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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/NCT03298412
Registration number
NCT03298412
Ethics application status
Date submitted
12/09/2017
Date registered
2/10/2017
Date last updated
11/09/2020
Titles & IDs
Public title
Effect of Blinatumomab on Minimal Residual Disease (MRD) in Diffuse Large B-Cell Lymphoma (DLBCL) Subjects Post Autologous Hematopoietic Stem Cell Transplantation (aHSCT)
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Scientific title
A Phase 2 Open-Label Study to Determine the Effect of Blinatumomab on Minimal Residual Disease in Subjects With High-risk Diffuse Large B-cell Lymphoma Post-autologous Hematopoietic Stem-cell Transplantation.
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Secondary ID [1]
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2016-003255-30
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Secondary ID [2]
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20150291
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
High-risk Diffuse Large B-cell Lymphoma
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Condition category
Condition code
Cancer
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Cancer
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Blinatumomab
Experimental: Blinatumomab - After a run-in period of up to 24 months to evaluate MRD status and assess eligibility for treatment assignment, participants received blinatumomab intravenous (IV) infusion at an initial dose of 9 µg/day for the first 7 days of treatment, escalated (dose-step) to 28 µg/day starting on Day 8 (Week 2), followed by a dose-step to 112 µg/day starting on Day 15 (Week 3) and continuing until completion of therapy (Day 57 of Cycle 1).
Cycle 1 of blinatumomab treatment is 12 weeks (84 days) in duration and includes 8 weeks (56 days) of blinatumomab IV infusion followed by a 4-week (28-day) treatment-free interval.
Treatment: Drugs: Blinatumomab
Blinatumomab is administered as a continuous IV infusion.
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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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MRD-Negative Rate at the End of Cycle 1
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Assessment method [1]
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The estimated MRD-negative rate, calculated as the percentage of participants with MRD-negative status after treatment with blinatumomab. MRD-negative status was assessed by positron emission tomography-computed tomography (PET-CT) or computed tomography (CT).
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Timepoint [1]
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12 weeks (84 days)
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Secondary outcome [1]
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Kaplan-Meier Estimate: Progression-Free Survival (PFS)
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Assessment method [1]
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PFS, calculated as the time from the date of first dose of blinatumomab until the date of diagnosis of relapse of lymphoma (by PET-CT, CT, clinical assessment or relapse biopsy, whichever was the preferred method), or date of death, whichever was earliest. Participants who were alive and who did not have progression or new anti-tumor treatment (excluding any stem cell transplantation) were to be censored at last date of tumor assessment.
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Timepoint [1]
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up to 1 year from first dose of blinatumomab
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Secondary outcome [2]
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Kaplan-Meier Estimate: Duration of MRD-Negative Status
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Assessment method [2]
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The duration of MRD-negative status, assessed only in participants who achieve MRD-negative status after blinatumomab treatment, was defined as the time when a negative MRD result was first established until documented MRD-positive re-occurrence, disease progression or, death due to any cause. Participants without any of these events at the time of the analysis were to be censored at their last disease assessment date. MRD-negative status was assessed by PET-CT or CT.
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Timepoint [2]
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up to 1 year from first dose of blinatumomab
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Secondary outcome [3]
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Kaplan-Meier Estimate: Overall Survival (OS)
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Assessment method [3]
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OS, defined as time from the first dose of blinatumomab treatment until death due to any cause. Participants still alive at the time of the analysis were censored at date last known to be alive.
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Timepoint [3]
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up to 1 year from first dose of blinatumomab
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Secondary outcome [4]
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Number of Participants With Treatment Emergent Adverse Events (TEAEs)
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Assessment method [4]
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An adverse event (AE) is defined as any untoward medical occurrence. A serious AE is defined as an AE that is: fatal; life threatening; requires in-patient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; a congenital anomaly/birth defect; other medically important serious event. TEAEs are events with an onset after the administration of the first dose of blinatumomab treatment through 30 days after the end of blinatumomab treatment. Events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE): Grade 1 (mild), Grade 2 (moderate), Grade 3 (severe), Grade 4 (life-threatening), Grade 5 (death).
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Timepoint [4]
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From first dose of study drug through 30 days after the last dose of study drug. The treatment duration for the participant who received blinatumomab was 57 days.
