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    Clinical Trial Results:
    A Randomized, Open Label, Phase 2 Study of Rituximab and Bendamustine With or Without Brentuximab Vedotin for Relapsed or Refractory CD30-Positive Diffuse Large B-Cell Lymphoma

    Summary
    EudraCT number
    2015-001671-51
    Trial protocol
    GB   CZ   FR   ES   PL  
    Global end of trial date
    30 Sep 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    03 Oct 2018
    First version publication date
    03 Oct 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    SGN35-023
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02594163
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Seattle Genetics, Inc.
    Sponsor organisation address
    21823 30th Dr, Bothell, United States, 98021
    Public contact
    Chief Medical Officer, Seattle Genetics, Inc., 1 8554732436, medinfo@seagen.com
    Scientific contact
    Chief Medical Officer, Seattle Genetics, Inc., 1 8554732436, medinfo@seagen.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
    01 Aug 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Sep 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Sep 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    This is a randomized, open-label, multicenter, Phase 2 clinical trial designed to evaluate the efficacy and safety of brentuximab vedotin in combination with rituximab and bendamustine for the treatment of patients with relapsed or refractory CD30-positive diffuse large B-cell lymphoma (DLBCL) after failure of second-line salvage therapy or as second-line treatment in patients ineligible for autologous stem cell transplant (ASCT). Patients will be randomized in a 1:1 manner to receive rituximab plus bendamustine with or without brentuximab vedotin. Patients who respond to combination treatment containing brentuximab vedotin and do not experience excessive toxicity may receive additional single-agent brentuximab vedotin following combination treatment, for up to an additional 10 cycles (up to 16 total cycles of treatment).
    Protection of trial subjects
    The protocol for this study was designed in accordance with the general ethical principles outlined in the Declaration of Helsinki. The conduct of all aspects of the study, including methods for obtaining informed consent, were also in accordance with principles enunciated in the declaration, the International Council for Harmonisation (ICH) Good Clinical Practices (GCP), and applicable Food and Drug Administration (FDA) regulations/guidelines set forth in Title 21 CFR Parts 11, 50, 56, and 312. The consent form approved by each IRB/IEC included all elements required by the applicable regional laws and regulations, including a statement that Seattle Genetics, Inc. and authorities had access to patient records. Consent was obtained from all patients before any protocol-required procedures were performed, including any procedure not part of normal patient care.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    14 Sep 2015
    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
    Poland: 1
    Country: Number of subjects enrolled
    United Kingdom: 5
    Country: Number of subjects enrolled
    Czech Republic: 1
    Country: Number of subjects enrolled
    France: 6
    Country: Number of subjects enrolled
    Italy: 7
    Country: Number of subjects enrolled
    United States: 5
    Worldwide total number of subjects
    25
    EEA total number of subjects
    20
    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)
    10
    From 65 to 84 years
    14
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    First patient began treatment on 09 Mar 2016; the last patient began treatment on 11 May 2017.

    Pre-assignment
    Screening details
    The population to be studied includes patients with relapsed or refractory CD30-positive diffuse large B-cell lymphoma.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Rituximab, Bendamustine Control
    Arm description
    Subjects randomized to the control arm will receive IV infusions of rituximab on day 1 or day 2 and bendamustine on both days 1 and 2 of each 21 day cycle. Rituximab Bendamustine
    Arm type
    Active comparator

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    375 mg/m2 IV infusion (per institutional standard of care) on Day 2 (+1) of each 21-day cycle

    Investigational medicinal product name
    Bendamustine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    90 mg/m2 IV infusion on Day 1 AND Day 2 (+1) of each 21-day cycle

    Arm title
    Brentuximab Vedotin plus Rituximab plus Bendamustine
    Arm description
    Subjects randomized to the brentuximab vedotin arm will receive IV infusions of brentuximab vedotin followed by bendamustine on day 1, and rituximab followed by bendamustine on day 2 of each 21 day cycle. Brentuximab Vedotin Rituximab Bendamustine
    Arm type
    Experimental

