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    Clinical Trial Results:
    A multicentric phase II study evaluating the benefit of a short induction treatment by Bendamustine and Rituximab followed by maintenance therapy with rituximab In Elderly (≥ 60 years old) patients with untreated Follicular lymphoma patients, with an intermediate or high FLIPI score

    Summary
    EudraCT number
    2010-020757-14
    Trial protocol
    BE  
    Global end of trial date
    01 Jul 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Mar 2019
    First version publication date
    27 Mar 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BRIEF
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01313611
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    LYSARC
    Sponsor organisation address
    CHU LYON SUD PAVILLON 6D, PIERRE BENITE, France,
    Public contact
    Chairman of the study, Professor Pierre Feugier, +33 383 15 32 82, p.feugier@chu-nancy.fr
    Scientific contact
    Project Management, LYSARC, +33 4 72 66 93 33, affaires-reglementaires@lysarc.org
    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
    01 Jul 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Jul 2016
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the complete response rate according to Cheson criteria 1999 after a short induction treatment by Rituximab and Bendamustine in 1st line follicular lymphoma patients, ≥ 60 years old, with an intermediate or high FLIPI score, and without high tumor burden (according to GELF criteria)
    Protection of trial subjects
    Standard care
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    22 Feb 2011
    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
    Belgium: 2
    Country: Number of subjects enrolled
    France: 61
    Worldwide total number of subjects
    63
    EEA total number of subjects
    63
    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)
    0
    From 65 to 84 years
    63
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    clinical examination (weight, BSA, pulse, blood pressure, Temp, physical examination, ECOG PS, Biochemical test, blood celle count), inclusion/exclusion criteria

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

    Arms
    Arm title
    Experimental
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    bendamustine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    - Two cycles of bendamustine (LEVACT®) at the dose of 90 mg/m² intravenously over 60 minutes on days 1 and 2, with a four weeks interval (28 days) between the two cycles.

    Investigational medicinal product name
    rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    - Four cycles of rituximab (MABTHERA®) 375 mg/m² intravenously at the appropriate infusion rate on days 1, 8, 15, and 22.

    Number of subjects in period 1
    Experimental
    Started
    63
    Completed
    37
    Not completed
    26
         no drug received
    1
         Protocol deviation
    25

    Baseline characteristics

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

    Reporting group values
    Induction Total
    Number of subjects
    63 63
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    0
    Age continuous
    Units: years
        arithmetic mean (inter-quartile range (Q1-Q3))
    69.6 (64 to 75) -
    Gender categorical
    Units: Subjects
        Female
    34 34
        Male
    29 29

    End points

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

    Primary: Complete Response Rate according to Cheson 2007

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    End point title
    Complete Response Rate according to Cheson 2007 [1]
    End point description
    End point type
    Primary
    End point timeframe
    end of induction phase
    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: 1 arm = no comparative statistical analysis
    End point values
    Experimental
    Number of subjects analysed
    63
    Units: percent
        arithmetic mean (confidence interval 5%)
    54 (40.9 to 66.6)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    28 days after end of treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.1
    Reporting groups
    Reporting group title
    Experimental
    Reporting group description
    -

    Serious adverse events
    Experimental
    Total subjects affected by serious adverse events
         subjects affected / exposed
    21 / 62 (33.87%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Myelofibrosis
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Adenocarcinoma of prostate
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Auricular fibrillation
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Heart failure
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Transurethral bladder resection
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Neuralgia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stroke
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Adenocarcinoma
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    Neutropenia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile aplasia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Reduced general condition
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    Pyrexia
         subjects affected / exposed
    3 / 62 (4.84%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Scrotal hernia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhea
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Interstitial pneumonia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnea
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pyuria
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Streptococcus pneumoniae pneumonia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Bronchitis
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Infective myositis
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Progressive multifocal leucoencephalopathy
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection urinary tract
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia Pseudomonas aeruginosa
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Experimental
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    52 / 62 (83.87%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    NEOPLASM BENIGN, MALIGNANT AND UNSPECIFIED
         subjects affected / exposed
    9 / 62 (14.52%)
         occurrences all number
    9
    Vascular disorders
    VASCULAR DISORDERS
         subjects affected / exposed
    6 / 62 (9.68%)
         occurrences all number
    6
    General disorders and administration site conditions
    GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS
         subjects affected / exposed
    26 / 62 (41.94%)
         occurrences all number
    26
    Immune system disorders
    IMMUNE SYSTEM DISORDERS
         subjects affected / exposed
    4 / 62 (6.45%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    RESPIRATORY, THORACIC AND MEDIASTINAL DISORDERS
         subjects affected / exposed
    12 / 62 (19.35%)
         occurrences all number
    12
    Investigations
    INVESTIGATIONS
         subjects affected / exposed
    31 / 62 (50.00%)
         occurrences all number
    31
    Cardiac disorders
    CARDIAC DISORDERS
         subjects affected / exposed
    4 / 62 (6.45%)
         occurrences all number
    4
    Nervous system disorders
    NERVOUS SYSTEM DISORDERS
         subjects affected / exposed
    18 / 62 (29.03%)
         occurrences all number
    18
    Blood and lymphatic system disorders
    BLOOD & LYMPHATIC SYSTEM DISORDERS/INVESTIGATIONS
         subjects affected / exposed
    52 / 62 (83.87%)
         occurrences all number
    147
    Gastrointestinal disorders
    GASTRO-INTESTINAL DISORDERS
         subjects affected / exposed
    38 / 62 (61.29%)
         occurrences all number
    38
    Hepatobiliary disorders
    HEPATOBILIARY DISORDERS
         subjects affected / exposed
    3 / 62 (4.84%)
         occurrences all number
    3
    Skin and subcutaneous tissue disorders
    SKIN AND SUBCUTANEOUS TISSUE DISORDERS
         subjects affected / exposed
    12 / 62 (19.35%)
         occurrences all number
    12
    Renal and urinary disorders
    RENAL AND URINARY DISORDERS
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    5
    Infections and infestations
    INFECTIONS AND INFESTATIONS
         subjects affected / exposed
    32 / 62 (51.61%)
         occurrences all number
    32
    Metabolism and nutrition disorders
    METABOLISM AND NUTRITION DISORDERS
         subjects affected / exposed
    9 / 62 (14.52%)
         occurrences all number
    9

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Apr 2011
    Addition and precision of secondary objectives : 12 infusion in maintenance instead of 13, as recommended in the MA
    06 Sep 2012
    Clarification of GELF criteria Addition of platelet count every 4 weeks during maintenant as required by IDMC
    10 Jan 2013
    Treatment STOP

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    13 Nov 2012
    Two cycles of bendamustine administered concomitantly with 4 weekly cycles of rituximab may result in a high response rate and PFS. Due to the observed toxicity-related deaths, this scheme may not be recommended in LTBFL. Further research aiming at proposing short-term treatments with low toxicity and prolonged PFS should be encouraged for these patients. Because of 3 deaths evaluated to be related to the experimental treatment, the Scientific Board of the LYSA met on November 13, 2012, and decision was made to definitively stop rituximab treatment during maintenance phase, according to DSMC recommendations
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Two cycles of bendamustine administered concomitantly with 4 weekly cycles of rituximab may result in a high response rate and PFS. Due to the observed toxicity-related deaths, this scheme may not be recommended in LTBFL. Further research aiming at p
    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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