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This is a prospective, multicenter, single-arm, open Phase Ib/II clinical study to explore the safety and efficacy of pomadomide in combination with rituximab and methotrexate (RPM) in newly diagnosed primary central nervous system lymphoma (PCNSL) subjects. The Phase I study is a dose escalation study, in which rituximab and methotrexate are fixed doses, and pomadomide is set into 3 dose groups: 3mg/d, 4mg/d and 5mg/d. In strict accordance with the "3+3" dose escalation principle, 3-6 subjects are to be recruited in each dose group, and each subject is to be observed for 1 cycle after treatment to determine MTD. Phase II study: RP2D is planned to be determined based on the Phase Ib study, with an additional 25 active participants enrolled to further evaluate efficacy and safety. Subjects with initial treatment of PCNSL who met the inclusion/exclusion criteria were screened, and after signing the informed consent letter, they received 4 courses of PRM regimen. The patients achieving CR or PR were consolidated by autologous transplantation consolidation regimen or the original regimen for 2 courses, and then were given pomadomide maintenance therapy for 12 cycles. Follow-ups should be taken up to the first 3 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PRM treatment | Experimental | Experimental arm will be treated with PRM regimen (pomadomide in combination with rituximab and methotrexate) for 4 cycles as initiate induction. If the patients achieved complete remission(CR)or partial remission(PR), They would be consolidated by autologous transplantation consolidation regimen or the original regimen for additional 2 courses, and then were given pomadomide maintenance therapy for 12 cycles. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pomalidomide | Drug | 3-5mg d1-d14 for 4-6 cycles, every 21 days as induction/consolidation chemotherapy, Then 3-5mg d1-d14 for 12 cycles, every 28 days as maintenance treatment. |
|
| Measure | Description | Time Frame |
|---|---|---|
| MTD | MTD of pomalidomide when given in combination with rituximab and methotrexate determined by dose-limiting toxicities graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0 | 21days |
| Objective response rate(ORR) | The objective response rate is defined as the proportion of patients with a response of complete response(CR) or partial response(PR). | 4 cycles of threatment |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | From date of patients sign informed consent until the date of progression or death or the date of last follow-up time, whichever came first, assessed up to 3 years | Time from registration to progression or death due to PCNSL, assessed up to 2 years |
| Overall survival |
| Measure | Description | Time Frame |
|---|---|---|
| pomalidomide levels in the CNS | Based on pomalidomide levels in CSF at different time points | Up to day 3 of course 2 |
| pomalidomide levels in the Blood | Based on pomalidomide levels in blood at different time points |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xianggui Yuan, Doctor | Contact | +8613989883884 | yuanxg@zju.edu.cn | |
| Wenbin Qian | Contact | +8613605801032 | qianwb@zju.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 2nd Affiliated Hospital, School of Medicine, Zhejiang University | Recruiting | Hanzhou | Zhejiang | 310009 | China |
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| Rituximab | Drug | 375mg/m2 intravenous infusion d1, every 3 weeks for 1 cycle, 4-6 cycles will be prescribed. |
|
| Methotrexate | Drug | 3.5g/m2 intravenous infusion for 4 hours in d1, every 21 days for 1 cycle, 4-6 cycles will be prescribed. |
|
From date of patients sign informed consent until the date of progression or death or the date of last follow-up time, whichever came first, assessed up to 3 years |
| Time from registration to death due to any cause, assessed up to 3 years |
| Up to day 3 of course 2 |
| ID | Term |
|---|---|
| C467566 | pomalidomide |
| D000069283 | Rituximab |
| D008727 | Methotrexate |
| 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 |
| D000630 | Aminopterin |
| D011622 | Pterins |
| D011621 | Pteridines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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