AI-Driven Treatment Strategy vs Pola-R-CHP in Untreated LBCL (GUIDANCE-10)
A Study to Evaluate the Efficacy and Safety of an AI-Driven Treatment Strategy Versus Pola-R-CHP in Patients With Previously Untreated Large B-Cell Lymphoma
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Weili Zhao
- Telefonnummer: +862164370045 Ext. 610707
- E-mail: zwl_trial@163.com
Undersøgelse Kontakt Backup
- Navn: Pengpeng Xu
- Telefonnummer: +862164370045 Ext. 610707
- E-mail: pengpeng_xu@126.com
Studiesteder
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Kina, 200020
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
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Kontakt:
- Weili Zhao
- Telefonnummer: 64370045
- E-mail: zwl_trial@163.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age 18-75 years with comprehensive geriatric assessment stratified as fit
- Previously untreated participants with CD20-positive LBCL (without central nervous system involvement)
- ECOG Performance Status of 0, 1, or 2
- After 1 cycle of Pola-R-CHP, classified as intermediate-risk or high-risk by AI-based multimodal stratification
- Life expectancy ≥ 3 months
- At least 1 measurable site of disease (defined as lymph nodes with the long diameters longer than 1.5cm, or extra-nodal sites with the long diameters longer than 1.0cm; meanwhile, any lesion site with at least 2 measurable vertical diameters)
- The patient or his or her legal representative must provide written informed consent prior to any special examination or procedure for the research.
- Anti-lymphoma drugs have not been used before (except glucocorticoids)
Exclusion Criteria:
- Prior solid organ transplantation or SCT
- Significant or extensive history of cardiovascular disease such as New York Heart Association Class III or IV cardiac disease or Objective Assessment Class C or D, myocardial infarction within the last 6 months prior to the start of Cycle 1, unstable arrhythmias, or unstable angina
- History or presence of an abnormal ECG that is clinically significant in the investigator's opinion
Any of the following abnormal laboratory values (unless any of these abnormalities are due to underlying lymphoma):
- Absolute neutrophil count <1.0 × 10⁹/L.
- Platelet count <75 × 10⁹/L
- Serum AST and ALT ≥ 2.5 x ULN
- Total bilirubin ≥ 1.5 x ULN
- Serum creatinine clearance < 30 mL/min (using Cockcroft-Gault formula)
- Any active infection within 7 days prior to Cycle 1 Day 1 that would impact participant safety
- Positive test results for chronic hepatitis B infection (defined as positive hepatitis B surface antigen [HBsAg] serology):Participants with occult or prior hepatitis B infection (defined as positive total hepatitis B core antibody and negative HbsAg) may be included if hepatitis B virus (HBV) DNA is undetectable at the time of screening. Such participants must be willing to undergo HBV DNA testing every month and appropriate antiviral therapy as indicated
- Positive test results for hepatitis C (hepatitis C virus [HCV] antibody serology testing):Participants positive for HCV antibody are eligible only if PCR is negative for HCV RNA
- Participants with a history of progressive multifocal leukoencephalopathy
- Pregnancy or breastfeeding, or intention of becoming pregnant during the study or within 12 months after final dose of treatment
- Participants with uncontrolled coagulation disorders, connective tissue diseases, severe infectious diseases
- Other concurrent and uncontrolled medical conditions that, in the opinion of the investigator, would affect the patient's participation in the study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Genotype-guided targeted agents or glofitamab in combination with Pola-R-CHP
Participants will receive polatuzumab vedotin 1.8 milligrams per kilogram (mg/kg) intravenously (IV) on Day 2, rituximab 375 milligrams per square meter (mg/m²) IV on Day 1, cyclophosphamide 750 mg/m² IV on Day 2, doxorubicin 50 mg/m² IV on Day 2, and prednisone 100 milligrams per day (mg/day) orally (PO) on Days 2-6 of the first 21-day cycle.
For the remaining five cycles, participants will receive standard Pola-R-CHP in combination with one of the following: zanubrutinib 160 mg BID PO on Days 1-21, lenalidomide 25 mg/day PO on Days 2-11, decitabine 10 mg/m²/day IV on Days -5 to -1, or glofitamab administered IV with step-up dosing of 2.5 mg on Cycle 2 Day 8, 10 mg on Cycle 2 Day 15, and 30 mg on Day 8 of Cycles 3-6.
Each treatment cycle is 21 days.
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Polatuzumab vedotin IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Cyclophosphamid IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Doxorubicin IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Prednison PO vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Lenalidomid PO vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Decitabin IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Zannubrutinib PO administreres i henhold til den plan, der er angivet i den respektive arm.
Glofitamab IV infusion administreres i henhold til tidsplanen angivet i den respektive arm.
Rituximab IV infusion will be administered as per the schedule specified in the respective arm.