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    375 mg/m2 IV infusion (per institutional standard of care) on Day 2 (+1) of each 21-day cycle

    Investigational medicinal product name
    Bendamustine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    90 mg/m2 IV infusion on Day 1 AND Day 2 (+1) of each 21-day cycle

    Investigational medicinal product name
    Brentuximab vedotin
    Investigational medicinal product code
    Other name
    Adcetris
    Pharmaceutical forms
    Powder for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    1.8 mg/kg IV infusion on Day 1 of each 21-day cycle

    Number of subjects in period 1
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Started
    12
    13
    Completed
    1
    1
    Not completed
    11
    12
         Withdrawl by Subject
    -
    1
         Physician decision
    -
    1
         Adverse Event
    -
    1
         Death
    2
    5
         Progressive Disease
    2
    -
         Lost to follow-up
    1
    -
         Study Termination by Sponsor
    6
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Rituximab, Bendamustine Control
    Reporting group description
    Subjects randomized to the control arm will receive IV infusions of rituximab on day 1 or day 2 and bendamustine on both days 1 and 2 of each 21 day cycle. Rituximab Bendamustine

    Reporting group title
    Brentuximab Vedotin plus Rituximab plus Bendamustine
    Reporting group description
    Subjects randomized to the brentuximab vedotin arm will receive IV infusions of brentuximab vedotin followed by bendamustine on day 1, and rituximab followed by bendamustine on day 2 of each 21 day cycle. Brentuximab Vedotin Rituximab Bendamustine

    Reporting group values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine Total
    Number of subjects
    12 13 25
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    6 4 10
        From 65-84 years
    5 9 14
        85 years and over
    1 0 1
    Age continuous
    Units: years
        median (full range (min-max))
    64.5 (47 to 85) 68 (40 to 79) -
    Gender categorical
    Units: Subjects
        Female
    8 6 14
        Male
    4 7 11
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    2 1 3
        Not Hispanic or Latino
    7 10 17
        Unknown or Not Reported
    3 2 5
    Race (NIH/OMB)
    Units: Subjects
        White
    9 11 20
        Unknown or Not Reported
    3 2 5
    Eastern Cooperative Oncology Group (ECOG) Performance Status
    0=Normal activity; 1=Symptoms but ambulatory; 2=In bed <50% of the time; 3= In bed >50% of the time; 4=100% bedridden; 5=Dead
    Units: Subjects
        0: Normal Activity
    7 6 13
        1: Symptoms but ambulatory
    5 4 9
        2: In bed less than 50% of the time
    0 3 3

    End points

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    End points reporting groups
    Reporting group title
    Rituximab, Bendamustine Control
    Reporting group description
    Subjects randomized to the control arm will receive IV infusions of rituximab on day 1 or day 2 and bendamustine on both days 1 and 2 of each 21 day cycle. Rituximab Bendamustine

    Reporting group title
    Brentuximab Vedotin plus Rituximab plus Bendamustine
    Reporting group description
    Subjects randomized to the brentuximab vedotin arm will receive IV infusions of brentuximab vedotin followed by bendamustine on day 1, and rituximab followed by bendamustine on day 2 of each 21 day cycle. Brentuximab Vedotin Rituximab Bendamustine

    Primary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR) [1]
    End point description
    ORR is defined as the percentage of patients who achieve a Complete Response (CR) (including Complete Metabolic Response (CMR)) or Partial Response (PR) (including Partial Metabolic Response (PMR)) as best response to combination therapy on study
    End point type
    Primary
    End point timeframe
    Approximately 1 year
    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: Due to the small number of patients recruited in the study there will be no formal assessment of the primary endpoint. The observed ORR (a best response of CR/CMR, PR/PMR) is presented by treatment arm for the ITT population along with the corresponding exact 90% and 95% confidence intervals (CIs) using the exact binomial method (i.e., Clopper-Pearson method).
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    12
    13
    Units: percentage of participants
        number (confidence interval 95%)
    91.7 (61.5 to 99.8)
    61.5 (31.6 to 86.1)
    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
    PFS is defined as the time from randomization to disease progression/relapse, receipt of subsequent lymphoma chemotherapy other than the components of the study treatment regimen, or death from any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    Up to 11.8 months
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    12
    13
    Units: months
        median (full range (min-max))
    4.9 (1.6 to 11.8)
    3.7 (0.8 to 11.5)
    No statistical analyses for this end point

