Ofatumumab With IVAC Salvage Chemotherapy in Diffuse Large B Cell Lymphoma Patients (PLRG8)
Primary Purpose
Diffuse Large B Cell Lymphoma
Status
Completed
Phase
Phase 2
Locations
Poland
Study Type
Interventional
Intervention
Ofatumumab
Etoposide
Ifosfamid
Mesna
Cytarabine
Methotrexate
Leukovorin
Granulocyte-Colony Stimulating Factor
Sponsored by
About this trial
This is an interventional treatment trial for Diffuse Large B Cell Lymphoma focused on measuring Salvage therapy in DLBCL
Eligibility Criteria
Inclusion Criteria:
- Patients under consideration for participation in this study must meet all of the following inclusion criteria:
- Histologically confirmed CD20 positive diffuse large B-cell lymphoma.
- Progressing or relapsed following prior treatment including but not limited to rituximab-CHOP chemotherapy regimen.
- Not suitable for ASCT (age > 60 years, PS ≥ 2, prior ASCT as a part of the previous treatment for DLBCL, and/or other medical conditions that unable the patients to undergo the ASCT, e.g. NYHA II, creatinine clearance < 50 mL/min).
- Age ≥ 18 years.
- ECOG/ WHO performance status grades 0 - 3.
- Resolution of toxicities from previous therapy to grade ≤ 1.
- Written signed and dated informed consent prior to any study procedures being performed.
Exclusion Criteria:
- Known or suspected hypersensitivity to study treatments.
- Prior treatment with anti-CD20 monoclonal antibodies with the exception of rituximab.
Screening laboratory values:
- platelets < 75 x 109/L (unless due to DLBCL involvement of the bone marrow),
- neutrophils < 1.5 x 109/L (unless due to DLBCL involvement of the bone marrow),
- creatinine > 2.0 times upper normal limit (unless normal creatinine clearance),
- total bilirubin >1.5 times upper normal limit (unless due to DLBCL involvement of liver or a known history of Gilbert's disease),
- ALT > 2.5 times upper normal limit (unless due to DLBCL involvement of liver),
- alkaline phosphatase > 2.5 times upper normal limit (unless due to DLBCL involvement of the liver or bone marrow).
- Subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment).
- Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to enrolment, whichever is longer, or currently participating in any other interventional clinical study.
- Other past or current malignancy. Subjects who have been free of malignancy for at least 5 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible.
- Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C.
- History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequel.
- Known HIV positive.
- Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to randomization, congestive heart failure (NYHA III-IV), and arrhythmia unless controlled by therapy, with the exception of extra systoles or minor conduction abnormalities.
- Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease which in the opinion of the investigator may represent a risk for the patient.
- Positive serology for Hepatitis B (HB).
- Positive serology for hepatitis C (HC).
- Pregnant or lactating women. Women of childbearing potential must have a negative pregnancy test at screening.
- Women of childbearing potential, including women whose last menstrual period was less than one year prior to screening, unable or unwilling to use adequate contraception from study start to one year after the last dose of protocol therapy.
- Male subjects unable or unwilling to use adequate contraception methods from study start to one year after the last dose of protocol therapy.
- Patients unwilling or unable to comply with the protocol.
