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| ID | Type | Description | Link |
|---|---|---|---|
| 2015-005173-20 | EudraCT Number |
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This Phase 2, two-arm, open-label study is designed to evaluate the safety, clinical activity, and predictive biomarkers of durvalumab in combination with R-CHOP or R2-CHOP, followed by durvalumab consolidation therapy in previously untreated subjects with high-risk diffuse large B-cell lymphoma (DLBCL). Induction treatment with R-CHOP (± lenalidomide) will last for a total of up to 6 to 8 treatment cycles (21 day cycles), and the total time on study treatment, including durvalumab consolidation, will last up to 12 months.
On 05-Sep-2017, the US FDA has issued a Partial Clinical Hold on this study resulting in the discontinuation of enrollment into Arm B (Durvalumab + Lenalidomide + R-CHOP). After the US FDA Partial Clinical Hold, new eligible participants have been enrolled in Arm A (Durvalumab + R-CHOP).
This research study is conducted in participants with previously untreated, high-risk diffuse large B-cell lymphoma (DLBCL). Patients with high-risk DLBCL typically have insufficient therapeutic outcomes. Therefore, the addition of novel agents to the currently used induction therapy (R-CHOP) is a rational approach to improve therapeutic outcomes in this disease setting.
Based on pre-clinical and clinical observations, it is hypothesized that durvalumab will have activity in DLBCL because the PD 1/PD L1 pathway is involved in the pathophysiology of DLBCL. In particular, the addition of durvalumab may augment the anti-tumor activity of R-CHOP against high-risk DLBCL sub-types.
The safety of durvalumab has already been explored. However, as there is limited clinical experience with durvalumab in DLBCL, the study is divided into two stages:
Results posted following Primary Outcome Completion date are based on a database cut-off of August 2, 2018.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DUR + R-CHOP | Experimental | On Day 1 of each 21-day cycle, participants received durvalumab 1125 mg intravenously (IV) followed by R-CHOP (IV rituximab 375 mg/m^2, doxorubicin 50 mg/m^2, vincristine 1.4 mg/m^2 (maximum dose of 2.0 mg total), and cyclophosphamide 750 mg/m^2); Participants also were administered daily oral or IV prednisone/prednisolone 100 mg from Day 1 to 5. Induction treatment continued for a total of 6-8 cycles. Participants who achieve a complete response or partial response continue with consolidation therapy treatment consisting of durvalumab monotherapy 1500 mg by IV on Day 1 of each 28-day cycle for up to a total of 12 months. |
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| DUR + R2-CHOP | Experimental | Participants start the study on durvalumab in combination with R-CHOP (as described in Arm DUR + R-CHOP). Based on their DLBCL Cell-of-Origin subtype (test typically done between cycles 1 and 2), participants with ABC subtype continue the study taking durvalumab in combination with R2-CHOP. On Day 1 of each 21-day cycle, participants received durvalumab 1125 mg intravenously (IV) followed by R-CHOP. Participants were also administered daily oral or IV prednisone/prednisolone 100 mg from Day 1 to 5. In addition, a daily oral lenalidomide 15 mg was administered from Day 1 to 14 of each 21-day cycle. Induction treatment continued for a total of 6-8 cycles. Participants who achieve a complete response or partial response continue with consolidation therapy treatment consisting of durvalumab monotherapy 1500 mg by IV on Day 1 of each 28-day cycle for up to a total of 12 months. Enrollment into Arm B was discontinued. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Durvalumab | Drug | Durvalumab was supplied in single use vials as a liquid solution containing 500 mg (nominal) of durvalumab at a concentration of 50 mg/mL to be infused by intravenous (IV) injection. Day 1 of each treatment cycle (Induction Period and Consolidation Period) started with the administration of IV durvalumab followed by a 2-hour observation period post infusion. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants Who Achieved a Complete Response (CR) at the End of Induction Therapy | The primary efficacy analysis evaluated the complete response rate (CRR) at the end of the induction therapy in the efficacy evaluable population in a comparative manner against historical control. The response to treatment was assessed according to the 2014 International Working Group (IWG) Response Criteria for Non-Hodgkin's Lymphoma (NHL) (Cheson, 2014). CR was defined as a complete metabolic response and radiographic evidence showing target nodes/nodal masses regressed to ≤ 1.5 cm in longest diameter, no new lesions, regression of lymph nodes to normal size, absence of splenomegaly, and absence of bone marrow involvement. Clopper-Pearson two-sided 95% confidence interval is reported. Null hypothesis for the primary endpoint was rejected if the lower limit of the confidence interval for the complete response rate at the completion of the induction therapy in the efficacy evaluable population is above 55%. | From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants Who Responded During Induction and Continued Into Consolidation Therapy (Database Cutoff Date: 02-Aug-2018) | The percentage of participants who