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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT00910910
Registration number
NCT00910910
Ethics application status
Date submitted
28/05/2009
Date registered
1/06/2009
Date last updated
9/07/2019
Titles & IDs
Public title
Study Of The Effectiveness & Safety Of Lenalidomide Versus Chlorambucil As First Line Therapy For Elderly Patients With B-Cell CLL (The ORIGIN Trial)
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Scientific title
A Phase 3, Multicenter, Randomized, Openlabel, Parallel-Group Study of the Efficacy and Safety of Lenalidomide (Revlimid®) Versus Chlorambucil as First-Line Therapy for Previously Untreated Elderly Patients With B-Cell Chronic Lymphocytic Leukemia (The Origin Trial)
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Secondary ID [1]
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2008-003079-32
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Secondary ID [2]
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CC-5013-CLL-008
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Universal Trial Number (UTN)
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Trial acronym
ORIGIN
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
B-Cell Chronic Lymphocytic Leukemia
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Lenalidomide
Treatment: Drugs - Chlorambucil
Experimental: 1 - Lenalidomide - 1 - Lenalidomide
Active Comparator: 2- Chlorambucil - 2- Chlorambucil
Treatment: Drugs: Lenalidomide
For patients with normal renal function (defined as CrCl = 60 mL/min), 5 mg once daily on Days 1 through 28 of the first 28-day cycle, 10 mg once daily on Days 1 through 28 starting at the second cycle, 15 mg once daily starting at the third cycle and for the remainder of the study until PD or unacceptable toxicity, whichever occurs first.
For patients with moderate renal impairment (defined as CrCl = 30 to < 60 mL/min), 2.5 mg once daily on Days 1 through 28 of the first 28-day cycle, 5 mg once daily on Days 1 through 28 starting at the second cycle, 7.5 mg once daily starting at the third cycle and for the remainder of the study until PD or unacceptable toxicity, whichever occurs first.
Treatment: Drugs: Chlorambucil
Patients assigned to the chlorambucil arm will receive oral chlorambucil tablets at 0.8 mg/kg on Days 1 and 15 of each 28-day cycle for a total duration of 12 months (approximately 13 cycles).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Kaplan-Meier Estimate of Progression Free Survival (PFS)
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Assessment method [1]
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Progression-free survival was defined as the time from randomization to the first documented progression confirmed per investigator's assessment or death due to any cause on study, whichever occurred first. The progression date was assigned to the earliest time when any progression was observed without prior missing assessments. If withdrawal of consent or lost to follow-up occurred before documented progression or death, then these observations were censored at the date when the last complete tumor assessments determined a lack of progression
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Timepoint [1]
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From first dose of study drug to date of data cut-off of 18 Feb 2013; up to approximately 39 months
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Primary outcome [2]
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Kaplan-Meier Estimate of Progression Free Survival (PFS) With a Later Cut-off Date of 14 March 2014
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Assessment method [2]
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Progression-free survival was defined as the time from randomization to the first documented progression confirmed per investigator's assessment or death due to any cause on study, whichever occurred first. Progressive disease included lymphadenopathy, an appearance of any new lesion such as enlarged lymph nodes (> 1.5 cm), splenomegaly, hepatomegaly or other organ infiltrates, an increase by 50% or more in greatest determined diameter of any previous site or an increase by 50% or more in the sum of the product of diameters of multiple nodes. The progression date was assigned to the earliest time when any progression was observed without prior missing assessments. If withdrawal of consent or lost to follow-up occurred before documented progression or death, then these observations were censored at the date when the last complete tumor assessments determined a lack of progression.
