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Study of Ofatumomab in Combination With ICE-chemotherapy in Patients With Diffuse Large B-cell Lymphoma (DLBCL) (DLBL)

Primary Purpose

Diffuse Large B-cell Lymphoma

Status
Completed
Phase
Phase 2
Locations
Singapore
Study Type
Interventional
Intervention
O-ICE (ofatumumab, Ifosfamide, Carboplatin, Etoposide)
Sponsored by
National Cancer Centre, Singapore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B-cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Refractory or relapsed CD20 positive DLBCL following rituximab combined with chemotherapy.
  2. Participants must have measurable disease
  3. ECOG performance status 0-2
  4. Unless due to lymphomatous involvement, participants must have adequate organ and marrow function as defined below:

    • Hemoglobin ≥ 10g/dL
    • Absolute neutrophil count ≥ 1500/mm3
    • Platelets ≥ 100 000/mm3
    • ALT and AST ≤ 3 x upper limit of normal (ULN),
    • Total serum bilirubin ≤ 1.5 x ULN
    • Serum creatinine ≤ 1.5 x ULN
  5. Fully recovered (≤ Grade 1 or returned to baseline or deemed irreversible) from the acute effects of prior cancer therapy before initiation of study drug
  6. Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  1. Any previous cancer therapy for lymphoma, with the exception of Rituximab in combination with chemotherapy (not more than 1 prior line of chemotherapy)
  2. Participants who have had systemic anti-cancer therapy within 3 weeks (8 weeks for nitrosoureas or mitomycin C) prior to study entry
  3. Participants who have had radiotherapy and/ or major surgery within 3 weeks prior to study entry
  4. Participants who have had systemic corticosteroids for the purpose of treating lymphoma within 2 weeks prior to study entry are ineligible. Patients receiving stable (not increased within the last month) chronic doses of systemic corticosteroids with a maximum dose of 20 mg of prednisolone (or equivalent) per day are eligible if they are being given for disorders other than lymphoma
  5. Concurrent use of any other anti-cancer therapies or study agents.
  6. Presence of symptomatic or uncontrolled brain or central nervous system lymphomatous lesions
  7. Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, clinically significant cardiac disease including a history of cardiac disease or congestive heart failure > NYHA class 2, unstable angina (anginal symptoms at rest) or new-onset angina within the last 3 months or myocardial infarction within the past 6 months, significant cardiac arrhythmias and/ or requiring anti-arrhythmics; pulmonary disease; liver diseases such as cirrhosis, chronic active or persistent hepatitis; or acute/ chronic medical/ psychiatric illness/ social situations or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or limit compliance with study requirements, or interfere with the interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study.
  8. Known or suspected hypersensitivity to study treatments.
  9. History of HIV or Hepatitis C
  10. Individuals with a history of a different malignancy, other than treated cervical cancer in situ, basal cell or squamous cell carcinoma of the skin, are ineligible, except if they have been disease-free for at least 5 years, and are deemed by the investigator to be at low risk for recurrence of that malignancy OR other primary malignancy is neither currently clinically significant nor requiring active intervention.
  11. Pregnant or lactating women.
  12. 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 ofatumumab therapy. Adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method or total abstinence. Women of childbearing potential must have a negative pregnancy test prior at screening.
  13. Male subjects unable or unwilling to use adequate contraception methods from the time of first dose of study medication until one year after the last dose of ofatumumab.

Sites / Locations

  • National Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

O-ICE

Arm Description

O-ICE: Ofatumumab 1000mg intravenous (IV) infusion on Day 1 and Day 8 of cycle 1 of the salvage chemotherapy, and thereafter on Day 1 of each cycle; Ifosfamide 1667 mg/m2 IV infusion over 2 hours on days 1,2,3 of each cycle; Carboplatin 5 x ((25 + Creatinine clearance (CrCl)) IV in 250 ml Normal Saline over 1 hour on day 1 of each cycle; Etoposide 100mg/m2/day IV infusion day 1,2,3 over 45 to 60 minutes of each cycle.

