CR-CHOP+X in Previously Untreated DEL

Phase 2

Recruiting

• Conditions: DLBCL
• Interventions: Drug: CR-CHOP+PD1 inhibitor; Drug: CR-CHOP + Orelabrutinib; Drug: CR-CHOP + decitabine

• Registration Number: NCT06701357
• Lead Sponsor: Ruijin Hospital

Brief Summary

This is a prospective, single-arm, open-label phase II clinical trial that evaluates the efficacy and safety of CR-CHOP regimen combined with different targeted drugs based on different molecular subtypes in newly diagnosed DEL patients.

Detailed Description

Participants who met the inclusion/exclusion criteria signed informed consent and received 1 course of CR-CHOP, followed by stratification of the remaining 5 cycles based on genetic subtypes. C1 plus PD1 inhibitor; C2 and C3 were treated with orelabrutinib. TP53mut plus decitabine. During chemotherapy, routine evaluation was performed after each course of treatment, and an objective comprehensive evaluation of efficacy was performed after 3 courses of treatment. Efficacy evaluation Patients with CR or PR should continue the original treatment, and patients with SD or PD should be recommended second-line salvage treatment. For the first summary evaluation after completion of all treatments, CR patients are placed on chidamide maintenance therapy (2 years recommended unless intolerable toxicity or disease progression occurs).

Study Timeline

• Study First Submitted: 2024-11-21
• Study First Submitted QC: 2024-11-21
• Study First Posted: 2024-11-22
• Status Verified: 2024-12
• Study Start: 2024-12-10
• Last Update Submitted: 2024-12-26
• Last Update Posted: 2024-12-30
• Primary Completion: 2026-12-01
• Study Completion: 2028-12-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 49

Inclusion Criteria

• 1. Histologically confirmed diffuse large B-cell lymphoma with CD20 positive;
• 2. MYC and BCL2 are expressed simultaneously, WHO immunohistochemical standards: MYC≥40%, BCL2 ≥50%;
• 3. Age ≥ 18 years old, ≦75 years old;
• 4. ECOG physical status score of 0, 1 or 2;
• 5. No previous history of malignant tumors; No other tumors occurred simultaneously;
• 6. Patients judged by the investigator to have a life expectancy of at least 6 months;
• 7. The patient or his legal representative must provide written informed consent prior to any research special examination or procedure;
• 8. International prognostic Index (IPI) >1 score.

Exclusion Criteria

• 1. Have previously received systemic or local treatment including chemotherapy;
• 2. Previously received autologous stem cell transplantation;
• 3. Previous history of other malignant tumors, except skin basal cell carcinoma and cervical carcinoma in situ;
• 4. Accompanied by uncontrolled cardiovascular and cerebrovascular diseases, coagulation disorders, connective tissue diseases, serious infectious diseases and other diseases;
• 5. Primary central nervous system lymphoma;
• 6. Left ventricular ejection fraction ≤ 50%;
• 7. Laboratory test values at the time of screening (unless due to lymphoma): A. Neutrophils <1.5*109/L; B. Platelet <75*109/L; C. ALT or AST were 2 times higher than the upper limit of normal, AKP and bilirubin were 1.5 times higher than the upper limit of normal; D. Creatinine levels higher than 1.5 times the upper limit of normal;
• 8. Other concurrent and uncontrolled medical conditions that the investigator believes will affect patient participation in the study;
• 9. Patients with mental illness or other patients known or suspected to be unable to fully comply with the study protocol;
• 10. Pregnant or lactating women;
• 11. People living with HIV;
• 12. Patients with positive HbsAg test results need to undergo HBV DNA test, and can be enrolled before turning negative. In addition, if the HBsAg test result is negative, but the HBcAb test is positive (regardless of the HBsAb status), HBV DNA test should also be performed. If the result is positive, the treatment should also be negative before admission.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cluster1 DEL：CR-CHOP+PD1 inhibitor	CR-CHOP+PD1 inhibitor	Participants who met the inclusion/exclusion criteria signed informed consent and received 1 course of CR-CHOP, followed by stratification of the remaining 5 cycles based on genetic subtypes. C1 plus PD1 inhibitor.
Cluster 2 and 3 DEL：CR-CHOP plus Orelabrutinib	CR-CHOP + Orelabrutinib	Participants who met the inclusion/exclusion criteria signed informed consent and received 1 course of CR-CHOP, followed by stratification of the remaining 5 cycles based on genetic subtypes. C2 and C3 were treated with Orelabrutinib.
Tp53 mut DEL：CR-CHOP plus Decitabine	CR-CHOP + decitabine	Participants who met the inclusion/exclusion criteria signed informed consent and received 1 course of CR-CHOP, followed by stratification of the remaining 5 cycles based on genetic subtypes.TP53mut plus decitabine.

Primary Outcome Measures

Name	Time	Method
CRR（Complete response rate）	End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days]	CR rate at the end of treatment by FDG-PET defined as the proportion of participants with CR at the end of treatment according to the 2014 Lugano Response Criteria; as determined by the investigator

Secondary Outcome Measures

Name	Time	Method
OS（Overall survival）	2-year	OS defined as the time from treatment to death from any cause
PFS（Progression-free survival）	2-year	PFS, defined as the time from treatment to the first occurrence of disease progression or relapse using the 2014 Lugano Response Criteria or death due to any cause, whichever occurs first; as determined by the investigator
ORR（Overall response rate）	End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days]	ORR at treatment completion or discontinuation defined as the proportion of participants with partial response (PR) or CR at the end of treatment according to the 2014 Lugano Response Criteria; as determined by the investigator

Trial Locations

Locations (1)

No. 197 Ruijin 2nd Road, Huangpu District, Shanghai; 🇨🇳 Shanghai, Shanghai, China