Phase Ib/II Study of the Efficacy and Safety of the R-CMC544/R-GEMOX Combination in Diffuse Lage B-cell Lymphoma at First or Second Relapse

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Pfizer
Information provided by (Responsible Party):
The Lymphoma Academic Research Organisation
ClinicalTrials.gov Identifier:
NCT01562990
First received: March 20, 2012
Last updated: December 23, 2014
Last verified: December 2014
  Purpose

The purpose of this study is to determine the recommended dose of CMC544 administered in combination with rituximab (R-CMC544), and in alternance with rituximab, gemcitabine and oxaliplatin (R-GEMOX) in the first phase of the study. After that, efficacy and safety of this combination will be evaluated preliminarily in patients with DLBCL in relapse or refractory, who are no candidates for autologous transplant.


Condition Intervention Phase
Diffuse Large B-Cell Lymphoma
Drug: Rituximab, CMC544, Gemcitabine and Oxaliplatine
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multi-center, Phase IB/II, Open Label, Single Arm Study of Inotuzumab Ozogamicin Plus Rituximab (R-CMC544) Alternating With Gemcitabine-oxaliplatin Plus Rituximab(R-GEMOX)in Patients Aged From 18 to 80 Years With CD20 and CD22 Positive Diffuse Large B-cell Lymphoma (DLBCL) in Relapse After/Refractory to 1ST or 2ND Line Treatment, Who Are no Candidates for Autologous Transplant.

Resource links provided by NLM:


Further study details as provided by The Lymphoma Academic Research Organisation:

Primary Outcome Measures:
  • Determination of the Recommended Dose of R-CMC544 [ Time Frame: Up to 16 weeks ] [ Designated as safety issue: Yes ]
    Determination of recommended dose will be based on safety parameters and particularly on incidence of DLTs


Secondary Outcome Measures:
  • OVERALL RESPONSE RATE [ Time Frame: Up to 32 weeks ] [ Designated as safety issue: No ]
    Assessment of response will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma (Cheson, 1999 and 2007). Patient is defined as a responder if he/she has a complete response (CR) or partial response (PR) at the end of treatment. A descriptive analysis will also be performed considering as non-responders all patients who relapsed or died during treatment phase even if they were prematurely withdrawn as responder

  • PROGRESSION-FREE SURVIVAL [ Time Frame: Up to 3.5 years ] [ Designated as safety issue: No ]
    Progression-Free Survival will be measured from the date of inclusion to the date of first documented disease progression, relapse or death from any cause. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.

  • EVENT FREE SURVIVAL [ Time Frame: Up to 3.5 years ] [ Designated as safety issue: No ]
    Event-Free Survival will be measured from the date of inclusion to the date of first documented disease progression, relapse, initiation of new anti-lymphoma therapy or death from any cause. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.

  • OVERALL SURVIVAL [ Time Frame: Up to 3.5 years ] [ Designated as safety issue: No ]
    Overall survival will be measured from the date of inclusion to the date of death from any cause. Patients who are alive at the time of analysis will be censored at the date of the last contact.

  • COMPLETE RESPONSE RATE [ Time Frame: 30 or 32 weeks (depending on induction cycle length) ] [ Designated as safety issue: No ]

    Assessment of response will be based on the International Workshop to Standardize Response criteria for NHL (Criteria for evaluation of response in Non-Hodgkin's lymphoma (Cheson, 2007)).

    Patient without response assessment (due to whatever reason) will be considered as nonresponder.



Estimated Enrollment: 40
Study Start Date: December 2012
Estimated Study Completion Date: April 2016
Primary Completion Date: August 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: R-CMC544 and R-GEMOX
Treatment with R-CMC544 and R-GEMOX
Drug: Rituximab, CMC544, Gemcitabine and Oxaliplatine

2 cycles of induction of 56 days each, starting with the administration of R-CMC544 on day 1, followed by the administration of R-GEMOX on day 29 and 43.

2 cycles of consolidation of 56 days each, starting with the administration of R-CMC544 on day 1, followed by the administration of R-GEMOX on day 29 and 43.


Detailed Description:

This study is a multicenter, phase Ib/II, open-label, single arm trial evaluating the efficacy and safety of R-CMC544 alternated with R-GEMOX in patients with CD20 and CD22 positive DLBCL in relapse after/refractory to 1st or 2nd line treatment, who are no candidates for autologous transplant.

The study consists of 2 phases. In part 1 (potential dose de-escalation phase) subjects will be enrolled at a fixed dose of CMC544. In case of occurrence of dose limiting toxicity (DLT), cohorts of 3 to 6 subjects will evaluate a de-escalating dose of CMC544 in combination with set doses of rituximab, gemcitabine and oxaliplatin in order to obtain the MTD or recommended dose of CMC544 in this regimen. In part 2 (dose expansion phase) further safety and preliminary efficacy data of the proposed combination will be analyzed.

All patients will receive two 56 day induction cycles of alternating R-CMC544 (given on day 1) and R-GEMOX (given on day 29 and 43). Patients who obtain CR or PR, will then go on a consolidation of another two 56 day cycles of alternating R-CMC544 (given on day 1) and R-GEMOX (given on day 29 and 43).