Outcomes

Primary Outcome Measures

Response rate as measured by the new international criteria proposed by Cheason for response in non Hodgkin's lymphoma at the end of cycle 2 ofatumomab
Response (partial or complete response) status will be evaluated following two cycles of ofatumumab in combination with ICE chemotherapy

Secondary Outcome Measures

Progression free survival as measured from time of treatment start to time of disease progression
Progression evaluation will follow the new international criteria proposed by Cheason for response in non Hodgkin's lymphoma
Safety and tolerability of Ofatumomab in combination with ICE chemotherapy as measured by CTCAE
Adverse events will be graded following CTCAE (Common Terminology Criteria for Adverse Events) V4.03, and the relationship to the study treatment will be assessed by investigators.

Full Information

First Posted
March 31, 2015
Last Updated
March 21, 2016
Sponsor
National Cancer Centre, Singapore
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT02412267
Brief Title
Study of Ofatumomab in Combination With ICE-chemotherapy in Patients With Diffuse Large B-cell Lymphoma (DLBCL)
Acronym
DLBL
Official Title
An Open-label, Non-randomized Phase 2 Study of Ofatumomab (O) in Combination With ICE (Ifosfamide, Carboplatin, Etoposide)-Chemotherapy in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma (DLBCL)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
April 2011 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
March 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Centre, Singapore
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the efficacy and safety of ofatumomab in combination with ICE chemotherapy in subjects with relapsed/refractory DLBCL following failure to combination rituximab and anthracycline based chemotherapy. Participants with the option of potentially curative stem cell therapy may proceed to high dose chemotherapy and stem cell rescue. Participants with disease not considered curable with stem cell therapy, ineligible for or decline stem cell therapy may receive up to a maximum of 6 cycles of study drugs.
Detailed Description
This is a Phase II, single-arm, non randomized, safety and efficacy study of ofatumumab in combination with salvage ICE chemotherapy (O-ICE) in 61 subjects with relapsed or refractory aggressive B cell lymphoma. O-ICE would be administered as an inpatient. The cycles are administered at 3 weeks intervals for ICE. Study subjects who are candidates for high dose chemotherapy (HDC) and autologous stem cell rescue (ASCR) would receive one or two more cycle of ICE salvage chemotherapy with ofatumumab before stem cell mobilization. G-CSF at 10 ug/kg per day after the third or forth cycle of treatment (at the discretion of the treating physician) would be administered until the end of leukapheresis for stem cell mobilization. After the third or forth cycle of salvage chemotherapy, leukapheresis was initiated until a collection of more than 5 x 106 CD34 cells/kg white blood or 5 procedures were performed, whichever occurred first. Collection of <2x106 CD34+ cells/kg from peripheral blood will be considered mobilization failure for the purposes of the study. Leukapheresis and cryopreservation will be performed according to hospital practice. High dose chemotherapy will be administered as per our institution's protocol. Study subjects who are not candidates for HDC and ASCR would receive at most 6 cycles of salvage chemotherapy with ofatumumab. Subjects who progressed on treatment would be taken off study protocol.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B-cell Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
O-ICE
Arm Type
Experimental
Arm Description
O-ICE: Ofatumumab 1000mg intravenous (IV) infusion on Day 1 and Day 8 of cycle 1 of the salvage chemotherapy, and thereafter on Day 1 of each cycle; Ifosfamide 1667 mg/m2 IV infusion over 2 hours on days 1,2,3 of each cycle; Carboplatin 5 x ((25 + Creatinine clearance (CrCl)) IV in 250 ml Normal Saline over 1 hour on day 1 of each cycle; Etoposide 100mg/m2/day IV infusion day 1,2,3 over 45 to 60 minutes of each cycle.
Intervention Type
Drug
Intervention Name(s)
O-ICE (ofatumumab, Ifosfamide, Carboplatin, Etoposide)
Other Intervention Name(s)
Arzerra, Mitoxana, Paraplatin, Etopophos
Intervention Description
Ofatumab in combination with ICE (Ifosfamide, Carboplatin, Etoposide) are given to subjects according to protocol schedule
Primary Outcome Measure Information:
Title
Response rate as measured by the new international criteria proposed by Cheason for response in non Hodgkin's lymphoma at the end of cycle 2 ofatumomab
