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Rituximab,Methotrexate and Lenalidomide in Newly Diagnosed Primary Central Nervous System Lymphoma

Primary Purpose

Primary Central Nervous System Lymphoma

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Rituximab
Lenalidomide
Methotrexate
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Central Nervous System Lymphoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Histologically confirmed Primary Central Nervous System (CNS) lymphoma
  2. Age range 18-75 years old.
  3. Eastern Cooperative Oncology Group performance status 0 to 3, 4 maybe allowed in special conditions .
  4. Previously untreated. Patients treated with steroid alone are eligible.
  5. Patient's who are not planned to undergo consolidation with autologous hematopoietic stem cell transplantation(HSCT).
  6. Measurable disease was defined as at least ≥1.0cm in short-diameter by MRI.
  7. Life expectancy of ≥ 3 months (in the opinion of the investigator).
  8. Participants must be able to understand and be willing to sign a written informed consent document.
  9. Women of reproductive potential must agree to use highly effective methods of birth control during the period of therapy and for 6 months after the last dose of the study drug. Men who are sexually active must agree to use highly effective contraception during the period of therapy and for 6 months after the last dose.
  10. Women of childbearing potential must have a negative plasma pregnancy test upon study entry.
  11. Adequate renal function: Estimated glomerular filtration rate (GFR) or estimated creatinine clearance (CrCl) ≥ 50 mL/min;Serum creatinine ≤ 2 times the upper limit of normal.
  12. Adequate liver functions: Transaminase (AST/ALT) < 3 X upper normal value & Bilirubin < 2 X upper normal value.
  13. Adequate hematological function: hemoglobin ≥ 9 g/dL absolute neutrophil count (ANC) ≥ 1,500/μL and platelet count ≥ 75,000/μL.

Exclusion Criteria:

  1. Patient with systemic, non-CNS lymphoma metastatic to the CNS.
  2. Patient is concurrently using other approved or investigational antineoplastic agents.
  3. Presence of active hepatitis B virus(HBV) infection (HBsAg positive and HBV-DNA≥ 104), hepatitis C virus(HCV) infection, acquired and congenital immunodeficiency diseases include but not limited to HIV.
  4. Patient is allergic to components of the study drug.
  5. Patient has an active concurrent malignancy requiring active therapy.
  6. Patient has significant abnormalities on screening electrocardiogram (EKG) and active and significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, uncontrolled congestive heart failure, uncontrolled hypertension, valvular disease, pericarditis, or myocardial infarction within 6 months of screening.
  7. Patient is known to have an uncontrolled active systemic infection.
  8. Patient has a life-threatening illness, medical condition, or organ system dysfunction that, in the opinion of the investigator, could compromise the subject's safety or put the study outcomes at undue risk.
  9. Women who are pregnant or nursing (lactating), where pregnancy is defined as a state of a female after conception until the termination of gestation, confirmed by a positive plasma human chorionic gonadotropin(hCG) laboratory test of > 5 mIU/mL.
  10. The patient is unwell or unable to participate in all required study evaluations and procedures.
  11. Drug abuse, medical, psychological or social conditions which may interfering with subjects' participation in the study or evaluation of the results.
  12. Patients considered unsuitable to participate in the study by the researchers.

Sites / Locations

  • 2nd Affiliated Hospital, School of Medicine, Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

R2-MTX

Arm Description

Experimental arm will be treated with R2-MTX regimen(Lenalidomide plus Rituximab and Methotrexate) for 6 cycles as initiate induction.If the patients achieved complete remission(CR)or partial remission(PR)with additional whole-brain radiotherapy(WBRT), they processed to R2 maintenance(Lenalidomide plus Rituximab) for 4 cycles.

Outcomes

Primary Outcome Measures

Objective response rate(ORR)
The objective response rate is defined as the proportion of patients with a response of complete response(CR) or partial response(PR).

Secondary Outcome Measures

Progression free survival
From date of patients sign informed consent until the date of progression or death or the date of last follow-up time, whichever came first, assessed up to 3 years
Overall survival
From date of patients sign informed consent until the date of death or the date of last follow-up time, whichever came first, assessed up to 3 years
Treatment-related adverse events
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Full Information

