- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT03568461
Efficacité et innocuité du tisagenlecleucel chez les patients adultes atteints de lymphome folliculaire réfractaire ou récidivant (ELARA)
Un essai ouvert multicentrique de phase II, à un seul bras, visant à déterminer l'efficacité et l'innocuité du tisagenlecleucel (CTL019) chez des patients adultes atteints de lymphome folliculaire réfractaire ou récidivant
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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Ulm, Allemagne, 89081
- Novartis Investigative Site
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Bavaria
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Munich, Bavaria, Allemagne, 81377
- Novartis Investigative Site
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North Rhine-Westphalia
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Cologne, North Rhine-Westphalia, Allemagne, 50937
- Novartis Investigative Site
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Herston, Australie, QLD 4006
- Novartis Investigative Site
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New South Wales
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Camperdown, New South Wales, Australie, 2050
- Novartis Investigative Site
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Victoria
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Melbourne, Victoria, Australie, 3000
- Novartis Investigative Site
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Ghent, Belgique, 9000
- Novartis Investigative Site
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Madrid, Espagne, 28041
- Novartis Investigative Site
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Seville, Espagne, 41013
- Novartis Investigative Site
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Paris, France, 75475
- Novartis Investigative Site
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Pierre-Bénite, France, 69495
- Novartis Investigative Site
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BO
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Bologna, BO, Italie, 40138
- Novartis Investigative Site
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MI
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Milan, MI, Italie, 20132
- Novartis Investigative Site
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Fukuoka, Japon, 8128582
- Novartis Investigative Site
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Hokkaido
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Sapporo, Hokkaido, Japon, 060-8648
- Novartis Investigative Site
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Miyagi
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Sendai, Miyagi, Japon, 9808574
- Novartis Investigative Site
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Linz, L'Autriche, 4020
- Novartis Investigative Site
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Norway
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Oslo, Norway, Norvège, 0310
- Novartis Investigative Site
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North Holland
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Amsterdam, North Holland, Pays-Bas, 1081 HV
- Novartis Investigative Site
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London, Royaume-Uni, SE5 9RS
- Novartis Investigative Site
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West Midlands
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Birmingham, West Midlands, Royaume-Uni, B15 2TH
- Novartis Investigative Site
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California
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Duarte, California, États-Unis, 91010 3000
- City of Hope National Medical Center
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San Francisco, California, États-Unis, 94143
- UCSF Medical Center
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Florida
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Tampa, Florida, États-Unis, 33612
- H Lee Moffitt Cancer Center and Research Institute
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Illinois
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Chicago, Illinois, États-Unis, 60637
- Uni of Chi Medi Ctr Hema and Onco
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Kansas
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Kansas City, Kansas, États-Unis, 66160
- Univ of Kansas Hosp and Med Ctr
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Michigan
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Ann Arbor, Michigan, États-Unis, 48109 5271
- Michigan Med University of Michigan
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Oregon
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Portland, Oregon, États-Unis, 97239
- Oregon Health Sciences University
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Pennsylvania
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Philadelphia, Pennsylvania, États-Unis, 19104
- University of Pennsylvania Clinical
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Texas
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Houston, Texas, États-Unis, 77030
- MD Anderson Cancer Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
La description
Critère d'intégration:
- Lymphome folliculaire réfractaire ou récidivant (grade 1, 2, 3A)
- Maladie radiographiquement mesurable lors du dépistage
Critère d'exclusion:
- Preuve de transformation histologique
- Lymphome folliculaire Grade 3B
- Traitement anti-CD19 antérieur
- Thérapie génique antérieure
- Thérapie cellulaire T adoptive antérieure
- Greffe allogénique antérieure de cellules souches hématopoïétiques
- Atteinte active du SNC par malignité
D'autres critères d'inclusion/exclusion définis par le protocole peuvent s'appliquer.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: CTL019
Tous les patients ayant reçu une perfusion de tisagenlecleucel.
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Le tisagenlecleucel est en perfusion unique.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Taux de réponse complète (CRR) par évaluation du comité d'examen indépendant (CRI)
Délai: 1 an
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Le taux de réponse complète a été défini comme le pourcentage de participants avec une meilleure réponse globale (BOR) de réponse complète (RC) enregistrée depuis la perfusion de tisagenlecleucel jusqu'à la progression de la maladie ou le début d'un nouveau traitement anticancéreux, selon la première éventualité.
