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    Clinical Trial Results:
    Phase 3 Multi-Center Randomized Study to Compare Efficacy and Safety of Romidepsin¬CHOP (Ro-CHOP) versus CHOP in subjects with Previously Untreated Peripheral T-Cell Lymphoma.

    Summary
    EudraCT number
    2012-001580-68
    Trial protocol
    BE   ES   IT   DE   PT   AT  
    Global end of trial date
    13 Dec 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Dec 2023
    First version publication date
    15 Dec 2023
    Other versions
    Summary report(s)
    20190717_Ro-CHOP Study_Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    Ro-CHOP Study
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    LYSARC
    Sponsor organisation address
    Centre Hospitalier Lyon-Sud - Bâtiment 2D, PIERRE-BENITE, France, 69495
    Public contact
    Fabienne MORAND, LYSARC, 33 472 66 93 33, fabienne.morand@lysarc.org
    Scientific contact
    Fabienne MORAND, LYSARC, 33 472 66 93 33, fabienne.morand@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
    13 Dec 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Dec 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study is to compare efficacy of romidepsin when administered with CHOP versus CHOP alone in subjects with previously untreated peripheral T-cell lymphoma (PTCL)
    Protection of trial subjects
    DSMC periodically reviewed the safety and efficacy data from the trial prepared by the independent statistician. All data presented at the meeting were confidential. Following each meeting the DMSC prepared a report and may recommended changes in the trial conduct.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Jan 2013
    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
    Spain: 44
    Country: Number of subjects enrolled
    Belgium: 34
    Country: Number of subjects enrolled
    France: 252
    Country: Number of subjects enrolled
    Germany: 17
    Country: Number of subjects enrolled
    Italy: 24
    Country: Number of subjects enrolled
    Korea, Republic of: 22
    Country: Number of subjects enrolled
    Australia: 5
    Country: Number of subjects enrolled
    Singapore: 16
    Country: Number of subjects enrolled
    Austria: 7
    Worldwide total number of subjects
    421
    EEA total number of subjects
    378
    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)
    202
    From 65 to 84 years
    219
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    420 planned (210/treatment arm); 421 enrolled; 421 randomized subjects (211 subjects in Ro-CHOP arm and 210 subjects in CHOP arm), and 418 treated (210 subjects in Ro-CHOP arm and 208 subjects in CHOP arm).

    Pre-assignment
    Screening details
    The study consisted of 3 phases: Screening Phase, Treatment Phase, and Follow-up Phase. Subjects were eligible for screening once they had signed the informed consent form. In the Screening Phase, subjects were to undergo baseline assessments of their disease and other assessments up to 14 days before first dose of study drug, except for imaging

    Period 1
    Period 1 title
    Treatment phase
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ro-CHOP
    Arm description
    Romidepsin + CHOP 6 cycles
    Arm type
    Experimental

    Investigational medicinal product name
    Romidepsin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Romidepsin was supplied as a dual pack containing 10 mg lyophilized romidepsin and 20 mg povidone in a sterile single-use vial (active drug) and 2 mL of 20% ethanol in propylene glycol in a sterile single use vial (diluent). Romidepsin was reconstituted with the supplied diluent (5 mg/mL solution) and further diluted with 0.9% sodium chloride injection before IV infusion. Romidepsin was administered in Arm B, Ro-CHOP regimen at the dose of 12 mg/m² IV infused over a 4-hour period on Days 1 and 8 of a 21-day cycle.

    Arm title
    CHOP
    Arm description
    CHOP 6 cycles cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)
    Arm type
    Active comparator

    Investigational medicinal product name
    Romidepsin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Romidepsin was supplied as a dual pack containing 10 mg lyophilized romidepsin and 20 mg povidone in a sterile single-use vial (active drug) and 2 mL of 20% ethanol in propylene glycol in a sterile single use vial (diluent). Romidepsin was reconstituted with the supplied diluent (5 mg/mL solution) and further diluted with 0.9% sodium chloride injection before IV infusion. Romidepsin was administered in Arm B, Ro-CHOP regimen at the dose of 12 mg/m² IV infused over a 4-hour period on Days 1 and 8 of a 21-day cycle.

