Efficacy of Lenalidomide in Combination With Subcutaneous Rituximab + miniCHOP in DLBCL Patients of 80 y/o or+

NCT ID: NCT02128061

Last Updated: 2021-04-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-31

Study Completion Date

2021-01-31

Brief Summary

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The purpose of this study is to compare the efficacy of R2-miniCHOP (Sub-cutaneous Rituximab-miniCHOP + lenalidomide) and R-miniCHOP (Sub-cutaneous Rituximab-miniCHOP) in patients aged 80 years old or more with not previously treated cluster of differentiation antigen 20 positive (CD20+) diffuse large B-cell lymphoma as measured by the overall survival (OS).The SENIOR trial will evaluate the tolerance and efficacy of the combination of the R2-miniCHOP regimen and compare this experimental arm to the standard R-miniCHOP regimen.The statistical plan is based on the hypothesis of an increase by 15% of the 2y-OS in favor of the experimental arm, as compared to the reference arm (R-miniCHOP).

Detailed Description

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The purpose of this study is to compare the efficacy of R2-miniCHOP (Sub-cutaneous Rituximab-miniCHOP + lenalidomide) and R-miniCHOP (Sub-cutaneous Rituximab-miniCHOP) in patients aged 80 years old or more with not previously treated cluster of differentiation antigen 20 positive (CD20+) diffuse large B-cell lymphoma as measured by the overall survival (OS).

Primary endpoint of the study is to compare the efficacy of R2-miniCHOP (Sub-cutaneous Rituximab-miniCHOP + lenalidomide) and R-miniCHOP ((Sub-cutaneous Rituximab-miniCHOP) in patients of 80 years old or more with not previously treated CD20+ diffuse large B-cell lymphoma as measured by the overall survival (OS).

Secondary endpoints are:

* To evaluate the efficacy and the safety of R2-miniCHOP as measured by the PFS (Progression Free Survival), EFS (Event Free Survival), the DoR (duration of response), the DFS (disease free survival), response rate at the end of the treatment, the additional toxicities
* To evaluate the simplified scale prognostic impact (IADL, MNA, G8, CIRS-G)
* To assess the quality of life before and after treatment This study is a multicentric, phase III, open-label, randomized (1:1) trial evaluating the efficacy of R2-miniCHOP in patients aged of 80 years or more with non-previously treated CD20+ diffuse large B-cell lymphoma (age-adjusted IPI= 0 to 3), Ann Arbor stage II to IV with a performance status ECOG from 0 to 2.

This study includes a run in phase to assess feasibility, safety and tolerance of subcutaneous rituximab injections and oral lenalidomide (10 mg D1-D14) in combination with dose-reduced intensity CHOP regimen.

Conditions

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Diffuse Large B Cell Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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R-miniCHOP

All patients will be treated with R-miniCHOP at a three-weeks interval for 6 cycles CYCLOPHOSPHAMIDE IV: 400 mg/m² Day 1 (D1) DOXORUBICINE IV : 25 mg/m² D1 VINCRISTINE IV : 1 mg Total Dose (TD) D1 PREDNISONE PO : 40 mg/m² D1 to D5 RITUXIMAB SC\* : 1400 mg TD D1

\*The first cycle of rituximab is delivered by IV at the dose of 375 mg/m2

Group Type ACTIVE_COMPARATOR

Rituximab

Intervention Type DRUG

R2-miniCHOP

All patients will be treated with R2-miniCHOP at a three-weeks interval for 6 cycles CYCLOPHOSPHAMIDE IV: 400 mg/m² D1 - DOXORUBICINE IV : 25 mg/m² D1 - VINCRISTINE IV : 1 mg TD D1 - PREDNISONE PO : 40 mg/m² D1 to D5 - RITUXIMAB SC\* : 1400 mg TD D1 LENALIDOMIDE PO\*\* :10 mg TD D1 to D14

\*The first cycle of rituximab is delivered by IV at the dose of 375 mg/m2

Group Type EXPERIMENTAL

Lenalidomide

Intervention Type DRUG

Rituximab

Intervention Type DRUG

Interventions

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Lenalidomide

Intervention Type DRUG

Rituximab

Intervention Type DRUG

Other Intervention Names

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Revlimid Mabthera

Eligibility Criteria

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Inclusion Criteria

* Patient with histologically proven CD20+ diffuse large B-cell lymphoma (DLBCL) (WHO classification 2008) including all clinical subtypes (primary mediastinal, intravascular, etc…), with all age-adjusted International Prognostic Index (aaIPI).

