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    Summary
    EudraCT Number:2020-002990-84
    Sponsor's Protocol Code Number:MOR208C310
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-06-04
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-002990-84
    A.3Full title of the trial
    A phase 3, multicenter, randomized, double-blind, placebo-controlled trial comparing the efficacy and safety of tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP in previously untreated, high-intermediate and high-risk patients with newly-diagnosed diffuse large B cell lymphoma (DLBCL)
    Studio di fase III, multicentrico, randomizzato, in doppio cieco, controllato con placebo, volto a confrontare l’efficacia e la sicurezza di tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a R-CHOP in pazienti con linfoma diffuso a grandi cellule B (DLBCL) di nuova diagnosi, a rischio intermedio-alto e alto, non precedentemente trattati
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Trial comparing the efficacy and safety of tafasitamab plus lenalidomide in addition to standard therapy versus standard therapy in patients newly diagnosed with lymphoma
    Studio volto a confrontare l'efficacia e sicurezza di tafasitamab più lenalidomide in aggiunta alla terapia standard rispetto alla terapia standard in pazienti con linfoma di nuova diagnosi
    A.3.2Name or abbreviated title of the trial where available
    frontMIND
    frontMIND
    A.4.1Sponsor's protocol code numberMOR208C310
    A.5.4Other Identifiers
    Name:US IND NumberNumber:145009
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorMORPHOSYS AG
    B.1.3.4CountryGermany
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMorphoSys AG
    B.4.2CountryGermany
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMorphoSys AG
    B.5.2Functional name of contact pointGlobal Program Medical Director
    B.5.3 Address:
    B.5.3.1Street AddressSemmelweisstrasse 7
    B.5.3.2Town/ cityPlanegg
    B.5.3.3Post code82152
    B.5.3.4CountryGermany
    B.5.4Telephone number+49898992726624
    B.5.5Fax number+498989927526624
    B.5.6E-mailinfo@morphosys.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLenalidomide
    D.3.2Product code [N/A]
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.2Current sponsor codeN/A
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Monjuvi
    D.2.1.1.2Name of the Marketing Authorisation holderMorphoSys AG
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEMA/3/14/1424
    D.3 Description of the IMP
    D.3.1Product nameTafasitamab
    D.3.2Product code [MOR00208]
    D.3.4Pharmaceutical form Powder for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTafasitamab
    D.3.9.2Current sponsor codeMOR00208
    D.3.9.4EV Substance CodeSUB91252
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLenalidomide
    D.3.2Product code [N/A]
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.2Current sponsor codeN/A
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLenalidomide
    D.3.2Product code [N/A]
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.2Current sponsor codeN/A
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Newly-diagnosed high-intermediate and high-risk diffuse large B-cell lymphoma (DLBCL).
    Linfoma diffuso a grandi cellule B (DLBCL) di nuova diagnosi, a rischio intermedio-alto e alto
    E.1.1.1Medical condition in easily understood language
    Recently diagnosed cancer of the blood system.
    Cancro del sistema sanguigno di nuova diagnosi
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10012818
    E.1.2Term Diffuse large B-cell lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10012820
    E.1.2Term Diffuse large B-cell lymphoma NOS
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the efficacy of tafasitamab plus lenalidomide in addition to R-CHOP versus tafasitamab placebo, lenalidomide placebo and R-CHOP (henceforth referred to as R-CHOP in the context of the control arm).
    Confrontare l’efficacia di tafasitamab più lenalidomide in aggiunta al regime R-CHOP con quella di tafasitamab placebo, lenalidomide placebo e R-CHOP (trattamento da qui in avanti definito R-CHOP nel contesto del braccio di controllo).
    E.2.2Secondary objectives of the trial
    1. To compare the efficacy (additional parameters) of tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP.
    2. To compare the safety of tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP.
    3. To compare the efficacy of tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP in DLBCL subtypes of COO
    4. To compare the efficacy of tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP in DLBCL subtypes: DLBCL not otherwise specified versus HGBL versus other.
