A Study of Ibrutinib in Combination With Rituximab, in Japanese Participants With Waldenstrom's Macroglobulinemia (WM)
Primary Purpose
Waldenstrom Macroglobulinemia
Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
Ibrutinib
Rituximab
Sponsored by
About this trial
This is an interventional treatment trial for Waldenstrom Macroglobulinemia
Eligibility Criteria
Inclusion Criteria:
- Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia (WM) in accordance with the consensus panel of the second International Workshop on Waldenstrom's Macroglobulinemia (IWWM)
- Japanese participants with treatment naïve or relapsed/refractory WM
- Measurable disease defined as serum monoclonal immunoglobulin M (IgM) greater than (>) 0.5 gram per deciliter (g/dL)
- Symptomatic disease, requiring treatment
- Eastern Cooperative Oncology Group (ECOG) performance status of less than or equal to (<=) 2
- Hematology and biochemical values within protocol-defined limits
- Female participants of childbearing potential must have a negative serum pregnancy test at screening and agree to use highly effective methods of contraception while taking study drug. Women of childbearing potential must be practicing a highly effective, preferably user independent method of birth control during treatment with any drug in this study and for up to 12 months after the last dose of rituximab, 1 month after last dose of ibrutinib. Male participants must use an effective barrier method of contraception during the study and after receiving the last dose of ibrutinib, and for up to 12 months after last dose of rituximab if sexually active with a female of childbearing potential
- Must sign an informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study. Participants must be willing and able to adhere to the prohibitions and restrictions specified in this protocol
- Must be willing and able to adhere to the lifestyle restrictions specified in this protocol
Exclusion Criteria:
- Involvement of the central nervous system by WM
- Prior exposure to ibrutinib or other Bruton's Tyrosine Kinase (BTK) inhibitors
- Rituximab treatment within the last 12 months before the first dose of study intervention
- Received any WM-related therapy <=30 days prior to first administration of study treatment
- Plasmapheresis less than (<) 35 days prior to the initiation of study drug, except when at least one serum IgM central assessment was performed during the screening period and was >35 days from the most recent plasmapheresis procedure
- History of other malignancies
- Vaccinated with live, attenuated vaccines within 4 weeks of first dose of study drug
- Infection requiring systemic treatment that was completed <=14 days before the first dose of study drug
- Currently active, clinically significant Child-Pugh Class B or C hepatic impairment
- Inability or difficulty swallowing capsules, malabsorption syndrome, or any disease or medical condition significantly affecting gastrointestinal function
- Stroke or intracranial hemorrhage within 12 months prior to enrollment
- Currently active, clinically significant cardiovascular disease
- Requires treatment with a strong cytochrome P450 (CYP) 3A inhibitor
- Infection with human immunodeficiency virus (HIV) or active infection with hepatitis B or hepatitis C virus
- Major surgery within 4 weeks of first dose of study drug
- Lactating or pregnant
- Male participants who plan to father a child while enrolled in this study or within 3 months after the last dose of ibrutinib, and within 12 months after last dose of rituximab
- Any contraindication to ibrutinib or rituximab including hypersensitivity to the active substance or to any of the excipients of ibrutinib or rituximab per local prescribing information
- Received an investigational intervention (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before the planned first dose of study intervention or is currently enrolled in an investigational study
- Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg [for example], compromise the wellbeing) or that could prevent, limit, or confound the protocol-specified assessments
- Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator
Sites / Locations
- Kameda General Hospital
- National Cancer Center Hospital
- National Hospital Organization Kumamoto Medical Center
- Matsuyama Red Cross Hospital
- Nagoya City University Hospital
- Osaka Metropolitan University Hospital
- Osaka University Hospital
- National Hospital Organization Disaster Medical Center
- University of Tsukuba Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ibrutinib + Rituximab
Arm Description
Participants will receive ibrutinib 420 milligram (mg) orally, once daily, from Day 1 of Week 1 until disease progression or unacceptable toxicity in combination with rituximab 375 milligram per square meter (mg/m^2) intravenously (IV) on Day 1 of Weeks 1 to 4 and Weeks 17 to 20.
Outcomes
Primary Outcome Measures
Overall Response Rate (ORR) According to the Modified Sixth International Workshop on Waldenstrom's Macroglobulinemia (IWWM) Criteria
ORR is defined as the percentage of participants achieving a best overall response of confirmed complete response (CR), very good partial response (VGPR) or partial response (PR) according to the modified sixth IWWM criteria (National Comprehensive Cancer Network [NCCN] version 2, 2019), as assessed by the Independent Review Committee (IRC). CR: Immunoglobulin M (IgM) in normal range, disappearance of monoclonal protein by immunofixation, no histologic evidence of bone marrow involvement, resolution of any adenopathy/organomegaly (if present at baseline) along with no signs or symptoms attributable to Waldenstrom's Macroglobulinemia (WM); VGPR and PR: greater than or equal to (>=) 90 percent (%) (for VGPR) and >=50% (for PR) reduction of serum IgM, decrease in adenopathy/organomegaly (if present at baseline) on physical examination or computerized tomography (CT) scan, no new symptoms or signs of active disease.