Le CRR a été déterminé par un comité d'examen indépendant (IRC) et était basé sur les critères de réponse de la classification de Lugano 2014.
La réponse radiologique est d'abord obtenue à partir d'études CT et PET selon les critères de Lugano 2014.
La réponse CT est basée sur des mesures anatomiques des lésions index/non index/nouvelles et de la longueur de la rate.
Les résultats de réponse possibles sont une réponse complète (RC), une réponse partielle (PR), une maladie stable (SD) ou une maladie progressive (PD).
Réponse TEP basée sur une échelle de 5 points (5PS) ou un score de Deauville.
Les résultats possibles de la réponse TEP sont la réponse métabolique complète (CMR), la réponse métabolique partielle (PMR), l'absence de réponse métabolique (NMR) ou la maladie métabolique progressive (PMD).
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1 an
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Taux de réponse global (ORR) selon l'évaluation de l'IRC
Délai: 1 an
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Le taux de réponse global est défini comme le pourcentage de participants avec une meilleure réponse globale à la maladie de réponse complète (RC) ou de réponse partielle (RP).
La réponse a été évaluée selon les critères de réponse de la classification de Lugano 2014.
La réponse radiologique est d'abord obtenue à partir d'études CT et PET selon les critères de Lugano 2014.
La réponse CT est basée sur des mesures anatomiques des lésions index/non index/nouvelles et de la longueur de la rate.
Les résultats de réponse possibles sont une réponse complète (RC), une réponse partielle (PR), une maladie stable (SD) ou une maladie progressive (PD).
Réponse TEP basée sur une échelle de 5 points (5PS) ou un score de Deauville.
Les résultats possibles de la réponse TEP sont la réponse métabolique complète (CMR), la réponse métabolique partielle (PMR), l'absence de réponse métabolique (NMR) ou la maladie métabolique progressive (PMD).
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1 an
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Duration of Response (DOR) Per IRC Assessment
Délai: approx. 60 months
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Duration of response (DOR) applied only to participants whose best overall disease response was CR or PR.
It is defined as the time from the date of first documented disease response (CR or PR) to the date of first documented progression or death due to follicular lymphoma (FL).
DOR was estimated using the Kaplan-Meier method.
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approx. 60 months
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Duration of Response (DOR) for Complete Response (CR) Only Per IRC Assessment
Délai: approx. 60 months
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Duration of response (DOR) applied only to participants whose best overall disease response was complete response (CR) only.
It is defined as the time from the date of first documented disease response (CR only) to the date of first documented progression or death due to follicular lymphoma (FL).
DOR was estimated using the Kaplan-Meier method.
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approx. 60 months
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Progression Free Survival (PFS) Per IRC Assessment
Délai: up to 61.7 months
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Progression free survival is the time from tisagenlecleucel infusion to first documented disease progression or death due to any cause.
PFS was estimated using the Kaplan-Meier method.
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up to 61.7 months
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Overall Survival (OS)
Délai: up to 65.8 months
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Overall Survival is the time from tisagenlecleucel infusion to death due to any cause.
OS was estimated using the Kaplan-Meier method.
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up to 65.8 months
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Tisagenlecleucel Transgene Concentration Levels as Measured by Quantitative Polymerase Chain Reaction (qPCR) Method, by Clinical Response Per IRC Assessment
Délai: Month 60 (peripheral blood), Month 6 (bone marrow)
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This is the summary of cellular kinetic concentrations for tisagenlecleucel (CTL019) transgene levels in peripheral blood and bone marrow following infusion.
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Month 60 (peripheral blood), Month 6 (bone marrow)
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Cmax; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response IRC Assessment
Délai: up to 60 months after infusion
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Cmax is the maximum (peak) observed in peripheral blood after single dose administration.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters parameters.
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up to 60 months after infusion
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Tmax; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response by IRC Assessment
Délai: up to 60 months after infusion
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Tmax is the time to reach maximum (peak) peripheral blood after single dose administration (days).
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters.
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up to 60 months after infusion
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AUC0-28d and AUC0-84d; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response by IRC Assessment
Délai: 0 to 28 days after infusion, 0 to 84 days after infusion
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AUC0-28 is the area under curve (AUC) from time zero to day 28 in peripheral blood.
AUC0-84d is the AUC from time zero to day 84 in peripheral blood.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters.
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0 to 28 days after infusion, 0 to 84 days after infusion
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AUC0-28d and AUC0-84d; Cellular Kinetic Parameter for Tisagenlecleucel by Flow Cytometry, Based on Clinical Response by IRC Assessment
Délai: AUC0-28d: from time of infusion to 28 days post-dose; AUC0-84d: from time of infusion to 84 days post-infusion
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Exposure is summarized as area under the curve (AUC) from time 0 to 28 days (AUC0-28d) and from time to 84 days (AUC0-84d).
The cellular kinetic parameters were estimated from the percentages of CD3+/CTL019+ cells obtained from flow cytometry.
Flow cytometry measures the surface expression of chimeric antigen receptors (CARs) on T cells.
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AUC0-28d: from time of infusion to 28 days post-dose; AUC0-84d: from time of infusion to 84 days post-infusion
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Cmax; Cellular Kinetic Parameter for Tisagenlecleucel by Flow Cytometry, Based on Clinical Response by IRC Assessment
Délai: From pre-dose until 60 months after infusion
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Cmax is the maximum (peak) observed in peripheral blood after single dose administration.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters parameters.
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From pre-dose until 60 months after infusion
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Summary of Exposure of CD3+ Tisagenlecleucel Cells in Peripheral Blood for Tmax
Délai: From pre-dose until 60 months after infusion
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In vivo cellular kinetics of CD3+/CTL019+ levels tisagenlecleucel cells detected by flow cytometry base on best overall response (BOR).
The cellular kinetic parameters were estimated from the percentages of CD3+/CTL019+ cells obtained from flow cytometry.
Flow cytometry measures the surface expression of chimeric antigen receptors (CARs) on T cells.
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From pre-dose until 60 months after infusion
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Humoral Immunogenicity: Number of Participants With Anti-mCAR19 Antibodies, Per IRC Assessment
Délai: at any time post-baseline, up to 24 months post-infusion
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Antibody titers specific to the tisagenlecleucel molecule prior to and following infusion.
Percentage of participants who tested positive for anti-mCAR19 antibodies at any time post-baseline.
A participant was only defined as positive for tisagenlecleucel treatment-induced or -boosted anti-mCAR19 antibodies when the anti-mCAR19 antibody median fluorescence intensity (MFI) at any time post-infusion was at least 2.28-fold higher than pre-infusion levels for patients whose baseline status was positive (boosted) or if the baseline status was negative, but any post-baseline interpretation was positive (induced).
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at any time post-baseline, up to 24 months post-infusion
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Cellular Immunogenicity: Percentage of Interferon Gamma (IFNg+) Cells by Flow Cytometry Per IRC Assessment
Délai: pre-infusion (pre-Lymph depletion evaluation), 24 months post-infusion
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Activation of T-cells in peripheral blood mononuclear cells collected from participants in response to mCAR19-derived peptides was used to assess the cellular immunogenicity against tisagenlecleucel. T-cell activation was measured by the percentage of interferon gamma (IFNg+) cells by flow cytometry. Cellular responses to mCART peptides were measured pre-infusion (enrollment) and post-tisagenlecleucel infusion. Pool 1 and Pool 2 are a pool of 60 peptides (peptides 1-60) and 59 peptides (peptides 61-119) , respectively, corresponding to the CTL019 transgene product. Together, they comprised 119 peptides spanning the CTL019 transgene product and were used to stimulate PBMCs to detect antigen-specific T cell responses via intracellular cytokine staining. |
pre-infusion (pre-Lymph depletion evaluation), 24 months post-infusion
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Summary Scores of Patient-reported Outcome (PRO) Measured by SF-36v2 Quality of Life Questionnaire by Visit
Délai: Baseline (BL) Month (M) 3, M3, M6, M9, M12, M18, M24
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the Short Form Health Survey (SF-36) v2 form.
The SF-36 v2 is a widely used and extensively studied instrument to measure health-related quality of life among healthy patients and patients with acute and chronic conditions.
It consists of eight subscales that can be scored individually: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health.
Two overall summary scores, the Physical Component Summary (PCS) and the Mental Component Summary (MCS) were computed by summing the item responses on the questions for each domain in accordance with the respective scoring method provided by the developers.
Each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.
A high score defines a more favorable health state.
