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GVM±R in Patients With Relapsed or Refractory Aggressive NHL

Primary Purpose

Non Hodgkin Lymphoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Liposomal Mitoxantrone Hydrochloride dose level 1
Liposomal Mitoxantrone Hydrochloride dose level 2
Liposomal Mitoxantrone Hydrochloride dose level 3
Liposomal Mitoxantrone Hydrochloride dose level 4
Gemcitabine
Vinorelbine
Rituximab
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Hodgkin Lymphoma focused on measuring GVM±R, liposomal mitoxantrone hydrochloride

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects fully understand and voluntarily participate in this study and sign the informed consent
  2. Age ≥18, ≤70years, no gender limitation
  3. Expected survival ≥ 3 months;
  4. Histologically confirmed diagnosis of aggressive NHL.
  5. Subjects with relapsed or refractory NHL. Relapsed disease is defined as the disease relapsing after CR or PR, and the duration of prior response is more than 6 months. Refractory disease can be confirmed if any of the following conditions are met: 1) no PR or CR has been obtained after previous treatment; 2) CR / PR was achieved after prior therapy, but recurred within 6 months; 3) Recurrence after hematopoietic stem cell transplantation.
  6. Subjects must have at least one evaluable or measurable lesion per lugano2014 criteria: for lymph node lesions, the length and diameter should be > 1.5cm; For non-lymph node lesions, the length and diameter should be > 1.0cm;
  7. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) : 0-1
  8. The following baseline laboratory criteria are required: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelet count (PLT) ≥75×109/L, Hemoglobin(HB)≥ 80g/L, Total bilirubin (TBIL) ≤1.5X upper limit of normal (ULN), Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5X ULN, Serum creatinine (Scr) ≤1.5X ULN.

Exclusion Criteria:

  1. The subject had previously received any of the following anti-tumor treatments:

    1. Subjects who have been treated with mitoxantrone or mitoxantrone liposomes;
    2. Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin was more than 360 mg/m2 (1 mg doxorubicin equivalent to 2 mg epirubicin);
    3. Subjects who received anti-tumor treatment (including chemotherapy, targeted therapy, glucocorticoid, traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received trial drugs within 4 weeks before the first administration of the study drugs;
    4. Subjects who received autologous hematopoietic stem cell transplantation or allogeneic hematopoietic stem cell transplantation within 100 days of the first administration of study drugs;
  2. Hypersensitivity to any study drug or its components;
  3. Uncontrolled systemic diseases (such as active infection, uncontrolled hypertension, diabetes, etc.)
  4. Heart function and disease meet one of the following conditions:

    1. Long QTc syndrome or QTc interval > 480 ms;
    2. Complete left bundle branch block, grade II or III atrioventricular block;
    3. Serious and uncontrolled arrhythmias requiring drug treatment;
    4. New York Heart Association grade ≥ III;
    5. Cardiac ejection fraction (LVEF)< 50%;
    6. A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment.

9. Hepatitis B and hepatitis C active infection (defined as hepatitis B virus surface antigen positive and hepatitis B virus DNA higher than 1x103 copy/mL; hepatitis C virus RNA high than 1x103 copy/mL) 10. Human immunodeficiency virus (HIV) infection (defined as HIV antibody positive) 11. Patients with other malignant tumors, except for effectively controlled non- melanoma skin basal cell carcinoma, breast/cervical carcinoma in situ or other tumors without treatment during the past 5 years.

12. Pregnant and lactating women and patients of childbearing age who are unwilling to take contraceptive measures; 13. Unsuitable subjects for this study determined by the investigator.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Liposomal mitoxantrone hydrochloride 16 mg/m^2 (with a caret included)

    Liposomal mitoxantrone hydrochloride 18 mg/m^2 (with a caret included)

    Liposomal mitoxantrone hydrochloride 20 mg/m^2 (with a caret included)

    Liposomal mitoxantrone hydrochloride 22 mg/m^2 (with a caret included)

    Arm Description

    Outcomes

    Primary Outcome Measures

    Maximum tolerated dose (MTD)
    Maximum tolerated dose (MTD) of liposomal mitoxantrone hydrochloride in GVM±R