Sites / Locations
- Dolnośląskie Centrum Transplantacji Komórkowych
- Instytut Hematologii i Transfuzjologii
- Centrum Onkologii - Istytut im. M.Sklodowskiej-Curie
- Szpital Specjalistyczny w Brzozowie Podkarpacki Ośrodek Onkologiczny im. ks. Bronisława Markiewicza
- Uniwersyteckie Cenrum Medyczne
- Szpital Morski im. PCK Oddz. Onkologii i Radioterapii
- Klinika Transplantacji Szpiku i Onkohematologii; Centrum Onkologii Instytut im. M.Sklodowskiej-Curie, Oddz. w Gliwicach
- Oddz. Hematologii, Samodzielny Publiczny ZOZ MSW z Warminsko-Mazurskim Centrum Onkologii w Olsztynie
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
O-IVAC
Arm Description
Ofatumumab Etoposide Ifosfamide Mesna Cytarabine Methotrexate Leukovorin Granulocyte-Colony Stimulating Factor
Outcomes
Primary Outcome Measures
Response rate
Complete response + partial response
Secondary Outcome Measures
Progression-free survival
Staying free of disease progression
Event-free survival
Staying free of event such as disease progression, relapse, death, starting new anticancer therapy, patient's refusal to continue study treatment, Serious Adverse Event that causes discontinuation of study treatment
Overall survival
Time since entering the study till death of any reason
Number of participants with adverse events as a measure of safety and tolerability
Reporting Adverse Events and Serious Adverse Events
Full Information
NCT ID
NCT01481272
First Posted
November 14, 2011
Last Updated
December 23, 2021
Sponsor
Polish Lymphoma Research Group
1. Study Identification
Unique Protocol Identification Number
NCT01481272
Brief Title
Ofatumumab With IVAC Salvage Chemotherapy in Diffuse Large B Cell Lymphoma Patients
Acronym
PLRG8
Official Title
A Phase II Trial on Ofatumumab With IVAC Salvage Chemotherapy in Diffuse Large B Cell Lymphoma Patients Progressing or Relapsed After Prior R-CHOP Treatment Not Suitable for Autologous Stem Cell Transplant
Study Type
Interventional
2. Study Status
Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
November 2011 (undefined)
Primary Completion Date
July 2017 (Actual)
Study Completion Date
December 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Polish Lymphoma Research Group
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
It is expected that addition of anti-CD20 antibody - ofatumumab would enhance the activity of the etoposide+ifosphamide with mesna+cytarabine+methotrexate+lenograstim or filgrastim (IVAC) regimen. This study is planned to determine the efficacy and safety of ofatumumab in combination with IVAC chemotherapy in patients with CD20 positive diffuse large B cell lymphoma progressing or relapsed after prior R-CHOP chemotherapy not suitable for Autologous Stem Cell Transplant (ASCT).
Detailed Description
The purpose of this study is to assess the Overall Response Rate (ORR) = Complete Response (CR) + Partial Response (PR) in adult Diffuse Large B Cell Lymphoma (DLBCL) patients progressing or relapsed after prior R-CHOP treatment not suitable for ASCT treated with O-IVAC salvage chemotherapy regimen. The secondary objective is the evaluation of progression-free survival (PFS), event-free survival (EFS), overall survival (OS), safety and tolerability.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B Cell Lymphoma
Keywords
Salvage therapy in DLBCL
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
77 (Actual)
8. Arms, Groups, and Interventions
Arm Title
O-IVAC
Arm Type
Experimental
Arm Description
Ofatumumab Etoposide Ifosfamide Mesna Cytarabine Methotrexate Leukovorin Granulocyte-Colony Stimulating Factor
Intervention Type
Drug
Intervention Name(s)
Ofatumumab
Other Intervention Name(s)
Arzerra
Intervention Description
1000 IV, according to detailed instruction included in the protocol, on day 1 of each 21-day cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Etoposide
Other Intervention Name(s)
VePesid
Intervention Description
60mg/m2 IV, daily over 1 hour, on days 1-5 of 21-day cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Ifosfamid
Other Intervention Name(s)
Ifex
Intervention Description
1500mg/m2 or 1000mg/m2 (patients >/=60 years), IV, daily over 1 hour, on 1-5 days of each 21-day cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Mesna
Other Intervention Name(s)
Mesnex
Intervention Description
300mg/m2 or 200mg/m2 (patients >/=60 years), IV, over 1 hour, mixed with ifosfamid then 900mg/m2 or 600mg/m2 (patients >/=60 years)over 12 hour or by local practice, on 1-5 days of each 21 day cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Other Intervention Name(s)
Cytosar
Intervention Description
