Study of the Combination of Rituximab, Cyclophosphamide, Doxorubicin, VELCADE, and Prednisone or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Patients With Newly Diagnosed Mantle Cell Lymphoma
NCT ID: NCT00722137
Last Updated: 2018-07-12
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE3
487 participants
INTERVENTIONAL
2008-05-01
2017-06-17
Brief Summary
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Detailed Description
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The study enrolled 487 patients. Participants were randomly assigned (by chance, like flipping a coin) to one of the two treatment groups in a 1:1 ratio:
Treatment Group A (VcR-CAP) Treatment Group B (R-CHOP)
The study included a screening phase, a treatment phase, a short-term follow-up phase, and a long-term follow-up phase. The screening phase was up to 28 days (56 days for bone marrow evaluation) prior to randomization.
This multi-center trial was conducted worldwide. The total study duration from randomization of the first patient until the last progression-free survival (PFS) event required for the final analysis was expected to be approximately 42 months (24 months for enrollment and 18 months for follow-up) and survival follow-up every 12 weeks until death.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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R-CHOP
Rituximab 375 mg/m\^2, Cyclophosphamide 750 mg/m\^2, Doxorubicin 50 mg/m\^2, Vincristine 1.4 mg/m\^2, and Prednisone 100 mg/m\^2
Rituximab 375 mg/m^2
Intravenous rituximab 375 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles.
Cyclophosphamide 750 mg/m^2
Intravenous cyclophosphamide 750 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
Doxorubicin 50 mg/m^2
Intravenous doxorubicin 50 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
Prednisone 100 mg/m^2
Oral prednisone 100 mg/m\^2 on Day 1 to Day 5 of a 21-day (3 week) cycle for 6 cycles
Vincristine 1.4 mg/m^2
Intravenous vincristine 1.4 mg/m\^2 on Day 1of a 21-day (3 week) cycle for 6 cycles. Maximum of 2 mg. Participants could receive 8 cycles if a response was initially documented at the Cycle 6 assessment.
VcR-CAP
Rituximab 375 mg/m\^2, Cyclophosphamide 750 mg/m\^2, Doxorubicin 50 mg/m\^2, VELCADE 1.3 mg/m\^2, and Prednisone 100 mg/m\^2
Rituximab 375 mg/m^2
Intravenous rituximab 375 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles.
Cyclophosphamide 750 mg/m^2
Intravenous cyclophosphamide 750 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
Doxorubicin 50 mg/m^2
Intravenous doxorubicin 50 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
VELCADE 1.3 mg/m^2
Intravenous VELCADE 1.3 mg/m\^2 on Days 1,4,8, and 11of a 21-day (3 week) cycle for 6 cycles
Prednisone 100 mg/m^2
Oral prednisone 100 mg/m\^2 on Day 1 to Day 5 of a 21-day (3 week) cycle for 6 cycles
Interventions
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Rituximab 375 mg/m^2
Intravenous rituximab 375 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles.
Cyclophosphamide 750 mg/m^2
Intravenous cyclophosphamide 750 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
Doxorubicin 50 mg/m^2
Intravenous doxorubicin 50 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles
VELCADE 1.3 mg/m^2
Intravenous VELCADE 1.3 mg/m\^2 on Days 1,4,8, and 11of a 21-day (3 week) cycle for 6 cycles
Prednisone 100 mg/m^2
Oral prednisone 100 mg/m\^2 on Day 1 to Day 5 of a 21-day (3 week) cycle for 6 cycles
Vincristine 1.4 mg/m^2
Intravenous vincristine 1.4 mg/m\^2 on Day 1of a 21-day (3 week) cycle for 6 cycles. Maximum of 2 mg. Participants could receive 8 cycles if a response was initially documented at the Cycle 6 assessment.
Eligibility Criteria
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Inclusion Criteria
* Diagnosis of mantle cell lymphoma MCL (Stage II, III or IV) as evidenced by lymph node histology and either expression of cyclin D1 (in association with CD20 and CD5) or evidence of t(11;14) translocation, such as by cytogenetics, fluorescent in situ hybridization (FISH) or polymerase chain reaction (PCR). Patients with a diagnosis of Stage I MCL will not be permitted to enter study.
