A Study of Obinutuzumab [RO5072759 (GA101)] in Combination With CHOP Chemotherapy in Patients With Previously Untreated Advanced Diffuse Large B-Cell Lymphoma (GATHER)
- Conditions
- Lymphoma, B-Cell
- Interventions
- Registration Number
- NCT01414855
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This open-label, multicenter study will evaluate the efficacy and safety of obinutuzumab \[RO5072759 (GA101)\] in combination with CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) chemotherapy in patients with advanced diffuse large B-cell lymphoma. Patients will receive 8 cycles of obinutuzumab (1000 mg intravenously on Day 1 of each 21-day cycle, during Cycle 1 obinutuzumab will also be infused on Days 8 and 15) in combination with CHOP chemotherapy on Day 1 of cycles 1 to 6. A substudy will investigate the drug-drug interaction of obinutuzumab with CHOP chemotherapy agents. For the substudy, an additional cohort of approximately 15 patients are planned to be enrolled at a subset of investigational sites.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- Adult patients, ≥18 years of age
- Previously untreated cluster of differentiation antigen 20 (CD20)-positive diffuse large B-cell lymphoma
- Ann Arbour Stage III/IV and bulky II (mass >10 cm)
- At least one bi-dimensionally measurable lesion defined as >1.5 cm in its largest dimension by CT scan
- Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2
- Left ventricular ejection fraction ≥50%
- Adequate hematologic function
- Transformed lymphoma (follicular IIIB) if previously treated with chemotherapy or immunotherapy
- Prior therapy for diffuse large B-cell lymphoma except for nodal biopsy or local irradiation
- Central nervous system (CNS) lymphoma, primary mediastinal large cell lymphoma, primary cutaneous lymphoma, primary effusion lymphoma
- Patients who received cytotoxic drugs or rituximab as part of their treatment for another condition (e.g. rheumatoid arthritis) or prior use of an anti-CD20 antibody
- Chemotherapy or other investigational therapy within 28 days prior to the start of Cycle 1
- Contraindication to any of the individual components of CHOP, including prior receipt of anthracyclines
- History of severe allergic or anaphylactic reactions to monoclonal antibody therapy
- History of other malignancy, except for curatively treated basal or squamous cell carcinoma or melanoma of the skin or in situ carcinoma of the cervix, or malignancy treated with or without curative intent and in remission without treatment for ≥2 years prior to enrolment
- Positive for hepatitis B, hepatitis C, human immunodeficiency virus (HIV) or human T-cell leukemia virus (HTLV-1) infection
- Pregnant or lactating women
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description obinutuzumab + CHOP prednisone Participants received 1000 mg obinutuzumab intravenously on Day 1 of each 21-day cycle for 8 cycles; during Cycle 1 administration also on Days 8 and 15. Participants also received standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for 6 cycles. obinutuzumab + CHOP obinutuzumab Participants received 1000 mg obinutuzumab intravenously on Day 1 of each 21-day cycle for 8 cycles; during Cycle 1 administration also on Days 8 and 15. Participants also received standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for 6 cycles. obinutuzumab + CHOP cyclophosphamide Participants received 1000 mg obinutuzumab intravenously on Day 1 of each 21-day cycle for 8 cycles; during Cycle 1 administration also on Days 8 and 15. Participants also received standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for 6 cycles. obinutuzumab + CHOP vincristine Participants received 1000 mg obinutuzumab intravenously on Day 1 of each 21-day cycle for 8 cycles; during Cycle 1 administration also on Days 8 and 15. Participants also received standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for 6 cycles. obinutuzumab + CHOP doxorubicin Participants received 1000 mg obinutuzumab intravenously on Day 1 of each 21-day cycle for 8 cycles; during Cycle 1 administration also on Days 8 and 15. Participants also received standard CHOP therapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for 6 cycles.
- Primary Outcome Measures
Name Time Method Complete Response (CR) Rate as Assessed by the Investigator at the End of Treatment From the first dose of study treatment to end of treatment response assessment (approximately 228 to 258 days) Complete response rate is defined as the percentage of participants with Complete Response (CR) according to the Revised Response Criteria for Malignant Lymphoma (Cheson et al., 2007). Disease response was evaluated by the investigator using regular clinical and laboratory examinations, fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT). CR is the disappearance of all evidence of disease.
