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NCT01649856 · CITED IN SOURCE DOCUMENTS

A Study of Subcutaneous Versus Intravenous MabThera/Rituxan (Rituximab) in Combination With CHOP Chemotherapy in Patients With Previously Untreated CD20-Positive Diffuse Large B-Cell Lymphoma

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase
PHASE3
Status at capture
COMPLETED
Registry last update
2017-10-11

This multicenter, randomized, open label parallel-group study will evaluate the efficacy and safety of subcutaneous versus intravenous MabThera/Rituxan (rituximab) in combination with CHOP chemotherapy in patients with previously untreated CD20-positive diffuse large B-Cell lymphoma. Patients will be randomized to receive either MabThera/Rituxan 1400 mg subcutaneously or MabThera/Rituxan 375 mg/m2 intravenously on Day 1 of each cycle for 8 cycles, in combination with 6-8 cycles of CHOP chemotherapy. Anticipated time on study treatment is 6 months.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

Who could take part
eligibility Criteria
Inclusion Criteria: * Adult patients, \>/= 18 and \</= 80 years of age at time of study inclusion * Histologically confirmed, previously untreated CD20-positive diffuse large B-cell lymphoma (DLBCL) according to the WHO classification system * Patients with an International Prognostic Index (IPI) score 1-5, or IPI score 0 with bulky disease, defined as one lesion \>/= 7.5 cm * At least one bi-dimensionally measurable lesion defined as \>/= 1.5 cm in its largest dimension on CT scan, PET-CT scan or MRI * Adequate hematologic function * Eastern Cooperative Oncology Group (EOCD) performance status \</= 2 Exclusion Criteria: * Primary or secondary central nervous system lymphoma, histologic evidence of transformation to Burkitt lymphoma, primary mediastinal DLBCL, primary effusion lymphoma, primary cutaneous DLBCL, or primary DLBCL of the testis * Transformed lymphoma or follicular lymphoma IIIB * Prior therapy for DLBCL, with the exception of nodal biopsy or local irradiation * History of other malignancy, except for curatively treated basal or squamous cell carcinoma or melanoma of the skin, carcinoma in situ of the cervix, or a malignancy that has been treated without curative intent and has been in remission without treatment for \>/= 5 years prior to enrolment * Inadequate renal or hepatic function * Known human immunodeficiency virus (HIV) infection or HIV seropositive status * Active hepatitis B virus (HBV) or active hepatitis C virus (HCV) infection. Patients with occult or prior HBV infection as defined by protocol may be included. Patients positive for HCV antibody are eligible only if polymerase chain reaction testing for HCV ribonucleic acid is negative. * History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products * Contraindication to any of the individual components of CHOP, including prior receipt of anthracyclines * Prior treatment with cytotoxic drugs or rituximab for another condition (e.g. rheumatoid arthritis) or prior use of an anti-CD20 antibody * Pregnant or lactating women
healthy Volunteers
false
maximum Age
80 Years
minimum Age
18 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. intervention Names
    1. Drug: CHOP
    2. Drug: rituximab [MabThera/Rituxan]
    label
    A: Rituximab SC
    type
    EXPERIMENTAL
  2. intervention Names
    1. Drug: CHOP
    2. Drug: rituximab [MabThera/Rituxan]
    label
    B: Rituximab IV
    type
    ACTIVE_COMPARATOR
interventions
  1. arm Group Labels
    1. A: Rituximab SC
    2. B: Rituximab IV
    description
    CHOP chemotherapy: cyclophosphamide, doxorubicin, vincristine, prednisone/prednisolone; 6 or 8 cycles
    name
    CHOP
    type
    DRUG
  2. arm Group Labels
    1. A: Rituximab SC
    description
    The first rituximab dose will be administered intravenously on Day of Cycle 1 at a dose of 375 mg/m2. Subsequent doses of 1400 mg are administered subcutaneously on Day 1 of each cycle, for a further 7 cycles
    name
    rituximab [MabThera/Rituxan]
    type
    DRUG
  3. arm Group Labels
    1. B: Rituximab IV
    description
    375 mg/m2 intravenously on Day 1 of each cycle, 8 cycles
    name
    rituximab [MabThera/Rituxan]
    type
    DRUG
Study design
allocation
RANDOMIZED
intervention Model
PARALLEL
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
572
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    Tumor response was assessed per criteria published by Cheson et al (1999). According to consensus recommendations, CR was defined as complete disappearance of all clinical and radiographic evidence of disease and disease-related symptoms, regression of lymph nodes to normal size, absence of splenomegaly, and absence of bone marrow involvement. CRu was defined as disappearance of clinical and radiographic evidence of disease and absence of splenomegaly, with regression of lymph nodes by greater than (\>) 75 percent (%) but still \>1.5 centimeters (cm) in size, and indeterminate bone marrow assessment. The percentage of participants with either response at the end of induction (EOI) was determined with corresponding 95% Pearson-Clopper confidence interval (CI).
    measure
    Percentage of Participants With Complete Response (CR) or Complete Response Unconfirmed (CRu)
    time Frame
    Up to approximately 4.25 years
secondary Outcomes
  1. description
    The CTSQ is a validated 16-item questionnaire that measures three domains related to satisfaction with cancer therapy. These include expectations of therapy, feelings about side effects, and satisfaction with therapy. Each domain is scored on a scale of 0 to 100, with higher scores indicative of more positive feelings toward therapy. The score for each domain was averaged among all participants.
    measure
    Cancer Treatment Satisfaction Questionnaire (CTSQ) Domain Scores
