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Ofatumumab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma

Phase 2
Completed
Conditions
Lymphoma
Registration Number
NCT01190449
Lead Sponsor
Alliance for Clinical Trials in Oncology
Brief Summary

RATIONALE: Monoclonal antibodies, such as ofatumumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them.

PURPOSE: This randomized phase II trial is studying ofatumumab to see how well it works in treating patients with previously untreated stage II, stage III, or stage IV follicular non-Hodgkin lymphoma.

Detailed Description

OBJECTIVES:

Primary

* To determine the response rate in patients with previously untreated CD20-positive bulky stage II, or stage III or IV follicular non-Hodgkin lymphoma (NHL) treated with a lower- or high-dose of ofatumumab.

Secondary

* To determine the progression-free survival (PFS) of patients treated with these regimens.

* To determine the toxicity profile of these regimens in these patients.

* To establish whether the therapeutic effect of single-agent ofatumumab is sufficiently promising to warrant evaluation in subsequent randomized, ofatumumab-based, biologic doublet trials.

* To evaluate the two ofatumumab doses by independent comparison of response, PFS, and toxicity to a historical control in previously untreated patients with follicular NHL.

* To prospectively validate the FLIPI2 prognostic index in low- and intermediate-risk patients and compare to low- and intermediate-risk stratified patients by standard FLIPI scoring to determine a more reliable indicator of response and PFS.

OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive high-dose ofatumumab IV over 2-8 hours on days 1, 8, 15, and 22 and then once monthly in months 3-9.

* Arm II: Patients receive a lower dose of ofatumumab IV over 2-8 hours on days 1, 8, 15, and 22 and then once monthly in months 3-9.

In both arms, treatment continues in the absence of disease progression or unacceptable toxicity.

Patients may undergo blood and bone marrow sample collection for correlative studies.

After completion of study therapy, patients are followed up every 4 months for 2 years and then every 6 months for 8 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
51
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Overall Response Rate (Complete or Partial Response) by Month 12From baseline to month 12

The primary endpoint of this trial is overall response rate (OR=complete response (CR) or partial response (PR)) to 500 mg or 1000 mg dose of ofatumumab in previously untreated patients with CD20+ follicular NHL. The response outcome is defined as the best response during the 12 months of first-line and extended induction treatment. A CR is defined as complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. A PR is defined as at least a 50% decrease in the sum of the product of the diameters (SPD) of up to six of the largest dominant nodes or nodal masses, with no increase observed in the size of other nodes, liver, or spleen and no new sites of disease should be observed. The ORR (percentage of patients) reported below by arm is the percentage of patients whose best response during the 12 months of treatment was CR or PR.

Secondary Outcome Measures
NameTimeMethod
Median Progression-free Survival TimeFrom date of study entry until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 4 years

The median progression-free survival (PFS) time for each arm was estimated using the Kaplan-Meier method. PFS was calculated as the time from study entry until progression or death, whichever occurred first. Patients were censored at the time last known alive and progression free. Lymph nodes should be considered abnormal if the long axis is \> 1.5 cm, regardless of the short axis. If a lymph node has a long axis of 1.1 to 1.5 cm, it should only be considered abnormal if its short axis is \> 1.0. Lymph nodes ≤ 1.0 cm by ≤ 1.0 cm will not be considered as abnormal for relapse or progressive disease. Progression is defined using the 2007 revised response criteria reported by Cheson et al. as follows: Appearance of any new lesion, At least a 50% increase from nadir in the SPD of any previously involved nodes, At least a 50% increase in the longest diameter of any single previously identified node \> 1.0 cm in its short axis.

Trial Locations

Locations (48)

Tunnell Cancer Center at Beebe Medical Center

🇺🇸

Lewes, Delaware, United States

CCOP - Christiana Care Health Services

🇺🇸

Newark, Delaware, United States

Cleveland Clinic Florida - Weston

🇺🇸

Weston, Florida, United States

Illinois CancerCare - Bloomington

🇺🇸

Bloomington, Illinois, United States

Illinois CancerCare - Canton

🇺🇸

Canton, Illinois, United States

Eureka Community Hospital

🇺🇸

Eureka, Illinois, United States

Illinois CancerCare - Eureka

🇺🇸

Eureka, Illinois, United States

Galesburg Clinic, PC

🇺🇸

Galesburg, Illinois, United States

Illinois CancerCare - Macomb

🇺🇸

Macomb, Illinois, United States

BroMenn Regional Medical Center

🇺🇸

Normal, Illinois, United States

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Tunnell Cancer Center at Beebe Medical Center
🇺🇸Lewes, Delaware, United States

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