E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Indolent Non-Hodgkin Lymphoma |
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E.1.1.1 | Medical condition in easily understood language |
Indolent Non-Hodgkin Lymphoma |
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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 | 18.1 |
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 | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Evaluate the efficacy of DBR vs PBR in subjects with previously-treated iNHL |
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E.2.2 | Secondary objectives of the trial |
• Evaluate the safety of DBR and PBR in subjects with previously-treated iNHL
• Characterize the pharmacokinetics (PK) of duvelisib when administered with bendamustine and rituximab (BR) in subjects with previously-treated iNHL
Exploratory Objectives:
• Evaluate if pre-treatment biomarkers in tissue can predict clinical efficacy and/or safety of DBR vs PBR in subjects with previously-treated iNHL
• Evaluate Quality of Life (QoL) outcomes in subjects with previously-treated iNHL |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• ≥ 18 years of age
• Diagnosis of iNHL with one of the following histologic sub-types and grade:
- Follicular lymphoma (FL)Grade 1, 2, or 3a
- Small lymphocytic lymphoma (SLL)
- Marginal zone lymphoma (MZL)( splenic, nodal, or extranodal)
• Have received the following systemic treatments for iNHL:
- an anti-CD20 antibody; and
- chemotherapy
• At least 1 measurable disease lesion > 1.5 cm in at least one dimension by computed tomography (CT)/CT-PET or magnetic resonance imaging (MRI)
• Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2 (corresponds to Karnofsky Performance Status [(KPS) ≥60%])
For full inclusion criteria list, refer to protocol. |
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E.4 | Principal exclusion criteria |
• Clinical evidence of transformation to a more aggressive subtype of lymphoma or grade 3B FL
• Refractory to BR, defined as:
− Progression of disease while receiving or within 6 months of completing bendamustine + rituximab therapy
• Severe allergic or anaphylactic reaction to any monoclonal antibody therapy, murine protein, or known hypersensitivity to any of the study drugs
• Received prior allogeneic transplant
• Received prior treatment with a phosphoinositide-3-kinase (PI3K) inhibitor
• Infection with hepatitis B, hepatitis C, or human immunodeficiency virus (HIV).
• History of tuberculosis treatment within the two years prior to randomization
• History of chronic liver disease, veno-occlusive disease, or alcohol abuse
• Ongoing treatment with chronic immunosuppressants (e.g., cyclosporine) or systemic steroids > 20 mg of prednisone (or equivalent) daily (QD)
• Ongoing treatment for systemic bacterial, fungal, or viral infection at screening
• Unable to receive prophylactic treatment for pneumocystis, herpes simplex virus (HSV), or herpes zoster (VZV) at screening
• Concurrent active malignancy other than non-melanoma skin cancer, carcinoma in situ of the cervix, or prostate intraepithelial neoplasia
• History of stroke, unstable angina, myocardial infarction, or ventricular arrhythmia requiring medication or a pacemaker within the last 6 months prior to screening
For full exclusion criteria list, refer to protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression-Free Survival (PFS), defined as the time from randomization to documented progressive disease (PD) according to the revised International Working Group (IWG) criteria as assessed by the Independent Review Committee (IRC), or death due to any cause |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From date of enrollment until the date of first documentation of progression or date of death from any cause, whatever came first, assessed up to 78 months |
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E.5.2 | Secondary end point(s) |
-Complete Response (CRR): Time Frame is every 3-6 Cycles (each cycle is 28 days) from date of randomization, until date of first documented progression. Subjects will be evaluated for progression through the primary analysis of the study or 5 years from randomization, whichever is later.
-Overall Response Rate (ORR) : Time Frame is every 3-6 Cycles (each cycle is 28 days) from date of randomization, until date of first documented progression. Subjects will be evaluated for progression through the primary analysis of the study or 5 years from randomization, whichever is later.
-Overall Survival (OS): Time Frame is every 6 months for up to 5 years from date of randomization.
-Duration of Response (DOR): Time Frame is every 3-6 Cycles (each cycle is 28 days) from date of randomization, until date of first documented progression. Subjects will be evaluated for progression through the primary analysis of the study or 5 years from randomization, whichever is later.
-Safety (Treatment- emergent adverse events (TEAEs) and changes in safety laboratory values) :Time Frame is Continuous from informed consent until 30 days from last dose
-Pharmacokinetics (PK): Time Frame is Cycle 1 and Cycle 2 (each cycle is 28 days)] to evaluate the Duvelisib concentration in plasma sample.
-Pharmacokinetics (PK): Time Frame is Cycle 1 and Cycle 2 (each cycle is 28 days)] to evaluate IPI-656 (metabolite) concentration in plasma sample. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
All timeframe are described in section E.5.2
-Complete Response (CRR)
-Overall Response Rate (ORR)
-Overall Survival (OS)
-Duration of Response (DOR)
-Safety (Treatment- emergent adverse events (TEAEs) and changes in safety laboratory values)
-Pharmacokinetics (PK) |
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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 | Yes |
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) | 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 | Yes |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 80 |
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 |
Austria |
Belarus |
Belgium |
Brazil |
Bulgaria |
Canada |
Chile |
China |
Colombia |
Costa Rica |
Czech Republic |
Denmark |
Ecuador |
Egypt |
Estonia |
Finland |
France |
Georgia |
Germany |
Greece |
Guatemala |
Hong Kong |
Hungary |
Israel |
Italy |
Japan |
Korea, Republic of |
Latvia |
Lebanon |
Lithuania |
Malaysia |
Mexico |
Netherlands |
New Zealand |
Panama |
Peru |
Philippines |
Poland |
Portugal |
Romania |
Russian Federation |
Serbia |
Singapore |
Slovakia |
Slovenia |
South Africa |
Spain |
Sweden |
Switzerland |
Taiwan |
Thailand |
Turkey |
Ukraine |
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
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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 | 8 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 8 |
E.8.9.2 | In all countries concerned by the trial months | 5 |