    Number of subjects in period 1
    Ro-CHOP CHOP
    Started
    211
    210
    Completed
    164
    154
    Not completed
    47
    56
         Consent withdrawn by subject
    2
    4
         toxicity
    3
    4
         insufficient response
    1
    4
         Death
    2
    2
         Other
    8
    7
         Progression
    28
    33
         Concurrent illness
    3
    2
    Period 2
    Period 2 title
    Follow-up
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ro-CHOP
    Arm description
    Romidepsin + CHOP 6 cycles
    Arm type
    Experimental

    Investigational medicinal product name
    Romidepsin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Romidepsin was supplied as a dual pack containing 10 mg lyophilized romidepsin and 20 mg povidone in a sterile single-use vial (active drug) and 2 mL of 20% ethanol in propylene glycol in a sterile single use vial (diluent). Romidepsin was reconstituted with the supplied diluent (5 mg/mL solution) and further diluted with 0.9% sodium chloride injection before IV infusion. Romidepsin was administered in Arm B, Ro-CHOP regimen at the dose of 12 mg/m² IV infused over a 4-hour period on Days 1 and 8 of a 21-day cycle.

    Arm title
    Standard arm
    Arm description
    Cyclophosphamide, doxorubicine, vincristine, and prednisone (CHOP) 6 cycles
    Arm type
    Active comparator

    Investigational medicinal product name
    Romidepsin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Injection
    Dosage and administration details
    Romidepsin was supplied as a dual pack containing 10 mg lyophilized romidepsin and 20 mg povidone in a sterile single-use vial (active drug) and 2 mL of 20% ethanol in propylene glycol in a sterile single use vial (diluent). Romidepsin was reconstituted with the supplied diluent (5 mg/mL solution) and further diluted with 0.9% sodium chloride injection before IV infusion. Romidepsin was administered in Arm B, Ro-CHOP regimen at the dose of 12 mg/m² IV infused over a 4-hour period on Days 1 and 8 of a 21-day cycle.

    Number of subjects in period 2
    Ro-CHOP Standard arm
    Started
    164
    154
    Completed
    62
    59
    Not completed
    102
    95
         Consent withdrawn by subject
    10
    7
         Death
    75
    77
         Lost to follow-up
    17
    11

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ro-CHOP
    Reporting group description
    Romidepsin + CHOP 6 cycles

    Reporting group title
    CHOP
    Reporting group description
    CHOP 6 cycles cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)

    Reporting group values
    Ro-CHOP CHOP Total
    Number of subjects
    211 210 421
    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
    0
        85 years and over
    0
    Age continuous
    Age at baseline
    Units: years
        median (full range (min-max))
    65.0 (26 to 80) 65.0 (25 to 81) -
    Gender categorical
    Units: Subjects
        Female
    86 74 160
        Male
    125 136 261

    End points

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    End points reporting groups
    Reporting group title
    Ro-CHOP
    Reporting group description
    Romidepsin + CHOP 6 cycles

    Reporting group title
    CHOP
    Reporting group description
    CHOP 6 cycles cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)
    Reporting group title
    Ro-CHOP
    Reporting group description
    Romidepsin + CHOP 6 cycles

    Reporting group title
    Standard arm
    Reporting group description
    Cyclophosphamide, doxorubicine, vincristine, and prednisone (CHOP) 6 cycles

    Primary: Progression Free Survival

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    End point title
    Progression Free Survival
    End point description
    End point type
    Primary
    End point timeframe
    Median progression free survival from randomization
    End point values
    Ro-CHOP CHOP
    Number of subjects analysed
    211
    210
    Units: months
        median (confidence interval 95%)
    12.0 (9.0 to 25.8)
    10.2 (7.4 to 13.2)
    Attachments
    Ro CHOP PFS
    Statistical analysis title
    stratified log-rank test of difference in PFS
    Comparison groups
    Ro-CHOP v CHOP
    Number of subjects included in analysis
    421
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0274
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.789
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.62
         upper limit
    1.005

