An open-label, prospective Phase III clinical study to compare polatuzumab vedotin plus rituximab, ifosfamide, carboplatin and etoposide (Pola-R-ICE) with rituximab, ifosfamide, carboplatin and etoposide (R-ICE) alone as salvage therapy in patients with primary refractory or relapsed diffuse large B-cell lymphoma (DLBCL)
The study is designed as an international, multicenter, open-label, two-arm, prospective phase III study to compare the treatment of polatuzumab vedotin plus rituximab, ifosfamide, carboplatin and etoposide (Pola-R-ICE) with the combination of rituximab, ifosfamide, carboplatin and etoposide (R-ICE) alone as salvage therapy in patients with primary refractory or relapsed DLBCL. The study will involve study sites in Germany, UK, Spain, and Austria. It is planned to include 324 patients who will be randomized 1:1 to receive either treatment in the experimental arm (Pola-R-ICE) or in the standard arm (R-ICE) to end up with 308 evaluable subjects for the randomized part of the trial. Further 10 patients will be treated with Pola-R-ICE during the safety run-in phase. The study consists of a screening/inclusion visit, three chemotherapy cycles, an end-of - treatment visit (EoT), and follow-up visits. For each subject, the total duration of the study will be approximately 3 months of treatment plus at least 21 months follow-up. The study will end when the last included patient will have passed the last follow-up visit (LPLFU). For the study as a whole, the primary outcome will be evaluated when the last included patient will have completed the 21 months follow-up period or has left the study prematurely. For the study as a whole, the primary outcome will be evaluated when the last included patient will have completed the 21 months follow-up period or has left the study prematurely.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
306
Polatuzumab vedotin 1.8 mg/kg will be administered intravenously on Day 1 of each 21-day cycle for up to 3 cycles.
Rituximab (Mabthera/Rituxan®) will be administered as per local practice at a dose of 375 mg/m2 intravenously on Day 1 of each 21-day cycle for up to 3 cycles.
Ifosfamide 5000 mg/m² will be administered i.v. over a 24 hr period starting on cycle Day 2.
Carboplatin AUC 5 max 800 mg will be administered i.v. on cycle Day 2.
Etoposide 100 mg/m² will be administered i.v. on cycle Days 1, 2 and 3.
UK Graz Universitätsklinik für Innere Medizin Klinische Abteilung für Hämatologie
Graz, Austria
LKH Hochsteiermark Standort Leoben Abteilung für Innere Medizin Department für Hämato-Onkologie
Leoben, Austria
Ordensklinikum Linz GmbH- Elisabethinen: I. Interne Abteilung Hämato-Onkologie
Linz, Austria
Kepler Universitätsklinikum Med Campus III, Univ.-Klinik für Hämatologie und Internistische Onkologie
Linz, Austria
Landeskrankenhaus Salzburg
Salzburg, Austria
Assessment of the event-free survival of patients with DLBCL at first progression and the occurrence of any of the following events:
* Failure to achieve sufficient response in PET-CT (Deauville score 3 or less) at end of study treatment (metabolic CR) * Disease progression (PD) * Start of additional unplanned anti-tumor treatment (radiation therapy allowed) * Relapse after achieving CR * Death due to any cause
Time frame: Day of randomization until end of follow up (12 weeks treatment and at least 21 months follow up)
Assessment of the rate of metabolic complete response.
Number of complete remissions.
Time frame: Day of randomization until end weeks 12 treatment.
Evaluation of the partial response rate.
Number of partial responses.
Time frame: Day of randomization until end of 12 weeks treatment.
Assessment of the overall response rate.
Number of complete and partial responses.
Time frame: Day of randomization until end of 12 weeks treatment.
Assessment duration of response.
Time from documentation of tumor response to disease progression or relapse.
Time frame: Day of randomization until end of follow up (12 weeks treatment and at least 21 months follow up)
Assessment of the rate of progressive disease.
Number of progressive diseases.
Time frame: Day of randomization until end of 12 weeks treatment.
Assessment of disease relapse.
Number of relapses.
Time frame: Day of randomization until end of 12 weeks treatment.
Assessment of progression free survival.
Occurence of disease progression, relapse or death due to any cause.
Time frame: Day of randomization until end of follow up (12 weeks treatment and at least 21 months follow up)
Assessment of overall survival.
Time frame: Day of randomization until end of follow up (12 weeks treatment and at least 21 months follow up)
Assessment of the rate of patients proceeding to transplantation.
Time frame: Day of randomization until week 12.
Assessment of the rate of patients with non-relapse mortality.
Time frame: Day of randomization until end of follow up (12 weeks treatment and at least 21 months follow up)
Evaluation of the frequency of adverse and serious adverse events including the incidence and duration of the adverse events neutropenia and thrombocytopenia with grade 4.
Time frame: Day of Randomization until 28 days after start of last cycle or start of further therapy
Assessment of the number of patients with treatment-related death.
Time frame: Day of Randomization until up week 12 or 2 months after week 12 but before start of further therapy
To determine the number of patients with occurence of second malignancies
Time frame: Day of Randomization until Day of randomization until end of follow up (at least 21 months follow up)
Assessment of the protocol adherence by the rate and duration of chemotherapy cycles patients received.
Time frame: Day of Randomizaton until week 12.
Assessment of the cumulative and relative dose of each IMP( ifosfamide, carboplatin and etoposide, rituximab and of the polatuzumab vedotin) by quantitative measurement.
Time frame: Day of Randomizaton until week 12.
Assessment of the change in health related quality of life by generic questionnaire.
Scale scores to be obtained for the multi-items scales. Range in score from 0 to 100. A high scale score represents a higher response level.
Time frame: Day of Randomization until weeks 12 and months 3 and 12 in follow up.
Assessment of the change in health related quality of life by five-item questionnaire.
Time frame: Day of Randomization until weeks 12 and months 3 and 12 in follow up
Assessment visual analogue scale to measure health state.
This scale is provided with numbers from 0 to 100.100 is the best health state and 0 (zero) is the worst health state.
Time frame: Day of Randomization until weeks 12 and months 3 and 12 in follow up
Functional assessment of the cancer therapy-lymphoma by general questions and specific questions for lymphoma.
Assessment how lymphoma-specific symptoms impact quality of life.
Time frame: Day of Randomization until weeks 12 and months 3 and 12 in follow up.
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AKH Meduni Wien Universitätsklinik für Innere Medizin I:
Vienna, Austria
Hanusch Krankenhaus
Vienna, Austria
Klinikum Wels-Grieskirchen Abteilung für Innere Medizin IV
Wels, Austria
Universitätsklinikum RWTH-Aachen
Aachen, Germany
HELIOS Klinik Berlin-Buch, Klinik für Hämatologie und Stammzelltransplantation
Berlin, Germany
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