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GOAL: GA101 Plus Pixantrone for Relapsed Aggressive Lymphoma

Primary Purpose

Lymphoma, Non-Hodgkin

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Obinutuzumab and Pixantrone
Sponsored by
Johannes Gutenberg University Mainz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma, Non-Hodgkin focused on measuring Diffuse large B-cell lymphoma, Follicular lymphoma, Transformed indolent lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Patients aged ≥ 18 years
  • Histologically proven diagnosis of diffuse large cell B-cell lymphoma (DLBCL), follicular lymphoma (FL) IIIB or transformed indolent lymphoma according to the World Health Organization classification (central pathology review)
  • Relapsed disease
  • Eastern Cooperative Oncology Group (ECOG) performance Status ≤2, unless tumor associated
  • Adequate cardiac reserve: Serum Troponin level must be consistent with no significant acute or chronic myocardial damage and there should be no evidence of symptomatic disease
  • No curative option available
  • At least 1 measurable tumor mass (>1.5 cm x >1.0 cm) or bone marrow infiltration
  • Adequate bone marrow (BM) reserve: Platelets of at least 100.000/µl (in case of extensive BM-infiltration 75.000/µl may be acceptable after discussion with the coordinating investigator), absolute neutrophil count of at least 1000/µl. Adequate hepatic and renal function: Alanine aminotransferase <2.5 x upper limit of normal (ULN); Aspartate aminotransferase <2.5 x ULN, total bilirubin <1.5 x ULN
  • No active Hepatitis B or C or HIV-infection
  • Measured or calculated creatinine clearance >30 mL/min
  • Fresh tumor biopsy or archived tissue available
  • Ability of patients to understand nature, importance and individual consequences of clinical trial.
  • Signed informed consent
  • Women post-menopausal for more than two years can participate in the trial. Women with childbearing potential can only participate, if they are surgically sterile or a negative pregnancy test (serum or urine) is available before trial and they are willing to practice a highly effective and medically accepted contraception method during trial and for a period of 18 months post-treatment. Reliable contraception comprises systematic contraceptives (oral, implant, injection) or diaphragm / condoms / intrauterine devices (IUP) with spermicide.
  • Male patients are advised to use contraceptive methods (preferably barrier) during treatment and for a period of 6 months post-treatment

Exclusion Criteria:

  • Lymphoma other than DLBCL, FL IIIB, transformed indolent Non-Hodgkin's lymphoma (NHL)
  • Central nervous System (CNS) involvement (brain MRI (Magnetic resonance Imaging) is required only in cases of clinically suspicious involvement)
  • Pregnant or breast-feeding women
  • Severe concomitant disease (e.g. uncontrolled arterial hypertension, heart failure (NYHA III-IV), uncontrolled diabetes mellitus, pulmonary fibrosis, uncontrolled hyperlipoproteinaemia)
  • Myocardial infarction within the last 6 months
  • Active uncontrolled infections including HIV-positivity, active Hepatitis B or C
  • Vaccination with live vaccine within last 4 weeks
  • Mental status precluding patient's compliance
  • Known CD20 negativity
  • Diagnosed or treated for a malignancy other than NHL except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, Ductal Carcinoma in Situ (DCIS) of the breast, or other solid tumors curatively treated with no evidence of disease for >3 years, or prostate cancer with a life expectancy of more than 2 years
  • Treatment with any approved anticancer agent within last 2 weeks. Any agents must have been stopped at least 2 weeks prior to day 1 of GOAL treatment and all treatment related adverse events must have returned to Grade 1.
  • Prior exposition to Obinutuzumab or Pixantrone
  • History of hypersensitivity to medicinal products with similar chemical structure as the trial medication
  • Active participation in other interventional clinical trials during the present clinical trial or within the last 2 weeks prior to treatment initiation. Concurrent participation in non-treatment studies is not excluded
  • Medical or psychological conditions that would jeopardize an adequate and orderly completion of the trial.

Sites / Locations

  • Department of Hematology, Oncology and Pneumology; University Medical Center of the Johannes Gutenberg-University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Obinutuzumab and Pixantrone

Arm Description

Obinutuzumab: 1000 mg flat dose on day 1, 8, 15 of cycle one and day 1 of subsequent cycles Pixantrone: 50 mg/m² Pixantrone on day 1,8,15 of each 28 d cycle

Outcomes

Primary Outcome Measures

Objective overall response rate (ORR) after six treatment cycles or the individual end of treatment
The response to treatment is measured by results of computer tomography (CT) for measurable lesions and evaluation for non-measurable lesions after cycle 6 or at the individual end of treatment.