\- Paraffin embedded biopsy tissue block (preferably of lymph node origin) must be sent to the central laboratory for confirmation of MCL diagnosis prior to randomization. In China, a paraffin embedded lymph node biopsy tissue block must be sent for central confirmation of sample adequacy, prior to randomization
* At least 1 measurable site of disease
* No prior therapies for MCL
* Not eligible for bone marrow transplantation as assessed by the treating physician (e.g., age or the presence of co-morbid conditions that may have a negative impact on the tolerability to transplantation).
* Eastern Cooperative Oncology Group ECOG status ≤2
* Absolute neutrophil count (ANC) ≥1500 cells/µL,
* Platelets ≥100,000 cells/µL or ≥75,000 cells/µL if thrombocytopenia is considered by the investigator to be secondary to MCL (e.g., due to bone marrow infiltration or sequestration from splenomegaly).
* Alanine transaminase ≤3 x upper limit of normal (ULN)
* Aspartate transaminase ≤3 x ULN
* Total bilirubin ≤1.5 x ULN,
* Calculated creatinine clearance ≥20 mL/min.
* Female patients must be post menopausal for at least 1 year (must not have had a natural menses for at least 12 months), surgically sterile, or practicing an effective method of birth control (e.g., prescription oral contraceptives, contraceptive injections, intrauterine device, double-barrier method, contraceptive patch, male partner sterilization) and have a negative serum βHCG or urine pregnancy test at screening. They must also be prepared to continue birth control measures for at least 6 months after terminating treatment.
* Male patients must agree to use an acceptable method of contraception (for themselves or female partners as listed above) for the duration of the study.
* All patients (or their legally acceptable representatives) must have signed an informed consent document indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study.
* In order to participate in the pharmacogenomics component of this study, patients (or their legally acceptable representative) must have signed the informed consent form for pharmacogenomics research indicating willingness to participate in the pharmacogenomics component of the study. Acquisition of tumor sample collections is required for all patients (where available); all other sample collections are optional
Exclusion Criteria
* Prior antineoplastic (including unconjugated therapeutic antibodies), experimental or radiation therapy, radioimmunoconjugates or toxin immunoconjugates for the treatment of MCL. In the event that a patient has received doxorubicin for the treatment of any condition, other than MCL, the maximum dose and exposure received prior to entry into this study should not exceed 150 mg/m2.
\- short course (maximum of 10 days, not exceeding 100 mg/day) prednisone or equivalent steroids are allowed to treat symptoms in patients with advanced disease who enter the screening phase and are waiting to be randomized.
* Major surgery (at the discretion of the treating physician and in consultation with the sponsor's medical monitor) within 2 weeks before randomization
* Peripheral neuropathy or neuropathic pain of Grade 2 or worse (as per the investigators assessment)
* Diagnosed or treated for a malignancy other than MCL within 1 year of randomization, or who were previously diagnosed with a malignancy other than MCL and have any radiographic or biochemical marker evidence of malignancy. Patients with completely resected basal cell carcinoma, squamous cell carcinoma of the skin, or in situ malignancy are not excluded.
* Active systemic infection requiring treatment and patients with known diagnosis of human immunodeficiency virus HIV or active hepatitis B (carriers of hepatitis B are permitted to enter study)
* History of allergic reaction attributable to compounds containing boron, mannitol, or hydroxybenzoates
* Known anaphylaxis or immunoglobulin E (IgE)-mediated hypersensitivity to murine proteins or to any component of rituximab including polysorbate 80 and sodium citrate dihydrate
* Female or male patients of child-bearing potential who will not use adequate contraception during the course of the study.
* Serious medical (e.g., pericardial disease, cardiac failure \[New York Heart Association; NYHA Class III or IV, Attachment 12 or left ventricular ejection fraction; LVEF \<50%\], active peptic ulceration, uncontrolled diabetes mellitus, or acute diffuse infiltrative pulmonary disease), or psychiatric illness likely to interfere with participation in this clinical study
* Concurrent treatment with another investigational agent.