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically documented CD20 and CD22 positive diffuse large B-cell lymphoma, according to WHO classification. CD20 and CD22 immunophenotyping at initial diagnosis is acceptable. If such prior documentation is not available, then the immunophenotyping at relapse must be established by fine-needle aspirate or biopsy or by circulating CD20 and CD22 positive NHL cells from peripheral blood during screening. Upon registration the pathological report confirming the diagnosis, must be available
  • In first or second relapse or refractory to first and/or second line treatment. Refractory is defined as having exhibited less than or PR to a prior rituximab containing regimen or having relapsed within 6 months of the last dose of a prior rituximab containing regimen.
  • Measurable disease by bidimensional transverse CT scan assessment
  • Not eligible for autologous transplantation.
  • Previously treated with a chemotherapy regimen containing anthracyclines and rituximab.
  • Aged 18 - 80 years.
  • ECOG performance status 0 to 2.
  • Minimum life expectancy of 3 months.
  • Signed written informed consent.

Exclusion Criteria:

  • Burkitt, mantle cell and T-cell lymphomas.
  • Central nervous system or meningeal involvement by the lymphoma.
  • Contraindication to any drug contained in the R-GEMOX combination chemotherapy.
  • Treatment with any investigational drug within 30 days before the first planned cycle of chemotherapy and during the study.
  • Nitrosurea or mitomycin C administration within 6 weeks prior to study start.
  • Major debulking surgery within 3 weeks of treatment.
  • Any of the following lab abnormalities (unless related to the lymphoma or bone marrow infiltration):

Absolute neutrophil count (ANC) < 1.500/µL (1,5.109/L).

Platelet count < 100.000/µL (100.109/L).

Creatinin level > 150 µmol/L (1,7 mg/dL) or 1,5 - 2,0x ULN.

Total bilirubin level > 30 µmol/L (1,8 mg/dL) or 1,5x ULN.

Serum AST/SGOT or ALT/SGPT >2,5x ULN.

  • Documented infection with HIV, active hepatitis B or C infection.
  • Any serious active disease or co-morbid medical condition that, according to the investigator's decision, will substantially increase the risk associated with the subject's participation in the study. Prior history of malignancies other than lymphoma with the exception of non-melanoma skin tumors (basal cell or squamous cell carcinoma of the skin) or stage 0 (in situ) cervical carcinoma unless the subject has been disease-free for 5 or more years..
  • LVEF less than 50% (measured by echocardiography or scintigraphy).
  • Previous myocardial infarction or pulmonary hypertension within 6 months before the first dose of investigational product.
  • Congestive heart failure NYHA stage III or IV
  • Known chronic liver disease (eg. Cirrhosis) or suspected alcohol abuse.
  • Pregnant or lactating females
  • Men and women who are biologically capable of having children not willing to use an adequate method of birth control during the study and up to 18 months after the last dose of investigational product.
  • Adult patient unable to provide informed consent because of intellectual impairment, any serious medical condition, laboratory abnormality or psychiatric illness.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01562990

Locations
Belgium
AZ Sint Jan
Bruges, Belgium, 8000
University Hospital Gent
Gent, Belgium, 9000
CHU Mont-Godinne
Yvoir, Belgium
France
Hôpital Henri Mondor
Créteil, France, 94010
CHU de Dijon
Dijon, France, 21000
CHRU de Lille
Lille, France, 59037
CHU Lyon - Sud
Lyon, France, 69495
CHU Hôtel Dieu
Nantes, France, 44093
CHU Pontchaillou
Rennes, France, 35003
Centre Henri Becquerel
Rouen, France, 76038
CHU Brabois
Vandoeuvre les nancy, France, 54511
Sponsors and Collaborators
The Lymphoma Academic Research Organisation
Pfizer
Investigators
Study Chair: Fritz OFFNER, MD Lymphoma Study Association
Study Chair: Corinne HAIOUN, PhD Lymphoma Study Association
  More Information

Additional Information:
No publications provided

Responsible Party: The Lymphoma Academic Research Organisation
ClinicalTrials.gov Identifier: NCT01562990     History of Changes
Other Study ID Numbers: CMC-R-GEMOX, 2011-003849-18
Study First Received: March 20, 2012
Last Updated: December 23, 2014
Health Authority: Belgium: Federal Agency for Medicinal Products and Health Products
Belgium: Ethics Committee - Universitair Ziekenhuis Gent
France: Agence Nationale de Sécurité du Médicament et des produits de santé

Additional relevant MeSH terms:
Lymphoma
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Immune System Diseases
Immunoproliferative Disorders
Lymphatic Diseases
Lymphoma, Non-Hodgkin
Lymphoproliferative Disorders
Neoplasms
Neoplasms by Histologic Type
Gemcitabine
Rituximab
Anti-Infective Agents
Antimetabolites
Antimetabolites, Antineoplastic
Antineoplastic Agents
Antirheumatic Agents
Antiviral Agents
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Radiation-Sensitizing Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on May 21, 2015