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This is an open-label, multicentre Phase Ib study to evaluate the safety and preliminary efficacy of new generation Bruton Tyrosine Kinase inhibitor Rocbrutinib in combination to R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristin, Prednison) in adult patients with newly diagnosed, previously untreated B-cell Non-Hodgkin Lymphoma [Diffuse Large B-cell Lymphoma (DLBCL), Marginal Zone Lymphoma (MZL) or Mantle Cell Lymphoma (MCL)].
OUTLINE:
Dose escalation portion(Part A): In the dose escalation portion of the study, the escalating doses of Rocbrutinib combined with R-CHOP may be explored, using the 3+3 principle for dose determination. If dose escalation is acceptable, and subsequently will determine the recommended Phase 2 dose.
Dose expansion portion(Part B): This will be conducted as a multicenter, open-label study, including three cohorts(Cohort 1: non-GCB DLBCL; Cohort 2: MZL; Cohort 3: MCL). Eligible subjects will receive Rocbrutinib combined with R-CHOP for 6 cycles, then Rocbrutinib plus Rituximab for 2 cycles, and followed by Rocbrutinib maintenance for 2 years.
After completion of study treatment, patients are followed up every 12 weeks for 1 year, then every 24 weeks for 4 year.
PRIMARY OBJECTIVES:
I. To evaluate the safety of Rocbrutinib in combination to R-CHOP in B-cell Non-Hodgkin Lymphoma, including the maximum tolerated dose (MTD), dose limiting toxicities(DLT), adverse events (AEs), clinically significant laboratory abnormalities.
2. To determine the recommended dose. 3. To determine the pharmacokinetic characteristics of Rocbrutinib in combination to R-CHOP.
SECONDARY OBJECTIVES:
I. To determine the overall response rate, the complete response rate, duration of remission, survival outcomes (progression free survival, event free survival, overall survival) in DLBCL/ Non-germinal Center(non-GCB) DLBCL.
2. To determine the overall response rate, the complete response rate, duration of remission, survival outcomes (progression free survival, event free survival, overall survival) in MZL.
3. To determine the overall response rate, the complete response rate, duration of remission, survival outcomes (progression free survival, event free survival, overall survival) in MCL.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Escalation | Experimental | Patients with DLBCL or MCL or MZL receive Rocbrutinib(at escalating dose)+R-CHOP |
|
| Dose Expansion [non-GCB DLBCL] | Experimental | Patients with non-GCB DLBCL receive Rocbrutinib(at recommended dose )+R-CHOP |
|
| Dose Expansion [MCL] | Experimental | Patients with MCL receive Rocbrutinib(at recommended dose )+R-CHOP |
|
| Dose Expansion [MZL] | Experimental | Patients with MZL receive Rocbrutinib(at recommended dose )+R-CHOP |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rocbrutinib | Drug | orally once daily in a 21-day cycle for eight cycles, and as maintenance for 2 years. |
|
| Measure | Description | Time Frame |
|---|---|---|
| MTD | Standard phase I 3+3 design. | Up to 21 days after the initial dose |
| Recommended Dose | Recommended Dose will be determined using available safety and pharmacokinetics data upon completion of the dose escalation phase. | Up to 1.5 years |
| Incidence of AEs | Type, frequency and severity of AEs, relationship of AEs to study treatment Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 Type, frequency and severity of AEs, relationship of AEs to study treatment Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 | From first dose of study drug to 28 days after the last dose of study drugs |
| Incidence of clinically significant laboratory abnormalities | Clinically significant abnormalities in hematology, chemistry, coagulation and urinalysis. | From first dose of study drug to 28 days after last dose of study drug |
| Cmax of Rocbrutinib | Maximum plasma concentration (Cmax) of Rocbrutinib. | Up to 24 hours post dose |
| Tmax of Rocbrutinib | Time to maximum plasma concentration (Tmax) of Rocbrutinib. | Up to 24 hours post dose |
| T1/2 of Rocbrutinib | The terminal elimination half-life (t1/2). |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | Assessment using the Lugano Response Criteria for Malignant Lymphoma. | Evey 2 cycles for 8 cycles, and followed every 3cyles for 24 months |
| Complete remission (CR) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yue Shen, Ph D | Contact | 86-020-31605119 | yshen@lupengbio.com |
| Name | Affiliation | Role |
|---|---|---|
| Qingqing Cai, Ph D | Sun Yat-Sen University Cancer Center | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sun Yat-sen University Cancer Center | Recruiting | Guangzhou | Guangdong | 510060 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25042202 | Background | Younes A, Thieblemont C, Morschhauser F, Flinn I, Friedberg JW, Amorim S, Hivert B, Westin J, Vermeulen J, Bandyopadhyay N, de Vries R, Balasubramanian S, Hellemans P, Smit JW, Fourneau N, Oki Y. Combination of ibrutinib with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) for treatment-naive patients with CD20-positive B-cell non-Hodgkin lymphoma: a non-randomised, phase 1b study. Lancet Oncol. 2014 Aug;15(9):1019-26. doi: 10.1016/S1470-2045(14)70311-0. Epub 2014 Jul 17. | |
| 30901302 |
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|
| Rituximab | Biological | 375 mg/m2 administered intravenously once on Day 1 in a 21-day cycle for eight cycles. |
|
|
| Cyclophosphamide | Drug | 750 mg/m2 administered intravenously once on Day 1 or 2 in a 21-day cycle for six cycles. |
|
|
| doxorubicin | Drug | 50 mg/m2 administered intravenously once on Day 1 or 2 in a 21-day cycle for six cycles. |
|
|
| Vincristin | Drug | 1.4 mg/m2 administered intravenously once on Day 1 or 2 in a 21-day cycle for six cycles. |
|
|
| Prednisone | Drug | 100 mg orally once on Day 1 to Day 5 in a 21-day cycle for six cycles. |
|
|
| Up to 24 hours post dose |
| AUC0-t of Rocbrutinib | Area under the plasma concentration-time curve (AUC) from 0 to the time of the last measurable concentration of Rocbrutinib. | Up to 24 hours post dose |
| CL/F of Rocbrutinib | Apparent clearance (CL/F) of Rocbrutinib. | Up to 24 hours post dose |
Assessment using the Lugano Response Criteria for Malignant Lymphoma.
| Evey 2 cycles for 8 cycles, and followed every 3cyles for 24 months |
| Duration of Response(DOR) | DOR is defined as the number of days from the date of the first remission to the date of earliest disease progression or death. | Measured from the date of the first remission to the date of earliest disease progression or death, and assessed up to 5 years. |
| Progression-Free Survival(PFS) | PFS is defined as the number of days from the date of the first dose of study drug to the date of earliest disease progression or death. | Measured from the date of first dose of study drug to the date of earliest disease progression or death or last visit, and assessed up to 5 years. |
| Event-free Survival (EFS) | EFS is defined as the number of days from the date of first dose to the date of earliest evidence of disease progression/relapse, or initiation of new non-protocol-specified antitumor therapy without documented progression, or death. | Measured from the date of first dose to the date of earliest evidence of disease progression, initiation of new non-protocol-specified antitumor therapy without documented progression, death, and for up to 5 years after the last subject is enrolled. |
| Overall survival (OS) | OS is defined as the number of days from the date of first dose to the date of death. | Measured from the date of date of first dose to the date of death or last visit, and for up to 5 years after the last subject is enrolled. |
| Result |
| Younes A, Sehn LH, Johnson P, Zinzani PL, Hong X, Zhu J, Patti C, Belada D, Samoilova O, Suh C, Leppa S, Rai S, Turgut M, Jurczak W, Cheung MC, Gurion R, Yeh SP, Lopez-Hernandez A, Duhrsen U, Thieblemont C, Chiattone CS, Balasubramanian S, Carey J, Liu G, Shreeve SM, Sun S, Zhuang SH, Vermeulen J, Staudt LM, Wilson W; PHOENIX investigators. Randomized Phase III Trial of Ibrutinib and Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Non-Germinal Center B-Cell Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2019 May 20;37(15):1285-1295. doi: 10.1200/JCO.18.02403. Epub 2019 Mar 22. |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| 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 |
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| ID | Term |
|---|---|
| D000069283 | Rituximab |
| D003520 | Cyclophosphamide |
| D004317 | Doxorubicin |
| D014750 | Vincristine |
| D011241 | Prednisone |
| 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 |
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D003630 | Daunorubicin |
| D018943 | Anthracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| 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 |
| D011244 | Pregnadienediols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
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