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出境医 / 临床实验 / Sintilimab Plus R-CHOP as the First-line Treatment in Patients With Diffuse Large B-Cell Lymphoma.

Sintilimab Plus R-CHOP as the First-line Treatment in Patients With Diffuse Large B-Cell Lymphoma.

Study Description
Brief Summary:
The purpose of this study is to evaluate the efficacy and safety of Sintilimab and R-CHOP regimen as the first-line treatment for DLBCL patients with TP53 mutation and PD-L1 positive.

Condition or disease Intervention/treatment Phase
Diffuse Large B-Cell Lymphoma Sintilimab TP53 Mutation Drug: Sintilimab-R-CHOP Phase 2

Detailed Description:
This Phase II, open-label, single-center, non-randomized study will evaluate the safety and efficacy of induction treatment consisting of Sintilimab in combination with Rituximab plus chemotherapy (R-CHOP) as the first-line treatment in participants with DLBCL, followed by consolidation treatment with Sintilimab alone in patients who achieve CR at the end of induction.For safety reasons, the initial enrollment of the first 6 patients in the study will be slow and conduct intensive monitoring for safety. If the dose-limited toxicity event was observed in more than 2 of the first 6 patients and was assessed caused by cumulative exposure to the study drug combination therapy, the trial will be stopped.This study also aim to evaluate the correlation of clinical efficacy to the expression of PD-L1,PD-1,CD3,CD4,CD8,CD56,CD58,β2-MG,HLA-DR/DP/DQ and so on by immunohistochemical techniques.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Study of Sintilimab Plus R-CHOP as the First-line Treatment for DLBCL Patients With TP53 Mutation and PD-L1 Positive.
Estimated Study Start Date : December 1, 2019
Estimated Primary Completion Date : July 30, 2020
Estimated Study Completion Date : July 30, 2021
Arms and Interventions
Arm Intervention/treatment
Experimental: Sintilimab-R-CHOP
Participants with previously untreated DLBCL will receive rituximab and CHOP during Cycle 1 (21-day cycle) and Sintilimab, rituximab, and CHOP during Cycles 2-6 (21-day cycle) ,Sintilimab and rituximab during Cycles 6-8 (21-day cycle) , followed by Sintilimab from Cycles 9-14 (8-week cycle) during consolidation treatment.
Drug: Sintilimab-R-CHOP

Drug:Sintilimab:

Sintilimab:200 mg IV on Day 1 Cycles 2-8, during induction treatment, followed by 200 mg IV on Day 1 of Cycles 9-14.

Drug: Rituximab Rituximab:Participants with previously untreated DLBCL will receive rituximab at a dose of 375 mg/m^2 IV on Day 1 of Cycle 1-8, during induction treatment.

Drug: Cyclophosphamide Cyclophosphamide will be administered at a dose of 750 mg/m^2 IV on Day 2 of Cycle 1-6, during induction treatment.

Drug: Doxorubicin Hydrochloride Liposome Injection Doxorubicin Hydrochloride Liposome Injection will be administered at a dose of 35 mg/m^2 IV on Day 2-3 of Cycle 1-6, during induction treatment.

Drug: Vincristine Vincristine will be administered at a dose of 1.4 mg/m^2 (maximum 2 mg) IV on Day 2 of Cycle 1-6, during induction treatment.

Drug: Prednisone Prednisone will be administered at a dose of 40 mg/m^2 orally on Days 1-5 of Cycle 1-6, during induction treatment. Prednisolone may be given if prednisone is unavailable.


Outcome Measures
Primary Outcome Measures :
  1. complete remission rate [ Time Frame: every 3 months until 30 months after the last patient's enrollment. ]
    complete remission rate after treated by Sintilimab+ R-CHOP regimen.


Secondary Outcome Measures :
  1. overall survival [ Time Frame: 30 months after the last patient's enrollment ]
    from the date of inclusion to date of death, irrespective of cause

  2. adverse events [ Time Frame: from the date of first cycle of treatment to 30 months after last patient's enrollment ]
    any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure.For safety reasons, the initial enrollment of the first 6 patients in the study will be slow and conduct intensive monitoring for safety. the monitoring time window for each patient is 21 days after the first treatment. If the dose-limited toxicity event was observed in more than 2 of the first 6 patients and was assessed by the research team as caused by cumulative exposure to the study drug combination therapy, the trial will be stopped.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Diagnosed as diffuse large B-cell Lymphoma with positive CD20 results;
  2. Age between 18 to 70 years old;
  3. World health organization-Eastern Cooperative Oncology Group Performance Status (ECOG) 0-2;
  4. No history of malignant tumors, having no tumor other than DLBCL at the time of enrollment;
  5. Life expectancy no less than 6 months;
  6. The patient or his/her attorney would be able to provide written consent for necessary examinations or procedures;
  7. Ann Arbor stage I~ IV
  8. previously untreated advanced DLBCL.
  9. At least one bi-dimensionally measurable lesion (greater than [>] 1.5 centimeters in its largest dimension by CT scan or magnetic resonance imaging)
  10. Availability of a representative tumor specimen and the corresponding pathology report for retrospective central confirmation of the diagnosis of DLBCL.
  11. Agree to remain abstinent or use contraceptive measures.

