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A Study Of Inotuzumab Ozogamicin Plus Rituximab For Relapsed/Refractory Aggressive Non-Hodgkin Lymphoma Patients Who Are Not Candidates For Intensive High-Dose Chemotherapy

Registration Number
NCT01232556
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to evaluate the efficacy of inotuzumab ozogamicin plus rituximab in relapsed/refractory aggressive Non-Hodgkin lymphoma patients who are not candidates for intensive high-dose chemotherapy. Specifically, the goal is to demonstrate the superiority of this combination compared with an active comparator arm (investigator's choice of rituximab+bendamustine or rituximab+gemcitabine) using the primary endpoint of overall survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
338
Inclusion Criteria
Exclusion Criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2rituximab +bendamustineInvestigator's choice of (1) rituximab+gemcitabine, or (2) rituximab+bendamustine
2rituximab + gemcitabineInvestigator's choice of (1) rituximab+gemcitabine, or (2) rituximab+bendamustine
1RituximabInotuzumab ozogamicin+rituximab
1Inotuzumab ozogamicinInotuzumab ozogamicin+rituximab
Primary Outcome Measures
NameTimeMethod
Overall SurvivalFrom randomization up to 5 years after last dose or up to final study visit, whichever occurs first.

Overall Survival (OS) was defined as the time from randomization to death due to any cause, censoring at the date of last contact or the end of the study. The Kaplan-Meier method was used to determine OS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.

Percentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)Up to 20 weeks after the first dose of study drug

Includes all TEAEs: Any event that occurred after the first dose of study drug and was not present prior to study drug administration or worsened in severity after study drug administration..

Secondary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS)From randomization up to 2 years or final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

PFS is defined as time from date of randomization to date of progressive disease (PD, including investigator's claim of clinical progression), date of death from any cause, or initiation of a new treatment for the lymphoma due to persistent/refractory disease. The Kaplan-Meier method was used to determine PFS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.

PD requires the following:

1. Appearance of any new lesion more than 1.5 cm in any axis during or at the end of treatment, even if other lesions are decreasing in size.

2. At least a 50% increase from nadir in the sum of the product diameters of any previously involved nodes, or in a single involved node, or the size of other lesions.

3. At least a 50% increase in the longest diameter of any single previously identified node more than 1 cm in its short axis.

Percentage of Participants With A Best Overall Response of CR or Partial Response (PR) Per NCI International Response Criteria for NHLUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment).

Partial Response (PR) requires the following:

1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses.

2. No increase in the size of other nodes, liver, or spleen.

3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter.

4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present.

5. No new sites of disease. The 95% CI was determined using the exact method based on binomial distribution.

Percentage of Participants With A Best Overall Response of CR, Unconfirmed CR (unCR), PR, or Unconfirmed PR (unPR) Per NCI International Response Criteria for NHLUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment).

Partial Response (PR) requires the following:

1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses.

2. No increase in the size of other nodes, liver, or spleen.

3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter.

4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present.

5. No new sites of disease. unCR and unPR means didn't have confirmatory assessment (including bone marrow assessment for CR).

The 95% CI was determined using the exact method based on binomial distribution.

Duration of ResponseUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

The duration of overall response is measured from the first date of response until the first date that the progressive disease (PD) or death is objectively documented. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.

Health Status as Assessed by the European Quality of Life 5 Dimension (EQ-5D) QuestionnaireAssessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reported

EQ-5D consists of a descriptive system and an EQ visual analogue scale. The descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, extreme problems. The scale, the best state is marked 100 and the worst state is marked 0, is to help the participant to say how good or bad a health state is. EQ-5D index, which was reported, was derived based on US weight. The range of EQ-5D index is -0.109 to 1.00. Higher scores mean better outcomes. The average post-baseline scores for EQ-5D index were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.