    5. To compare the incidence of central nervous system relapse in patients receiving tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP.
    6. To assess patient-reported outcomes in patients receiving tafasitamab plus lenalidomide in addition to R-CHOP versus R-CHOP.
    7. To assess the pharmacokinetic profile of tafasitamab.
    8. To assess the potential immunogenicity of tafasitamab.
    9. To assess the role of baseline NK cell count as a predictor of response.
    1.Confrontare l’efficacia (parametri aggiuntivi) di tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a quella di R-CHOP
    2.Confrontare la sicurezza di tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a quella di R-CHOP
    3.Confrontare l’efficacia di tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a quella di R-CHOP nei sottotipi di DLBCL per COO
    4.Confrontare l’efficacia di tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a quella di R-CHOP nei sottotipi di DLBCL: DLBCL non altrimenti specificato contro HGBL contro altri sottotipi.
    5.Confrontare l’incidenza di recidive al sistema nervoso centrale nei pazienti trattati con tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a R-CHOP.
    6.Valutare gli esiti riferiti dai pazienti (PRO) nei soggetti trattati con tafasitamab più lenalidomide in aggiunta a R-CHOP rispetto a R-CHOP.
    7.Valutare il profilo farmacocinetico (PK) di tafasitamab.
    8.Valutare la potenziale immonogenicità di tafasitamab.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Written informed consent.
    2. Age 18 to 80 years at time of signing of the ICF.
    3. Previously untreated patients with local biopsy-proven, CD20-positive
    DLBCL, including one of the following diagnoses by 2016 World Health
    Organization (WHO) classification of lymphoid neoplasms are eligible:
    a. DLBCL, NOS including GCB type, ABC type
    b. T-cell rich large BCL
    c. Epstein-Barr virus-positive DLBCL, NOS
    d. Anaplastic lymphoma kinase (ALK)-positive large BCL
    e. Human herpes virus-8 (HHV8)-positive DLBCL, NOS
    f. High-grade BCL with MYC and B-cell lymphoma 2 (BCL2) and/or B-cell
    lymphoma 6 (BCL6) rearrangements (double-hit or triple-hit lymphoma).
    g. DLBCL coexistent with either follicular lymphoma (FL) of any grade,
    gastric MALT lymphoma or non-gastric MALT lymphoma
    h. FL grade 3b
    4. Availability of archival or freshly collected tumor tissue sent for
    retrospective central pathology review.
    5. Up to six of the largest target nodes, nodal masses, or other
    lymphomatous lesions that are measurable in two diameters should be
    identified by local assessment from different body regions
    representative of the patient's overall disease burden and include
    mediastinal and retroperitoneal disease, if involved.
    6. ECOG performance status of 0, 1, or 2.
    7. IPI status of 3 to 5 (for patients of more than 60 years of age) or aaIPI 2 to 3
    (for patients less and equal 60 years of age).
    8. Diagnosis to treatment interval, defined as the time between the date
    of DLBCL diagnosis (date of the local pathology report) and the start of
    treatment (C1D1) less and equal 28 days.
    9. Left ventricular ejection fraction equal to or greater than lower limit of
    institutional normal range, assessed by local echocardiography or
    cardiac multi-gated acquisition (MUGA) scan
    10. Patient must have the following local laboratory criteria at screening:
    a. Absolute neutrophil count (ANC) equal or more than 1.5 x 109/L (unless secondary to
    bone marrow involvement by DLBCL)
    b. Platelet count equal or more than 75 x 109/L (unless secondary to bone marrow
    involvement by DLBCL)
    c. Total serum bilirubin below 1.5 × upper limit of normal (ULN) unless
    secondary to Gilbert's Syndrome or documented liver involvement by
    lymphoma. Patients with Gilbert's Syndrome or documented liver
    involvement by lymphoma may be included if their total bilirubin is equal or less than 5 ×
    ULN
    d. Alanine aminotransferase (ALT), aspartate aminotransferase (AST)
    and alkaline phosphatase (ALP) equal or less that 3 × ULN, or equal or less than t 5 × ULN in cases of
    documented liver involvement
    e. Serum creatinine clearance must be equal or more that 30 mL/minute either measured
    or calculated using a standard Cockcroft and Gault formula (Cockroft and
    Gault, 1976)
    11. In the opinion of investigator, the patient must:
    a. Be able and willing to receive adequate prophylaxis and/or therapy
    for thromboembolic events, e.g. aspirin 70 to 325 mg daily or low
    molecular weight heparin.