    Secondary Outcome Measures

    Dose limited toxicities (DLTs)
    adverse events (AE) defined as DLT events per protocol
    The incidence rates of AE and SAE
    AE or severe adverse events (SAE) occur since the first dose of therapy is given
    Objective response rate (ORR)
    Response is assessed according to the lugano criteria
    Complete response rate (CRR)
    Response is assessed according to the lugano criteria
    progression-free survival(PFS)
    From the date of the first dose of therapy is given until disease progression, death or last follow-up

    Full Information

    First Posted
    March 10, 2022
    Last Updated
    March 17, 2022
    Sponsor
    Institute of Hematology & Blood Diseases Hospital, China
    Collaborators
    CSPC Ouyi Pharmaceutical Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05299164
    Brief Title
    GVM±R in Patients With Relapsed or Refractory Aggressive NHL
    Official Title
    Liposomal Mitoxantrone Hydrochloride, Gemcitabine, Vinorelbine With or Without Rituximab (GVM±R) in Patients With Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    May 15, 2022 (Anticipated)
    Primary Completion Date
    June 30, 2023 (Anticipated)
    Study Completion Date
    December 31, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Institute of Hematology & Blood Diseases Hospital, China
    Collaborators
    CSPC Ouyi Pharmaceutical Co., Ltd.

    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
    This is a prospective, dose-escalation clinical study to evaluate the safety and efficacy of GVM±R in patients with relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL).
    Detailed Description
    This is a single-arm, single-center, dose-escalation clinical study to explore the maximum tolerated dose (MTD) of liposomal mitoxantrone hydrochloride when combined with gemcitabine, vinorelbine and/or rituximab (GVM ± R) in patients with relapsed or refractory aggressive non-Hodgkin lymphoma (NHL). Liposomal mitoxantrone hydrochloride will be given on day 1 at four different doses (16 mg/m2, 18 mg/m2, 20 mg/m2,22 mg/m2) and be combined with gemcitabine, vinorelbine and/or rituximab (rituximab only in CD20+ lymphoma). The dose limited toxicity (DLT) will be evaluated after the first cycle of therapy. A maximum of 6 cycles of therapy are planned.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non Hodgkin Lymphoma
    Keywords
    GVM±R, liposomal mitoxantrone hydrochloride