Secondary Outcome Measures

Safety of the combination treatment as measured by the rate of adverse events, which reflects tolerability of the treatment.
rate of adverse events
Percentage of patients completing the entire trial treatment
Percentage of patients completing the entire trial treatment
Evaluation of best response to trial treatment as measured as best response either during or post the entire treatment
best response either during or post the entire treatment
Progression free survival
Progression-free survival rate: The time from first intake/dose of trial medication to first documentation of objective tumor progression or to death due to any cause, whichever occurs first.
Overall survival
2-year survival: rate of patients surviving for at least two years after first intake/dose of trial medication. Median overall survival: the time between first applications of trial medication to date of death of half of the patients due to any cause
Overall response rate (ORR) in separate germinal-center B-cell-like (GCB)- vs. non GCB-analysis (gene expression profiling (GEP))
Overall response rate (ORR) in separate germinal-center B-cell-like (GCB)- vs. non GCB-analysis (gene expression profiling (GEP))

Full Information

First Posted
July 6, 2015
Last Updated
March 30, 2022
Sponsor
Johannes Gutenberg University Mainz
Collaborators
Roche Pharma AG, Servier
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1. Study Identification

Unique Protocol Identification Number
NCT02499003
Brief Title
GOAL: GA101 Plus Pixantrone for Relapsed Aggressive Lymphoma
Official Title
The GOAL Trial: Rescue Treatment With the Monoclonal Anti CD20-antibody Obinutuzumab (GA101) in Combination With Pixantrone for the Treatment of Patients With Relapsed Aggressive B-cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
August 14, 2015 (Actual)
Primary Completion Date
January 2, 2019 (Actual)
Study Completion Date
January 2, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Johannes Gutenberg University Mainz
Collaborators
Roche Pharma AG, Servier

