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    Clinical Trial Results:
    A SINGLE-ARM MULTI-CENTER TRIAL OF PENTOSTATIN PLUS CYCLOPHOSPHAMIDE WITH OFATUMUMAB (PCO) IN OLDER PATIENTS WITH PREVIOUSLY UNTREATED CHRONIC LYMPHOCYTIC LEUKEMIA

    Summary
    EudraCT number
    2010-022332-37
    Trial protocol
    IT  
    Global end of trial date
    18 Nov 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    17 Dec 2017
    First version publication date
    17 Dec 2017
    Other versions
    Summary report(s)
    PCO Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    PCO
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01681563
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AZIENDA OSPEDALIERA OSPEDALE NIGUARDA CA' GRANDA
    Sponsor organisation address
    P.zza Ospedale Maggiore, 3 , Milano, Italy, 20162
    Public contact
    Dipartimento Oncologia/Ematologia, Ospedale Niguarda Ca' Granda, +39 0264444074, marco.montillo@ospedaleniguarda.it
    Scientific contact
    Dipartimento Oncologia/Ematologia, Ospedale Niguarda Ca' Granda, +39 0264444074, marco.montillo@ospedaleniguarda.it
    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
    06 Jun 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    18 Nov 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Nov 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of this study was to determine whether the PCO combination is effective as first line treatment of older CLL patients as defined by Overall Response Rate (ORR)
    Protection of trial subjects
    According to study protocol all patients should receive prophylaxis against pneumocystis carinii pneumonia, antiemetic medications, allopurinol for tumor lysis and acyclovir. Antifungal agents may be used as per institutional practice. Use of granulocyte colony stimulating factors (G-CSF) and erythropoietin (EPO) to treat for neutropenia and anaemia respectively is permitted while on study. Subjects received full supportive care, including antibiotics and hydration when appropriate and according to the most appropriate manner determined by the treating physician.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    05 Sep 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
    Italy: 49
    Worldwide total number of subjects
    49
    EEA total number of subjects
    49
    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
    49
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    From 02 August 2011 to 24 June 2013

    Pre-assignment
    Screening details
    49 patients, aged>/= 65, with untreated B-Cell CLL showing progressive disease were enrolled.

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

    Arms
    Arm title
    PCO combination
    Arm description
    The regimen consisted of intravenous pentostatin 2mg/m2 and cyclophsphamide 600 mg/m2 on day 1 every 3 weeks for a total of 6 cycles. On the first cycle, intravenous ofatumumab was administered at 300 mg on day 1 and 1000 mg on day 8. For the subsequent cycles, patients received ofaumumab on day 1 at the dose of 1000 mg.
    Arm type
    Experimental

    Investigational medicinal product name
    Ofatumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Ofatumumab was infused intravenously on day 1 (300 mg) and day 8 (1000 mg) in the first cycle, followed by infusions of 1000 mg at the first day from cycle 2 to cycle 6. Each cycle lasted 21 days.

    Investigational medicinal product name
    Pentostatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Pentostatin was administered at the dose of 2 mg/m2 over a 30 minutes infusion on Day 1 from cycle 1 to cycle 6. Each cycles lasted 21 days.

    Investigational medicinal product name
    Cyclofosfamide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cyclofosphamide was administered at the dose of 600 mg/m2 over a 30 minutes infusion on day 1 of each cycle for a total of 6 cycles of 21 days.

    Number of subjects in period 1
    PCO combination
    Started
    49
    Completed
    34
    Not completed
    15
         Adverse event, serious fatal
    2
         Physician decision
    1
         Consent withdrawn by subject
    1
         Adverse event, non-fatal
    1
         Progression
    9
         Start a new therapy
    1

