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A Study Combining Ibrutinib With Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Patients With CD20-Positive B-Cell Non Hodgkin Lymphoma

Information source: Janssen Research & Development, LLC
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: CD20-positive B-cell Non-Hodgkin Lymphoma

Intervention: Part 1, Cohort 1 (Drug); Part 1, Cohort 2 (Drug); Part 1, Cohort 3 (Drug); Part 2, Cohort 1 (Drug); Part 2, Cohort 2 (Drug)

Phase: Phase 1

Status: Completed

Sponsored by: Janssen Research & Development, LLC

Official(s) and/or principal investigator(s):
Janssen Research & Development, LLC Clinical Trial, Study Director, Affiliation: Janssen Research & Development, LLC

Summary

The purpose of this study is to identify if, and at what dose, ibrutinib may be administered with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and to document responses of this combination in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Clinical Details

Official title: A Phase 1b Study Combining Ibrutinib With Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) in Subjects With CD20-Positive B-Cell Non Hodgkin Lymphoma (NHL)

Study design: Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Part 1 maximum tolerated dose of ibrutinib

Secondary outcome:

The number of participants affected by a dose-limiting toxicity

Number of participants with potential drug-drug interactions between ibrutinib and vincristine

Overall response rate

Duration of response

Progression-free survival

Mean plasma concentrations of ibrutinib

Maximum observed plasma concentration of ibrutinib

Time to reach the maximum plasma concentration of ibrutinib

Area under the plasma concentration-time curve from time 0 to 24 hours of ibrutinib

Elimination half-life associated with the terminal slope of the semilogarithmic drug concentration-time curve of ibrutinib

Elimination half-life associated with the terminal slope of the semilogarithmic drug concentration-time curve of vincristine

Partial area under the plasma concentration versus time curve of vincristine

The number of participants with pharmacodynamic markers of ibrutinib in peripheral blood mononuclear cells

The number of participants with biomarkers predictive of clinical response

The number of participants affected by an adverse event

Detailed description: This is an open-label (individuals will know the identity of study treatments), dose escalation study to establish the recommended dose of ibrutinib combined with standard R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in approximately 33 adults with CD20-positive B-cell non-Hodgkin lymphoma (NHL) for whom R-CHOP is an appropriate therapy. There will be 3 periods of the study: a pretreatment (screening) period of up to 28 days before enrollment; an open-label treatment period (up to 6 cycles of ibrutinib and R-CHOP; ending at the end-of-treatment visit); and a posttreatment follow-up period until the end of study (maximum of up to 1 year after the last patient has completed the end-of-treatment visit). There are 2 parts to the study (dose escalation [Part 1] and expansion [Part 2]). During the dose escalation period, the "3+3" design will be applied and approximately 18 patients with CD20 positive B cell NHL (diffuse large B-cell lymphoma [DLBCL], mantle cell lymphoma [MCL], and follicular lymphoma [FL]) may be enrolled. Patients will be assigned to cohorts of increasing oral daily doses of ibrutinib (280, 420, and 560 mg) administered in combination with R-CHOP. The maximum tolerated dose (MTD), assessed in Cycle 1 (dose-limiting toxicity [DLT] period), is defined as the highest dose of the combination regimen at which <=33% of patients experience DLT. Baseline and follow-up electrocardiograms will be performed throughout the study. A Study Evaluation Team will review all available data upon completion of the first cycle for all patients at each dose cohort to determine DLTs, if dose escalation is acceptable, and subsequently will determine the recommended Phase 2 dose. Once the recommended Phase 2 dose is determined, approximately 15 patients with newly diagnosed DLBCL will be entered into the expansion cohort at the dose level selected to further assess the safety, pharmacokinetics, pharmacodynamics, pharmacogenomics, and activity of the combination. Patients whose disease has not progressed at the end of Cycle 1 will continue to receive ibrutinib and R CHOP up to a maximum of 6 cycles. During the posttreatment follow-up period, long term safety, survival status, disease progression, and subsequent antilymphoma therapy will be collected. The study will end 1 year after the last patient has completed the end of treatment visit.

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Histopathologically-confirmed CD20-positive B-cell non Hodgkin lymphoma disease for

whom R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) is an appropriate therapy (diffuse large B-cell lymphoma, mantle cell lymphoma, or follicular lymphoma); for the expansion cohort, at least 1 cohort will only include patients with newly diagnosed diffuse large B-cell lymphoma

- Stage I AX (bulk defined as single lymph node mass >=10 cm in diameter) to Stage IV

disease

- At least 1 measurable site of disease based on the Revised Response Criteria for

Malignant Lymphoma

- Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2

- Adequate bone marrow, liver, and renal function

Exclusion Criteria:

- History of protocol-defined disallowed therapies

- Prior multidrug chemotherapy treatment for lymphoma

- History of stroke or intracranial hemorrhage within 6 months prior to the first dose

of study drug

- Major surgery within 3 weeks before enrollment

- Known bleeding diatheses, platelet dysfunction disorders, or requires therapeutic

anticoagulation

- Known lymphoma of the central nervous system

- Uncontrolled or severe cardiovascular disease including myocardial infarction within

6 months of enrollment, New York Heart Association Class III or IV heart failure, uncontrolled angina, pericardial disease, cardiac amyloidosis, clinically significant cardiac arrhythmia, or left ventricular ejection fraction outside of institutional limits

- Active systemic infection requiring treatment including hepatitis B and hepatitis C

infection

- Documented or suspected human immunodeficiency virus infection

- Diagnosed or treated for a malignancy other than non-Hodgkin lymphoma except;

adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, ductal carcinoma in situ of the breast, or other solid tumors curatively treated with no evidence of disease for >5 years

- Has any condition that, in the opinion of the investigator, would make study

participation not be in the best interest (eg, compromise the well-being) of the patient or that could prevent, limit, or confound the protocol-specified assessments

Locations and Contacts

Lille Cedex, France

Paris, France

Vandoeuvre Les Nancy, France

New York, New York, United States

Rochester, New York, United States

Nashville, Tennessee, United States

Houston, Texas, United States

Additional Information

Starting date: June 2012
Last updated: December 30, 2014

Page last updated: August 23, 2015

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