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Lenalidomide, Rituximab, Gemcitabine, Oxaliplatin and Dexamethasone in Relapse and Refractory DLBCL (R2-GOD)

Primary Purpose

Diffuse Large B-cell Lymphoma Recurrent, Diffuse Large B Cell Lymphoma Refractory

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Rituximab
Gemcitabine
Oxaliplatin
Dexamethasone
Lenalidomide Oral Capsule
Sponsored by
The First Affiliated Hospital with Nanjing Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B-cell Lymphoma Recurrent focused on measuring lenalidomide, R-GOD, DLBCL

Eligibility Criteria

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

Inclusion Criteria:

  • Age 18-65 years old;
  • ECOG PS 0- 2;
  • Histologically confirmed diffuse large B cell lymphoma(With exception of Primary mediastinal large B cell lymphoma、Primary central nervous system lymphoma、HIV-related lymphoma),relapse or refractory,defined as:

    • relapse after standard first-line immunochemotherapy( R-CHOP or R-CHOP like)
    • SD as best response after 4 cycles or PD after 2 cycles of first-line immunochemotherapy;
  • a measurable or evaluable disease at the time of enrollment(diameter ≥ 1.5cm);
  • Eligible for subsequent autologous stem cell transplantation;
  • Female subjects in childbearing age, their serum or urine pregnancy test must be negative. All patients must agree to take effective contraceptive measures during the trial measures
  • Expected survival ≥ 12 weeks;
  • Understand and voluntarily sign an informed consent form, able to adhere to the study visit schedule and other protocol requirements

Exclusion Criteria:

  • Women who are pregnant or lactating. Patients have breeding intent in 12 months or cannot take effective contraceptive measures during the trial measures;
  • Uncontrollable active infection within four week. Prophylactic antibiotic, antiviral and antifungal treatment is permissible. Active hepatitis B or hepatitis C virus infection, as well as acquired, congenital immune deficiency diseases, including but not limited to HIV-infected persons;
  • Used of systemic anti-tumor treatment within four weeks;
  • CNS or meningeal involvement;
  • Poor hepatic and/or renal function, defined as total bilirubin, ALT, AST, Cr more than two fold of upper normal level,Ccr< 50 mL/min unless these abnormalities were related to the lymphoma;
  • Poor bone-marrow reserve, defined as neutrophil count less than 1.5×10⁹/L or platelet count less than 75×10⁹/L, unless caused by bone marrow infiltration;
  • New York Heart Association class III or IV cardiac failure; or Ejection fraction less than 50%;or history of following disease in past 6 months: acute coronary syndrome、acute heart failure、severe ventricular arrhythmia;
  • Known sensitivity or allergy to investigational Product;
  • Major surgery within three weeks;
  • Presence of Grade III nervous toxicity within past two weeks;
  • Active and severe infectious diseases;
  • History of DVT or PE within past 12 months;
  • Any potential drug abuse, medical, psychological or social conditions which may disturb this investigation and assessment;
  • In any conditions which investigator considered ineligible for this study.

Sites / Locations

  • The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

R2-GOD

Arm Description

Outcomes

Primary Outcome Measures

maximum tolerated dose and dose limited toxicity

Secondary Outcome Measures

Overall response rate,
overall response rate after treated by R-GemOx or R-miniCHOP overall response rate after treated by R2-GOD regimen regimen
Progressive free survival
from date of inclusion to date of progression, relapse, or death from any causePFS:from date of inclusion to date of progression, relapse, or death from any cause
Overall survival
from the date of inclusion to date of death, irrespective of cause

Full Information

First Posted
January 1, 2019
Last Updated
February 13, 2019
Sponsor
The First Affiliated Hospital with Nanjing Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT03795571
Brief Title
Lenalidomide, Rituximab, Gemcitabine, Oxaliplatin and Dexamethasone in Relapse and Refractory DLBCL
Acronym
R2-GOD
Official Title
Lenalidomide, Rituximab, Gemcitabine, Oxaliplatin and Dexamethasone (R2-GOD) in Treatment of Relapse/Refractory DLBCL:A Phase I Study
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Unknown status
Study Start Date
January 1, 2019 (Actual)
Primary Completion Date
December 31, 2019 (Anticipated)
Study Completion Date
December 31, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The First Affiliated Hospital with Nanjing Medical University

4. Oversight

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

5. Study Description

Brief Summary
Previous study showed that Lenalidomide or R-GDP could achieve response in Relapse and Refractory DLBCL.The investigators therefore design this phase I study to investigate the safety and efficacy of R2-GOD in relapsed diffuse large-cell lymphoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B-cell Lymphoma Recurrent, Diffuse Large B Cell Lymphoma Refractory
Keywords
lenalidomide, R-GOD, DLBCL

