VEGA: A Study of Ibrutinib With Rituximab in Relapsed/Refractory Mantle Cell Lymphoma

Sponsor
Janssen Research & Development, LLC (Industry)
Overall Status
Recruiting
CT.gov ID
NCT05564052
Collaborator
Pharmacyclics LLC. (Industry)
490
151
6
126.8
3.2
0

Study Details

Study Description

Brief Summary

The purpose of this study is to determine the recommended dosage of ibrutinib when administered in combination with rituximab in participants with relapsed or refractory (r/r) mantle cell lymphoma (MCL) (Phase 2); and to compare the progression-free survival (PFS) of ibrutinib plus rituximab versus physician's choice of lenalidomide plus rituximab or bortezomib plus rituximab (Phase 3).

Condition or Disease Intervention/Treatment Phase
Phase 2/Phase 3

Detailed Description

MCL is an uncommon and incurable clinicopathologic subtype of B-cell non-Hodgkin Lymphoma (NHL). Ibrutinib is a first-in-class potent, orally administered, covalently-binding small molecule inhibitor of Bruton's tyrosine kinase (BTKi) for the treatment of B-cell malignancies and chronic graft-versus-host disease. The primary hypothesis of the study is that ibrutinib plus rituximab using the recommended Phase 3 dosage selected in the Phase 2 part will prolong PFS versus physician's choice of lenalidomide plus rituximab or bortezomib plus rituximab, in participants with r/r MCL who are BTKi naive. The study will include a Screening Phase (up to 30 days prior to randomization), a Treatment Phase (from randomization until study treatment discontinuation), and a Post-treatment Follow-up Phase (from treatment discontinuation until death, consent withdrawal, or study end, whichever occurs first). Safety assessments include adverse events (AEs), serious adverse events (SAEs), clinical laboratory tests, vital signs, electrocardiogram (ECG), physical examination. The total duration of the study will be up to 10 years 8 months.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
490 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Randomized, Controlled, Open-label, Multicenter, Inferentially Seamless Phase 2/3 Study of Ibrutinib in Combination With Rituximab Versus Physician's Choice of Lenalidomide Plus Rituximab or Bortezomib Plus Rituximab in Participants With Relapsed or Refractory Mantle Cell Lymphoma
Actual Study Start Date :
Dec 6, 2022
Anticipated Primary Completion Date :
Nov 1, 2027
Anticipated Study Completion Date :
Jul 1, 2033

Arms and Interventions

Arm Intervention/Treatment
Experimental: Phase 2: Treatment Arm A1 (Rituximab plus Ibrutinib)

Participants will receive rituximab 375 milligrams per meter square (mg/m^2) intravenously (IV) on Day 1 of Cycles 1 to 6 with ibrutinib 560 milligrams (mg) orally, once daily starting on Day 1 of Cycle 1 until disease progression or unacceptable toxicity (each cycle length is 28 days).

Drug: Ibrutinib
Ibrutinib capsules will be administered orally.
Other Names:
  • JNJ-54179060, IMBRUVICA, PCI-32765
  • Drug: Rituximab
    Rituximab will be administered IV.

    Experimental: Phase 2: Treatment Arm A2 (Rituximab plus Ibrutinib)

    Participants will receive rituximab 375 mg/m^2 IV on Day 1 of Cycles 1 to 6 with ibrutinib 420 mg orally, once daily starting on Day 1 of Cycle 1 until disease progression or unacceptable toxicity (each cycle length is 28 days).

    Drug: Ibrutinib
    Ibrutinib capsules will be administered orally.
    Other Names:
  • JNJ-54179060, IMBRUVICA, PCI-32765
  • Drug: Rituximab
    Rituximab will be administered IV.

    Experimental: Phase 2: Treatment Arm A3 (Rituximab plus Ibrutinib)

    Participants will receive rituximab 375 mg/m^2 IV on Day 1 of Cycles 1 to 6 with ibrutinib 140 mg orally, twice daily starting on Day 1 of Cycle 1 until disease progression or unacceptable toxicity (each cycle length is 28 days).

    Drug: Ibrutinib
    Ibrutinib capsules will be administered orally.
    Other Names:
  • JNJ-54179060, IMBRUVICA, PCI-32765
  • Drug: Rituximab
    Rituximab will be administered IV.