First Posted
June 14, 2021
Last Updated
November 18, 2022
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT04934579
Brief Title
Rituximab,Methotrexate and Lenalidomide in Newly Diagnosed Primary Central Nervous System Lymphoma
Official Title
Efficacy and Safety Study of Rituximab, Methotrexate and Lenalidomide Chemotherapy(R2-MTX) in Newly Diagnosed Primary Central Nervous System Lymphoma:a Single Arm, Multicenter, Phase 2 Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
January 1, 2020 (Actual)
Primary Completion Date
October 15, 2022 (Actual)
Study Completion Date
November 15, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
It is a single arm, multicenter, phase 2 study to explore the efficacy and safety study of R2-MTX chemotherapy(Lenalidomide, Rituximab and Methotrexate)as first-line regimens in the treatment of newly diagnosed primary central nervous system lymphoma. Objective response rate is the primary endpoint.
Detailed Description
This is a single arm, multicenter, phase 2 study designed to evaluate the efficacy and safety of rituximab, methotrexate and lenalidomide as first-line regimens in the treatment of newly primary central nervous system lymphoma. A total of 40 patients plan to participate in this study to receive a total 6 cycles of induction chemotherapy followed by 4 cycles of maintenance chemotherapy. Follow-ups should be taken up to the first 3 years. The primary endpoint is objective response rate (ORR) and secondary endpoint includes Progression free survival (PFS), overall survival (OS), and adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Central Nervous System Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
R2-MTX
Arm Type
Experimental
Arm Description
Experimental arm will be treated with R2-MTX regimen(Lenalidomide plus Rituximab and Methotrexate) for 6 cycles as initiate induction.If the patients achieved complete remission(CR)or partial remission(PR)with additional whole-brain radiotherapy(WBRT), they processed to R2 maintenance(Lenalidomide plus Rituximab) for 4 cycles.
Intervention Type
Drug
Intervention Name(s)
Rituximab
Intervention Description
375mg/m2 intravenous infusion d1, every 3 weeks for 1 cycle, 6 cycles will be prescribed for induction therapy. 375mg/m2 intravenous infusion d1, every 8 weeks for 1 cycle, 4 cycles will be prescribed for maintenance therapy.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Intervention Description
25mg orally d1-10 every 3 weeks for 1 cycle, 6 cycles will be prescribed for induction therapy. 25mg orally d1-14,d29-42 every 8 weeks for 1 cycle, 4 cycles will be prescribed for maintenance therapy.
Intervention Type
Drug
Intervention Name(s)
Methotrexate
Intervention Description
3.5g/m2 intravenous infusion for 4 hours in d1, every 21 days for 1 cycle, 6 cycles will be prescribed.
Primary Outcome Measure Information:
Title
Objective response rate(ORR)
Description
The objective response rate is defined as the proportion of patients with a response of complete response(CR) or partial response(PR).
Time Frame
At the end of Cycle 6 chemotherapy (each cycle is 21 days), assessed up to 18 weeks.
Secondary Outcome Measure Information:
Title
Progression free survival
Description
From date of patients sign informed consent until the date of progression or death or the date of last follow-up time, whichever came first, assessed up to 3 years
Time Frame
3 years
Title
Overall survival
Description
From date of patients sign informed consent until the date of death or the date of last follow-up time, whichever came first, assessed up to 3 years
Time Frame
3 years
Title
Treatment-related adverse events
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed Primary Central Nervous System (CNS) lymphoma Age range 18-75 years old. Eastern Cooperative Oncology Group performance status 0 to 3. Previously untreated. Patients treated with steroid alone are eligible. Patient's who are not planned to undergo consolidation with autologous hematopoietic stem cell transplantation(HSCT). Measurable disease was defined as at least ≥1.0cm in short-diameter by MRI. Life expectancy of ≥ 3 months (in the opinion of the investigator). Participants must be able to understand and be willing to sign a written informed consent document. Women of reproductive potential must agree to use highly effective methods of birth control during the period of therapy and for 6 months after the last dose of the study drug. Men who are sexually active must agree to use highly effective contraception during the period of therapy and for 6 months after the last dose. Women of childbearing potential must have a negative plasma pregnancy test upon study entry. Adequate renal function: Estimated glomerular filtration rate (GFR) or estimated creatinine clearance (CrCl) ≥ 50 mL/min;Serum creatinine ≤ 2 times the upper limit of normal. Adequate liver functions: Transaminase (AST/ALT) < 3 X upper normal value & Bilirubin < 2 X upper normal value. Adequate hematological function: hemoglobin ≥ 9 g/dL absolute neutrophil count (ANC) ≥ 1,500/μL and platelet count ≥ 75,000/μL. Exclusion Criteria: Patient with systemic, non-CNS lymphoma metastatic to the CNS. Patient is concurrently using other approved or investigational antineoplastic agents. Presence of active hepatitis B virus(HBV) infection (HBsAg positive and HBV-DNA≥ 104), hepatitis C virus(HCV) infection, acquired and congenital immunodeficiency diseases include but not limited to HIV. Patient is allergic to components of the study drug. Patient has an active concurrent malignancy requiring active therapy. Patient has significant abnormalities on screening electrocardiogram (EKG) and active and significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, uncontrolled congestive heart failure, uncontrolled hypertension, valvular disease, pericarditis, or myocardial infarction within 6 months of screening. Patient is known to have an uncontrolled active systemic infection. Patient has a life-threatening illness, medical condition, or organ system dysfunction that, in the opinion of the investigator, could compromise the subject's safety or put the study outcomes at undue risk. Women who are pregnant or nursing (lactating), where pregnancy is defined as a state of a female after conception until the termination of gestation, confirmed by a positive plasma human chorionic gonadotropin(hCG) laboratory test of > 5 mIU/mL. The patient is unwell or unable to participate in all required study evaluations and procedures. Drug abuse, medical, psychological or social conditions which may interfering with subjects' participation in the study or evaluation of the results. Patients considered unsuitable to participate in the study by the researchers.
Facility Information:
Facility Name
2nd Affiliated Hospital, School of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310009
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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Rituximab,Methotrexate and Lenalidomide in Newly Diagnosed Primary Central Nervous System Lymphoma

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