Overview

This trial is active, not recruiting.

Conditions lymphoma, diffuse large b-cell lymphoma
Treatments lenalidomide, placebo
Phase phase 3
Sponsor The Lymphoma Academic Research Organisation
Start date April 2009
End date September 2016
Trial size 650 participants
Trial identifier NCT01122472, REMARC

Summary

This study is designed as a phase III, randomized, double-blind, placebo-controlled trial to explore the effect of maintenance therapy with lenalidomide versus placebo on progression-free survival (PFS) in patients treated with R-CHOP responding to induction therapy

For the primary efficacy variable, PFS, an improvement in median PFS from 38.6 months for Treatment Arm B to 54 months for Treatment Arm A (corresponding to a 2-year PFS of 65% vs 73.6%), is considered clinically relevant.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification safety/efficacy study
Intervention model parallel assignment
Masking double blind (subject, caregiver, investigator, outcomes assessor)
Primary purpose treatment
Arm
(Experimental)
Lenalidomide daily for 3 weeks every 4 weeks for 24 months
lenalidomide Revlimid
Daily for 3 weeks every 4 weeks for 24 months
(Placebo Comparator)
Placebo daily for 3 weeks every 4 weeks for 24 months
placebo
Daily for 3 weeks every 4 weeks for 24 months

Primary Outcomes

Measure
Progression-Free-Survival (PFS)
time frame: Final PFS analysis will be realized when the number of events (160) has been reached or at the latest when the last patient into the study will finish follow up. The approximate schedule will be 75 months after the first patient randomized.

Secondary Outcomes

Measure
Overall survival (OS)
time frame: 5 years
Event-Free Survival (EFS)
time frame: 5 years
Response rate at the end of maintenance treatment
time frame: 24 months
Percentage of patients who convert from PR (partial response) to CR (complete response)
time frame: 24 months
Safety of lenalidomide in maintenance
time frame: 5 years
PFS2
time frame: 5 years

Eligibility Criteria

Male or female participants from 60 years up to 80 years old.

Ages Eligible for Study: Between 60 and 80 years old Genders Eligible for Study: Both Accepts Healthy Volunteers: No Inclusion Criteria: For patients registered at the time of initial diagnosis - Patient with histologically proven CD20+ diffuse large B cel LYMPHOMA (DLBCL) 5WHO classification 2008) including clinical subtypes (primitive mediastinal, intravascular, etc.). Patients with De Novo Transformed DLBCL from low grade lymphoma (Follicular, other..) may also be included. Patients with DLBCL associated with some small cell infiltration in bone marrow may also be included Or CD20+ B-cell lymphoma with intermediate features between DLBCL and Burkitt or with intermediate features between DLBCL and classical Hodgkin lymphoma Or CD20+ Follicular lymphoma grade 3B Or CD20+ Aggressive B-cell lymphoma unclassifiable - previous untreated with chemo- or radiotherapy For patients registered after response evaluation to first line treatment with R-CHOP: - Patient with histologically proven CD20+ diffuse large B cell LYMPHOMA (DLBCL) 5WHO classification 2008) including clinical subtypes (primitive mediastinal, intravascular, etc.). Patients with De Novo Transformed DLBCL from low grade lymphoma (Follicular, other..) may also be included. Patients with DLBCL associated with some small cell infiltration in bone marrow may also be included Or CD20+ B-cell lymphoma with intermediate features between DLBCL and Burkitt or with intermediate features between DLBCL and classical Hodgkin lymphoma Or CD20+ Follicular lymphoma grade 3B Or CD20+ Aggressive B-cell lymphoma unclassifiable - Have reached a CR or PR after first line treatment with at least 6 cycles of R-CHOP 14 regimens and up to 8 cycles of R-CHOP21 - Previously untreated with Radiotherapy For all patients: - aged from 60 to 80 years at time of registration - Ann Arbor stages II-IV at time of initial diagnosis - aaIPI> 1 at time of initial diagnosis - ECOG performance status 0-2 - Minimum life expectancy of 3 months - Following laboratory values at screening: - ANC≥ 1000.10^6/L and Platelets≥60000.10^6/L - AST<5*ULN, ALT<5*ULN, Total Bilirubin<1,5*ULN - Creatinine clearance>30mL/min - Women are are using effective contraception, are not pregnant and agree not to become pregnant during participation in the trial and after end of study. Men agree not to father a child during participation in the trial and during the 12 months thereafter. - Having previously signed a written informed consent form Exclusion Criteria: - Any other histological type of Lymphoma, Burkitt included. - Any history of treated or non treated small B-cell lymphoma - Central nervous system or meningeal involvement by lymphoma - Contraindication to any drug contained in the chemotherapy regimen Myocardial infarction during last 3 months or unstable coronary disease or uncontrolled chronic symptomatic congestive heart insufficiency NYHA III-IV - Uncontrolled hypertension - Uncontrolled diabetes mellitus as defined by the investigator - Active systemic infection requiring treatment - previously known HIV positive serology - Active hepatitis B or C - Prior history of malignancies other than lymphoma within 3 years - Serious medical or psychiatric illness

Additional Information

Official title Double Blind Randomized Phase III Study of Lenalidomide Maintenance Versus Placebo in Responding Elderly Patients With DLBCL and Treated With R-CHOP in First Line
Principal investigator Bertrand COIFFIER, Prof
Description Patients should have received at least 6 and up to 8 cycles of the R-CHOP 14 or R-CHOP 21 regimen or 6 R-CHOP-14 or -21 completed by 2 Rituximab alone in accordance to local preferences. Patients can be registered to participate in the study at two time points: - At time of initial diagnosis and study enrolment (signature of informed consent) before the first cycle of treatment with R-CHOP. - At randomization (signature of informed consent) after treatment in first line with R-CHOP and have reached at least PR or CR. Evaluation of the response to R-CHOP must be in accordance with Revised Response Criteria for Malignant Lymphoma(2007). Stratification: Before randomization, the patients will be stratified according to the country and the response to R-CHOP (PR vs CR). Randomization: Patients in CR/PR after R-CHOP will be randomized to maintenance therapy with lenalidomide or placebo.
Trial information was received from ClinicalTrials.gov and was last updated in July 2016.
Information provided to ClinicalTrials.gov by The Lymphoma Academic Research Organisation.