    Experimental: Phase 2: Treatment Arm B (Rituximab plus Lenalidomide or Bortezomib)

    Participants will receive rituximab 375 mg/m^2 IV on Day 1 of Cycles 1 to 6 (each cycle length is 21 or 28 days) with physician's choice of either lenalidomide 20 mg orally, once daily from Day 1 through Day 21 of 28-day cycle or bortezomib 1.3 mg/m^2 IV or subcutaneously (SC) on Days 1, 4, 8 and 11 of a 21-day cycle until disease progression or unacceptable toxicity.

    Drug: Lenalidomide
    Lenalidomide capsules will be administered orally.

    Drug: Rituximab
    Rituximab will be administered IV.

    Drug: Bortezomib
    Bortezomib will be administered either intravenously or subcutaneously.

    Experimental: Phase 3: Treatment Arm A (Rituximab plus Ibrutinib)

    Participants will receive rituximab 375 mg/m^2 IV on Day 1 of Cycles 1 to 6 with recommended dose of ibrutinib identified in the Phase 2 starting on Day 1 of Cycle 1 until disease progression or unacceptable toxicity (each cycle length is 28 days).

    Drug: Ibrutinib
    Ibrutinib capsules will be administered orally.
    Other Names:
  • JNJ-54179060, IMBRUVICA, PCI-32765
  • Drug: Rituximab
    Rituximab will be administered IV.

    Experimental: Phase 3: Treatment Arm B (Rituximab plus Lenalidomide or Bortezomib)

    Participants will receive rituximab 375 mg/m^2 IV on Day 1 of Cycles 1 to 6 with physician's choice of either lenalidomide 20 mg orally, once daily from Day 1 through Day 21 of a 28-day cycle or bortezomib 1.3 mg/m^2 IV or SC on Days 1, 4, 8 and 11 of a 21-day cycle until disease progression or unacceptable toxicity.

    Drug: Lenalidomide
    Lenalidomide capsules will be administered orally.

    Drug: Rituximab
    Rituximab will be administered IV.

    Drug: Bortezomib
    Bortezomib will be administered either intravenously or subcutaneously.

    Outcome Measures

    Primary Outcome Measures

    1. Phase 2: Complete Response Rate (CRR) [Up to 35 months]

      CRR is defined as the percentage of participants who achieve complete response (CR) on or prior to the initiation of subsequent anticancer therapy according to Lugano 2014 criteria based on independent review committee (IRC) assessment.

    2. Phase 2: Number of Participants with Treatment Emergent Adverse Events (TEAEs) [Up to 35 months]

      An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. TEAEs are defined as AEs with onset or worsening on or after date of first dose of study treatment.

    3. Phase 2: Number of Participants with TEAEs by Severity [Up to 35 months]

      TEAEs are defined as AEs with onset or worsening on or after date of first dose of study treatment. Severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Severity scale ranges from Grade 1 (Mild) to Grade 5 (Death). Grade 1= Mild, Grade 2= Moderate, Grade 3= Severe, Grade 4= Life-threatening and Grade 5= Death related to adverse event.

    4. Phase 2: Number of Participants with Serious Adverse Events (SAEs) [Up to 35 months]

      An SAE is any untoward medical occurrence that at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is a suspected transmission of any infectious agent via a medicinal product.

    5. Phase 2: Progression Free Survival (PFS) [Up to 35 months]

      PFS is defined as the duration from the date of randomization to either disease progression based on IRC assessment or death, whichever comes first.

    6. Phase 3: Progression Free Survival (PFS) [Up to 60 months]

      PFS is defined as the duration from the date of randomization to either disease progression based on IRC assessment or death, whichever comes first.

    Secondary Outcome Measures

    1. Phase 3: Overall Response Rate (ORR) [Up to 60 months]

      ORR is defined as the percentage of participants who achieve CR or partial response (PR) as the best overall response on or prior to initiation of subsequent antineoplastic therapy according to Lugano 2014 criteria based on IRC assessment.

    2. Phase 3: Overall Survival (OS) [Up to 129 months]

      OS is defined as the time from the date of randomization to the date of the participant's death.

    3. Phase 3: Complete Response Rate (CRR) [Up to 60 months]

      CRR is defined as the percentage of participants who achieve CR on or prior to the initiation of subsequent anticancer therapy according to Lugano 2014 criteria based on IRC assessment.

    4. Phase 3: Time-to-next Treatment (TTNT) [Up to 60 months]

      TTNT is defined as interval from the date of randomization to the start date of any anti-mantle cell lymphoma (MCL) treatment subsequent to the study treatment.

    5. Phase 3: Number of Participants with AEs [Up to 60 months]

      An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study.

