E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Indolent Non-Hodgkin Lymphoma (iNHL) |
Linfoma no-Hodgkin indolente |
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E.1.1.1 | Medical condition in easily understood language |
Blood cancer |
Cancer de sangre |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10029621 |
E.1.2 | Term | Non-Hodgkin's lymphomas unspecified histology indolent |
E.1.2 | System Organ Class | 100000004851 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to evaluate whether the addition of ibrutinib to bendamustine and rituximab (BR) combination or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) combination will result in prolongation of PFS compared with either BR or R-CHOP alone in subjects with previously treated iNHL (FL or MZL). |
El objetivo principal es evaluar si la adición de ibrutinib a bendamustina y rituximab (BR) y en combinacion con rituximab, ciclofosfamida, doxorubicina, vincristina y prednisona (R-CHOP) prolonga la supervivencia libre de evento (SLE) en comparación con solo BR o R-CHOP en sujetos con linfoma no-Hodgkin indolente (LNHi) previamente tratado. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to compare treatment groups in terms of the following: ? overall survival (OS) ? complete response rate (CR) ? overall response rate ORR (CR+PR) ? duration of response (DOR) ? patient-reported lymphoma symptoms and concerns as measured by the Lym subscale of the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) ? safety of ibrutinib when combined with BR or R-CHOP |
Los objetivos secundarios consisten en comparar los siguientes parámetros entre los grupos de tratamiento: ?supervivencia global (SG) ?tasa de respuestas completas (RC) ?tasa de respuestas globales (TRG, RC+RP) ?duración de la respuesta (DR) ?síntomas y problemas del linfoma comunicados por el paciente, determinados mediante la subescala Lym de la Evaluación funcional del tratamiento del cáncer-Linfoma (FACT-Lym). ?seguridad del ibrutinib cuando se combina con BR o con R-CHOP |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Histologically confirmed diagnosis of B-cell indolent Non-Hodgkin lymphoma with histological subtype limited to follicular lymphoma or marginal zone lymphoma - At least 1 prior treatment with a CD20 antibody combination chemotherapy regimen - Disease that has relapsed or was refractory after prior chemoimmunotherapy - At least 1 measurable site of disease according to Revised Response Criteria for Malignant Lymphoma 2007 - Eastern Cooperative Oncology Group performance status grade 0 or 1 - Laboratory values within protocol-defined parameters - Agrees to protocol-defined use of effective contraception - Men must agree not to donate sperm during and after the study for 6 months after the last dose of bendamustine, 12 months after the last dose of rituximab, or 3 months after the last dose of study medication, whichever is later - Women of childbearing potential must have a negative serum or urine pregnancy test at screening |
-Diagnóstico de LNHel de linfocitos B con confirmación histológica, cuyo subtipo histológico esté limitado a linfoma folicular o linfoma de la zona marginal -Como mínimo un tratamiento previo basado en una pauta de quimioterapia combinada con un anticuerpo anti-CD20 -Enfermedad que haya recaido o que fuera resistente después de la quimioinmunoterapia anterior -Al menos un foco mensurable de enfermedad según los Criterios revisados de respuesta en el linfoma maligno (Cheson 2007) -Estado funcional del Eastern Cooperative Oncology Group de 0 o 1. -Los valores hematológicos deben estar dentro de los límites definidos en el protocolo. -Comprometerse a usar metodos anticonceptivos eficades definidos en el protocolo. -Los varones también deberán comprometerse a no donar semen durante el estudio después de la última dosis de bendamustina, 12 meses después de la última dosis de rituximab o 3 meses después de la última dosis de la medicación del estudio, lo que suceda más tarde. -Las mujeres en edad fértil deben obtener un resultado negativo en una prueba de embarazo en suero u orina en el momento de la selección. |
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E.4 | Principal exclusion criteria |
-Prior treatment according to protocol-defined criteria -Unable to receive background chemotherapy based on prior treatment history and cardiac function -Known central nervous system lymphoma -Diagnosed or treated for malignancy other than indolent Non-Hodgkin lymphoma -History of stroke or intracranial hemorrhage within 6 months prior to randomization -Requires anticoagulation with warfarin or equivalent Vitamin K antagonists or treatment with strong CYP3A4/5 inhibitors -Clinically significant cardiovascular disease -Known history of human immunodeficiency virus or active infection with hepatitis C or B or any uncontrolled active systemic infection requiring intravenous antibiotics -Any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator?s opinion, could compromise the participant?s safety, interfere with the absorption or metabolism of ibrutinib capsules, or put the study outcomes at undue risk -Women who are pregnant or breastfeeding |
-Tratamiento previo de acuerdo a los criterios definidos en el Protocolo - Incapacidad para recibir quimioterapia de base debido al tratamiento previo y a la función cardíaca -Linfoma del SNC conocido. -Diagnóstico o tratamiento de un tumor maligno distinto del LNHel - Antecedentes de ictus o de hemorragia intracraneal en los 6 meses anteriores a la aleatorización - Necesidad de anticoagulación con warfarina o antagonistas de la vitamina K equivalentes o de de tratamiento con inhibidores potentes de la CYP3A4/5 - Enfermedades cardiovasculares clínicamente importantes - Cualquier enfermedad, proceso médico o disfunción orgánica potencialmente mortal que, en opinión del investigador, pueda comprometer la seguridad del sujeto, interferir en la absorción o el metabolismo de las cápsulas de ibrutinib o suponer un riesgo excesivo para los resultados del estudio. -Mujeres embarazadas o en periodo de lactancia. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression-free survival |
Supervivencia libre de progresión |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Up to approximately 7 years after the first participant is randomized |
Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. |
|
E.5.2 | Secondary end point(s) |
Overall survival 1/ Overall survival 2/ Complete response rate 3/ Overall response rate 4/ Duration of response 5/ Participants with change in patient-reported lymphoma symptoms and concerns as measured by the Lym subscale of the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) 6/ Number of participants affected by adverse events by MedDRA system organ class (SOC) and Preferred term (PT) |
Supervivencia global. 1/Supervivencia global 2/Tasa de respuesta completa 3/Tasa de respuesta global 4/Duración de la respuesta 5/ Pacientes que informen de cambios en los sintomas del linfoma determinados mediante la subescala Lym de la Evaluación funcional del tratamiento del cáncer-Linfoma (FACT-Lym). 6/Número de participantes afectados por eventos adversos segun los órganos y sistemas MedDRA (SOC) y el término preferido (PT) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1/ Up to approximately 7 years after the first participant is randomized 2/ Up to approximately 7 years after the first participant is randomized 3/ Up to approximately 7 years after the first participant is randomized 4/ Up to approximately 7 years after the first participant is randomized 5/ Up to approximately 7 years after the first participant is randomized 6/ Up to 30 days after the last dose of study medication |
1/ Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. 2/ Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. 3/ Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. 4/ Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. 5/ Hasta aproximadamente 7 años despues de que el primer participante sea randomizado. 6/ Hasta 30 dias despues de la ultima dosis de la medicacion del estudio. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Biomarker analysis |
Analisis de biomarcadores |
|
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 68 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Australia |
Belgium |
Brazil |
China |
France |
Germany |
Israel |
Italy |
Japan |
Poland |
Russian Federation |
Ukraine |
Korea, Republic of |
Spain |
Sweden |
Turkey |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
Per protocol, the end of the trial is defined as the time when 50% of subjects have died. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 7 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |