Non Hodgkin Lymphoma Clinical Trial
A Study Evaluating the Safety, Efficacy and Pharmacokinetics of Venetoclax Combined With Chemotherapy in Participants With B-Cell Non-Hodgkin’s Lymphoma (NHL) and DLBCL
Summary
This is a multicenter, open-label, dose-finding study of venetoclax administered orally in combination with rituximab (R) or obinutuzumab (G) and standard doses of cyclophosphamide, doxorubicin, vincristine and oral prednisone (CHOP) in participants with Non-Hodgkin's Lymphoma (NHL). The study consisted of 2 stages: a dose-finding Phase Ib stage and a Phase II expansion stage. In the Phase I portion of the study, participants were randomized to one of 2 treatment arms venetoclax in combination with R-CHOP (Arm A) and venetoclax in combination with G-CHOP (Arm B) and explored the doses of venetoclax in combination with R-CHOP and G-CHOP. The maximum tolerated dose (MTD) of venetoclax in combination with R-CHOP and G-CHOP was determined during the dose-finding stage. For the Phase II portion of the study, the venetoclax dose for venetoclax + R-CHOP was on a non-continuous dosing schedule as determined by the Phase Ib portion of the study based on safety and tolerability observed in participants treated in the dose escalation portion of the study. On 17 July 2016, Roche/Genentech as the sponsor of Study BO21005 (Goya study), a Phase III study that evaluated G CHOP versus R-CHOP in 1L DLBCL, informed through a press release that the primary endpoint of investigator-assessed PFS was not met. Given these results, Arm B (venetoclax + G-CHOP) was not expanded in Phase II in patients who are first-line with DLBCL.
Eligibility Criteria
Inclusion Criteria:
General Inclusion Criteria:
At least one bi-dimensionally measurable lymphoma lesion on CT scan defined as > 1.5 cm in its longest dimension, which is also FDG avid by screening PET scan.
Confirmed availability of archival or freshly biopsied tumor tissue prior to study enrollment
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
Adequate hematologic function
For female participants of childbearing potential, agreement to use highly effective forms of contraception
Dose-Escalation Portion of the Study:
Participants must have histologically confirmed B-cell NHL, except MCL or SLL
Participants must have never received previous R-CHOP treatment
Any relapsed/refractory participants that are enrolled during the dose escalation should have received only a single previous treatment regimen
Expansion Portion of the Study:
Participants must have previously untreated CD20-positive DLBCL and IPI score must be 2-5
Exclusion Criteria:
General Exclusion Criteria:
History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products
Contraindication to receive any of the individual components of CHOP, rituximab or obinutuzumab
Prior anthracycline therapy
Participants with ongoing corticosteroid use >30 mg per day of prednisone or equivalent
CNS lymphoma or primary mediastinal DLBCL
Vaccination with live vaccines within 28 days prior to randomization
Chemotherapy or other investigational therapy within 28 days prior to the start of Cycle 1
History of other malignancy that could affect compliance with the protocol or interpretation of results
Evidence of significant, uncontrolled concomitant disease
Significant cardiovascular disease or significant pulmonary disease
Left ventricular ejection fraction less than (<) 50% as defined by multiple-gated acquisition (MUGA)
Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment, or any major episode of infection requiring treatment with IV antibiotics or hospitalization (relating to the completion of the course of antibiotics) within 4 weeks prior to Cycle 1 Day 1
Received the following agents within 7 days prior to the first dose of venetoclax: steroid therapy for anti-neoplastic intent; strong and moderate cytochrome P450 (CYP) 3A4 inhibitors or inducers; grapefruit/grapefruit products, seville oranges or star fruit within 3 days prior to the first dose of venetoclax
Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis
Recent major surgery
Women who are pregnant or lactating
Dose-Escalation Portion of the Study:
Participants with confirmed mantle cell lymphoma (MCL) or small lymphocytic lymphoma (SLL)
Expansion Portion of the Study:
Participants with transformed lymphoma (participants with discordant bone marrow involvement (i.e., low grade histology in bone marrow) may be considered after discussion with the Medical Monitor)
Prior therapy for NHL
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There are 52 Locations for this study
Fullerton California, 92835, United States
Los Angeles California, 90095, United States
Santa Maria California, 93454, United States
Saint Louis Missouri, 63129, United States
Hackensack New Jersey, 07601, United States
Farmington New Mexico, 87401, United States
New York New York, 10065, United States
Rochester New York, 14642, United States
Nashville Tennessee, 37203, United States
Concord New South Wales, 2139, Australia
Woolloongabba Queensland, 4102, Australia
Melbourne Victoria, 3000, Australia
Parkville Victoria, 3050, Australia
Salzburg , 5020, Austria
Wien , 1090, Austria
Edmonton Alberta, T6G 1, Canada
Kelowna British Columbia, V1Y 5, Canada
Vancouver British Columbia, V5Z 4, Canada
Montréal Quebec, H3T 1, Canada
Quebec , G1J 1, Canada
Brno , 613 0, Czechia
Hradec Kralove , 500 0, Czechia
Ostrava - Poruba , 708 5, Czechia
Praha 2 , 128 0, Czechia
Creteil , 94010, France
La Roche sur Yon , 85025, France
Le Mans , 72015, France
Lille , 59037, France
Montpellier , 34295, France
Nantes , 44093, France
Paris , 75475, France
Pierre-Benite , 69495, France
Rennes cedex 09 , 35033, France
Rouen , 76038, France
Vandoeuvre-les-nancy , 54511, France
Budapest , 1083, Hungary
Budapest , 1122, Hungary
Debrecen , 4032, Hungary
Napoli Campania, 80131, Italy
Genova Liguria, 16132, Italy
Torino Piemonte, 10126, Italy
Palermo Sicilia, 90127, Italy
Pisa Toscana, 56100, Italy
Amsterdam , 1081 , Netherlands
Rotterdam , 3015 , Netherlands
Utrecht , 3508 , Netherlands
Barcelona , 08003, Spain
Barcelona , 08035, Spain
Barcelona , 08907, Spain
Madrid , 28014, Spain
Madrid , 28034, Spain
Salamanca , 37007, Spain
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