    Baseline characteristics

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

    Reporting group values
    Overall Trial Total
    Number of subjects
    49 49
    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)
    0 0
        From 65-84 years
    49 49
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    72 (65 to 83) -
    Gender categorical
    Units: Subjects
        Female
    17 17
        Male
    32 32
    ECOG PS
    Units: Subjects
        Zero
    38 38
        One
    10 10
        Two
    1 1
    Binet Staging System
    Units: Subjects
        Binet A
    2 2
        Binet B
    38 38
        Binet C
    9 9
        Not recorded
    0 0
    RAI Classification Stage
    Units: Subjects
        RAI 0
    1 1
        RAI I
    15 15
        RAI II
    20 20
        RAI III
    7 7
        RAI IV
    6 6
    Active Disease Conditions - Marrow Failure
    Units: Subjects
        Marrow failure
    13 13
        No Marrow failure
    36 36
    Active Disease Conditions - Splenomegaly
    Units: Subjects
        Splenomegaly
    8 8
        No Splenomegaly
    41 41
    Active Disease Conditions - Lymphadenopathy
    Units: Subjects
        Lymphdenopathy
    21 21
        No Lymphadenopaty
    28 28
    Active Disease Conditions - Lymphocytosis
    Units: Subjects
        Lymphocytosis
    17 17
        No Lymphocytosis
    32 32
    Disease evaluation by physical examination - Abnormal liver
    Units: Subjects
        Abnormal liver
    46 46
        No abnormal liver
    3 3
    Disease evaluation by physical examination - Abnormal spleen
    Units: Subjects
        Abnormal spleen
    27 27
        No abnormal spleen
    22 22
    Disease evaluation by physical examination - Abnormal Nuchal LN
    Units: Subjects
        Abnormal nuchal LN
    45 45
        No abnormal nuchal LN
    4 4
    Disease evaluation by physical examination - Abnormal Cervical LN
    Units: Subjects
        Abnormal cervical LN
    19 19
        No abnormal cervical LN
    30 30
    Disease evaluation by physical examination - Abnormal axillary LN
    Units: Subjects
        Abnormal axillary LN
    17 17
        No abnormal axillary LN
    32 32
    Disease evaluation by physical examination - Abnormal sipraclavicular LN
    Units: Subjects
        Abnormal sipraclavicular LN
    35 35
        No abnormal sipraclavicular LN
    14 14
    Disease evaluation by physical examination - Abnormal inguinal LN
    Units: Subjects
        Abnormal inguinal LN
    25 25
        No abnormal inguinal LN
    24 24
    Beta-2 microglobulin
    Units: Subjects
        >/= 4 mg/ml
    9 9
        < 4mg/ml
    26 26
        Not recorded
    14 14
    IgHV (peripheral blood)
    Units: Subjects
        Mutated
    9 9
        Unmutated
    15 15
        Not recorded
    25 25
    IgHV (bone marrow)
    Units: Subjects
        Mutated
    9 9
        Unmutated
    6 6
        Not recorded
    34 34
    FISH (peripheral blood)
    Units: Subjects
        Del11q22+
    4 4
        Del13q14+
    9 9
        Trisomy 12+
    6 6
        No mutations
    1 1
        Not recorded
    29 29
    FISH (Bone marrow)
    Units: Subjects
        Del17p13+
    3 3
        Del13q14+
    9 9
        Trisomy 12+
    3 3
        No mutations
    2 2
        Not recorded
    32 32
    CD Markers - CD5+ (peripheral blood)
    Units: Subjects
        Positive
    34 34
        Negative or Not Recorded
    15 15
    CD Markers - CD19+ (peripheral blood)
    Units: Subjects
        Positive
    35 35
        Negative or Not Recorded
    14 14
    CD Markers - CD20+ (peripheral blood)
    Units: Subjects
        Positive
    28 28
        Negative or Not Recorded
    21 21
    CD Markers - CD23+ (peripheral blood)
    Units: Subjects
        Positive
    31 31
        Negative or Not Recorded
    18 18
    CD Markers - CD79b+ (peripheral blood)
    Units: Subjects
        Positive
    8 8
        Negative or Not Recorded
    41 41
    CD Markers - ZAP70+ (peripheral blood)
    Units: Subjects
        Positive
    7 7
        Negative or Not Recorded
    42 42
    CD Markers - CD5+ (bone marrow)
    Units: Subjects
        Positive
    36 36
        Negative or Not Recorded
    13 13
    CD Markers - CD19+ (bone marrow)
    Units: Subjects
        Positive
    37 37
        Negative or Not Recorded
    12 12
    CD Markers - CD20+ (bone marrow)
    Units: Subjects
        Positive
    31 31
        Negative or Not Recorded
    18 18
    CD Markers - CD23+ (bone marrow)
    Units: Subjects
        Positive
    38 38
        Negative or Not Recorded
    11 11
    CD Markers - CD79b+ (bone marrow)
    Units: Subjects
        Positive
    5 5
        Negative or Not Recorded
    44 44
    CD Markers - ZAP70+ (bone marrow)
    Units: Subjects
        Positive
    8 8
        Negative or Not Recorded
    41 41
    Subject analysis sets