18 Years
ALL
No
Sponsors
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Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
INDUSTRY
Millennium Pharmaceuticals, Inc.
INDUSTRY
Responsible Party
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Principal Investigators
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Medical Director Clinical Science
Role: STUDY_DIRECTOR
Takeda
Locations
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St. Francis Hosptial and Medical Center
Hartford, Connecticut, United States
Center for Cancer Care at Goshen Hospital
Goshen, Indiana, United States
Sinai Hospital
Baltimore, Maryland, United States
Capitol Comp. Cancer Center
Jefferson City, Missouri, United States
Nebraska Cancer Specialists
Omaha, Nebraska, United States
Hematology-Oncology Associates of Northern NJ
Morristown, New Jersey, United States
Legacy Pharma Research
Bismarck, North Dakota, United States
Division of Hematology and Oncology Vanderbilt University
Nashville, Tennessee, United States
Cancer Outreach Associates, PC
Abingdon, Virginia, United States
St.Johanns Spital/Landeskrankenhaus Salzburg
Salzburg, , Austria
Allgemeines Krankenhaus der Stadt Wien
Vienna, , Austria
AZ Stuivenberg Oncologie/ Hematologie
Antwerp, , Belgium
AZ St Jan AV
Bruges, , Belgium
UZ Brussel Department Medical Oncology
Brussels, , Belgium
UZA Hematologie, 1e verdiep
Edegem, , Belgium
Universitair Ziekenhuis Gent - UZ GENT, Hematologie, 9K12IE 9de verdiep- polikliniek Hematologie
Ghent, , Belgium
UZ Leuven Gasthuisberg Hematologie
Leuven, , Belgium
C.H.R. Citadelle
Liège, , Belgium
Centre Hospitalier Universitaire
Liège, , Belgium
Ucl de Mont-Godinne
Yvoir, , Belgium
Centro de Hematologia E Hemoterapia - Unicamp
Campinas, , Brazil
Fundacao Hospital Amaral Carvalho
Jaú, , Brazil
Hospital Nossa Senhora da Conceicao
Porto Alegre, , Brazil
Hospital Sao Lucas Puc-Rs
Porto Alegre, , Brazil
Inca - Instituto Nacional Do Cancêr
Rio de Janeiro, , Brazil
Centro de Estudos de Hematologia E Oncologia Da Fmabc
São Paulo, , Brazil
Fundacao Pio XII - Hospital de Cancer de Barretos
São Paulo, , Brazil
Hospital Ac Camargo
São Paulo, , Brazil
Hospital Alemao Oswaldo Cruz
São Paulo, , Brazil
Hospital das Clínicas da Faculdade de Medicina da USP
São Paulo, , Brazil
Santa Casa de Misericórida de São Paulo
São Paulo, , Brazil
Cross Cancer Institute
Edmonton, Alberta, Canada
University Health Network, Princess Margaret Hospital
Toronto, Ontario, Canada
Hospital Clinico Universidad Catolica de Chile
Santiago, , Chile
Hospital Del Salvador
Santiago, , Chile
Instituto Nacional Del Cancer
Santiago, , Chile
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, China
West China Hospital, Sichuan University
Chengdu, Sichuan, China
Zhejiang University First Hospital
Hangzhou, Zhejiang, China
Beijing Cancer Hospital
Beijing, , China
Cancer Institute & Cancer Hospital, CAMS&PUMC
Beijing, , China
Peking University Third Hospital
Beijing, , China
Cancer hospital, Fudan University
Shanghai, , China
Ruijin Hospital
Shanghai, , China
Tianjin Medical University Cancer Hospital and Institute
Tianjin, , China
Clinica Reina Sofia
Bogotá, , Colombia
Hospital Pablo Tobon Uribe
Medellín, , Colombia
Hospital Universitario San Vicente de Paul
