Description:
This phase 2 trial studies the efficacy and safety of zanubrutinib plus rituximab followed by
R-DHAOx (rituximab, dexamethasone, cytarabine and oxaliplatin) regimen then maintenance with
zanubrutinib for newly-diagnosed Mantle Cell Lymphoma (MCL).
Title
- Brief Title: Zanubrutinib and Rituximab Followed by R-DHAOx Then Maintenance With Zanubrutinib for Newly-Diagnosed MCL
- Official Title: Zanubrutinib and Rituximab Followed by R-DHAOx (Rituximab, Dexamethasone, Cytarabine and Oxaliplatin) Regimen Then Maintenance With Zanubrutinib for Newly-Diagnosed Mantle Cell Lymphoma (MCL): a Single Arm, Open Label, Multi-center Phase II Study
Clinical Trial IDs
- ORG STUDY ID:
B2020-232-01
- NCT ID:
NCT04624958
Conditions
- Mantle Cell Lymphoma
- Newly-diagnosed Mantle Cell Lymphoma
Interventions
Drug | Synonyms | Arms |
---|
Zanubrutinib and Rituximab | PART A | zanubrutinib, rituximab, consolidation chemotherapy and zanubrutinb maintenance |
R-DHAOx | PART B | zanubrutinib, rituximab, consolidation chemotherapy and zanubrutinb maintenance |
Zanubrutinib Maintenance | | zanubrutinib, rituximab, consolidation chemotherapy and zanubrutinb maintenance |
Purpose
This phase 2 trial studies the efficacy and safety of zanubrutinib plus rituximab followed by
R-DHAOx (rituximab, dexamethasone, cytarabine and oxaliplatin) regimen then maintenance with
zanubrutinib for newly-diagnosed Mantle Cell Lymphoma (MCL).
Trial Arms
Name | Type | Description | Interventions |
---|
zanubrutinib, rituximab, consolidation chemotherapy and zanubrutinb maintenance | Experimental | Part A (Zanubrutinib and Rituximab): Patients receive zanubrutinib on days 1-28 and rituximab on day 1. Treatment cycles repeat every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity or until patients achieve CR.
PART B (Consolidation chemotherapy of R-DHAOx): Patients receive R-DHAOx regimen every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Elderly patients (> 65 years old) and patients who achieved CR and minimal residual disease negative after PART B receive zanubrutinb maintenance therapy. Young patients (<65 years old) who achieved CR but minimal residual disease positive after PART B can receive autologous stem cell transplantation and then zanubrutinb maintenance therapy. Patients with PD, SD or PR after PART B quit the trial.
ZANUBRUTINB MAINTENANCE: Patients receive zanubrutinib every day for up to one year. | - Zanubrutinib and Rituximab
- R-DHAOx
- Zanubrutinib Maintenance
|
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed CD20 positive mantle cell lymphoma;
- Patients with MCL-related symptomatic and need immediate therapy; Include any of the
following: (1) Blastoid variant (2) Pleomorphic variant (3) Ki-67 ≥30% (4) Bulky mass
> 7 cm or ≥2 tumors, each ≥5 cm in diameter (5) Mutations in TP53, c-MYC or NOTCH
genes (6) Size of spleen ≥20 cm (7) Lymphoma B symptoms (8) Mantle Cell International
Prognostic Score (MIPI) > 3 (9) Lymphoma threatening organ function (10) Elevated
lactate dehydrogenase (11) Peripheral blood white blood cell > 50×10^9/L (12)
Pancytopenia due to bone marrow involvement (13) Pain due to lymphoma;
- Patients received no prior anti-lymphoma treatment;
- At least one evaluable lesion according to 2014 Lugano criteria;
- Ann Arbor stage II-IV;
- Eastern Cooperative Oncology Group (ECOG) of 0-2;
- Life expectancy > 3 months;
- Able to participate in all required study procedures;
- Proper functioning of the major organs: 1) The absolute value of neutrophils
(>1.5×10^9/L); 2) platelet count (> 75×10^9/L); 3) Hemoglobin (> 80 g/L); 4) Serum
creatinine <1.5 times Upper Limit Normal (ULN) ; 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), Prothrombin Time
(PT), Activated Partial Thromboplastin Time (APTT) < 1.5 times ULN (unless the subject
is receiving anticoagulant therapy and PT and APTT are within the expected range at
screening time);
Exclusion Criteria:
- Involvement of central nervous system (CNS)
- Patients with Hemophagocytic syndrome;
- Patients with active bleeding, bleeding tendency or require anticoagulation treatment;
- Patients require treatment with strong CYP3A inhibitors;
- Uncontrolled active infection, with the exception of tumor-related B symptom fever;
- History of human immunodeficiency virus (HIV) infection and/or patients with acquired
immunodeficiency syndrome are known;
- 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 (no more than 1000
IU/mL) and HCV RNA (no more than the lower limit of the detection method) in the row.
Hepatitis B carriers, stable hepatitis B (DNA titer should not be higher than 1000
IU/mL) after drug treatment, and cured hepatitis C patients can be enrolled in the
group;
- Diagnosed with or receiving treatment for malignancy other than lymphoma;
- Pregnant or breastfeeding women;
- Other researchers consider it unsuitable for patients to participate in this study.
Maximum Eligible Age: | 75 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Complete remission rate after PART A |
Time Frame: | 3 years |
Safety Issue: | |
Description: | Complete remission rate will be determined on the basis of investigator assessments according to 2014 Lugano criteria. |
Secondary Outcome Measures
Measure: | Complete remission rate after study treatment |
Time Frame: | 3 years |
Safety Issue: | |
Description: | Complete remission rate will be determined on the basis of investigator assessments according to 2014 Lugano criteria. |
Measure: | Objective Response rate |
Time Frame: | 3 years |
Safety Issue: | |
Description: | Objective Response rate will be determined on the basis of investigator assessments according to 2014 Lugano criteria. |
Measure: | Progression Free Survival |
Time Frame: | 5 years |
Safety Issue: | |
Description: | The time from the start of treatment to the progression of the tumor or death (due to any cause). |
Measure: | Overall Survival |
Time Frame: | 5 years |
Safety Issue: | |
Description: | The time from the start of treatment to time of death (due to any cause). |
Measure: | Time to Response |
Time Frame: | 3 years |
Safety Issue: | |
Description: | The time from the start of treatment to the first assessment of complete remission or partial remission. |
Measure: | Duration of Response |
Time Frame: | 5 years |
Safety Issue: | |
Description: | The time from the first assessment of complete remission or partial remission to progressive disease or death (due to any cause). |
Measure: | Percentage of Participants With Adverse Events |
Time Frame: | 3 years |
Safety Issue: | |
Description: | Adverse Events will be determined and graded on the basis of investigator assessments according to NCI CTC AE 5.0 |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Sun Yat-sen University |
Last Updated
May 27, 2021