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    Clinical Trial Results:
    Phase II Single Agent Lenalidomide (Revlimid) in Relapsed / Refratory Mantle Cell Lymphoma.

    Summary
    EudraCT number
    2007-005472-13
    Trial protocol
    GB  
    Global end of trial date
    16 Dec 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    21 Sep 2019
    First version publication date
    21 Sep 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    Ply-5013
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    IRAS number: 4140, REC reference: 08/H0203/152
    Sponsors
    Sponsor organisation name
    University Hospitals Plymouth NHS Trust (formerly Plymouth Hospitals NHS Trust)
    Sponsor organisation address
    Research Office, L2 MSCP, Bircham Park Offices, 1 Roscoff Rise, Derriford, Plymouth, United Kingdom, PL6 5FP
    Public contact
    Dr Chris Rollinson, Research Governance Manager, University Hospitals Plymouth NHS Trust, Research Development and Innovation, 01752 432842, c.rollinson@nhs.net
    Scientific contact
    Prof Simon Rule, Consultant Haematologist, University Hospitals Plymouth NHS Trust, Haematology Department, 01752 517505, simon.rule@nhs.net
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    31 Mar 2010
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    31 Mar 2010
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Dec 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the rates of overall response to lenalidomide in terms of complete response, complete response unconfirmed and partial response
    Protection of trial subjects
    The study is approved by the MHRA and the South West - Cornwall & Plymouth (formerly Cornwall and Plymouth) Research Ethics Committee (NRES). 20% source data verification, as well as 100% verification of patient consent and central monitoring of data was carried out throughout the trial. Study monitoring is conducted by Peninsula CTU (Pen CTU).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    13 Nov 2008
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 26
    Worldwide total number of subjects
    26
    EEA total number of subjects
    26
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    9
    From 65 to 84 years
    17
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study population will comprise of patients with refractory mantle cell lymphoma and patients who have relapsed after completion of two or more treatment regimens.

    Pre-assignment
    Screening details
    Screening assessments (medical history, previous lymphoma history, date of diagnosis, prior treatment & responses, date & duration of responses, other significant illnesses); Demographics; Physical examination; CT scan (neck, thorax abdomen & pelvis); Bone marrow tests; Blood tests; ECG (heart trace); Pregnancy tests (all female patients).

    Pre-assignment period milestones
    Number of subjects started
    26
    Number of subjects completed
    26

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Lenalidomide
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Lenalidomide
    Investigational medicinal product code
    Other name
    Revlimid
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Participants were enrolled on a dose of 25mg per day for 21 days in a 28 day cycle for six cycles, then reduce to 15mg per day for 21 out of 28 days for a maintenance period.

    Number of subjects in period 1
    Lenalidomide
    Started
    26
    Completed
    15
    Not completed
    11
         Consent withdrawn by subject
    2
         Adverse events
    4
         Withdrew due to progressive disease
    5

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Lenalidomide
    Reporting group description
    -

    Reporting group values
    Lenalidomide Total
    Number of subjects
    26 26
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    66 (45 to 81) -
    Gender categorical
    Units: Subjects
        Female
    7 7
        Male
    19 19
    Ann Arbor stage
    At study entry.
    Units: Subjects
        III-IV
    26 26
    Bone marrow involvement? Y/N
    At study entry.
    Units: Subjects
        Yes
    14 14
        No
    12 12
    Lymphocytosis? Y/N
    At study entry.
    Units: Subjects
        Yes
    8 8
        No
    18 18
    Blastic histology? Y/N
    Units: Subjects
        Yes
    4 4
        No
    22 22
    ECOG (Performance Status)
    Units: Subjects
        Grade 0
    11 11
        Grade 1
    11 11
        Grade 2
    4 4
    Prior therapy: Rituximab (Y/N)
    Units: Subjects
        Yes
    19 19
        No
    7 7
    Prior therapy: Bortezomib (Y/N)
    Units: Subjects
        Yes
    8 8
        No
    18 18
    Prior therapy: Thalidomide (Y/N)
    Units: Subjects
        Yes
    2 2
        No
    24 24
    Prior therapy: Stem cell transplantation (Y/N)
    Units: Subjects
        Yes
    6 6
        No
    20 20
    Prior therapy: Purine analogue (Y/N)
    Units: Subjects
        Yes
    19 19
        No
    7 7
    Prior therapy: Anthracycline (Y/N)
    Units: Subjects
        Yes
    18 18
        No
    8 8
    Prior therapy: Alkylating agent (Y/N)
    Units: Subjects
        Yes
    25 25
        No
    1 1
    Refractory to last treatment
    Units: Subjects
        Refractory
    6 6
        Not refractory
    20 20
    Time from diagnosis
    Units: Years
        median (full range (min-max))
    3.9 (0.3 to 12.9) -
    Prior therapies
    Units: Number
        median (full range (min-max))
    3 (2 to 7) -