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Eligibility
Key inclusion criteria
Inclusion and
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Minimum age
18
Years
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Maximum age
100
Years
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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
Exclusion Criteria - Part 1
Inclusion Criteria - Part 1
- Subject has provided informed consent prior to initiation of any study-specific
activities/procedures or subject's legally acceptable representative has provided
informed consent prior to any study-specific activities/procedures being initiated
when the subject has any kind of condition that, in the opinion of the investigator,
may compromise the ability of the subject to give written informed consent.
- Age = 18 at time of informed consent
- Biopsy-proven DLBCL excluding DLBCL that represents transformation of indolent
non-Hodgkin's lymphoma (NHL) Note: Lymphoblastic Lymphoma and Burkitt Lymphoma
histology are not eligible
- Subject has = 1 characteristic feature of high-risk DLBCL:
- High-risk first complete remission (defined as interim positron emission
tomography - computed tomography (PET-CT) positive or < complete remission to
frontline chemotherapy AND achieved complete remission to platinum-containing
salvage)
- Relapse within 1 year of diagnosis
- Secondary age-adjusted international prognostic index > 1
- Partial response/partial metabolic response after minimum of 2 cycles of
platinum-containing salvage chemotherapy
- C-myc rearrangement
- aHSCT with high-dose chemotherapy following first (or later) salvage treatment.
- PET-CT negative (Deauville score = 3) 90 days (± 30 days) post aHSCT
- Available relapsed and/or diagnostic pathology formalin-fixed paraffin-embedded (FFPE)
tumor block or slide samples at the time of enrollment including the successful
identification of malignant clone sequences by the central laboratory.
- MRD plasma sample collected = 3 weeks after the post aHSCT PET-CT scan
- Eastern Cooperative Oncology Group (ECOG) performance status = 2.
- Adequate organ function determined = 3 weeks prior to enrollment defined as follows:
- Hematological:
Absolute neutrophil count (ANC) = 1.0 x 109/L Platelet count = 75 x 109/L Hemoglobin = 8
g/dL
- Renal:
Creatinine clearance = 50 mL/min Cockcroft-Gault equation
- Hepatic:
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x upper limit of
normal (ULN) Total bilirubin < 2 x ULN (unless Gilbert's Disease or if liver involvement
with lymphoma)
- Subject will be available to complete all protocol-required study visits or
procedures, and/or to comply with all required study procedures to the best of the
subject's and investigator's knowledge including but not limited to:
- Completion of up to a 24-month run-in period
- Completion of all regularly scheduled study visits including blood draws for MRD
assessment, clinical disease state assessment, PET-CT scans (ie, at time of MRD
positivity or relapse), assignment to treatment with blinatumomab
- Other Inclusion criteria may apply. See "Inclusion and Exclusion criteria - Part
2".
Exclusion Criteria - Part 1
- Clinically relevant central nervous system (CNS) pathology such as epilepsy, seizure,
paresis, aphasia,stroke, severe brain injury, dementia, Parkinson's disease,
cerebellar disease, organic brain syndrome, and psychosis
- Evidence of CNS involvement with DLBCL at disease evaluation obtained prior to
starting blinatumomab
- Current autoimmune disease or history of autoimmune disease with potential of CNS
involvement
- Prior anti-CD19 directed therapies
- Prior alloHSCT
- Received radiation = 2 weeks prior to enrollment
- Infection with human immunodeficiency virus or chronic infection with hepatitis B
virus (hepatitis B surface antigen positive) or hepatitis C virus (anti-hepatitis C
virus positive)
- History of malignancy other than DLBCL within the past 3 years with the following
exceptions:
- Malignancy treated with curative intent and with no known active disease present
for = 3 years before enrollment and felt to be at low risk for recurrence by the
treating physician
- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence
of disease
- Adequately treated cervical carcinoma in situ without evidence of disease
- Adequately treated breast ductal carcinoma in situ without evidence of disease
- Prostatic intraepithelial neoplasia without evidence of prostate cancer
- Adequately treated urothelial papillary noninvasive carcinoma or carcinoma in
situ
- Subject has known hypersensitivity to immunoglobulins or any of the products or
components to be administered during dosing.