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Timepoint [2]
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From randomization to data cut off date of 31 March 2014; median follow up time for all participants was 12.6 months
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Secondary outcome [1]
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Number of Participants With Adverse Events (AEs)
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Assessment method [1]
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AEs = any noxious, unintended, or untoward medical occurrence that may appear or worsen during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, regardless of cause. Serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; constitutes an important medical event. The severity of AEs were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0); AEs were evaluated for severity according to the following scale: Grade 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death
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Timepoint [1]
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From randomization up to data cut-off of 18 Feb 2013; Up to approximately 39 months; maximum duration of exposure for Lenalidomide was 1086 days and 406 days for Chlorambucil
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Secondary outcome [2]
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Number of Participants With Adverse Events With a Later Cut-off Date of 31 March 2014
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Assessment method [2]
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AEs = any noxious, unintended, or untoward medical occurrence that may appear or worsen during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, regardless of cause. Serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; constitutes an important medical event. The severity of AEs were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0); AEs were evaluated for severity according to the following scale: Grade 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death
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Timepoint [2]
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From randomization to the data cut-off date of 31 March 2014; Up to 53 months; maximum duration of exposure for Lenalidomide was 1140 days and 406 days for Chlorambucil
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Secondary outcome [3]
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Percentage of Participants With the Best Overall Response Based on the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) Guidelines
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Assessment method [3]
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A best overall response rate is a CR, CRi, nPR or PR and is defined as:
Complete Remission (CR):
No lymphadenopathy
No hepatomegaly or splenomegaly
Absence of constitutional symptoms
Polymorphonuclear leukocytes = 1500/ul
No circulating clonal B-lymphocytes
Platelets > 100,000/ul
Hemoglobin > 11.0 g/dl
Normocellular <30% lymphocytes, no B-lymphoid nodules;
Incomplete Clinical Response (CRi):
• CR without bone marrow biopsy confirmation.
Nodular Partial Response (nPR):
• CR with the presence of residual clonal nodules.
Partial Response (PR) requires:
= 50% decrease in peripheral blood lymphocyte count
= 50% reduction in lymphadenopathy
= 50% reduction in size of liver and/or spleen
1 or more of the following:
Polymorphonuclear leukocytes = 1500/ul
Platelets >100,000/ul
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Timepoint [3]
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Up to data cut-off date of 18 Feb 2013; approximately 39 months
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Secondary outcome [4]
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Percentage of Participants With a Best Overall Response Based on IWCLL Guidelines With a Later Cut-off Date of 31 March 2014
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Assessment method [4]
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A best overall response rate is a CR, CRi, nPR or PR and is defined as:
Complete Remission (CR):
No lymphadenopathy
No hepatomegaly or splenomegaly
Absence of constitutional symptoms
Polymorphonuclear leukocytes = 1500/ul
No circulating clonal B-lymphocytes
Platelets > 100,000/ul
Hemoglobin > 11.0 g/dl
Normocellular <30% lymphocytes, no B-lymphoid nodules;
Incomplete Clinical Response (CRi):
• CR without bone marrow biopsy confirmation.
Nodular Partial Response:
• CR with the presence of residual clonal nodules.
Partial Response requires:
= 50% decrease in peripheral blood lymphocyte count
= 50% reduction in lymphadenopathy
= 50% reduction in size of liver and/or spleen
1 or more of the following:
Polymorphonuclear leukocytes = 1500/ul
Platelets >100,000/ul
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Timepoint [4]
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Up to data cut-off of 31 March 2014; approximately 53 months
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Secondary outcome [5]
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Kaplan-Meier Estimate for Duration of Response
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Assessment method [5]
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Duration of response was defined as the time from first nPR, PR, CRi, or CR to PD. Duration of response was censored at the last date that the patient was known to be progression-free for: 1) participants who had not progressed at the time of analysis; 2) participants who had withdrawn consent or were lost to follow-up prior to documentation of progression
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Timepoint [5]
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Up to data cut-off of 18 Feb 2013; up to approximately 39 months
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Secondary outcome [6]
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Kaplan-Meier Estimate for Duration of Response With a Later Cut-off Date of 31 March 2014
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Assessment method [6]
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Duration of response was defined as the time from first nPR, PR, CRi, or CR to PD. Duration of response was censored at the last date that the patient was known to be progression-free for: 1) patients who had not progressed at the time of analysis; 2) patients who had withdrawn consent or were lost to follow-up prior to documentation of progression
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Timepoint [6]
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Up to data cut-off of 31 March 2014; up to approximately 53 months
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Secondary outcome [7]
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Time to Response
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Assessment method [7]
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Time to response was calculated as the time from randomization to the first nPR, PR, CRi or CR based on IWCLL guidelines
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Timepoint [7]
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Up to data cut-off of 18 Feb 2013; up to approximately 39 months
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Secondary outcome [8]
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Time to Response for a Later Cut-off Date of 31 March 2014
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Assessment method [8]
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Time to response was calculated as the time from randomization to the first nPR, PR, CRi or CR based on IWCLL guidelines
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Timepoint [8]
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Up to data cut-off of 31 March 2014; up to approximately 53 months
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Secondary outcome [9]
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Kaplan Meier Estimate of Overall Survival
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Assessment method [9]
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Overall Survival is defined as the time between randomization and death from any cause.