Exclusion Criteria:

  1. History of autologous stem cell transplantation,radiotherapy or chemotherapy.
  2. History of other malignant tumors, except skin basal cell carcinoma and in situ cervical cancer;
  3. With uncontrolled cardiovascular/ cerebrovascular disease, coagulation disorders, connective tissue disease, severe infectious diseases;
  4. Lymphoma originated in the central nervous system;
  5. Left ventricular ejection fraction ≦50%;
  6. Abnormal lab results in enrollment:Neutrophil count: <1.5*10^9/L;Platelet count <75*10^9/L;AST or ALT >2 times the upper limit of normal level,AKP and total bilirubin >1.5 times the upper limit of normal level;serum creatinine >1.5 times the upper limit of normal level;
  7. Other uncontrolled medical conditions which the investigators think might influence the results of the trial;
  8. Patients with mental illnesses or other diseases that might not comply with the trial plan;
  9. Women during pregnancy or lactation;
  10. HIV positive patients;
  11. HbsAg (+) patients with HBV DNA(+), can be enrolled only when his/her HBV DNA turns negative; patients with HBsAg(-) HBcAb(+) can be enrolled only when his/her HBV DNA turns negative;
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Yuankai Shi, M.D 86 010-87788293 syuankaipumc@126.com
Contact: Yan Qin, M.D 86 010-87788293 13601282738@163.com

Sponsors and Collaborators
Chinese Academy of Medical Sciences
Investigators
Layout table for investigator information
Principal Investigator: Yuankai Shi, M.D Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Tracking Information
First Submitted Date  ICMJE July 16, 2019
First Posted Date  ICMJE July 18, 2019
Last Update Posted Date December 11, 2019
Estimated Study Start Date  ICMJE December 1, 2019
Estimated Primary Completion Date July 30, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 16, 2019)
complete remission rate [ Time Frame: every 3 months until 30 months after the last patient's enrollment. ]
complete remission rate after treated by Sintilimab+ R-CHOP regimen.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: December 9, 2019)
  • overall survival [ Time Frame: 30 months after the last patient's enrollment ]
    from the date of inclusion to date of death, irrespective of cause
  • adverse events [ Time Frame: from the date of first cycle of treatment to 30 months after last patient's enrollment ]
    any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure.For safety reasons, the initial enrollment of the first 6 patients in the study will be slow and conduct intensive monitoring for safety. the monitoring time window for each patient is 21 days after the first treatment. If the dose-limited toxicity event was observed in more than 2 of the first 6 patients and was assessed by the research team as caused by cumulative exposure to the study drug combination therapy, the trial will be stopped.
Original Secondary Outcome Measures  ICMJE
 (submitted: July 16, 2019)
  • overall survival [ Time Frame: 30 months after the last patient's enrollment ]
    from the date of inclusion to date of death, irrespective of cause
  • adverse events [ Time Frame: from the date of first cycle of treatment to 30 months after last patient's enrollment ]
    any unfavorable and unintended sign , symptom, or disease temporally associated with the use of a medical treatment or procedure that may or may not be considered related to the medical treatment or procedure
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Sintilimab Plus R-CHOP as the First-line Treatment in Patients With Diffuse Large B-Cell Lymphoma.
Official Title  ICMJE Phase II Study of Sintilimab Plus R-CHOP as the First-line Treatment for DLBCL Patients With TP53 Mutation and PD-L1 Positive.
Brief Summary The purpose of this study is to evaluate the efficacy and safety of Sintilimab and R-CHOP regimen as the first-line treatment for DLBCL patients with TP53 mutation and PD-L1 positive.
Detailed Description This Phase II, open-label, single-center, non-randomized study will evaluate the safety and efficacy of induction treatment consisting of Sintilimab in combination with Rituximab plus chemotherapy (R-CHOP) as the first-line treatment in participants with DLBCL, followed by consolidation treatment with Sintilimab alone in patients who achieve CR at the end of induction.For safety reasons, the initial enrollment of the first 6 patients in the study will be slow and conduct intensive monitoring for safety. If the dose-limited toxicity event was observed in more than 2 of the first 6 patients and was assessed caused by cumulative exposure to the study drug combination therapy, the trial will be stopped.This study also aim to evaluate the correlation of clinical efficacy to the expression of PD-L1,PD-1,CD3,CD4,CD8,CD56,CD58,β2-MG,HLA-DR/DP/DQ and so on by immunohistochemical techniques.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Diffuse Large B-Cell Lymphoma
  • Sintilimab
  • TP53 Mutation
Intervention  ICMJE Drug: Sintilimab-R-CHOP

Drug:Sintilimab:

Sintilimab:200 mg IV on Day 1 Cycles 2-8, during induction treatment, followed by 200 mg IV on Day 1 of Cycles 9-14.