Secondary Outcome Measures
Progression Free Survival (PFS)
PFS was defined as duration from the date of initial dose of ibrutinib to the date of first documented evidence of disease progression or death, whichever occurred first regardless of the use of subsequent antineoplastic therapy prior to documented disease progression or death.
Plasma Concentrations of Ibrutinib
Plasma concentrations of ibrutinib were reported.
Plasma Concentrations of PCI-45227
Plasma concentrations of PCI-45227 were reported.
Number of Participants With Myeloid Differentiation Primary Response Gene 88 (MYD88) Biomarker
Number of participants with MYD88 biomarker were reported.
Number of Participants With C-X-C Chemokine Receptor Type 4 (CXCR-4) Biomarker
Number of participants with CXCR-4 biomarker were reported.
Number of Participants With Treatment- Emergent Adverse Events (TEAEs)
An adverse event was defined as any untoward medical event that occurred in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. TEAEs were defined as any AE that occurred at or after the initial administration of study intervention through the day of last dose plus 30 days.
Full Information
NCT ID
NCT04062448
First Posted
August 19, 2019
Last Updated
April 19, 2023
Sponsor
Janssen Pharmaceutical K.K.
1. Study Identification
Unique Protocol Identification Number
NCT04062448
Brief Title
A Study of Ibrutinib in Combination With Rituximab, in Japanese Participants With Waldenstrom's Macroglobulinemia (WM)
Official Title
Phase 2 Study of Bruton's Tyrosine Kinase (BTK) Inhibitor, Ibrutinib (PCI-32765) in Combination With Rituximab, in Japanese Patients With Waldenstrom's Macroglobulinemia (WM)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
September 25, 2019 (Actual)
Primary Completion Date
August 24, 2021 (Actual)
Study Completion Date
March 2, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Pharmaceutical K.K.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate overall response rate (ORR) by Independent Review Committee (IRC) assessment, when combined with rituximab in Japanese participants with treatment naïve or relapsed/refractory Waldenstrom's Macroglobulinemia (WM).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Waldenstrom Macroglobulinemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ibrutinib + Rituximab
Arm Type
Experimental
Arm Description
Participants will receive ibrutinib 420 milligram (mg) orally, once daily, from Day 1 of Week 1 until disease progression or unacceptable toxicity in combination with rituximab 375 milligram per square meter (mg/m^2) intravenously (IV) on Day 1 of Weeks 1 to 4 and Weeks 17 to 20.
Intervention Type
Drug
Intervention Name(s)
Ibrutinib
Other Intervention Name(s)
PCI-32765
Intervention Description
Ibrutinib 420 mg will be administered orally.
Intervention Type
Drug
Intervention Name(s)
Rituximab
Intervention Description
Rituximab 375 mg/m^2 will be administered intravenously.
Primary Outcome Measure Information:
Title
Overall Response Rate (ORR) According to the Modified Sixth International Workshop on Waldenstrom's Macroglobulinemia (IWWM) Criteria
Description
ORR is defined as the percentage of participants achieving a best overall response of confirmed complete response (CR), very good partial response (VGPR) or partial response (PR) according to the modified sixth IWWM criteria (National Comprehensive Cancer Network [NCCN] version 2, 2019), as assessed by the Independent Review Committee (IRC). CR: Immunoglobulin M (IgM) in normal range, disappearance of monoclonal protein by immunofixation, no histologic evidence of bone marrow involvement, resolution of any adenopathy/organomegaly (if present at baseline) along with no signs or symptoms attributable to Waldenstrom's Macroglobulinemia (WM); VGPR and PR: greater than or equal to (>=) 90 percent (%) (for VGPR) and >=50% (for PR) reduction of serum IgM, decrease in adenopathy/organomegaly (if present at baseline) on physical examination or computerized tomography (CT) scan, no new symptoms or signs of active disease.
Time Frame
Up to 1 year 11 months
Secondary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
PFS was defined as duration from the date of initial dose of ibrutinib to the date of first documented evidence of disease progression or death, whichever occurred first regardless of the use of subsequent antineoplastic therapy prior to documented disease progression or death.
Time Frame
Up to 1 year 11 months
Title
Plasma Concentrations of Ibrutinib
Description
Plasma concentrations of ibrutinib were reported.
Time Frame
Day 1 of Week 4: Predose, 1 hour, 2 hours, 4 hours, and 6 hours postdose
Title
Plasma Concentrations of PCI-45227
Description
Plasma concentrations of PCI-45227 were reported.
Time Frame
Day 1 of Week 4: Predose, 1 hour, 2 hours, 4 hours, and 6 hours postdose
Title
Number of Participants With Myeloid Differentiation Primary Response Gene 88 (MYD88) Biomarker
Description
Number of participants with MYD88 biomarker were reported.
Time Frame
Day 1 of Week 1
Title
Number of Participants With C-X-C Chemokine Receptor Type 4 (CXCR-4) Biomarker
Description
Number of participants with CXCR-4 biomarker were reported.
