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Phase II Study of Durvalumab in Combination With Lenalidomide in Relapsed/Refractory NK-T-cell Lymphoma

Primary Purpose

LYMPHOMA

Status
Unknown status
Phase
Phase 2
Locations
Singapore
Study Type
Interventional
Intervention
Durvalumab
Lenali
Sponsored by
Singapore General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for LYMPHOMA

Eligibility Criteria

21 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Histologically proven NK/T-cell lymphoma that has relapsed after at least one cycle of induction chemotherapy.
  2. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
  3. Previously treated with at least one cycle of chemotherapy that includes L-asparaginase or gemcitabine.
  4. Must be aged ≥ 21 years and able to sign informed consent form.
  5. Adequate hematological function (unless abnormalities are related to lymphoma infiltration of the bone marrow or hemophagocytic syndrome related to NKL) within 30 days prior to signing informed consent, including:

    1. Absolute neutrophil count (ANC) ≥ 1.0 x 109/L
    2. Platelet count ≥ 50 x 109/L
    3. Hemoglobin ≥ 8 g/dL
  6. Must be able to adhere to study visit schedules and other protocol requirements.
  7. Females of childbearing potential must:

    1. Have 2 negative pregnancy tests as verified by a Study Investigator prior to starting study therapy. She must agree to ongoing pregnancy testing during the course of the study, and after end of study therapy. This applies even if the patient practices complete abstinence from heterosexual contact.
    2. Either commit to complete abstinence from heterosexual contact or agree to use, and be able to comply with, effective contraception without interruption, 28 days prior to starting study drug, during the study therapy (including dose interruptions), and for 28 days after discontinuation of study therapy.
  8. Male patients must practice complete abstinence or agree to use a condom during sexual contact with a pregnant female or female of childbearing potential while participating in the study, during dose interruptions and for 28 days after discontinuation of study therapy, even if he has undergone successful vasectomy.
  9. All patients must:

    1. Have an understanding that the study drug could have a potential teratogenic risk.
    2. Agree to abstain from donating blood while taking study drug, during dose interruptions and for 28 days after discontinuation of study therapy.
    3. Agree not to share study medication with another person.
    4. Agree to be counseled about pregnancy precautions and risk of fetal exposure.
    5. Females must agree to abstain from breast feeding during the study participation and for 28 days after discontinuation of study therapy.
  10. Male subjects should not donate sperm or semen while taking lenalidomide, during breaks (dose interruptions), and for at least 28 days after the last dose of lenalidomide.

Exclusion Criteria:

  1. Concomitant use of any other investigational agent.
  2. Known infection with human immunodeficiency virus (HIV).
  3. Patient has known clinically active hepatitis B; carriers of hepatitis B are permitted but need to be on appropriate anti-viral therapy or have regular hepatitis B DNA virus monitored as advised by a Gastroenterologist.
  4. Subject has a calculated or measured creatinine clearance of < 30 mL/minute.
  5. Neuropathy > Grade 2.
  6. Presence of CNS involvement by lymphoma.
  7. Myocardial infarction within 6 months prior to enrolment or has New York Hospital Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant.
  8. Clinically significant active infection or uncontrolled intercurrent illness.
  9. Pregnant or lactating females.
  10. Coexistent second malignancy or history of prior malignancy within the preceding 3 years (excluding non-melanoma skin tumors or in situ carcinoma of the cervix).
  11. Any significant medical or psychiatric condition that might prevent the patient from complying with all study procedures.

Sites / Locations

  • National University Hospital Singapore
  • Singapore General Hospital
  • National Cancer Centre Singapore
  • Raffles Hospital Singapore

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Durvalumab and lenalidomide

Arm Description

Open-label use of 2 drugs: Durvalumab 1500 mg intravenously on day 1 of a 28-day cycle until progressive disease or intolerance. Lenalidomide orally on days 1 through 21 of each 28-day cycle for 6 cycles.

Outcomes

Primary Outcome Measures

Efficacy as measured by overall response rate measured at the time of best response.
Overall response rate (ORR) is defined as the proportion of patients with reduction in tumor burden of at least 50%.

Secondary Outcome Measures

Progression-free survival (PFS)
PFS is defined as the time from enrolment to progression or death due to any cause. The distribution of PFS will be estimated using the method of Kaplan-Meier.
Overall survival (OS)
OS is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier.
Time-to-response (TTR)
Defined for all evaluable patients who have achieved an overall response as the date at which the patient's objective status is first noted to be a CR or PR.
Duration of response (DoR)
Defined for all evaluable patients who have achieved an overall response as the date at which the patient's objective status is first noted to be a CR or PR to the earliest date progression is documented.

