Clinical Trials /

Camrelizumab in Combination With Apatinib in Refractory and Relapsed DLBCL



This study will evaluate the efficacy and safety of camrelizumab in combination with apatinib in in patients with relapsed or refractory diffuse large B cell lymphoma failed from second line chemotherapy.

Related Conditions:
  • ALK-Positive Large B-Cell Lymphoma
  • Diffuse Large B-Cell Lymphoma
  • EBV-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise Specified
  • Grade 3b Follicular Lymphoma
  • Systemic EBV-Positive T-Cell Lymphoma of Childhood
  • Transformed Non-Hodgkin Lymphoma
Recruiting Status:



Phase 1/Phase 2

Trial Eligibility



  • Brief Title: Camrelizumab in Combination With Apatinib in Refractory and Relapsed DLBCL
  • Official Title: Camrelizumab in Combination With Apatinib in in Patients With Relapsed or Refractory Diffuse Large B Cell Lymphoma: a Phase Ib/II, Multicentre, Open-label, Single-arm Trial

Clinical Trial IDs

  • NCT ID: NCT04476459


  • Diffuse Large B Cell Lymphoma
  • High-grade B-cell Lymphoma
  • Follicular Lymphoma Grade IIIb
  • Transformed Lymphoma
  • EBV-Positive DLBCL, Nos
  • ALK-Positive Anaplastic Large Cell Lymphoma


Camrelizumabcamrelizumab in combination with apatinib
Apatinibcamrelizumab in combination with apatinib


This study will evaluate the efficacy and safety of camrelizumab in combination with apatinib in in patients with relapsed or refractory diffuse large B cell lymphoma failed from second line chemotherapy.

Detailed Description

      Patients with relapsed /refractory diffuse large B cell lymphoma usually have a bad
      prognosis. These patients cannot be treated successfully with the conventional chemotherapy
      of CHOP. Apatinib is a new type of oral tyrosine kinase inhibitor targeting VEGFR-2. Some
      studies have shown that the combination of low-dose apatinib and camrelizumab shows a
      synergistic effect in the exploration of multiple solid tumors, and the adverse reactions of
      low-dose apatinib are significantly reduced, and the patients are well tolerated.The
      investigators will evaluate the efficacy and safety of camrelizumab in combination with
      apatinib in the patients with relapsed refractory diffuse large B cell lymphomafailed from
      second line chemotherapy.

Trial Arms

camrelizumab in combination with apatinibExperimentalApatinib should be given at a fixed time. On the day of camrelizumab infusion, Apatinib should be taken 30 minutes after the end of camrelizumab infusion
  • Camrelizumab
  • Apatinib

Eligibility Criteria

        Inclusion Criteria:

          1. Age range 18-80 years old; male or female

          2. DLBCL, or follicular lymphoma grade 3B, or transformed DLBCL, EBV (+) DLBCL, ALK (+)
             DLBCL, high-grade lymphoma were confirmed by histopathology examination;

          3. Failed from standard first-line rituximab-contained chemotherapy, and relapsed or
             refractory after second-line regimens with or without rituximab.

          4. Estimated survival time > 3 months.

          5. There must be at least one evaluate able or measurable lesion that meets the LYRIC
             2016 Malignant Lymphoma criteria [evaluable lesion: 18F-fluorodeoxyglucose/Positron
             Emission Tomography (18FDG/PET) examination showing increased lymph node or extranodal
             uptake (higher than liver) and PET and/or computed tomography (Computed Tomography)
             CT) features are consistent with lymphoma findings; lesions can be measured: nodular
             lesions > 15mm or extranodal lesions > 10mm (if the only measurable lesion has
             received radiotherapy in the past, there must be evidence of radiological progress
             after radiotherapy), and accompanied by increased 18FDG uptake). Except for this,
             there is no measurable increase in diffuse 18FDG uptake in the liver;

          6. ECOG performance status 0-2.

          7. Prior chemotherapy and radiotherapy should have been completed more than 4 weeks.

          8. Adequate organ and bone marrow function, no severe hematopoietic dysfunction, cardiac,
             pulmonary, liver, kidney, thyroid dysfunction and immune deficiency (no blood
             transfusion, granulocyte colony stimulating factor or other medical support was
             received within 14 days prior to the use of the research drug): 1) The absolute value
             of neutrophils (>1.5×10^9/L); 2) platelet count (> 75×10^9/L); 3) Hemoglobin (> 9
             g/dL); 4) Upper Limit Normal (ULN) or creatinine clearance rate (>40 mL/min) of serum
             creatinine (<1.5 times normal value upper limit) (estimated by Cockcroft-Gault
             formula); 5) Serum total bilirubin < 1.5 times ULN; 6) Aspartate Aminotransferase
             (AST), Alanine Aminotransferase (ALT) = 2.5 times ULN; 7) Coagulation function:
             International Normalized Ratio (INR) = 1.5 times ULN; Prothrombin Time (PT), Activated
             Partial Thromboplastin Time (APTT) = 1.5 times ULN (unless the subject is receiving
             anticoagulant therapy and PT and APTT are using anticoagulant therapy at screening
             time). Within the expected range; 8) Thyrotropin (TSH) or free thyroxine (FT4) or free
             triiodothyronine (FT3) were all within the normal range (+10%);

          9. There was no evidence that subjects had difficulty breathing at rest, and the measured
             value of pulse oximetry at rest was more than 92%;

         10. Participants must pass a pulmonary function test (PFT) to confirm that forced
             expiratory volume (FEV1)/forced vital capacity (FVC) in the first second is more than
             60%, unless it is a large mediastinal mass caused by lymphoma that cannot meet this
             standard; carbon monoxide diffusion (DLCO), FEV1 and FVC are all above 50% of the
             predicted value; all PFT results must be obtained within four weeks before the first