    Secondary: Complete Remission (CR) Rate

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    End point title
    Complete Remission (CR) Rate
    End point description
    CRR is the proportion of patients who achieve a Complete Response (CR) (including Complete Metabolic Response (CMR)) as best response to combination therapy on study.
    End point type
    Secondary
    End point timeframe
    Approximately 1 year
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    12
    13
    Units: participants
    8
    7
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    DOR is defined as the time from first observation of response to disease progression/relapse, receipt of subsequent lymphoma chemotherapy other than the components of the study treatment regimen, or death from any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    Up to 10.5 months
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    11
    8
    Units: months
        median (full range (min-max))
    3.7 (0.0 to 10.5)
    4.1 (0.0 to 10.1)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS is defined as the time randomization to death from any cause.
    End point type
    Secondary
    End point timeframe
    Up to 1.5 years
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    12
    13
    Units: months
        median (full range (min-max))
    14.3 (3.9 to 18)
    6.5 (1.9 to 11.9)
    No statistical analyses for this end point

    Secondary: Number and Severity of Adverse Events (AEs)

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    End point title
    Number and Severity of Adverse Events (AEs)
    End point description
    All AEs are included in the summaries, unless treatment-emergent is specified.
    End point type
    Secondary
    End point timeframe
    Approximately 1 year
    End point values
    Rituximab, Bendamustine Control Brentuximab Vedotin plus Rituximab plus Bendamustine
    Number of subjects analysed
    12
    13
    Units: events
        Treatment-Emergent Adverse Event
    11
    13
        Treatment-Related Adverse Event
    10
    13
        Brentuximab Vedotin-Related Adverse Event
    0
    11
        Rituximab-Related Adverse Event
    6
    10
        Bendamustine-Related Adverse Event
    10
    13
        Adverse Event with Outcome of Death
    0
    1
        Serious Adverse Event
    3
    8
        Treatment-Related Serious Adverse Event
    3
    3
        Adverse Event Leading to Dose Delay
    3
    0
        Adverse Event Leading to Treatment Discontinuation
    1
    5
        Grade 3-5 Treatment-Emergent Adverse Event
    4
    11
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Approximately 1 year
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    Rituximab, Bendamustine Control
    Reporting group description
    Subjects randomized to the control arm will receive IV infusions of rituximab on day 1 or day 2 and bendamustine on both days 1 and 2 of each 21 day cycle. Rituximab Bendamustine

    Reporting group title
    Brentuximab Vedotin
    Reporting group description
    Subjects randomized to the brentuximab vedotin arm will receive IV infusions of brentuximab vedotin followed by bendamustine on day 1, and rituximab followed by bendamustine on day 2 of each 21 day cycle. Brentuximab Vedotin Rituximab Bendamustine

