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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02187861
Other study ID # BO29337
Secondary ID 2014-000576-26
Status Completed
Phase Phase 2
First received
Last updated
Start date December 1, 2014
Est. completion date March 16, 2018

Study information

Verified date June 2019
Source Hoffmann-La Roche
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This open-label, international, multicenter study will investigate the safety and efficacy of venetoclax (GDC-0199) in combination with bendamustine plus rituximab (venetoclax + BR) compared with BR alone in participants with relapsed and refractory fNHL, comparing two chemotherapy-containing regimens (Chemotherapy-Containing Cohort). In addition, an exploratory analysis of the safety and efficacy of venetoclax in combination with rituximab (venetoclax + rituximab), a chemotherapy-free regimen, will be performed (Chemotherapy-Free Cohort). Assignment to the Chemotherapy-Containing or Chemotherapy-Free Cohort will be decided at the discretion of the Investigator, unless one of the cohorts is not open to enrollment; in which case, participants may be enrolled only to the open cohort. The first 6 participants enrolled in the Chemotherapy-Containing Cohort (or more if required) will comprise the Safety Run-In group for Treatment Arm B, dosing venetoclax at 600 milligrams (mg) in combination with BR. Once a dose has been chosen from the Safety Run-In Period, randomization to the two treatment arms of the Chemotherapy-Containing Cohort (Arms B and C) will begin.


Recruitment information / eligibility

Status Completed
Enrollment 163
Est. completion date March 16, 2018
Est. primary completion date September 27, 2016
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Participants must have histologically confirmed follicular lymphoma (FL) of Grade 1, 2, or 3a

- Participants must have received at least one prior therapy for FL

- For participants potentially receiving chemotherapy: if the participant has received prior bendamustine, response duration must have been greater than (>) 1 year

- At least one bi-dimensionally measurable lesion on imaging scan defined as >1.5 centimeters (cm) in its longest dimension

- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2

- Adequate hematologic function

- For female participants of childbearing potential and male participants with female partners of childbearing potential, agreement to use one highly effective form of non-hormonal contraception or two effective forms of non-hormonal contraception throughout the course of study treatment and for at least 30 days after the last dose of venetoclax and 12 months after the last dose of rituximab, whichever is longer

- Confirmed availability of archival or freshly biopsied tumor tissue meeting protocol-defined specifications prior to study enrollment

Exclusion Criteria:

- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products

- Contraindication to potential treatment agents

- Ongoing corticosteroid use >30 milligrams per day (mg/day) of prednisone or equivalent. Participants receiving corticosteroid treatment with less than equal to (</=) 30 mg/day of prednisone or equivalent must be documented to be on a stable dose of at least 4 weeks duration prior to randomization (Cycle 1 Day 1)

- Primary central nervous system (CNS) lymphoma

- Vaccination with live vaccines within 28 days prior to treatment

- Chemotherapy or other investigational therapy within five half-lives of a biologic agent with a minimum of 28 days prior to the start of Cycle 1

- History of other malignancy that could affect compliance with the protocol or interpretation of results

- Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results or that could increase risk to the participant

- Significant cardiovascular disease (such as New York Heart Association Class III or IV cardiac disease, congestive heart failure, myocardial infarction within the previous 6 months, unstable arrhythmias, or unstable angina) or significant pulmonary disease (including obstructive pulmonary disease and history of bronchospasm)

- Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment or any major episode of infection requiring treatment with intravenous antibiotics or hospitalization (relating to the completion of the course of antibiotics) within 4 weeks prior to Cycle 1 Day 1

- Requires the use of warfarin

- Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis

- Presence of positive test results for hepatitis B surface antigen or hepatitis C virus (HCV) antibody

- Participants who are positive for HCV antibody must be negative for HCV by polymerase chain reaction (PCR) to be eligible for study participation

- Participants with occult or prior hepatitis B virus (HBV) infection may be included if HBV deoxyribonucleic acid (DNA) is undetectable at screening. These participants must be willing to undergo monthly HBV DNA test until at least 12 months after the last treatment cycle

- Known infection with human immunodeficiency virus (HIV) or human T-cell leukemia virus 1 (HTLV-1)

- Pregnant or lactating

- Recent major surgery (within 6 weeks before the start of Cycle 1 Day 1), other than for diagnosis

Study Design


Intervention

Drug:
Venetoclax
Venetoclax will be administered as per the schedule specified under arm description.
Bendamustine
Bendamustine will be administered as per the schedule specified under arm description.
Rituximab
Rituximab will be administered as per the schedule specified under arm description.