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the overall response rate of Obinutuzumab (GA101) in combination with Pixantrone in patients with relapsed aggressive B-cell lymphoma. 70 patients with diffuse large B-cell lymphoma, follicular lymphoma grade IIIB or transformed indolent lymphoma will receive up to 6 cycles of the described combination regimen. Follow up visits are scheduled for up to 3 years.
Detailed Description
In patients with multiple relapsed aggressive lymphoma or refractory lymphoma life expectancy is short. Without potent treatment options the remaining life span can be measured in weeks to a few months. Recently, an increasing number of reports have shown that either single agent use or the incorporation of potentially more potent agents or new approaches aiming at the inhibition of lymphoma specific pathways may help to overcome the current stagnation in the improvement of first and second line therapies. Surprisingly, little efforts have been undertaken to identify optimal standard dose backbone regimens based on currently available and novel drugs, which ideally would combine activity with reasonable safety and tolerability which allows the addition of targeted drugs in the future. Therefore this trial aims to test prospectively one potential combination to evaluate its potency in patients not suitable for intensive treatment. Obinutuzumab is an anti-CD20 monoclonal antibody which has shown clinical efficacy even in patients failing Rituximab pre-treatment and therefore is an attractive combination partner within chemo-immunotherapy regimen. Pixantrone belongs to the most potent class of cytostatic drugs for the treatment of lymphoma. Given the proven efficacy of both drugs in relapsed aggressive lymphoma as well as the side effect profiles of both drugs, combination treatment seems sufficiently safe and promises significant efficacy. This is a multicenter, prospective, open-label, non-randomized trial to evaluate the overall response rate of Obinutuzumab (GA101) in combination with Pixantrone in patients with relapsed aggressive B-cell lymphoma. The trial consists of a 28-days screening period, a treatment-period of up to 6 cycles of the combination regiment, including an interim staging prior to cycle 4 and an end of treatment visit 4-6 weeks after the last study-medication application. The response to treatment is measured by results of computer tomography (CT) after cycle 6 or at the individual end of treatment. Structured follow up visits are scheduled for 2 years, afterwards patients will be followed for survival and progression via a simplified survey until the end of the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Non-Hodgkin
Keywords
Diffuse large B-cell lymphoma, Follicular lymphoma, Transformed indolent 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
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Obinutuzumab and Pixantrone
Arm Type
Experimental
Arm Description
Obinutuzumab: 1000 mg flat dose on day 1, 8, 15 of cycle one and day 1 of subsequent cycles Pixantrone: 50 mg/m² Pixantrone on day 1,8,15 of each 28 d cycle
Intervention Type
Drug
Intervention Name(s)
Obinutuzumab and Pixantrone
Other Intervention Name(s)
GA101 /Gazyvaro, Pixuvri
Intervention Description
Obinutuzumab: 1000 mg flat dose on day 1, 8, 15 of cycle one and day 1 of subsequent cycles, Pixantrone: 50 mg/m² Pixantrone on day 1,8,15 of each 28 d cycle
Primary Outcome Measure Information:
Title
Objective overall response rate (ORR) after six treatment cycles or the individual end of treatment
Description
The response to treatment is measured by results of computer tomography (CT) for measurable lesions and evaluation for non-measurable lesions after cycle 6 or at the individual end of treatment.
Time Frame
30 weeks
Secondary Outcome Measure Information:
Title
Safety of the combination treatment as measured by the rate of adverse events, which reflects tolerability of the treatment.
Description
rate of adverse events
Time Frame
30 weeks
Title
Percentage of patients completing the entire trial treatment
Description
Percentage of patients completing the entire trial treatment
Time Frame
30 weeks
Title
Evaluation of best response to trial treatment as measured as best response either during or post the entire treatment
Description
best response either during or post the entire treatment
Time Frame
30 weeks
Title
Progression free survival
Description
Progression-free survival rate: The time from first intake/dose of trial medication to first documentation of objective tumor progression or to death due to any cause, whichever occurs first.
Time Frame
up to 3 years
Title
Overall survival
Description
2-year survival: rate of patients surviving for at least two years after first intake/dose of trial medication. Median overall survival: the time between first applications of trial medication to date of death of half of the patients due to any cause
Time Frame
up to 3 years
Title
Overall response rate (ORR) in separate germinal-center B-cell-like (GCB)- vs. non GCB-analysis (gene expression profiling (GEP))
Description
Overall response rate (ORR) in separate germinal-center B-cell-like (GCB)- vs. non GCB-analysis (gene expression profiling (GEP))
Time Frame
30 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients aged ≥ 18 years Histologically proven diagnosis of diffuse large cell B-cell lymphoma (DLBCL), follicular lymphoma (FL) IIIB or transformed indolent lymphoma according to the World Health Organization classification (central pathology review) Relapsed disease Eastern Cooperative Oncology Group (ECOG) performance Status ≤2, unless tumor associated Adequate cardiac reserve: Serum Troponin level must be consistent with no significant acute or chronic myocardial damage and there should be no evidence of symptomatic disease No curative option available At least 1 measurable tumor mass (>1.5 cm x >1.0 cm) or bone marrow infiltration Adequate bone marrow (BM) reserve: Platelets of at least 100.000/µl (in case of extensive BM-infiltration 75.000/µl may be acceptable after discussion with the coordinating investigator), absolute neutrophil count of at least 1000/µl. Adequate hepatic and renal function: Alanine aminotransferase <2.5 x upper limit of normal (ULN); Aspartate aminotransferase <2.5 x ULN, total bilirubin <1.5 x ULN No active Hepatitis B or C or HIV-infection Measured or calculated creatinine clearance >30 mL/min Fresh tumor biopsy or archived tissue available Ability of patients to understand nature, importance and individual consequences of clinical trial. Signed informed consent Women post-menopausal for more than two years can participate in the trial. Women with childbearing potential can only participate, if they are surgically sterile or a negative pregnancy test (serum or urine) is available before trial and they are willing to practice a highly effective and medically accepted contraception method during trial and for a period of 18 months post-treatment. Reliable contraception comprises systematic contraceptives (oral, implant, injection) or diaphragm / condoms / intrauterine devices (IUP) with spermicide. Male patients are advised to use contraceptive methods (preferably barrier) during treatment and for a period of 6 months post-treatment Exclusion Criteria: Lymphoma other than DLBCL, FL IIIB, transformed indolent Non-Hodgkin's lymphoma (NHL) Central nervous System (CNS) involvement (brain MRI (Magnetic resonance Imaging) is required only in cases of clinically suspicious involvement) Pregnant or breast-feeding women Severe concomitant disease (e.g. uncontrolled arterial hypertension, heart failure (NYHA III-IV), uncontrolled diabetes mellitus, pulmonary fibrosis, uncontrolled hyperlipoproteinaemia) Myocardial infarction within the last 6 months Active uncontrolled infections including HIV-positivity, active Hepatitis B or C Vaccination with live vaccine within last 4 weeks Mental status precluding patient's compliance Known CD20 negativity Diagnosed or treated for a malignancy other than NHL except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, Ductal Carcinoma in Situ (DCIS) of the breast, or other solid tumors curatively treated with no evidence of disease for >3 years, or prostate cancer with a life expectancy of more than 2 years Treatment with any approved anticancer agent within last 2 weeks. Any agents must have been stopped at least 2 weeks prior to day 1 of GOAL treatment and all treatment related adverse events must have returned to Grade 1. Prior exposition to Obinutuzumab or Pixantrone History of hypersensitivity to medicinal products with similar chemical structure as the trial medication Active participation in other interventional clinical trials during the present clinical trial or within the last 2 weeks prior to treatment initiation. Concurrent participation in non-treatment studies is not excluded Medical or psychological conditions that would jeopardize an adequate and orderly completion of the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Georg Hess, MD
Organizational Affiliation
Johannes Gutenberg University Mainz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Hematology, Oncology and Pneumology; University Medical Center of the Johannes Gutenberg-University
City
Mainz
State/Province
RLP
ZIP/Postal Code
55131
Country
Germany

12. IPD Sharing Statement

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GOAL: GA101 Plus Pixantrone for Relapsed Aggressive Lymphoma

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