Description:
The purpose of this study is to evaluate whether copanlisib in combination with rituximab is
superior to placebo in combination with rituximab in prolonging progression free survival
(PFS) in patients with relapsed iNHL who have received one or more lines of treatment,
including rituximab and who either had a treatment-free interval of ≥ 12 months after
completion of the last rituximab-containing treatment, or who are unwilling to receive
chemotherapy/for whom chemotherapy is contraindicated on reason of age, comorbidities, and/or
residual toxicity.
Title
- Brief Title: Copanlisib and Rituximab in Relapsed Indolent B-cell Non-Hodgkin's Lymphoma (iNHL)
- Official Title: A Phase III, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of Copanlisib in Combination With Rituximab in Patients With Relapsed Indolent B-cell Non-Hodgkin's Lymphoma (iNHL) - CHRONOS-3
Clinical Trial IDs
- ORG STUDY ID:
17067
- SECONDARY ID:
2013-003893-29
- NCT ID:
NCT02367040
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Copanlisib (BAY 80-6946) | | Copanlisib + Rituximab |
Placebo | | Placebo + Rituximab |
Rituximab | | Copanlisib + Rituximab |
Purpose
The purpose of this study is to evaluate whether copanlisib in combination with rituximab is
superior to placebo in combination with rituximab in prolonging progression free survival
(PFS) in patients with relapsed iNHL who have received one or more lines of treatment,
including rituximab and who either had a treatment-free interval of ≥ 12 months after
completion of the last rituximab-containing treatment, or who are unwilling to receive
chemotherapy/for whom chemotherapy is contraindicated on reason of age, comorbidities, and/or
residual toxicity.
Trial Arms
Name | Type | Description | Interventions |
---|
Copanlisib + Rituximab | Experimental | Combination of the Copanlisib and rituximab | - Copanlisib (BAY 80-6946)
- Rituximab
|
Placebo + Rituximab | Placebo Comparator | Combination of Copanlisib placebo and rituximab | |
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed diagnosis of Indolent non-Hodgkin's lymphoma (iNHL) in CD20
positive patients, with histological subtype limited to:
- Follicular lymphoma(FL) grade1-2-3a
- Small lymphocytic lymphoma(SLL) with absolute lymphocyte count <5x10*9/L at study
entry
- Lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia (LPL/WM)
- Marginal zone lymphoma (MZL) (splenic, nodal, or extra-nodal)
- Patients must have relapsed (recurrence after complete response or presented
progression after partial response) after the last rituximab-, rituximab biosimilars-,
or anti-CD20 monoclonal antibody (e.g. obinutuzumab)-containing therapy (other
previous treatment lines after rituximab are allowed). A previous regimen is defined
as one of the following: at least 2 months of single-agent therapy (less than 2 months
of therapy is allowed for patients who responded to single-agent rituximab, rituximab
biosimilars, or anti-CD20 monoclonal antibody); at least 2 consecutive cycles of
polychemotherapy; autologous transplant; radioimmunotherapy. Previous exposure to PI3K
is acceptable (except to copanlisib) provided there is no resistance. Patients with
prior intolerance to PI3K inhibitors other than copanlisib are eligible.
- Non-WM must have at least one bi-dimensionally measurable lesion (which has not been
previously irradiated) according to the Lugano Classification. For patients with
splenic MZL (Marginal-zone lymphoma) this requirement may be restricted to
splenomegaly alone since that is usually the only manifestation of measurable disease.
- Patients affected by WM who do not have at least one bi-dimensionally measurable
lesion in the baseline radiologic assessment must have measurable disease, defined as
presence of immunoglobulin M (IgM) paraprotein with a minimum IgM level ≥ 2 x upper
limit of normal (ULN) and positive immunofixation test .
