A Study of the Bruton's Tyrosine Kinase Inhibitor Ibrutinib Given in Combination With Bendamustine and Rituximab in Patients With Newly Diagnosed Mantle Cell Lymphoma
A Randomized, Double-blind, Placebo-controlled Phase 3 Study of the Bruton's Tyrosine Kinase (BTK) Inhibitor, PCI-32765 (Ibrutinib), in Combination With Bendamustine and Rituximab (BR) in Subjects With Newly Diagnosed Mantle Cell Lymphoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Buenos Aires, Argentina
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Ciudad Autonoma de Buenos Aires, Argentina
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Cordoba, Argentina
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La Capital, Argentina
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Parana, Argentina
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Adelaide, Australia
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Auchenflower, Australia
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Box Hill, Australia
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Concord, Australia
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Douglas, Australia
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Gosford, Australia
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Hobart, Australia
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Prahran, Australia
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Antwerpen, Belgium
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Brugge, Belgium
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Brussels, Belgium
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Gent, Belgium
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Leuven, Belgium
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Wilrijk, Belgium
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Yvoir, Belgium
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Barretos, Brazil
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Goiania, Brazil
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Porto Alegre, Brazil
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Ribeirao Preto, Brazil
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Rio de Janeiro, Brazil
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Sao Paulo, Brazil
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Alberta
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Edmonton, Alberta, Canada
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British Columbia
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Vancouver, British Columbia, Canada
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Ontario
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Hamilton, Ontario, Canada
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Ottawa, Ontario, Canada
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Quebec
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Montreal, Quebec, Canada
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Beijing, China
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Chengdu, China
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Guangzhou, China
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Hangzhou, China
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Shanghai, China
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Tianjin, China
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Brno, Czechia
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Hradec Kralove, Czechia
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Praha 10, Czechia
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Creteil, France
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F-75 730 Paris Cedex 15, France
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Grenoble, France
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Nantes, France
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Paris, France
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Pessac, France
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Tours Cedex 9, France
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Berlin, Germany
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Heidelberg, Germany
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Jena, Germany
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Mainz, Germany
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München, Germany
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TÿBINGEN, Germany
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Ulm, Germany
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Villingen-Schwenningen, Germany
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Athens, Greece
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Athens Attica, Greece
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Thessalonikis, Greece
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Budapest N/a, Hungary
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Debrecen, Hungary
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Kaposvár, Hungary
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Pecs, Hungary
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Szeged, Hungary
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Dublin, Ireland
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Galway, Ireland
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Afula, Israel
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Beer-Sheva, Israel
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Haifa, Israel
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Jerusalem, Israel
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Nahariya, Israel
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Petach Tikva, Israel
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Ramat-Gan, Israel
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Tel Aviv, Israel
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Zerifin, Israel
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Fukuoka, Japan
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Hiroshima, Japan
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Kyoto, Japan
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Nagoya, Japan
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Osaka, Japan
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Sapporo, Japan
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Sendai-shi, Japan
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Suita, Japan
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Tokyo, Japan
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Gyeonggi-do, Korea, Republic of
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Jeollanam-do, Korea, Republic of
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Seoul, Korea, Republic of
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Monterrey, Mexico
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Oaxaca, Mexico
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Amsterdam Zuidoost, Netherlands
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Dordrecht, Netherlands
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Groningen, Netherlands
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Leiden, Netherlands
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Rotterdam, Netherlands
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Utrecht, Netherlands
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Bydgoszcz, Poland
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Krakow, Poland
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Olsztyn, Poland
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Warszawa, Poland
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Wroclaw, Poland
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San Juan, Puerto Rico
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Chelyabinsk, Russian Federation
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Ekaterinburg, Russian Federation
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Krasnodar, Russian Federation
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Moscow, Russian Federation
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Moscow N/a, Russian Federation
