description
classification by cause of death
Time Frame
5.5 years
Title
Secondary cancers
Description
classification by type of cancer
Time Frame
5.5 years
Title
Number of SAE from the first administration
Description
for Rituximab SC as of C1 cohort
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed follicular lymphoma CD20+ grade 1, 2 and 3a by biopsy within 4 months before signing informed consent Have a bone marrow biopsy within 4 months before the first study drug administration Have no prior therapy except surgery for diagnosis Aged 18 years or more with no upper age limit ECOG performance status 0-2 Ann Arbor Stage II, III or IV Bi-dimensionally measurable disease defined by at least one single node or tumor lesion > 1.5 cm assessed by CT scan and/or clinical examination With low-tumor burden defined as: Nodal or extra-nodal tumor mass with diameter less than 7 cm in its greater diameter And involvement of less than 3 nodal or extra nodal sites with diameter greater than 3 cm And absence of B symptoms And no symptomatic splenomegaly And no compression syndrome (ureteral, orbital, gastrointestinal…) And no pleural or peritoneal serous effusion And no cytopenia, with hemoglobin > 10 g/dL (6.25mmol/L) and absolute neutrophil count> 1.5 G/L and platelets > 100 G/L within 28 days before the randomization And LDH < ULN within 28 days before the randomization And β2 microglobulin < ULN within 28 days before the randomization Have signed an informed consent Must be covered by a social security system Exclusion Criteria: Grade 3b follicular lymphoma Ann Arbor Stage I Seropositive for or active viral infection with hepatitis B virus (HBV) HBs Ag positive HBs Ag negative, anti-HBs antibody positive and/or anti-HBc antibody positive and detectable viral DNA Note: Patients who are HBs Ag negative, anti-HBs positive and/or anti-HBc positive but viral DNA negative are eligible Patients who are seropositive due to a history of hepatitis B vaccine are eligible Known seropositive for, or active viral infection with hepatitis C virus (HCV) Known seropositive for, or active viral infection with Human Immunodeficiency Virus (HIV) Any of the following laboratory abnormalities within 28 days before the randomization: Total bilirubin or GGT or AST or ALT > 3 ULN. Calculated creatinine clearance (Cockcroft and Gault formula) < 60 mL /min Presence or history of CNS involvement by lymphoma 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 Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. Patient with mental deficiency preventing proper understanding of the informed consent and the requirements of treatment. Adult under law-control Adult under tutelage Contraindication to use rituximab or known sensitivity or allergy to murine products Pregnant or lactating females. Concomitant disease requiring prolonged use of corticosteroids or corticosteroids administration for lymphoma within 28 days before the first study drug administration. Male and female patients of childbearing potential who cannot or do not wish to use an effective method of contraception, during the study treatment and for 12 months thereafter.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guillaume Cartron, MD PhD
Organizational Affiliation
Lymphoma Study Association
Official's Role
Study Chair
Facility Information:
Facility Name
CH de Pays d'Aix
City
Aix En Provence
ZIP/Postal Code
13606
Country
France
Facility Name
CHU Angers
City
Angers
ZIP/Postal Code
49933
Country
France
Facility Name
CH d'Avignon - Hôpital Henri Duffaut
City
Avignon
ZIP/Postal Code
84902
Country
France
Facility Name
Hôpital de Bayonnes
City
Bayonne
ZIP/Postal Code
64100
Country
France
Facility Name
CH de BLOIS
City
Blois
ZIP/Postal Code
41016
Country
France
Facility Name
Hôpital d'Avicenne
City
Bobigny
ZIP/Postal Code
93009
Country
France
Facility Name
Institut Bergonié
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Facility Name
