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High-risk Diffuse Large B-cell LymphomaPhase 2NCT03298412

Effect of Blinatumomab on Minimal Residual Disease (MRD) in Diffuse Large B-Cell Lymphoma (DLBCL) Subjects Post Autologous Hematopoietic Stem Cell Transplantation (aHSCT)

A Phase 2 study testing Blinatumomab in people with High-risk Diffuse Large B-cell Lymphoma, run by Amgen at 32 sites in 7 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial 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%. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
High-risk Diffuse Large B-cell Lymphoma
What is being tested?
Blinatumomab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
32 sitesin 7 countries
Study dates
23 May 2018to 30 Sep 2019
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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
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  • 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".
  • 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)

Who cannot join

  • 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
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  • 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".
  • Subject has active infection requiring systemic therapy
  • Any change in the part 1 eligibility criteria during the run-in period.

Trial locations and contacts

32 sites in 7 countries.

32 sites in 7 countries

France8 sites
  • Research Site

    Créteil, 94010

  • Research Site

    Lille, 59037

  • Research Site

    Marseille, 13009

  • Research Site

    Montpellier, 34295

  • Research Site

    Paris, 75475

  • Research Site

    Pessac, 33604

  • Research Site

    Pierre-Bénite, 69495

  • Research Site

    Rouen, 76038

Other trials in France

Italy6 sites
  • Research Site

    Bergamo, 24127

  • Research Site

    Brescia, 25123

  • Research Site

    Florence, 50134

  • Research Site

    Milan, 20162

  • Research Site

    Palermo, 90146

  • Research Site

    Torino, 10126

Other trials in Italy

United States4 sites
  • Research Site

    Atlanta, Georgia, 30342

  • Research Site

    Cleveland, Ohio, 44195

  • Research Site

    Dallas, Texas, 75246

  • Research Site

    Maywood, Illinois, 60153

Other trials in United States

Australia4 sites
  • Research Site

    Clayton, Victoria, 3168

  • Research Site

    Geelong, Victoria, 3220

  • Research Site

    St Leonards, New South Wales, 2065

  • Research Site

    Westmead, New South Wales, 2145

Other trials in Australia

Switzerland4 sites
  • Research Site

    Bellinzona, 6500

  • Research Site

    Bern, 3010

  • Research Site

    Lausanne, 1011

  • Research Site

    Zurich, 8091

Other trials in Switzerland

Belgium3 sites
  • Research Site

    Charleroi, 6000

  • Research Site

    Leuven, 3000

  • Research Site

    Liège, 4000

Other trials in Belgium

Greece3 sites
  • Research Site

    Athens, 10676

  • Research Site

    Athens, 11527

  • Research Site

    Thessaloniki, 57010

Other trials in Greece

About this study

Official 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.

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.

Read the detailed description

This is a phase 2, multicenter, open-label, single arm estimation study in adult subjects with high-risk DLBCL in complete remission. The study will consist of up to a 28-day screening period, a run-in period of up to 24 months, a 12-week treatment period (8 weeks of blinatumomab treatment followed by a 4-week treatment free period), a 30-day safety follow-up visit after the last dose of blinatumomab, and a long-term follow-up period that begins after the safety follow-up visit is completed until 1 year from the first dose of blinatumomab. The study will enroll approximately 90 subjects in the screening period with biopsy proven, high-risk DLBCL that are positron emission tomography-computer tomography (PET-CT) negative 90 days (± 30 days) post aHSCT. During the run-in period subjects will be followed by clinic visits at regular interval for up to 24 months for monitoring of MRD status in plasma by a next generation sequencing (NGS)-based assay. It is estimated 30 subjects will be either MRD-positive at screening or become MRD-positive during the 24-month run-in period. The number of subjects enrolled may be altered in order to ensure that approximately 30 subjects are assigned to treatment with blinatumomab. Enrollment may be stopped, once approximately 30 subjects have been assigned to treatment with blinatumomab.

Being tested
Blinatumomab

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BlinatumomabDrug

    Also called BLINCYTO, AMG 103

    Blinatumomab is administered as a continuous IV infusion.

Study groups in NCT03298412
Study groupRoleWhat they receive
BlinatumomabExperimentalAfter 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.
Receives: Drug: Blinatumomab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. MRD-Negative Rate at the End of Cycle 1

    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).

    Measured: 12 weeks (84 days)

Secondary outcomes (4)
  1. Kaplan-Meier Estimate: Progression-Free Survival (PFS)

    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.

    Measured: up to 1 year from first dose of blinatumomab

  2. Kaplan-Meier Estimate: Duration of MRD-Negative Status

    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.

    Measured: up to 1 year from first dose of blinatumomab

  3. Kaplan-Meier Estimate: Overall Survival (OS)

    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.

    Measured: up to 1 year from first dose of blinatumomab

  4. Number of Participants With Treatment Emergent Adverse Events (TEAEs)

    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).

    Measured: 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.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Oct 2017
  2. Study start23 May 2018
  3. Primary completion30 Sep 2019
  4. Study completion30 Sep 2019

Why it stopped: Early Closure due to rare patient population

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03298412
Sponsor's protocol ID
20150291
Other IDs
2016-003255-30, 2016
Status last verified
Sep 2020
First submitted
12 Sep 2017
Last updated
11 Sep 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Blinatumomab in people with High-risk Diffuse Large B-cell Lymphoma, run by Amgen at 32 sites in 7 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 34 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 11 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in France, Italy, United States, Australia, Switzerland and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

MRD-Negative Rate at the End of Cycle 1 (time frame: 12 weeks (84 days)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Sep 2020.

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