achieved a partial response (PR) or complete response (CR) at the end of Induction and continued into consolidation period in the efficacy evaluable population in a comparative manner against historical control. The response to treatment was assessed according to the 2014 International Working Group (IWG) Response Criteria for Non-Hodgkin's Lymphoma (NHL) (Cheson, 2014). CR was defined in outcome #1. PR was defined as a partial metabolic response and radiographic evidence showing ≥ 50% decrease in sum of perpendicular diameters (SPD) of up to 6 target measurable nodes and extranodal sites, no new lesions, spleen must have regressed > 50% in length beyond normal, and residual bone marrow involvement improved from baseline. Clopper-Pearson two-sided 95% confidence interval is reported. Null hypothesis was rejected if the lower limit of the confidence interval for the rate of subjects who continue consolidation therapy out of all subjects. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bristol-Myers Squibb | Bristol-Myers Squibb | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banner MD Anderson Cancer Center | Gilbert | Arizona | 85234 | United States | ||
| Parkview Research Center |
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| Label | URL |
|---|---|
| BMS Clinical Trial Information | View source |
| BMS Clinical Trial Patient Recruiting | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | DUR + R-CHOP | Participants receive Induction Therapy (21-day cycles): Durvalumab 1125 mg intravenously (IV) on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5). Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Oct 25, 2019 |
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| Rituximab | Drug | Subsequent to durvalumab infusion, rituximab was administered by IV. Rituximab administration could be split over 2 consecutive days according to local clinical practice. Rapid infusion of rituximab was not allowed in this clinical study. |
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| Doxorubicin | Drug | A component of the CHOP therapy administered by IV. CHOP therapy was administered following rituximab. |
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| Vincristine | Drug | A component of the CHOP therapy administered by IV. CHOP therapy was administered following rituximab. |
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| Cyclophosphamide | Drug | A component of the CHOP therapy administered by IV. CHOP therapy was administered following rituximab. |
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| Prednisone | Drug | Prednisone was administered as an IV infusion or by mouth (PO) on Day 1, followed by PO administration on Days 2-5 of each cycle. Prednisone could be given prior to other drugs of the CHOP therapy. It was administered after lenalidomide dosing in the R2-CHOP treatment arm. |
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| Lenalidomide | Drug | Lenalidomide was administered orally in capsule form on Days 1-14 of the DUR+R2-CHOP treatment arm only. |
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| From first dose of study drug to completion of at least one cycle in the Consolidation Period (Day 1 up to Week 52) |
| Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) CD8 T-Cell Density | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
| Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) Programmed Death Ligand - 1 (PDL1) Total Percentage | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
| Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) Programmed Death Ligand - 1 (PDL1) Percentage of Tumor Cells | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
| Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for the Interferon Gamma Score (IFNG-Score) From Ribonucleic Acid (RNA)-Sequencing Data | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
| Participants With Treatment Emergent Adverse Events (TEAE) | An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen during a study. A serious AE is any AE occurring at any dose that: • Results in death; • Is life-threatening; • Requires or prolongs existing inpatient hospitalization; • Results in persistent or significant disability/incapacity; • Is a congenital anomaly/birth defect; • Constitutes an important medical event. The Investigator assessed the relationship of each AE to study drug and graded the severity according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, Version 4.03): - Grade 1 = Mild (no limitation in activity or intervention); - Grade 2 = Moderate (some limitation in activity; no/minimal medical intervention required); - Grade 3 = Severe (marked limitation in activity; medical intervention required, hospitalization possible); - Grade 4 = Life-threatening; - Grade 5 = Death. Relation to IP is determined by the investigator. | From the date of the first dose of study drug to within 90 days after the last dose of durvalumab or 28 days after the last dose of any investigational product (IP) whichever is greater. (Up to approximately 72 weeks) |
| Fort Wayne |
| Indiana |
| 46845 |
| United States |
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| Roswell Park Cancer Institute | Buffalo | New York | 14263 | United States |
| University of Rochester Medical Center | Rochester | New York | 14642 | United States |
