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临床试验/2024-511235-10-00
2024-511235-10-00招募中3 期

TRIANGLE - autologous Transplantation after a Rituximab/Ibrutinib/Ara-c containing iNduction in Generalized mantle cell Lymphoma – a randomized European mcl network trial

Klinikum der Universitaet Muenchen AöR142 个研究点 分布在 10 个国家目标入组 832 人开始时间: 2024年11月8日最近更新:

试验速览

阶段
3 期
状态
招募中
发起方
入组人数
832
试验地点
142
主要终点
FFS defined as time from randomization to stable disease at end of immuno-chemotherapy, progressive disease, or death from any cause.

研究概览

简要总结

To establish one of three study arms, R-CHOP/R-DHAP followed by ASCT (control arm A), R-CHOP+ibrutinib /R-DHAP followed by ASCT and ibrutinib maintenance (experimental arm A+I), and R-CHOP+ibrutinib /R-DHAP followed by ibrutinib maintenance (experimental arm I) as future standard based on the comparison of the investigator-assessed failure-free survival (FFS).

入排标准

年龄范围
18 years 至 64 years(18-64 Years)
接受健康志愿者

入选标准

  • Histologically confirmed diagnosis of MCL according to WHO classification
  • Sexually active men and women of child-bearing potential must agree to use one of the highly effective contraceptive methods (combined oral contraceptives using two hormones, contraceptive implants, injectables, intrauterine devices, sterilized partner) together with one of the barrier methods (latex condoms, diaphragms, contraceptive caps) while on study; this should be maintained for 90 days after the last dose of study drug and 12 months after the last dose of rituximab
  • suitable for high-dose treatment including high-dose Ara-C
  • Stage II-IV (Ann Arbor)
  • Age ≥ 18 years and ≤ 65 years
  • Previously untreated MCL
  • At least 1 measurable lesion; in case of bone marrow infiltration only, bone marrow aspiration and biopsy is mandatory for all staging evaluations.
  • ECOG/WHO performance status ≤ 2
  • The following laboratory values at screening (unless related to MCL): - Absolute neutrophil count (ANC) ≥ 1000 cells/- Platelets ≥100,000 cells/- Transaminases (AST and ALT) ≤3 x upper limit of normal (ULN) Total bilirubin Total bilirubin ≤2 x ULN unless due to known Morbus Meulengracht [Gilbert-Meulengracht-Syndrome]) - Creatinine ≤ 2 mg/dL or calculated creatinine clearance ≥ 50 mL/min
  • Written informed consent form according to ICH/EU GCP and national regulations

排除标准

  • Major surgery within 4 weeks prior to randomization.
  • Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow up schedule
  • Requires anticoagulation with warfarin or equivalent vitamin K antagonists (e.g. phenprocoumon).
  • Subjects not able to give consent
  • Subjects without legal capacity who are unable to understand the nature, scope, significance and consequences of this clinical trial
  • Participation in another clinical trial within 30 days before randomization in this study.
  • History of stroke or intracranial hemorrhage within 6 months prior to randomization.
  • Requires treatment with strong CYP3A4/5 inhibitors.
  • Any life-threatening illness, medical condition, or organ system dysfunction, which, in the investigator’s opinion, could compromise the subject’s safety, interfere with the absorption or metabolism of ibrutinib capsules, or put the study outcomes at undue risk
  • Vaccinated with live, attenuated vaccines within 4 weeks prior to randomization.
  • Known CNS involvement of MCL
  • Previous lymphoma therapy with radiation, cytostatic drugs, anti-CD20 antibody or interferon except prephase therapy according to trial protocol
  • Clinically significant hypersensitivity (e.g., anaphylactic or anaphylactoid reactions to the compound of ibrutinib itself or to the excipients in its formulation)
  • Known anti-murine antibody (HAMA) reactivity or known hypersensitivity to murine antibodies
  • Serious concomitant disease interfering with a regular therapy according to the study protocol: - Cardiac (Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification or LVEF below LLN ) - Pulmonary (e.g. chronic lung disease with hypoxemia) - Endocrinological (e.g. severe, not sufficiently controlled diabetes mellitus) - Renal insufficiency (unless caused by the lymphoma): creatinine > 2x normal value and/or creatinine clearance < 50 ml/min) - Impairment of liver function (unless caused by the lymphoma): transaminases > 3x normal or bilirubin > 2,0 mg/dl unless due to Morbus Meulengracht (Gilbert-Meulengracht-Syndrome)
  • Positive test results for chronic HBV infection (defined as positive HBsAg serology) (mandatory testing) . Patients with occult or prior HBV infection (defined as negative HBsAg and positive total HBcAb) may be included if HBV DNA is undetectable, provided that they are willing to undergo monthly DNA testing. Patients who have protective titers of hepatitis B surface antibody (HBSAb) after vaccination are eligible
  • Positive test results for hepatitis C (mandatory hepatitis C virus [HCV] antibody serology testing). Patients positive for HCV antibody are eligible only if PCR is negative for HCV RNA
  • Patients with known HIV positive infection (mandatory test)
  • Prior organ, bone marrow or peripheral blood stem cell transplantation
  • Concomitant or previous malignancies within the last 3 years other than basal cell skin cancer or in situ uterine cervix cancer
  • Pregnancy or lactation

结局指标

主要结局

FFS defined as time from randomization to stable disease at end of immuno-chemotherapy, progressive disease, or death from any cause.

FFS defined as time from randomization to stable disease at end of immuno-chemotherapy, progressive disease, or death from any cause.

次要结局

  • Overall survival (OS)
  • Progression-free survival (PFS) from randomization, from end of induction immuno-chemotherapy in patients with CR or PR at end of induction immuno-chemotherapy, and from the staging 6 weeks after end of induction assessment (at month 6)
  • Overall response and complete remission rates at midterm, at end of induction, 3 months after end of induction immunochemotherapy (at month 6)
  • PR to CR conversion rate during follow-up after end of induction immuno-chemotherapy
  • Rates of AEs, SAEs, and SUSARs by CTC grade (Version 4.03) during induction immuno-chemotherapy and during periods of follow-up after response to immune-chemotherapy
  • Cumulative incidence rates of SPMs

研究者

发起方
Klinikum der Universitaet Muenchen AöR
申办方类型
Hospital/Clinic/Other health care facility
责任方
Principal Investigator
主要研究者

Martin Dreyling

Scientific

Klinikum der Universitaet Muenchen AöR

研究点 (142)

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