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Timepoint [9]
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Up to data cut off of 31 March 2014; median follow-up for all participants was 18.8 months
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Secondary outcome [10]
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Kaplan Meier Estimate for Overall Survival at the Final Analysis
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Assessment method [10]
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Overall Survival is defined as the time between randomization and death from any cause. Overall survival was censored at the last date that the subject was known to be alive for participants who were alive as of the data cutoff date and for participants who were lost to follow-up before death was documented.
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Timepoint [10]
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Up to the last patient last visit date of 19 May 2018; median follow-up for all participants was 46.7 months
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Secondary outcome [11]
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Functional Assessment of Cancer Therapy-General to Create the FACT-Leukemia (FACT-Leu) Quality of Life Instrument
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Assessment method [11]
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The FACT-Leu scale is a valid, reliable, and efficient measure of leukemia-specific health-related quality of life for acute and chronic disease. The FACT-Leu is described as including 27 items that assess 17 physical symptoms (fevers, bleeding, general pain, stomach pain, chills, night sweats, bruising, lymph node swelling, weakness, tiredness, weight loss, appetite, shortness of breath, functional ability, diarrhea, concentration, and mouth sores) and 10 emotional/social concerns (frustration with activity limitation, discouraged by illness, future planning, uncertainty, worry about illness, emotional lability, isolation, infertility concern, family worry, and worry about infections).
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Timepoint [11]
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Day 1 and once every 8 weeks
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Secondary outcome [12]
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Euro Quality of Life Five Dimension (EQ-5D) Questionnaire
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Assessment method [12]
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The standardized extended version of EQ-5D was designed for the collection of health state values using a visual analogue scale (VAS) rating scale - a vertical 20 cm visual analogue scale with the end points labeled best imaginable health state at the top and worst imaginable health state at the bottom having numeric values of 100 and 0 respectively. The participant is asked to indicate his/her health state by ticking (or placing a cross) in the box against the most appropriate statement in each of the 5 dimensions.
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Timepoint [12]
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Day 1 and once every 8 weeks
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Secondary outcome [13]
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Number of Participants and Types of Subsequent Anti-cancer Therapies Received Post Treatment
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Assessment method [13]
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Subsequent anti-cancer therapies administered to participants following the discontinuation of study drug (either Lenalidomide or Chlorambucil)
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Timepoint [13]
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Up to the last patient last visit date of 19 May 2018; median follow-up for all participants was 46.7 months
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Eligibility
Key inclusion criteria
1. Must sign an informed consent form.
2. Age = 65 years
3. Must be able to adhere to the study visit schedule and other protocol requirements.
4. Must have a documented diagnosis of B-cell CLL.
5. Must have an Eastern Cooperative Oncology Group (ECOG) performance status score of =2.
6. Must agree to follow pregnancy precautions as required by the protocol.
7. Must agree to receive counseling related to teratogenic and other risks of
lenalidomide.
8. Must agree not to donate blood or semen as defined by the protocol
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Prior treatment for B-cell CLL.
2. Any medical condition, that would prevent the subject from signing the informed
consent form.
3. Active infections requiring systemic antibiotics.
4. Systemic infection that has not resolved > 2 months prior to initiating lenalidomide
5. Pregnant or lactating females.
6. Participation in any clinical study or having taken any investigational therapy within
28 days.
