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    Clinical Trial Results:
    A multicenter pilot phase II study for the preliminary evaluation of feasibility, activity and safety of the administration of Bendamustine and Ofatumumab in combination in marginal zone B-cell lymphomas (MZL)

    Summary
    EudraCT number
    2011-003495-36
    Trial protocol
    IT  
    Global end of trial date
    26 Sep 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Oct 2017
    First version publication date
    15 Oct 2017
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    S10BEOF01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    CLinical Organization for Strategies and Solutions S.r.l. - CLIOSS S.r.l.
    Sponsor organisation address
    Viale Pasteur 10, Nerviano (Mi), Italy, 20014
    Public contact
    Direzione Scientifica, CLIOSS Srl, 0039 0331581482, cristina.davite@clioss.com
    Scientific contact
    Direzione Scientifica, CLIOSS Srl, 0039 0331581482, cristina.davite@clioss.com
    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
    03 May 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    26 Sep 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    26 Sep 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy (Overall Remission Rate) of ofatumumab and bendamustine in relapsed or refractory marginal zone B-cell lymphomas
    Protection of trial subjects
    Study Protocol foresees that therapies considered necessary for the patient's well being might be given at the discretion of the Investigator, i.e. chronic treatments for concomitant medical conditions, as well as agents required for life-threatening medical problems.
    Background therapy
    Study Protocol foresees that pre-medication with paracetamol, antihistamine and glicocorticoids had to be performed before each ofatumumab infusion.
    Evidence for comparator
    NA
    Actual start date of recruitment
    13 Mar 2012
    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
    Switzerland: 8
    Country: Number of subjects enrolled
    Italy: 8
    Worldwide total number of subjects
    16
    EEA total number of subjects
    8
    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
    7
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment lasted from 28 March 2012 to 03 April 2014.

    Pre-assignment
    Screening details
    All 16 patients were elegible and treated with bendamustine and ofatumumab.

    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
    Arm 1
    Arm description
    All patients treated with ofatumumab and bendamustine
    Arm type
    Experimental

    Investigational medicinal product name
    OFATUMUMAB
    Investigational medicinal product code
    GSK1841157
    Other name
    NA
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Patients were treated with Ofatumumab iv 1000 mg on day 1 every 28 days for 6 cycles. The initial rate of the first infusion of 1000 mg ofatumumab (1 mg/mL) had to be 12 mL/h. If no infusion reactions occurred the infusion rate had to be increased every 30 minutes, to a maximum of 400 mL/h. If an infusion reaction developed, the infusion had to be temporarily slowed or interrupted. If the previous infusion were completed without grade ≥ 3 infusion-associated AEs, the subsequent infusion of the 1000 mg ofatumumab (1 mg/mL) could start at a rate of 25 mL/h and had to be doubled every 30 minutes up to a maximum of 400 mL/h.

    Investigational medicinal product name
    BENDAMUSTINE HYDROCHLORIDE
    Investigational medicinal product code
    NA
    Other name
    NA
    Pharmaceutical forms
    Powder and solvent for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Bendamustine 90 mg/m2 was administered on days 1 and 2 by iv infusion over 30-60 minutes. I

    Number of subjects in period 1
    Arm 1
    Started
    16
    Completed
    11
    Not completed
    5
         Start new therapy
    3
         Death
    1
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Arm 1
    Reporting group description
    All patients treated with ofatumumab and bendamustine

    Reporting group values
    Arm 1 Total
    Number of subjects
    16 16
    Age categorical
    Alla treated patients
    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)
    9 9
        From 65-84 years
    7 7
        85 years and over
    0 0
    Age continuous
    All treated patients
    Units: years
        median (full range (min-max))
    63.5 (46 to 78) -
    Gender categorical
    Units: Subjects
        Female
    7 7
        Male
    9 9
    Race
    Units: Subjects
        Caucasian
    16 16
    Performance Status (ECOG)
    Units: Subjects
        Zero
    15 15
        One
    1 1
    Tumor Stage at Study Entry
    Units: Subjects
        Stage I
    1 1
        Stage II
    2 2
        Stage III
    1 1
        Stage IV
    12 12
    Primary Tumor Site
    One patient enrolled with the diagnosis of mediastinic marginal zone B-cell lymphoma at stage IV was actually suffering from neuroendocrin tumor.
    Units: Subjects
        Dist. Oesophagus, L. Orbit
    1 1
        Gastric
    2 2
        Gastric Fundus
    1 1
        Left Orbit
    1 1
        Lung
    2 2
        Lymphonodes
    1 1
        Mediastinum
    1 1
        Right Thigh Radix
    1 1
        Spleen
    5 5
        Stomach
    1 1
    Prior Antitumor Therapies
    Units: Subjects
        1-3
    11 11
        4-6
    3 3
        7-9
    2 2
    Type of Prior Therapies
    Units: Subjects
        Systemic
    7 7
        Sistemic + Surgery
    9 9

    End points

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    End points reporting groups
    Reporting group title
    Arm 1
    Reporting group description
    All patients treated with ofatumumab and bendamustine

    Subject analysis set title
    Evaluable patients
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Efficacy Evaluable (EE) population defined as all treated patients, with no major deviations from the eligibility criteria affecting efficacy evaluation, for whom the tumor response could be evaluated at least once while on treatment. These patients should have received at least 2 cycles after treatment starts, unless disease progression occurred at cycle 1.