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Sequential Assignment
    Model Description
    3+3 dose-escalation
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    24 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Liposomal mitoxantrone hydrochloride 16 mg/m^2 (with a caret included)
    Arm Type
    Experimental
    Arm Title
    Liposomal mitoxantrone hydrochloride 18 mg/m^2 (with a caret included)
    Arm Type
    Experimental
    Arm Title
    Liposomal mitoxantrone hydrochloride 20 mg/m^2 (with a caret included)
    Arm Type
    Experimental
    Arm Title
    Liposomal mitoxantrone hydrochloride 22 mg/m^2 (with a caret included)
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Liposomal Mitoxantrone Hydrochloride dose level 1
    Intervention Description
    Drug: Liposomal Mitoxantrone Hydrochloride 16 mg/m^2 (with a caret included) on day 1, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Liposomal Mitoxantrone Hydrochloride dose level 2
    Intervention Description
    Drug: Liposomal Mitoxantrone Hydrochloride 18 mg/m^2 (with a caret included) on day 1, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Liposomal Mitoxantrone Hydrochloride dose level 3
    Intervention Description
    Drug: Liposomal Mitoxantrone Hydrochloride 20 mg/m^2 (with a caret included) on day 1, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Liposomal Mitoxantrone Hydrochloride dose level 4
    Intervention Description
    Drug: Liposomal Mitoxantrone Hydrochloride 22 mg/m^2 (with a caret included) on day 1, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Gemcitabine
    Intervention Description
    Gemcitabine (800 mg/m^2) on day 1,8, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Vinorelbine
    Other Intervention Name(s)
    Vinorelbine injection
    Intervention Description
    Vinorelbine (25mg/m^2) on day 1,8, every 3 weeks;
    Intervention Type
    Drug
    Intervention Name(s)
    Rituximab
    Intervention Description
    Rituximab (375mg/m^2) on day 1, every 3 weeks, only used in patients with CD20+ lymphoma;
    Primary Outcome Measure Information:
    Title
    Maximum tolerated dose (MTD)
    Description
    Maximum tolerated dose (MTD) of liposomal mitoxantrone hydrochloride in GVM±R
    Time Frame
    Through the last patient complete his DLT observation, assessed up to 21 days
    Secondary Outcome Measure Information:
    Title
    Dose limited toxicities (DLTs)
    Description
    adverse events (AE) defined as DLT events per protocol
    Time Frame
    Through the last patient complete his DLT observation, assessed up to 21 days
    Title
    The incidence rates of AE and SAE
    Description
    AE or severe adverse events (SAE) occur since the first dose of therapy is given
    Time Frame
    up to 28 days after the last patient complete his study therapy
    Title
    Objective response rate (ORR)
    Description
    Response is assessed according to the lugano criteria
    Time Frame
    up to 2 years
    Title
    Complete response rate (CRR)
    Description
    Response is assessed according to the lugano criteria
    Time Frame
    up to 2 years
    Title
    progression-free survival(PFS)
    Description
    From the date of the first dose of therapy is given until disease progression, death or last follow-up
    Time Frame
    up to 2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subjects fully understand and voluntarily participate in this study and sign the informed consent Age ≥18, ≤70years, no gender limitation Expected survival ≥ 3 months; Histologically confirmed diagnosis of aggressive NHL. Subjects with relapsed or refractory NHL. Relapsed disease is defined as the disease relapsing after CR or PR, and the duration of prior response is more than 6 months. Refractory disease can be confirmed if any of the following conditions are met: 1) no PR or CR has been obtained after previous treatment; 2) CR / PR was achieved after prior therapy, but recurred within 6 months; 3) Recurrence after hematopoietic stem cell transplantation. Subjects must have at least one evaluable or measurable lesion per lugano2014 criteria: for lymph node lesions, the length and diameter should be > 1.5cm; For non-lymph node lesions, the length and diameter should be > 1.0cm; Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) : 0-1 The following baseline laboratory criteria are required: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelet count (PLT) ≥75×109/L, Hemoglobin(HB)≥ 80g/L, Total bilirubin (TBIL) ≤1.5X upper limit of normal (ULN), Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5X ULN, Serum creatinine (Scr) ≤1.5X ULN. Exclusion Criteria: The subject had previously received any of the following anti-tumor treatments: Subjects who have been treated with mitoxantrone or mitoxantrone liposomes; Previously received doxorubicin or other anthracycline treatment, and the total cumulative dose of doxorubicin was more than 360 mg/m2 (1 mg doxorubicin equivalent to 2 mg epirubicin); Subjects who received anti-tumor treatment (including chemotherapy, targeted therapy, glucocorticoid, traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received trial drugs within 4 weeks before the first administration of the study drugs; Subjects who received autologous hematopoietic stem cell transplantation or allogeneic hematopoietic stem cell transplantation within 100 days of the first administration of study drugs; Hypersensitivity to any study drug or its components; Uncontrolled systemic diseases (such as active infection, uncontrolled hypertension, diabetes, etc.) Heart function and disease meet one of the following conditions: Long QTc syndrome or QTc interval > 480 ms; Complete left bundle branch block, grade II or III atrioventricular block; Serious and uncontrolled arrhythmias requiring drug treatment; New York Heart Association grade ≥ III; Cardiac ejection fraction (LVEF)< 50%; A history of myocardial infarction, unstable angina pectoris, severe unstable ventricular arrhythmia or any other arrhythmia requiring treatment, a history of clinically serious pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities within 6 months before recruitment. 9. Hepatitis B and hepatitis C active infection (defined as hepatitis B virus surface antigen positive and hepatitis B virus DNA higher than 1x103 copy/mL; hepatitis C virus RNA high than 1x103 copy/mL) 10. Human immunodeficiency virus (HIV) infection (defined as HIV antibody positive) 11. Patients with other malignant tumors, except for effectively controlled non- melanoma skin basal cell carcinoma, breast/cervical carcinoma in situ or other tumors without treatment during the past 5 years. 12. Pregnant and lactating women and patients of childbearing age who are unwilling to take contraceptive measures; 13. Unsuitable subjects for this study determined by the investigator.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Wei Liu
    Phone
    86-022-23909282
    Email
    liuwei@ihcams.ac.cn

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    GVM±R in Patients With Relapsed or Refractory Aggressive NHL

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