- History or evidence of any other clinically significant disorder, condition or disease
(with the exception of those outlined above) that, in the opinion of the investigator
or Amgen physician, if consulted, would pose a risk to subject safety or interfere
with the study evaluation, procedures or completion.
- Women who are pregnant or breastfeeding or planning to become pregnant or breastfeed
while receiving blinatumomab and for an additional 48 hours after the last treatment
dose of blinatumomab. (Females of child bearing potential should only be included
after a negative highly sensitive urine or serum pregnancy test.)
- Women of childbearing potential unwilling to use an acceptable method of effective
contraception while receiving blinatumomab and for an additional 48 hours after last
dose of blinatumomab. Note: The pregnancy, breastfeeding and contraceptive
requirements are specific to blinatumomab. The investigator is responsible for
providing the subject (male and female) with pregnancy and breastfeeding (female only)
avoidance requirements for other medications given during the study.
- Currently receiving treatment in another investigational device or drug study or less
than 30 days since ending treatment on another investigational device or drug study.
Other investigational procedures while participating in this study are excluded.
- Other Exclusion criteria may apply. See "Inclusion and Exclusion criteria - Part
2".
Inclusion and Exclusion Criteria - Part 2
Inclusion Criteria - Part 2
- MRD-positive assessment (by NGS analysis) at enrollment or at any time during the
run-in 1 period
- PET-CT negative (defined by Deauville criteria = 3) at run-in 2 performed = 3 weeks
from MRD test result available to the site at run-in 1. Historical PET-CT are allowed
if performed = 6 weeks from day 1 (first dose of blinatumomab) and subject has no
clinical signs or symptoms suggestive of disease progression (eg, increase in lactate
dehydrogenase [LDH] not otherwise explained)
- Adequate organ function determined = 7 days prior to treatment assignment with
blinatumomab as follows:
- Hematological:
ANC = 1.0 x 109/L Hemoglobin = 8 g/L Platelet count = 75 x 109/L
- Renal:
Creatinine clearance = 50 mL/min Cockcroft-Gault equation
- Hepatic:
AST and ALT < 3 x ULN Total bilirubin < 2 x ULN (unless Gilbert's Disease or if liver
involvement with lymphoma)
Exclusion Criteria - Part 2
- Subject has active infection requiring systemic therapy
- Any change in the part 1 eligibility criteria during the run-in period.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
N/A
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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
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Terminated
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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
23/05/2018
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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
30/09/2019
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Sample size
Target
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Accrual to date
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Final
10
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Research Site - St Leonards
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Recruitment hospital [2]
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Research Site - Westmead
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Recruitment hospital [3]
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Research Site - Clayton
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Recruitment hospital [4]
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Research Site - Geelong
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Recruitment postcode(s) [1]
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2065 - St Leonards
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Recruitment postcode(s) [2]
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2145 - Westmead
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Recruitment postcode(s) [3]
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3168 - Clayton
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Recruitment postcode(s) [4]
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3220 - Geelong
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Recruitment outside Australia
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United States of America
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Georgia
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United States of America
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Illinois
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Ohio
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United States of America
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Texas
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Belgium
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Charleroi
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Belgium
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Leuven
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Belgium
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Liege
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France
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Créteil Cedex
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France
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Lille
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France
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Marseille
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France
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Montpellier cedex 5
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France
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Paris Cedex 10
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France
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Pessac Cedex
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France
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Pierre Benite Cedex
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France
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Rouen
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Greece
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Athens
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Greece
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Thessaloniki
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Italy
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Bergamo
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Italy
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Brescia
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Italy
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Firenze
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Italy
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Milano
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Italy
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Palermo
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Italy
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Torino
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Switzerland
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Bellinzona
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Switzerland
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Bern
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Switzerland
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Lausanne
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Switzerland
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Zurich
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Amgen
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The study will estimate the MRD-negative response rate after treatment with blinatumomab in
subjects with high-risk DLBCL who are MRD-positive following aHSCT. The clinical hypothesis
is that the MRD-negative response rate will be greater than 10%. Achieving an MRD-negative
response rate of 30% would be of scientific and clinical interest.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT03298412
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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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MD
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Address
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Amgen
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Contact person for public queries
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT03298412
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