Health Related Quality of Life as Assessed by the Functional Assessment of Cancer Therapy for Lymphoma (FACT-Lym) QuestionnaireAssessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reported

FACT-Lym is a questionnaire that begins with 27 items covering four core Health-Related Quality of Life subscales: Physical Well-being (7 items), Social/Family Well-being (7), Emotional Well-being (6), and Functional Well-being (7). The FACT-Lym also includes an additional concerns subscale (15 items). It also asks participants about their concerns about lumps and swelling, fevers, infections, weight, appetite, emotional stability and treatment. The participants were requested to circle one number on a 0 to 4 points scale per line to indicate how true each statement has been for him/her during the past 7 days. FACT-Lym total score, which was reported, was derived based on FACT-Lym scoring guideline (Version 4). The range of FACT-Lym total score is 0 to 168. Higher scores mean better outcomes. The average post-baseline FACT-Lym total scores were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.

Trial Locations

Locations (168)

Ronald Reagan UCLA Medical Center Drug Information Center Department of Pharmaceutical Services

🇺🇸

Los Angeles, California, United States

University of Kansas Cancer Center and Medical Pavilion

🇺🇸

Westwood, Kansas, United States

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Sahyadri Clinical Research and Development Center

🇮🇳

Pune, Maharashtra, India

Sahyadri Speciality Hospital

🇮🇳

Pune, Maharashtra, India

Disney Family Cancer Center at Providence St Joseph Medical Center

🇺🇸

Burbank, California, United States

Providence St Joseph Medical Center

🇺🇸

Burbank, California, United States

Hematology-Oncology Medical Group of Fresno Inc

🇺🇸

Fresno, California, United States

Peter Morton Medical Plaza

🇺🇸

Los Angeles, California, United States

Ronald Reagan UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Howard University Hospital

🇺🇸

Washington, District of Columbia, United States

Sansum Clinic

🇺🇸

Solvang, California, United States

UCLA Santa Monica Hematology Oncology

🇺🇸

Santa Monica, California, United States

Mount Sinai Comprehensive Cancer Center at Aventura

🇺🇸

Aventura, Florida, United States

University Cancer Institute

🇺🇸

Boynton Beach, Florida, United States

21st Century Oncology of Jacksonville, LLC

🇺🇸

Orange Park, Florida, United States

Shands Cancer Hospital at the University of Florida

🇺🇸

Gainesville, Florida, United States

Davis Cancer Pavilion and Shands Medical Plaza

🇺🇸

Gainesville, Florida, United States

UF Health Davis Cancer Pavillion and Shands Med Plaza

🇺🇸

Gainesville, Florida, United States

UF Health Shands Cancer Hospital

🇺🇸

Gainesville, Florida, United States

Shands Hospital at the University of Florida

🇺🇸

Gainesville, Florida, United States

UF Health Shands Hospital

🇺🇸

Gainesville, Florida, United States

Baptist Medical Center

🇺🇸

Jacksonville, Florida, United States

Baptist Cancer Institute

🇺🇸

Jacksonville, Florida, United States

21st Century Oncology of Jacksonville, Inc.

🇺🇸

Jacksonville, Florida, United States

Medical Specialists Of The Palm Beaches

🇺🇸

Lake Worth, Florida, United States

Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

Georgia Regents University

🇺🇸

Augusta, Georgia, United States

Georgia Regents Medical Cancer Pharmacy

🇺🇸

Augusta, Georgia, United States

Kootenai Cancer Center

🇺🇸

Post Falls, Idaho, United States

Decatur Memorial Hospital (DMH)

