E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
chronic lymphocytic leukemia/small lymphocytic lymphoma |
Leucemia Linfatica Cronica/ Linfoma linfocitico a piccole cellule |
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E.1.1.1 | Medical condition in easily understood language |
chronic lymphocytic leukemia/small lymphocytic lymphoma |
Leucemia Linfatica Cronica/ Linfoma linfocitico a piccole cellule |
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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 | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008976 |
E.1.2 | Term | Chronic lymphocytic leukemia |
E.1.2 | System Organ Class | 100000004864 |
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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 percentage of BM MRD <10-4 in BM at +30 days of follow-up after ibrutinib (Cycles 1-24) and obinutuzumab (Cycle 13 Days 1,2,8,15; Cycles 14-18 Day 1) |
Valutare la percentuale di BM MRD <10-4 nel BM a +30 giorni di follow-up dopo ibrutinib (Cicli 1-24) e obinutuzumab (Ciclo 13 Giorni 1,2,8,15; Cicli 14-18 Giorno 1) |
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E.2.2 | Secondary objectives of the trial |
¿ To evaluate the response to treatment after ibrutinib (Cycles 1-24) and obinutuzumab (Cycle 13 Days 1,2,8,15; Cycles 14-18 Day 1); ¿ Evaluate PFS after ibrutinib (Cycles 1-24) and obinutuzumab (Cycle 13 Days 1,2,8,15; Cycles 14-18 Day 1); ¿ To evaluate OS after ibrutinib (Cycles 1-24) and obinutuzumab (Cycle 13 Days 1,2,8,15; Cycles 14-18 Day 1); ¿ Evaluate the response to retreatment with ibrutinib monotherapy in patients who experience disease recurrence after discontinuation of treatment; ¿ To study the safety and tolerance of the combined treatment with a limited duration (treatment and post-treatment period) and compare the results with historical controls. |
¿ Valutare la risposta al trattamento dopo ibrutinib (Cicli 1-24) e obinutuzumab (Ciclo 13 Giorni 1,2,8,15; Cicli 14-18 Giorno 1); ¿ Valutare la PFS dopo ibrutinib (Cicli 1-24) e obinutuzumab (Ciclo 13 Giorni 1,2,8,15; Cicli 14-18 Giorno 1); ¿ Valutare la OS dopo ibrutinib (Cicli 1-24) e obinutuzumab (Ciclo 13 Giorni 1,2,8,15; Cicli 14-18 Giorno 1); ¿ Valutare la risposta al ritrattamento con ibrutinib in monoterapia nei pazienti che vanno incontro a recidiva di malattia dopo l’interruzione del trattamento; ¿ Studiare la sicurezza e la tolleranza del trattamento combinato a durata limitata (period di trattamento e post-trattamento) e confrontare i risultati con I controlli storici. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age =18 years 2. Diagnosis of chronic lymphocytic leukemia (CLL) or small lymphocyte lymphoma (SLL) according to iwCLL diagnostic criteria 3. Previously untreated active disease requiring treatment according to iwCLL criteria 4. ECOG PS 0 or 1 5. Lymph node disease measurable (longest diameter> 1.5 cm) by CT 6. Adequate blood count defined as: ¿ Absolute neutrophil count (ANC)> 750 cells / µL (750 cells / mm3 or 0.75 x 109 / L) ¿ Platelet count> 30,000 / µL (30,000 cells / mm3 or 30 x 109 / L) ¿ Hemoglobin> 8.0 g / dL 7. Adequate liver and kidney function defined as: ¿ Serum aspartate transaminase (AST) or alanine transaminase (ALT) =3.0 x upper limit of normal (ULN) ¿ Estimated Creatinine Clearance (CrCl) =30 mL / min (Cockcroft-Gault) ¿ Bilirubin =1.5 x ULN (unless increased bilirubin is due to Gilbert's syndrome or of non-hepatic origin) 8. Prothrombin time (PT) / International normal ratio (INR) <1.5 x ULN and PTT (activated partial thromboplastin time [aPTT]) <1.5 x ULN (unless abnormalities are related to coagulopathy or bleeding disorder) . |
1. Età =18 anni 2. Diagnosi di leucemia linfatica cronica (CLL) o linfoma a piccolo linfociti (SLL) secondo i criteri diagnostici iwCLL 3. Malattia attiva precedentemente non trattata che richiede un trattamento secondo i criteri iwCLL 4. ECOG PS 0 o 1 5. Malattia linfonodale misurabile (diametro più lungo> 1.5 cm) mediante TC 6. Adeguata crasi ematica definita come: ¿ Conta assoluta dei neutrofili (ANC)> 750 cellule / µL (750 cellule / mm3 o 0.75 x 109/L) ¿ Conta piastrinica> 30.000/µL (30.000 cellule/mm3 o 30 x 109/L) ¿ Emoglobina> 8.0 g / dL 7. Adeguata funzionalità epatica e renale definita come: ¿ Aspartato transaminasi (AST) o alanina transaminasi (ALT) sieriche =3.0 x limite superiore della norma (ULN) ¿ Clearance stimata della creatinina (CrCl) =30 mL/ min (Cockcroft-Gault) ¿ Bilirubina =1.5 x ULN (a meno che l'aumento della bilirubina non sia dovuto alla sindrome di Gilbert o di origine non epatica) 8. Tempo di protrombina (PT)/International normal ratio (INR) <1.5 x ULN e PTT (tempo di tromboplastina parziale attivata [aPTT]) <1.5 x ULN (a meno che le anomalie non siano correlate a coagulopatia o disturbo emorragico). |
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E.4 | Principal exclusion criteria |