Locations

Country Name City State
Australia Royal Prince Alfred Hospital; Medical Oncology Camperdown New South Wales
Australia Monash Medical Centre Clayton Victoria
Australia Townsville General Hospital Douglas Queensland
Australia Royal Hobart Hospital Hobart Tasmania
Australia St George Hospital Kogarah, New South Wales New South Wales
Australia Royal North Shore Hospital St. Leonards New South Wales
Australia Westmead Hospital; Haematology Sydney New South Wales
Australia Calvary Mater Newcastle Waratah New South Wales
Australia Queen Elizabeth Hospital; Haematology Woodville South South Australia
Australia Princess Alexandra Hospital Woolloongabba Queensland
Belgium ZNA Stuivenberg Antwerpen
Belgium AZ Sint Jan Brugge
Belgium Cliniques Universitaires St-Luc Bruxelles
Canada Cross Cancer Institute Edmonton Alberta
Canada British Columbia Cancer Agency Kelowna British Columbia
Canada Chum Hopital Notre Dame; Centre D'Oncologie Montreal Quebec
Canada Hopital Maisonneuve- Rosemont; Oncology Montreal Quebec
Canada Jewish General Hospital Montreal Quebec
Canada Saskatoon Cancer Centre; Uni of Saskatoon Campus Saskatoon Saskatchewan
Canada University Health Network; Princess Margaret Hospital; Medical Oncology Dept Toronto Ontario
France Institut de Cancerologie de l'Ouest Angers
France CHU Clermont Ferrand - Hôpital d'Estaing Clermont Ferrand cedex 1
France Hopital Henri Mondor Creteil
France CHU de Dijon - Hopital le Bocage Dijon
France Centre Jean Bernard Le Mans
France CHU Montpellier Montpellier
France Centre Hospitalier Lyon Sud; Hematolgie Pierre Benite
Germany Klinikum Chemnitz gGmbH; Klinik f. Innere Medizin III Chemnitz
Germany Städtisches Klinikum Dessau Dessau-Roßlau
Germany BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie-Onkologie Dresden
Germany Universitätsklinik Essen; Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie Essen
Germany Universitätsklinikum Jena; Klinik für Innere Medizin II Jena
Germany Universitätsklinikum Köln; Klinik I für Innere Medizin Koeln
Germany Universitätsklinikum Schleswig-Holstein / Campus Lübeck, Med. Klinik I, Hämatologie/Onkologie Lübeck
Germany Uni. der Johannes Gutenberg-Universitaet Mainz; III. Medizinische Klinik und Poliklinik Mainz
Germany Universitätsklinikum Ulm; Apotheke Ulm
Germany Universitätsklinikum Würzburg; Medizinische Klinik und Poliklinik II; Hämatologie / Onkologie Würzburg
Italy Asst Papa Giovanni XXIII Bergamo Lombardia
Italy A.O. Universitaria Policlinico S.Orsola-Malpighi Di Bologna Bologna Emilia-Romagna
Italy Az. Osp. Di Careggi; Divisione Di Ematologia Firenze Toscana
Italy IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica Meldola Emilia-Romagna
Italy Ospedale Niguarda Milano Milano Lombardia
Italy Irccs Policlinico San Matteo; Divisione Di Ematologia Pavia Lombardia
Italy Ospedale di Ravenna Ravenna Emilia-Romagna
Italy Ospedale Infermi di Rimini Rimini Emilia-Romagna
Italy Azienda Ospedale San Giovanni Torino Piemonte
United Kingdom Blackpool Victoria Hospital Blackpool
United Kingdom St James University Hospital Leeds
United Kingdom Leicester Royal Infirmary; Dept. of Medical Oncology Leicester
United Kingdom Royal Marsden Nhs Trust; Consultant Cancer Physician London
United Kingdom University College London, Department of Haematology London
United Kingdom Christie Hospital; Breast Cancer Research Office Manchester
United Kingdom Churchill Hospital; Oxford Cancer and Haematology Centre Oxford
United Kingdom Royal Marsden NHS Foundation Trust Sutton
United States Nothwest Georgia Oncology Centers P.C Austell Georgia
United States Sidney Kimmel Comp Cancer Ctr Baltimore Maryland
United States University of Virginia Charlottesville Virginia
United States Northwestern University Chicago Illinois
United States University of Illinois at Chicago College of Medicine Chicago Illinois
United States Hackensack University Medical Center Hackensack New Jersey
United States Primary Healthcare Associates SC - Harvey Harvey Illinois
United States UCLA School of Medicine; Hematology/Oncology Los Angeles California
United States Southern Cancer Center, PC Mobile Alabama
United States West Virginia Uni Med. Center - Robert Byrd Health Science Morgantown West Virginia
United States University of Pennsylvania; School of Medicine Philadelphia Pennsylvania
United States Allegheny General Hospital Pittsburgh Pennsylvania
United States University of Pittsburgh Pittsburgh Pennsylvania
United States VCU Massey Cancer Center Richmond Virginia
United States James P. Wilmot Cancer Center Rochester New York
United States Arizona Cancer Center Tucson Arizona
United States University of Kansas; Medical Center & Medical pavilion Westwood Kansas