    Serious adverse events
    Rituximab, Bendamustine Control Brentuximab Vedotin
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 12 (25.00%)
    8 / 13 (61.54%)
         number of deaths (all causes)
    2
    5
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diffuse large B-cell lymphoma
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Diffuse large B-cell lymphoma refractory
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastases to peritoneum
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Transient ischaemic attack
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Histiocytosis haematophagic
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Hypoxia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Sepsis
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Kidney infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphangitis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia viral
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Rituximab, Bendamustine Control Brentuximab Vedotin
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    11 / 12 (91.67%)
    13 / 13 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Diffuse large B-cell lymphoma refractory
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Vascular disorders
    Hypotension
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    5
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 12 (16.67%)
    3 / 13 (23.08%)
         occurrences all number
    6
    3
    Fatigue
         subjects affected / exposed
    2 / 12 (16.67%)
    3 / 13 (23.08%)
         occurrences all number
    2
    6
    Pyrexia
         subjects affected / exposed
    1 / 12 (8.33%)
    4 / 13 (30.77%)
         occurrences all number
    4
    5
    Chills
         subjects affected / exposed
    2 / 12 (16.67%)
    0 / 13 (0.00%)
         occurrences all number
    3
    0
    Device malfunction
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Performance status decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 12 (16.67%)
    3 / 13 (23.08%)
         occurrences all number
    3
    3
    Dyspnoea
         subjects affected / exposed
    2 / 12 (16.67%)
    1 / 13 (7.69%)
         occurrences all number
    3
    2
    Hypoxia
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    3
    Pleural effusion
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    2
    Hiccups
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Nasal congestion
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Pneumomediastinum
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Pneumonitis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Respiratory failure
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    1 / 12 (8.33%)
    2 / 13 (15.38%)
         occurrences all number
    1
    6
    Platelet count decreased
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
         occurrences all number
    7
    8
    White blood cell count decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    8
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Amylase increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Blood phosphorus decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    2
    Lipase increased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Lymphocyte count decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    6
    Weight decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Lumbar vertebral fracture
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 12 (8.33%)
    2 / 13 (15.38%)
         occurrences all number
    1
    2
    Paraesthesia
         subjects affected / exposed
    0 / 12 (0.00%)
    3 / 13 (23.08%)
         occurrences all number
    0
    3
    Neuropathy peripheral
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    2
    Syncope
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    3
    Dysaesthesia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Dysgeusia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Dyskinesia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 12 (25.00%)
    2 / 13 (15.38%)
         occurrences all number
    3
    2
    Neutropenia
         subjects affected / exposed
    3 / 12 (25.00%)
    1 / 13 (7.69%)
         occurrences all number
    9
    5
    Thrombocytopenia
         subjects affected / exposed
    2 / 12 (16.67%)
    0 / 13 (0.00%)
         occurrences all number
    2
    0
    Pancytopenia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    2
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Vertigo
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Eye disorders
    Eye pain
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    2 / 12 (16.67%)
    6 / 13 (46.15%)
         occurrences all number
    2
    9
    Nausea
         subjects affected / exposed
    3 / 12 (25.00%)
    5 / 13 (38.46%)
         occurrences all number
    3
    7
    Vomiting
         subjects affected / exposed
    1 / 12 (8.33%)
    5 / 13 (38.46%)
         occurrences all number
    1
    5
    Abdominal pain
         subjects affected / exposed
    0 / 12 (0.00%)
    4 / 13 (30.77%)
         occurrences all number
    0
    4
    Dyspepsia
         subjects affected / exposed
    1 / 12 (8.33%)
    2 / 13 (15.38%)
         occurrences all number
    1
    2
    Constipation
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
         occurrences all number
    1
    1
    Stomatitis
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
         occurrences all number
    1
    1
    Abdominal distension
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Abdominal pain upper
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Gastritis
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Dermatitis exfoliative
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Dry skin
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Eczema
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Generalised erythema
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Pruritus
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    2
    0
    Rash
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    2
    0
    Urticaria
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    2