7. Known presence of alcohol and/or drug abuse.
8. Central nervous system (CNS) involvement.
9. Prior history of malignancies, other than CLL, unless the subject has been free of the
disease for =3 years. Exceptions include the following:
- Basal cell carcinoma of the skin
- Squamous cell carcinoma of the skin
- Carcinoma in situ of the cervix
- Carcinoma in situ of the breast
- Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b)
10. History of renal failure requiring dialysis.
11. Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and/or Hepatitis C
Virus (HCV) infection.
12. Prior therapy with lenalidomide.
13. Evidence of TLS at screening
14. Presence of specific hematology and/or chemistry abnormalities
15. Uncontrolled hyperthyroidism or hypothyroidism
16. Venous thromboembolism within one year
17. = Grade-2 neuropathy
18. Uncontrolled autoimmune hemolytic anemia or thrombocytopenia
19. Disease transformation [i.e. Richter's Syndrome (lymphomas) or prolymphocytic
leukemia]
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
13/10/2009
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
9/05/2018
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Sample size
Target
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Accrual to date
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Final
450
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Recruitment in Australia
Recruitment state(s)
QLD,SA,VIC
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Recruitment hospital [1]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [2]
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IMVS - Adelaide
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Western Hospital - Footscray
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Royal Melbourne Hospital - Melbourne
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Flinders Medical Centre - Bedford Park
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St. Vincent Hospital - Fitzroy
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Nepean Hospital - Kingswood, NSW
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Recruitment hospital [8]
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Calvary Mater Hospital - Waratah
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Recruitment hospital [9]
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Westmead Hospital Australia - Westmead
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Recruitment postcode(s) [1]
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4102 - Woolloongabba
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Recruitment postcode(s) [2]
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5000 - Adelaide
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Recruitment postcode(s) [3]
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3011 - Footscray
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Recruitment postcode(s) [4]
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3050 - Melbourne
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Recruitment postcode(s) [5]
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5042 - Bedford Park
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Recruitment postcode(s) [6]
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3065 - Fitzroy
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Recruitment postcode(s) [7]
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2751 - Kingswood, NSW
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Recruitment postcode(s) [8]
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2298 - Waratah
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Recruitment postcode(s) [9]
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NSW2145 - Westmead
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Recruitment outside Australia
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United States of America
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California
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Connecticut
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Illinois
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Indiana
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Brussels
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Haine-Saint Paul
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France
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France
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State/province [58]
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0
Kaposvar
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Country [59]
0
0
Hungary
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State/province [59]
0
0
Szeged
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Country [60]
0
0
Hungary
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State/province [60]
0
0
Tatabanya
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Country [61]
0
0
Hungary
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State/province [61]
0
0
Vasvari Pal U. 2
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Country [62]
0
0
Israel
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State/province [62]
0
0
Afula
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Country [63]
0
0
Israel
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State/province [63]
0
0
Ashkelon
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Country [64]
0
0
Israel
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State/province [64]
0
0
Beer Sheva
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Country [65]
0
0
Israel
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State/province [65]
0
0
Haifa
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Country [66]
0
0
Israel
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State/province [66]
0
0
Jerusalem
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Country [67]
0
0
Israel
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State/province [67]
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Kfar-Saba
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Country [68]
0
0
Israel
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State/province [68]
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0
Naharia
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Country [69]
0
0
Israel
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State/province [69]
0
0
Petach Tikva
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Country [70]
0
0
Israel
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State/province [70]
0
0
Rehovot
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Country [71]
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0
Israel
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State/province [71]
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0
Tel Aviv
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Country [72]
0
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Israel
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State/province [72]
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Tel Hashomer
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Country [73]
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Italy
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State/province [73]
0
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Bari
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Country [74]
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0
Italy
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State/province [74]
0
0
Firenze
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Country [75]
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Italy
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State/province [75]
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Milan
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Country [76]
0
0
Italy
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State/province [76]
0
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Modena
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Country [77]
0
0
Italy
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State/province [77]
0
0
Naples
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Country [78]
0
0
Italy
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State/province [78]
0
0
Novara
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Country [79]
0
0
Italy
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State/province [79]
0
0
Orbassano
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Country [80]
0
0
Italy
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State/province [80]
0
0
Padova
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Country [81]
0
0
Italy
Query!
