- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03072771
Blinatumomab Consolidation Post Autologous Stem Cell Transplantation in Patients With Diffuse Large B-Cell Lymphoma (DLBCL)
A Pilot Trial of Blinatumomab Consolidation Post Autologous Stem Cell Transplantation in Patients With DLBCL
Based on the further need to improve progression-free survival (PFS) and overall survival (OS) post autologous stem cell transplant (SCT) for DLBCL, the hematopoietic profile of patients following auto-SCT, the activity of blinatumomab in DLBCL and its favorable toxicity profile, the investigators propose a pilot study to test blinatumomab as consolidation therapy post auto-SCT for patients with DLBCL.
The investigators hypothesize the blinatumomab consolidation will optimize the effector to target (E-T) ratio and aid in the eradication of remaining tumor cells, leading to decreased relapse and increased overall survival. In addition, since tumor burden will be at a minimum, infusional toxicities including neurologic toxicities may also be limited. The purpose of this pilot study is to study the feasibility and tolerability of blinatumomab consolidation post auto-SCT for patients with chemo-sensitive DLBCL undergoing auto-SCT.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Missouri
-
Saint Louis, Missouri, United States, 63110
- Washington University School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Pre-ASCT Inclusion Criteria
- At least 18 years of age
- Histologically confirmed diagnosis of CD19 positive diffuse large B-cell lymphoma (DLBCL) or transformed large cell lymphoma from low grade lymphoma.
- Chemo-sensitive (defined by complete remission (CR) or partial remission (PR) to most recent chemo regimen) based on pre-transplant positron emission tomography (PET) within 2 months of autologous transplant
- Patients with bulky disease are eligible for study provided that the patient not undergo radiation therapy until 30 days after the end of blinatumomab administration.
- Available representative tissue (from fresh or formalin fixed paraffin embedded tissue) from the most recent biopsy or archival tumor tissue for Clonotype evaluation for minimal residual disease (MRD) testing.
Pre-ASCT Exclusion Criteria
- Chemo-resistant (defined by stable disease (SD) or progressive disease (PD) to most recent chemo regimen)
- Pregnant or breastfeeding
- Active central nervous system (CNS) involvement of Non-Hodgkin's Lymphoma (NHL)
- Clinically relevant CNS pathology such as epilepsy, childhood or adult seizure, paresis, aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis
- Prior stem cell transplant
- Concurrent hematologic or non-hematologic malignancy requiring treatment
- HIV seropositive, or active Hepatitis A, B, or C infection.
- Uncontrolled congestive heart failure (CHF) or other comorbid systemic illnesses or severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.
Eligibility Criteria to Begin Consolidation Therapy
- A participant must meet all of the following criteria on Day +42 visit in order to continue on the study to begin consolidation therapy with blinatumomab.
- Performance status of Eastern Cooperative Oncology Group (ECOG) ≤ 2 or Karnofsky ≥ 60 %
- Absence of clinically relevant CNS pathology such as epilepsy, paresis, aphasia, stroke, sever brain injuries, dementia, or psychosis
Required clinical laboratory values:
- Absolute neutrophil count (ANC) ≥ 1,000
- Platelets ≥ 75,000
- Hemoglobin ≥ 8 g/dL
- Total bilirubin ≤ 1.5 x upper limit of normal (ULN) (unless related to Gilbert's or Meulengracht's syndrome)
- Alkaline phosphatase ≤ 5 x ULN
- ALT and AST ≤ 5 x ULN
- Calculated or measured creatinine clearance ≥ 50ml/min
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ASCT + BEAM + Blinatumomab
|
-Blinatumomab is a bispecific T cell engaging antibody
Other Names:
-Standard of care
Other Names:
-Carmustine is an alkylating agent.
It will be sourced from commercial supply.
Institutional guidelines will be followed for storage, preparation, and administration of carmustine.
Other Names:
-Etoposide is a semi-synthetic podophyllotoxin derivative.
It will be sourced from commercial supply.
Institutional guidelines will be followed for storage, preparation, and administration of etoposide.
Other Names:
-Cytarabine, commonly known as Ara-C, is a synthetic nucleoside.
It will be sourced from commercial supply.
Institutional guidelines will be followed for storage, preparation, and administration of cytarabine.
Other Names:
-Melphalan is an alkylating agent.
It will be sourced from commercial supply.
Institutional guidelines will be followed for storage, preparation, and administration of melphalan.
Other Names:
-Day +42, Day + 43, Day +56, and Day +100
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility and tolerability of blinatumomab consolidation post auto-SCT as measured by percentage of patients who can finish a full course of blinatumomab post-auto-SCT
Time Frame: Up to Day 70
|
-The primary endpoint is calculated by the proportion of patients who complete a full course of blinatumomab to the total number of patients started blinatumomab after auto-SCT.
|
Up to Day 70
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-free survival (PFS)
Time Frame: 1 year post-auto-SCT
|
-PFS is defined as from the date of Day 0 to date of progression or death, which occurs first.
They are censored at the last follow-up otherwise.
|
1 year post-auto-SCT
|
Progression-free survival (PFS)
Time Frame: 3 years post-auto-SCT
|
-PFS is defined as from the date of Day 0 to date of progression or death, which occurs first.
They are censored at the last follow-up otherwise.
|
3 years post-auto-SCT
|
Overall survival
Time Frame: 1 year post-auto-SCT
|
-OS is defined as from the date of Day 0 to date of death.
They are censored at the last follow-up otherwise.
|
1 year post-auto-SCT
|
Overall survival
Time Frame: 3 years post-auto-SCT
|
-OS is defined as from the date of Day 0 to date of death.
They are censored at the last follow-up otherwise.
|
3 years post-auto-SCT
|
Complete remission rate in patients with residual disease after auto-SCT
Time Frame: Up to Day 100
|
-Complete remission=disappearance of all evidence of disease
|
Up to Day 100
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Armin Ghobadi, M.D., Washington University School of Medicine
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Lymphoma, B-Cell
- Lymphoma, Large B-Cell, Diffuse
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Etoposide
- Melphalan
- Cytarabine
- Carmustine
- Blinatumomab
Other Study ID Numbers
- 201704108
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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