Drug: Rituximab Rituximab:Participants with previously untreated DLBCL will receive rituximab at a dose of 375 mg/m^2 IV on Day 1 of Cycle 1-8, during induction treatment.

Drug: Cyclophosphamide Cyclophosphamide will be administered at a dose of 750 mg/m^2 IV on Day 2 of Cycle 1-6, during induction treatment.

Drug: Doxorubicin Hydrochloride Liposome Injection Doxorubicin Hydrochloride Liposome Injection will be administered at a dose of 35 mg/m^2 IV on Day 2-3 of Cycle 1-6, during induction treatment.

Drug: Vincristine Vincristine will be administered at a dose of 1.4 mg/m^2 (maximum 2 mg) IV on Day 2 of Cycle 1-6, during induction treatment.

Drug: Prednisone Prednisone will be administered at a dose of 40 mg/m^2 orally on Days 1-5 of Cycle 1-6, during induction treatment. Prednisolone may be given if prednisone is unavailable.

Study Arms  ICMJE Experimental: Sintilimab-R-CHOP
Participants with previously untreated DLBCL will receive rituximab and CHOP during Cycle 1 (21-day cycle) and Sintilimab, rituximab, and CHOP during Cycles 2-6 (21-day cycle) ,Sintilimab and rituximab during Cycles 6-8 (21-day cycle) , followed by Sintilimab from Cycles 9-14 (8-week cycle) during consolidation treatment.
Intervention: Drug: Sintilimab-R-CHOP
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Not yet recruiting
Estimated Enrollment  ICMJE
 (submitted: July 16, 2019)
30
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE July 30, 2021
Estimated Primary Completion Date July 30, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Diagnosed as diffuse large B-cell Lymphoma with positive CD20 results;
  2. Age between 18 to 70 years old;
  3. World health organization-Eastern Cooperative Oncology Group Performance Status (ECOG) 0-2;
  4. No history of malignant tumors, having no tumor other than DLBCL at the time of enrollment;
  5. Life expectancy no less than 6 months;
  6. The patient or his/her attorney would be able to provide written consent for necessary examinations or procedures;
  7. Ann Arbor stage I~ IV
  8. previously untreated advanced DLBCL.
  9. At least one bi-dimensionally measurable lesion (greater than [>] 1.5 centimeters in its largest dimension by CT scan or magnetic resonance imaging)
  10. Availability of a representative tumor specimen and the corresponding pathology report for retrospective central confirmation of the diagnosis of DLBCL.
  11. Agree to remain abstinent or use contraceptive measures.

Exclusion Criteria:

  1. History of autologous stem cell transplantation,radiotherapy or chemotherapy.
  2. History of other malignant tumors, except skin basal cell carcinoma and in situ cervical cancer;
  3. With uncontrolled cardiovascular/ cerebrovascular disease, coagulation disorders, connective tissue disease, severe infectious diseases;
  4. Lymphoma originated in the central nervous system;
  5. Left ventricular ejection fraction ≦50%;
  6. Abnormal lab results in enrollment:Neutrophil count: <1.5*10^9/L;Platelet count <75*10^9/L;AST or ALT >2 times the upper limit of normal level,AKP and total bilirubin >1.5 times the upper limit of normal level;serum creatinine >1.5 times the upper limit of normal level;
  7. Other uncontrolled medical conditions which the investigators think might influence the results of the trial;
  8. Patients with mental illnesses or other diseases that might not comply with the trial plan;
  9. Women during pregnancy or lactation;
  10. HIV positive patients;
  11. HbsAg (+) patients with HBV DNA(+), can be enrolled only when his/her HBV DNA turns negative; patients with HBsAg(-) HBcAb(+) can be enrolled only when his/her HBV DNA turns negative;
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 70 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Yuankai Shi, M.D 86 010-87788293 syuankaipumc@126.com
Contact: Yan Qin, M.D 86 010-87788293 13601282738@163.com
Listed Location Countries  ICMJE Not Provided
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04023916
Other Study ID Numbers  ICMJE NCC2066
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Shi Yuankai, Chinese Academy of Medical Sciences
Study Sponsor  ICMJE Chinese Academy of Medical Sciences
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Yuankai Shi, M.D Cancer Institute and Hospital, Chinese Academy of Medical Sciences
PRS Account Chinese Academy of Medical Sciences
Verification Date December 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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