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BLINAtumomab After R-CHOP Debulking Therapy for Patients With Richter Transformation

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03931642
Recruitment Status : Recruiting
First Posted : April 30, 2019
Last Update Posted : July 19, 2019
Sponsor:
Collaborator:
Amgen
Information provided by (Responsible Party):
French Innovative Leukemia Organisation

Brief Summary:

Blinatumomab (BLINCYTO) is a bi-specific T-cell engaging (BiTE®) antibody construct that transiently links CD3-positive T cells to CD19-positive B-cells, inducing T-cell activation and subsequent lysis of tumor cells.

The investigators propose to evaluate the efficacy, safety and tolerability of blinatumomab administered after R-CHOP debulking therapy in patients with Richter Syndrome (RS) of diffuse large B-cell lymphoma (DLBCL) histology.

The investigators hypothesize that 8-week blinatumomab induction therapy leads to Complete Response (CR) rate improvement (revised Cheson criteria) from a baseline of 7percent as observed in the prospective study evaluating R-CHOP.


Condition or disease Intervention/treatment Phase
Richter Syndrome Drug: RCHOP Drug: Blinatumomab Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 35 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: BLINAtumomab After R-CHOP Debulking Therapy for Patients With Richter Transformation
Actual Study Start Date : July 5, 2019
Estimated Primary Completion Date : July 4, 2021
Estimated Study Completion Date : July 4, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: R-CHOP- blinatumomab

Patients will first undergo a prior debulking therapy including 2 cycles of R-CHOP.

At Day1 (D1) : Rituximab 375 mg/m² Intravenous (IV) + Cyclophosphamide 750 mg/m² IV + Doxorubicin 50 mg/m² IV + Vincristine 1.4 mg/m² IV.

From D1 to D5 : Prednisone 60 mg/m² Per Os (PO). Patients with CR and no measurable lesion left will not be treated further in the setting of the present trial. All the remaining patients will be continuing and treating on study with a single cycle of blinatumomab induction therapy : Blinatumomab at 9 μg/d IV by continuous vein infusion from day 1-7, 28 μg/d from day 8-14 and 112 μg/d from day 15-56.

Patients who achieve an objective response after induction are eligible to receive one further optional cycle of blinatumomab consolidation : blinatumomab 9 μg/d IV by continuous vein infusion from day 1-7, 28 μg/d from day 8-14 and 112 μg/day IV from day 15-28.

Drug: RCHOP

D1 : Rituximab 375 mg/m² IV + Cyclophosphamide 750 mg/m² IV + Doxorubicin 50 mg/m² IV + Vincristine 1.4 mg/m² IV.

From D1 to D5 : Prednisone 60 mg/m² PO.


Drug: Blinatumomab
Blinatumomab by continuous vein infusion




Primary Outcome Measures :
  1. Complete remission (CR) rate according to the revised Lugano criteria [ Time Frame: at week 16 from baseline ]
    the objective response rate to one 8-week cycle of blinatumomab following a debulking therapy with 2 R-CHOP cycles


Secondary Outcome Measures :
  1. Number of patients with treatment-related adverse events as assessed by CTCAE v4.0 [ Time Frame: From the first treatment administration and during treatment period (R-CHOP and blinatomomab) ]
    safety and toxicity of blinatumomab after 2 cycles of R-CHOP

  2. overall response [ Time Frame: At week 16 from baseline, after blinatumomab induction and at week 24 after blinatumomab consolidation. ]
    Overall response rate (revised Lugano criteria) after the first and second cycle of blinatumomab,

  3. CR rate [ Time Frame: After blinatumomab consolidation (total of 4 weeks) at week 24 from the beginning of study treatment. ]
    CR rate (revised Lugano criteria) after the second cycle of blinatumomab



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:

  • Confirmed diagnosis of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma according to the revised iwCLL criteria19 with biopsy proven transformation to diffuse large B-cell lymphoma, consistent with RS according to the 2016 WHO classification
  • Both patients with previously treated or treatment-naïve CLL are eligible
  • Age greater than or equal to 18 years
  • Eastern Cooperative Oncology Group (ECOG) performance status <3
  • Patients must meet the following hematologic criteria at screening, unless they have significant bone marrow involvement of either CLL or RS cells confirmed on biopsy: absolute neutrophil count ≥1.0 G/L, platelet count ≥50 G/L independent of transfusion within 7 days of screening
  • Subject must have adequate coagulation, renal, and hepatic function at screening
  • Adequate left ventricular ejection function (> 50 %)
  • Patients who have undergone prior allogeneic hematopoietic stem-cell transplantation (HSCT) are eligible as long as they do not have significant active graft versus host disease and that their transplant day 0 is > 6 months from their first dose of protocol therapy
  • Female patients of child bearing potential must have negative pregnancy test and use an effective method of birth control during treatment period and 48h thereafter; Males must use an effective method of birth control during treatment period and 48h thereafter.
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Patients with the Hodgkin variant of RS
  • Patients with previously treated RS
  • History or presence of clinically relevant disorder affecting the central nervous system (CNS)
  • Known active DLBCL in the CNS (confirmed by cerebrospinal fluid analysis)
  • Steroids treatment (≥ 20 mg for one week) before inclusion
  • HSCT within 6 months before inclusion
  • Active graft-versus-host disease
  • History of other malignancies, except: i) malignancy treated with curative intent and with no recurrence over the last 5 years ii) adequately treated non-melanoma skin cancer without evidence of disease iii) adequately treated carcinoma in situ without evidence of disease
  • History of human immunodeficiency virus
  • Hepatitis B or C seropositivity (unless clearly due to vaccination)
  • Pregnant or breastfeeding women
  • Unwilling or unable to participate in all required study evaluations and procedures.
  • Unable to understand the purpose and risks of the study and to provide a signed and dated informed consent form and authorization to use protected health information (in accordance with national and local subject privacy regulations)
  • Abnormal screening laboratory values as defined as following: a) serum glutamate oxaloacetate transaminase and/or serum glutamate pyruvate transaminase and/or alkaline phosphatase > or =5 x upper limit of normal (ULN); b) Total bilirubin > or = 1.5 x ULN, unless due to Gilbert's disease; c) Creatinine > or = 2.0 x ULN or creatinine clearance <50 mL/min (calculated).
  • Fertile male and female patients who cannot or do not wish to use an effective method of contraception during treatment and for 48h after the final treatment used for the purposes of the study
  • Treatment with other investigational agent or participating to another trial within 30 days prior to entering the study
  • No affiliated to social security

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): NCT03931642


Contacts
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Contact: Laetitia AUVRAY 0785226327 ext 33 l.auvray.goelams@gmail.com
Contact: Valérie ROUILLE 0467332645 ext 33 v-rouille@chu-montpellier.fr

Locations
Show Show 28 study locations
Sponsors and Collaborators
French Innovative Leukemia Organisation
Amgen
Investigators
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Principal Investigator: Romain GUIEZE University Hospital, Clermont-Ferrand

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Responsible Party: French Innovative Leukemia Organisation
ClinicalTrials.gov Identifier: NCT03931642    
Other Study ID Numbers: FILOCLL13-BLINART
First Posted: April 30, 2019    Key Record Dates
Last Update Posted: July 19, 2019
Last Verified: July 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Blinatumomab
Antibodies, Bispecific
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs