Description:
This study was conducted to evaluate the complete response rate of Ibrutinib + R-CHOP in
patients with Epstein-Barr virus-positive diffuse large B-cell lymphoma.
Title
- Brief Title: Study of Ibrutinib in Combination With Rituximab-CHOP in Epstein-Barr Virus-positive Diffuse Large B-cell Lymphoma
- Official Title: Phase II Study of Ibrutinib in Combination With Rituximab-CHOP in Epstein-Barr Virus-positive Diffuse Large B-cell Lymphoma 54179060LYM2003 (Nick Name: IVORY Study)
Clinical Trial IDs
- ORG STUDY ID:
2015-04-027
- NCT ID:
NCT02670616
Conditions
- Epstein-Barr Virus-positive Diffuse Large B-cell Lymphoma
Interventions
Drug | Synonyms | Arms |
---|
Ibrutinib | Imbruvica | ibrutinib in combination with r-CHOP |
Rituximab | Mabthera | ibrutinib in combination with r-CHOP |
Cyclophosphamide | Endoxan | ibrutinib in combination with r-CHOP |
Doxorubicin | Adriamycin | ibrutinib in combination with r-CHOP |
vincristine | | ibrutinib in combination with r-CHOP |
Prednisolone | solondo | ibrutinib in combination with r-CHOP |
Purpose
This study was conducted to evaluate the complete response rate of Ibrutinib + R-CHOP in
patients with Epstein-Barr virus-positive diffuse large B-cell lymphoma.
Detailed Description
EBV-positive diffuse large B-cell lymphoma has EBV-mediated carcinogenic signaling pathway
activation, and this diverse intracellular pathway may be a potential therapeutic target in
this disease.
The BTK inhibitor, ibrutinib, targets the B cell receptor signaling pathway and is active
against B cell non-Hodgkin lymphoma. As a result, evidence of the antitumor effect of
ibrutinib has been accumulated in some B-cell lymphoma forms such as mantle cell lymphoma.
The addition of ibrutinib to standard chemotherapy, rituximab-CHOP, is considered to be an
effective treatment for patients with EBV-positive diffuse large B-cell lymphomas, because it
is known to show a poor response to treatment compared to (NOS) diffuse large B- It can
provide benefits to patients.
The BTK inhibitor, ibrutinib, targets the B cell receptor signaling pathway and is active
against B cell non-Hodgkin lymphoma. As a result, evidence of the antitumor effect of
ibrutinib has been accumulated in some B-cell lymphoma forms such as mantle cell lymphoma.
The addition of ibrutinib to standard chemotherapy, rituximab-CHOP, is considered to be an
effective treatment for patients with EBV-positive diffuse large B-cell lymphomas, because it
is known to show a poor response to treatment compared to (NOS) diffuse large B- It can
provide benefits to patients.
Trial Arms
Name | Type | Description | Interventions |
---|
ibrutinib in combination with r-CHOP | Experimental | Ibrutinib560 mg daily on day 1-21 per each cycle ,Rituximab375 mg/m2, Cyclophosphamide750 mg/m2, doxorubicin 50 mg/m2, vincristine1.4 mg/m2 on day 1; Prednisolone 100mg per day on day 1-5 ,cycle length: 21 days ,Six cycles of treatment | - Ibrutinib
- Rituximab
- Cyclophosphamide
- Doxorubicin
- vincristine
- Prednisolone
|
Eligibility Criteria
Inclusion Criteria:
1. Newly diagnosed, histologically proven EBV-positive Diffuse large B-cell lymphoma
A.EBV positivity: The presence of EBER-positive tumor cells ≥ 20% B.DLBCL based on the
WHO classification 2008
2. Hematology values must be within the following limits:
A.Absolute neutrophil count 1000/mm3 independent of growth factor support B.Platelets
100,000/mm3 or 50,000/mm3 if bone marrow involvement independent of transfusion
support in either situation C.Hemoglobin ≥ 10.0 g/dL (may be transfused or
erythropoietin treated)
3. Biochemical values within the following limits:
A.Alanine aminotransferase and aspartate aminotransferase≤ 3 x upper limit of normal
B.Total bilirubin ≤ 1.5 x ULN unless bilirubin rise is due to Gilbert's syndrome or of
non-hepatic origin C.Serum creatinine ≤ 2 x ULN or estimated Glomerular Filtration
Rate (Cockroft Gault) ≥ 40 mL/min/1.73m2 D.Serum calcium ≤ 12.0 mg/dL
4. Women of childbearing potential and men who are sexually active must be practicing a
highly effective method of birth control during and after the study consistent with
local regulations regarding the use of birth control methods for subjects
participating in clinical trials. Men must agree to not donate sperm during and after
the study. For females, these restrictions apply for 1 month after the last dose of
study drug. For males, these restrictions apply for 3 months after the last dose of
study drug
5. Women of childbearing potential must have a negative serum (beta-human chorionic
gonadotropin)or urine pregnancy test at Screening. Women who are pregnant or
breastfeeding are ineligible for this study.
6. Sign (or their legally-acceptable representatives must sign) an informed consent
document indicating that they understand the purpose of and procedures required for
the study, including biomarkers, and are willing to participate in the study.
7. At least one measurable lesion
8. ECOG PS 0-2
9. Informed consent
10. Age ≥ 19 years
Exclusion Criteria:
1. Previous treatment history for EBV-positive DLBCL including any kinds of chemotherapy
•Exception: a) Prednisolone 100mg or equivalent dosage of any types of steroid is
allowed (Maximum 7 days); b) Radiation for reducing symptom related with mass effect
is allowed
2. History of or known carcinomatous meningitis, or evidence of symptomatic
leptomeningeal disease or secondary CNS involvement on CT or MRI scan.
3. Pregnancy or breastfeeding
4. Major surgery within 4 weeks of enrollment
5. History of stroke or intracranial hemorrhage within 6 months prior to enrollment
6. Requires anticoagulation with warfarin or equivalent vitamin K antagonists (eg,
phenprocoumon).
7. Requires treatment with strong CYP3A inhibitors.
8. Clinically significant cardiovascular disease such as uncontrolled or symptomatic
arrhythmias, congestive heart failure, or myocardial infarction within 6 months of
Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by
the New York Heart Association Functional Classification.
9. Vaccinated with live, attenuated vaccines within 4 weeks of enrollment.
10. Known history of human immunodeficiency virus (HIV) or active Hepatitis C Virus or
active Hepatitis B Virus infection or any uncontrolled active systemic infection
requiring intravenous (IV) antibiotics.
11. Any life-threatening illness, medical condition, or organ system dysfunction which, in
the investigator's opinion, could compromise the subject's safety, interfere with the
absorption or metabolism of ibrutinib capsules, or put the study outcomes at undue
risk.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 19 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | complete response rate |
Time Frame: | From date of enrollment until the date first documented disease progression or unacceptable toxicity, whichever came first, assessed up to 48 months |
Safety Issue: | |
Description: | To assess the efficacy of disease control including complete response (CR), partial response (PR) and stable disease (SD) |
Secondary Outcome Measures
Measure: | Progression-free survival |
Time Frame: | the time between the date of treatment start and the date of death due to any cause or date of disease progression..assessed up to 48 months |
Safety Issue: | |
Description: | It is a measure of the period of survival without disease progression |
Measure: | Overall survival (OS) |
Time Frame: | Time between the start of treatment and the date of death.assessed up to 48 months |
Safety Issue: | |
Description: | It measures the time from start of treatment to death. |
Measure: | Toxicity Profile |
Time Frame: | from the date of informed consent signature to 30 days after last drug administration. |
Safety Issue: | |
Description: | Clinical and laboratory toxicity/symptomatology will be graded based on the NCIC CTG v4.03. Adverse events not reported in NCIC CTG will be categorized into mild, moderate, severe, and fatal and further classified to CTCAE Grades 1-4. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Samsung Medical Center |
Last Updated
October 22, 2020