| Mid Ohio Oncology Hematology Inc | Columbus | Ohio | 43219 | United States |
| Swedish Cancer Institute | Seattle | Washington | 98104 | United States |
| Innsbruck Medical University Department of Internal Medicine | Innsbruck | 6020 | Austria |
| Landeskrankenhaus Salzburg | Salzburg | 5020 | Austria |
| Hanusch Krankenhaus | Vienna | 1140 | Austria |
| Local Institution - 101 | Vienna | 1190 | Austria |
| Medical University of Vienna Internalmedicine 1, Hematology | Vienna | 1190 | Austria |
| Aarhus Sygehus | Arhus C | DK-8000 | Denmark |
| Rigshospitalet, Kobenhavns Universitet - Centre for Clinical Intervention Research - The Copenhagen | Copenhagen | 2100 | Denmark |
| Odense Universitetshospital | Odense C | DK5000 | Denmark |
| (North Estonia Medical Centre) - Onkoloogia-ja Hematoloogiakliinik | Tallinn | 13419 | Estonia |
| Tartu University Hospital | Tartu | 51014 | Estonia |
| University Hospital Birmingham | Birmingham | B15 2TH | United Kingdom |
| Royal Marsden Hospital | London | SW3 6JJ | United Kingdom |
| Oxford University Hospitals NHS Trust- Churchill Hospital-Oxford Centre for Respiratory Medicine | Oxford | 0X3 7LE | United Kingdom |
| FG001 | DUR + R2-CHOP | Participants receive Induction Therapy (21-day cycles): Cycle 1 - induction therapy of durvalumab in combination with R-CHOP (as described in DUR + R-CHOP arm). Starting at cycle 2 - Durvalumab 1125 mg IV on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R2-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5; daily oral lenalidomide 15 mg from Day 1 to 14) from the cycle following COO determination until end of induction therapy (Cycle 6 or Cycle 8) or starting Cycle 1 if ABC subtype is identified prior to C1D1. Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
| Completed Induction Treatment |
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| Completed Consolidation Treatment |
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| COMPLETED |
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| NOT COMPLETED |
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Safety population
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| ID | Title | Description |
|---|---|---|
| BG000 | DUR + R-CHOP | Participants receive Induction Therapy (21-day cycles): Durvalumab 1125 mg intravenously (IV) on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5). Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
| BG001 | DUR + R2-CHOP | Participants receive Induction Therapy (21-day cycles): Cycle 1 - induction therapy of durvalumab in combination with R-CHOP (as described in DUR + R-CHOP arm). Starting at cycle 2 - Durvalumab 1125 mg IV on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R2-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5; daily oral lenalidomide 15 mg from Day 1 to 14) from the cycle following COO determination until end of induction therapy (Cycle 6 or Cycle 8) or starting Cycle 1 if ABC subtype is identified prior to C1D1. Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Age, Customized | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Eastern Cooperative Oncology Group (ECOG) | ECOG performance status is used by doctors and researchers to assess how a participant's disease is progressing, assess how the disease affects the daily living activities of the participant and determine appropriate treatment and prognosis. - 0 = Fully Active (most favorable status); - 1 = Restricted activity but ambulatory; - 2 = Ambulatory but unable to carry out work activities; - 3 = Limited Self-Care; - 4 = Completely Disabled, No self-care (least favorable status) | Count of Participants | Participants |
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| Ann Arbor Stage at Diagnosis | The criteria for Clinical Stage (Ann Arbor staging) are as below: - I: involvement of a single nodal region. - II: involvement of 2 or more lymph node regions on the same side of the diaphragm. - III: involvement of lymph node regions on both sides of the diaphragm. - IV: disseminated involvement of 1 or more extra-lymphatic sites with or without associated lymph node involvement. | Count of Participants | Participants |
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| Presence of Bulky Disease at Baseline | Bulky disease refers to the size of the tumor. - Yes = tumor diameter >= 7.0 cm. - No = tumor diameter < 7.0 cm. | Count of Participants | Participants |
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| International Prognostic Index (IPSS) Score | The IPI assesses risk of central nervous system disease according to the following scale: - 0-1: Low risk - 2: Low-Intermediate risk - 3: High-Intermediate risk - 4-5: High risk | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