Full Information

First Posted
February 13, 2017
Last Updated
February 15, 2017
Sponsor
Singapore General Hospital
Collaborators
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT03054532
Brief Title
Phase II Study of Durvalumab in Combination With Lenalidomide in Relapsed/Refractory NK-T-cell Lymphoma
Official Title
Phase II Study of Durvalumab in Combination With Lenalidomide in Relapsed/Refractory NK-T-cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Unknown status
Study Start Date
July 2017 (Anticipated)
Primary Completion Date
January 2021 (Anticipated)
Study Completion Date
July 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Singapore General Hospital
Collaborators
Celgene

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multi-center, open-label, phase II study of durvalumab in combination with lenalidomide for treatment of relapsed/refractory NK/T-cell lymphoma (NKTCL). The study will employ a 2-stage Simon Optimal design with 80% power and type 1 error rate (significance level) of 5%. Stage 1 will involve 8 patients and will require at least 2 patients to achieve the primary end point of overall response in order to proceed onto to stage 2, which will have a target enrolment of 14 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
LYMPHOMA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Open-label phase II study
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Durvalumab and lenalidomide
Arm Type
Experimental
Arm Description
Open-label use of 2 drugs: Durvalumab 1500 mg intravenously on day 1 of a 28-day cycle until progressive disease or intolerance. Lenalidomide orally on days 1 through 21 of each 28-day cycle for 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Intervention Description
Durvalumab intravenous 1500 mg
Intervention Type
Drug
Intervention Name(s)
Lenali
Intervention Description
Lenalidomide oral 20 mg/day
Primary Outcome Measure Information:
Title
Efficacy as measured by overall response rate measured at the time of best response.
Description
Overall response rate (ORR) is defined as the proportion of patients with reduction in tumor burden of at least 50%.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from enrolment to progression or death due to any cause. The distribution of PFS will be estimated using the method of Kaplan-Meier.
Time Frame
2 years
Title
Overall survival (OS)
Description
OS is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier.
Time Frame
2 years
Title
Time-to-response (TTR)
Description
Defined for all evaluable patients who have achieved an overall response as the date at which the patient's objective status is first noted to be a CR or PR.
Time Frame
2 years
Title
Duration of response (DoR)
Description
Defined for all evaluable patients who have achieved an overall response as the date at which the patient's objective status is first noted to be a CR or PR to the earliest date progression is documented.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically proven NK/T-cell lymphoma that has relapsed after at least one cycle of induction chemotherapy. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. Previously treated with at least one cycle of chemotherapy that includes L-asparaginase or gemcitabine. Must be aged ≥ 21 years and able to sign informed consent form. Adequate hematological function (unless abnormalities are related to lymphoma infiltration of the bone marrow or hemophagocytic syndrome related to NKL) within 30 days prior to signing informed consent, including: Absolute neutrophil count (ANC) ≥ 1.0 x 109/L Platelet count ≥ 50 x 109/L Hemoglobin ≥ 8 g/dL Must be able to adhere to study visit schedules and other protocol requirements. Females of childbearing potential must: Have 2 negative pregnancy tests as verified by a Study Investigator prior to starting study therapy. She must agree to ongoing pregnancy testing during the course of the study, and after end of study therapy. This applies even if the patient practices complete abstinence from heterosexual contact. Either commit to complete abstinence from heterosexual contact or agree to use, and be able to comply with, effective contraception without interruption, 28 days prior to starting study drug, during the study therapy (including dose interruptions), and for 28 days after discontinuation of study therapy. Male patients must practice complete abstinence or agree to use a condom during sexual contact with a pregnant female or female of childbearing potential while participating in the study, during dose interruptions and for 28 days after discontinuation of study therapy, even if he has undergone successful vasectomy. All patients must: Have an understanding that the study drug could have a potential teratogenic risk. Agree to abstain from donating blood while taking study drug, during dose interruptions and for 28 days after discontinuation of study therapy. Agree not to share study medication with another person. Agree to be counseled about pregnancy precautions and risk of fetal exposure. Females must agree to abstain from breast feeding during the study participation and for 28 days after discontinuation of study therapy. Male subjects should not donate sperm or semen while taking lenalidomide, during breaks (dose interruptions), and for at least 28 days after the last dose of lenalidomide. Exclusion Criteria: Concomitant use of any other investigational agent. Known infection with human immunodeficiency virus (HIV). Patient has known clinically active hepatitis B; carriers of hepatitis B are permitted but need to be on appropriate anti-viral therapy or have regular hepatitis B DNA virus monitored as advised by a Gastroenterologist. Subject has a calculated or measured creatinine clearance of < 30 mL/minute. Neuropathy > Grade 2. Presence of CNS involvement by lymphoma. Myocardial infarction within 6 months prior to enrolment or has New York Hospital Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant. Clinically significant active infection or uncontrolled intercurrent illness. Pregnant or lactating females. Coexistent second malignancy or history of prior malignancy within the preceding 3 years (excluding non-melanoma skin tumors or in situ carcinoma of the cervix). Any significant medical or psychiatric condition that might prevent the patient from complying with all study procedures.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Colin Phipps, MD
Phone
6562223322
Email
colin.phipps.diong@singhealth.com.sg
Facility Information:
Facility Name
National University Hospital Singapore
City
Singapore
ZIP/Postal Code
119228
Country
Singapore
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michelle Poon, MD
Phone
6567795555
Email
NUH_Enquiries@nuhs.edu.sg
Facility Name
Singapore General Hospital
City
Singapore
ZIP/Postal Code
169608
Country
Singapore
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Colin Phipps, MD
Phone
6562223322
Email
colin.phipps.diong@singhealth.com.sg
Facility Name
National Cancer Centre Singapore
City
Singapore
ZIP/Postal Code
169610
Country
Singapore
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Soon Thye Lim, MD
Phone
6564368000
Email
callcentre@nccs.com.sg
Facility Name
Raffles Hospital Singapore
City
Singapore
ZIP/Postal Code
188770
Country
Singapore
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daryl Tan, MD
Phone
6563111111
Email
enquiries@raffleshospital.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase II Study of Durvalumab in Combination With Lenalidomide in Relapsed/Refractory NK-T-cell Lymphoma

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