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    Clinical Trial Results:
    Rituximab in Primary Central Nervous system Lymphoma. A randomized HOVON / ALLG intergroup study

    Summary
    EudraCT number
    2009-014722-42
    Trial protocol
    NL  
    Global end of trial date
    21 Dec 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Mar 2024
    First version publication date
    06 Mar 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HO105
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    HOVON
    Sponsor organisation address
    Dr. Molenwaterplein 40, Rotterdam, Netherlands,
    Public contact
    Dr. J.K. Doorduijn, HOVON Data Center, +31 (0)107041560, hovon@erasmusmc.nl
    Scientific contact
    Dr. J.K. Doorduijn, HOVON Data Center, +31 (0)107041560, hovon@erasmusmc.nl
    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
    30 Jun 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    23 May 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Dec 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Assess the effect of the addition of rituximab to standard chemotherapy for PCNSL
    Protection of trial subjects
    Monitoring and Insurance
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 Jul 2010
    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
    Australia: 30
    Country: Number of subjects enrolled
    New Zealand: 15
    Country: Number of subjects enrolled
    Netherlands: 157
    Worldwide total number of subjects
    202
    EEA total number of subjects
    157
    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)
    128
    From 65 to 84 years
    74
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    All subjects gave written informed consent and were screened according to the inclusion- and exclusion criteria

    Period 1
    Period 1 title
    Overall period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Control group
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    MBVP
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    All patients will be treated with 2 courses of MBVP (total of 4 MTX doses) according to the schedule below. The 2nd course is scheduled 28 days after start of the previous course (at day 29): Agent Dose/day Route Days Methotrexate (HD-MTX) 3000 mg/m2 1 hr infusion i.v. 1,15 Teniposide 100 mg/m2 i.v. 2,3 BCNU 100 mg/m2 i.v. 4 Prednisolone 60 mg/m2 Orally or i.v. 1, 2, 3, 4, 5 The second HD-MTX dose is given 14 days after the first dose.

    Arm title
    Experimental group
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Rituximab Mabthera
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intrathecal use
    Dosage and administration details
    Rituximab 375 mg/m2 course 1: d 0,7,14,21 course 2: d 0, 14

    Number of subjects in period 1
    Control group Experimental group
    Started
    101
    101
    Completed
    75
    76
    Not completed
    26
    25
         Unknown
    3
    4
         Patients request
    3
    3
         Adverse reaction
    4
    11
         Lack of efficacy
    16
    7

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall period
    Reporting group description
    -

    Reporting group values
    Overall period Total
    Number of subjects
    202 202
    Age categorical
    Adults (26-70 years)
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    128 128
        From 65-84 years
    74 74
        85 years and over
    0 0
        Adults (26-70 years)
    0 0
    Gender categorical
    Units: Subjects
        Female
    91 91
        Male
    111 111

    End points

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

    Reporting group title
    Experimental group
    Reporting group description
    -

    Primary: Primary endpoint

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    End point title
    Primary endpoint [1] [2]
    End point description
    End point type
    Primary
    End point timeframe
    See publication
    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: See attached chart/documents for results
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: See attached chart/documents for results
    End point values
    Control group
    Number of subjects analysed
    101
    Units: Whole
    199
    Attachments
    Untitled (Filename: saedata105-11Dec2023.pdf)
    Untitled (Filename: nonsaedata105-11Dec2023.pdf)
    Untitled (Filename: HO105_statistical data section form publication 30-06-2017 (1).pdf)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events will be reported from the first study-related procedure until 30 days following the last dose of any drug or RT treatment from the protocol treatment schedule or until the start of subsequent systemic therapy for the disease under study,
    Adverse event reporting additional description
    if earlier. Adverse events occurring after 30 days should also be reported if considered at least possibly related to the protocol treatment by the investigator. Special attention should be given to neurological and cognitive symptoms. Adverse Events have to be reported on the Adverse Events CRF.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    Control group
    Reporting group description
    -