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| Primary | Percentage of Participants Who Achieved a Complete Response (CR) at the End of Induction Therapy | The primary efficacy analysis evaluated the complete response rate (CRR) at the end of the induction therapy in the efficacy evaluable population in a comparative manner against historical control. The response to treatment was assessed according to the 2014 International Working Group (IWG) Response Criteria for Non-Hodgkin's Lymphoma (NHL) (Cheson, 2014). CR was defined as a complete metabolic response and radiographic evidence showing target nodes/nodal masses regressed to ≤ 1.5 cm in longest diameter, no new lesions, regression of lymph nodes to normal size, absence of splenomegaly, and absence of bone marrow involvement. Clopper-Pearson two-sided 95% confidence interval is reported. Null hypothesis for the primary endpoint was rejected if the lower limit of the confidence interval for the complete response rate at the completion of the induction therapy in the efficacy evaluable population is above 55%. | Efficacy Evaluable Population includes participants who completed at least one cycle of their assigned treatment, had a baseline assessment by CT scan and at least one post baseline tumor response assessment. | Posted | Number | 95% Confidence Interval | percentage of participants | From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
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| Secondary | Percentage of Participants Who Responded During Induction and Continued Into Consolidation Therapy (Database Cutoff Date: 02-Aug-2018) | The percentage of participants who achieved a partial response (PR) or complete response (CR) at the end of Induction and continued into consolidation period in the efficacy evaluable population in a comparative manner against historical control. The response to treatment was assessed according to the 2014 International Working Group (IWG) Response Criteria for Non-Hodgkin's Lymphoma (NHL) (Cheson, 2014). CR was defined in outcome #1. PR was defined as a partial metabolic response and radiographic evidence showing ≥ 50% decrease in sum of perpendicular diameters (SPD) of up to 6 target measurable nodes and extranodal sites, no new lesions, spleen must have regressed > 50% in length beyond normal, and residual bone marrow involvement improved from baseline. Clopper-Pearson two-sided 95% confidence interval is reported. Null hypothesis was rejected if the lower limit of the confidence interval for the rate of subjects who continue consolidation therapy out of all subjects. | Efficacy Evaluable Population includes participants who completed at least one cycle of their assigned treatment, had a baseline assessment by CT scan and at least one post baseline tumor response assessment. | Posted | Number | 95% Confidence Interval | percentage of participants | From first dose of study drug to completion of at least one cycle in the Consolidation Period (Day 1 up to Week 52) |
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| Secondary | Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) CD8 T-Cell Density | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | The RNA Biomarker Analysis Set included all Efficacy Evaluable participants who have RNA Sequencing analysis performed on a biopsy sample and collected from the participant before treatment on the protocol. Population included participants who received durvalumab. Samples with whole transcriptome data of low quality were excluded from the set. | Posted | Number | percentage of participants | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
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| Secondary | Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) Programmed Death Ligand - 1 (PDL1) Total Percentage | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | The RNA Biomarker Analysis Set included all Efficacy Evaluable participants who have RNA Sequencing analysis performed on a biopsy sample and collected from the participant before treatment on the protocol. Population included participants who received durvalumab. Samples with whole transcriptome data of low quality were excluded from the set. | Posted | Number | percentage of participants | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
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| Secondary | Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for Immunohistochemistry (IHC) Programmed Death Ligand - 1 (PDL1) Percentage of Tumor Cells | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | The RNA Biomarker Analysis Set included all Efficacy Evaluable participants who have RNA Sequencing analysis performed on a biopsy sample and collected from the participant before treatment on the protocol. Population included participants who received durvalumab. Samples with whole transcriptome data of low quality were excluded from the set. | Posted | Number | percentage of participants | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
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| Secondary | Percentage of Participants Who Achieved a Clinical Response in the Biomarker Subpopulation for the Interferon Gamma Score (IFNG-Score) From Ribonucleic Acid (RNA)-Sequencing Data | Data in the analysis include all participants who received durvalumab, irrespective of the study arm in which they enrolled, because the selected biomarkers have been associated with response in other anti-PD1 or anti-PDL1 studies, such as durvalumab. IHC analysis was performed on the baseline tumor biopsy to quantify CD8 T-cell density. Participants with 'high' values, i.e. above the threshold defined as the median value of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods, were predicted to be responders to treatment with durvalumab. The definition of a complete response was that used in the primary outcome. | The RNA Biomarker Analysis Set included all Efficacy Evaluable participants who have RNA Sequencing analysis performed on a biopsy sample and collected from the participant before treatment on the protocol. Population included participants who received durvalumab. Samples with whole transcriptome data of low quality were excluded from the set. | Posted | Number | percentage of participants | Biomarker biopsies: Days -28 to Day -1. Clinical response: From first dose of study drug to end of Induction therapy (Day 1 up to Week 26 - maximum duration of Induction Period). |