    b. Be able to understand, give written informed consent, and comply
    with all study-related procedures, medication use, and evaluations
    c. Not have a history of noncompliance in relation to medical regimens
    nor be considered potentially unreliable and/or uncooperative
    d. Be able to understand the reason for complying with the special
    conditions of the pregnancy prevention risk management plan and in
    writing acknowledge to adhere to this plan
    1. Consenso informato scritto
    2. Età da 18 a 80 anni al momento della firma del consenso informato.
    3. Sono eleggibili i pazienti precedentemente non trattati affetti da DLBCL CD20-positivo, confermato da biopsia locale, comprendente una delle seguenti diagnosi secondo la classificazione 2016 delle neoplasie linfoidi dell’Organizzazione mondiale della sanità (OMS):
    a. DLBCL NAS, compresi i tipi GBC e ABC
    b. Linfoma a grandi cellule B ricco in linfociti T
    c. DLBCL positivo per il virus di Epstein-Barr, NAS
    d. Linfoma a grandi cellule B positivo per chinasi del linfoma anaplastico (ALK)
    e. DLBCL positivo per l’herpesvirus umano tipo 8 (HHV8), NAS
    f. Linfoma a cellule B ad alto grado con riarrangiamenti di MYC e BCL2 e/o BCL6 (linfoma double hit o triple hit).
    g. DLBCL in concomitanza con linfoma follicolare di qualsiasi grado, MALToma gastrico o MALToma non gastrico
    h. Linfoma follicolare di grado 3b
    4. Disponibilità di tessuto tumorale d’archivio o fresco inviato per l’esecuzione della revisione patologica centralizzata retrospettiva.
    5. Si devono identificare mediante valutazione locale fino a sei delle lesioni bersaglio più grandi (linfonodi, masse linfonodali o altre lesioni linfomatose) misurabili in due diametri, localizzate in diverse regioni del corpo rappresentative del carico di malattia globale del paziente e che comprendano la malattia retroperitoneale e mediastinica, se presente.
    6. Performance status ECOG pari a 0, 1 o 2.
    7. IPI da 3 a 5 (per pazienti di età maggiore d 60 anni) oppure aaIPI da 2 a 3 (per pazienti di età minore o uguale a 60 anni).
    8. Intervallo tra diagnosi e trattamento, definito come il tempo intercorrente tra la data della diagnosi di DLBCL (data del primo campione bioptico contenente linfoma in base al referto patologico locale) e l’inizio del trattamento (giorno 1 del ciclo 1) inferiore o uguale a 28 giorni.
    9. Frazione di eiezione ventricolare sinistra maggiore o uguale al limite inferiore dell’intervallo normale della struttura, valutata mediante ecocardiografia o scansione MUGA (Multi-Gated Acquisition) locali.