1. Any prior therapy (including but not limited to chemotherapy, targeted therapy, immunomodulatory therapy, radiotherapy, and / or monoclonal antibody) used to treat CLL or SLL. 2. Patients with del (17p) and / or TP53 mutation according to centralized laboratory assessment. 3. History of other malignancies, except: ¿ Malignant tumor treated with curative intent and with no known active disease present for =3 prior to first dose of study drug and deemed low risk of recurrence by treating physician ¿ Malignant skin neoplasm not adequately treated or lentigo maligna with no evidence of disease ¿ Adequately treated carcinoma in situ with no evidence of disease. 4. Known or suspected history of Richter's transformation. 5. Known hypersensitivity to one or more study drugs. 6. Known bleeding disorders (eg von Willebrand disease or haemophilia). 7. History of stroke or intracranial haemorrhage within 6 months prior to enrollment. 8. Known history of human immunodeficiency virus (HIV) or active hepatitis C virus (HCV) or hepatitis B virus (HBV) infection. Individuals who are positive for hepatitis B core antibody, hepatitis B surface antigen (HBsAg), or hepatitis C antibody must have a negative polymerase chain reaction (PCR) result before enrollment. Those who test positive for PCR will be excluded. 9. Inability to swallow capsules / tablets or malabsorption syndrome, any disease that significantly affects gastrointestinal function, or resection of the stomach or small intestine, symptomatic inflammatory bowel disease or ulcerative colitis, or partial or complete bowel obstruction. 10. Concomitant use of warfarin or other vitamin K antagonists. 11. Major surgery within 4 weeks of the first dose of study drug |
1. Qualsiasi terapia precedente (inclusa ma non limitata a chemioterapia, terapia mirata, terapia immunomodulante, radioterapia e/o anticorpo monoclonale) utilizzata per il trattamento di CLL o SLL. 2. Pazienti portatori di del (17p) e/o mutazione di TP53 in base alla valutazione del laboratorio centralizzato. 3. Storia di altre neoplasie, eccetto: ¿ Tumore maligno trattato con intento curativo e senza malattia attiva nota presente per =3 prima della prima dose del farmaco in studio e ritenuta a basso rischio di recidiva dal medico curante ¿ Tumore maligno della pelle non melanoma adeguatamente trattato o lentigo maligna senza evidenza di malattia ¿ Carcinoma in situ adeguatamente trattato senza evidenza di malattia. 4. Storia nota o sospetta di trasformazione di Richter. 5. Ipersensibilità nota a uno o più farmaci in studio. 6. Disturbi emorragici noti (ad esempio, malattia di von Willebrand o emofilia). 7. Storia di ictus o emorragia intracranica nei 6 mesi precedenti l'arruolamento. 8. Anamnesi nota di virus dell'immunodeficienza umana (HIV) o infezione attiva da virus dell'epatite C (HCV) o virus dell'epatite B (HBV). I soggetti che sono positivi per l'anticorpo core dell'epatite B, l'antigene di superficie dell'epatite B (HBsAg) o l'anticorpo dell'epatite C devono avere un risultato negativo della reazione a catena della polimerasi (PCR) prima dell'arruolamento. Saranno esclusi coloro che risultano positivi alla PCR. 9. Incapacità di deglutire capsule/compresse o sindrome da malassorbimento, qualsiasi malattia che influisce in modo significativo sulla funzione gastrointestinale, o resezione dello stomaco o dell'intestino tenue, malattia infiammatoria intestinale sintomatica o colite ulcerosa, o ostruzione intestinale parziale o completa. 10. Uso concomitante di warfarin o altri antagonisti della vitamina K. 11. Intervento chirurgico maggiore entro 4 settimane dalla prima dose del farmaco in studio |
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E.5 End points |
E.5.1 | Primary end point(s) |
Percentage of patients with MRD <10-4 in BM at +30 follow-up days after completion of therapy |
Percentuale di pazienti con MRD<10-4 nel BM a +30 giorni follow-up dopo il completamento della terapia |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
30 days after completion of therapy |
30 giorni dopo completamento della terapia |
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E.5.2 | Secondary end point(s) |
Safety and tolerance; Overall response (partial response, partial response with lymphocytosis and complete response); Percentage of MRD undetectable at Cycle 13 Day 1 (before the start of obinutuzumab), Cycle 19 Day 1 (at the end of treatment with obinutuzumab); Percentage of complete responses; Progression-free survival; Overall survival; Overall response rate to Ibrutinib retreatment to relapse |
Sicurezza e tolleranza; Risposta complessiva (risposta parziale, risposta parziale con linfocitosi e risposta completa); Percentuale di MRD non rilevabile al Ciclo 13 Giorno 1 (prima dell’inizio di obinutuzumab), al Ciclo 19 Giorno 1 (al termine del trattamento con obinutuzumab); Percentuale di risposte complete; Sopravvivenza libera da progressione; Sopravvivenza globale; Percentuale di risposta complessiva al ritrattamento con ibrutinib alla ricaduta |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
during treatment and follow up period; during treatment and follow up period; during treatment; during treatment period and follow up period; duirng follow up period; during treatment period and follow up period; during follow up period |
durante il trattamento e nel follow up; durante il trattamento e nel periodo di follow up; durante il trattamento; durante il periodo di trattamento e durante il periodo di follow up; durante il periodo di follow up; Durante il trattamento e durante il periodo di follow up; durante il periodo di follow up |
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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 | 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 | No |
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 | 12 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 6 |
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 | 6 |
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 |