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Nizhny Novgorod, Russian Federation
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Novosibirsk, Russian Federation
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Petrozavodsk, Russian Federation
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Rostov-Na-Donu, Russian Federation
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Ryazan, Russian Federation
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Sochi, Russian Federation
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St-Petersburg, Russian Federation
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St.Petersurg, Russian Federation
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Syktyvkar, Russian Federation
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Volgograd, Russian Federation
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Banska Bystrica, Slovakia
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Bratislava, Slovakia
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Kosice, Slovakia
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Martin, Slovakia
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Presov 1, Slovakia
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Barcelona, Spain
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Madrid, Spain
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Oviedo, Spain
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Palma De Mallorca, Spain
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Salamanca, Spain
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Santiago De Compostela, Spain
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Linköping, Sweden
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Lund, Sweden
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Stockholm, Sweden
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Umeaa, Sweden
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Uppsala, Sweden
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Changhua, Taiwan
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Kaohsiung County, Taiwan
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Taichung, Taiwan
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Tainan, Taiwan
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Taipei, Taiwan
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Taoyuan, Taiwan
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Adana, Turkey
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Ankara, Turkey
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Diyarbakir, Turkey
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Istanbul, Turkey
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Izmir, Turkey
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Kayseri, Turkey
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Mersin, Turkey
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Cherkassy, Ukraine
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Donetsk, Ukraine
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Khmelnitskiy, Ukraine
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Kiev, Ukraine
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Lviv, Ukraine
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Canterbury, United Kingdom
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Glasgow, United Kingdom
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Leeds, United Kingdom
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Leicester, United Kingdom
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Liverpool, United Kingdom
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London, United Kingdom
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Manchester, United Kingdom
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Plymouth, United Kingdom
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Southampton, United Kingdom
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Sutton, United Kingdom
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Arizona
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Tucson, Arizona, United States
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California
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Burbank, California, United States
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La Jolla, California, United States
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Stanford, California, United States
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Colorado
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Denver, Colorado, United States
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Connecticut
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New Haven, Connecticut, United States
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Stamford, Connecticut, United States
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Illinois
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Chicago, Illinois, United States
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Maywood, Illinois, United States
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Niles, Illinois, United States
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Springfield, Illinois, United States
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Indiana
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Goshen, Indiana, United States
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Iowa
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Iowa City, Iowa, United States
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Sioux City, Iowa, United States
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Kansas
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Topeka, Kansas, United States
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Westwood, Kansas, United States
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Kentucky
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Lexington, Kentucky, United States
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Louisville, Kentucky, United States
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Louisiana
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Metairie, Louisiana, United States
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Michigan
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Ann Arbor, Michigan, United States
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Detroit, Michigan, United States
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Missouri
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Jefferson City, Missouri, United States
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Nebraska
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Lincoln, Nebraska, United States
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New Jersey
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Hackensack, New Jersey, United States
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New Brunswick, New Jersey, United States
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New Mexico
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Albuquerque, New Mexico, United States
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New York
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Albany, New York, United States
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Hawthorne, New York, United States
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New York, New York, United States
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North Carolina
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Durham, North Carolina, United States
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Greenville, North Carolina, United States
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North Dakota
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Bismarck, North Dakota, United States
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Fargo, North Dakota, United States
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Oregon
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Eugene, Oregon, United States