Sponsors (2)

Lead Sponsor Collaborator
Hoffmann-La Roche AbbVie

Countries where clinical trial is conducted

United States,  Australia,  Belgium,  Canada,  France,  Germany,  Italy,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants With Complete Metabolic Response (CMR) According to Independent Review Committee (IRC) as Per Lugano Classification, Using Positron Emission Tomography (PET) Scan at Primary Response Assessment (PRA) CMR: a score 1 (no uptake above background), 2 (uptake less than or equal to [<=] mediastinum), or 3 (uptake less than [<] mediastinum but <=liver) with or without a residual mass on PET 5-point scale (5-PS), for lymph nodes and extralymphatic sites with no new lesions and no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow. Assessment was performed by an IRC according to Lugano classification using PET scan. 95% confidence interval (CI) for percentage of responders was calculated using Clopper-Pearson method. 6-8 weeks after Cycle 6 Day 1 (PRA) (Cycle length = 28 days)
Secondary Percentage of Participants With CMR According to Investigator as Per Lugano Classification, Using PET Scan at PRA CMR: a score 1 (no uptake above background), 2 (uptake <=mediastinum), or 3 ( 4-10 weeks after Cycle 6 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With CMR According to IRC as Per Lugano Classification, Using PET Scan at Year 1 CMR: a score 1 (no uptake above background), 2 (uptake <=mediastinum), or 3 (uptake 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With CMR According to Investigator as Per Lugano Classification, Using PET Scan at Year 1 CMR: a score 1 (no uptake above background), 2 (uptake <=mediastinum), or 3 ( 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With Complete Response (CR) According to IRC as Per Lugano Classification, Using Computed Tomography (CT) Scan CR: defined as reduction of longest transverse diameter of lesion (LDi) of target nodes/nodal masses to <=1.5 centimeters (cm), and no extralymphatic sites of disease; absence of non-measured lesions and new lesions; reduction of enlarged organs to normal; and normal/immunohistochemistry (IHC)-negative bone marrow morphology. Assessment was performed by an IRC according to Lugano classification using CT scan. 95% CI for percentage of responders was calculated using Clopper-Pearson method. 6-8 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With CR According to Investigator as Per Lugano Classification, Using CT Scan CR: defined as reduction of LDi of target nodes/nodal masses to <=1.5 cm, and no extralymphatic sites of disease; absence of non-measured lesions and new lesions; reduction of enlarged organs to normal; and normal/IHC-negative bone marrow morphology. Assessment was performed by Investigator according to Lugano classification using CT scan. 95% CI for percentage of responders was calculated using Clopper-Pearson method. 4-10 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With Objective Response (OR) According to IRC as Per Lugano Classification, Using PET Scan OR was defined as CMR or Partial Metabolic Response (PMR). CMR: a score 1 (no uptake above background), 2 (uptake <=mediastinum), or 3 ( 6-8 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With OR According to Investigator as Per Lugano Classification, Using PET Scan OR was defined as CMR or PMR. CMR: a score 1 (no uptake above background), 2 (uptake <=mediastinum), or 3 ( 4-10 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With OR According to IRC as Per Lugano Classification, Using CT Scan OR was defined as CR or Partial Response (PR). CR: reduction of LDi of target nodes/nodal masses to <=1.5 cm, and no extralymphatic sites of disease; absence of non-measured lesions and new lesions; reduction of enlarged organs to normal; and normal/IHC-negative bone marrow morphology. PR: greater than or equal to (>=) 50 percent (%) decrease in sum of the product of the perpendicular diameters (SPD) of up to 6 target measurable nodes and extra-nodal sites; absence/reduction/no increase in size of non-measured lesions; reduction in length of spleen at least >50% beyond normal; and no new lesions. Assessment was performed by an IRC according to Lugano classification using CT scan. 95% CI for percentage of responders was calculated using Clopper-Pearson method. 