🇺🇸

Decatur, Illinois, United States

Floyd Memorial Cancer Center of Indiana

🇺🇸

New Albany, Indiana, United States

University of Kentucky Markey Cancer Center

🇺🇸

Lexington, Kentucky, United States

University of Kentucky A.B. Chandler Medical Center

🇺🇸

Lexington, Kentucky, United States

Tulane University Hospital and Clinic

🇺🇸

New Orleans, Louisiana, United States

Park Nicollet Frauenshuh Cancer Center

🇺🇸

Saint Louis Park, Minnesota, United States

Barnes-Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

Washington University in St Louis

🇺🇸

Saint Louis, Missouri, United States

Barnes-Jewish St. Peters

🇺🇸

Saint Peters, Missouri, United States

Southeast Nebraska Hematology & Oncology Consultants, P.C. d/b/a Southeast Nebraska Cancer Center

🇺🇸

Lincoln, Nebraska, United States

Beth Israel Medical Center;

🇺🇸

New York, New York, United States

Beth Israel Comprehensive Cancer Center

🇺🇸

New York, New York, United States

Stony Brook University Medical Center, The Cancer Center

🇺🇸

Stony Brook, New York, United States

Stony Brook University Medical Center

🇺🇸

Stony Brook, New York, United States

St Luke's- Roosevelt Hospital Center

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

West Chester Hospital Medical Building

🇺🇸

West Chester, Ohio, United States

Good Samaritan Hospital, Corvallis

🇺🇸

Corvallis, Oregon, United States

Good Samaritan Hospital Corvallis

🇺🇸

Corvallis, Oregon, United States

Guthrie Clinic, Ltd.

🇺🇸

Sayre, Pennsylvania, United States

Samaritan Pacific Coast Hospital

🇺🇸

Newport, Oregon, United States

Samaritan Ambulatory Infusion Services

🇺🇸

Corvallis, Oregon, United States

Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Robert Packer Hospital

🇺🇸

Sayre, Pennsylvania, United States

University Hospital - St. Paul

🇺🇸

Dallas, Texas, United States

Thompson Oncology Group

🇺🇸

Sevierville, Tennessee, United States

University Hospital - Zale Lipshy

🇺🇸

Dallas, Texas, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Baylor: Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Grand Hopital de Charleroi

🇧🇪

Charleroi, Belgium

Simmons Comprehensive Cancer Center

🇺🇸

Dallas, Texas, United States

Universitaire Ziekenhuizen Leuven

🇧🇪

Leuven, Vlaams Brabant, Belgium

H.-Hartziekenhuis Roeselare-Menen

🇧🇪

Roeselare, Belgium

Spetsializirana Bolnitsa za Aktivno Lechenie na Hematologichni Zabolyavania, CTH Sofia

