Sintilimab Combined With Chidamide in Treating Peripheral T Cell Lymphoma (Sincerely20)
Primary Purpose
Peripheral T-cell Lymphoma
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
PD-1 antibody+ HDAC inhibitor
Sponsored by
About this trial
This is an interventional treatment trial for Peripheral T-cell Lymphoma focused on measuring relapsed/refractory peripheral T-cell lymphoma, PD-1 antibody, HDAC inhibitor, objective response rate, safety profile
Eligibility Criteria
Inclusion Criteria:
- Age range from 18 to 75 years;
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2;
- Pathologically confirmed relapsed/refractory Peripheral T-cell lymphoma (Including PTCL-NOS, AITL, anaplastic large cell lymphoma(ALTL), excluding Nature Killer(NK)/T cell lymphoma);
- At least one two-dimensional measurable lesion with a length diameter of at least 1.5cm and vertical diameter of at least 1.0cm (measured by CT or MRI);
- Adequate medullary hematopoiesis function ( WBC≥3.5×109/L, ANC≥1.5×109/L, PLT≥80×109/L, HB≥90g/L. If the peripheral blood indicators demonstrate abnormal due to bone marrow or spleen invasion by lymphoma, Enrollment decision can be determined by the investigator as appropriate;
- Adequate hepatic function (total serum bilirubin, ALT and AST≤1.5 times of upper limit of normal);
- Adequate renal function (serum creatinine≤1.5 times the upper limit of normal, creatinine clearence≥50ml/min);
- Echocardiography or radionuclide cardia functional test, LVEF≥50%;
- Patients of child-bearing period agree to use appropriate contraception. The serum pregnancy test of women in childbearing period was negative within 2 weeks before enrollment.
- Willingness to provide pathological tissue specimens (20 pieces of wax or paraffin tissue sections);
- Expectation survival time over 3 months;
- Willingness to provide written informed consent.
Exclusion Criteria:
- Patients allergic of any drug in this regimen;
- Previous treatment with anti-PD-1 antibody combined with HDAC inhibitor (Patients only received single agent of treatment regime or sequentially received anti-PD-1 and HDAC inhibitor are allowed to enroll);
- Patients with clinically significant heart disease, including severe cardiac insufficiency: New York Heart Disease Association (NYHA) grade IV cardiac insufficiency, unstable angina. And myocardial infarction, congestive heart failure, and QTC interphase > 500ms which occurred before 6 month of screening;
- Patients who have received grade II or above surgery within 3 weeks before enrollment;
- History of other malignancy within the past 5 years (except for 1. basal cell carcinoma of the skin and 2. carcinoma in situ of the cervix and 3. patients who had received treatment for the purpose of cure and had not developed a malignant tumor with a known active disease in the previous 5 years);
- Patients who had received other antitumor therapy (including corticosteroid therapy, immunotherapy) or participated in other clinical studies within 4 weeks before the start of the enrollment (if patients received small-molecule targeted drug therapy, they could be included in the study if the drug was discontinued for more than 5 half-lives), or had not recovered from the previous toxicity;
- Patients with significant coagulation abnormality;
- Patients with autoimmune diseases requiring treatment or with a history of syndrome requiring systemic use of steroid immunosuppressive agents, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism, hypothyroidism, etc;
- Other serious, uncontrolled concomitant diseases that may affect protocol compliance or interfere with results interpretation, including uncontrolled diabetes, or pulmonary disease (a history of interstitial pneumonia, obstructive pulmonary disease, and symptomatic bronchospasm);
- Evidence of central nervous system disease;
- Patients who received the live vaccine within 4 weeks of the start of the enrollment;
- Patients with hepatitis B (HBV HBsAg positive and HBV-DNA≥105), hepatitis C (HCV) infection (HCV antibody positive and HCV-RNA detectable); And subjects with other acquired or congenital immune deficiency diseases, including but not limited to hiv-infected;
- Pregnant or lactating women;
- Patients who have had previous organ transplants (except autologous hematopoietic stem cell transplants);
- Severe or uncontrolled infections;
- Patients with history of severe neurological or psychiatric illness, including dementia or epilepsy;
- Patients with drug abuse, medical, psychological or social conditions that may interfere with the study results or the assessment of the study results;
- Patients are unsuitable for the enrollment according to investigator's judgement.
Sites / Locations
- Dongmei JiRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Sinitilimab+Chidamide
Arm Description
Anti-PD-1 antibody Sintilimab 200mg intravenously every 3 weeks; HDAC inhibitor Chidamide 30mg orally twice every week
Outcomes
Primary Outcome Measures
Progression Free Survival (PFS)
Time from the data of enrollment to of disease progression, or death of any cause, or date of lost follow-up, whichever comes first, otherwise subject data were censored at time last known disease free.