Medellín, , Colombia
Interni hematoonkoligicka klinika
Brno, , Czechia
Interni klinika - Oddeleni klin. hematologie Fakultni nemocnice Hradec Kralove
Hradec Králové, , Czechia
Oddeleni klinicke hematologie, Fakultni nemocnice Kralovske Vinohrady
Prague, , Czechia
Vivantes Klinikum Neukölln Klinik für Innere Medizin Hämatologie und Onkologie
Berlin, , Germany
Vivantes Klinikum Spandau Klinik für Innere Medizin - Hämatologie, Onkologie und Gastroenterologie
Berlin, , Germany
Städt. Kliniken Frankfurt-Hoechst Med. Klinik II - Hämatologie und Onkologie
Frankfurt, , Germany
Tumorklinik SANAFONTIS Alpine GmbH
Freiburg im Breisgau, , Germany
Wilhelm-Anton-Hospital Goch gGmbH Klinik für Hämatologie und internistische Onkologie
Goch, , Germany
Klinikum Lippe-Lemgo Med. Klinik II - Hämatologie und Onkologie
Lemgo, , Germany
Johannes-Gutenberg-Universität Mainz III. Med. Klinik
Mainz, , Germany
Mutterhaus der Borromäerinnen Med. Klinik I
Trier, , Germany
Schwarzwald-Baar-Kliniken Innere Med. II
Villingen, , Germany
Debreceni Egyetem Orvos- es Egeszsegtudomanyi Centrum, III. sz. Belgyogyaszati Klinika
Debrecen, , Hungary
Petz Aladár Kórház, II. Belgyógyászat
Győr, , Hungary
Kaposi Mor Megyei Korhaz, Belgyogyaszat
Kaposvár, , Hungary
Apollo Hospital and Research Foundation, Apollo Hospitals
Hyderabad 500033, Andhra Pradesh, India
Kidwai Memorial Institute of Oncology
Bangalore 560 029, Karnataka, India
Regional Cancer Centre, Medical Oncology
Thiruvananthapuram, Kerala-695011, India
Jehangir Hospital
Pune-411002, Maharashtra, India
Sir Ganga Ram Hospital
New Delhi- 110060, National Capital Territory of Delhi, India
Apollo Speciality Hospital, Chennai
Chennai-600035, Tamil Nadu, India
Netaji Subash Chanda Bose Cancer Research Institute
Kolkata- 700016, West Bengal, India
Rambam Medical Center-Hematology department
Haifa, , Israel
Hadassah Medical Center - Hematology department
Jerusalem, , Israel
Rabin Medical Center, Beilinson Campus
Petach Tiqva, , Israel
Sheba Medical Center
Ramat Gan, , Israel
Kaplan Medical Center - Hematology Institute
Rehovot, , Israel
Azienda Ospedaliera Universitaria di Bologna Policlinico S.Orsola-Malpighi Dipartimento di Ematologia e Scienze Oncologiche "L. e A. Seragnoli"
Bologna, , Italy
Spedali Civili di Brescia
Brescia, , Italy
Dipartimento di Oncologia ed Ematologia Università di Modena e Reggio Emilia
Modena, , Italy
AZIENDA OSPEDALIERA UNIVERSITARIA POLICLINICO TOR VERGATA DIPARTIMENTO DI MEDICINA U.O.C. Ematologia
Roma, , Italy
Azienda Ospedaliera San Giovanni Battista "Molinette" Struttura Complessa Ematologia 2
Torino, , Italy
University Malaya Medical Centre
Kuala Lumpur, , Malaysia
Gleneagles Medical Centre
Pulau Pinang, , Malaysia
Hopital Du 20 Aout 1953
Casablanca, , Morocco
Centre D'oncologie Al Azhar
Rabat, , Morocco
Institut National D'oncologie
Rabat, , Morocco
National Kidney and Transplant Institute
Quezon City, , Philippines
St Lukes Medical Center
Quezon City, , Philippines
Szpital Morski im. PCK w Gdyni Gdynskie Centrum Onkologii Oddzial Chemioterapii
Gdynia, , Poland
Klinika Hematologii Uniwersytetu Medycznego w Lodzi
Lodz, , Poland
"Katedra i Klinika Hematologii i Chorob Rozrostowych Ukladu Krwiotworczego
Poznan, , Poland
Klinika Hematologii Nowotworow Krwi i Transplantacji Szpiku Akademii Medycznej we Wroclawiu