    Urinary retention
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    2
    Bone pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Groin pain
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Musculoskeletal pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
         occurrences all number
    2
    1
    Bronchitis
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
         occurrences all number
    1
    0
    Cystitis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Oral candidiasis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Oral fungal infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Pneumonia viral
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Rhinovirus infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Urinary tract infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 12 (8.33%)
    3 / 13 (23.08%)
         occurrences all number
    1
    3
    Hypokalaemia
         subjects affected / exposed
    0 / 12 (0.00%)
    4 / 13 (30.77%)
         occurrences all number
    0
    9
    Hypocalcaemia
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
         occurrences all number
    0
    3
    Dehydration
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    2
    Failure to thrive
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1
    Fluid retention
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    2
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    4
    Hyponatraemia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    2
    Hypophosphataemia
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    3
    Vitamin D deficiency
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
         occurrences all number
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    17 Jun 2015
    The protocol was updated to add the EudraCT number to the cover page.
    10 Nov 2015
    The protocol was amended for the following reasons: • To provide additional detail in the study objective and endpoints. • To exclude patients unable to give consent by removing the option for a legally acceptable representative to consent. • Revise the entry criteria to: o Increase the required platelet count for study entry to ≥75,000/μL o Require females of childbearing potential and males who have partners of childbearing potential to use 2 effective contraceptive methods and to specify which methods are considered effective o Exclude subjects with major surgery less than 30 days prior to first dose of study drug , live vaccines within 1 month of first dose of study drug, current severe immunodeficiency, history of recurring or chronic infections or with underlying conditions which may further predispose patients to serious infection, or concomitant use of bleomycin. • Require study discontinuation in the case of pregnancy. o Require pretreatment assessment for hepatitis B. o Require electrocardiogram assessment at each cycle. o Require pregnancy testing (for women of childbearing potential only) at each cycle and require that pregnancy testing be by serum β-hCG • Clearly specify the requirement for physical examinations and require physical examination to include neurological examination at all time points where physical examination is required, including where it is required as part of the lymphoma assessment. • To clarify that sampling for brentuximab and MMAE exposure was only required for subjects on the treatment arm (brentuximab vedotin) and to extend this sampling to all combination treatment cycles (up to Cycle 6). • To limit ATA sampling to the treatment arm (brentuximab vedotin). • Clarify that safety reporting is required in all regions of study conducted as required by local and international standards. • To update the reference to the NCCN guideline for the prevention and treatment of cancer-related infections.
    19 Feb 2016
    The protocol was amended to • Clarify that the objectives of the study were to investigate the effects of study treatment both in patients with DLCBL and those with follicular NHL grade 3b • Allow a second dose reduction of bendamustine (to 50 mg/m2) • Recommend prophylactic growth factor support and clarified that transfusions and intrathecal prophylactic treatment for cerebral/meningeal disease are permitted • Correct an error regarding timing of posttreatment assessments: The timing of all posttreatment assessments is relative to Cycle 1 Day 1 (not the end of treatment) • Add an additional safety assessment visit during the second week of Cycles 1 and 2 • To change the definition of PFS and OS to begin at randomization (rather than date of first treatment) and to include subsequent treatment for lymphoma (other than post-treatment consolidative radiotherapy, post-treatment chemotherapy for the purpose of mobilizing peripheral blood stem cells, and consolidative autologous or allogeneic SCT) as an event in the progression analyses to reflect current statistical planning • Remove the requirement that biopsy samples be obtained within than 1 year before screening • Clarify that tumor samples are only to be collected from archival samples; no tumor biopsies are required to be performed for this study • Make minor editorial and formatting changes throughout the protocol
    13 Jul 2016
    The protocol was amended to • Reflect that Teva Pharmaceuticals is discontinuing distribution of the bendamustine hydrochloride liquid formulation TREANDA, which was being used at all US sites in this study. Investigators may continue to dispense TREANDA until its expiration date, as described in previous versions of the protocol and in the pharmacy manual. When acquiring new supplies, sites are to acquire bendamustine hydrochloride lyophilized powder. • Allow the assessment of CD30 for eligibility assessment to be performed either by local or central laboratory • Clarify that a new biopsy may be required for subjects with relapsed disease if one has not been obtained since relapse • To correct an inconsistency between the schedule of follow-up assessments and the text description of follow-up events • Make minor editorial and formatting changes throughout the protocol

    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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