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| Secondary | Participants With Treatment Emergent Adverse Events (TEAE) | An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen during a study. A serious AE is any AE occurring at any dose that: • Results in death; • Is life-threatening; • Requires or prolongs existing inpatient hospitalization; • Results in persistent or significant disability/incapacity; • Is a congenital anomaly/birth defect; • Constitutes an important medical event. The Investigator assessed the relationship of each AE to study drug and graded the severity according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, Version 4.03): - Grade 1 = Mild (no limitation in activity or intervention); - Grade 2 = Moderate (some limitation in activity; no/minimal medical intervention required); - Grade 3 = Severe (marked limitation in activity; medical intervention required, hospitalization possible); - Grade 4 = Life-threatening; - Grade 5 = Death. Relation to IP is determined by the investigator. | Safety Population, which consists of all participants who received at least 1 dose of the study medications. Participants were analyzed in the arm of the actual treatment received. | Posted | Count of Participants | Participants | From the date of the first dose of study drug to within 90 days after the last dose of durvalumab or 28 days after the last dose of any investigational product (IP) whichever is greater. (Up to approximately 72 weeks) |
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AEs and SAEs were assessed from first dose to 90 days after the last dose of durvalumab or 28 days after the last dose of any other IP, whichever is later (up to approximately 72 weeks) and up to 5 years after enrollment (C1D1) of the last participant to receive lenalidomide (up to approximately 5 years). All-Cause Mortality was assessed in participants from their first dose to their study completion (up to approximately 5 years).
Participants treated with lenalidomide during any stage of the study will be continued to be followed for Second Primary Malignancies (SPM) for up to 5 years after enrollment (C1D1) of the last participant to receive lenalidomide as part of their study treatment.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | DUR + R-CHOP | Participants receive Induction Therapy (21-day cycles): Durvalumab 1125 mg intravenously (IV) on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5). Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. | 5 | 43 | 23 | 43 | 43 | 43 |
| EG001 | DUR + R2-CHOP | Participants receive Induction Therapy (21-day cycles): Cycle 1 - induction therapy of durvalumab in combination with R-CHOP (as described in DUR + R-CHOP arm). Starting at cycle 2 - Durvalumab 1125 mg IV on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R2-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5; daily oral lenalidomide 15 mg from Day 1 to 14) from the cycle following COO determination until end of induction therapy (Cycle 6 or Cycle 8) or starting Cycle 1 if ABC subtype is identified prior to C1D1. Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. | 1 | 3 | 1 | 3 | 3 | 3 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Febrile neutropenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Leukopenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Neutropenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Pancytopenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Atrial fibrillation | Cardiac disorders | 22.0 | Systematic Assessment |
| |
| Cardiac arrest | Cardiac disorders | 22.0 | Systematic Assessment |
| |
| Myocardial ischaemia | Cardiac disorders | 22.0 | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Fatigue | General disorders | 22.0 | Systematic Assessment |
| |
| General physical health deterioration | General disorders | 22.0 | Systematic Assessment |
| |
| Pyrexia | General disorders | 22.0 | Systematic Assessment |
| |
| Autoimmune hepatitis | Hepatobiliary disorders | 22.0 | Systematic Assessment |
| |
| Haemophagocytic lymphohistiocytosis | Immune system disorders | 22.0 | Systematic Assessment |
| |
| Device related infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Influenza | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Lung infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Meningitis bacterial | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Perirectal abscess | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Staphylococcal bacteraemia | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Viral diarrhoea | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Infusion related reaction | Injury, poisoning and procedural complications | 22.0 | Systematic Assessment |
| |
| Hyponatraemia | Metabolism and nutrition disorders | 22.0 | Systematic Assessment |
| |