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Baseline (BL) Month (M) 3, M3, M6, M9, M12, M18, M24
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Summary Scores of PRO Measured by SF-36v2 Quality of Life Questionnaire Reported by Change From Baseline
Délai: Change from baseline (CFB) M3, CFB M6, CFB M9, CFB M12, CFB M18, CFB M24
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the Short Form Health Survey (SF-36) v2 form.
The SF-36 v2 is a widely used and extensively studied instrument to measure health-related quality of life among healthy patients and patients with acute and chronic conditions.
It consists of eight subscales that can be scored individually: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health.
Two overall summary scores, the Physical Component Summary (PCS) and the Mental Component Summary (MCS) were computed by summing the item responses on the questions for each domain in accordance with the respective scoring method provided by the developers.
Each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.
A high score defines a more favorable health state.
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Change from baseline (CFB) M3, CFB M6, CFB M9, CFB M12, CFB M18, CFB M24
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Health Status Measured by EQ-5D-3L Questionnaire
Délai: Baseline (BL), Month 3, Month 6, Month 9, Month 12, Month 18, Month 24, Month 36
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Effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the EuroQol 5-Dimension, 3-Level instrument (EQ-5D-3L).
The EQ-5D-3L is a widely used, self-administered questionnaire designed to evaluate health status in adults.
It consists of two sections.
The first includes one item for each of the five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression).
Patients rate each dimension as "no problems" (level 1), "some problems" (level 2), or "extreme problems" (level 3).
This record summarizes, for each of the five dimensions, the number of patients falling into each response level.
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Baseline (BL), Month 3, Month 6, Month 9, Month 12, Month 18, Month 24, Month 36
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Summary Scores of PRO Measured by EQ-VAS Quality of Life Questionnaire by Visit
Délai: Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the EQ-VAS (EuroQol Visual Analogue Scale).
The EQ-VAS is a 20 cm vertical, 0-100 numerical scale used alongside the EQ-5D questionnaire to measure a patient's self-rated health.
It anchors "best imaginable health" (100) at the top and "worst imaginable health" (0) at the bottom, providing a quick, subjective, quantitative, and global assessment of health status on the day of survey.
The second section of the questionnaire measures self-rated (global) health status utilizing a vertically oriented visual analogue scale where 100 represents the "best possible health state" and 0 represents the "worst possible health state."
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Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Summary Scores of PRO Measured by EQ-VAS Quality of Life Questionnaire Reported by Change From Baseline
Délai: Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the EQ-VAS (EuroQol Visual Analogue Scale).
The EQ-VAS is a 20 cm vertical, 0-100 numerical scale used alongside the EQ-5D questionnaire to measure a patient's self-rated health.
It anchors "best imaginable health" (100) at the top and "worst imaginable health" (0) at the bottom, providing a quick, subjective, quantitative, and global assessment of health status on the day of survey
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Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Summary Scores of PRO Measured by FACT-Lym Quality of Life Questionnaire
Délai: Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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The effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire, which measures quality of life in participants with lymphoma.
FACT-Lym is composed of the FACT-G (27 items across Physical, Social/Family, Emotional, and Functional Well-Being, plus Additional Concerns) and a 15-item lymphoma-specific subscale.
All items use a five-point self-administered response scale (0-4), with higher scores indicating better quality of life.
The possible score ranges are as follows: - Physical Well-Being (PWB): 0-28 - Social/Family Well-Being (SWB): 0-28 - Emotional Well-Being (EWB): 0-24 - Functional Well-Being (FWB): 0-28 - Lym Subscale (15 items): 0-60 - Lymphoma Trial Outcome Index (TOI: PWB + FWB + Lym): 0-116 - FACT-G Total (PWB + SWB + EWB + FWB): 0-108 - FACT-Lym Total (FACT-G + Lym): 0-168 In all cases, higher scores indicate better outcomes within the corresponding domain.
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Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Summary Scores of PRO Measured by FACT-Lym Quality of Life Questionnaire Reported by Change From Baseline
Délai: Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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The effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire, which measures quality of life in participants with lymphoma.
FACT-Lym is composed of the FACT-G (27 items across Physical, Social/Family, Emotional, and Functional Well-Being, plus Additional Concerns) and a 15-item lymphoma-specific subscale.
All items use a five-point self-administered response scale (0-4), with higher scores indicating better quality of life.