    Reporting group title
    Experimental
    Reporting group description
    -

    Serious adverse events
    Control group Experimental
    Total subjects affected by serious adverse events
         subjects affected / exposed
    48 / 100 (48.00%)
    53 / 99 (53.54%)
         number of deaths (all causes)
    64
    55
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Vascular disorders
    Vascular disorders
    Additional description: All combined
         subjects affected / exposed
    2 / 100 (2.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    General disorders
    Additional description: All combined
         subjects affected / exposed
    8 / 100 (8.00%)
    4 / 99 (4.04%)
         occurrences causally related to treatment / all
    4 / 8
    3 / 4
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    Immune system disorders
    Immune system disorders
    Additional description: All combined
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
    Additional description: All combined
         subjects affected / exposed
    3 / 100 (3.00%)
    5 / 99 (5.05%)
         occurrences causally related to treatment / all
    2 / 3
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Psychiatric disorders
    Additional description: All combined
         subjects affected / exposed
    2 / 100 (2.00%)
    2 / 99 (2.02%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Investigations
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
    Additional description: All combined
         subjects affected / exposed
    3 / 100 (3.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac disorders
    Additional description: All combined
         subjects affected / exposed
    2 / 100 (2.00%)
    4 / 99 (4.04%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 5
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined
         subjects affected / exposed
    11 / 100 (11.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    5 / 12
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Blood and lymphatic system disorders
    Blood and lymphatic system disorders
    Additional description: all combined
         subjects affected / exposed
    6 / 100 (6.00%)
    8 / 99 (8.08%)
         occurrences causally related to treatment / all
    6 / 6
    9 / 9
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined
         subjects affected / exposed
    4 / 100 (4.00%)
    6 / 99 (6.06%)
         occurrences causally related to treatment / all
    2 / 5
    3 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal and urinary disorders
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    6 / 99 (6.06%)
         occurrences causally related to treatment / all
    1 / 1
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Infections and infestations
    Additional description: All combined
         subjects affected / exposed
    20 / 100 (20.00%)
    23 / 99 (23.23%)
         occurrences causally related to treatment / all
    14 / 23
    18 / 25
         deaths causally related to treatment / all
    3 / 3
    1 / 1
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Control group Experimental
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    79 / 100 (79.00%)
    82 / 99 (82.83%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms bening, malignant and unspecified
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 99 (0.00%)
         occurrences all number
    1
    0
    Vascular disorders
    Vascular disorders
    Additional description: All combined
         subjects affected / exposed
    18 / 100 (18.00%)
    17 / 99 (17.17%)
         occurrences all number
    21
    20
    Surgical and medical procedures
    Surgical and medical procedures
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    5 / 99 (5.05%)
         occurrences all number
    1
    6
    General disorders and administration site conditions
    General disorders and administration site conditions
    Additional description: All combined
         subjects affected / exposed
    26 / 100 (26.00%)
    12 / 99 (12.12%)
         occurrences all number
    33
    15
    Immune system disorders
    Immune system disorders
    Additional description: All combined
         subjects affected / exposed
    2 / 100 (2.00%)
    0 / 99 (0.00%)
         occurrences all number
    2
    0
    Social circumstances
    Social circumstances
    Additional description: All combined
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    Reproductive system and breast disorders
    Reproductive system and breast disorders
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    5 / 99 (5.05%)
         occurrences all number
    4
    6
    Psychiatric disorders
    Psychiatric disorders
    Additional description: All combined
         subjects affected / exposed
    10 / 100 (10.00%)
    10 / 99 (10.10%)
         occurrences all number
    11
    11
    Investigations
    Investigations
    Additional description: All combined
         subjects affected / exposed
    29 / 100 (29.00%)
    29 / 99 (29.29%)
         occurrences all number
    76
    82
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
    Additional description: All combined
         subjects affected / exposed
    4 / 100 (4.00%)
    4 / 99 (4.04%)
         occurrences all number
    4
    5
    Congenital, familial and genetic disorders
    Congenital, familial and genetic disorders
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 99 (0.00%)
         occurrences all number
    1
    0
    Cardiac disorders
    Cardiac disorders
    Additional description: All combined
         subjects affected / exposed
    6 / 100 (6.00%)
    5 / 99 (5.05%)
         occurrences all number
    7
    5
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined
         subjects affected / exposed
    23 / 100 (23.00%)
    15 / 99 (15.15%)
         occurrences all number
    27
    16
    Blood and lymphatic system disorders
    Blood and lymphatic disorders
    Additional description: All combined
         subjects affected / exposed
    19 / 100 (19.00%)
    15 / 99 (15.15%)
         occurrences all number
    32
    27
    Ear and labyrinth disorders
    Ear and labyrinth disorders
    Additional description: All combined
         subjects affected / exposed
    3 / 100 (3.00%)
    2 / 99 (2.02%)
         occurrences all number
    3
    2
    Eye disorders
    Eye disorders
    Additional description: All combined
         subjects affected / exposed
    9 / 100 (9.00%)
    5 / 99 (5.05%)
         occurrences all number
    9
    5
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined
         subjects affected / exposed
    33 / 100 (33.00%)
    37 / 99 (37.37%)
         occurrences all number
    47
    56
    Hepatobiliary disorders
    Hepatobiliary disorders
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    1
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
    Additional description: All combined
         subjects affected / exposed
    12 / 100 (12.00%)
    5 / 99 (5.05%)
         occurrences all number
    13
    6
    Renal and urinary disorders
    Renal and urinary disorders
    Additional description: All combined
         subjects affected / exposed
    8 / 100 (8.00%)
    15 / 99 (15.15%)
         occurrences all number
    9
    20
    Endocrine disorders
    Endocrine disorders
    Additional description: All combined
         subjects affected / exposed
    1 / 100 (1.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    1
    Musculoskeletal and connective tissue disorders
    Musculoskeletal and connective tissue disorders
    Additional description: All combined
         subjects affected / exposed
    9 / 100 (9.00%)
    10 / 99 (10.10%)
         occurrences all number
    10
    10
    Infections and infestations
    Infections and infestations
    Additional description: All combined
         subjects affected / exposed
    39 / 100 (39.00%)
    33 / 99 (33.33%)
         occurrences all number
    62
    51
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
    Additional description: All combined
         subjects affected / exposed
    22 / 100 (22.00%)
    24 / 99 (24.24%)
         occurrences all number
    40
    43

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    18 May 2011
    Safety reporting procedures, adding exclusion criterion, add sites
    20 Feb 2013
    - Adding the option for the participation of temporarily incapacitated patients. - A new monitoring plan.
    10 Mar 2015
    Change of investigator OLVG Amsterdam. New safety information about Rituximab and pregnancy prevention
    29 Mar 2016
    Change of investigator UMCG. -Longer conduct of quality of life and neuropsychological examination

    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/30630772
    For support, Contact us.
    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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