    Subject analysis set title
    Evaluable Patients
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population included all patients who received at least one dose of study medication

    Subject analysis sets values
    Evaluable Patients
    Number of subjects
    47
    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
    47
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    72 (65 to 83)
    Gender categorical
    Units: Subjects
        Female
    16
        Male
    31
    ECOG PS
    Units: Subjects
        Zero
    38
        One
    9
        Two
    0
    Binet Staging System
    Units: Subjects
        Binet A
    1
        Binet B
    37
        Binet C
    9
        Not recorded
    0
    RAI Classification Stage
    Units: Subjects
        RAI 0
    0
        RAI I
    14
        RAI II
    20
        RAI III
    7
        RAI IV
    6
    Active Disease Conditions - Marrow Failure
    Units: Subjects
        Marrow failure
    13
        No Marrow failure
    34
    Active Disease Conditions - Splenomegaly
    Units: Subjects
        Splenomegaly
    7
        No Splenomegaly
    40
    Active Disease Conditions - Lymphadenopathy
    Units: Subjects
        Lymphdenopathy
    20
        No Lymphadenopaty
    27
    Active Disease Conditions - Lymphocytosis
    Units: Subjects
        Lymphocytosis
    16
        No Lymphocytosis
    31
    Disease evaluation by physical examination - Abnormal liver
    Units: Subjects
        Abnormal liver
    44
        No abnormal liver
    3
    Disease evaluation by physical examination - Abnormal spleen
    Units: Subjects
        Abnormal spleen
    26
        No abnormal spleen
    21
    Disease evaluation by physical examination - Abnormal Nuchal LN
    Units: Subjects
        Abnormal nuchal LN
    43
        No abnormal nuchal LN
    4
    Disease evaluation by physical examination - Abnormal Cervical LN
    Units: Subjects
        Abnormal cervical LN
    18
        No abnormal cervical LN
    29
    Disease evaluation by physical examination - Abnormal axillary LN
    Units: Subjects
        Abnormal axillary LN
    16
        No abnormal axillary LN
    31
    Disease evaluation by physical examination - Abnormal sipraclavicular LN
    Units: Subjects
        Abnormal sipraclavicular LN
    33
        No abnormal sipraclavicular LN
    14
    Disease evaluation by physical examination - Abnormal inguinal LN
    Units: Subjects
        Abnormal inguinal LN
    24
        No abnormal inguinal LN
    23
    Beta-2 microglobulin
    Units: Subjects
        >/= 4 mg/ml
    9
        < 4mg/ml
    25
        Not recorded
    13
    IgHV (peripheral blood)
    Units: Subjects
        Mutated
    9
        Unmutated
    14
        Not recorded
    24
    IgHV (bone marrow)
    Units: Subjects
        Mutated
    9
        Unmutated
    6
        Not recorded
    32
    FISH (peripheral blood)
    Units: Subjects
        Del11q22+
    4
        Del13q14+
    9
        Trisomy 12+
    6
        No mutations
    1
        Not recorded
    27
    FISH (Bone marrow)
    Units: Subjects
        Del17p13+
    3
        Del13q14+
    8
        Trisomy 12+
    2
        No mutations
    2
        Not recorded
    32
    CD Markers - CD5+ (peripheral blood)
    Units: Subjects
        Positive
    33
        Negative or Not Recorded
    14
    CD Markers - CD19+ (peripheral blood)
    Units: Subjects
        Positive
    34
        Negative or Not Recorded
    13
    CD Markers - CD20+ (peripheral blood)
    Units: Subjects
        Positive
    27
        Negative or Not Recorded
    20
    CD Markers - CD23+ (peripheral blood)
    Units: Subjects
        Positive
    31
        Negative or Not Recorded
    16
    CD Markers - CD79b+ (peripheral blood)
    Units: Subjects
        Positive
    8
        Negative or Not Recorded
    39
    CD Markers - ZAP70+ (peripheral blood)
    Units: Subjects
        Positive
    7
        Negative or Not Recorded
    40
    CD Markers - CD5+ (bone marrow)
    Units: Subjects
        Positive
    35
        Negative or Not Recorded
    12
    CD Markers - CD19+ (bone marrow)
    Units: Subjects
        Positive
    36
        Negative or Not Recorded
    11
    CD Markers - CD20+ (bone marrow)
    Units: Subjects
        Positive
    30
        Negative or Not Recorded
    17
    CD Markers - CD23+ (bone marrow)
    Units: Subjects
        Positive
    37
        Negative or Not Recorded
    10
    CD Markers - CD79b+ (bone marrow)
    Units: Subjects
        Positive
    5
        Negative or Not Recorded
    42
    CD Markers - ZAP70+ (bone marrow)
    Units: Subjects
        Positive
    8
        Negative or Not Recorded
    39