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    End point type
    Secondary
    End point timeframe
    Overall survival from date of randomization
    End point values
    Ro-CHOP CHOP
    Number of subjects analysed
    211
    210
    Units: months
        median (confidence interval 95%)
    62.2 (35.7 to 86.6)
    43.8 (30.1 to 70.2)
    Attachments
    Ro CHOP OS
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    After the subject signed the informed consent until 30 days after the last study drug administration.
    Adverse event reporting additional description
    All adverse events (AE), whatever grade of intensity, occurring from the date of informed consent signature until 30 days after last study drug administration will be recorded in the AE pages of the CRF. A Serious Adverse Event that occurs after this time, including during the follow-up period, if considered related, will be reported.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Ro-CHOP
    Reporting group description
    Romidepsin + CHOP 6 cycles

    Reporting group title
    CHOP
    Reporting group description
    CHOP 6 cycles cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)

    Serious adverse events
    Ro-CHOP CHOP
    Total subjects affected by serious adverse events
         subjects affected / exposed
    87 / 210 (41.43%)
    61 / 208 (29.33%)
         number of deaths (all causes)
    110
    119
         number of deaths resulting from adverse events
    3
    4
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified
         subjects affected / exposed
    2 / 210 (0.95%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Vascular disorders
    Vascular disorders
         subjects affected / exposed
    5 / 210 (2.38%)
    1 / 208 (0.48%)
         occurrences causally related to treatment / all
    2 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    General disorders
         subjects affected / exposed
    16 / 210 (7.62%)
    9 / 208 (4.33%)
         occurrences causally related to treatment / all
    8 / 20
    7 / 10
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Immune system disorders
         subjects affected / exposed
    0 / 210 (0.00%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
         subjects affected / exposed
    8 / 210 (3.81%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    6 / 8
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Psychiatric disorders
         subjects affected / exposed
    1 / 210 (0.48%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Product issues
         subjects affected / exposed
    0 / 210 (0.00%)
    1 / 208 (0.48%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Investigations
         subjects affected / exposed
    3 / 210 (1.43%)
    0 / 208 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
         subjects affected / exposed
    4 / 210 (1.90%)
    3 / 208 (1.44%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac disorders
         subjects affected / exposed
    6 / 210 (2.86%)
    6 / 208 (2.88%)
         occurrences causally related to treatment / all
    4 / 6
    5 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Nervous system disorders
         subjects affected / exposed
    4 / 210 (1.90%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    3 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Blood and lymphatic system disorders
         subjects affected / exposed
    13 / 210 (6.19%)
    11 / 208 (5.29%)
         occurrences causally related to treatment / all
    13 / 13
    7 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal disorders
         subjects affected / exposed
    11 / 210 (5.24%)
    6 / 208 (2.88%)
         occurrences causally related to treatment / all
    7 / 12
    2 / 6
         deaths causally related to treatment / all
    0 / 1
    1 / 1
    Hepatobiliary disorders
    Hepatobiliary disorders
         subjects affected / exposed
    1 / 210 (0.48%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
         subjects affected / exposed
    3 / 210 (1.43%)
    0 / 208 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal and urinary disorders
         subjects affected / exposed
    2 / 210 (0.95%)
    2 / 208 (0.96%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal and connective tissue disorders
         subjects affected / exposed
    3 / 210 (1.43%)
    0 / 208 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Infections and Infestations
         subjects affected / exposed
    39 / 210 (18.57%)
    30 / 208 (14.42%)
         occurrences causally related to treatment / all
    26 / 49
    18 / 44
         deaths causally related to treatment / all
    1 / 1
    2 / 2
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