Description
Response (partial or complete response) status will be evaluated following two cycles of ofatumumab in combination with ICE chemotherapy
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Progression free survival as measured from time of treatment start to time of disease progression
Description
Progression evaluation will follow the new international criteria proposed by Cheason for response in non Hodgkin's lymphoma
Time Frame
5 years
Title
Safety and tolerability of Ofatumomab in combination with ICE chemotherapy as measured by CTCAE
Description
Adverse events will be graded following CTCAE (Common Terminology Criteria for Adverse Events) V4.03, and the relationship to the study treatment will be assessed by investigators.
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Refractory or relapsed CD20 positive DLBCL following rituximab combined with chemotherapy. Participants must have measurable disease ECOG performance status 0-2 Unless due to lymphomatous involvement, participants must have adequate organ and marrow function as defined below: Hemoglobin ≥ 10g/dL Absolute neutrophil count ≥ 1500/mm3 Platelets ≥ 100 000/mm3 ALT and AST ≤ 3 x upper limit of normal (ULN), Total serum bilirubin ≤ 1.5 x ULN Serum creatinine ≤ 1.5 x ULN Fully recovered (≤ Grade 1 or returned to baseline or deemed irreversible) from the acute effects of prior cancer therapy before initiation of study drug Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Any previous cancer therapy for lymphoma, with the exception of Rituximab in combination with chemotherapy (not more than 1 prior line of chemotherapy) Participants who have had systemic anti-cancer therapy within 3 weeks (8 weeks for nitrosoureas or mitomycin C) prior to study entry Participants who have had radiotherapy and/ or major surgery within 3 weeks prior to study entry Participants who have had systemic corticosteroids for the purpose of treating lymphoma within 2 weeks prior to study entry are ineligible. Patients receiving stable (not increased within the last month) chronic doses of systemic corticosteroids with a maximum dose of 20 mg of prednisolone (or equivalent) per day are eligible if they are being given for disorders other than lymphoma Concurrent use of any other anti-cancer therapies or study agents. Presence of symptomatic or uncontrolled brain or central nervous system lymphomatous lesions Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, clinically significant cardiac disease including a history of cardiac disease or congestive heart failure > NYHA class 2, unstable angina (anginal symptoms at rest) or new-onset angina within the last 3 months or myocardial infarction within the past 6 months, significant cardiac arrhythmias and/ or requiring anti-arrhythmics; pulmonary disease; liver diseases such as cirrhosis, chronic active or persistent hepatitis; or acute/ chronic medical/ psychiatric illness/ social situations or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or limit compliance with study requirements, or interfere with the interpretation of study results, and in the judgment of the investigator would make the patient inappropriate for entry into this study. Known or suspected hypersensitivity to study treatments. History of HIV or Hepatitis C Individuals with a history of a different malignancy, other than treated cervical cancer in situ, basal cell or squamous cell carcinoma of the skin, are ineligible, except if they have been disease-free for at least 5 years, and are deemed by the investigator to be at low risk for recurrence of that malignancy OR other primary malignancy is neither currently clinically significant nor requiring active intervention. Pregnant or lactating women. 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 ofatumumab therapy. Adequate contraception is defined as hormonal birth control, intrauterine device, double barrier method or total abstinence. Women of childbearing potential must have a negative pregnancy test prior at screening. Male subjects unable or unwilling to use adequate contraception methods from the time of first dose of study medication until one year after the last dose of ofatumumab.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Soon Thye Lim, Dr
Organizational Affiliation
National Cancer Centre, Singapore
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Cancer Centre
City
Singapore
ZIP/Postal Code
169610
Country
Singapore

12. IPD Sharing Statement

Learn more about this trial

Study of Ofatumomab in Combination With ICE-chemotherapy in Patients With Diffuse Large B-cell Lymphoma (DLBCL)

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