         11. Female patients of childbearing age must have a negative pregnancy test at the time of
             enrollment and are willing to use reliable contraceptive methods, i.e. barrier
             methods, oral contraceptives, implant methods, skin contraception, long-acting
             injection contraceptives, intrauterine devices, or tubal ligation;

         12. Paraffin tissue specimens or fresh puncture tissue specimens are available;

         13. Volunteers who signed informed consent.

        Exclusion Criteria:

          1. Primary central nervous system lymphoma or secondary central nervous system

          2. Hemophagocytic syndrome;

          3. Previously treated with immunological checkpoint inhibitors (PD-1, PD-L1, CTLA-4,

          4. Previously treated with Apatinib.

          5. Patients with active autoimmune diseases requiring systematic treatment in the past
             two years (hormone replacement therapy is not considered systematic treatment, such as
             type I diabetes mellitus, hypothyroidism requiring only thyroxine replacement therapy,
             adrenocortical dysfunction or pituitary dysfunction requiring only physiological doses
             of glucocorticoid replacement therapy); Patients with autoimmune diseases who do not
             require systematic treatment within two years can be enrolled;

          6. Begin the study on subjects requiring systemic glucocorticoid therapy or other
             immunosuppressive therapy for a given condition within 14 days before treatment
             [allowing subjects to use local, ocular, intra-articular, intranasal and inhaled
             glucocorticoid therapy (with very low systemic absorption); and allowing short-term (<
             7 days) glucocorticoid prophylaxis (e.g., contrast agent overdose) Sensitivity) or for
             the treatment of non-autoimmune diseases (e.g. delayed hypersensitivity caused by
             contact allergens), except for tumor reduction due to large tumor burden (prednisone
             30mg, bid × 5 days or equivalent dose of other glucocorticoid therapy);

          7. In the past five years, patients with other malignant tumors have undergone radical
             treatment, except for basal cell carcinoma of skin, squamous cell carcinoma of skin,
             carcinoma in situ of breast and carcinoma in situ of cervix;

          8. Begin the study and receive systemic antineoplastic therapy within 28 days before
             treatment, including chemotherapy, immunotherapy, biotherapy (cancer vaccine,
             cytokines, or growth factors that control cancer), etc.;

          9. The study began with AHST(Autologous Hemopoietic Stem Cell Transplantation) within
             1month before treatment or Allo-HSCT(Allogeneic Hematopoietic Stem Cell
             Transplantation) within 3 months before treatment;

         10. The study began with major surgery within 28 days before treatment or radiotherapy
             within 90 days before treatment;

         11. Start the study and receive Chinese herbal medicine or Chinese 12.patent medicine
             treatment within 7 days before treatment;

         12. Begin research on live vaccination (except influenza attenuated vaccine) within 28
             days before treatment;

         13. History of human immunodeficiency virus (HIV) infection and/or patients with acquired
             immunodeficiency syndrome are known;

         14. Patients with active hepatitis B or active hepatitis C. Patients who are positive for
             hepatitis B Surface Antigen (HBsAg) or hepatitis C Virus (HCV) antibodies at screening
             stage must pass further detection of hepatitis B Virus (HBV) DNA titer (no more than
             2500 copies/mL or 500 IU/mL) and HCV RNA (no more than the lower limit of the
             detection method) in the row. In addition to active hepatitis B or hepatitis C
             infections requiring treatment, group trials can be conducted. Hepatitis B carriers,
             stable hepatitis B (DNA titer should not be higher than 2500 copies/mL or 500 IU/mL)
             after drug treatment, and cured hepatitis C patients can be enrolled in the group; 19.
             Patients with active pulmonary tuberculosis;

         15. Start studying any active infections requiring systemic anti-infective treatment
             within 14 days of treatment.

         16. Pregnant or lactating women;

         17. People with known history of alcoholism or drug abuse;

         18. History of interstitial lung disease or non-infectious pneumonia. Subjects who had
             previously had non-infectious pneumonia caused by drugs or radiation but had no
             symptoms were allowed to enter the group;

         19. Past psychiatric history; incapacitated or restricted;

         20. According to the researchers' judgment, patients' underlying condition may increase
             their risk of receiving research drug treatment, or confuse their judgment on toxic

         21. Other researchers consider it unsuitable for patients to participate in this study.
Maximum Eligible Age:80 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Response Rate (ORR), Investigator-Assessed
Time Frame:upto 24 months
Safety Issue:
Description:Overall response was determined on the basis of investigator assessments according to lymphoma response to immunomodulatory therapy criteria (LYRIC) for Malignant Lymphoma, 2016. Tumor assessments were performed with CT/MRI with or without PET.

Secondary Outcome Measures

Measure:Progression-free Survival
Time Frame:up to 36 months
Safety Issue:
Description:The time between the start of randomization and the progression of the tumor (any aspect) or (for any reason) death
Measure:Overall Survival
Time Frame:up to 36 months
Safety Issue:
Description:Time from randomization to death for any reason Time from randomization to death for any reason Time from randomization to death for any reason Time from randomization to death for any reason
Measure:Duration of Response
Time Frame:up to 36 months
Safety Issue:
Description:The time from the first assessment of CR or PR to PD (progressive disease) or death from any cause
Measure:Time To Progression
Time Frame:up to 36 months
Safety Issue:
Description:Time from randomization to PD
Measure:Percentage of Participants With Adverse Events (AEs)
Time Frame:Up to 36 months
Safety Issue:
Description:An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.


Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Huiqiang Huang

Trial Keywords

  • relapsed
  • refractory

Last Updated

March 15, 2021