Lymphoma Clinical Trial
Official title:
A Phase II Study of Plitidepsin in Patients With Relapsed or Refractory Angioimmunoblastic T-cell Lymphoma
Prospective, multicenter, phase II clinical trial to determine the efficacy of plitidepsin in patients with relapsed/refractory (R/R) angioimmunoblastic Tcell lymphoma (AITL).This is an international, multicenter study (with approximately 17 investigative sites).
Prospective, multicenter, phase II clinical trial to determine the efficacy of plitidepsin in
patients with relapsed/refractory (R/R) AITL. The primary endpoint will be overall response
rate (ORR) according to the Lugano classification response criteria per independent review.
Medical specialists (radiologists and hematologists) who are directly involved in the care of
patients with AITL (but are not participating in this trial as investigators) will review all
efficacy data (including radiological assessments, bone marrow biopsies) and will assign the
best response and the date of objective response or progression/censoring according to their
independent evaluation.
Central pathological review of each patient's original diagnosis report(s) will be required
before inclusion.
Two futility analyses of the primary endpoint (ORR according to the Lugano classification
criteria and per Independent Review Committee (IRC)) are planned around six months after
approximately 25% and 50% of eligible patients (i.e., 15 and 30 patients respectively with
AITL confirmed by central pathological review) have been treated. Two or less responders out
of 15 patients or seven or less responders out of 30 patients, according to boundaries and
sample size assumptions, will mean that the alternative hypothesis could be rejected, and
thus recruitment might be stopped at the time of the first or second futility analysis,
respectively. Otherwise, accrual will continue to 60 patients with AITL confirmed by central
pathological review. This decision will be taken at the time by an Independent Data
Monitoring Committee (IDMC). The IDMC, which will include specialists in peripheral T-cell
lymphomas (PTCL) supported by a medical statistician, will review data provided by the
Investigators, the IRC efficacy assessments and safety information and will advise whether
the study should continue. Recruitment can continue during the review period.
If there are 19 or more responders of 60 patients, the efficacy of plitidepsin will be
considered as clinically relevant in AITL patients.
Central pathological review will be conducted by experienced pathologists appointed by the
Sponsor and available to the investigative sites for consultation about AITL diagnosis
confirmation. Central pathological review is required for (a) local histopathology reports
prior to patient treatment, and (b) tumor samples before each futility analysis and at the
end of the study.
The central laboratory pathologists will be responsible for (a) approving patient inclusion
on the basis of investigative site pathology reports provided during screening, (b) analyzing
tumor biopsies (initial diagnosis and/or relapses) to confirm the AITL diagnosis, and (c)
analyzing blood samples to identify plasma biomarkers and extract DNA.
Tumor samples (initial diagnosis and relapses) are required for central review to confirm
AITL diagnosis but not to approve inclusion. Archived tissue samples of representative tumors
must be sent for central review and biomarker analysis. If the diagnosis biopsy is not
available (because the patient was diagnosed at another site, for example), the most recent
representative biopsy (relapse and/or progression) will be used. Submitting both, however, is
strongly recommended. Tumor blocks will be returned to the centers.
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