- Male or female patients ≥ 18 years of age
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
- Life expectancy of at least 3 months
- Availability of fresh tumor tissue and/or archival tumor tissue for central
pathology(obtained within 5 years of the consent date) at Screening
- Adequate baseline laboratory values collected no more than 7 days before starting
study treatment
- Left ventricular ejection fraction ≥ 45%
- Patients must either:
- have had a progression-free and treatment-free interval of at least 12 months
after completion of the rituximab-, rituximab biosimilars-, or anti-CD20
monoclonal antibody-containing treatment OR
- be considered unfit to receive chemotherapy on reason of age, concomitant
morbidities, and/or residual toxicity from previous treatments, or unwillingness
to receive chemotherapy. These patients must also have had a progression-free and
treatment-free interval of at least 6 months after completion of the last
rituximab-, rituximab biosimilars-, or anti-CD20 monoclonal antibody-containing
treatment. Patients in whom chemotherapy is contraindicated are defined by one of
the following features:
- Age ≥ 80 years
- Age < 80 years and at least 1 of the following conditions:
- at least 3 grade 3 CIRS-G comorbidities OR
- at least 1 grade 4 CIRS-G comorbidity (if compatible to participation
in the study).
Exclusion Criteria:
- Histologically confirmed diagnosis of follicular lymphoma grade 3b or transformed
disease, or chronic lymphocytic leukemia
- Progression free interval or treatment free interval of less than 12 months since the
last rituximab-, rituximab biosimilars-, or anti-CD20 monoclonal antibody (e.g.
obinutuzumab)-containing treatment(including maintenance with these drugs). For
patients considered unwilling/unfit to receive chemotherapy : progression free
interval or treatment free interval of less than 6 months since the last rituximab-,
rituximab biosimilars-, or anti-CD20 monoclonal antibody-containing treatment
(including maintenance with these drugs), as assessed by the investigator
- History or concurrent condition of interstitial lung disease of any severity and/or
severely impaired lung function
- Known lymphomatous involvement of the central nervous system
- Patients with HbA1c > 8.5% at Screening
- Known history of human immunodeficiency virus (HIV) infection
- Hepatitis B (HBV) or hepatitis C (HCV). Patients positive for HBsAg or HBcAb will be
eligible if they are negative for HBV-DNA, these patients should receive prophylactic
antiviral therapy. Patients positive for anti- HCV antibody will be eligible if they
are negative for HCV-RNA
- Documented evidence of resistance to prior treatment with idelalisib or other PI3K
inhibitors.
- Prior treatment with copanlisib
- Cytomegalovirus (CMV) infection. Patients who are CMV PCR positive at baseline will
not be eligible.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Progression free survival (PFS) |
Time Frame: | 59 months |
Safety Issue: | |
Description: | Progression free survival is defined as the time (in days) from randomization to Disease Progression or death from any cause (if no progression documented). |
Secondary Outcome Measures
Measure: | Objective tumor response |
Time Frame: | 59 months |
Safety Issue: | |
Description: | Proportion of responders with best response either complete or partial response. |
Measure: | Duration of response (DOR) |
Time Frame: | 59 months |
Safety Issue: | |
Description: | Duration of response will only be defined for patients with at least one Complete Response or Partial Response. Patients without disease progression or death at the time of analysis will be censored at the date of their last tumor evaluation. |
Measure: | Complete response |
Time Frame: | 59 months |
Safety Issue: | |
Description: | Assessed in all patients up to the time of analysis of Progression-free survival. |
Measure: | Time to progression (TTP) |
Time Frame: | 59 months |
Safety Issue: | |
Description: | The time from randomization to Disease progression or death related to Disease Progression. |
Measure: | Overall survival (OS) |
Time Frame: | 59 months |
Safety Issue: | |
Description: | The time (in days) from randomization until death from any cause. |
Measure: | Time to deterioration in DRS-P of at least 3 points as measured by the FLymSI-18 (Lymphoma Symptom Index -18)questionnaire |
Time Frame: | 59 months |
Safety Issue: | |
Description: | |
Measure: | Number of participants with adverse Events as a measure of safety and tolerability |
Time Frame: | 59 months |
Safety Issue: | |
Description: | |
Measure: | Time to improvement in DRS-P of at least 3 points, as measured by the FLymSI-18 questionnaire, will be evaluated for patients with a baseline DRS-P score of 30 points or less |
Time Frame: | 59 months |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Bayer |
Trial Keywords
- Clinical trial, Phase III
- Phosphatidylinositol-3-kinase
- Non-Hodgkin's lymphoma
- Indolent B-cell non-Hodgkin's lymphoma
Last Updated
August 19, 2021