Overall Response Rate (ORR) as Assessed by the Investigator at the End of Treatment From the first dose of study treatment to end of treatment response assessment (approximately 228 to 258 days) Overall response rate was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) according to the Revised Response Criteria for Malignant Lymphoma (Cheson et al., 2007). Disease response was evaluated by the investigator using regular clinical and laboratory examinations, FDG-PET and computed tomography (CT). CR is the disappearance of all evidence of disease. PR is at least 50% regression of measurable disease compared to tumors measured by a baseline scan and no new sites.
- Secondary Outcome Measures
Name Time Method Complete Response (CR) Rate as Assessed by the Independent Review Facility (IRF) at the End of Treatment From the first dose of study treatment to end of treatment response assessment (approximately 228 to 258 days) Complete response rate is defined as the percentage of participants with Complete Response (CR) according to the Revised Response Criteria for Malignant Lymphoma (Cheson et al., 2007). Disease response was evaluated by the IRF using CT scans, PET scans and pertinent clinical information. CR is the disappearance of all evidence of disease.
Progression-Free Survival (PFS) as Assessed by the Investigator From the first dose of study treatment to PFS assessment (up to 64 months) PFS was defined as the time from the date of the first dose of study treatment until the date of disease progression, relapse, or death from any cause.
Pharmacokinetics (PK): Maximum Concentration Observed (Cmax) for Obinutuzumab Cycle 1 Day 1 pre and post dose, Days 3,5, Day 8 pre and post-dose, Day 15 pre-dose. Cycle 8 Day 1 pre and post-dose, Days 5,8,12 Blood was collected for PK Parameters. Serum samples were sent to a central lab and were analyzed for obinutuzumab using a validated enzyme-linked immunosorbent assay (ELISA) measured in micrograms per milliliter (μg/mL).
Pharmacokinetics: Terminal Half-Life (t1/2) for Obinutuzumab Cycle 1 Day 1 pre and post dose, Days 3,5, Day 8 pre and post-dose, Day 15 pre-dose. Cycle 8 Day 1 pre and post-dose, Days 5,8,12 T1/2 is the time required for the concentration of the drug to reach half of its original value. Blood was collected for PK Parameters. Serum samples were sent to a central lab and were analyzed for obinutuzumab using a validated enzyme-linked immunosorbent assay (ELISA) measured in days
Overall Response Rate (ORR) as Assessed by the IRF at the End of Treatment From the first dose of study treatment to end of treatment response assessment (approximately 228 to 258 days) Overall response rate was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) according to the Revised Response Criteria for Malignant Lymphoma (Cheson et al., 2007). Disease response was evaluated by the IRF using CT scans, PET scans and pertinent clinical information. CR is the disappearance of all evidence of disease. PR is at least 50% regression of measurable disease compared to tumors measured by a baseline scan and no new sites.
Duration of Response (DOR) From the response assessment to relapse, progression, or death (up to 64 months) DOR is defined as first occurrence of documented response (CR or PR) until the first occurrence of relapse or progression or death of any cause. CR: disappearance of all evidence of disease. PR: at least 50% regression of measurable disease compared to tumors measured by a baseline scan and no new sites.
Percentage of Participants With Adverse Events as a Measure of Safety From the first dose of study treatment to end of study (up to 5 years 4 months) An adverse event was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug or other protocol-imposed intervention. Preexisting conditions that worsened during the study were reported as adverse events.
Number of Participants With Grade 3 to 4 Infusion-Related (IRR) Adverse Events (AE) in Participants Receiving Shorter Duration Infusion (SDI) From the first dose of study treatment to end of treatment response assessment (approximately 228 to 258 days) SDI 120 is a shorter duration infusion of 120 minutes and SDI 90 is shorter duration infusion of 90 minutes. Grade 3 IRR AE: Prolonged (e.g., not rapidly responsive to symptomatic medication and/or brief interruption of infusion); recurrence of symptoms following initial improvement; hospitalization indicated for clinical sequelae. Grade 4 IRR AE: Life-threatening consequences; urgent intervention indicated.
Pharmacokinetics: Clearance (Cl) for Obinutuzumab Cycle 1 Day 1 pre and post dose, Days 3,5, Day 8 pre and post-dose, Day 15 pre-dose. Cycle 8 Day 1 pre and post-dose, Days 5,8,12 Cl is the volume of serum cleared of the drug per unit of time. Serum samples were sent to a central lab and were analyzed for obinutuzumab using a validated enzyme-linked immunosorbent assay (ELISA) measured in milliliters/day (mL/day).
