Ibrutinib and Lenalidomide With Dose Adjusted EPOCH-R in Subjects With Relapsed/Refractory Diffuse Large B-cell Lymphoma

NCT ID: NCT02142049

Last Updated: 2019-02-05

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2017-08-31

Brief Summary

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This is a Phase 1b/2, open-label, non-randomized multicenter study to assess the safety and efficacy of ibrutinib and lenalidomide in combination with DA-EPOCH-R in subjects with relapsed/refractory Diffuse Large B-cell Lymphoma (DLBCL).

Detailed Description

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This is a Phase 1b, open-label, non-randomized multicenter study conducted in 2 parts. Part 1, will determine the MTD of the combination of ibrutinib, lenalidomide and DA-EPOCH-R in subjects with DLBCL.

Ibrutinib will be administered at a fixed dose of 560 mg and lenalidomide will be dose-escalated. DA-EPOCH-R will be given at standard doses.

For Part 2, the MTD determined in Part 1 will be the dose used for all subjects. If no MTD is identified, then subjects in Part 2 will be treated with the maximum administered doses (MAD, treatment doses from dose Level 4).

The primary objective for Part 2 is to determine the ORR of ibrutinib and lenalidomide in combination with DA-EPOCH-R in subjects with ABC DLBCL as analyzed by gene expression profiling when treated at recommended phase 2 dose (RP2D).

Conditions

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Diffuse Large B Cell Lymphoma Relapsed Diffuse Large B Cell Lymphoma Refractory

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Part 1: Dose Level 1

Ibrutinib 560 mg PO + DA-EPOCH-R

Group Type EXPERIMENTAL

Ibrutinib

Intervention Type DRUG

Ibrutinib

DA-EPOCH-R

Intervention Type DRUG

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Part 1: Dose Level 2

Ibrutinib 560 mg (PO) +lenalidomide 15 mg (PO) + DA-EPOCH-R

Group Type EXPERIMENTAL

Ibrutinib

Intervention Type DRUG

Ibrutinib

DA-EPOCH-R

Intervention Type DRUG

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Lenalidomide

Intervention Type DRUG

Lenalidomide

Part 1: Dose Level 3

Ibrutinib 560 mg (PO) +lenalidomide 20 mg (PO) + DA-EPOCH-R

Group Type EXPERIMENTAL

Ibrutinib

Intervention Type DRUG

Ibrutinib

DA-EPOCH-R

Intervention Type DRUG

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Lenalidomide

Intervention Type DRUG

Lenalidomide

Part 1: Dose Level 4

Ibrutinib 560 mg (PO) +lenalidomide 25 mg (PO) + DA-EPOCH-R

Group Type EXPERIMENTAL

Ibrutinib

Intervention Type DRUG

Ibrutinib

DA-EPOCH-R

Intervention Type DRUG

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Lenalidomide

Intervention Type DRUG

Lenalidomide

Part 2: RP2D

Recommended Phase 2 Dose(RP2D): Ibrutinib 560 mg (PO) +lenalidomide 25 mg (PO) + DA-EPOCH-R

Group Type EXPERIMENTAL

Ibrutinib

Intervention Type DRUG

Ibrutinib

DA-EPOCH-R

Intervention Type DRUG

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Lenalidomide

Intervention Type DRUG

Lenalidomide

Interventions

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Ibrutinib

Ibrutinib

Intervention Type DRUG

DA-EPOCH-R

Etoposide, Prednisone, Doxorubicin, Cyclophosphamide, Vincristine, Rituximab, Pegfilgrastim

Intervention Type DRUG

Lenalidomide

Lenalidomide

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) performance status of ≤2
* Pathologically confirmed relapsed/refractory DLBCL
* Subjects must have ≥1 measurable disease site on CT scan (≥ 1.5 cm in longest dimension).
* Adequate hepatic and renal function:

* AST or ALT ≤2.5 x ULN
* Serum Creatinine ≤ 2.0 mg/dL and creatinine clearance ≥60 mL/min/1.73
* Bilirubin ≤1.5 x ULN
* Adequate hematologic function:

* ANC \>1,000 cells/mm3
* Platelets ≥75,000 cells/mm3
* Hemoglobin ≥8.0 g/dL
* Prothrombin time (PT) and activated partial thromboplastin time (aPTT) must be ≤1.5 x the upper limit of the normal range (ULN)
* Must be registered into the Revlimid REMS™program and be willing to comply with the requirements of Revlimid REMS™.

Exclusion Criteria

* Known central nervous system lymphoma
* Any chemotherapy, external beam radiation therapy, or anti-cancer antibodies within 2 weeks
* Radio- or toxin-immunoconjugates within 10 weeks
* Prior allogenetic stem cell (or other organ) transplant within 6 months or any evidence of active graft-versus-host disease or requirement for immunosuppressants within 28 days prior to first dose of study drug
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Celgene Corporation

INDUSTRY

Sponsor Role collaborator

Pharmacyclics LLC.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jutta Neuenburg, MD

Role: STUDY_DIRECTOR

Pharmacyclics LLC.

Locations

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SITE-1

Duarte, California, United States

Site Status

SITE-2

Los Angeles, California, United States

Site Status

SITE-10

Orange, California, United States

Site Status

SITE-3

Chicago, Illinois, United States

Site Status

SITE-5

Baltimore, Maryland, United States

Site Status

SITE-6

Bethesda, Maryland, United States

Site Status

SITE-4

Ann Arbor, Michigan, United States

Site Status

SITE-8

Albuquerque, New Mexico, United States

Site Status

SITE-9

Stony Brook, New York, United States

Site Status

SITE-7

Charleston, South Carolina, United States

Site Status

Countries

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United States

References

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Wilson WH, Phillips T, Popplewell L, de Vos S, Chhabra S, Kimball AS, Beaupre D, Huang DW, Wright G, Kwei K, Ping J, Neuenburg JK, Staudt LM. Phase 1b/2 study of ibrutinib and lenalidomide with dose-adjusted EPOCH-R in patients with relapsed/refractory diffuse large B-cell lymphoma. Leuk Lymphoma. 2021 Sep;62(9):2094-2106. doi: 10.1080/10428194.2021.1907371. Epub 2021 Apr 15.

Reference Type DERIVED
PMID: 33856277 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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PCYC-1124-CA

Identifier Type: -

Identifier Source: org_study_id

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