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Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) in the Treatment of Untreated Early Non-upper Respiratory Tract or Advanced Extranodal NK/T-cell Lymphoma

Primary Purpose

NK-T-Cell Lymphoma, Extranodal

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) regimen
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 NK-T-Cell Lymphoma, Extranodal

Eligibility Criteria

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

Inclusion Criteria: 1. Voluntarily join this study and sign the informed consent form; 2. 18 years old ≤ age ≤ 75 years old; 3. Expected survival time ≥ 3 months; 4. Histopathologically confirmed early non-upper aerodigestive or advanced 5. There must be at least one evaluable or measurable lesion that meets the Lugano2014 criteria: lymph node lesions, measurable lymph nodes need to have a long diameter > 1.5cm; non-lymph node lesions, extranodal lesions that can be measured Long diameter > 1.0cm; 6. ECOG score 0-2 points; 7. Bone marrow function: neutrophil count ≥ 1.5×109/L, platelet count ≥ 75×109/L, hemoglobin ≥ 80g/L; 8. Liver and kidney function: serum creatinine ≤ 1.5 times the upper limit of the normal value; alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤ 2.5 times the upper limit of the normal value (for patients with liver invasion ≤ 5 times the normal value upper limit); total bilirubin ≤ 1.5 times the upper limit of normal value (for patients with liver invasion ≤ 3 times the upper limit of normal value). Exclusion Criteria: 1. Hypersensitivity to any study drug or its components; 2. Uncontrollable systemic diseases (such as advanced infection, uncontrollable hypertension, diabetes, etc.); 3. Cardiac function and disease meet one of the following conditions : long QTc syndrome or QTc interval >480 ms; complete left bundle branch block, second-degree or third-degree atrioventricular block; severe, uncontrolled arrhythmia requiring drug treatment ; New York Society of Cardiology ≥ Grade III; Cardiac ejection fraction (LVEF) lower than 50%; Myocardial infarction, unstable angina, and severely unstable ventricular rhythm within 6 months before recruitment History of arrhythmia or any other arrhythmia requiring treatment, history of clinically severe pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities. 4. Active hepatitis B and C infection (positive hepatitis B virus surface antigen and more than 1x103 copies/mL of hepatitis B virus DNA; more than 1x103 copies/mL of hepatitis C virus RNA); 5. Human immunodeficiency virus (HIV) infection (positive HIV antibody); 6. Previously or currently suffering from other malignant tumors (except for effectively controlled non-melanoma skin basal cell carcinoma, breast/cervix carcinoma in situ and other malignant tumors that have been effectively controlled without treatment in the past five years); 7. Central nervous system (CNS) involvement at the time of recruitment; 8. Pregnant, lactating women and patients of childbearing age who do not want to take contraceptive measures; Other investigators judge that they are not suitable for participating in this study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    P-GEMD group

    Arm Description

    Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) regimen

    Outcomes

    Primary Outcome Measures

    CRR
    Complete Response Rate

    Secondary Outcome Measures

    ORR
    Objective Response Rate
    DoR
    Duration of remission
    1 year PFS rate
    1 year PFS rate
    1 year OS rate
    1 year OS rate

    Full Information

    First Posted
    March 7, 2023
    Last Updated
    March 7, 2023
    Sponsor
    The First Affiliated Hospital with Nanjing Medical University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05774028
    Brief Title
    Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) in the Treatment of Untreated Early Non-upper Respiratory Tract or Advanced Extranodal NK/T-cell Lymphoma
    Official Title
    A Single-arm, Multi-center Phase II Clinical Study on Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) in the Treatment of Untreated Early Non-upper Respiratory Tract or Advanced Extranodal NK/T-cell Lymphoma.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    April 2023 (Anticipated)
    Primary Completion Date
    April 2024 (Anticipated)
    Study Completion Date
    April 2025 (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
    NK/T-cell lymphoma (NKTCL) is one of the most common types of extranodal lymphoma.NKTCL originates from NK cells and T lymphocytes and is highly invasive. There is a lack of efficient and specific treatment methods in clinical practice, and the prognosis is poor. The molecular heterogeneity of NKTCL is strong, and molecular typing and risk stratification are of great significance for understanding the disease and improving the curative effect.Based on the preclinical studies of mitoxantrone liposomes, the investigators put forward a hypothesis: mitoxantrone liposome injection combined with pegaspargase, gemcitabine, and dexamethasone (P-GEMD) in the treatment of early non-upper respiratory digestive tract It is safe and can improve the therapeutic effect in patients with gastric or advanced extranodal NK/T cell lymphoma.
    Detailed Description
    NK/T-cell lymphoma (NKTCL) is one of the most common types of extranodal lymphoma.NKTCL originates from NK cells and T lymphocytes and is highly invasive. There is a lack of efficient and specific treatment methods in clinical practice, and the prognosis is poor. The molecular heterogeneity of NKTCL is strong, and molecular typing and risk stratification are of great significance for understanding the disease and improving the curative effect. In the phase II clinical study of mitoxantrone liposome, 108 patients with relapsed and refractory PTCL received mitoxantrone liposome monotherapy, and the IRC evaluation ORR was 41.7% [32.3%, 51.5%] , the CR rate was 23.1% (25/108), the median PFS was 8.5 months, and the median OS was 22.8 months. The safety was tolerable and the efficacy was definite. Based on this, Mitoxantrone liposome was approved for marketing , for the treatment of adult patients with relapsed and refractory PTCL. Based on the preclinical studies of mitoxantrone liposomes, the investigators put forward a hypothesis: mitoxantrone liposome injection combined with pegaspargase, gemcitabine, and dexamethasone (P-GEMD) in the treatment of early non-upper respiratory digestive tract It is safe and can improve the therapeutic effect in patients with gastric or advanced extranodal NK/T cell lymphoma.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    NK-T-Cell Lymphoma, Extranodal