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Portland, Oregon, United States
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Pennsylvania
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Philadelphia, Pennsylvania, United States
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South Carolina
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Greenville, South Carolina, United States
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South Dakota
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Watertown, South Dakota, United States
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Tennessee
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Nashville, Tennessee, United States
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Texas
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Houston, Texas, United States
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San Antonio, Texas, United States
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Vermont
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Burlington, Vermont, United States
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Washington
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Spokane, Washington, United States
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Vancouver, Washington, United States
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of mantle cell lymphoma (MCL) reviewed and approved by central laboratory: diagnosis must include morphology and expression of either cyclin D1 in association with other relevant markers (eg, CD19, CD20, PAX5 and CD5) or evidence of t(11;14) as assessed by cytogenetics, fluorescent in situ hybridization (FISH), or polymerase chain reaction (PCR)
- Clinical Stage II, III, or IV by Ann Arbor Classification
- At least 1 measurable site of disease according to Revised Response Criteria for Malignant Lymphoma
- No prior therapies for MCL
- Eastern Cooperative Oncology Group (ECOG) performance status grade 0 or 1
- Hematology and biochemical laboratory values within protocol-defined limits
- Agrees to protocol-defined use of effective contraception
- Negative blood or urine pregnancy test at screening
Exclusion Criteria:
- Major surgery within 4 weeks of random assignment
- Known central nervous system lymphoma
- Diagnosed or treated for malignancy other than MCL, except: malignancy treated with curative intent and with no known active disease present for >=3 years before random assignment; adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease; adequately treated cervical carcinoma in situ without evidence of disease
- Patients for whom the goal of therapy is tumor debulking prior to stem cell transplant
- History of stroke or intracranial hemorrhage within 6 months prior to random assignment
- Requires anticoagulation with warfarin or equivalent vitamin K antagonists
- Requires treatment with strong CYP3A inhibitors
- Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification
- Vaccinated with live, attenuated vaccines within 4 weeks of random assignment
- Known history of human immunodeficiency virus (HIV) or active hepatitis C virus or active hepatitis B virus infection or any uncontrolled active systemic infection requiring intravenous antibiotics
- Any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator's opinion, could compromise the patient's safety, interfere with the absorption or metabolism of ibrutinib capsules, or put the study outcomes at undue risk
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Treatment Arm B
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90 mg/m2 administered intravenously on Days 1-2, Cycles 1-6
375 mg/m2 administered intravenously on Day 1, Cycles 1-6; if complete response or partial response is achieved, 375 mg/m2 is administered on Day 1 of every second cycle for a maximum of 12 additional doses
560 mg (4 x 140 mg capsules) administered orally once daily continuously starting on Day 1, Cycle 1 until disease progression, or unacceptable toxicity, or study end
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Placebo Comparator: Treatment Arm A
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90 mg/m2 administered intravenously on Days 1-2, Cycles 1-6
375 mg/m2 administered intravenously on Day 1, Cycles 1-6; if complete response or partial response is achieved, 375 mg/m2 is administered on Day 1 of every second cycle for a maximum of 12 additional doses
4 capsules administered orally once daily continuously starting on Day 1, Cycle 1 until disease progression, or unacceptable toxicity, or the final analysis of progression-free survival
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Progression-free Survival (PFS)
Time Frame: Up to 97 months
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Progression-free survival (PFS) was defined as the interval between the date of randomization to the date of disease progression (PD) or relapse from complete response (CR) or death, whichever was first reported.
Disease assessments were based on the 2007 Revised Response Criteria for Malignant Lymphoma.
PD was defined as any new lesion or increase by 50 percent (%) of previously involved sites from nadir (PD criteria: Appearance of new nodal lesion 1.5 centimeters [cm] in any axis, 50% increase in sum of product of diameters [SPD] of greater than [>] 1 node or 50% increase in longest diameter of previously identified node 1 cm in short axis).
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Up to 97 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Time-to-Next Treatment
Time Frame: Up to 97 months
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Time-to-next treatment was measured from the date of randomization to the start date of any anti-mantle cell lymphoma (anti-MCL) treatment subsequent to the study treatment.
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Up to 97 months
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Minimal Residual Disease (MRD)-Negative Response Rate
Time Frame: Up to 97 months
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Minimal residual disease negative rate was defined as the percentage of participants with a best overall response of CR with MRD-negative disease status (that is, <5 mantle cell lymphoma [MCL] cell per 10,000 leukocytes for detection using the MRD assay), as assessed by flow cytometry of a bone marrow and/or peripheral blood sample.
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Up to 97 months
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Time to Response
Time Frame: Up to 97 months
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Time to response was defined as the interval between the date of randomization and the date of initial documentation of a response.
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Up to 97 months
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Overall Survival
Time Frame: From randomization (Day -3) up to 121 months
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Overall survival was defined as the time from the date of randomization to the date of the participant's death.
Kaplan-Meier estimate was used.
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From randomization (Day -3) up to 121 months
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Complete Response Rate
Time Frame: Up to 97 months
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Complete response (CR) rate was defined as the percentage of participants who achieve CR (based on investigator assessment) on or prior to the initiation of subsequent anticancer therapy.
Criteria for CR: disappearance of all evidence of disease; mass of any size permitted if positron emission tomography (PET) negative; regression to normal size on computed tomography (CT); spleen and liver: not palpable, nodules disappeared; bone marrow: infiltrate cleared on repeat biopsy.
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Up to 97 months
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Percentage of Participants With Overall Response
Time Frame: Up to 97 months
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Percentage of participants with overall response was defined as the portion of participants who achieved CR or PR.
