A multicenter study to evaluate the anti-viral activity of an interferon-free treatment with ledipasvir/sofosbuvir (G1 and G4) and sofosbuvir/velpatasvir (G2 and G3) for patients with hepatitis C virus-associated indolent B-cell lymphomas
- Conditions
- Patients with hepatitis C virus-associated indolent B-cell lymphomasMedDRA version: 23.0Level: PTClassification code 10065856Term: Non-Hodgkin's lymphoma unspecified histology indolentSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)MedDRA version: 20.1Level: PTClassification code 10065051Term: Acute hepatitis CSystem Organ Class: 10021881 - Infections and infestationsTherapeutic area: Diseases [C] - Virus Diseases [C02]
- Registration Number
- EUCTR2015-004830-81-IT
- Lead Sponsor
- FONDAZIONE ITALIANA LINFOMI ONLUS
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Authorised-recruitment may be ongoing or finished
- Sex
- All
- Target Recruitment
- 44
1.Age >18 years
2.Indolent B cell lymphoma including: marginal zone lymphoma (nodal, extranodal, splenic and disseminated), lymphoplasmacytic lymphoma, small lymphocytic lymphoma, follicular lymphoma grade 1 and 2, CD5-negative B-cell lymphoma NOS
3.HCV-RNA positivity
4.Assessable HCV genotype
5.No previous therapy for the lymphoma
6.6.Measurable disease after diagnostic biopsy (longest axis =1.5 cm for nodal and =1 cm for extranodal lesions) and/or evaluable disease (quantifiable BM infiltrate and =5 x 109/l clonal B-cell in peripheral blood in case of exclusive BM/leukemic disease in CD5-negative B-cell lymphoma NOS)
7.No need of immediate lymphoma treatment defined as absence of all the following criteria: systemic symptoms, bulky nodal or extranodal mass (>7 cm), symptomatic splenomegaly, progressive leukemic phase, serous effusions
8.Performance status <2 according to ECOG scale
9.Adequate hematological counts: ANC >1 x 109/L, hemoglobin >9 g/dl (transfusion independent), platelet count > 50 x 109/L (transfusion independent)
10.No central nervous system (CNS) disease (meningeal and/or brain involvement by lymphoma)
11.Adequate kidney function (creatinine clearance = 45 ml/min)
12.Cardiac ejection fraction =45% (echocardiography or MUGA scan)
13.Normal lung function
14.Non peripheral neuropathy or active neurological non neoplastic disease of CNS
15.Non major surgical intervention prior 3 months to enrolment if not due to lymphoma and/or no other disease life-threatening that can compromise chemotherapy treatment
16.Disease free of prior malignancies other than lymphoma for >3 years with exception of currently treated squamous cell and basal cell carcinoma of the skin or carcinoma in situ of the cervix or breast
17.Life expectancy > 6 months
18.No psychiatric illness that precludes understanding concepts of the trial or signing informed consent
19.Written informed consent
20.Women must be:
-postmenopausal for at least 1 year (must not have had a natural menses for at least 12 months)
-surgically sterile (have had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy),
-completely abstinent (at the discretion of the investigator/per local regulations) (periodic abstinence from intercourse is not permitted) or
-if sexually active, be practicing a highly effective method of birth control (eg, prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double-barrier method (eg: condoms, diaphragm, or cervical cap, with spermicidal foam, cream, or gel, male partner sterilization) as local regulations permit, before entry, and must agree to continue to use the same method of contraception throughout the study. They must also be prepared to continue birth control measures for at least 6 months after terminating treatment.
21.Women of childbearing potential must have a negative serum or urine beta-human chorionic gonadotropin (beta-hCG) pregnancy test at screening
22.Men must agree to use an acceptable method of contraception (for themselves or female partners as listed above) for the duration of the study. Men must agree to use a double barrier method of birth control and to not donate sperm during the study and for 1 month after receiving the last dose of study drug
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 44
F
1.Diagnosis of lymphoblastic lymphoma, Burkitt lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, follicular lymphoma grade 3, primary mediastinal B-cell lymphoma
2.Previous anti-HCV treatment with sustained virological response
3.Diagnosis of cirrhosis (histological or Stiffness >12 KpA)
4.CNS disease (meningeal and/or brain involvement by lymphoma)
5.History of clinically relevant liver or renal insufficiency; significant cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, rheumatologic, hematologic, psychiatric, or metabolic disturbances
6.Uncontrolled diabetes (if receiving antidiabetic agents, subjects must be on a stable dose for at least 3 months before first dose of study drug)
7.Concomitant therapy with amiodarone
8.Uncontrolled or severe cardiovascular disease including myocardial infarction within six months of enrollment, New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina,
9.Cardiac ejection fraction <45% (MUGA scan or echocardiography).
10.Creatinine clearance <45 ml/min
11.Presence of major neurological disorders
12.HIV positivity, HBV positivity (HbsAg+ or HBV-DNA+) with the exception of HBcAb+, HbsAg-, HBsAb+/- patients with HBV-DNA negativity
13.Ongoing systemic bacterial, fungal or viral infections at the time of initiation of study treatment (defined as requiring therapeutic dosing of an antimicrobial, antifungal or antiviral agent)
14.Major surgical intervention prior 3 months to enrollment if not due to lymphoma and/or other
15.Prior malignancies other than lymphoma in the last 3 years with exception of currently treated squamous cell and basal cell carcinoma of the skin or carcinoma in situ of the cervix or breast
16.Life expectancy <6 months
17.Any other coexisting medical or psychological condition that would preclude participation in the study or compromise ability to give informed consent.
18.If female, the patient is pregnant or breast-feeding.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: •Virological: to evaluate the efficacy of interferon-free regimens to eradicate HCV infection in patients with indolent B-cell lymphoma;Secondary Objective: •Hematological: to investigate the efficacy of interferon-free regimens on complete or partial regression of HCV-associated indolent B-cell lymphoma<br>•Hematological: to investigate the freedom from progression of disease and the survival probability in patients with HCV-associated indolent B-cell lymphoma <br>•Virological: to investigate on-treatment virological response and non-response<br>•Safety of treatment<br>;Primary end point(s): Sustained virologic response (SVR12) defined as undetectability of HCV-RNA 12 weeks after completion of antiviral therapy;Timepoint(s) of evaluation of this end point: 12 weeks from the end of treatment
- Secondary Outcome Measures
Name Time Method Secondary end point(s): •Overall response rate (ORR) of lymphoma: CR is defined by the complete disappearance of all detectable sites and symptoms; PR is defined as a more than 50% reduction. Responses different from CR/PR are defined as stable disease (SD); progressive disease (PD) is considered an increase in size of more than 50% of previously documented disease or the appearance of new lesions. Lymphoma response will be assessed 12 weeks after the end of antiviral treatment; PFS; Event-free survival (EFS) defined as time between enrolment and failure of treatment or death as a result of any cause; Overall survival (OS) defined as the time between enrolment and death from any cause; Rate of virological response;Timepoint(s) of evaluation of this end point: 12 weeks from the end of treatment; 36 months; 36 months; 36 months; 4 weeks