6-8 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With OR According to Investigator as Per Lugano Classification, Using CT Scan OR was defined as CR or PR. CR: reduction of LDi of target nodes/nodal masses to <=1.5 cm, and no extralymphatic sites of disease; absence of non-measured lesions and new lesions; reduction of enlarged organs to normal; and normal/IHC-negative bone marrow morphology. PR: >=50% decrease in SPD of up to 6 target measurable nodes and extra-nodal sites; absence/reduction/no increase in size of non-measured lesions; reduction in length of spleen at least >50% beyond normal; and no new lesions. Assessment was performed by Investigator according to Lugano classification using CT scan. 95% CI for percentage of responders was calculated using Clopper-Pearson method. 4-10 weeks after Cycle 6 Day 1 and 48-56 weeks after Cycle 1 Day 1 (Cycle length = 28 days)
Secondary Percentage of Participants With OR According to Investigator as Per Lugano Classification, Using PET or CT Scan OR was defined as CMR/CR or PMR/PR. CMR, CR, PMR, and PR have been defined in previous endpoints, and are not repeated here due to space constraint. Assessment was performed by Investigator according to Lugano classification using PET scan or CT scan (if PET is missing). Baseline until disease progression or death due to any cause (assessed up to approximately 2.5 years)
Secondary Duration of Response (DOR) According to Investigator as Per Lugano Classification, Using PET or CT Scan DOR was defined as time from CMR/CR or PMR/PR until progressive disease (PD) or death due to any cause. CMR, CR, PMR, and PR have been defined in previous endpoints, and are not repeated here due to space constraint. PD: a score 4 (uptake moderately >liver) or 5 (uptake markedly >liver and/or new lesions) with increase in intensity of uptake from baseline on PET 5-PS for individual target nodes/nodal lesions; new FDG-avid foci for extranodal lesions; new FDG-avid foci consistent with lymphoma for new lesions; or new or recurrent FDG-avid foci for bone marrow. Assessment was performed by Investigator according to Lugano classification using PET scan or CT scan (if PET is missing). DOR was calculated using Kaplan-Meier method. From CMR or PMR until disease progression or death due to any cause (assessed up to approximately 2.5 years)
Secondary Percentage of Participants With Disease Progression (According to Investigator as Per Lugano Classification, Using PET or CT Scan) or Death PD: a score 4 (uptake moderately >liver) or 5 (uptake markedly >liver and/or new lesions) with increase in intensity of uptake from baseline on PET 5-PS for individual target nodes/nodal lesions; new FDG-avid foci for extranodal lesions; new FDG-avid foci consistent with lymphoma for new lesions; or new or recurrent FDG-avid foci for bone marrow. Assessment was performed by Investigator according to Lugano classification using PET or CT scan. Baseline until disease progression or death due to any cause (assessed up to approximately 2.5 years)
Secondary Progression-Free Survival (PFS) According to Investigator as Per Lugano Classification, Using PET or CT Scan PFS was defined as the period from the date of treatment initiation (Safety Run-in and Arm A) or randomization date (Arms B and C) until the date of disease progression, or death due to any cause. PD: a score 4 (uptake moderately >liver) or 5 (uptake markedly >liver and/or new lesions) with increase in intensity of uptake from baseline on PET 5-PS for individual target nodes/nodal lesions; new FDG-avid foci for extranodal lesions; new FDG-avid foci consistent with lymphoma for new lesions; or new or recurrent FDG-avid foci for bone marrow. Assessment was performed by Investigator according to Lugano classification using PET or CT scan. PFS was calculated using Kaplan-Meier method. Baseline until disease progression or death due to any cause (assessed up to approximately 2.5 years)
