E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with lymphoid tissue lymphoma mucosa-associated (MALT) for which the standard treatments with radiotherapy, chemotherapy and / or immunotherapy show lack of efficacy. |
Pazienti con linfoma del tessuto linfoide associato alla mucosa (MALT) per i quali i trattamenti standard con radioterapia, chemioterapia e/o immunoterapia hanno mostrato una mancanza di efficacia. |
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E.1.1.1 | Medical condition in easily understood language |
Patients with an aggressive form of cancer that affects the cells and tissues that are responsible for defending the body against external agents and against disease, ensuring proper circulation of fl |
Pazienti con una forma aggressiva di tumore che colpisce le cellule e i tessuti che hanno il compito di difendere l'organismo dagli agenti esterni e dalle malattie e di garantire una corretta circolaz |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015823 |
E.1.2 | Term | Extranodal marginal zone B-cell lymphoma (MALT type) recurrent |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015824 |
E.1.2 | Term | Extranodal marginal zone B-cell lymphoma (MALT type) refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 |
To assess the overall response rate (complete and partial responses) of the combination treatment of clarithromycin and lenalidomide (Revlimid) in patients with MALT lymphoma, refractory or relapsing after radiotherapy and/or chemotherapy and/or immunotherapy. |
Valutare la percentuale complessiva di risposta (risposte complete e parziali) del trattamento combinato di claritromicina e lenalidomide (Revlimid) in pazienti con linfoma MALT, refrattario o recidivante, dopo radioterapia e / o chemioterapia e / o immunoterapia. |
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E.2.2 | Secondary objectives of the trial |
- To evaluate the safety profile of the clarithromycin + lenalidomide combination, including any late adverse reactions - To assess the progression-free survival after clarithromycin+ lenalidomide therapy - To assess the time to progression after clarithromycin + lenalidomide therapy - To assess the overall survival after clarithromycin + lenalidomide therapy |
Valutare il profilo di sicurezza della combinazione claritromicina e lenalidomide, comprese le eventuali reazioni avverse tardive. - Valutare la sopravvivenza libera da progressione dopo terapia con lenalidomide e claritromicina - Valutare il tempo alla progressione dopo terapia con lenalidomide e claritromicina - Valutare la sopravvivenza dopo la terapia con lenalidomide e claritromicina |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Histologically verified diagnosis of MALT lymphoma arising at any extranodal site
- Disease refractory to or in first or greater relapse after prior radiotherapy and/or chemotherapy and/or immunotherapy
- Measurable or non-measurable lesions where the response is nevertheless evaluable by non-imaging means (e.g., gastric or bone marrow infiltrations)
- Ann Arbor Stage I-IV
- Adequate cardiac, renal and liver function tests (LVEF > 40%, serum creatinine < 2.5 mg/dl, ALAT or ASAT < 2.5 x upper limit of normal range, alkaline phosphatase < 2.5 x upper limit of normal range, serum bilirubin < 2.0 mg/dl)
- Female patients of childbearing potential must agree to use, and be able to comply with, effective contraception and agree to have medically supervised pregnancy tests prior to starting the study
treatment and during therapy
- Male patients must agree to always use a condom during any sexual contact with females of reproductive potential and agree to not donate sperm while taking lenalidomide |
- Conferma istologica di diagnosi di linfoma MALT derivante in qualsiasi sito extranodale - Malattia refrattaria o recidivante (prima o successive recidive) dopo radioterapia e / o chemioterapia e / o immunoterapia - Lesioni misurabili o non-misurabili dove la risposta è tuttavia valutabile con mezzi non-imaging (ad esempio, infiltrazioni del gastrico o midollo osseo) - Ann Arbor Stadio I-IV - Test di funzionalità cardiaca, renale ed epatica corretti (FEVS> 40%, creatinina sierica <2,5 mg / dl, ALAT o ASAT <2,5 volte il limite superiore del range normale, fosfatasi alcalina <2,5 volte il limite superiore del range normale, bilirubina sierica <2.0 mg / dl) - Pazienti di sesso femminile in età fertile devono accettare di usare, ed essere in grado di attenersi a una contraccezione efficace e accettare di fare il test di gravidanza sotto controllo medico prima di iniziare il trattamento in studio e durante la terapia - I pazienti di sesso maschile devono accettare di usare sempre il preservativo durante qualsiasi rapporto sessuale con donne potenzialmente fertili e accettare di non essere donatore di sperma durante l'assunzione di lenalidomide
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E.4 | Principal exclusion criteria |
- Lymphoma histology other than MALT lymphoma or MALT lymphoma with a diffuse large cell lymphoma (“high gradelymphoma”) - component
- History of malignancy other than squamous cell carcinoma, basal cell carcinoma of the skin or carcinoma in situ of the uterine cervix within the last 5 years unless in complete remission since at least 3 years
- Dependency on red blood cell and/or platelet transfusions
- Evidence of central nervous system involvement
- Severe peripheral polyneuropathy
- Clinically significant cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmias not well controlled with medication) or myocardial infarction within the last 6 months and/or long QT-syndrome
- Presence of active opportunistic infections
- Pregnancy or lactation
- Uncontrolled diabetes mellitus
- Pre-existing thromboembolic conditions at study entry |
- Istologia del linfoma diverso da linfoma MALT oppure linfoma MALT con componente di linfoma diffuso a grandi cellule (linfoma ad alto grado) - Storia di tumore maligno diverso da carcinoma squamoso o basocellulare della pelle o carcinoma in situ della cervice uterina negli ultimi 5 anni, a meno di remissione completa da almeno 3 anni - Dipendenza da trasfusioni di globuli rossi e/o piastrine - Evidenza di coinvolgimento del sistema centrale nervoso - Polineuropatia periferica grave - Cardiopatia clinicamente significativa (ad esempio, insufficienza cardiaca congestizia, malattia coronarica e aritmie cardiache sintomatiche non ben controllate con i farmaci) o infarto del miocardio negli ultimi 6 mesi e / o sindrome del prolungamento del QT - Presenza di infezioni opportunistiche attive - Gravidanza o allattamento - Diabete mellito non controllato - Condizioni tromboemboliche pre-esistenti all'inizio dello studio |
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E.5 End points |
E.5.1 | Primary end point(s) |
Tumor response assessed according to the international Revised Response Criteria for Malignant Lymphoma (Cheson et al) and the GELA (Group d'Etude des Lymphomes de l'Adulte) histological scoring system for post-treatment biopsies of patients with gastric MALT lymphoma. The overall response rate will be represented by the total number of complete and partial responses. |
Risposta del tumore valutata secondo i criteri di risposta rivisti per Linfoma Maligno, sia clinicamente o endoscopicamente e istologicamente (in pazienti affetti da linfoma gastrico, secondo il sistema GELA [Gruppo d'Etude des Lymphomes de l'Adulte]. Il tasso di risposta globale (ORR) è rappresentato dal numero totale di risposte complete e parziali. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
For the whole duration of the study |
Per tutta la durata dello studio |
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E.5.2 | Secondary end point(s) |
- Adverse events incidence, severity and relationship to study treatment - Time from first investigational medicinal product administration to assessment of disease progression or death due to any cause - Time from first investigational medicinal product administration to assessment of disease progression or death due to progression 4-Time from first IMP administration to patient¿s death |
- Incidenza, gravit¿ e relazione di eventi avversi emergenti dal trattamento di studio - Tempistica dalla prima somministrazione di farmaco sperimentale fino alla valutazione della progressione di malattia o di morte per qualsiasi causa - Tempistica dalla prima somministrazione di farmaco sperimentale fino alla valutazione della progressione di malattia o di morte dovuta a progressione - Tempistica dalla prima somministrazione di farmaco sperimentale al decesso |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
For the whole duration of the study |
Per tutta la durata dello studio |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
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 | No |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 14 |
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 | Information not present in EudraCT |
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 |
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E.8.7 | Trial has a data monitoring committee | No |
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
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LVLS after 10 years follow-up |
LVLS dopo 10 anni di follow-up |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 13 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 13 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |