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| Name | Class |
|---|---|
| Ruijin Hospital | OTHER |
| The First Affiliated Hospital of Nanchang University | OTHER |
| Fujian Medical University Union Hospital | OTHER |
| RenJi Hospital |
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This is a open-label,multicenter, randomised, three-arm, phase II efficacy and safety study of ibrutinib in combination with MRE(methotrexate,rituximab,etoposide)-chemotherapy versus lenalidomide in combination with MRE-chemotherapy given to adult patients who have recurrent/refractory primary central nervous system lymphoma (PCNSL)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| I-MRE | Experimental | Ibrutinib 560 mg/day daily (starting dose) between days 4 and 28 of each cycle for six cycles. Then Ibrutinib is continued until disease progression, intolerable toxicity, death or up to two years. Methotrexate (standard hydration/leucovorin support) 3.5 g/m2 (0.5 g/m2 in 15 min+ 3 g/m2 in 3-hr infusion) d2. Rituximab 375 mg/m2 conventional infusion d1.Etoposide 250 mg/m2 over 3 hours on day3. Every 4 weeks for 1 cycle, 6 cycles will be prescribed as protocol. |
|
| L-MRE | Experimental | Oral lenalidomide 25mg/day (starting dose) between days 4 and 24 of each cycle for six cycles.Then lenalidomide is continued until disease progression, intolerable toxicity, death or up to two years. Methotrexate (standard hydration/leucovorin support) 3.5 g/m2 (0.5 g/m2 in 15 min+ 3 g/m2 in 3-hr infusion) d2. Rituximab 375 mg/m2 conventional infusion d1. Etoposide 250 mg/m2 over 3 hours on day3. Every 4 weeks for 1 cycle, 6 cycles will be prescribed as protocol. |
|
| MRE | Active Comparator | Methotrexate (standard hydration/leucovorin support) 3.5 g/m2 (0.5 g/m2 in 15 min+ 3 g/m2 in 3-hr infusion) d2. Rituximab 375 mg/m2 conventional infusion d1. Etoposide 250 mg/m2 over 3 hours on day3. Every 4 weeks for 1 cycle, 6 cycles will be prescribed as protocol. Patients who will not achieve SD or better after the 4th course, as well as those who will experience Progressive Disease (PD) at any time will be randomly allocated to the Experimental groups. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ibrutinib | Drug | Ibrutinib 560 mg/day daily (starting dose) between days 4 and 28 of each cycle for six cycles. Then Ibrutinib is continued until disease progression, intolerable toxicity, death or up to two years. |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | From date of randomization until recurrence/disease progression, unacceptable toxicity, death or discontinuation for any other reason, whichever comes first assessed up to 2 yrs | assessed up to 2 yrs |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) | To determine efficacy | assessed up to 2 yrs |
| Overall survival (OS) | To determine efficacy | assessed up to 2 yrs |
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Inclusion Criteria:
Participants must be able to understand and be willing to sign a written informed consent document.
Men and woman who are 18-75 years old on the day of consenting to the study.
Histologically documented PCNSL and histologically documented systemic diffuse large B-cell lymphoma (DLBCL).
Patients must have relapsed/refractory PCNSL or relapsed/refractory SCNSL
All patients need to have received at least one prior CNS directed therapy. There is no restriction on the number of recurrences.
Patients with parenchymal lesions must have unequivocal evidence of disease progression on imaging (MRI of the brain or head CT) 21 days prior to study registration.
Participants must have an ECOG performance status of 0-3.
Participants must have adequate bone marrow and organ function shown by:
Woman of reproductive potential must agree to use highly effective methods of birth control during the period of therapy and for 30 days after the last dose of the study drug. Men who are sexually active must agree to use highly effective contraception during the period of therapy and for 3 months after the last dose.
Patients must be able to tolerate MRI/CT scans.
Participants must have recovered to grade 1 toxicity from prior therapy.
Participants should be able to submit up to 20 unstained formalin-fixed, paraffinembedded (FFPE) slides from the initial tissue diagnosis prior to study registration for confirmation of diagnosis and correlative studies
NOTE: Prior autologous stem cell transplant as well as prior radiation to the CNS does NOT prevent patients from enrollment into the trial.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xiaohong Zhang | Contact | +8657189713673 | zeyyxy@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Hematology, the Second Affiliated Hospital, Zhejiang University School of Medicine | Recruiting | Hangzhou | China/Zhejiang Province | 310009 | China |
This is a open-label,multicenter, randomised, three-arm, phase II efficacy and safety study of ibrutinib in combination with MRE(methotrexate,rituximab,etoposide)-chemotherapy versus lenalidomide in combination with MRE-chemotherapy given to adult patients who have recurrent/refractory primary central nervous system lymphoma (PCNSL)
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| OTHER |
| Shanghai Tong Ren Hospital | OTHER |
| Shandong Provincial Hospital | OTHER_GOV |
| Cancer Hospital of Guangxi Medical University | OTHER |
| Sir Run Run Shaw Hospital | OTHER |
| Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University | OTHER |
| Ningbo Medical Center Lihuili Hospital | OTHER_GOV |
| Yinzhou Hospital Affiliated to Medical School of Ningbo University | OTHER |
| Zhejiang University | OTHER |
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| Lenalidomide | Drug | Oral lenalidomide 25mg/day between days 4 and 24 of each cycle for six cycles. Then lenalidomide is continued until disease progression, intolerable toxicity, death or up to two years. |
|
| Methotrexate | Drug | Methotrexate 3.5 g/m2 (0.5 g/m2 in 15 min + 3 g/m2 in 3-hr infusion) on day 1 |
|
| Rituximab | Drug | Rituximab 375 mg/m2 conventional infusion on day 1 |
|
| Etoposide | Drug | Etoposide 250 mg/m2 over 3 hours on day3 |
|
| PEGylated recombinant human granulocyte colony | Drug | PEGylated recombinant human granulocyte colony 100 ug/kg subcutaneous injection on day 5. |
|
| Number of patients with adverse events | Number of participants with treatment- and non-treatment related adverse events as assessed by CTCAE | assessed up to 2 yrs |
| ID | Term |
|---|---|
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C551803 | ibrutinib |
| D000077269 | Lenalidomide |
| D008727 | Methotrexate |
| D000069283 | Rituximab |
| D005047 | Etoposide |
| ID | Term |
|---|---|
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D010881 | Piperidones |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D054833 | Isoindoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D000630 | Aminopterin |
| D011622 | Pterins |
| D011621 | Pteridines |
| 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 |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
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