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    Clinical Trial Results:
    Phase II clinical trial of immunotherapy with Rituximab and autologous effector lymphocytes in patients with non-Hodgkin follicular lymphoma in response to first line chemotherapy

    Summary
    EudraCT number
    2009-017829-19
    Trial protocol
    ES  
    Global end of trial date
    30 Nov 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Nov 2021
    First version publication date
    27 Nov 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    LFNK
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01329354
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Clínica Universidad de Navarra/Universidad de Navarra
    Sponsor organisation address
    Avenida Pío XII, 36, Pamplona, Spain, 31008
    Public contact
    UCICEC, Clínica Universidad de Navarra, +34 948255400, ucicec@unav.es
    Scientific contact
    UCICEC, Clínica Universidad de Navarra, +34 948255400, ucicec@unav.es
    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
    22 Oct 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    12 Nov 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Nov 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the impact of treatment on progression-free survival
    Protection of trial subjects
    NA
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    08 Mar 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 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)
    23
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Patients with follicular lymphoma with criteria to start maintenance treatment, who have received induction treatment according to the standard R-CHOP chemotherapy regimen, were recruited.

    Pre-assignment
    Screening details
    Patients aged 18-75 years with histologically confirmed Grade I, II or IIIa CD20+ FL, ready to start maintenance therapy with rituximab after achieving a partial response (PR) or complete response (CR) subsequent to R-CHOP.

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Experimental group
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    LAK cells
    Investigational medicinal product code
    Other name
    Ex vivo expanded lymphokine-activated killer (LAK) cells
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    500 millions

    Number of subjects in period 1
    Experimental group
    Started
    26
    Completed
    20
    Not completed
    6
         Consent withdrawn by subject
    1
         Screening failure
    2
         Protocol deviation
    3

    Baseline characteristics

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

    Reporting group values
    Treatment period Total
    Number of subjects
    26 26
    Age categorical
    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)
    23 23
        From 65-84 years
    3 3
        85 years and over
    0 0
    Gender categorical
    Units: Subjects
        Female
    10 10
        Male
    16 16

    End points

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

    Primary: Progression free survival rate

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    End point title
    Progression free survival rate [1]
    End point description
    Percentage of patients without progression observed during the 5 years of follow-up period
    End point type
    Primary
    End point timeframe
    Five years after the end of treatment
    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: A Kaplan-Meier curve was generated.
    End point values
    Experimental group
    Number of subjects analysed
    20
    Units: Percent of patients without progression
        number (not applicable)
    80
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Non-serious AEs and SAEs were collected during the treatment period and for a minimun of 30 days following the last dose of study treatment. Treatment-related SAEs were collected and evaluated from study start until 60 month after last dose of treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18-1
    Reporting groups
    Reporting group title
    Experimental group
    Reporting group description
    -

    Serious adverse events
    Experimental group
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 20 (15.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Myocardial ischaemia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Female sterilisation
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostatic surgery
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Urosepsis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostatitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    Experimental group
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    20 / 20 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Uterine leiomyoma
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Vascular disorders
    Lymphoedema
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Deep vein thrombosis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Surgical and medical procedures
    Prostate surgery
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Hysterectomy
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    General disorders and administration site conditions
    Gait disturbance
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Asthenia
         subjects affected / exposed
    10 / 20 (50.00%)
         occurrences all number
    12
    Heat in the join of the administration area
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Chest pain
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Peripheral edema
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    General discomfort
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    4
    Reproductive system and breast disorders
    Balanoposthitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Erectile dysfunction
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Benign prostatic hyperplasia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Prostatitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Cold
         subjects affected / exposed
    10 / 20 (50.00%)
         occurrences all number
    15
    Nasal congestion
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Dysphonia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Dyspnea exertional
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    COPD
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Rales
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Productive cough
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    4
    Roncus
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    6
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Depression
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Insomnia
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Cardiac disorders
    Ventricular extrasystoles
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Dizziness
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Dizziness exertional
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Neuropathy peripheral
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Paraesthesia
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    5
    Polyneuropathy
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Carpal tunnel syndrome
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    5
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Eye disorders
    Blepharitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Keratitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Exfoliation syndrome
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    7
    Diverticulitis/Colitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Abdominal pain
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    4
    Dental pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Abdominal pain lower
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Abdominal pain upper
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Inguinal hernia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Aphthous ulcer
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Mouth ulceration
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hypertransaminasaemia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Seborrheic dermatitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Eczema
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Erythema
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Eruption
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Pruritus anal
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Haematuria
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    4
    Bleeding from the bladder
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    9 / 20 (45.00%)
         occurrences all number
    12
    Arthritis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Bursitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    2
    Neck pain
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Back pain
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    4
    Jaw pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pain in a limb
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Groin pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Musculoskeletal pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Muscle spasms
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Limb discomfort
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Rotator cuff syndrome
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    2
    Infections and infestations
    Dental abscess
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Bronchitis
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Cystitis
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Conjunctivitis bacterial
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pharyngitis
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Furuncle
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Ophthalmic herpes
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Oral herpes
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Herpes zoster
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Respiratory tract infection
         subjects affected / exposed
    11 / 20 (55.00%)
         occurrences all number
    15
    Urinary tract infection
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Dental infection
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Fungal infection
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Influenza
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Pneumonia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pyelonephritis chronic
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Rhinitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Sinusitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Tonsillitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Urosepsis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Dyslipidaemia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Hypercholesterolaemia
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Hyperglycaemia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Jul 2010
    Add thyroid function and autoimmunity tests at certain visits (Protocol v2)
    04 Feb 2011
    Adapt protocol to new standard treatment (Protocol v3) Modify ICF to clarify financial compensation (ICF v3)
    04 Mar 2011
    Add sites. Remove references to CRO (Protocol v4)
    02 Nov 2011
    Restructuring objectives. Sample size decrease. Errata correction (Protocol v5)
    25 Jun 2012
    Change of sponsor. Add the ability to draw blood and LAK infusion is done in referral centers (Protocol v7, ICF v4)
    21 Jun 2013
    Changes in the IMPD (IMPD v3)
    29 Oct 2013
    Change of PI in one of the sites
    02 Jun 2014
    Change in IB (IB v2) Eliminate the need to collect AEs and concomitant medications in follow-up and to report SAEs not related to the investigational product. Add intermediate analysis after completion of treatment of all patients (Protocol v8)
    04 Jan 2016
    Change of PI in one of the sites
    10 Nov 2016
    Change of PI in one of the sites

    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/32130737
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