    10. Allo screening, i pazienti devono rispettare i seguenti criteri di laboratorio, misurati a livello locale:
    a. Conta assoluta dei neutrofili (ANC) uguale o maggiore di 1,5 x 109/L (tranne nel caso in cui sia secondaria a interessamento del midollo osseo da parte del DLBCL).
    b. Conta piastrinica uguale o maggiore di 75 × 109/L (tranne nel caso in cui sia secondaria a interessamento del midollo osseo da parte del DLBCL).
    c. Bilirubina sierica totale inferiore a1,5 × limite superiore della norma (ULN) tranne nel caso in cui sia secondaria a Sindrome di Gilbert o interessamento epatico da parte del linfoma documentato. I pazienti con una di queste condizioni potranno essere inclusi se i valori di bilirubina totale sono uguale o inferiore a 5 × ULN.
    d. Alanina aminotransferasi (ALT), aspartato aminotransferasi (AST) e fosfatasi alcalina (ALP) uguale o inferiore a 3 × ULN o uguale o inferiore a 5 × ULN in caso di interessamento epatico documentato.
    e. La clearance della creatinina sierica misurata o calcolata con la formula standard di Cockcroft-Gault (Cockroft and Gault, 1976) deve essere uguale o maggiore di 30 mL/minuto.
    E.4Principal exclusion criteria
    1. Any other histological type of lymphoma according to WHO 2016 classification of lymphoid neoplasms, e.g., primary mediastinal (thymic) large B-cell lymphoma, Burkitt's lymphoma, BCL, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma (grey-zone lymphoma); primary effusion lymphoma; primary cutaneous DLBCL, leg type; primary DLBCL of the CNS; DLBCL arising from CLL or indolent lymphoma.
    2. History of radiation therapy to greater or equal to 25% of the bone marrow for other diseases.
    3. History of prior non-hematologic malignancy except for the following:
    a. Malignancy treated with curative intent and with no evidence of active
    disease present for more than 2 years before screening
    b. Adequately treated lentigo maligna melanoma without current
    evidence of disease or adequately controlled non-melanomatous skin
    cancer
    c. Adequately treated carcinoma in situ without current evidence of
    disease
    4. Patients with:
    a. Positive local test result during screening for hepatitis C (hepatitis C virus [HCV] antibody serology testing) and a positive test for HCV RNA. Patients with positive serology must have been tested locally for HCV RNA and are eligible, in case of negative HCV RNA test results
    b. Positive local test result during screening for chronic hepatitis B virus (HBV) infection (defined by hepatitis B surface antigen [HBsAg] positivity). Patients with occult or prior HBV infection (defined as
    negative HBsAg and positive total hepatitis B core antibody [HBcAb]) may be included if HBV DNA is undetectable (local test result), provided that they are willing to undergo ongoing DNA testing. Antiviral prophylaxis may be administered as per institutional guidelines. Patients who have protective titers of hepatitis B surface antibody (HBsAb) after vaccination or prior but cured hepatitis B are eligible
    c. Seropositive (local test result during screening) for, or history of active viral infection with human immunodeficiency virus (HIV)
    d. Known active systemic bacterial, viral, fungal, or other infection at screening, including patients with suspected active or latent tuberculosis (as confirmed by a positive interferon-gamma release assay)
    e. Positive results for the human T-lymphotrophic 1 virus (HTLV-1). HTLV testing during screening is required for patients at sites in endemic countries (Japan and Melanesia and countries in the Caribbean basin, South America, Central America, and sub-Saharan Africa)
    f. Known CNS lymphoma involvement
    g. History or evidence of clinically significant cardiovascular, CNS and/or other systemic disease that in the investigator's opinion would preclude participation in the study or compromise the patient's ability to give informed consent
    h. History or evidence of rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption
    i. Vaccination with live vaccine within 21 days prior to study randomization
    j. Major surgery within up to 21 days prior to signing the informed consent form (ICF), unless the patient is recovered at the time of signing the ICF
    k. Any systemic anti-lymphoma and/or investigational therapy prior to the start of C1D1, except for permitted pre-phase treatment
    l. Contraindication to any of the individual components of R-CHOP, including prior receipt of anthracyclines
    m. Pregnancy or lactation
    n. History of hypersensitivity to any component of R-CHOP, to
    lenalidomide, to compounds of similar biological or chemical composition
    to tafasitamab, IMiDs® and/or the excipients contained in the study
    drug formulations
    1. Qualsiasi altro tipo istologico di linfoma secondo la classificazione OMS 2016 delle neoplasie linfoidi, ad es. linfoma a grandi cellule B primitivo del mediastino (timico); linfoma di Burkitt; linfoma a cellule B; linfoma non classificabile, con caratteristiche intermedie tra DLBCL e linfoma di Hodgkin classico (linfoma della zona grigia); linfoma effusivo primitivo; DLBCL cutaneo primitivo, leg type; DLBCL primitivo del SNC; DLBCL che origina da LLC o linfoma indolente.
