Ibrutinib With Rituximab in Adults With Waldenström's Macroglobulinemia
Waldenström's Macroglobulinemia
About this trial
This is an interventional treatment trial for Waldenström's Macroglobulinemia focused on measuring Ibrutinib, Pharmacyclics, PCYC, Lymphoma, Btk inhibitor, WM, Rituximab, Rituxan, Waldenström's, Waldenstrom Macroglobulinemia, non-Hodgkin lymphoma, NHL
Eligibility Criteria
Eligibility Criteria for the Randomized Study
Inclusion Criteria:
- Untreated or previously treated for WM. Previously treated subjects must have either documented disease progression or had no response (stable disease) to the most recent treatment regimen
- Centrally confirmed clinicopathological diagnosis of WM
- Measurable disease defined as serum monoclonal immunoglobulin M (IgM) >0.5 g/dL
- Symptomatic disease meeting at least 1 of the recommendations from the Second International Workshop on Waldenström Macroglobulinemia for requiring treatment
- Hematology and biochemical values within protocol-defined limits
- Men and women ≥ 18 years of age
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
Exclusion Criteria:
- Known involvement of the central nervous system by WM
Disease that is refractory to the last prior rituximab-containing therapy defined as either
- Relapse after the last rituximab-containing therapy < 12 months since last dose of rituximab, OR
- Failure to achieve at least a minor response (MR) after the last rituximab-containing therapy If the subject meets this exclusion criterion and therefore is excluded from the main randomized study, participation in the non randomized substudy (Arm C) may be considered
- Rituximab treatment within the last 12 months before the first dose of study drug
- Known anaphylaxis or (immunoglobulin E) IgE-mediated hypersensitivity to murine proteins or to any component of rituximab
- Prior exposure to ibrutinib or other Bruton's tyrosine kinase (BTK) inhibitors
- Known bleeding disorders (eg, von Willebrand's disease) or hemophilia
- History of stroke or intracranial hemorrhage within 12 months prior to enrollment.
- Any uncontrolled active systemic infection.
- Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator's opinion, could compromise the subject's safety or put the study outcomes at undue risk.
- Currently active, clinically significant cardiovascular disease
- Requires treatment with a strong cytochrome P450 (CYP) 3A inhibitor
Eligibility Criteria for Open-label Substudy Treatment Arm C
The inclusion/exclusion criteria for the substudy (Arm C) are identical to those described above for the randomized study but, to be eligible, subjects need to be considered refractory to the last prior rituximab-containing therapy defined as either
- Relapse after the last rituximab-containing therapy <12 months since last dose of rituximab, OR
- Failure to achieve at least a MR after the last rituximab-containing therapy.
Sites / Locations
- University of California Los Angeles
- Stanford Cancer Center
- Colorado Blood Cancer Institute
- Emory University Hospital
- Northwestern Memorial Hospital
- Dana Farber Cancer Institute
- Hackensack University Medical Center
- Memorial Sloan Kettering Cancer Center
- Weill Cornell Medical Center
- Vanderbilt University Medical Center
- The Canberra Hospital
- Concord Repartriation General Hospital
- Flinders Medical Center
- Peter MacCallum Cancer Center
- Cross Cancer Institute
- Queen Elizabeth II Health Sciences Center
- Princess Margaret Hospital
- McGill University Health Center
- Institut Paoli-Calmettes
- Centre Hospitalier de Saint Brieuc Hopital Yves le Foll
- Hôtel Dieu
- CHU de Nancy-Hopital Brabois Adulte
- Hôpital Claude Huriez
- CHU Estaing
- Centre Hospitalier Lyon Sud
- Hopital Henri Mondor
- Hôpital Saint Louis
- Groupe Hospitalier Pitié Salpétrière
- Stauferklinikum Schwäbisch Gmünd
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz
- Universität Des Saarlandes
- DIAKO Evangelische Diakonie Krankenhaus gGmbH
- LMU Klinikum der Universität München
- University General Hospital of Patras
- Alexandra Hospital
- University General Hospital of Thessaloniki "AHEPA"
- Laiko General Hospital of Athens
- Azienda Ospedaliera Città della Salute e della Scienza di Torino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico
- ASST Grande Ospedale Metropolitano Niguarda
- ASST di Pavia - Fondazione IRCCS Policlinico San Matteo di Pavia
- Azienda Ospedaliero Universitaria Santa Maria della Misericordia di Udine
- Hospital Universitari Germans Trias i Pujol
- Hospital Universitario de Salamanca
- Hospital Clinic de Barcelona
- Hospital de La Santa Creu i Sant Pau
- Hospital Universitario Infanta Leonor
- Royal Bournemouth Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Randomized Study (Ibrutinib + Rituximab)
Randomized Study (Placebo + Rituximab)
Open-Label Substudy (Ibrutinib)
Ibrutinib: 420 mg (3 capsules x 140 mg) orally administered daily beginning from Day 1. Rituximab: 375 mg/m^2 intravenous (IV) per package insert weekly for four consecutive weeks, followed by a second four-weekly rituximab course after a three-month interval.
Placebo: 3 capsules of placebo orally administered daily beginning from Day 1. Rituximab: 375 mg/m^2 IV per package insert weekly for four consecutive weeks, followed by a second four-weekly rituximab course after a three-month interval.
Ibrutinib: 420 mg (3 capsules) orally administered daily beginning from Day 1.