Diffuse Large B-Cell Lymphoma, Not Otherwise Specified Clinical Trial
Official title:
Selinexor Combined With R-GemOx as Second-line Treatment in Patients With Diffuse Large B-cell Lymphoma: a Single-arm, Single-centre, Open-label Trial
The goal of this interventional study is to evaluate efficiency and safety in prior one-line treated diffuse large B-cell lymphoma. The main questions it aims to answer are: - Complete remission rate - Objective remission rate - Progression-free survival - tolerance Participants will recevied a minimum of 2 and a maximum of 6 cycles of R-GemOx(rituximab 375 mg/m2 IV on day 1 , Gemcitabine 1000 mg/m2, Oxaliplatin 100 mg/m2 IV on day 2) and 60 mg selinexor on days 1, 8, and 15 of each cycle
Status | Recruiting |
Enrollment | 32 |
Est. completion date | September 30, 2024 |
Est. primary completion date | March 31, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 75 Years |
Eligibility | Inclusion Criteria: - Have pathologically confirmed CD20 positive de novo DLBCL or DLBCL transformed from previously diagnosed indolent lymphoma (e.g., follicular lymphoma) - HIV-seropositive - Age 18-75 years - ECOG PS=2 - Positron emission tomography (PET) positive measurable disease with at least one node having the longest diameter (LDi)>1.5cm or one extranodal lesion with LDi>1cm (per the Lugano Criteria 2014) (Documentation to be provided) - Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) = 2.5 × Upper limit of normal value (ULN), or = 5 in the presence of known lymphoma involving the liver × ULN; Total serum bilirubin = 2 × ULN, or = 5 when Gilbert syndrome or known lymphoma affects the liver × ULN; Creatinine clearance (CrCl) calculated according to Cockcroft Gault formula = 30 mL/min; - Absolute neutrophil count (ANC)=1.5×10^9/L,or Platelet count=75×10^9/L(No platelet were transfused within 14 days before the treatment of the study drug),or Hemoglobin=80g/L(No red blood cells were transfused within 14 days before the treatment of the study drug) - Written informed consent in accordance with federal, local, and institutional guidelines - Patients understanding the characteristics of the disease and voluntarily joins the study program for treatment and follow-up - No other serious diseases in conflict with this program - Investigator believe that subjects can benefit Exclusion Criteria: - Patients with known central nervous system involvement by lymphoma; - Patients with a history of autoimmune diseases or syndrome requiring systemic use of steroid, such as hypophysitis, pneumonia, colitis, hepatitis, nephritis, hyperthyroidism and hypothyroidism - Patients received systemic glucocorticoid (prednisone >20mg/d) or any other immunosuppressive therapy within 7 days before the first administration,excluding nasal spray inhalation or other topical glucocorticoids; - Uncontrolled heart diseases, including unstable angina pectoris, acute myocardial infarction 6 months before randomization, congestive heart failure (NYHA), cardiac function grade greater than grade III or IV, or left ventricular ejection fraction<50%; - Patients previously treated with selinexor; - History of severe allergic reactions (as determined by treating physician) attributed to the drugs being used in the study; - Patients undergoing organ transplantation; - Diagnosed as malignant tumor other than lymphoma or receiving treatment,excluding: 1. Malignant tumors that have received treatment for the purpose of cure and have not developed known active diseases for = 5 years before enrollment 2. Basal cell carcinoma of the skin (excluding melanoma) with adequate treatment and no signs of disease 3. Cervical carcinoma in situ with adequate treatment and no signs of disease - Patients with grade 2 or more neurotoxicity occurred within two weeks before treatment; - Severe infection; - Drug abuse, medical psychological or social conditions that may interfere with the subject's participation in the study or the evaluation of the results of the study; - Any active, serious psychiatric, medical, or other conditions/situations which, in the treating physician's opinion, could compromise the patient's safety |
Country | Name | City | State |
---|---|---|---|
China | Chongqing University Cancer Hospital | Chongqing | Chongqing |
Lead Sponsor | Collaborator |
---|---|
Chongqing University Cancer Hospital |
China,