May also be included: De Novo transformed DLBCL from low grade lymphoma (Follicular, other...) and DLBCL associated with some small cell Infiltration in bone marrow or lymph node; or CD20+ B-cell lymphoma, with intermediate features between DLBCL and Burkitt or with intermediate features between DLBCL and classical Hodgkin lymphoma; or CD20+ Follicular lymphoma grade 3B (according to WHO classification); or CD20+ Aggressive B-cell lymphoma unclassifiable.

* With a Cluster of Differentiation antigen 10 (CD10) immunostaining performed by the participating center pathologist
* Aged ≥ 80 years old
* Ann Arbor stage II, III or IV
* Patient previously untreated for DLBCL Lymphoma
* Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
* With a minimum life expectancy of 3 months
* Negative HIV, HBV and HCV serologies test within 4 weeks before inclusion (except after hepatitis B vaccination or for patients who are HBs Ag negative, anti-HBs positive and/or anti-HBc positive but viral DNA negative)
* Patient able to give his consent and having signed a written Informed consent
* Patient affiliated to social security system, if applicable
* Male patients must practice complete abstinence or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions, and for 3 months following study drug discontinuation, even if they have undergone a successful vasectomy.
* All patients must agree to fulfill the global Lenalidomide Pregnancy Prevention Risk Management Plan as applicable according to the randomization arm (randomization arm)

Exclusion Criteria

* Any other histological type of lymphoma, Burkitt included
* Any history of treated or non-treated small-B cell lymphoma
* Central nervous system or meningeal involvement by lymphoma
* Contra-indication to any drug contained in the chemotherapy regimens ; for anthracycline use, ejection fraction should be \> 50%
* Any serious active disease (according to the investigator's decision)
* History of deep venous thrombosis or arterial thromboembolism events within the past 12 months before inclusion
* Poor renal function (creatinine clearance \< 40 ml/min, according to Modification of Diet in Renal Disease (MDRD) formula)
* Poor hepatic function (total bilirubin level \>30mmol/l, transaminases \>2.5 maximum normal level) unless these abnormalities are related to the lymphoma
* Poor bone marrow reserve as defined by neutrophils \<1.5 G/l or platelets \<100 G/l, unless related to bone marrow infiltration
* Any history of cancer during the last 5 years with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma Patients previously diagnosed with prostate cancer are eligible if (1) their disease was T1-T2a, N0, M0, with a Gleason score ≤7, and a prostate specific antigen (PSA) ≤10 ng/mL prior to initial therapy, (2) they had definitive curative therapy (i.e., prostatectomy or radiotherapy) 2 years before Day 1 of Cycle 1, and (3) at a minimum 2 years following therapy they had no clinical evidence of prostate cancer, and their PSA was undetectable if they underwent prostatectomy or \<1 ng/mL if they did not undergo prostatectomy
* Treatment with any investigational drug within 30 days before planned first cycle of chemotherapy and during the study
* Prior treatment with anti-CD20 monoclonal antibody or alemtuzumab within 3 months prior to start of therapy
* Prior use of lenalidomide
* Prior ≥ Grade 3 allergic reaction/hypersensitivity to thalidomide
* Prior ≥ Grade 3 rash or any desquamating (blistering) rash while taking thalidomide
* Subjects with ≥ Grade 2 neuropathy
* Adult patient under tutelage
* Female of childbearing potential are excluded. (Note: Females are defined as not of childbearing potential if there is documentation of "natural menopause for at least 24 consecutive months, a hysterectomy or bilateral oophorectomy")
Minimum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Henri Becquerel

OTHER

Sponsor Role collaborator

The Lymphoma Academic Research Organisation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fabrice Jardin, MD,Professor

Role: PRINCIPAL_INVESTIGATOR

The Lymphoma Study Association - LYSA

Locations

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ZNA Stuivenberg

Antwerp, , Belgium

Site Status

A. Z. Sint-Jan

Bruges, , Belgium

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Institut Jules Bordet

Brussels, , Belgium

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Université Catholique de Louvain Saint Luc

Brussels, , Belgium

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Hôpital Erasme

Brussels, , Belgium

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Grand Hôpital de Charleroi

Charleroi, , Belgium

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Universitair Ziekenhuis Gent

Ghent, , Belgium

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AZ Groeninge

Kortrijk, , Belgium

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CHR Citadelle

Liège, , Belgium

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CHU de Liège

Liège, , Belgium

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Hôpital Sainte Elisabeth

Namur, , Belgium

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Clinique Saint Pierre

Ottignies, , Belgium

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CHR Peltzer La Tourelle

Verviers, , Belgium

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CHRU Mont Godinne

Yvoir, , Belgium

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CH d'Abbeville

Abbeville, , France

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CH du Pays d'Aix

Aix-en-Provence, , France

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CHU d'Amiens

Amiens, , France

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CHU d'Angers

Angers, , France

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CH Victor Dupouy

Argenteuil, , France

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CH d'Arras

Arras, , France

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CH d Avignon - Hopital Henri Duffaut

