Aim of this trial is to assess the efficacy of new anti-CD20 antibody (GA101) in association with DHAP as induction therapy before high dose chemotherapy BEAM with ASCT in patients with relapsed/refractory DLBCL.
This is a prospective, multicenter, single arm, phase II trial in young patients (18-65 years) affected by relapsed/refractory Diffuse Large B-cell Lymphoma (DLBCL) at diagnosis,eligible to high-dose therapy. Aim of the study is to assess whether the addition of GA101 to DHAP is more promising than standard R-DHAP, as induction therapy before high dose chemotherapy BEAM with ASCT with respect to response. The study is designed primarily to evaluate the efficacy of GA101-DHAP in patients with DLBCL who have relapsed or are refractory to one chemotherapy regimen and secondarily to assess safety and capability to mobilize peripheral stem cells The study is designed with two stages and with stopping rules after the first stage. In particular, at the end of the first stage, the study will be stopped if the efficacy is too low or if the toxicity, measured during the drug administration period, is too high with respect to pre-defined thresholds. .
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
29
Aim of the study is to assess whether the addition of GA101 to DHAP is more promising than standard R-DHAP, as induction therapy before high dose chemotherapy BEAM with ASCT with respect to response. Scheme of treatment: * GA101 1000 mg iv day 1, 8, 15 on first cycle (starting from cycle 2, GA101 1000 mg day 1) * Cisplatin 100 mg/sqm iv day 1 of every cycles in 24-hours infusion * Cytarabine 2000 mg/sqm in 3-hours infusion every 12 hours iv day 2 of every cycles * Dexamethasone 40 mg day 1-4 of every cycles * Pegfilgrastim 6 mg sc single dose 24 hours after the end of chemotherapy or G-CSF from day 4 till stem cell harvest during mobilization's course (II o III cycle GA101-DHAP) * GA101 1000 mg iv 24 hours before apheresis as purging in vivo during second courses of therapy
Ospedale San Bortolo
Vicenza, VI, Italy
Ospedale di Bolzano, Reparto di Ematologia & CTMO
Bolzano, Italy
A.O. Universitaria Careggi
Florence, Italy
Ospedale dell'Angelo, U.O. Ematologia
Aim of this trial is to assess the efficacy of new anti-CD20 antibody (GA101) in association with DHAP as induction therapy before high dose chemotherapy BEAM with ASCT in patients with relapsed/refractory DLBCL.
Primary objective is to assess whether the treatment achieves an absolute increase of the CR proportion of at least 20% (from 30% to 50%) with respect to the standard treatment. The complete response rate (CR) evaluated by PET scan after four cycles of GA101-DHAP before ASCT according to Cheson criteria.
Time frame: 4 months
Overall Response Rate (ORR) prior to consolidation with BEAM and ASCT
A patient is defined as a responder if she/he has a complete or partial response, evaluated by PET/TC, after four cycles of GA101-DHAP
Time frame: 2 years
Progression free survival (PFS) at 6 month after the end of treatment (EOT)
Measured from the date of starting salvage therapy to the date of disease progression, relapse or death from any cause. Responding patients and patients who are lost to follow up will be surveyed at their last assessment date.
Time frame: 6 month
Overall Survival (OS) at 2 years after the EOT
Measured from the date of starting salvage therapy to the date of death from any cause. Patients alive at the time of the final analysis will be surveyed at the date of the last contact. For both PFS and OS minimum follow up time required for all patients will be 2 years.
Time frame: 2 years
Toxicity: Severe, life-threatening, fatal (grade 3, 4 and 5) and/or serious adverse events
Severe, life-threatening, fatal (grade 3, 4 and 5) and/or serious adverse events are defined according to "Common Terminology Criteria for Adverse Events" (CTCAE), version 4.0. and adverse events of special interests (AESI)
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Mestre, Italy
A.O. Universitaria Policlinico Di Modena
Modena, Italy
Ematologia Policlinico San Matteo
Pavia, Italy
AO di Perugia S. Maria della misericordia
Perugia, Italy
Ematologia Ospedale S.Camillo Forlanini
Roma, Italy
Policlinico Umberto I - Università "La Sapienza"
Roma, Italy
Ematologia e Trapianto Istituto Regina Elena IFO
Roma, Italy
Time frame: 2 years
The hematopoietic cell mobilization
Mobilizing potential: amount of CD34 + stem cell collected /Kg
Time frame: 2 years
Feasibility: the rate of patients actually proceeding to ASCT
Proportion of patients successfully completing ASCT
Time frame: 2 years