Clinical Trial Results:
A MULTI-CENTER, PHASE IB/II, OPEN LABEL, SINGLE ARM STUDY OF INOTUZUMAB OZOGAMICIN PLUS RITUXIMAB (R-CMC544) ALTERNATING WITH GEMCITABINE-OXALIPLATIN PLUS RITUXIMAB (R-GEMOX) IN PATIENTS AGED FROM 18 TO 80 YEARS WITH CD20 AND CD22 POSITIVE DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) IN RELAPSE AFTER/REFRACTORY TO 1ST OR 2ND LINE TREATMENT, WHO ARE NO CANDIDATES FOR AUTOLOGOUS TRANSPLANT
Summary
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EudraCT number |
2011-003849-18 |
Trial protocol |
BE |
Global end of trial date |
22 Mar 2016
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Results information
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Results version number |
v1(current) |
This version publication date |
13 Apr 2017
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First version publication date |
13 Apr 2017
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
CMC-R-GEMOX
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01562990 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
LYSARC
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Sponsor organisation address |
Secteur Sainte Eugénie - pavillon 6D, Pierre Bénite, France, 69495
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Public contact |
Elise Hutasse, LYSARC, +33 472669333, elise.hutasse@lysarc.org
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Scientific contact |
Elise Hutasse, LYSARC, +33 472669333, elise.hutasse@lysarc.org
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
22 Mar 2016
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
22 Mar 2016
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
The primary objective of the phase Ib part of the study is to determine the tolerability, safety and MTD or recommended dose of R-CMC544 alternating with RGEMOX in subjects aged from 18 to 80 years with CD20 and CD22 positive DLBCL in relapse after/refractory to 1st or 2nd line treatment, who are no candidates for autologous transplant.
The primary objective of the phase II part of the study is to assess the efficacy or RCMC544 alternating with R-GEMOX as measured by the overall response rate (ORR) by IWG criteria (Cheson 1999) at the end of treatment (after complete treatment or at withdrawal).
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Protection of trial subjects |
Patients have been followed for safety (adverse event) during all study duration.
If a patient does not respond to study treatment, relapses or has progressive disease, each site was free to initiate further treatment according to local guidelines
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Background therapy |
R-GEMOX is one of standard therapies for patients with relapsed/refractory diffuse large B-cell lymphoma. | ||
Evidence for comparator |
NA | ||
Actual start date of recruitment |
03 Dec 2012
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
France: 11
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Worldwide total number of subjects |
11
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EEA total number of subjects |
11
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
3
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From 65 to 84 years |
8
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85 years and over |
0
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Recruitment
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Recruitment details |
1st patient included in France in December, 2012. Elevent patients included in France, no patient included in Belgium. Last patient included in phase I in February, 2014. Phase II cancelled due to poor overall response rate and long duration of phase I which led to investigators demotivation. | ||||||||||||||
Pre-assignment
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Screening details |
No patient screen failed in eCRF. - Histologically documented CD20 and CD22 positive diffuse large B-cell lymphoma, according to WHO classification. - In 1st or 2nd relapse or refractory to 1st and/or 2nd line treatment. - Measurable disease by bidimensional transverse CT scan assessment - Not eligible for autologous transplantation | ||||||||||||||
Period 1
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Period 1 title |
Induction
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Is this the baseline period? |
Yes | ||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||
Arms
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Arm title
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experimental | ||||||||||||||
Arm description |
- | ||||||||||||||
Arm type |
Experimental | ||||||||||||||
Investigational medicinal product name |
inotuzumab-ozogamicin
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Investigational medicinal product code |
CMC544
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Other name |
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
CMC544 was given by IV route over 1 hour ± 10 minutes at the fixed dose rate of 50 mL/hour.
Dose administered was 1.8mg/m²
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Period 2
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Period 2 title |
Consolidation
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Is this the baseline period? |
No | ||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||
Arms
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Arm title
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Experimental | ||||||||||||||
Arm description |
- | ||||||||||||||
Arm type |
Experimental | ||||||||||||||
Investigational medicinal product name |
inotuzumab-ozogamicin
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Investigational medicinal product code |
CMC544
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Other name |
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Pharmaceutical forms |
Solution for injection/infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
CMC544 was given by IV route over 1 hour ± 10 minutes at the fixed dose rate of 50 mL/hour.