    2. Anamnesi positiva per radioterapia in percentuale uguale a 25% o del midollo osseo o maggiore per altre malattie.
    3. Anamnesi positiva per pregressa neoplasia maligna non ematologica, escluse le seguenti condizioni:
    a. Neoplasia maligna trattata con intento curativo e senza evidenze di malattia attiva presente da oltre 2 anni prima dello screening.
    b. Melanoma di tipo lentigo maligna adeguatamente trattato senza evidenze correnti di malattia o tumore cutaneo adeguatamente controllato diverso dal melanoma.
    c. Carcinoma in situ adeguatamente trattato senza evidenze correnti di malattia.
    4. Pazienti con:
    a. Risultato positivo a un test eseguito a livello locale durante lo screening per l’epatite C (test sierologico per gli anticorpi anti-HCV) e test positivo per l’HCV RNA. I pazienti con test sierologico positivo devono essere stati sottoposti a test locale per l’HCV RNA e sono eleggibili se quest’ultimo è risultato negativo.
    b. Risultato positivo a un test eseguito a livello locale durante lo screening per l’infezione cronica da virus dell’epatite B (HBV; definito dalla positività per l’antigene di superficie del virus dell’epatite B [HBsAg]). I pazienti con infezione da HBV pregressa o occulta (definita da negatività per l’HBsAg e positività per gli anticorpi totali anti-core dell’epatite B [HBcAb]) possono essere inclusi in caso di HBV DNA non rilevabile (risultato del test locale), a condizione che siano disposti a sottoporsi a test continuativi del DNA. La profilassi antivirale può essere eseguita conformemente alle linee guida dell’istituto. Sono eleggibili i pazienti con titoli protettivi di anticorpi anti-HBsAg dopo vaccinazione o dopo epatite B pregressa, ma guarita.
    c. Sieropositività (risultato di un test locale eseguito durante lo screening) al virus dell’immunodeficienza umana (HIV) o anamnesi positiva per infezione da HIV attiva.
    d. Presenza nota di infezioni sistemiche batteriche, virali, fungine o di altro tipo allo screening, ivi inclusi i pazienti
    con sospetta tubercolosi latente o attiva (come confermato da positività al test di rilascio dell’interferone gamma).
    e. Risultati positivi al test per il virus T-linfotropo umano tipo 1 (HTLV-1). Il test per l’HTLV durante lo screening è richiesto per i pazienti dei centri ubicati in Paesi endemici (Giappone, Melanesia e Paesi del territorio caraibico, Sud America, America centrale e Africa sub-sahariana).
    E.5 End points
    E.5.1Primary end point(s)
    PFS, defined as the time from randomization to the first occurrence of disease progression or relapse as assessed by the investigator, using the Lugano Response Criteria for Malignant Lymphoma, or death from any cause, whichever occurs earlier.
    PFS, definita come il tempo intercorrente tra la randomizzazione e la prima comparsa di progressione di malattia o recidiva valutata dallo sperimentatore secondo i criteri di risposta di Lugano per il linfoma maligno, o il decesso per qualsiasi causa, in base all’evento che si verifica per primo.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Day 18 cycle 3 and EOT
    Giorno 18 ciclo 3 e EOT
    E.5.2Secondary end point(s)
    Key secondary
    1. Event-free survival (EFS) as assessed by the investigator
    2. Overall survival (OS) Secondary
    Secondary
    1. Metabolic, PET-negative complete response (CR) rate at end of treatment (EOT) as assessed by the BIRC
    2. Metabolic, PET-negative CR rate at EOT as assessed by the investigator
    3. ORR at EOT as assessed by the investigator
    4. Time to next anti-lymphoma treatment (TTNT)
    5. Duration of CR as assessed by the investigator
    6. Minimal residual disease (MRD) status by cell-free circulating tumor DNA (ctDNA) assessment at EOT
    7. EFS rate at 3 years as assessed by the investigator
    8. PFS rate at 3 years as assessed by the investigator
    9. OS rate at 3 years
    10. Incidence and severity of TEAEs from the first dose of study medication until 30 days after Day 21 of the last treatment cycle.