State/province [81]
0
0
Pisa
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Country [82]
0
0
Italy
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State/province [82]
0
0
Potenza
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Country [83]
0
0
Italy
Query!
State/province [83]
0
0
Siena
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Country [84]
0
0
Italy
Query!
State/province [84]
0
0
Torrette Di Ancona
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Country [85]
0
0
Netherlands
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State/province [85]
0
0
Eindhoven
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Country [86]
0
0
Netherlands
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State/province [86]
0
0
Hoofddorp
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Country [87]
0
0
Netherlands
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State/province [87]
0
0
Zwolle
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Country [88]
0
0
New Zealand
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State/province [88]
0
0
Christchurch
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Country [89]
0
0
New Zealand
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State/province [89]
0
0
Takapuna
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Country [90]
0
0
Poland
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State/province [90]
0
0
Gdansk
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Country [91]
0
0
Poland
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State/province [91]
0
0
Lodz
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Country [92]
0
0
Poland
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State/province [92]
0
0
Torun
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Country [93]
0
0
Poland
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State/province [93]
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0
Warszawa
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Country [94]
0
0
Poland
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State/province [94]
0
0
Wroclaw
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Country [95]
0
0
Portugal
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State/province [95]
0
0
Coimbra
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Country [96]
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0
Portugal
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State/province [96]
0
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Porto
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Country [97]
0
0
Romania
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State/province [97]
0
0
Bucharest
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Country [98]
0
0
Romania
Query!
State/province [98]
0
0
Iasi
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Country [99]
0
0
Romania
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State/province [99]
0
0
Sibiu
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Country [100]
0
0
Romania
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State/province [100]
0
0
Timisoara
Query!
Country [101]
0
0
Russian Federation
Query!
State/province [101]
0
0
Arkhangelsk
Query!
Country [102]
0
0
Russian Federation
Query!
State/province [102]
0
0
Barnaul
Query!
Country [103]
0
0
Russian Federation
Query!
State/province [103]
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0
Ekaterinburg
Query!
Country [104]
0
0
Russian Federation
Query!
State/province [104]
0
0
Moscow
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Country [105]
0
0
Russian Federation
Query!
State/province [105]
0
0
Nizhniy Novgorod
Query!
Country [106]
0
0
Russian Federation
Query!
State/province [106]
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0
Novosibirsk
Query!
Country [107]
0
0
Russian Federation
Query!
State/province [107]
0
0
St. Petersburg
Query!
Country [108]
0
0
Serbia
Query!
State/province [108]
0
0
Kragujevac
Query!
Country [109]
0
0
Serbia
Query!
State/province [109]
0
0
Nis
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Country [110]
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0
Slovakia
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State/province [110]
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0
Bratislava
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Country [111]
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0
Slovakia
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State/province [111]
0
0
Martin
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Country [112]
0
0
South Africa
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State/province [112]
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0
Parktown
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Country [113]
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0
South Africa
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State/province [113]
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0
Pretoria
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Country [114]
0
0
Spain
Query!
State/province [114]
0
0
Badalona
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Country [115]
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0
Spain
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State/province [115]
0
0
Barcelona
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Country [116]
0
0
Spain
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State/province [116]
0
0
Madrid
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Country [117]
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0
Spain
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State/province [117]
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0
Majadahonda
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Country [118]
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0
Spain
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State/province [118]
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0
Murcia
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Country [119]
0
0
Spain
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State/province [119]
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0
Salamanca
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Country [120]
0
0
Spain
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State/province [120]
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0
San Sebastian
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Country [121]
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0
Spain
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State/province [121]
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0
Santander
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Country [122]
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0
Spain
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State/province [122]
0
0
Valencia
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Country [123]
0
0
United Kingdom
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State/province [123]
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0
Bournemouth
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Country [124]
0
0
United Kingdom
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State/province [124]
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0
London
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Celgene
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to determine the safety and efficacy of lenalidomide as a first
line therapy in treating patients with B-cell Chronic Lymphocytic Leukemia. This study will
compare the effects (good and bad) of lenalidomide with chlorambucil.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT00910910
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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0
Jeffrey Jones, MD
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Address
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Celgene Corporation
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Phone
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT00910910
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