Arboe B, Olsen MH, Gorlov JS, Duun-Henriksen AK, Dalton SO, Johansen C, de Nully Brown P. Treatment intensity and survival in patients with relapsed or refractory diffuse large B-cell lymphoma in Denmark: a real-life population-based study. Clin Epidemiol — View Citation
Azizian NG, Li Y. XPO1-dependent nuclear export as a target for cancer therapy. J Hematol Oncol. 2020 Jun 1;13(1):61. doi: 10.1186/s13045-020-00903-4. — View Citation
Cazelles C, Belhadj K, Vellemans H, Camus V, Poullot E, Gaulard P, Veresezan L, Itti E, Becker S, Carvalho M, Dupuis J, Le Bras F, Lemonnier F, Roulin L, El Gnaoui T, Jardin F, Mounier N, Tilly H, Haioun C. Rituximab plus gemcitabine and oxaliplatin (R-Ge — View Citation
Corazzelli G, Capobianco G, Arcamone M, Ballerini PF, Iannitto E, Russo F, Frigeri F, Becchimanzi C, Marcacci G, De Chiara A, Pinto A. Long-term results of gemcitabine plus oxaliplatin with and without rituximab as salvage treatment for transplant-ineligi — View Citation
Corno C, Stucchi S, De Cesare M, Carenini N, Stamatakos S, Ciusani E, Minoli L, Scanziani E, Argueta C, Landesman Y, Zaffaroni N, Gatti L, Perego P. FoxO-1 contributes to the efficacy of the combination of the XPO1 inhibitor selinexor and cisplatin in ova — View Citation
Crump M, Neelapu SS, Farooq U, et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017;130(16):1800-1808. Blood. 2018 Feb 1;131(5):587-588. doi: 10.1182/blood-2017-11-817775. No abstract ava — View Citation
Cunningham D, Hawkes EA, Jack A, Qian W, Smith P, Mouncey P, Pocock C, Ardeshna KM, Radford JA, McMillan A, Davies J, Turner D, Kruger A, Johnson P, Gambell J, Linch D. Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone in patient — View Citation
Deng M, Zhang M, Xu-Monette ZY, Pham LV, Tzankov A, Visco C, Fang X, Bhagat G, Zhu F, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Choi WWL, Huh J, Ponzoni M, Ferreri AJM, Moller MB, Parsons BM, van Krieken JH, Piris MA, Winter JN, Hagemeister F, Alinari L, Li — View Citation
Gandhi UH, Senapedis W, Baloglu E, Unger TJ, Chari A, Vogl D, Cornell RF. Clinical Implications of Targeting XPO1-mediated Nuclear Export in Multiple Myeloma. Clin Lymphoma Myeloma Leuk. 2018 May;18(5):335-345. doi: 10.1016/j.clml.2018.03.003. Epub 2018 M — View Citation
Gisselbrecht C, Glass B, Mounier N, Singh Gill D, Linch DC, Trneny M, Bosly A, Ketterer N, Shpilberg O, Hagberg H, Ma D, Briere J, Moskowitz CH, Schmitz N. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituxima — View Citation
Harris LJ, Patel K, Martin M. Novel Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma. Int J Mol Sci. 2020 Nov 13;21(22):8553. doi: 10.3390/ijms21228553. — View Citation
Kalakonda N, Maerevoet M, Cavallo F, Follows G, Goy A, Vermaat JSP, Casasnovas O, Hamad N, Zijlstra JM, Bakhshi S, Bouabdallah R, Choquet S, Gurion R, Hill B, Jaeger U, Sancho JM, Schuster M, Thieblemont C, De la Cruz F, Egyed M, Mishra S, Offner F, Vassi — View Citation
Kazim S, Malafa MP, Coppola D, Husain K, Zibadi S, Kashyap T, Crochiere M, Landesman Y, Rashal T, Sullivan DM, Mahipal A. Selective Nuclear Export Inhibitor KPT-330 Enhances the Antitumor Activity of Gemcitabine in Human Pancreatic Cancer. Mol Cancer Ther — View Citation
Krok-Schoen JL, Fisher JL, Stephens JA, Mims A, Ayyappan S, Woyach JA, Rosko AE. Incidence and survival of hematological cancers among adults ages >/=75 years. Cancer Med. 2018 Jul;7(7):3425-3433. doi: 10.1002/cam4.1461. Epub 2018 Apr 13. — View Citation
Mounier N, El Gnaoui T, Tilly H, Canioni D, Sebban C, Casasnovas RO, Delarue R, Sonet A, Beaussart P, Petrella T, Castaigne S, Bologna S, Salles G, Rahmouni A, Gaulard P, Haioun C. Rituximab plus gemcitabine and oxaliplatin in patients with refractory/rel — View Citation
Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, Lopez-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuh — View Citation
Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgk — View Citation
* Note: There are 17 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Complete remission rate | Response rates will be estimated as proportions with 95% Wilson confidence intervals | UP to 2 years | |
Secondary | Progression-free survival | PFS will be described with Kaplan-Meier curves and estimated medians with 95% confidence intervals | From baseline to disease progression or death from any cause, assessed up to 2 years | |
Secondary | Objective remission rate | Response rates will be estimated as proportions with 95% Wilson confidence intervals | UP to 2 years |
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