Wroclaw, , Poland
Hospital Sao Marcos
Braga, , Portugal
Hospitais da Universidade de Coimbra
Coimbra, , Portugal
Hospital de Santa Maria
Lisbon, , Portugal
Instituto Portugues de Oncologia
Porto, , Portugal
Spitalul Judetean de Urgenta "Dr. Constantin Opris", Hematologie
Baia Mare, , Romania
Institutul Clinic Fundeni, Hematologie
Bucharest, , Romania
Spitalul Clinic Coltea, Clinica Hematologie
Bucharest, , Romania
Spitalul Clinic Universitar de Urgenta Bucuresti, Hematologie
Bucharest, , Romania
Spitalul Clinic Judetean de Urgenta "Sf. Spiridon" Iasi, Oncologie Medicala
Iași, , Romania
Arkhangelsk Regional Clinical Hospital
Arkhangelsk, , Russia
Belgorod Regional Oncology Center
Belgorod, , Russia
Chelyabinsk Regional Oncology Center
Chelyabinsk, , Russia
1st Republican Clinical Hospital of Udmurtia
Izhevsk, , Russia
Cancer Research Center RAMS - N.N. Blokhin - Academy of Medical Science
Moscow, , Russia
Hematology Scientific Center
Moscow, , Russia
Moscow Regional Clinical Research Institute
Moscow, , Russia
S.P. Botkin Moscow City Clinical Hospital
Moscow, , Russia
Nizhniy Novgorod Region Clinical Hospital
Nizhny Novgorod, , Russia
Medical Scientific Radiology - Center
Obninsk, , Russia
Omsk Regional Oncology Dispensary
Omsk, , Russia
Medical Sanitary Unit # 1
Perm, , Russia
Republikan Hospital named after V.A/ Baranov
Petrozavodsk, , Russia
Rostov Research Institute of Oncology
Rostov-on-Don, , Russia
Central Res. Inst. of Roentgen-Radiology
Saint Petersburg, , Russia
City Clinical Oncology Dispensary
Saint Petersburg, , Russia
Leningrad Region Clinical Hospital
Saint Petersburg, , Russia
Pavlov State Medical Univercity
Saint Petersburg, , Russia
St.-Petersburg Clinical Research Institute of Hematology and Transfusiology
Saint Petersburg, , Russia
Sverdlovsk Regional Oncology Dispensary
Yekaterinburg, , Russia
National Cancer Centre
Singapore, , Singapore
Singapore General Hospital - Hematology
Singapore, , Singapore
Chris Hani Baragwanath Hospital
Johannesburg, Gauteng, South Africa
Medical Oncology Center of Rosebank
Johannesburg, Gauteng, South Africa
University of the Witwatersrand Oncology
Johannesburg, Gauteng, South Africa
Pretoria Academic Hospital-Dr. Savage Road, 3rd Floor Radiotherapy Building, Prinshof
Pretoria, Gauteng, South Africa
Dr AI Pirjol & Dr WM Szpak Inc.
Durban, KwaZulu-Natal, South Africa
Hospital Universitario Germans Trias i Pujol
Badalona, Barcelona, Spain
Hospital Clinic I Provincial de Barcelona
Barcelona, , Spain
Hospital de la Princesa
Madrid, , Spain
Hospital Universitario 12 de Octubre
Madrid, , Spain
Hospital Clinico Universitario Salamanca
Salamanca, , Spain
Chang Gung Memorial Hospital, Linkou
Taoyuan District, , Taiwan
King Chulalongkorn Memorial Hospital
Bangkok, , Thailand
Ramathibodi Hospital
Bangkok, , Thailand
Siriraj Hospital-Hematology Unit
Bangkok, , Thailand
Maharaj Nakorn Chiang Mai hospital - Faculty of Medicine
Chiang Mai, , Thailand
Hôpital Farhat Hached
Sousse, , Tunisia
Centre National de Greffe de Moelle osseuse
Tunis, , Tunisia
Hôpital Aziza Othmana
Tunis, , Tunisia
Institut Salah Azaiz
Tunis, , Tunisia
Hacettepe University Medical Faculty
Ankara, , Turkey (Türkiye)
Dokuz Eylul University Med. Fac.