Pharmacokinetics: Volume of Distribution (V) for Obinutuzumab Cycle 1 Day 1 pre and post dose, Days 3,5, Day 8 pre and post-dose, Day 15 pre-dose. Cycle 8 Day 1 pre and post-dose, Days 5,8,12 V is the apparent volume in which a drug is distributed in the body. Serum samples were sent to a central lab and were analyzed for obinutuzumab using a validated enzyme-linked immunosorbent assay (ELISA) measured in milliliters (mL).
Pharmacokinetics: Area Under the Concentration-Time Curve 7 Day (AUC7day) Cycle 1 Day 1 pre and post dose, Days 3,5, Day 8 pre and post-dose, Day 15 pre-dose. Cycle 8 Day 1 pre and post-dose, Days 5,8,12 Blood was collected for PK parameters. Serum samples were sent to a central lab and were analyzed for obinutuzumab using a validated enzyme-linked immunosorbent assay (ELISA) measured in in day times micrograms per milliliter (day\*μg/mL).
Pharmacodynamics: Peripheral Blood CD19-positive B-cell Count Up to approximately 24 months
Trial Locations
- Locations (38)
Norwalk Hospital
🇺🇸Norwalk, Connecticut, United States
Onc Hem Assoc of Central IL
🇺🇸Peoria, Illinois, United States
Florida Cancer Specialists; Saint Petersburg
🇺🇸Saint Petersburg, Florida, United States
Northwestern University; Robert H. Lurie Comp Can Ctr
🇺🇸Chicago, Illinois, United States
Willamette Valley Cancer Insitute and Research Center
🇺🇸Springfield, Oregon, United States
Aurora Bay Care Medical Center
🇺🇸Green Bay, Wisconsin, United States
USO - Tyler Cancer Ctr
🇺🇸Tyler, Texas, United States
Northwest Cancer Specialists - Vancouver
🇺🇸Vancouver, Washington, United States
Florida Cancer Specialists; Department of Oncology
🇺🇸Fort Myers, Florida, United States
Yakima Valley Memorial Hospital/North Star Lodge
🇺🇸Yakima, Washington, United States
Jewish Cancer Care
🇺🇸Louisville, Kentucky, United States
McFarland Clinic
🇺🇸Ames, Iowa, United States
University of Massachusetts Medical School
🇺🇸Worcester, Massachusetts, United States
Cancer Therapy & Research Center
🇺🇸San Antonio, Texas, United States
Memorial Sloan-Kettering; Cancer Center
🇺🇸Commack, New York, United States
Blue Ridge Cancer Care - Roanoke
🇺🇸Roanoke, Virginia, United States
MD Anderson Cancer Center Department of Lymphoma & Myeloma
🇺🇸Houston, Texas, United States
Methodist Hospital Research Institute
🇺🇸Houston, Texas, United States
University of Colorado Cancer Center Department of Hematology
🇺🇸Aurora, Colorado, United States
Rocky Mountain Cancer Ctr - Denver (Williams)
🇺🇸Denver, Colorado, United States
cCare
🇺🇸Encinitas, California, United States
Northwest Georgia Oncology Centers PC - Marietta
🇺🇸Marietta, Georgia, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
MSKCC at Sleepy Hollow
🇺🇸Sleepy Hollow, New York, United States
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
Emerywood Hematology and Onc
🇺🇸High Point, North Carolina, United States
Kootenai Medical Center
🇺🇸Coeur d'Alene, Idaho, United States
MT Cancer Inst Fndtn; MT Can Spec
🇺🇸Missoula, Montana, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
MSKCC at Basking Ridge
🇺🇸Basking Ridge, New Jersey, United States
Medical University of SC (MUSC)
🇺🇸Charleston, South Carolina, United States
SCRI-Tennessee Oncology
🇺🇸Nashville, Tennessee, United States
University of Michigan
🇺🇸Ann Arbor, Michigan, United States
San Juan Oncology Associates
🇺🇸Farmington, New Mexico, United States
MSKCC at Mercy Med Ctr
🇺🇸Rockville Centre, New York, United States
Onc & Hem Assoc; USO Cent Pharm
🇺🇸Fort Worth, Texas, United States
Medical Oncology Associates
🇺🇸Spokane, Washington, United States
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States