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Aktiv komparator: Pola-R-CHP
Participants will receive polatuzumab vedotin 1.8 milligrams per kilogram (mg/kg) intravenously (IV) on Day2, rituximab 375 milligrams per square meter (mg/m²) IV on Day 1, cyclophosphamide 750 mg/m² IV on Day 2, doxorubicin 50 mg/m² IV on Day 2, and prednisone 100 milligrams per day (mg/day) orally (PO) on Days 2-6 of every 21-day cycle for 6 cycles.
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Polatuzumab vedotin IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Cyclophosphamid IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Doxorubicin IV-infusion vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Prednison PO vil blive administreret i henhold til skemaet specificeret i den respektive arm.
Rituximab IV infusion will be administered as per the schedule specified in the respective arm.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Progression-free survival
Tidsramme: From randomization to the first occurrence of disease progression or relapse, or death from any cause, whichever occurs earlier (up to 24 months)
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PFS, defined as the time from randomization to the first occurrence of disease progression or relapse using the 2014 Lugano Response Criteria or death due to any cause, whichever occurs first.
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From randomization to the first occurrence of disease progression or relapse, or death from any cause, whichever occurs earlier (up to 24 months)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Antal deltagere med behandlingsrelaterede bivirkninger vurderet ved CTCAE v6.0
Tidsramme: Fra tilmelding til afslutning af studiet, maksimalt 4 år
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Fra tilmelding til afslutning af studiet, maksimalt 4 år
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Event-free survival
Tidsramme: Up to approximately 24 months
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EFS, defined as the time from date of randomization to the earliest occurrence of any of the following: Disease progression/relapse; Death due to any cause; The primary efficacy reason that leads to initiation of NALT (other than disease progression/relapse).
If biopsy is obtained after treatment completion and is positive for residual disease regardless of whether NALT is initiated or not.
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Up to approximately 24 months
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Complete response rate
Tidsramme: End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days] )
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CR rate at the end of treatment by FDG-PET defined as the proportion of participants with CR at the end of treatment according to the 2014 Lugano Response Criteria
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End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days] )
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Objective response rate
Tidsramme: End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days] )
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ORR at treatment completion or discontinuation defined as the proportion of participants with partial response (PR) or CR at the end of treatment according to the 2014 Lugano Response Criteria
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End of treatment visit (6-8 weeks after last dose on Day 1 of Cycle 6 [Cycle length=21 days] )
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Overall survival
Tidsramme: Up to approximately 3 years
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OS defined as the time from randomization to death from any cause
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Up to approximately 3 years
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Duration of response
Tidsramme: From documentation of CR/PR until relapse/progression or death due to any reason without documented relapse, whichever came first, assessed up to 3 years.
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From documentation of CR/PR until relapse/progression or death due to any reason without documented relapse, whichever came first, assessed up to 3 years.
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Duration of complete response
Tidsramme: From documentation of CR until relapse/progression or death due to any reason without documented relapse, whichever came first, assessed up to 3 years.
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From documentation of CR until relapse/progression or death due to any reason without documented relapse, whichever came first, assessed up to 3 years.
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Patient reported outcome assessed by EORTC QLQ-C30 (Verison 3.0)
Tidsramme: Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Patient reported outcome assessed by EORTC QLQ-ELD14
Tidsramme: Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Patient reported outcome assessed by FACT-Lym LymS
Tidsramme: Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Day 1 of Cycles 1 and 4 (Cycle length=21 days); 30 days after treatment completion
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Aminosyrer, peptider og proteiner
- Proteiner
- Organiske kemikalier
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Heterocykliske forbindelser, 2-ring
- Heterocykliske forbindelser, smeltet ring
- Nukleinsyrer, nukleotider og nukleosider
- Kulbrinter
- Kulbrinter, cyklisk
- Kulhydrater
- Carboxylsyrer
- Polycykliske aromatiske kulbrinter
- Kulbrinter, aromatisk
- Polycykliske forbindelser
- Glycosider
- Piperidiner
- Antistoffer, monoklonal
- Antistoffer
- Immunoglobuliner
- Immunoproteiner
- Blodproteiner
- Serum globuliner
- Globuliner
- Cytidin
- Pyrimidin -nukleosider
- Pyrimidiner
- Gravidier
- Graviditet
- Steroider
- SMUSED-RING-forbindelser
- Fosforamid -sennep
- Nitrogen sennepsforbindelser
- Sennepsforbindelser
- Kulbrinter, halogeneret
- Phosphoramider
- Organophosphorforbindelser
- AZA -forbindelser
- Nukleosider
- Ribonucleosider
- Gravideretioler
- Anthracycliner
- Naphthacenes
- Aminoglycosider
- Antistoffer, monoklonal, murint afledt
- Daunorubicin
- Azacitidin
- Phthalimider
- Phthalinsyrer
- Syrer, carbocykliske
- Piperidones
- Isoindoler
- Decitabin
- Lenalidomid
- Rituximab
- Prednison
- Cyclofosfamid
- Doxorubicin
- Zannubrutinib
- Polatuzumab Vedotin
- Glofitamab
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- GUIDANCE-10
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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