IBER Salvage Treatment Followed by Ibrutinib Maintenance for Relapsed or Refractory PCNSL

NCT ID: NCT04066920

Last Updated: 2019-08-26

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-01

Study Completion Date

2023-09-30

Brief Summary

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This is a multicenter, single-arm, prospective phase II study to evaluate the efficacy and safety of a novel combination regimen for relapsed/refractory PCNSL. Specifically, ibrutinib will be administered in combination with ifosfamide, etoposide and rituximab (IBER) as a salvage chemotherapy, which is followed by maintenance ibrutinib monotherapy of fixed duration.

Detailed Description

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Given the limited activity of salvage therapy with high-dose methotrexate re-treatment and/or alkylator-based treatment in patients with relapse or refractory PCNSL, the development of novel salvage chemotherapy regimen remains an area of clinical unmet need.

Ibrutinib, an oral inhibitor of bruton tyrosine kinase (BTK), is known to induce death of diffuse large B-cell lymphoma (DLBCL) cells with dysregulated B-cell receptor (BCR) signaling and has shown promising activity in patients with a variety of B-cell malignancies. Recently, several studies reported that ibrutinib may have an excellent single-agent clinical activity against relapsed or refractory PCNSL. Furthermore, proven pharmacokinetic data suggested that ibrutinib successfully penetrated the BBB and reached the achievable concentration in cerebrospinal fluid. When ibrutinib is administered in combination with BBB-destructing chemotherapeutic agents (such as, temozolomide or etoposide) for salvage treatment of PCNSL, therefore, anti-lymphoma activity of ibrutinib could be maximized.

In this context, this phase II study is designed to evaluate the efficacy and safety of IBER salvage chemotherapy followed by ibrutinib maintenance for transplant ineligible patients with relapsed or refractory PCNSL.

Conditions

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Primary Central Nervous System Lymphoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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IBER treatment arm

This is the only arm in a single-arm phase II study.

Group Type EXPERIMENTAL

IBER salvage chemotherapy followed by ibrutinib maintenance therapy

Intervention Type DRUG

Induction therapy with IBER (up to 6 cycles) \[ Ibrutinib 560 mg/d on D1-21 + Rituximab 375 mg/m2 on D1 (on D1/8/15 in C1) + Ifosfamide 3.75 g/m2 on D2 + Etoposide 100 mg/m2 on D2-4 \], followed by ibrutinib 560 mg/d maintenance therapy for up to 6 months

Interventions

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IBER salvage chemotherapy followed by ibrutinib maintenance therapy

Induction therapy with IBER (up to 6 cycles) \[ Ibrutinib 560 mg/d on D1-21 + Rituximab 375 mg/m2 on D1 (on D1/8/15 in C1) + Ifosfamide 3.75 g/m2 on D2 + Etoposide 100 mg/m2 on D2-4 \], followed by ibrutinib 560 mg/d maintenance therapy for up to 6 months

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed PCNSL of CD20+ diffuse large B cell lymphoma (DLBCL)
* PCNSL relapsed or refractory after frontline methotrexate-based chemotherapy (with or without radiation therapy)
* At least one measurable lesion, which is defined as longest diameter of lesion \> 0.5 cm, by contrast-enhanced MRI
* ECOG performance status 0-2
* Normal function of major organs

Exclusion Criteria

* PCNSL other than DLBCL
* Primary ocular lymphoma
* PCNSL accompanied by systemic involvement
* Active infection with hepatitis B or C virus
* Known history of human immunodeficiency virus (HIV) infection
* Therapy with myelosuppressive chemotherapy or biologic therapy \< 21 days prior to registration
Minimum Eligible Age

20 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deok-Hwan Yang

OTHER

Sponsor Role lead

Responsible Party

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Deok-Hwan Yang

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Deok-Hwan Yang

Role: PRINCIPAL_INVESTIGATOR

Chonnam National University Hospital

Locations

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Chonnam National University Hwasun Hospital

Hwasun, Jeollanam-do, South Korea

Site Status

Countries

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South Korea

Central Contacts

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Deok-Hwan Yang, M.D., Ph.D.

Role: CONTACT

+82-61-379-7636

Yoon Seok Choi, M.D., Ph.D.

Role: CONTACT

+82-42-280-7107

References

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Other Identifiers

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IBER

Identifier Type: -

Identifier Source: org_study_id

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