Dose administered was 1.8mg/m²
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Baseline characteristics reporting groups
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Reporting group title |
Induction
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Reporting group description |
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End points reporting groups
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Reporting group title |
experimental
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Reporting group description |
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Reporting group title |
Experimental
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Reporting group description |
- | ||
Subject analysis set title |
Evaluable set
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
The evaluable population includes all enrolled patients who received at least one dose of any investigational drugs. Primary endpoint of the phase II will be analyzed on this population.
Secondary efficacy and safety endpoints (for both phase Ib and II) will be performed on this population.
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Subject analysis set title |
DLT evaluable set
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Subject analysis set type |
Sub-group analysis | ||
Subject analysis set description |
The DLT evaluable population includes all patients from “Evaluable population” with a DLT assessment. It is considered that a patient have a DLT assessment if he/she performed completely the first two cycles unless a DLT occurred before the end of the cycle 2, in which case he/she remains evaluable for DLT.
Primary endpoint of the phase Ib will be analyzed on this population
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End point title |
Number of patients with DLT [1] | ||||||||
End point description |
Recommended dose will be identified according to the incidence of DLTs during the first 2 cycles of treatment (induction).
DLT is defined as follows (NCI CTCAE vs. 4):
- Grade 4 neutropenia ≥ 7 days
- Grade 4 thrombocytopenia ≥ 7 days
- Grade 3 or 4 thrombocytopenia associated with bleeding requiring a transfusion
- Grade 3 non-hematologic toxicity (except alopecia) ≥ 7 days or determined to be investigational product-related
- Grade 4 non-hematologic toxicity (except alopecia)
- Grade 4 AST/ALT increase irrespective of duration
- Grade 2 hyperbilirubinemia (> 1.5 x ULN) > 7 days
- Grade 3 or greater QTc prolongation (average of three ECGs)
- Delayed recovery from an investigational product-related toxicity that prevents redosing by more than 21 days
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End point type |
Primary
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End point timeframe |
Two first induction cycles
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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: No statistical analysis is performed for the primary endpoint of the phase Ib part of the study as the Recommended Dose is determined by the number of patients with at least one DLT in each cohort level. |
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No statistical analyses for this end point |
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End point title |
ORR according to Cheson 99 at the end of treatment | ||||||||||
End point description |
ORR as defined by Cheson 99 criteria: ORR = CR/CRu/PR
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End point type |
Secondary
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End point timeframe |
At the end of treatment defined as after complete treatment or at permanent treatment discontinuation
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse Events (AE) occurring from the signing of the Informed Consent and until 30 days after the end of the last cycle of treatment have been recorded on the AE pages of the CRF.
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Adverse event reporting additional description |
Only grade 3 and 4 toxicities (NCIC Common Toxicity Criteria grading system – version 4.03) or grade 2 for infections, and toxicities (grade 1 to 4) related to a Serious Adverse Event as described below, have been be reported as “Adverse Event” in the appropriate CRF pages.
All “Alopecia” toxicity have not been recorded as “Adverse Event”.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
4.03
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Reporting groups
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Reporting group title |
All patients
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Reporting group description |
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||||||
Date |
Amendment |
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22 Jun 2012 |
• A change in the name only of the Sponsor name from Groupe d’Etude des Lymphomes de l’Adulte Recherche Clinique (GELARC) to LYSARC on 1 June 2012.
• The definition of DLTs was modified slightly to specify that all grade 4 non-hematologic toxicities will be considered as DLT whatever duration or relationship to study treatment.
•The sentence explaining that a copy signed consent forms would be recovered by the sponsor in a sealed envelope was deleted
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25 Jul 2014 |
• Prolongation of study duration from 4 years to 5.5 years.
• Addition of details on the main study objective phase-by-phase
• Precision of secondary and exploratory objectives
• Correction of the inconsistencies identified between the body of the text on the dose de-escalation rules and the summary table: summary table was corrected to properly describe the de-escalation process, as described in the text.
• Clarification of statistical endpoints of phase I and phase II
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Interruptions (globally) |
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Were there any global interruptions to the trial? Yes | |||||||
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Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||||||
None reported |