Secondary Outcome Measures
Overall Survival (OS)
Time from the date of enrollment to data of death from any cause, or date of lost follow-up, whichever comes first, and otherwise censored at time last known alive.
incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
All the adverse events of the patients related will be assessed and graded by NCI CTCAE v 5.0]
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04512534
Brief Title
Sintilimab Combined With Chidamide in Treating Peripheral T Cell Lymphoma
Acronym
Sincerely20
Official Title
A Phase II Study of Anti-Programmed Death-1(PD-1) Antibody Sintilimab Plus Histone Deacetylase(HDAC) Inhibitor Chidamide in Patients With Relapsed/ Refractory Peripheral T-cell Lymphoma
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 13, 2020 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
September 1, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a single-center, single-arm, phase 2 study to evaluate the efficacy and safety of Anti-PD-1 antibody(Sintilimab) plus HDAC inhibitor(Chidamide) in patients with relapsed/refractory peripheral T-cell lymphoma (r/r PTCL).
Detailed Description
Peripheral T-cell lymphoma accounts for 12-15% of non-Hodgkin's lymphomas in western countries, however, this number is up to 35% or more in some Asian countries, including China. According to the 2016 World Health Organization annual classification, there are 29 subtypes of peripheral T cell lymphoma, among which the most common types are peripheral T cell lymphoma non-specific type (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL) and anaplastic large cell lymphoma (ALCL). For r/r PTCL, the prognosis was poor with objective response rate range from 8-50% and median progression free survival(PFS)range from 3.2-5 months for chemotherapy. Thus, the treatment of this patient population remained clinically unmet need.
This clinical trial will be conducted under Simon's optimal two-stage design. The first stage needs 15 participants, if ≥5 participants acquire remission, the study will move on to the second stage and enroll another 36 patients to achieve a total number of 51 participants enrolled. Drop rate is assumed to be 10%, to insure 47 participants involving the efficacy evaluation statistically.
Participants will receive anti-PD-1 antibody plus HDAC inhibitor every three weeks for a cycle, until disease progression or severe/ intolerant toxicity, the maximum treatment period is 2 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral T-cell Lymphoma
Keywords
relapsed/refractory peripheral T-cell lymphoma, PD-1 antibody, HDAC inhibitor, objective response rate, safety profile
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Simon's optimal two-stage design
Masking
None (Open Label)
Allocation
N/A
Enrollment
51 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Sinitilimab+Chidamide
Arm Type
Experimental
Arm Description
Anti-PD-1 antibody Sintilimab 200mg intravenously every 3 weeks; HDAC inhibitor Chidamide 30mg orally twice every week
Intervention Type
Drug
Intervention Name(s)
PD-1 antibody+ HDAC inhibitor
Other Intervention Name(s)
Sintilimab, Chidamide
Intervention Description
Patients receive anti-PD-1 antibody Sintilimab+ HDAC inhibitor Chidamide three weeks for a cycle, detailed as follows:
Anti-PD-1 antibody (Sintilimab): Fixed dose of 200 mg every 3 weeks, intravenous drip (without pretreatment), infusion time: 30 minutes (no less than 20 mins, no more than 60 mins), the maximum treatment period is 2 years (up to 35 doses), complete remission(CR)patients confirmed by imaging assessment can be considered off anti-PD-1 treatment after 12 treatment cycles.
Chidamide: Chidamide is administered orally at a dose of 30mg (initial dose). It is recommended to be administered within 0.5h after a meal with a fixed time. Chidamide will be given until disease progression or intolerant toxicity. The maximum treatment is 2 years. If chidamide therapy requires to be continued over 2 years due to clinical benefit, the prescription/decision should be made after discussion with the principal investigator.
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
Time from the data of enrollment to of disease progression, or death of any cause, or date of lost follow-up, whichever comes first, otherwise subject data were censored at time last known disease free.
Time Frame
Up to two years after the start of the study
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
Time from the date of enrollment to data of death from any cause, or date of lost follow-up, whichever comes first, and otherwise censored at time last known alive.