2g/m2 or 0,5-1g/m2 (patients >/= 60 years), IV, over 3 hours, 12 hourly (total of 4 doses), on days 1-2 of each 21 day cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Methotrexate
Other Intervention Name(s)
Methotrexat Ebeve
Intervention Description
12mg, it, on day 5 of each 21 days cycle, maximum 6 cycles
Intervention Type
Drug
Intervention Name(s)
Leukovorin
Other Intervention Name(s)
Folinic Acid
Intervention Description
15mg, po 24 hours after methotrexate it
Intervention Type
Drug
Intervention Name(s)
Granulocyte-Colony Stimulating Factor
Other Intervention Name(s)
Filgrastim
Intervention Description
5 microgram/kg or 263 microgram ampoule, sc, daily, starting on day 7 of each 21 day cycle, until ANC>1.0x109/l
Primary Outcome Measure Information:
Title
Response rate
Description
Complete response + partial response
Time Frame
12 months post-therapy
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
Staying free of disease progression
Time Frame
12 month post-therapy
Title
Event-free survival
Description
Staying free of event such as disease progression, relapse, death, starting new anticancer therapy, patient's refusal to continue study treatment, Serious Adverse Event that causes discontinuation of study treatment
Time Frame
12 month post-therapy
Title
Overall survival
Description
Time since entering the study till death of any reason
Time Frame
12 months post-therapy
Title
Number of participants with adverse events as a measure of safety and tolerability
Description
Reporting Adverse Events and Serious Adverse Events
Time Frame
12 months post-therapy
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients under consideration for participation in this study must meet all of the following inclusion criteria:
Histologically confirmed CD20 positive diffuse large B-cell lymphoma.
Progressing or relapsed following prior treatment including but not limited to rituximab-CHOP chemotherapy regimen.
Not suitable for ASCT (age > 60 years, PS ≥ 2, prior ASCT as a part of the previous treatment for DLBCL, and/or other medical conditions that unable the patients to undergo the ASCT, e.g. NYHA II, creatinine clearance < 50 mL/min).
Age ≥ 18 years.
ECOG/ WHO performance status grades 0 - 3.
Resolution of toxicities from previous therapy to grade ≤ 1.
Written signed and dated informed consent prior to any study procedures being performed.
Exclusion Criteria:
Known or suspected hypersensitivity to study treatments.
Prior treatment with anti-CD20 monoclonal antibodies with the exception of rituximab.
Screening laboratory values:
platelets < 75 x 109/L (unless due to DLBCL involvement of the bone marrow),
neutrophils < 1.5 x 109/L (unless due to DLBCL involvement of the bone marrow),
creatinine > 2.0 times upper normal limit (unless normal creatinine clearance),
total bilirubin >1.5 times upper normal limit (unless due to DLBCL involvement of liver or a known history of Gilbert's disease),
ALT > 2.5 times upper normal limit (unless due to DLBCL involvement of liver),
alkaline phosphatase > 2.5 times upper normal limit (unless due to DLBCL involvement of the liver or bone marrow).
Subjects who have current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment).
Treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to enrolment, whichever is longer, or currently participating in any other interventional clinical study.
Other past or current malignancy. Subjects who have been free of malignancy for at least 5 years, or have a history of completely resected non-melanoma skin cancer, or successfully treated in situ carcinoma are eligible.
Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment such as, but not limited to, chronic renal infection, chronic chest infection with bronchiectasis, tuberculosis and active Hepatitis C.
History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequel.
Known HIV positive.
Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months prior to randomization, congestive heart failure (NYHA III-IV), and arrhythmia unless controlled by therapy, with the exception of extra systoles or minor conduction abnormalities.
Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease which in the opinion of the investigator may represent a risk for the patient.
Positive serology for Hepatitis B (HB).
Positive serology for hepatitis C (HC).
Pregnant or lactating women. Women of childbearing potential must have a negative pregnancy test at screening.
Women of childbearing potential, including women whose last menstrual period was less than one year prior to screening, unable or unwilling to use adequate contraception from study start to one year after the last dose of protocol therapy.