| Spinal pain | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Clear cell renal cell carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 22.0 | Systematic Assessment |
| |
| Diffuse large B-cell lymphoma recurrent | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 22.0 | Systematic Assessment |
| |
| Lymphoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 22.0 | Systematic Assessment |
| |
| Tumour pain | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 22.0 | Systematic Assessment |
| |
| Cerebrovascular accident | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Acute kidney injury | Renal and urinary disorders | 22.0 | Systematic Assessment |
| |
| Seborrhoeic dermatitis | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Deep vein thrombosis | Vascular disorders | 22.0 | Systematic Assessment |
| |
| Venous thrombosis | Vascular disorders | 22.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Leukopenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Neutropenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Thrombocytopenia | Blood and lymphatic system disorders | 22.0 | Systematic Assessment |
| |
| Hypoacusis | Ear and labyrinth disorders | 22.0 | Systematic Assessment |
| |
| Vision blurred | Eye disorders | 22.0 | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Abdominal pain upper | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Dry mouth | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Gastrooesophageal reflux disease | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Stomatitis | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | 22.0 | Systematic Assessment |
| |
| Chills | General disorders | 22.0 | Systematic Assessment |
| |
| Fatigue | General disorders | 22.0 | Systematic Assessment |
| |
| Mucosal inflammation | General disorders | 22.0 | Systematic Assessment |
| |
| Oedema peripheral | General disorders | 22.0 | Systematic Assessment |
| |
| Pyrexia | General disorders | 22.0 | Systematic Assessment |
| |
| Influenza | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Lung infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Oral candidiasis | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Oral herpes | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | 22.0 | Systematic Assessment |
| |
| Fall | Injury, poisoning and procedural complications | 22.0 | Systematic Assessment |
| |
| Infusion related reaction | Injury, poisoning and procedural complications | 22.0 | Systematic Assessment |
| |
| Blood pressure increased | Investigations | 22.0 | Systematic Assessment |
| |
| Platelet count decreased | Investigations | 22.0 | Systematic Assessment |
| |
| Weight decreased | Investigations | 22.0 | Systematic Assessment |
| |
| Decreased appetite | Metabolism and nutrition disorders | 22.0 | Systematic Assessment |
| |
| Hypokalaemia | Metabolism and nutrition disorders | 22.0 | Systematic Assessment |
| |
| Hypomagnesaemia | Metabolism and nutrition disorders | 22.0 | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Back pain | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Muscle spasms | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Myalgia | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Spinal pain | Musculoskeletal and connective tissue disorders | 22.0 | Systematic Assessment |
| |
| Histiocytic necrotising lymphadenitis | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 22.0 | Systematic Assessment |
| |
| Cognitive disorder | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Dizziness | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Dysgeusia | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Headache | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Peripheral sensory neuropathy | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Restless legs syndrome | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Sensory disturbance | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Taste disorder | Nervous system disorders | 22.0 | Systematic Assessment |
| |
| Depression | Psychiatric disorders | 22.0 | Systematic Assessment |
| |
| Insomnia | Psychiatric disorders | 22.0 | Systematic Assessment |
| |
| Dysuria | Renal and urinary disorders | 22.0 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | 22.0 | Systematic Assessment |
| |
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | 22.0 | Systematic Assessment |
| |
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | 22.0 | Systematic Assessment |
| |
| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders | 22.0 | Systematic Assessment |
| |
| Alopecia | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Dry skin | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Erythema | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Generalised erythema | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | 22.0 | Systematic Assessment |
| |
| Hot flush | Vascular disorders | 22.0 | Systematic Assessment |
| |
| Hypotension | Vascular disorders | 22.0 | Systematic Assessment |
|
After the US FDA Partial Clinical Hold, enrollment of new participants into Arm B was discontinued. If receiving clinical benefit at the discretion of the Investigator, participants could continue treatment in Arm B after being reconsented. Any newly enrolled participant with DLBCL of ABC COO subtype after the US FDA Partial Clinical Hold could continue induction therapy on Arm A after Cycle 1.
