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Genotype-guided Treatment in PTCL (THEORY)

Primary Purpose

Peripheral T Cell Lymphoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
CHOP+selinexor+5-Azacitidine
CHOP+duvelisib+5-Azacitidine
CHOP+chidamide+tislelizumab
Sponsored by
Ruijin Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral T Cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria: Histologically-confirmed Peripheral T-cell lymphoma Availability of archival or freshly collected tumor tissue before study enrollment Evaluable lesion by PET-CT or CT scan Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2 Life expectancy greater than or equal to (>/=) 3 months Informed consent Exclusion Criteria: Patients with central nervous system (CNS) lymphoma History of malignancies except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix Uncontrolled cardio- and cerebro-vascular disease, blood clotting disorders, connective tissue diseases, serious infectious diseases and other diseases Laboratory measures meet the following criteria at screening (unless caused by lymphoma): Neutrophils<1.0×10^9/L Platelets<75×10^9/L (Platelets<50×10^9/L in case of bone marrow involvement) ALT or AST is 2.5 times higher than the upper limits of normal (ULN), AKP and bilirubin are 1.5 times higher than the ULN. Creatinine is 1.5 times higher than the ULN. HIV-infected patients Active hepatitis infection Patients with psychiatric disorders or patients who are known or suspected to be unable to fully comply with the study protocol Pregnant or lactation Other medical conditions determined by the researchers that may affect the study For T3 should exclude patiens with active autoimmune disease

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    CHOP+selinexor+5-Azacitidine

    CHOP+duvelisib+5-Azacitidine

    CHOP+chidamide+tislelizumab

    Arm Description

    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and selinexor 40mg or 60mg in phase I triaI on days d1,d8 while selinexor RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.

    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and duvelisib 25mg or 50mg in phase I triaI on days d1-21 while duvelisib RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.

    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive tislelizumab 200mg d1 ivgtt and chidamide 20mg or 30mg po in phase I triaI biw while chidamide RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.

    Outcomes

    Primary Outcome Measures

    complete response rate
    Percentage of participants with complete response was determined on the basis of investigator assessments according to 2014 Lugano criteria.

    Secondary Outcome Measures

    Progression-free survival
    Progression-free survival was defined as the time from the date of randomization until the date of the first documented day of disease progression or relapse, using 2014 Lugano criteria, or death from any cause, whichever occurred first.
    Overall survival
    Overall survival was defined as the time from the date of randomization to the date of death from any cause.
    Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v5.0
    An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.

    Full Information

    First Posted
    December 29, 2022
    Last Updated
    December 29, 2022
    Sponsor
    Ruijin Hospital
    Collaborators
    Peking University People's Hospital, Sun Yat-sen University, Tongji Hospital, West China Hospital, Nanfang Hospital, Southern Medical University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05675813
    Brief Title
    Genotype-guided Treatment in PTCL
    Acronym
    THEORY
    Official Title
    T-cell Lymphoma Series:A Genotype-guided Therapy in Newly Diagnosed Patients With Peripheral T-cell Lymphoma (THEORY Study)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    January 15, 2023 (Anticipated)
    Primary Completion Date
    December 15, 2024 (Anticipated)
    Study Completion Date
    December 15, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Ruijin Hospital
    Collaborators
    Peking University People's Hospital, Sun Yat-sen University, Tongji Hospital, West China Hospital, Nanfang Hospital, Southern Medical University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    A multicenter, prospective, randomized, open-label, controlled trial to evaluate the efficacy and safety of genotype-guided targeted agents plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP-X2) versus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with peripheral T-cell lymphoma.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    264 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CHOP+selinexor+5-Azacitidine
    Arm Type
    Experimental
    Arm Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and selinexor 40mg or 60mg in phase I triaI on days d1,d8 while selinexor RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Arm Title
    CHOP+duvelisib+5-Azacitidine
    Arm Type
    Experimental
    Arm Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and duvelisib 25mg or 50mg in phase I triaI on days d1-21 while duvelisib RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Arm Title
    CHOP+chidamide+tislelizumab
    Arm Type
    Experimental
    Arm Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive tislelizumab 200mg d1 ivgtt and chidamide 20mg or 30mg po in phase I triaI biw while chidamide RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Intervention Type
    Drug
    Intervention Name(s)
    CHOP+selinexor+5-Azacitidine
    Intervention Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and selinexor 40mg or 60mg in phase I triaI on days d1,d8 while selinexor RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Intervention Type
    Drug
    Intervention Name(s)
    CHOP+duvelisib+5-Azacitidine
    Intervention Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive 5-Azacitidine ih d-7-d-1 and duvelisib 25mg or 50mg in phase I triaI on days d1-21 while duvelisib RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Intervention Type
    Drug
    Intervention Name(s)
    CHOP+chidamide+tislelizumab
    Intervention Description
    Patients in this arm will receive cyclophosphamide 750 mg/m² IV, doxorubicin 50 mg/m² IV, and vincristine 1.4 mg/m² IV (maximum 2 mg) on day 1, and prednisone 100 mg/day PO on days 1-5 of every 21-day cycle for the first cycle. For the remaining 5 cycles, they will receive tislelizumab 200mg d1 ivgtt and chidamide 20mg or 30mg po in phase I triaI biw while chidamide RP2D po in phase II trial followed by standard CHOP of every 21-day cycle.
    Primary Outcome Measure Information:
    Title
    complete response rate
    Description
    Percentage of participants with complete response was determined on the basis of investigator assessments according to 2014 Lugano criteria.
    Time Frame
    End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days]
    Secondary Outcome Measure Information:
    Title
    Progression-free survival
    Description
    Progression-free survival was defined as the time from the date of randomization until the date of the first documented day of disease progression or relapse, using 2014 Lugano criteria, or death from any cause, whichever occurred first.
    Time Frame
    Baseline up to data cut-off (up to approximately 2 years)
    Title
    Overall survival
    Description
    Overall survival was defined as the time from the date of randomization to the date of death from any cause.
    Time Frame
    Baseline up to data cut-off (up to approximately 2 years)
    Title
    Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v5.0
    Description
    An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
    Time Frame
    From enrollment to study completion, a maximum of 4 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: Histologically-confirmed Peripheral T-cell lymphoma Availability of archival or freshly collected tumor tissue before study enrollment Evaluable lesion by PET-CT or CT scan Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2 Life expectancy greater than or equal to (>/=) 3 months Informed consent Exclusion Criteria: Patients with central nervous system (CNS) lymphoma History of malignancies except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix Uncontrolled cardio- and cerebro-vascular disease, blood clotting disorders, connective tissue diseases, serious infectious diseases and other diseases Laboratory measures meet the following criteria at screening (unless caused by lymphoma): Neutrophils<1.0×10^9/L Platelets<75×10^9/L (Platelets<50×10^9/L in case of bone marrow involvement) ALT or AST is 2.5 times higher than the upper limits of normal (ULN), AKP and bilirubin are 1.5 times higher than the ULN. Creatinine is 1.5 times higher than the ULN. HIV-infected patients Active hepatitis infection Patients with psychiatric disorders or patients who are known or suspected to be unable to fully comply with the study protocol Pregnant or lactation Other medical conditions determined by the researchers that may affect the study For T3 should exclude patiens with active autoimmune disease
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Weili Zhao
    Phone
    +862164370045
    Ext
    610707
    Email
    zwl_trial@163.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Pengpeng Xu
    Phone
    +862164370045
    Ext
    610707
    Email
    pengpeng_xu@126.com

    12. IPD Sharing Statement

    Learn more about this trial

    Genotype-guided Treatment in PTCL

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