Avignon, , France

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CH Côte Basque

Bayonne, , France

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CHU Jean Minjoz

Besançon, , France

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CH de Blois

Blois, , France

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Institut Bergonié

Bordeaux, , France

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Polyclinique Bordeaux Nord

Bordeaux, , France

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CH de Boulogne-sur-Mer

Boulogne-sur-Mer, , France

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CH de Bourg en Bresse

Bourg-en-Bresse, , France

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CHU Morvan

Brest, , France

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CH de Brive

Brivé, , France

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IHBN

Caen, , France

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CH de Cannes

Cannes, , France

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Clinique Du Parc

Castelnau-le-Lez, , France

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Médipôle de Savoie

Challes-les-Eaux, , France

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CHU de Châlon sur Sâone

Chalon-sur-Sâone, , France

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CH Métropole Savoie

Chambéry, , France

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Hôpital d'Instruction des Armées Percy

Clamart, , France

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CHU Estaing

Clermont-Ferrand, , France

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Pôle Santé République

Clermont-Ferrand, , France

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CH Sud Francilien de Corbeil

Corbeil-Essonnes, , France

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APHP - Hopital Henri Mondor

Créteil, , France

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CHU de Dijon - Hôpital le Bocage

Dijon, , France

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CH de Dunkerque

Dunkirk, , France

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CH Eure Seine

Évreux, , France

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CHU de Grenoble

Grenoble, , France

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Institut Daniel Hollard

Grenoble, , France

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CH Départemental de Vendée

La Roche-sur-Yon, , France

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Hôpital St Louis

La Rochelle, , France

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CH de Versailles - Hopital André Mignot

Le Chesnay, , France

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Hôpital Bicêtre

Le Kremlin-Bicêtre, , France

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CH du Mans

Le Mans, , France

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Clinique Victor Hugo

Le Mans, , France

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CHRU Lille - Hôpital Claude Huriez

Lille, , France

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Hôpital Saint Vincent de Paul

Lille, , France

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CHU de Limoges

Limoges, , France

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Centre Léon Bérard

Lyon, , France

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Institut Paoli Calmette

Marseille, , France

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Hôpital de la conception

Marseille, , France

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CH des Chanaux

Mâcon, , France

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CH de Meaux

Meaux, , France

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Hôpital de Mercy

Metz, , France

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Centre Hospitalier Annecy Genevois

Metz-Tessy, , France

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CHU de Montpellier

Montpellier, , France

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CHU de Mulhouse

Mulhouse, , France

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CHU de Nantes

Nantes, , France

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Centre Antoine Lacassagne

Nice, , France

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CHU de Nîmes

Nîmes, , France

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CHR de la Source

Orléans, , France

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Hopital Saint Antoine

Paris, , France

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APHP - Hôpital Saint Louis

Paris, , France

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Hôpital de la Pitié Salpêtrière

Paris, , France

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APHP - Hôpital Necker

Paris, , France

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CH de Perpigan

Perpignan, , France

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CHU du Haut Leveque

Pessac, , France

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Clinique Francheville

Périgueux, , France

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CH Périgueux

Périgueux, , France

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Chu Lyon Sud

Pierre-Bénite, , France

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CHU de Poitiers

Poitiers, , France

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CH René Dubos

Pontoise, , France

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CH de Cornouaille

Quimper, , France

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CHU Robert Debre

Reims, , France

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CHU de Rennes

Rennes, , France

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CH de Roubaix

Roubaix, , France

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Centre Henri Becquerel

Rouen, , France

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CH de Saint Brieuc

Saint-Brieuc, , France

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Centre René Huguenin - Institut Curie

Saint-Cloud, , France

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Groupe Hospitalier Sud Réunion

Saint-Pierre, , France

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CH Saint Quentin

Saint-Quentin, , France

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CHU de Saint Malo

St-Malo, , France

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Strasbourg Oncologie Libérale

Strasbourg, , France

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CHU de Strasbourg

Strasbourg, , France

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CHI Toulon La Seyne-sur-mer

Toulon, , France

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CHU Purpan - Toulouse

Toulouse, , France

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CHRU Bretonneau

Tours, , France

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Hôpital de Valence

Valence, , France

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CHU de Brabois

Vandœuvre-lès-Nancy, , France

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CH de Bretagne Atlantique

Vannes, , France

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Countries

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Belgium France

Other Identifiers

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SENIOR

Identifier Type: -

Identifier Source: org_study_id

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