🇧🇬

Sofia, Bulgaria

Cliniques universitaires UCL de Mont-Godinne,

🇧🇪

Yvoir, Belgium

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

University Hospital Zagreb

🇭🇷

Zagreb, Croatia

Centre Hospitalier Universitaire de Sherbrooke (CHUS), Hopital Fleurimont

🇨🇦

Sherbrooke, Quebec, Canada

Fakultni nemocnice Kralovske Vinohrady

🇨🇿

Praha 10, Czech Republic, Czechia

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Département Pharmacie

🇫🇷

Marseille, Bouches-du-rhône, France

Centre Leon Berard

🇫🇷

Lyon, France

Institut Paoli Calmettes

🇫🇷

Marseille, Cedex 09, France

CHU Saint Eloi

🇫🇷

Montpellier, France

Hopital Andre Mignot

🇫🇷

Le Chesnay, Yvelines, France

Hopital du haut Leveque

🇫🇷

Pessac, France

Universitaetsklinikum Aachen

🇩🇪

Aachen, Germany

Sozialstiftung Bamberg

🇩🇪

Bamberg, Germany

Charite Campus Virchow-Klinikum

🇩🇪

Berlin, Germany

Charite Campus Benjamin Franklin

🇩🇪

Berlin, Germany

TU Muenchen III. Medizinische Klinik

🇩🇪

Muenchen, Germany

Universitaetsklinik Ulm

🇩🇪

Ulm, Germany

Universitaetsklinikum Mainz

🇩🇪

Mainz, Germany

Egyesitett Szent Istvan es Szent Laszlo Korhaz /

🇭🇺

Budapest, Hungary

DEOEC, Belgyogyaszati Intezet

🇭🇺

Debrechen, Hungary

OEC Record Management Company Pvt. Ltd.,

🇮🇳

Pune, Maharashtra, India

Somongy Megyei Kaposi Mor Okato Korhaz/ Belgyogyaszati osztaly

🇭🇺

Kaposvar, Hungary

Kodlikeri Memorial Hospital

🇮🇳

Aurangabad, Maharashtra, India

National Cancer Center Hospital East

🇯🇵

Kashiwa, Chiba, Japan

Nagoya Daini Red Cross Hospital

🇯🇵

Nagoya, Aichi, Japan

Bon Secours Hospital

🇮🇪

Cork, Ireland

Akita University Hospital

🇯🇵

Akita, Japan

National Kyushu Cancer Center

🇯🇵

Fukuoka, Japan

University Hospital, Kyoto Prefectural University of Medicine

🇯🇵

Kyoto, Japan

Klinika Nowotworow Ukladu Chlonnego

🇵🇱

Warszawa, Poland

Instituto Biomédico de Investigación A.C.

🇲🇽

Aguascalientes, Aguascalientes. Mexico, Mexico

Hospital Espanol Auxilio Mutuo de Puerto Rico Inc

🇵🇷

San Juan, Puerto Rico

Moscow State Healthcare Institution City clinical hospital S.P. Botkin

🇷🇺

Moscow, Russian Federation

National University Hospital

🇸🇬

Singapore, Singapore

Institute of Pediatric Hematology and Transplantology R.M.Gorbacheva

🇷🇺

Saint-Petersburg, Russian Federation

Federal State Budgetary Institution Hematology Scientific Centre of Ministry of

🇷🇺

Moscow, Russian Federation

Hospital Virgen Del Rocio

🇪🇸

Sevilla, Andalucia, Spain

Narodny onkologicky ustav

🇸🇰

Bratislava, Slovakia

Hospital Universitario De Salamanca

🇪🇸

Salamanca, Castille AND LION, Spain

Hospital Clinic Universitari de Barcelona

🇪🇸

Barcelona, Spain

Institut Catala d'Oncologia-L'Hospitalet

🇪🇸

L'Hospitalet De Llobregat (bcn), Spain

Hospital Universitario de Canarias

🇪🇸

La Laguna (Tenerife), Spain

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Hospital de la Princesa

🇪🇸

Madrid, Spain

Universitetssjukhuset

🇸🇪

Linkoping, Sweden

Skanes Universitetssjukhus i Lund

🇸🇪

Lund, Sweden

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Medical Foundation - Linkou Branch

🇨🇳

Kuei-Shan Hsiang, Taoyuan County, Taiwan

Chiang Mai University

🇹🇭

Chiang Mai, Thailand

Barts Cancer Centre Dept Haemato-oncology St. Bartholomew's Hospital Barts Health NHS Trust

🇬🇧

London, United Kingdom

SI"Research Center for Radiation Medicine of NAMS of Ukraine"

🇺🇦

Kyiv, Ukraine

Chemotherapy Preparative Unit St. Bartholomew's Hospital

🇬🇧

London, United Kingdom

The Christie NHS Foundation Trust - Christie Hospital

🇬🇧

Manchester, United Kingdom

Department of Medical Oncology St. Bartholomew's Hospital

🇬🇧

London, United Kingdom

Department of Clinical Biochemistry Newcastle upon Tyne Hospitals

🇬🇧

Newcastle upon Tyne, United Kingdom

Department of Clinical Pathology Newcastle upon Tyne Hospitals NHS Foundation Trust Royal Victoria I