    time Frame
    At Cycle 7 (each cycle was 14 or 21 days)
  2. description
    The RASQ is a 20-item questionnaire that measures five domains related to the impact of treatment administration. These include physical impact, psychological impact, impact on activities of daily living (ADLs), convenience, and satisfaction. Each domain is scored on a scale of 0 to 100, with higher scores indicative of more positive feelings toward therapy. The score for each domain was averaged among all participants.
    measure
    Rituximab Administration Satisfaction Questionnaire (RASQ) Domain Scores
    time Frame
    At Cycle 7 (each cycle was 14 or 21 days)
  3. description
    Duration of rituximab administration was defined as the time from start to end of the SC injection or IV infusion. The median duration was reported.
    measure
    Median Duration of Rituximab Administration for Each Treatment Cycle
    time Frame
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
  4. description
    Chair time was defined as the amount of time the participant occupied an infusion chair/bed for a single treatment cycle of rituximab + CHOP chemotherapy. Where the chair time was not documented for a given cycle, it was reported as "Missing".
    measure
    Percentage of Participants by Time Spent in the Infusion Chair/Bed for Each Treatment Cycle
    time Frame
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
  5. description
    Hospital time was defined as the amount of time the participant was in the hospital for the course of one cycle of rituximab + CHOP chemotherapy. Where the hospital time was not documented for a given cycle, it was reported as "Missing".
    measure
    Percentage of Participants by Time Spent in the Hospital for Each Treatment Cycle
    time Frame
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
  6. description
    EFS events included disease progression, relapse, initiation of other anti-lymphoma therapy, or death. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as greater than or equal to (≥) 50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu.
    measure
    Number of Participants With an Event-Free Survival (EFS) Event
    time Frame
    Up to approximately 4.25 years
  7. description
    EFS was defined as the time from randomization to first occurrence of disease progression, relapse, initiation of other anti-lymphoma therapy, or death, whichever occurred first. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as a ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu.
    measure
    Duration of EFS
    time Frame
    Up to approximately 4.25 years
  8. description
    Tumor response was assessed according to criteria published by Cheson et al (1999). Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu. The number of participants who had experienced relapse or death prior to the clinical cut-off date (October 2014) was determined.
    measure
    Number of Participants With Relapse or Death at the Time of Primary Analysis
    time Frame
    Up to approximately 2 years (assessed at Baseline, Day 1 of each cycle [maximum 8 cycles; each cycle was 14 or 21 days], every 3 months thereafter, and/or 4 weeks after early termination)
  9. description
    DFS was defined as the time from date of initial CR/CRu to the date of relapse or death from any cause. Tumor response was assessed according to criteria published by Cheson et al (1999). Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu.
    measure
    Duration of Disease-Free Survival (DFS)
    time Frame
    Up to approximately 4.25 years
  10. description
    Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu.
    measure
    Number of Participants With Progression, Relapse, or Death
    time Frame
    Up to approximately 4.25 years
  11. description
    PFS was defined as the time from randomization to first occurrence of disease progression, relapse, or death from any cause. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node \>1 cm, following an earlier assessment of CR or CRu.
    measure
    Duration of Progression-Free Survival (PFS)
    time Frame
    Up to approximately 4.25 years
  12. measure
    Number of Deaths
    time Frame
    Up to approximately 4.25 years
Full study description
brief Summary
This multicenter, randomized, open label parallel-group study will evaluate the efficacy and safety of subcutaneous versus intravenous MabThera/Rituxan (rituximab) in combination with CHOP chemotherapy in patients with previously untreated CD20-positive diffuse large B-Cell lymphoma. Patients will be randomized to receive either MabThera/Rituxan 1400 mg subcutaneously or MabThera/Rituxan 375 mg/m2 intravenously on Day 1 of each cycle for 8 cycles, in combination with 6-8 cycles of CHOP chemotherapy. Anticipated time on study treatment is 6 months.
Source references
references
  1. citation
    Lugtenburg P, Avivi I, Berenschot H, Ilhan O, Marolleau JP, Nagler A, Rueda A, Tani M, Turgut M, Osborne S, Smith R, Pfreundschuh M. Efficacy and safety of subcutaneous and intravenous rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in first-line diffuse large B-cell lymphoma: the randomized MabEase study. Haematologica. 2017 Nov;102(11):1913-1922. doi: 10.3324/haematol.2017.173583. Epub 2017 Sep 21.
    pmid
    28935843
    type
    DERIVED
Source notices and limitations
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        s with event 18 (8.8%) 26 (12.7%) Hazard Ratio [95% CI] (unstratified Cox model) 0.70 [0.38;1.27] 14.2 Diffuse Large B-Cell Lymphoma (DLBCL) The MabEase study [NCT01649856] enrolled a total of 576 patients with previously untreated CD20-positive DLBCL. Patients were randomized (2:1) to receive either a rituximab product by intrav
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    Preserved source evidence · Not medical advice