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Study of OBINUTUZUMAB Combined to LENALIDOMIDE for the Treatment of Relapsed/Refractory Follicular and Aggressive B-cell Lymphoma

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ClinicalTrials.gov Identifier: NCT01582776
Recruitment Status : Active, not recruiting
First Posted : April 23, 2012
Last Update Posted : August 26, 2019
Sponsor:
Information provided by (Responsible Party):
The Lymphoma Academic Research Organisation

Brief Summary:

This study is to determine first the appropriate dose of lenalidomide to administer in combination with fixed doses of obinutuzumab in relapsed/refractory follicular lymphoma patients.

In a second step, this study aims to determine the efficacy of this combination in 3 separate populations: relapsed/refractory aggressive lymphoma (diffuse large B-cell lymphoma and mantle cell lymphoma: cohort 1), relapsed/refractory follicular lymphoma (cohort 2) and previously untreated follicular lymphoma (cohorts 3 and 4).


Condition or disease Intervention/treatment Phase
Follicular Lymphoma Patients (Phase IB) Follicular and Agressive (DLBCL&MCL) B-cell Lymphoma Patients (Phase II) Drug: Lenalidomide and GA101 Phase 1 Phase 2

Detailed Description:

This study is an open label, multicenter study with two phases:

The Phase IB part of the study is a dose escalation study of lenalidomide (Revlimid) administered orally during on 3 weeks of every 28-day cycle, in combination with fixed doses of obinutuzumab (GA101) in relapsed/refractory follicular lymphoma patients.

The Phase II part of the study is an efficacy study of the association of the recommended dose of lenalidomide associated with GA101 in 2 separate populations of patients: relapsed/refractory aggressive lymphoma (diffuse large B-cell lymphoma and mantle cell lymphoma: cohort 1), relapsed/refractory follicular lymphoma (cohort 2) and previously untreated follicular lymphoma (cohorts 3 and 4). First, all patients will receive a combination of obinutuzumab and lenalidomide for a total of 6 cycles. Patients who achieve at least a partial response after 6 cycles will receive a maintenance treatment with obinutuzumab for 2 years and Lenalidomide for 1 year as tolerated, or until disease progression.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 317 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase Ib/II Study of OBINUTUZUMAB Combined to LENALIDOMIDE for the Treatment of Follicular and Relapsed/Refractory Aggressive (DLBCL and MCL) B-cell Lymphoma
Actual Study Start Date : October 3, 2012
Actual Primary Completion Date : July 11, 2018
Estimated Study Completion Date : March 2022


Arm Intervention/treatment
Experimental: Lenalidomide and GA101
Ga101 and lenalidomide
Drug: Lenalidomide and GA101
1000mg of GA101 on D8, D15 and D22of cycle 1 and on D1 of cycles 2 to 6. Oral lenalidomide once daily at 10/15/20/25mg (phase I part) or at recommended dose (phase II part) on days 1 to 21 of a 28-day cycle for the first cycle and on days 2 to 22 of a 28-day cycle for cycles 2 to 6.
Other Names:
  • Revlimid
  • Obinutuzumab




Primary Outcome Measures :
  1. Phase I part: Determination of the recommended dose of lenalidomide in combination with fixed doses of GA101 [ Time Frame: 28 days ]
    The determination of the recommended dose of lenalidomide in combination with fixed doses of GA101 will be performed by a dose escalation approach. Dose Limiting Toxicities (DLTs) observed during the administration of the first 2 cycles of the study will be listed for each escalation step.

  2. Phase II part: Overall Response Rate (CR+CRu+PR) after 6 cycles [ Time Frame: 24 weeks ]
    Response rates at the end of treatment including maintenance will be expressed as percentages with their 95% Exact Clopper Pearson Confidence Interval limits


Secondary Outcome Measures :
  1. Overall survival (OS) [ Time Frame: Up to 4.5 years ]

    Overall survival will be measured from the date of inclusion to the date of death from any cause.

    Alive patients will be censored at their last date known to be alive


  2. Event Free survival [ Time Frame: Up to 4.5 years ]
    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.

  3. Progression free survival [ Time Frame: Up to 4.5 years ]
    Progression-Free Survival will be measured according to the Cheson 2007 criteria. Responding patients and patients who are lost to follow up will be censored at their last tumor assessment date.

  4. Response duration [ Time Frame: Up to 4.5 years ]
    Patients alive and free of progression will be censored at their last follow-up date

  5. Response rate at the end of maintenance treatment [ Time Frame: 2.5 years ]
    Response rates will be evaluated at the end of maintenance phase for patients who achieve a CR/PR after induction treatment and received at least one dose of maintenance. 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 after maintenance treatment (due to whatever reason) will be considered as non-responder.

  6. Complete response rate after induction [ Time Frame: 24 weeks ]
    Disease response evaluation after 6 cycles will be used to determine the Complete Response Rate. Response after 6 cycles will be assessed only if patient completes induction phase. 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)).

  7. Complete response rate after 3 cycles [ Time Frame: 12 weeks ]

    Disease response evaluation after 3 cycles will be used to determine the Complete Response Rate.

    Response after 3 cycles will be assessed at the end of completion of the 3 cycles if patient received all 3 cycles or at withdrawal. 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).




Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Phase IB only: Histologically documented CD20-positive follicular lymphoma (WHO grade 1, 2, or 3a) patients
  • Phase II: Patients with either histologically documented CD20-positive Diffuse large-cell lymphoma or Mantle cell lymphoma (cohort 1) or follicular lymphoma, WHO grade 1, 2 or 3a (cohort 2-3-4)
  • Phase IB and II:
  • Relapsed/refractory NHL after ≥1 prior R-containing regimen with no curative option (cohort 2 only)
  • Aged 18 years or more
  • ECOG performance status 0, 1 or 2
  • At least one bi-dimensionally measurable nodal or tumor lesion defined by CT scan as: greatest transverse diameter > 1.5 cm and a short axis ≥ 10mm
  • Signed inform consent
  • Life expectancy ≥ 3 months.
  • All subjects must be able to understand and fulfill the lenalidomide Pregnancy Prevention Plan requirements (see in appendix)
  • Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual contact during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; 3) dose interruptions; and 4) for at least 2 months after discontinuation of all study treatments.

Exclusion Criteria:

  • Previous treatment with obinutuzumab or lenalidomide
  • Known CD20 negative status at relapse/progression. Biopsy at relapse/progression is recommended but not mandatory
  • Central nervous system or meningeal involvement by lymphoma
  • Contraindication to any drug contained in the study treatment regimen
  • Known HIV or HTLV-1 infection, positive serology to HB surface antigen [HBsAg] or total HB core antibody [anti-HB-c]) and Hepatitis C (Hepatitis C virus [HCV] antibody)
  • Any serious active disease or co-morbid medical condition (such as New York Heart Association Class II or IV cardiac disease, severe arrhythmia, myocardial infarction within the last 6 months, unstable arrhythmias, or unstable angina) or pulmonary disease (including obstructive pulmonary disease and history of bronchospasm or other according to investigator's decision)
  • Any of the following laboratory abnormalities unless secondary to underlying lymphoma:

    • Absolute neutrophil count (ANC) < 1,500 cells/mm3 (1.5 x 109/L).
    • Platelet count < 100,000/mm3 (100 x 109/L) unless due to lymphoma for phase II part.
    • Serum SGOT/AST or SGPT/ALT 3.0 x upper limit of normal (ULN) unless disease involvement.
    • Serum total bilirubin > 2.0 mg/dL (34 μmol/L), except if disease related or in case of Gilbert syndrome
    • Calculated creatinine clearance (Cockcroft-Gault formula or MDRD) of < 50 mL /min. For phase II part of the study, patients with calculated creatinine clearance between 30 and 50ml/min can be included and lenalidomide dose will be adjusted as follows (10mg once daily)
  • Prior history of malignancies other than lymphoma unless the subject has been free of the disease for ≥ 5 years
  • Any serious medical condition, laboratory abnormality (other than mentioned above), or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or lactating females.
  • Prior ≥ Grade 3 allergic reaction/hypersensitivity to thalidomide.
  • Prior ≥ Grade 3 rash or any desquamating (blistering) rash while taking thalidomide.
  • Subjects with ≥ Grade 2 neuropathy.
  • Use of any standard or experimental anti-cancer drug therapy within 28 days of the initiation (Day 1) of study drug therapy
  • Patients taking corticosteroids during 4 weeks before inclusion, unless administered at a dose equivalent to ≤ 10 mg/day prednisone (over these 4 weeks)
  • Prior history of Progressive Multifocal Leukoencephalopathy (PML)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01582776


Locations
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Belgium
ZNA Stuivenberg
Antwerpen, Belgium, 2060
A.Z. Sint Jan AV
Bruges, Belgium, 8000
institut Jules Bordet
Bruxelles, Belgium, 1000
Université Catholique de Louvain Saint Luc
Bruxelles, Belgium, 1200
AZ Groeninge - Campus Maria's Voorzienigheid
Kortrijk, Belgium, 8500
CHU de Liège
Liège, Belgium, 4000
Université Catholique de Louvain Mont Godinne
Yvoir, Belgium, 5530
France
CHU d'Amiens
Amiens, France, 80054
Institut Bergonié
Bordeaux, France, 33076
Institut d'Hématologie de Basse Normandie
Caen, France, 14076
CHU d'Estaing
Clermont-Ferrand, France, 63000
Hôpital Henri Mondor
Créteil, France, 94010
CHU de Dijon
Dijon, France, 21034
CHU de Grenoble
Grenoble, France, 38043
CHRU de Lille
Lille, France, 59037
Centre Léon Bérard
Lyon, France, 69373
Institut Paoli Calmette
Marseille, France, 13273
CHU St Eloi
Montpellier, France, 34295
CHU Brabois
Nancy, France, 54511
CHU Hôtel Dieu
Nantes, France, 44093
Hôpital St Louis
Paris, France, 75475
Centre François Magendie
Pessac, France, 33604
CH Lyon Sud
Pierre Bénite, France, 69495
CHU Pontchaillou
Rennes, France, 35003
Centre henri Becquerel
Rouen, France, 76038
Sponsors and Collaborators
The Lymphoma Academic Research Organisation
Investigators
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Principal Investigator: Franck MORSCHHAUSER, Professor Lymphoma Study Association
Principal Investigator: Roch HOUOT, Professor Lymphoma Study Association

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: The Lymphoma Academic Research Organisation
ClinicalTrials.gov Identifier: NCT01582776     History of Changes
Other Study ID Numbers: GALEN
First Posted: April 23, 2012    Key Record Dates
Last Update Posted: August 26, 2019
Last Verified: August 2019
Additional relevant MeSH terms:
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Lenalidomide
Lymphoma
Lymphoma, B-Cell
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Obinutuzumab
Immunologic Factors
Physiological Effects of Drugs
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Antineoplastic Agents, Immunological