Clinical Efficacy and Safety of IBER Salvage Treatment Followed by Ibrutinib Maintenance for Transplant-ineligible Patients With Relapsed or Refractory Primary Central Nervous System Lymphoma (PCNSL): a Multicenter, Single-arm, Prospective Phase II Study
试验速览
- 阶段
- 2 期
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Overall response rate
研究概览
简要总结
This is a multicenter, single-arm, prospective phase II study to evaluate the efficacy and safety of a novel combination regimen for relapsed/refractory PCNSL. Specifically, ibrutinib will be administered in combination with ifosfamide, etoposide and rituximab (IBER) as a salvage chemotherapy, which is followed by maintenance ibrutinib monotherapy of fixed duration.
详细描述
Given the limited activity of salvage therapy with high-dose methotrexate re-treatment and/or alkylator-based treatment in patients with relapse or refractory PCNSL, the development of novel salvage chemotherapy regimen remains an area of clinical unmet need.
Ibrutinib, an oral inhibitor of bruton tyrosine kinase (BTK), is known to induce death of diffuse large B-cell lymphoma (DLBCL) cells with dysregulated B-cell receptor (BCR) signaling and has shown promising activity in patients with a variety of B-cell malignancies. Recently, several studies reported that ibrutinib may have an excellent single-agent clinical activity against relapsed or refractory PCNSL. Furthermore, proven pharmacokinetic data suggested that ibrutinib successfully penetrated the BBB and reached the achievable concentration in cerebrospinal fluid. When ibrutinib is administered in combination with BBB-destructing chemotherapeutic agents (such as, temozolomide or etoposide) for salvage treatment of PCNSL, therefore, anti-lymphoma activity of ibrutinib could be maximized.
In this context, this phase II study is designed to evaluate the efficacy and safety of IBER salvage chemotherapy followed by ibrutinib maintenance for transplant ineligible patients with relapsed or refractory PCNSL.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 79 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Histologically confirmed PCNSL of CD20+ diffuse large B cell lymphoma (DLBCL)
- •PCNSL relapsed or refractory after frontline methotrexate-based chemotherapy (with or without radiation therapy)
- •At least one measurable lesion, which is defined as longest diameter of lesion > 0.5 cm, by contrast-enhanced MRI
- •ECOG performance status 0-2
- •Normal function of major organs
排除标准
- •PCNSL other than DLBCL
- •Primary ocular lymphoma
- •PCNSL accompanied by systemic involvement
- •Active infection with hepatitis B or C virus
- •Known history of human immunodeficiency virus (HIV) infection
- •Therapy with myelosuppressive chemotherapy or biologic therapy < 21 days prior to registration
研究组 & 干预措施
IBER treatment arm
This is the only arm in a single-arm phase II study.
干预措施: IBER salvage chemotherapy followed by ibrutinib maintenance therapy (Drug)
结局指标
主要结局
Overall response rate
时间窗: From date of starting the study treatment until the date of finishing the study treatment for any reason, assessed up to 10 months
The percentage of patients with a complete response (CR) or a partial response (PR)
次要结局
- Safety and tolerability of the study treatment(From the first day of the first cycle of IBER induction chemotherapy to 30 days after the last dose of study drug, assessed up to 12 months)
研究者
Deok-Hwan Yang
Professor
Chonnam National University Hospital