The possible score ranges are as follows: - Physical Well-Being (PWB): 0-28 - Social/Family Well-Being (SWB): 0-28 - Emotional Well-Being (EWB): 0-24 - Functional Well-Being (FWB): 0-28 - Lym Subscale (15 items): 0-60 - Lymphoma Trial Outcome Index (TOI: PWB + FWB + Lym): 0-116 - FACT-G Total (PWB + SWB + EWB + FWB): 0-108 - FACT-Lym Total (FACT-G + Lym): 0-168 In all cases, higher scores indicate better outcomes within the corresponding domain.
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Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Directeur d'études: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Publications et liens utiles
Publications générales
- Salles G, Schuster SJ, Dreyling M, Fischer L, Kuruvilla J, Patten PEM, von Tresckow B, Smith SM, Jimenez-Ubieto A, Davis KL, Anjos C, Chu J, Zhang J, Lobetti Bodoni C, Thieblemont C, Fowler NH, Dickinson M, Martinez-Lopez J, Wang Y, Link BK. Efficacy comparison of tisagenlecleucel vs usual care in patients with relapsed or refractory follicular lymphoma. Blood Adv. 2022 Nov 22;6(22):5835-5843. doi: 10.1182/bloodadvances.2022008150.
- Fowler NH, Dickinson M, Dreyling M, Martinez-Lopez J, Kolstad A, Butler J, Ghosh M, Popplewell L, Chavez JC, Bachy E, Kato K, Harigae H, Kersten MJ, Andreadis C, Riedell PA, Ho PJ, Perez-Simon JA, Chen AI, Nastoupil LJ, von Tresckow B, Ferreri AJM, Teshima T, Patten PEM, McGuirk JP, Petzer AL, Offner F, Viardot A, Zinzani PL, Malladi R, Zia A, Awasthi R, Masood A, Anak O, Schuster SJ, Thieblemont C. Tisagenlecleucel in adult relapsed or refractory follicular lymphoma: the phase 2 ELARA trial. Nat Med. 2022 Feb;28(2):325-332. doi: 10.1038/s41591-021-01622-0. Epub 2021 Dec 17.
- Dreyling M, Fowler NH, Dickinson M, Martinez-Lopez J, Kolstad A, Butler J, Ghosh M, Popplewell L, Chavez JC, Bachy E, Kato K, Harigae H, Kersten MJ, Andreadis C, Riedell PA, Ho PJ, Perez-Simon JA, Chen AI, Nastoupil LJ, von Tresckow B, Maria Ferreri AJ, Teshima T, Patten PEM, McGuirk JP, Petzer AL, Offner F, Viardot A, Zinzani PL, Malladi R, Paule I, Zia A, Awasthi R, Han X, Germano D, O'Donovan D, Ramos R, Maier HJ, Masood A, Thieblemont C, Schuster SJ. Durable response after tisagenlecleucel in adults with relapsed/refractory follicular lymphoma: ELARA trial update. Blood. 2024 Apr 25;143(17):1713-1725. doi: 10.1182/blood.2023021567.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Processus pathologiques
- Tumeurs
- Attributs de la maladie
- Maladies du système immunitaire
- Tumeurs par type histologique
- Maladies lymphatiques
- Troubles lymphoprolifératifs
- Troubles immunoprolifératifs
- Lymphome non hodgkinien
- Lymphome
- Conditions pathologiques, signes et symptômes
- Maladies hémiques et lymphatiques
- Récurrence
- Lymphome folliculaire
- Agents antinéoplasiques immunologiques
- Agents antinéoplasiques
- tisagenlecleucel
Autres numéros d'identification d'étude
- CCTL019E2202
- 2017-004385-94 (Numéro EudraCT)
- 2023-508127-13-00 (Identificateur de registre: EU CTIS)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Novartis s'engage à partager avec des chercheurs externes qualifiés l'accès aux données au niveau des patients et aux documents cliniques à l'appui des études éligibles. Ces demandes sont examinées et approuvées par un groupe d'experts indépendants sur la base du mérite scientifique. Toutes les données fournies sont anonymisées afin de respecter la vie privée des patients qui ont participé à l'essai conformément aux lois et réglementations applicables.
Ces données d'essai sont actuellement disponibles selon le processus décrit sur www.clinicalstudydatarequest.com.
Informations sur les médicaments et les dispositifs, documents d'étude
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