    Primary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [1]
    End point description
    Overall Remission Rate (ORR) was defined as the percentage of patients with a CR or PR as per Cheson criteria (2007) . For patients with splenic MZL response was defined according to Matutes et al. (2008) and for patients with gastric lymphomas histological response was evaluated according to GELA scoring system (Copie-Bergman et al 2003). A patient with unknown or missing response was to be treated as a non-responder, i.e., the patient was to be included in the denominator when calculating the percentage. Exact methods for calculated confidence intervals were to be utilized.
    End point type
    Primary
    End point timeframe
    CT-scan at the end of cycle 2 and at FU1 (4 months), FU2 (8 months) and FU3 (24 months) 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: An ORR of at least 90% was obtained, as expected. The p-value given by the exact binomial test (<.001) lead the rejection of the null hyphotesis (p=0.55) in favour of the althernative one (p=0.90).
    End point values
    Evaluable patients
    Number of subjects analysed
    14
    Units: percentage
    number (not applicable)
        CR + PR
    92.9
        SD
    7.1
    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
    Progression Free Survival was defined as the time from the first treatment administration to documentation of disease progression, start of a new antitumor therapy or death (for any cause). Patients not known to have progressed or started a new antitumor therapy or died (for any cause) were to be censored for PFS at the time of last tumor assessment.
    End point type
    Secondary
    End point timeframe
    Two years after the end of the treatment.
    End point values
    Evaluable patients
    Number of subjects analysed
    Units: months
    median (confidence interval 95%)
        Progression Free Survival
    33 (21.9 to 999999)
    No statistical analyses for this end point

    Secondary: Duration of Response

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    End point title
    Duration of Response
    End point description
    Duration of Response was defined, for the subset of patients with a CR or PR, as the time from when criteria for response were first met until first documented relapse or progression or death due to any cause. If sample size permitted, duration of response had to be summarized descriptively using Kaplan-Meier medians and quartiles. Only the subset of patients who showed a CR or PR were to be included in this summary.
    End point type
    Secondary
    End point timeframe
    Time to relapse.
    End point values
    Evaluable patients
    Number of subjects analysed
    13 [2]
    Units: months
    median (confidence interval 95%)
        Duration of Response
    30.4 (15.5 to 999999)
    Notes
    [2] - Only patients showing CR and PR
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    During all study period and followed until 28 days following the last dose of investigational product.
    Adverse event reporting additional description
    Drug-related and serious adverse events ongoing at the end of this observation period had to be recorded until they were resolved or the investigator assessed them as chronic or the subject was lost to follow-up or started a new anti-cancer treatment, whichever occurred earlier.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20
    Reporting groups
    Reporting group title
    Arm 1
    Reporting group description
    All patients treated with ofatumumab and bendamustine

    Serious adverse events
    Arm 1
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 16 (25.00%)
         number of deaths (all causes)
    2
         number of deaths resulting from adverse events
    0
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Troponin I increased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Myocardial infarction
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Infusion related reaction
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure acute
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Fistula
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Arm 1
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    16 / 16 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Phlebitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Thrombophlebitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    8 / 16 (50.00%)
         occurrences all number
    15
    Infusion related reaction
         subjects affected / exposed
    8 / 16 (50.00%)
         occurrences all number
    12
    Asthenia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    3
    Pyrexia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Face oedema
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    3
    Infusion site extravasation
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Infusion site pain
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Localised oedema
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Mucosal inflammation
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Oedema peripheral
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Epistaxis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pneumonitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Investigations
    Lymphocyte count decreased
         subjects affected / exposed
    14 / 16 (87.50%)
         occurrences all number
    21
    Weight decreased
         subjects affected / exposed
    5 / 16 (31.25%)
         occurrences all number
    5
    Neutrophil count decreased
         subjects affected / exposed
    4 / 16 (25.00%)
         occurrences all number
    4
    White blood cell count decereased
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    4
    Haemoglobin decreased
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    3
    Platelet count decreased
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    3
    Blood bilirubin decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Blood glucose decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Blood magnesium decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Blood potassium decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Blood sodium decreased
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    3
    Ataxia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Cognitive disorder
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Dizziness
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Dysaesthesia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Hypoacusis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Vertigo
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Eyelid oedema
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Vision blurred
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    6 / 16 (37.50%)
         occurrences all number
    16
    Abdominal pain upper
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Constipation
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    5
    Abdominal pain
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    3
    Dyspepsia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    2
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Stomatitis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    3 / 16 (18.75%)
         occurrences all number
    3
    Onychoclasis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pain of skin
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    2
    Palmar erythema
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pityriasis rosea
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Rash macular
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Skin reaction
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Trichorrhexis
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Urticaria
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Myalgia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Pain in extremity
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Arthralgia
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Back pain
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Groin pain
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Infections and infestations
    Oral herpes
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2
    Central line infection
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Herpes zoster
         subjects affected / exposed
    1 / 16 (6.25%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    2 / 16 (12.50%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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
    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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