Male subjects unable or unwilling to use adequate contraception methods from study start to one year after the last dose of protocol therapy.
Patients unwilling or unable to comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jan Walewski, Prof.
Organizational Affiliation
CENTRUM ONKOLOGII - INSTYTUT im. Marii Skłodowskiej-Curie ul. W.K. Roentgena 5, 02-781 Warszawa
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Krzysztof Warzocha, Prof.
Organizational Affiliation
Instytut Hematologii i Transfuzjologii, 02-776 Warszawa ul. Indiry Gandhi 14
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andrzej Hellmann, Prof.
Organizational Affiliation
Klinika Hematologii i Tranplantologii, Uniwersyteckie Centrum Medyczne, ul. Dębinki 7, 80-952 Gdańsk
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andrzej Pluta, Prof.
Organizational Affiliation
Szpital Specjalistyczny w Brzozowie Podkarpacki Ośrodek Onkologiczny im. ks. Bronisława Markiewicza, ul. ks. Bielawskiego 18, 36-200 Brzozów
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andrzej Lange, Prof.
Organizational Affiliation
Dolnośląskie Centrum Transplantacji Komórkowych, 53-439 Wrocław, ul. Grabiszyńska105
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Wanda Knopinska-Posluszny, MD PhD
Organizational Affiliation
Oddz. Hematologii, Samodzielny Publiczny ZOZ MSW z Warminsko-Mazurskim Centrum Onkologii w Olsztynie; ul.Wojska Polskiego 37, 10-228 Olsztyn
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sebastian Giebel, Prof.
Organizational Affiliation
Klinika Transplantacji Szpiku i Onkohematologii, Centrum Onkologii Instytut im. M. Sklodowskiej-Curie w Gliwicach; al. Wybrzeże Armii Krajowej 15, 44-101 Gliwice
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jan M Zaucha, Prof.
Organizational Affiliation
Oddz. Onkologii i Radioterapii, Szpital Morski im. PCK; ul. Powstania Styczniowego 1, 81-519 Gdynia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dolnośląskie Centrum Transplantacji Komórkowych
City
Wrocław
State/Province
Dolnośląskie
ZIP/Postal Code
53-439
Country
Poland
Facility Name
Instytut Hematologii i Transfuzjologii
City
Warszawa
State/Province
Mazowieckie
ZIP/Postal Code
02-776
Country
Poland
Facility Name
Centrum Onkologii - Istytut im. M.Sklodowskiej-Curie
City
Warszawa
State/Province
Mazowieckie
ZIP/Postal Code
02-781
Country
Poland
Facility Name
Szpital Specjalistyczny w Brzozowie Podkarpacki Ośrodek Onkologiczny im. ks. Bronisława Markiewicza
City
Brzozów
State/Province
Podkarpackie
ZIP/Postal Code
16-200
Country
Poland
Facility Name
Uniwersyteckie Cenrum Medyczne
City
Gdańsk
State/Province
Pomorskie
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Szpital Morski im. PCK Oddz. Onkologii i Radioterapii
City
Gdynia
State/Province
Pomorskie
ZIP/Postal Code
81-519
Country
Poland
Facility Name
Klinika Transplantacji Szpiku i Onkohematologii; Centrum Onkologii Instytut im. M.Sklodowskiej-Curie, Oddz. w Gliwicach
City
Gliwice
State/Province
Slaskie
ZIP/Postal Code
44-101
Country
Poland
Facility Name
Oddz. Hematologii, Samodzielny Publiczny ZOZ MSW z Warminsko-Mazurskim Centrum Onkologii w Olsztynie
City
Olsztyn
State/Province
Warminsko-Mazurskie
ZIP/Postal Code
10-228
Country
Poland
12. IPD Sharing Statement
Plan to Share IPD
No
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Ofatumumab With IVAC Salvage Chemotherapy in Diffuse Large B Cell Lymphoma Patients
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