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    P-GEMD group
    Arm Type
    Experimental
    Arm Description
    Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) regimen
    Intervention Type
    Drug
    Intervention Name(s)
    Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) regimen
    Intervention Description
    P-GEMD regimen (Every 3 weeks as a cycle, a total of 6 cycles) : Pegaspargase 3750 IU, d2; Gemcitabine 1000mg/m2, d1; Etoposide 65mg/m2, d2-d4; Mitoxantrone hydrochloride liposome 12mg/m2, d1; Dexamethasone 40mg/d, d1- d4.
    Primary Outcome Measure Information:
    Title
    CRR
    Description
    Complete Response Rate
    Time Frame
    6 months
    Secondary Outcome Measure Information:
    Title
    ORR
    Description
    Objective Response Rate
    Time Frame
    6 months
    Title
    DoR
    Description
    Duration of remission
    Time Frame
    1 years
    Title
    1 year PFS rate
    Description
    1 year PFS rate
    Time Frame
    1 years
    Title
    1 year OS rate
    Description
    1 year OS rate
    Time Frame
    1 years

    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: 1. Voluntarily join this study and sign the informed consent form; 2. 18 years old ≤ age ≤ 75 years old; 3. Expected survival time ≥ 3 months; 4. Histopathologically confirmed early non-upper aerodigestive or advanced 5. There must be at least one evaluable or measurable lesion that meets the Lugano2014 criteria: lymph node lesions, measurable lymph nodes need to have a long diameter > 1.5cm; non-lymph node lesions, extranodal lesions that can be measured Long diameter > 1.0cm; 6. ECOG score 0-2 points; 7. Bone marrow function: neutrophil count ≥ 1.5×109/L, platelet count ≥ 75×109/L, hemoglobin ≥ 80g/L; 8. Liver and kidney function: serum creatinine ≤ 1.5 times the upper limit of the normal value; alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤ 2.5 times the upper limit of the normal value (for patients with liver invasion ≤ 5 times the normal value upper limit); total bilirubin ≤ 1.5 times the upper limit of normal value (for patients with liver invasion ≤ 3 times the upper limit of normal value). Exclusion Criteria: 1. Hypersensitivity to any study drug or its components; 2. Uncontrollable systemic diseases (such as advanced infection, uncontrollable hypertension, diabetes, etc.); 3. Cardiac function and disease meet one of the following conditions : long QTc syndrome or QTc interval >480 ms; complete left bundle branch block, second-degree or third-degree atrioventricular block; severe, uncontrolled arrhythmia requiring drug treatment ; New York Society of Cardiology ≥ Grade III; Cardiac ejection fraction (LVEF) lower than 50%; Myocardial infarction, unstable angina, and severely unstable ventricular rhythm within 6 months before recruitment History of arrhythmia or any other arrhythmia requiring treatment, history of clinically severe pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities. 4. Active hepatitis B and C infection (positive hepatitis B virus surface antigen and more than 1x103 copies/mL of hepatitis B virus DNA; more than 1x103 copies/mL of hepatitis C virus RNA); 5. Human immunodeficiency virus (HIV) infection (positive HIV antibody); 6. Previously or currently suffering from other malignant tumors (except for effectively controlled non-melanoma skin basal cell carcinoma, breast/cervix carcinoma in situ and other malignant tumors that have been effectively controlled without treatment in the past five years); 7. Central nervous system (CNS) involvement at the time of recruitment; 8. Pregnant, lactating women and patients of childbearing age who do not want to take contraceptive measures; Other investigators judge that they are not suitable for participating in this study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Wei XU, Doctor
    Phone
    025-68306034
    Email
    1151525490@qq.com

    12. IPD Sharing Statement

    Learn more about this trial

    Pegaspargase Combined With Gemcitabine, Etoposide, Liposomal Mitoxantrone Hydrochloride and Dexamethasone (P-GEMD) in the Treatment of Untreated Early Non-upper Respiratory Tract or Advanced Extranodal NK/T-cell Lymphoma

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