🇬🇧

Newcastle upon Tyne, United Kingdom

Nottingham University Hospital

🇬🇧

Nottingham, United Kingdom

Northern Centre for Cancer Care

🇬🇧

Newcastle upon Tyne, United Kingdom

Pathology Department Nottingham University Hospital - City Hospital Campus

🇬🇧

Nottingham, United Kingdom

Pharmacy Nottingham University Hospital - City Hospital Campus

🇬🇧

Nottingham, United Kingdom

Local Laboratory Nottingham University Hospital - City Hospital Campus

🇬🇧

Nottingham, United Kingdom

Mercy Research Institute

🇺🇸

Miami, Florida, United States

Advanced Medical Specialties

🇺🇸

Miami, Florida, United States

Mercy Hospital

🇺🇸

Miami, Florida, United States

University Hospital

🇺🇸

Cincinnati, Ohio, United States

Hematology Division Department of Medicine Faculty of Medicine Siriraj Hospital Mahidol University

🇹🇭

Bangkoknoi, Bangkok, Thailand

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Centre Henri Becquerel

🇫🇷

Rouen, France

New Cross Hospital

🇬🇧

Wolverhampton, United Kingdom

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

OU Medical Center Presbyterian Professional Building

🇺🇸

Oklahoma City, Oklahoma, United States

OU Medical Center Presbyterian Tower

🇺🇸

Oklahoma City, Oklahoma, United States

Peggy and Charles Stephenson Cancer Center (chemo & infusion)

🇺🇸

Oklahoma City, Oklahoma, United States

Peggy and Charles Stephenson Cancer Center (clinic location)

🇺🇸

Oklahoma City, Oklahoma, United States

Clinical Research Unit

🇺🇸

Los Angeles, California, United States

Institut Jules Bordet

🇧🇪

Bruxelles, Belgium

University Hospital Dubrava Department of Internal Medicine Division of Hematology

🇭🇷

Zagreb, Croatia

Tohoku University Hospital

🇯🇵

Sendai, Miyagi, Japan

Matsushita Memorial Hospital

🇯🇵

Moriguchi, Osaka, Japan

Tokai University Hospital

🇯🇵

Kanagawa, Japan

Klaipeda Seamen's Hospital, Public Institution, department of Oncology

🇱🇹

Klaipeda, Lithuania

Regional Treatment and Diagnostic Hematology Center Communal Establishment

🇺🇦

Cherkasy, Ukraine

SBAL na Hematologichnichni Zabolyavania,CTH Sofia

🇧🇬

Sofia, Bulgaria

National Taiwan University Hospital, Department of Internal Medicine

🇨🇳

Taipei, Taiwan

Shizuoka Cancer Center

🇯🇵

Sunto-gun, Shizuoka, Japan

St Augustinus Ziekenhuis

🇧🇪

Wilrijk, Belgium

Ehime University Hospital

🇯🇵

Toon-shi, Ehime, Japan

Advanced Infusion Services

🇵🇷

Catano, Puerto Rico

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

Hospital Universitaire Andre Mignot

🇫🇷

Le Chesnay Cedex, Yvelines, France

Niepubliczny Zaklad Opieki Zdrowotnej AVI Diagnostyka Obrazowa

🇵🇱

Warszawa, Poland

Singapore General Hospital

🇸🇬

Singapore, Singapore

UMBAL Sveti Georgi, Klinika po hematologia

🇧🇬

Plovdiv, Bulgaria

Gunma University Hospital

🇯🇵

Maebashi-city, Gunma, Japan

National Cancer Center Hospital

🇯🇵

Chuo-ku, Tokyo, Japan

Cancer Institute Hospital, Japanese Foundation For Cancer Research

🇯🇵

Koto-Ku, Tokyo, Japan

Department of Oncology and Medical Radiology of State Institution

🇺🇦

Dnipropetrovsk, Ukraine

Barbara Ann Karmanos Cancer Institute at farmington Hills

🇺🇸

Farmington Hills, Michigan, United States

Mount Sinai Comprehensive Cancer Center

🇺🇸

Miami Beach, Florida, United States

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