Bristol-Myers Squibb Co. agreements with investigators vary; constant is our right to embargo communications regarding trial results prior to public release for a period ≤60 days from submittal for review. We will not prohibit investigators from publishing, but will prohibit the disclosure of previously undisclosed confidential information other than study results, and request postponement of single-center publications until after disclosure of the clinical trial's primary publication.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Bristol-Myers Squibb Study Director | Bristol-Myers Squibb | Please email | Clinical.Trials@bms.com |
| Apr 24, 2023 |
| Prot_SAP_002.pdf |
| ID | Term |
|---|---|
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008223 | Lymphoma |
| D054739 | Dendritic Cell Sarcoma, Interdigitating |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D015620 | Histiocytic Disorders, Malignant |
| D015614 | Histiocytosis |
Not provided
Not provided
| ID | Term |
|---|---|
| C000613593 | durvalumab |
| D000069283 | Rituximab |
| D004317 | Doxorubicin |
| D014750 | Vincristine |
| D003520 | Cyclophosphamide |
| D011241 | Prednisone |
| D000305 | Adrenal Cortex Hormones |
| D011239 | Prednisolone |
| D000077269 | Lenalidomide |
| ID | Term |
|---|---|
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D003630 | Daunorubicin |
| D018943 | Anthracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |
| D000617 | Aminoglycosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D014748 | Vinca Alkaloids |
| D046948 | Secologanin Tryptamine Alkaloids |
| D026121 | Indole Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D054836 | Indolizidines |
| D007212 | Indolizines |
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D011244 | Pregnadienediols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D011246 | Pregnadienetriols |
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D010881 | Piperidones |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D054833 | Isoindoles |
Not provided
Not provided
| >=65 years |
|
| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Asian |
|
| Black or African American |
|
| Native Hawaiian or Other Pacific Islander |
|
| White |
|
| Not Colected or Reported |
|
| Other |
|
| 1 = Restricted activity but ambulatory |
|
| 2 = Ambulatory but unable to work |
|
| 3 = Limited Self-Care |
|
| 4 = Completely Disabled, No self-care |
|
| Stage II |
|
| Stage III |
|
| Stage IV |
|
| No |
|
| 2: Low-Intermediate risk |
|
| 3: High-Intermediate risk |
|
| 4-5: High risk |
|
| Missing |
|
| OG001 | DUR + R2-CHOP | Participants receive Induction Therapy (21-day cycles): Cycle 1 - induction therapy of durvalumab in combination with R-CHOP (as described in DUR + R-CHOP arm). Starting at cycle 2 - Durvalumab 1125 mg IV on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R2-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5; daily oral lenalidomide 15 mg from Day 1 to 14) from the cycle following COO determination until end of induction therapy (Cycle 6 or Cycle 8) or starting Cycle 1 if ABC subtype is identified prior to C1D1. Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
|
|
| OG001 | Low Group for CD8 Density | Participants had IHC analysis performed on a biopsy sample collected before treatment on this protocol. The result of their CD8 density evaluation was below threshold,defined as the median of 774 cells/mm^2 found in commercial DLBCL samples using matched analytical methods. Participants with values below threshold were predicted to be non-responders. |
|
|
|
| OG001 | Low Group for PDL1 % of Total Cells | Participants had IHC analysis performed on a biopsy sample collected before treatment on this protocol. The result of their PDL1 % of total cell evaluation was below threshold,defined as the median of 13.8% found in commercial DLBCL samples using matched analytical methods. Participants with values below threshold were predicted to be non-responders. |
|
|
|
| OG001 | Low Group for PDL1 % of Tumor Cells | Participants had IHC analysis performed on a biopsy sample collected before treatment on this protocol. The result of their PDL1 % of tumor cell evaluation was below threshold,defined as the median of 6.2% found in commercial DLBCL samples using matched analytical methods. Participants with values below threshold were predicted to be non-responders. |
|
|
|
| OG001 | Low Group for RNA IFN Gamma Score | Participants had RNA IFN Gamma Score calculated based on a biopsy sample collected before treatment on this protocol. The result of their RNA IFN Gamma Score was below threshold,defined as the median of 3.28 found in commercial DLBCL samples using matched analytical methods. Participants with values below threshold were predicted to be non-responders. |
|
|
|
| OG001 | DUR + R2-CHOP | Participants receive Induction Therapy (21-day cycles): Cycle 1 - induction therapy of durvalumab in combination with R-CHOP (as described in DUR + R-CHOP arm). Starting at cycle 2 - Durvalumab 1125 mg IV on Day 1 of each 21-day cycle in combination with 6 to 8 cycles R2-CHOP (IV rituximab, doxorubicin, vincristine and cyclophosphamide on Day 1; daily oral/IV prednisone/prednisolone from Day 1 to 5; daily oral lenalidomide 15 mg from Day 1 to 14) from the cycle following COO determination until end of induction therapy (Cycle 6 or Cycle 8) or starting Cycle 1 if ABC subtype is identified prior to C1D1. Participants then receive Consolidation Therapy (28-day cycles): Durvalumab 1500 mg IV on Day 1 of each 28-day cycle for up to a total of 12 months from C1D1 of induction therapy. |
|
|