Polyclinique Bordeaux Nord Aquitaine
City
Bordeaux
ZIP/Postal Code
33300
Country
France
Facility Name
IHBN - CHU de Caen
City
Caen
ZIP/Postal Code
14033
Country
France
Facility Name
Clinique du Parc
City
Castelnau Le Lez
ZIP/Postal Code
34170
Country
France
Facility Name
CH de Chambéry
City
Chambéry
ZIP/Postal Code
73011
Country
France
Facility Name
Chu Estaing
City
Clermont Ferrand
ZIP/Postal Code
63003
Country
France
Facility Name
Hôpital Pasteur
City
Colmar
ZIP/Postal Code
68024
Country
France
Facility Name
Hôpital Henri Mondor
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
CHU Dijon - Hôpital d'Enfants
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
Hôpital Albert Michallon
City
Grenoble
ZIP/Postal Code
38043
Country
France
Facility Name
CH Départemental Vendée
City
La Roche sur Yon
ZIP/Postal Code
85925
Country
France
Facility Name
Hôpital St Louis
City
La Rochelle
ZIP/Postal Code
17019
Country
France
Facility Name
Hôpital André Mignot
City
Le Chesnay
ZIP/Postal Code
78157
Country
France
Facility Name
Clinique Victor Hugo
City
Le Mans
ZIP/Postal Code
72015
Country
France
Facility Name
CHRU de Lille - Hôpital Claude Hurriez
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Centre Léon Bérard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
Hôpital de la Conception
City
Marseille
ZIP/Postal Code
13385
Country
France
Facility Name
Hôpital Mercy
City
Metz
ZIP/Postal Code
57085
Country
France
Facility Name
Hôpital Saint-Eloi
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Hôpital Emile Muller
City
Mulhouse
ZIP/Postal Code
68070
Country
France
Facility Name
CHU de Nantes - Hôtel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
Institut de Cancérologie du Gard Hématologie clinique
City
Nimes
ZIP/Postal Code
30029
Country
France
Facility Name
CHR de la Source
City
Orleans
ZIP/Postal Code
45067
Country
France
Facility Name
Hôpital Cochin
City
Paris
ZIP/Postal Code
75679
Country
France
Facility Name
Hôpital Necker
City
Paris
ZIP/Postal Code
75743
Country
France
Facility Name
Hôpital Saint Jean
City
Perpignan
ZIP/Postal Code
66046
Country
France
Facility Name
Hôpital Haut Lévêque - Centre François Magendie
City
Pessac
ZIP/Postal Code
33604
Country
France
Facility Name
CHU Lyon Sud
City
Pierre Benite
ZIP/Postal Code
69310
Country
France
Facility Name
CH René Dubos
City
Pontoise
ZIP/Postal Code
95300
Country
France
Facility Name
Centre Hospitalier Annecy-Genevois
City
Pringy
ZIP/Postal Code
74374
Country
France
Facility Name
Hôpital Robert Debré
City
Reims
ZIP/Postal Code
51092
Country
France
Facility Name
Hôpital Pontchaillou
City
Rennes
ZIP/Postal Code
35033
Country
France
Facility Name
Hôpital Victor Provo
City
Roubaix
ZIP/Postal Code
59100
Country
France
Facility Name
Centre Henri Becquerel
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Name
Institut de Cancérologie de l'Ouest René Gauducheau
City
Saint Herblain
ZIP/Postal Code
44805
Country
France
Facility Name
Institut de Cancérologie Lucien Neuwirth
City
Saint Priest en Jarez
ZIP/Postal Code
42271
Country
France
Facility Name
Hôpital Yves Le Foll
City
Saint-Brieuc
ZIP/Postal Code
20000
Country
France
Facility Name
Hôpital de Hautepierre
City
Strasbourg
ZIP/Postal Code
67098
Country
France
Facility Name
IUCT Oncopole
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
Hôpital Bretonneau
City
Tours
ZIP/Postal Code
37044
Country
France
Facility Name
CH de TROYES
City
Troyes
ZIP/Postal Code
10003
Country
France
Facility Name
CH de Valenciennes
City
Valenciennes
ZIP/Postal Code
59322
Country
France
Facility Name
CHU Nancy - Hôpital de Brabois
City
Vandoeuvre-les-Nancy
ZIP/Postal Code
54500
Country
France
Facility Name
CH Bretagne Atlantique
City
Vannes
ZIP/Postal Code
56017
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Follicular Lymphoma IV/SC Rituximab Therapy (FLIRT)

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