Time Frame
Up to two years after the start of the study
Title
incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
All the adverse events of the patients related will be assessed and graded by NCI CTCAE v 5.0]
Time Frame
Since the signing of informed consent forms to 30 days after the last cycle of treatment and 90 days after last dose of anti-PD-1 antibody
Other Pre-specified Outcome Measures:
Title
biomarker
Description
PD-L1, HDAC 3/4/10 expression, circulation tumor DNA(ctDNA)
Time Frame
the collection of the samples will begin from the signing of informed consent forms(ICF), and the detection will be competed within 3 months after the last patient discontinued the treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age range from 18 to 75 years;
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2;
Pathologically confirmed relapsed/refractory Peripheral T-cell lymphoma (Including PTCL-NOS, AITL, anaplastic large cell lymphoma(ALTL), excluding Nature Killer(NK)/T cell lymphoma);
At least one two-dimensional measurable lesion with a length diameter of at least 1.5cm and vertical diameter of at least 1.0cm (measured by CT or MRI);
Adequate medullary hematopoiesis function ( WBC≥3.5×109/L, ANC≥1.5×109/L, PLT≥80×109/L, HB≥90g/L. If the peripheral blood indicators demonstrate abnormal due to bone marrow or spleen invasion by lymphoma, Enrollment decision can be determined by the investigator as appropriate;
Adequate hepatic function (total serum bilirubin, ALT and AST≤1.5 times of upper limit of normal);
Adequate renal function (serum creatinine≤1.5 times the upper limit of normal, creatinine clearence≥50ml/min);
Echocardiography or radionuclide cardia functional test, LVEF≥50%;
Patients of child-bearing period agree to use appropriate contraception. The serum pregnancy test of women in childbearing period was negative within 2 weeks before enrollment.
Willingness to provide pathological tissue specimens (20 pieces of wax or paraffin tissue sections);
Expectation survival time over 3 months;
Willingness to provide written informed consent.
Exclusion Criteria:
Patients allergic of any drug in this regimen;
Previous treatment with anti-PD-1 antibody combined with HDAC inhibitor (Patients only received single agent of treatment regime or sequentially received anti-PD-1 and HDAC inhibitor are allowed to enroll);
Patients with clinically significant heart disease, including severe cardiac insufficiency: New York Heart Disease Association (NYHA) grade IV cardiac insufficiency, unstable angina. And myocardial infarction, congestive heart failure, and QTC interphase > 500ms which occurred before 6 month of screening;
Patients who have received grade II or above surgery within 3 weeks before enrollment;
History of other malignancy within the past 5 years (except for 1. basal cell carcinoma of the skin and 2. carcinoma in situ of the cervix and 3. patients who had received treatment for the purpose of cure and had not developed a malignant tumor with a known active disease in the previous 5 years);
Patients who had received other antitumor therapy (including corticosteroid therapy, immunotherapy) or participated in other clinical studies within 4 weeks before the start of the enrollment (if patients received small-molecule targeted drug therapy, they could be included in the study if the drug was discontinued for more than 5 half-lives), or had not recovered from the previous toxicity;
Patients with significant coagulation abnormality;
Patients with autoimmune diseases requiring treatment or with a history of syndrome requiring systemic use of steroid immunosuppressive agents, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism, hypothyroidism, etc;
Other serious, uncontrolled concomitant diseases that may affect protocol compliance or interfere with results interpretation, including uncontrolled diabetes, or pulmonary disease (a history of interstitial pneumonia, obstructive pulmonary disease, and symptomatic bronchospasm);
Evidence of central nervous system disease;
Patients who received the live vaccine within 4 weeks of the start of the enrollment;
Patients with hepatitis B (HBV HBsAg positive and HBV-DNA≥105), hepatitis C (HCV) infection (HCV antibody positive and HCV-RNA detectable); And subjects with other acquired or congenital immune deficiency diseases, including but not limited to hiv-infected;
Pregnant or lactating women;
Patients who have had previous organ transplants (except autologous hematopoietic stem cell transplants);
Severe or uncontrolled infections;
Patients with history of severe neurological or psychiatric illness, including dementia or epilepsy;
Patients with drug abuse, medical, psychological or social conditions that may interfere with the study results or the assessment of the study results;
Patients are unsuitable for the enrollment according to investigator's judgement.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dongmei Ji, doctor
Phone
13564183928
Email
jidongmei2000@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Junning Cao, doctor
Email
cao_junning@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dongmei Ji, doctor
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Junning Cao, Doctor
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dongmei Ji
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
021
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
dongmei ji, doctor
First Name & Middle Initial & Last Name & Degree
dongmei ji, doctor
Phone
13564183928
Email
jidongmei2000@126.com
First Name & Middle Initial & Last Name & Degree
Junning Cao
First Name & Middle Initial & Last Name & Degree
Dongmei Ji
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Sintilimab Combined With Chidamide in Treating Peripheral T Cell Lymphoma
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