Phase II Randomized Trial Comparing GA101 and Rituximab in Untreated Low Tumor Burden Indolent Non-Hodgkin's Lymphoma (PrE0401)
Indolent Non-Hodgkin's Lymphoma
About this trial
This is an interventional treatment trial for Indolent Non-Hodgkin's Lymphoma focused on measuring Untreated Non-Hodgkin's Lymphoma, Low Tumor Burden Non-Hodgkin's Lymphoma, NHL, Indolent, Rituximab, Rituxan, GA101, Obinutuzumab
Eligibility Criteria
Inclusion Criteria:
Registration: Patients having both diffuse and follicular architectural elements will be considered eligible if the histology is predominantly follicular (≥ 50% of the cross-sectional area), and there is no evidence of transformation to a large cell histology.
- Biopsy-proven diagnosis of Grade 1 or 2 follicular non-Hodgkin's lymphoma with no evidence of transformation to large cell histology.
Meet criteria for Low Tumor Burden:
- No nodal or extra nodal mass ≥ 7 centimeter (cm)
- <3 nodal masses >3 cm in diameter
- No systemic symptoms or B symptoms
- No splenomegaly >16 cm by CT scan
- No risk of compression of a vital organ.
- No leukemic phase with >5000/mm³ circulating lymphocytes.
No cytopenias defined as:
- Platelets <100,000/mm³
- Hemoglobin (Hgb) <10 g/dL
- Absolute Neutrophil Count (ANC) <1500/mm³
- Must have Stage III or Stage IV disease.
- Baseline measurements/evaluations obtained within 6 weeks of registration. Patient must have at least one objective measurable disease parameter.
- Age ≥ 18 years.
- Eastern Oncology Cooperative Group Performance Status 0-1.
- Must not have received investigational agents within 30 days of registration.
- Signed Institutional Review Board (IRB)-approved informed consent.
- Willing to provide blood samples for research purposes.
- Women must not be pregnant or breastfeeding.
- Women of childbearing potential and sexually active males must use an accepted and effective method of contraception.
- No prior chemotherapy, radiotherapy or immunotherapy for lymphoma.
- No prior treatment with cytotoxic drugs or rituximab for a previous cancer or another condition (e.g. rheumatoid arthritis) or prior use of an anti-CD20 antibody.
- No prior use of any monoclonal antibody within 3 months of randomization.
- No history of severe allergic/anaphylactic reactions to humanized/murine monoclonal antibodies or known sensitivity/allergy to murine products.
- No history of prior malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for at least 2 years and did not require treatment with cytotoxic drugs or rituximab.
- No major surgery within 4 weeks prior to randomization, other than for diagnosis.
- Must be Human Immunodeficiency Virus (HIV) negative.
Have adequate organ function without growth factor and/or transfusion support within ≤ 2 weeks prior to registration:
- ANC ≥ 1500/mm³
- Hgb ≥ 10 g/dL
- Platelets ≥ 100,000/mm³
- Serum Creatinine ≤ 2x Upper Limit Normal (ULN)
- Total Bilirubin ≤ 2x ULN
- AST (aspartate aminotransferase)/ALT (alanine aminotransferase) ≤ 5x ULN
- PTT (Partial Thromboplastin Time) or aPTT (activated Partial Thromboplastin Time) >1.5x the ULN in the absence of a lupus anticoagulant
- INR (International Normalized Ratio) >1.5x the ULN in the absence of therapeutic anticoagulation
- No active, uncontrolled infections (afebrile for ≥ 48 hours off antibiotics).
- Must not receive immunization with attenuated live vaccines within 28 days prior to registration or during the study period.
- Must be tested for hepatitis B surface antigen (HBsAg) and total hepatitis B core antibody (anti-HBc) within 2 weeks of registration. Patients who are chronic carriers of HBsAg and anti-HBc are excluded.
- Must be tested for hepatitis C antibody within 2 week of registration. If this test is positive, patients are excluded unless a hepatitis C virus ribonucleic acid (HCV RNA) is negative.
- No evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results, including significant cardiovascular disease (i.e., severe arrhythmia, myocardial infarction within the previous 6 months, unstable arrhythmias, or unstable angina) or pulmonary disease.
Sites / Locations
- University of South Alabama
- Marin Cancer Care
- St. Joseph's/Candler Health System
- Decatur Memorial Hospital
- Carle Cancer Center
- Indiana University
- Siouxland Hematology Oncology Associates
- Ochsner Cancer Institute
- Greater Baltimore Medical Center
- Tufts Medical Center
- St. Joseph Mercy Health System
- Mayo Clinic
- Metro MN CCOP
- Missouri Valley Cancer Consortium
- Montefiore Medical Center
- Aultman Hospital
- University Hospitals Case Medical Center
- Toledo Community Oncology Program
- Geisinger Medical Center
- Fox Chase Cancer Center
- Reading Hospital
- Susquehanna Health Cancer Center
- University of Virginia
- Charleston Area Medical Center (CAMC)
- Gundersen Health System
- Dean Clinic
- ProHealth Care, Inc.
- Aurora Health Care
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Arm A: Rituximab
Arm B: GA101
Rituximab 375 mg/m² IV weekly for 4 weeks.
GA101 1,000 mg IV weekly for 4 weeks.