Criteria for CR: disappearance of all evidence of disease; mass of any size permitted if PET negative; regression to normal size on CT; spleen and liver: not palpable, nodules disappeared; bone marrow: infiltrate cleared on repeat biopsy.
Criteria for PR: greater than or equal to (>=) 50% decrease in sum of the diameter of all target lesions compared with baseline, in absence of new lesions or unequivocal progression of non-target lesions.
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Up to 97 months
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Time to Worsening (TTW) in the Lymphoma (Lym) Subscale of the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) Questionnaire
Time Frame: Up to 97 months
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Time to worsening in the Lymphoma subscale of the FACT-Lym, defined as the interval from the date of randomization to the start date of worsening of participant symptoms.
Worsening was defined by a 5-point decrease from baseline, death, or a missing assessment due to being "too ill", whichever occurred first.
FACT-Lym Lymphoma subscale contains 15 questions, scores from 0 to 4 for each question (higher the worse).
Lymphoma subscale score was the total of reverse scores, ranged 0 to 60. Higher scores indicated a better quality of life.
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Up to 97 months
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Duration of Response (DoR)
Time Frame: Up to 97 months
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Duration of Response (DoR) was defined as the interval between the date of initial documentation of a response including PR and the date of first documented evidence of PD or death
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Up to 97 months
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Duration of Complete Response (DoCR)
Time Frame: Up to 97 months
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Duration of complete response (DoCR) was defined as the interval between the date of initial documentation of a CR and the date of first documented evidence of PD or death whichever occurs first.
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Up to 97 months
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Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Time Frame: Placebo + BR (Treatment A): From first dose of study treatment (Day 1) up to 100.1 months; Ibrutinib + BR (Treatment B): From first dose of study treatment (Day 1) up to 117.2 months
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Number of participants with TEAEs were reported.
An AE was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non investigational) product.
An AE does not necessarily have a causal relationship with the intervention.
Treatment-emergent adverse events were defined as adverse events with onset or worsening on or after date of first dose of study treatment up to and including 30 days after date of last dose of study medication, or the initiation of subsequent anticancer therapy, whichever is earlier.
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Placebo + BR (Treatment A): From first dose of study treatment (Day 1) up to 100.1 months; Ibrutinib + BR (Treatment B): From first dose of study treatment (Day 1) up to 117.2 months
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Oral Plasma Clearance (CL/F) of Ibrutinib
Time Frame: Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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CL/F was defined as apparent total systemic clearance of ibrutinib after extravascular administration.
Cl/F of Ibrutinib was determined using population pharmacokinetics (PopPK modeling).
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Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Oral Volume of Distribution at Steady State of Ibrutinib
Time Frame: Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Oral volume of distribution at steady state of ibrutinib was determined using PopPK modeling.
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Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Area Under the Concentration Curve of Ibrutinib During 24 Hours After Dosing at Steady State
Time Frame: Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Area under the concentration curve of ibrutinib during 24 hours after dosing at steady state was determined using PopPK modeling.
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Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Minimum Observed Plasma Concentration of Ibrutinib
Time Frame: Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Minimum observed plasma concentration of ibrutinib was determined using PopPK modeling.
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Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Maximum Observed Plasma Concentration of Ibrutinib
Time Frame: Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Maximum observed plasma concentration of ibrutinib was determined using PopPK modeling.
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Pre-dose on Day 2 of Cycles 1, 2 and 3; and 1, 2 and 4 hours post-dose on Day 2 of Cycles 1 and 2
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Janssen Research & Development, LLC Clinical Trial, Janssen Research & Development, LLC
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Immune System Diseases
- Neoplasms by Histologic Type
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Lymphoma, Mantle-Cell
- Antineoplastic Agents, Immunological
- Tyrosine Kinase Inhibitors
- Antineoplastic Agents
- Immunologic Factors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antirheumatic Agents
- Protein Kinase Inhibitors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Bendamustine Hydrochloride
- Rituximab
- Ibrutinib
Other Study ID Numbers
Other Study ID Numbers
- CR100967
- PCI-32765MCL3002 (Other Identifier: Janssen Research & Development, LLC)
- U1111-1137-0389 (Other Identifier: Universal Trial Number)
- 2012-004056-11 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated device product
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