Time Frame
Day 1 of Week 1
Title
Number of Participants With Treatment- Emergent Adverse Events (TEAEs)
Description
An adverse event was defined as any untoward medical event that occurred in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. TEAEs were defined as any AE that occurred at or after the initial administration of study intervention through the day of last dose plus 30 days.
Time Frame
Up to 1 year 11 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia (WM) in accordance with the consensus panel of the second International Workshop on Waldenstrom's Macroglobulinemia (IWWM)
Japanese participants with treatment naïve or relapsed/refractory WM
Measurable disease defined as serum monoclonal immunoglobulin M (IgM) greater than (>) 0.5 gram per deciliter (g/dL)
Symptomatic disease, requiring treatment
Eastern Cooperative Oncology Group (ECOG) performance status of less than or equal to (<=) 2
Hematology and biochemical values within protocol-defined limits
Female participants of childbearing potential must have a negative serum pregnancy test at screening and agree to use highly effective methods of contraception while taking study drug. Women of childbearing potential must be practicing a highly effective, preferably user independent method of birth control during treatment with any drug in this study and for up to 12 months after the last dose of rituximab, 1 month after last dose of ibrutinib. Male participants must use an effective barrier method of contraception during the study and after receiving the last dose of ibrutinib, and for up to 12 months after last dose of rituximab if sexually active with a female of childbearing potential
Must sign an informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study. Participants must be willing and able to adhere to the prohibitions and restrictions specified in this protocol
Must be willing and able to adhere to the lifestyle restrictions specified in this protocol
Exclusion Criteria:
Involvement of the central nervous system by WM
Prior exposure to ibrutinib or other Bruton's Tyrosine Kinase (BTK) inhibitors
Rituximab treatment within the last 12 months before the first dose of study intervention
Received any WM-related therapy <=30 days prior to first administration of study treatment
Plasmapheresis less than (<) 35 days prior to the initiation of study drug, except when at least one serum IgM central assessment was performed during the screening period and was >35 days from the most recent plasmapheresis procedure
History of other malignancies
Vaccinated with live, attenuated vaccines within 4 weeks of first dose of study drug
Infection requiring systemic treatment that was completed <=14 days before the first dose of study drug
Currently active, clinically significant Child-Pugh Class B or C hepatic impairment
Inability or difficulty swallowing capsules, malabsorption syndrome, or any disease or medical condition significantly affecting gastrointestinal function
Stroke or intracranial hemorrhage within 12 months prior to enrollment
Currently active, clinically significant cardiovascular disease
Requires treatment with a strong cytochrome P450 (CYP) 3A inhibitor
Infection with human immunodeficiency virus (HIV) or active infection with hepatitis B or hepatitis C virus
Major surgery within 4 weeks of first dose of study drug
Lactating or pregnant
Male participants who plan to father a child while enrolled in this study or within 3 months after the last dose of ibrutinib, and within 12 months after last dose of rituximab
Any contraindication to ibrutinib or rituximab including hypersensitivity to the active substance or to any of the excipients of ibrutinib or rituximab per local prescribing information
Received an investigational intervention (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before the planned first dose of study intervention or is currently enrolled in an investigational study
Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg [for example], compromise the wellbeing) or that could prevent, limit, or confound the protocol-specified assessments
Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Pharmaceutical K.K., Japan Clinical Trial
Organizational Affiliation
Janssen Pharmaceutical K.K.
Official's Role
Study Director
Facility Information:
Facility Name
Kameda General Hospital
City
Chiba
ZIP/Postal Code
296-8602
Country
Japan
Facility Name
National Cancer Center Hospital
City
Chuo-Ku
ZIP/Postal Code
104-0045
Country
Japan
Facility Name
National Hospital Organization Kumamoto Medical Center
City
Kumamoto-City
ZIP/Postal Code
860-0008
Country
Japan
Facility Name
Matsuyama Red Cross Hospital
City
Matsuyama-City
ZIP/Postal Code
790-8524
Country
Japan
Facility Name
Nagoya City University Hospital
City
Nagoya-City
ZIP/Postal Code
467-8602
Country
Japan
Facility Name
Osaka Metropolitan University Hospital
City
Osaka
ZIP/Postal Code
545-8586
Country
Japan
Facility Name
Osaka University Hospital
City
Suita-City
ZIP/Postal Code
565-0871
Country
Japan
Facility Name
National Hospital Organization Disaster Medical Center
City
Tachikawa
ZIP/Postal Code
190-0014
Country
Japan
Facility Name
University of Tsukuba Hospital
City
Tsukuba-City
ZIP/Postal Code
305-8576
Country
Japan
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The data sharing policy of the Janssen Pharmaceutical Companies of Johnson & Johnson is available at www.janssen.com/clinical trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale open Data Access (YODA) Project site at yoda.yale.edu
IPD Sharing URL
https://www.janssen.com/clinical-trials/transparency
Learn more about this trial
A Study of Ibrutinib in Combination With Rituximab, in Japanese Participants With Waldenstrom's Macroglobulinemia (WM)
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