Secondary Percentage of Participants With Disease Progression (According to Investigator as Per Lugano Classification, Using PET or CT Scan), Death, or Start of a New Anti-lymphoma Therapy PD: a score 4 (uptake moderately >liver) or 5 (uptake markedly >liver and/or new lesions) with increase in intensity of uptake from baseline on PET 5-PS for individual target nodes/nodal lesions; new FDG-avid foci for extranodal lesions; new FDG-avid foci consistent with lymphoma for new lesions; or new or recurrent FDG-avid foci for bone marrow. Assessment was performed by Investigator according to Lugano classification using PET or CT scan. Baseline until disease progression, death, or start of a new anti-lymphoma therapy whichever occurred first (assessed up to approximately 2.5 years)
Secondary Event-Free Survival (EFS) According to Investigator as Per Lugano Classification, Using PET or CT Scan EFS was defined as the period from the date of treatment initiation (Safety Run-in and Arm A) or randomization date (Arms B and C) to the date of disease progression, death, or start of a new anti-lymphoma therapy whichever occurred first. PD: a score 4 (uptake moderately >liver) or 5 (uptake markedly >liver and/or new lesions) with increase in intensity of uptake from baseline on PET 5-PS for individual target nodes/nodal lesions; new FDG-avid foci for extranodal lesions; new FDG-avid foci consistent with lymphoma for new lesions; or new or recurrent FDG-avid foci for bone marrow. Assessment was performed by Investigator according to Lugano classification using PET or CT scan. EFS was calculated using Kaplan-Meier method. Baseline until disease progression, death, or start of a new anti-lymphoma therapy whichever occurred first (assessed up to approximately 2.5 years)
Secondary Percentage of Participants Who Died Due to Any Cause Baseline until death due to any cause (assessed up to approximately 2.5 years
Secondary Overall Survival (OS) OS was defined as the period from the date of treatment initiation (Safety Run-in and Arm A) or randomization date (Arms B and C) to death due to any cause. For participants who are alive, OS was censored at the last contact. OS was calculated using Kaplan-Meier method. Baseline until death due to any cause (assessed up to approximately 2.5 years)
Secondary Apparent Clearance (CL) of Venetoclax CL is a quantitative measure of the rate at which a drug substance is removed from the body. Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
Secondary Apparent Volume of Distribution (Vd) of Venetoclax Vd was defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
Secondary Time to Maximum Plasma Concentration (Tmax) of Venetoclax Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
Secondary Maximum Plasma Concentration (Cmax) of Venetoclax Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
Secondary Area Under the Plasma Concentration-Time Curve From Time 0 to Last Observed Concentration (AUClast) of Venetoclax Area under the plasma concentration versus time curve from zero to the last measured concentration (AUClast). Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
Secondary Area Under the Plasma Concentration-Time Curve From Time 0 to 8 Hours Post Dose (AUC0-8h) of Venetoclax Area under the plasma concentration versus time curve from time 0 (pre-dose) to 8 hours post dose (AUC0-8h). Pre-dose (within 30 minutes), and 2, 4, 6, 8 hours post-dose on Cycle 1 Day 1; pre-dose (within 30 minutes) on Cycle 1 Days 8, 15, 22; pre-dose (within 30 minutes) and 4 hours post-dose on Day 1 of Cycles 4 and 6 (Cycle length = 28 days)
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