    11. PFS as assessed by the investigator by COO subtype
    12. Investigator-assessed EFS by COO subtype
    13. OS by COO subtype
    14. Metabolic, PET-negative CR rate at EOT as assessed by the BIRC by COO subtype
    15. Metabolic, PET-negative CR rate at EOT as assessed by the investigator by COO subtype
    16. PFS as assessed by the investigator by locally determined histological subtype
    17. Investigator assessed EFS by locally determined histological subtype
    18. OS by locally determined histological subtype
    19. Metabolic, PET-negative CR rate at EOT as assessed by the BIRC by locally determined histological subtype
    20. Metabolic, PET-negative CR rate at EOT as assessed by the investigator by locally determined histological subtype
    21. 2-year rate of relapse with CNS involvement, as assessed by the investigator
    22. Health-related quality of life (HRQoL), using the European Organisation for the Research and Treatment of Cancer (EORTC) QLQC30 and Functional Assessment of Cancer Therapy for Patients with Lymphoma (FACT-Lym) standardized measures.
    23. Serum concentration of tafasitamab at specific time points (trough and Cmax levels).
    24. Incidence of anti-tafasitamab antibody formation, titer determination of confirmed positive samples.
    25. PFS, EFS as assessed by the investigator, and OS by baseline NKCC low/high with a cut off point for NKCC low of less and equal115 NK cells/µL.
    Secondari principali
    1. Sopravvivenza libera da eventi (EFS), secondo la valutazione dello sperimentatore
    2. Sopravvivenza globale (OS)
    Secondari
    1. Tasso di risposta completa (CR) metabolica con PET negativa alla fine del trattamento in base alla valutazione del comitato di revisione indipendente in cieco (BIRC)
    2. Tasso di CR metabolica con PET negativa alla fine del trattamento, secondo la valutazione dello sperimentatore
    3. ORR alla fine del trattamento, secondo la valutazione dello sperimentatore
    4. Tempo al trattamento anti-linfoma successivo (TTNT)
    5. Durata della CR secondo la valutazione dello sperimentatore
    6. Stato relativo alla malattia minima residua (MRD) in base alla valutazione del DNA tumorale libero circolante (ctDNA) alla fine del trattamento
    7. Tasso di EFS a 3 anni secondo la valutazione dello sperimentatore
    8. Tasso di PFS a 3 anni secondo la valutazione dello sperimentatore
    9. Tasso di OS a 3 anni
    10. Incidenza e gravità degli eventi avversi emersi in corso di trattamento (TEAE) dalla prima dose del farmaco in studio fino a 30 giorni dopo il giorno 21 dell’ultimo ciclo di trattamento
    11. PFS valutata dallo sperimentatore in base al sottotipo per COO
    12. EFS valutata dallo sperimentatore in base al sottotipo per COO
    13. OS in base al sottotipo per COO
    14. Tasso di CR metabolica con PET negativa alla fine del trattamento, secondo la valutazione del BIRC in base al sottotipo per COO
    15. Tasso di CR metabolica con PET negativa alla fine del trattamento, secondo la valutazione dello sperimentatore in base al sottotipo per COO
    16. PFS valutata dallo sperimentatore in base al sottotipo istologico determinato a livello locale
    17. EFS valutata dallo sperimentatore in base al sottotipo istologico determinato a livello locale
    18. OS in base al sottotipo istologico determinato a livello locale
    19. Tasso di CR metabolica con PET negativa alla fine del trattamento, secondo la valutazione del BIRC in base al sottotipo istologico determinato a livello locale
    20. Tasso di CR metabolica con PET negativa alla fine del trattamento, secondo la valutazione dello sperimentatore in base al sottotipo istologico determinato a livello locale
    21. Tasso di recidive con interessamento del SNC a 2 anni, secondo la valutazione dello sperimentatore