Izmir, , Turkey (Türkiye)
Cherkassy Regional Oncology Center, Dept. of Hematology
Cherkassy, , Ukraine
Dnepropetrovsk City Clinical Hospital #4, Regional Hematology Center
Dnipro, , Ukraine
Institute of Urgent and Recovery Surgery named after V.K.Gusaka of AMS of Ukraine, Haematology Dept.
Donetsk, , Ukraine
Khmelnitskiy Regional Hospital, Hematology Department
Khmelnitsky, , Ukraine
National Cancer Institute, Department of chemotherapy of hemoblastosis
Kiev, , Ukraine
Institute of Blood Pathology and Transfusion Medicine, Lviv Clinical Hospital #5, Hematology Dept.
Lviv, , Ukraine
Crimean Republic Clinical Oncology Dispensary, Haematology Department
Simferopol, , Ukraine
Countries
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References
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Robak T, Jin J, Pylypenko H, Verhoef G, Siritanaratkul N, Drach J, Raderer M, Mayer J, Pereira J, Tumyan G, Okamoto R, Nakahara S, Hu P, Appiani C, Nemat S, Cavalli F; LYM-3002 investigators. Frontline bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) versus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in transplantation-ineligible patients with newly diagnosed mantle cell lymphoma: final overall survival results of a randomised, open-label, phase 3 study. Lancet Oncol. 2018 Nov;19(11):1449-1458. doi: 10.1016/S1470-2045(18)30685-5. Epub 2018 Oct 19.
Robak T, Huang H, Jin J, Zhu J, Liu T, Samoilova O, Pylypenko H, Verhoef G, Siritanaratkul N, Osmanov E, Pereira J, Mayer J, Hong X, Okamoto R, Pei L, Rooney B, van de Velde H, Cavalli F. Association between bortezomib dose intensity and overall survival in mantle cell lymphoma patients on frontline VR-CAP in the phase 3 LYM-3002 study. Leuk Lymphoma. 2019 Jan;60(1):172-179. doi: 10.1080/10428194.2017.1321750. Epub 2017 Jun 5.
Verhoef G, Robak T, Huang H, Pylypenko H, Siritanaratkul N, Pereira J, Drach J, Mayer J, Okamoto R, Pei L, Rooney B, Cakana A, van de Velde H, Cavalli F. Association between quality of response and outcomes in patients with newly diagnosed mantle cell lymphoma receiving VR-CAP versus R-CHOP in the phase 3 LYM-3002 study. Haematologica. 2017 May;102(5):895-902. doi: 10.3324/haematol.2016.152496. Epub 2017 Feb 9.
Robak T, Huang H, Jin J, Zhu J, Liu T, Samoilova O, Pylypenko H, Verhoef G, Siritanaratkul N, Osmanov E, Alexeeva J, Pereira J, Drach J, Mayer J, Hong X, Okamoto R, Pei L, Rooney B, van de Velde H, Cavalli F; LYM-3002 Investigators. Bortezomib-based therapy for newly diagnosed mantle-cell lymphoma. N Engl J Med. 2015 Mar 5;372(10):944-53. doi: 10.1056/NEJMoa1412096.
Provided Documents
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Document Type: Statistical Analysis Plan
Document Type: Study Protocol
Other Identifiers
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26866138-LYM-3002CTIL
Identifier Type: OTHER
Identifier Source: secondary_id
2007-005669-37
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
0970313683
Identifier Type: REGISTRY
Identifier Source: secondary_id
U1111-1195-3827
Identifier Type: OTHER
Identifier Source: secondary_id
26866138-LYM-3002
Identifier Type: -
Identifier Source: org_study_id
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