    End points

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    End points reporting groups
    Reporting group title
    PCO combination
    Reporting group description
    The regimen consisted of intravenous pentostatin 2mg/m2 and cyclophsphamide 600 mg/m2 on day 1 every 3 weeks for a total of 6 cycles. On the first cycle, intravenous ofatumumab was administered at 300 mg on day 1 and 1000 mg on day 8. For the subsequent cycles, patients received ofaumumab on day 1 at the dose of 1000 mg.

    Subject analysis set title
    Evaluable Patients
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population included all patients who received at least one dose of study medication

    Primary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [1]
    End point description
    Overall response rate (ORR) is defined as the proportion of patients who have a partial or complete response to therapy.
    End point type
    Primary
    End point timeframe
    All trial period.
    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: An ORR of 87.2% was obtained. The one-sided p-value obtained by the binomial test (<.05) lead the rejection of the null hypothesis (p=.75) in favor of the alternative one (p=.90). The drug association is to be considered effective enough to worth further clinical studies.
    End point values
    Evaluable Patients
    Number of subjects analysed
    47
    Units: percent
    number (confidence interval 95%)
        CR + CRi + PR
    87.2 (74.0 to 95.0)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS)

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    End point title
    Progression Free Survival (PFS)
    End point description
    Measured as the time from inclusion in the trial to disease progression, or death.
    End point type
    Secondary
    End point timeframe
    All study period.
    End point values
    Evaluable Patients
    Number of subjects analysed
    47
    Units: Months
        median (confidence interval 95%)
    30.42 (27.27 to 9999999)
    No statistical analyses for this end point

    Secondary: Complete Response Rate (CRR)

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    End point title
    Complete Response Rate (CRR)
    End point description
    Complete response rate (CRR) is defined as the proportion of patients who have complete response to therapy.
    End point type
    Secondary
    End point timeframe
    All study period
    End point values
    Evaluable Patients
    Number of subjects analysed
    47
    Units: percent
    number (confidence interval 95%)
        CR+CRi
    44.7 (30.0 to 60.0)
    No statistical analyses for this end point

    Secondary: Minimal Residual Disease (MRD)

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    End point title
    Minimal Residual Disease (MRD)
    End point description
    Complete Response Rate according to minimal residual disease
    End point type
    Secondary
    End point timeframe
    From 3 months after end of treatment within 2 years of follow-up
    End point values
    Evaluable Patients
    Number of subjects analysed
    21 [2]
    Units: percent
    number (not applicable)
        MDR negative
    76.2
        MDR positive
    19.0
        Missing
    4.8
    Notes
    [2] - CR + CRi
    No statistical analyses for this end point