         subjects affected / exposed
    7 / 210 (3.33%)
    3 / 208 (1.44%)
         occurrences causally related to treatment / all
    9 / 10
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    Ro-CHOP CHOP
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    208 / 210 (99.05%)
    203 / 208 (97.60%)
    Vascular disorders
    Vascular disorders
         subjects affected / exposed
    29 / 210 (13.81%)
    24 / 208 (11.54%)
         occurrences all number
    32
    30
    General disorders and administration site conditions
    General disorders and administration site conditions
         subjects affected / exposed
    139 / 210 (66.19%)
    115 / 208 (55.29%)
         occurrences all number
    278
    201
    Respiratory, thoracic and mediastinal disorders
    Respiratory thoracic and mediastinal disorders
         subjects affected / exposed
    70 / 210 (33.33%)
    48 / 208 (23.08%)
         occurrences all number
    97
    60
    Psychiatric disorders
    Psychiatric disorders
         subjects affected / exposed
    33 / 210 (15.71%)
    29 / 208 (13.94%)
         occurrences all number
    40
    36
    Investigations
    Investigations
         subjects affected / exposed
    133 / 210 (63.33%)
    92 / 208 (44.23%)
         occurrences all number
    870
    434
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
         subjects affected / exposed
    9 / 210 (4.29%)
    8 / 208 (3.85%)
         occurrences all number
    10
    8
    Cardiac disorders
    Cardiac disorders
         subjects affected / exposed
    29 / 210 (13.81%)
    13 / 208 (6.25%)
         occurrences all number
    35
    16
    Nervous system disorders
    Nervous system disorders
         subjects affected / exposed
    93 / 210 (44.29%)
    80 / 208 (38.46%)
         occurrences all number
    144
    118
    Blood and lymphatic system disorders
    Blood and lymphatic system disorders
         subjects affected / exposed
    186 / 210 (88.57%)
    126 / 208 (60.58%)
         occurrences all number
    1514
    639
    Ear and labyrinth disorders
    Ear and labyrinth disorders
         subjects affected / exposed
    11 / 210 (5.24%)
    7 / 208 (3.37%)
         occurrences all number
    11
    7
    Eye disorders
    Eye disorders
         subjects affected / exposed
    11 / 210 (5.24%)
    10 / 208 (4.81%)
         occurrences all number
    11
    10
    Gastrointestinal disorders
    Gastrointestinal disorders
         subjects affected / exposed
    179 / 210 (85.24%)
    128 / 208 (61.54%)
         occurrences all number
    654
    285
    Hepatobiliary disorders
    Hepatobiliary disorders
         subjects affected / exposed
    11 / 210 (5.24%)
    5 / 208 (2.40%)
         occurrences all number
    12
    8
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
         subjects affected / exposed
    43 / 210 (20.48%)
    41 / 208 (19.71%)
         occurrences all number
    59
    49
    Renal and urinary disorders
    Renal and urinary disorders
         subjects affected / exposed
    13 / 210 (6.19%)
    13 / 208 (6.25%)
         occurrences all number
    17
    19
    Musculoskeletal and connective tissue disorders
    Musculoskeletal and connective tissue disorders
         subjects affected / exposed
    39 / 210 (18.57%)
    47 / 208 (22.60%)
         occurrences all number
    57
    63
    Infections and infestations
    Infections and infestations
         subjects affected / exposed
    104 / 210 (49.52%)
    71 / 208 (34.13%)
         occurrences all number
    176
    116
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
         subjects affected / exposed
    104 / 210 (49.52%)
    33 / 208 (15.87%)
         occurrences all number
    268
    101

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Dec 2012
    - Update of the study rational - Removal of the pretreatment phase within 8 days of randomization - Clarification of the examinations carried out during the treatment phase - Adding of a CT scan between the 3rd and 4th cycle - Modification of the evaluation scheme in the event of progression/relapse - Modification in the frequency of completion of the quality of life questionnaires - Precision of the circuit for inclusion and review of anatomopathological diagnoses - Clarification of sensitivity analyses and overall survival as a primary secondary endpoint - Modification of study management - Modification of principal investigators / Addition of principal investigators - Protocol clarifications and corrections - Adding of the new version investigator brochure

    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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    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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