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
R2-GOD
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Rituximab
Intervention Description
Rituximab 375mg/m2,d0
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Gemcitabine 1000mg/m2,d1,d5
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
Oxaliplatin 75mg/m2,d1
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
Dexamethasone 40mg/d,d1~d4
Intervention Type
Drug
Intervention Name(s)
Lenalidomide Oral Capsule
Intervention Description
Lenalidomide 10mg/d、15mg/d、20mg/d、25mg/d d1~d10; 21days a cycle
Primary Outcome Measure Information:
Title
maximum tolerated dose and dose limited toxicity
Time Frame
28 days after first cycle of R2-GOD regimen
Secondary Outcome Measure Information:
Title
Overall response rate,
Description
overall response rate after treated by R-GemOx or R-miniCHOP overall response rate after treated by R2-GOD regimen regimen
Time Frame
6 months
Title
Progressive free survival
Description
from date of inclusion to date of progression, relapse, or death from any causePFS:from date of inclusion to date of progression, relapse, or death from any cause
Time Frame
2 years
Title
Overall survival
Description
from the date of inclusion to date of death, irrespective of cause
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-65 years old; ECOG PS 0- 2; Histologically confirmed diffuse large B cell lymphoma(With exception of Primary mediastinal large B cell lymphoma、Primary central nervous system lymphoma、HIV-related lymphoma),relapse or refractory,defined as: relapse after standard first-line immunochemotherapy( R-CHOP or R-CHOP like) SD as best response after 4 cycles or PD after 2 cycles of first-line immunochemotherapy; a measurable or evaluable disease at the time of enrollment(diameter ≥ 1.5cm); Eligible for subsequent autologous stem cell transplantation; Female subjects in childbearing age, their serum or urine pregnancy test must be negative. All patients must agree to take effective contraceptive measures during the trial measures Expected survival ≥ 12 weeks; Understand and voluntarily sign an informed consent form, able to adhere to the study visit schedule and other protocol requirements Exclusion Criteria: Women who are pregnant or lactating. Patients have breeding intent in 12 months or cannot take effective contraceptive measures during the trial measures; Uncontrollable active infection within four week. Prophylactic antibiotic, antiviral and antifungal treatment is permissible. Active hepatitis B or hepatitis C virus infection, as well as acquired, congenital immune deficiency diseases, including but not limited to HIV-infected persons; Used of systemic anti-tumor treatment within four weeks; CNS or meningeal involvement; Poor hepatic and/or renal function, defined as total bilirubin, ALT, AST, Cr more than two fold of upper normal level,Ccr< 50 mL/min unless these abnormalities were related to the lymphoma; Poor bone-marrow reserve, defined as neutrophil count less than 1.5×10⁹/L or platelet count less than 75×10⁹/L, unless caused by bone marrow infiltration; New York Heart Association class III or IV cardiac failure; or Ejection fraction less than 50%;or history of following disease in past 6 months: acute coronary syndrome、acute heart failure、severe ventricular arrhythmia; Known sensitivity or allergy to investigational Product; Major surgery within three weeks; Presence of Grade III nervous toxicity within past two weeks; Active and severe infectious diseases; History of DVT or PE within past 12 months; Any potential drug abuse, medical, psychological or social conditions which may disturb this investigation and assessment; In any conditions which investigator considered ineligible for this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Huayuan Zhu, PhD& MD
Phone
86 25 68306034
Email
huayuan.zhu@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wei Xu, PhD& MD
Organizational Affiliation
The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital)
Official's Role
Principal Investigator
Facility Information:
Facility Name
The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huayuan Zhu, PhD,MD
Phone
+86 68136034
Email
huayuan.zhu@hotmail.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
24661044
Citation
Feldman T, Mato AR, Chow KF, Protomastro EA, Yannotti KM, Bhattacharyya P, Yang X, Donato ML, Rowley SD, Carini C, Valentinetti M, Smith J, Gadaleta G, Bejot C, Stives S, Timberg M, Kdiry S, Pecora AL, Beaven AW, Goy A. Addition of lenalidomide to rituximab, ifosfamide, carboplatin, etoposide (RICER) in first-relapse/primary refractory diffuse large B-cell lymphoma. Br J Haematol. 2014 Jul;166(1):77-83. doi: 10.1111/bjh.12846. Epub 2014 Mar 25.
Results Reference
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PubMed Identifier
26847165
Citation
Martin A, Redondo AM, Dlouhy I, Salar A, Gonzalez-Barca E, Canales M, Montes-Moreno S, Ocio EM, Lopez-Guillermo A, Caballero D; Spanish Group for Lymphomas and Autologous Bone Marrow (GELTAMO). Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: a phase 1b study from GELTAMO group. Br J Haematol. 2016 Apr;173(2):245-52. doi: 10.1111/bjh.13945. Epub 2016 Feb 5.
Results Reference
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PubMed Identifier
25267740
Citation
Crump M, Kuruvilla J, Couban S, MacDonald DA, Kukreti V, Kouroukis CT, Rubinger M, Buckstein R, Imrie KR, Federico M, Di Renzo N, Howson-Jan K, Baetz T, Kaizer L, Voralia M, Olney HJ, Turner AR, Sussman J, Hay AE, Djurfeldt MS, Meyer RM, Chen BE, Shepherd LE. Randomized comparison of gemcitabine, dexamethasone, and cisplatin versus dexamethasone, cytarabine, and cisplatin chemotherapy before autologous stem-cell transplantation for relapsed and refractory aggressive lymphomas: NCIC-CTG LY.12. J Clin Oncol. 2014 Nov 1;32(31):3490-6. doi: 10.1200/JCO.2013.53.9593. Epub 2014 Sep 29.
Results Reference
background
PubMed Identifier
29752199
Citation
Shen QD, Zhu HY, Wang L, Fan L, Liang JH, Cao L, Wu W, Xia Y, Li JY, Xu W. Gemcitabine-oxaliplatin plus rituximab (R-GemOx) as first-line treatment in elderly patients with diffuse large B-cell lymphoma: a single-arm, open-label, phase 2 trial. Lancet Haematol. 2018 Jun;5(6):e261-e269. doi: 10.1016/S2352-3026(18)30054-1. Epub 2018 May 8.
Results Reference
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Lenalidomide, Rituximab, Gemcitabine, Oxaliplatin and Dexamethasone in Relapse and Refractory DLBCL

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