    Secondary: Complete Response Rate according to beta-2 microglobulin

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    End point title
    Complete Response Rate according to beta-2 microglobulin
    End point description
    End point type
    Secondary
    End point timeframe
    All study period
    End point values
    Evaluable Patients
    Number of subjects analysed
    21 [3]
    Units: percent
    number (not applicable)
        Beta-2 microglobulin >=4 mg/L
    4.8
        Beta-2 microglobulin <4 mg/L
    76.2
        Beta-2 microglobulin missing
    19.0
    Notes
    [3] - CR + CRi
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All study period: from the signing informed consent up to 28 days after the last dose of study treatment or until all drug-related toxicities had resolved or a new anticancer therapy was started.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    5.1
    Reporting groups
    Reporting group title
    PCO combination
    Reporting group description
    All patients who receive at least one dose of study medication.

    Serious adverse events
    PCO combination
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 47 (17.02%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural mesothelioma malignant advanced
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Syncope
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 47 (4.26%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Anaphylactoid reaction
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure acute
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Lung infection
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 47 (2.13%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    PCO combination
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    47 / 47 (100.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 47 (6.38%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    40 / 47 (85.11%)
         occurrences all number
    143
    Anaemia
         subjects affected / exposed
    16 / 47 (34.04%)
         occurrences all number
    60
    Thrombocytopenia
         subjects affected / exposed
    6 / 47 (12.77%)
         occurrences all number
    11
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    16 / 47 (34.04%)
         occurrences all number
    26
    Fatigue
         subjects affected / exposed
    8 / 47 (17.02%)
         occurrences all number
    16
    Oedema peripheral
         subjects affected / exposed
    7 / 47 (14.89%)
         occurrences all number
    16
    Rigors
         subjects affected / exposed
    6 / 47 (12.77%)
         occurrences all number
    8
    Chest pain
         subjects affected / exposed
    3 / 47 (6.38%)
         occurrences all number
    4
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    23 / 47 (48.94%)
         occurrences all number
    42
    Vomiting
         subjects affected / exposed
    13 / 47 (27.66%)
         occurrences all number
    25
    Diarrhoea
         subjects affected / exposed
    4 / 47 (8.51%)
         occurrences all number
    4
    Dyspepsia
         subjects affected / exposed
    3 / 47 (6.38%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    8 / 47 (17.02%)
         occurrences all number
    18
    Dyspnoea
         subjects affected / exposed
    6 / 47 (12.77%)
         occurrences all number
    6
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    39 / 47 (82.98%)
         occurrences all number
    89
    Pruritus
         subjects affected / exposed
    8 / 47 (17.02%)
         occurrences all number
    14
    Urticaria
         subjects affected / exposed
    3 / 47 (6.38%)
         occurrences all number
    5
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    5 / 47 (10.64%)
         occurrences all number
    8

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Apr 2012
    The purposes of the protocol amendment are: • To re-define processes related to SAEs management and evaluation of MRD (Minimal Residual Disease), as a result of the delegation of these activities to Nerviano Medical Sciences S.r.l. (NMS). • To remove the list of clinical centers participating in the trial reported in the original protocol since it became out of date; the updated list of participating investigators and relevant clinical centers will be provided as a separate document. • To add the signature of principal investigator and the signature of the relevant investigator by clinical site. • To modify exclusion criterion n. 14, from ‘Creatinine Clearance < 70 mL/min’ into ‘Creatinine Clearance < 60 mL/min’; this better represents the normal condition of renal efficiency in elderly patients. • To add the ofatumumab pharmacokinetic assessment among the secondary study objectives/endpoints, as well as overall survival (OS) and time-to-progression (TTP) for consistency purpose.
    07 Jun 2013
    The purpose of the present protocol amendment is: • To modify Ofatumumab Pharmacokinetic Profile Assessment. In order to improve patient compliance and optimize study organization, from April 2013 the number of blood samples collected for pharmacokinetic assessment has been reduced (21 samples required, instead of 33 at all) and timepoints scheduled only during patient’s cycles monitoring visit.

    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
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