    End points

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    End points reporting groups
    Reporting group title
    Lenalidomide
    Reporting group description
    -

    Primary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [1]
    End point description
    The primary endpoint was ORR, defined as the proportion of patients with partial response (PR), complete response unconfirmed (CRu), or complete response (CR).
    End point type
    Primary
    End point timeframe
    Response assessments - study visits took place at the beginning of each cycle. Response was evaluated using International Working Group criteria for NHL after 3 and 6 cycles of lenalidomide, and thereafter as clinically indicated.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The statistical analyses data was not available to the EudraCT Data Inputter. However, the statistical analysis and results have been published. A link to the publication is provided in the 'Online references' section.
    End point values
    Lenalidomide
    Number of subjects analysed
    26
    Units: Months
        median (confidence interval 95%)
    22.2 (0.0 to 53.6)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    PI’s make initial report describing the event and possible causality, to coordinating centre, within 24 hours. Initial reports must be followed by more detailed information as soon as it becomes available.
    Adverse event reporting additional description
    PI to sign/date SAEs reported. In PI’s absence a designated medically qualified person may sign report, but PI to countersign on return. Countersigned form must be sent to trial coordinator ASAP. Notifications for MHRA/ REC are generated from these reports. All investigators will receive SAEs/SUSARS notifications occurring during the study.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    None
    Dictionary version
    0
    Reporting groups
    Reporting group title
    Lenalidomide
    Reporting group description
    -

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: The non-serious adverse events data was not available to the EudraCT Data Inputter.
    Serious adverse events
    Lenalidomide
    Total subjects affected by serious adverse events
         subjects affected / exposed
    16 / 26 (61.54%)
         number of deaths (all causes)
    5
         number of deaths resulting from adverse events
    4
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    General disorders and administration site conditions
    Spleen disorder
    Additional description: Left loin pain, possible tumour flare - enlarged spleen.
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
    Additional description: Increased pain from leg lesion.
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile infection
    Additional description: Febrile illness following flu vaccination.
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
    Additional description: Abdominal and back pain - general deterioration in condition.
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Thrombocytopenia
    Additional description: Thrombocytopenia and deterioration in condition.
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pyrexia
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Pancytopenia
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    3 / 26 (11.54%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 2
    Neutropenia
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Vomiting
    Additional description: Vomiting and dehydration.
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    3 / 26 (11.54%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumonia
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    Plural effusion
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Dyspnea
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Respiratory tract infection
         subjects affected / exposed
    4 / 26 (15.38%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    Cough
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Laryngitis
    Additional description: Grade 3
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 26 (3.85%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    3 / 26 (11.54%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    1 / 1
    Neutropenic sepsis
         subjects affected / exposed
    2 / 26 (7.69%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Lenalidomide
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 26 (0.00%)

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 May 2009
    Protocol V2, 12 Mar 2009: Changes in the information regarding adverse reactions associated with Lenalidomide supplied by Celgene Ltd following publication of an updated IB. Most significant are: Tumour Lysis Syndrome, Tumour Flare Reaction, Allergic reactions (angioedema & serious dermatological reactions).
    25 Mar 2010
    Protocol V3, 6 Jan 2010: Changes in the information regarding adverse reactions associated with Lenalidomide supplied by Celgene Ltd following publication of an updated IB. Addition to the exclusion criteria and changes to the dose modification for haematological toxicity in cycles one and two.
    24 Dec 2010
    Protocol V4, 4 Oct 2010: Following a review by the Data Monitoring Committee a change has been made in the dosing schedule for the patients enrolled. The haematological entry criteria was also changed to allow patients with a previous treatment related compromised bone marrow to be enrolled into the trial. Increase the recruitment target by a further 10 participants as the initial recruitment target of 25 has been reached. Finally, changes to the dose modification for haematology toxicity in line with the changes to the dosing schedule.
    17 Aug 2011
    Protocol V5, 20 Jun 2011: Change to the entry criterion, in relation to platelet counts and the number of previous therapies the potential patients need to be eligible. Request for the addition of two biopsies to assess the mechanisms of the actions of Lenalidomide and the potential for biomarkers to be isolated. As a result of a revised IB, the protocol has been updated with two additional warnings and precautions.
    12 Dec 2011
    Protocol V6, 19 Oct 2011: Information relating to the potential for Lenalidomide to increase the patients risk of developing a second cancer. Change in the drug supply process and a change to the drug labels.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/22881386
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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