    22. Qualità di vita correlata alla salute (HRQoL), secondo le misure standardizzate QLQ-C30 dell’EORTC (Organisation for the Research and Treatment of Cancer) e FACT-Lym (Functional Assessment of Cancer Therapy for Patients with Lymphoma)
    23. Concentrazione sierica di tafasitamab in corrispondenza di timepoint specifici (livelli di concentrazione minima e massima)
    24. Incidenza di formazione di anticorpi anti-tafasitamab, determinazione dei titoli nei campioni positivi confermati
    25. PFS, EFS secondo la valutazione dello sperimentatore, e OS secondo la conta delle cellule NK al basale (alta/bassa) con una soglia per i livelli bassi fissata a inferiore e uguale115 cellule NK/µL.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Key secondary:
    a) event driven, primary analysis (PA) at 274 PFS events
    b) event driven, PA at 274 PFS events
    Secondary:
    a) end of treatment (EOT)
    b/c) EOT
    d/e) event driven, PA at 274 PFS events
    f) EOT
    g/h/i) 3 yrs after randomization
    j) 30 days after D21 of the last treatment cycle
    k/l/m) event driven, PA at 274 PFS events
    n/o) EOT
    p/q) event driven, PA at 274 PFS events
    r) event driven, PA analysis at 274 PFS events
    s/t) EOT
    u) 2 yrs after randomization
    v) event driven, PA at 274 PFS events
    w/x) during the study
    y) event driven, PA at 274 PFS events
    Secondari principali:
    a) event driven, analisi primaria (PA) a 274 eventi PFS
    b) event driven, PA a 274 eventi PFS
    Secondari:
    a) end of treatment (EOT)
    b/c) EOT
    d/e) event driven, PA a 274 eventi PFS
    f) EOT
    g/h/i) 3 anni dopo la randomizzazione
    j) 30 giorni dopo D21 dell'ultimo ciclo di trattamento
    k/l/m) event driven, PA a 274 eventi di PFS
    n/o) EOT
    p/q) event driven, PA a 274 eventi PFS
    r) event driven, analisi PA a 274 eventi PFS
    s/t) EOT
    u) 2 anni dopo la randomizzazione
    v) event driven, PA a 274 eventi PFS
    w/x) durante lo studio
    y) event driven, PA a 274 eventi PFS
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity, Biomarker
    Immunogenecità e Biomarker
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned27
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA133
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Canada
    Colombia
    India
    Israel
    Korea, Republic of
    Malaysia
    New Zealand
    Philippines
    Russian Federation
    Serbia
    Taiwan
    Thailand
    Turkey
    Ukraine
    United States
    Austria
    France
    Germany
    Hungary
    Ireland
    Italy
    Poland
    Romania
    Slovakia
    Spain
    United Kingdom
    Czechia
    Argentina
    E.8.7Trial 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
    The end of the study will occur after the last patient has completed a minimum of 3 years of follow up post treatment (this is expected to occur approximately 5 years after the first patient is enrolled).
    Si prevede che la fine dello studio avvenga dopo che l'ultimo paziente abbia completato almeno 3 anni di Follow-up post trattamento ( si prevede che questo avvenga approssimatamente 5 anni dopo che il primo paziente è arruolato).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 380
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 500
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state78
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 364
    F.4.2.2In the whole clinical trial 880
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Standard of Care
    Terapia standard
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-03-18
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-03-25
    P. End of Trial
    P.End of Trial StatusOngoing
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