    6. Phase 3: Number of Participants with AEs by Severity [Up to 60 months]

      An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the intervention under study. Severity will be graded according to the NCI-CTCAE version 5.0. Severity scale ranges from Grade 1 (Mild) to Grade 5 (Death). Grade 1= Mild, Grade 2= Moderate, Grade 3= Severe, Grade 4= Life-threatening and Grade 5= Death related to adverse event.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • At least 1 prior treatment regimen for mantle cell lymphoma (MCL) excluding inhibitor of Bruton's tyrosine kinase (BTKi)

    • Documented disease progression or relapse following the last anti-MCL treatment

    • At least 1 measurable site of disease on cross-sectional imaging that is greater than or equal to (>=) 2.0 centimeters (cm) in the longest diameter and measurable in 2 perpendicular dimensions per computed tomography (CT)

    • Eastern Cooperative Oncology Group (ECOG) performance status score 0 or 1

    Exclusion Criteria:
    • Prior therapy with ibrutinib or other BTK inhibitor

    • Prior treatment with both lenalidomide and bortezomib. Prior treatment with only 1 of these therapies is allowed

    • Major surgery within 4 weeks of randomization

    • Concurrent enrollment in another therapeutic investigational study

    • Known central nervous system lymphoma

    • History of stroke or intracranial hemorrhage within 6 months prior to randomization

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Fundacao Pio XII Barretos Brazil 14784-400
    2 Santa Casa de Misericordia de Belo Horizonte Belo Horizonte Brazil 30150-221
    3 Sociedade Beneficente de Senhoras - Hospital Sirio Libanes HSL Unidade Brasilia Brasília Brazil 70200-730
    4 Ynova Pesquisa Clinica Florianopolis Brazil 88020-210
    5 Centro de Pesquisa e Ensino em Oncologia de Santa Catarina - CEPEN Florianopolis Brazil 88034-000
    6 Instituto Do Cancer Do Ceara Fortaleza Brazil 60430-230
    7 Liga Norte Riograndense Contra O Cancer Natal Brazil 59062-000
    8 Complexo Hospitalar de Niterói Niterói Brazil 24020-096
    9 Irmandade Santa Casa de Misericordia de Porto Alegre Porto Alegre Brazil 90050-170
    10 Hospital das Clínicas da Faculdade de Medicina de RPUSP - HCRP Ribeirao Preto Brazil 14051-140
    11 Oncoclínicas Rio de Janeiro S.A. Rio de Janeiro Brazil 22250-905
    12 Instituto de Ensino e Pesquisa São Lucas Sao Paulo Brazil 01236-030
    13 Instituto D'Or de Pesquisa e Ensino (IDOR) Sao Paulo Brazil 04501-000
    14 Hospital Das Clinicas Da Faculdade De Medicina Da USP Sao Paulo Brazil 05403-000
    15 Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein Sao Paulo Brazil 05651-900
    16 Casa de Saúde Santa Marcelina - Hospital Santa Marcelina Sao Paulo Brazil 08270-120
    17 University Multiprofile Hospital For Active Treatment St George Plovdiv Bulgaria 4002
    18 Acibadem City Clinic Tokuda Hospital Sofia Bulgaria 1407
    19 UMHAT St. Ivan Rilski Sofia Bulgaria 1431
    20 Specialized Hospital for Active Treatment of Hematology Diseases EAD Sofia Bulgaria 1797
    21 Hunan Cancer hospital Changsha China 410013
    22 Sun Yat-Sen University Cancer Center Guangzhou China 510060
    23 The Second Affiliated Hospital of Kunming Medical University Kunming China 650101
    24 Linyi Cancer Hospital Linyi China 276000
    25 Jiangxi Provincial People's Hospital Nanchang China 330006
    26 Tianjin cancer hospital Tianjin China 300060
    27 Hubei province tumor hospital Wuhan China 430079
    28 CH Merkur Zagreb Croatia 10000
    29 Klinicki bolnicki centar Zagreb Zagreb Croatia 10000
    30 University Hospital Dubrava Zagreb Croatia 10000
    31 Fakultní nemocnice Olomouc Olomouc Czechia 779 00
    32 Fakultni nemocnice Ostrava Ostrava Czechia 708 52
    33 Fakultni nemocnice Kralovske Vinohrady Praha 10 Czechia 100 34
    34 General University Hospital in Prague Praha 2 Czechia 128 08
    35 Kuopio University Hospital Kuopio Finland 70210
    36 University Hospital of Alexandroupolis Alexandroupoli Greece 68100
    37 Attikon University General Hospital of Attica Athens Greece 12462
    38 University Hospital of Ioannina Ioannina Greece 45110
    39 Anticancer Hospital of Thessaloniki 'Theageneio' Thessaloniki Greece 546 39
    40 G.Papanikolaou Thessaloniki Greece 57010
    41 Queen Mary Hospital Hong Kong Hong Kong 999077
    42 Prince of Wales Hospital New Territories Hong Kong 999077
    43 Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet, Szent László Telephely Budapest Hungary 1097
    44 Orszagos Onkologiai Intezet Budapest Hungary 1122
    45 Debreceni Egyetem Klinikai Kozpont Debrecen Hungary 4032
    46 Petz Aladar Megyei Oktato Korhaz Gyor Hungary 9024
    47 Somogy Megyei Kaposi Mor Oktatokorhaz Kaposvar Hungary 7400
    48 Pecsi Tudomanyegyetem Klinikai Kozpont Pecs Hungary 7623
    49 Pecsi Tudomanyegyetem Klinikai Kozpont Pecs Hungary 7624
    50 Healthcare Global (HCG) Hospital Bangalore India 560027
    51 Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India 160012
    52 Amrita Institute of Medical Sciences Ernakulam India 682025
    53 Artemis Hospital Gurugram India 122001
    54 Narayana Superspeciality Hospital, Howrah Howrah India 711103
    55 American Oncology Institute (Cancer Treatment Hospital) - Hyderabad Hyderabad India 500019
    56 Bhagwan Mahaveer Cancer Hospital & Research Centre Jaipur India 302017
    57 HCG cancer center Jaipur India 302020
    58 Tata Medical Center Kolkata India 700156
    59 Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India 226014
    60 AMRI Hospital, Mukundapur Mukundapur India 700099
    61 Tata Memorial Hospital Mumbai India 400012
    62 HCG Manavta Cancer Centre Nashik India 422002
    63 Safdarjung Hospital New Delhi India 110029
    64 IMS and SUM Hospital Odisha India 751003
    65 Ruby Hall Clinic Pune India 411001
    66 Deenanath Mangeshkar Hospital and Research Centre Pune India 411004
    67 Synergy Superspeciality Hospital Rajkot India 360005
    68 Hospital Ampang Ampang Malaysia 68000
    69 Hospital Sultanah Aminah Johor Bharu Malaysia 80100
    70 Hospital Queen Elizabeth Kota Kinabalu Malaysia 88586
    71 University Malaya Medical Centre Kuala Lumpur Malaysia 59100
    72 Subang Jaya Medical Centre Subang Jaya Malaysia 47500
    73 Hidra Investigación Ciudad de México Mexico 04100
    74 Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán Ciudad de México Mexico 14080
    75 Oncotech La Paz Mexico 23040
    76 Health Pharma Professional Research Mexico Mexico 03100
    77 Hospital Universitario Dr. Jose Eleuterio Gonzalez Monterrey Mexico 64460
    78 Avix Investigacion Clinica, S.C. Monterrey Mexico 64710
    79 Hidra Investigación Morelia Mexico 58260
    80 Eme Red Hospitalaria Mérida Mexico 97000
    81 Oaxaca Site Management Organization S.C. México Mexico 68000
    82 Centro de Quimioterapia e Investigación Tlajomulco de Zúñiga Mexico 45640
    83 Hospital Nacional Daniel Alcides Carrion Callao Peru 02
    84 Unidad Oncológica Molecular Peruana Lima Peru 15720
    85 ONCOCARE Lima Peru 85193
    86 Hospital Nacional Edgardo Rebagliatti Martins Lima Peru L11
    87 Oncosalud San Borja Peru 15036
    88 Riverside Medical Center Bacolod City Philippines 6100
    89 Baguio General Hospital and Medical Center Baguio Philippines 2600
    90 Metro Davao Medical and Research Center Inc. Davao City Philippines 8000
    91 Philippine General Hospital Manila Philippines 1000
    92 The Medical City Pasig Philippines 1600
    93 ACE Medical Center Palawan Puerto Princesa Philippines 5300
    94 St. Luke's Medical Center Quezon City Philippines 1112
    95 East Avenue Medical Center Quezon Philippines 1101
    96 Szpital Specjalistyczny w Brzozowie Podkarpacki Osrodek Onkologiczny im. Ks. B. Markiewicza Brzozów Poland 36-200
    97 Swietokrzyskie Centrum Onkologii SPZOZ w Kielcach Kielce Poland 25-734
    98 Pratia MCM Krakow Kraków Poland 30-510
    99 Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Lodzi Lodz Poland 93-513
    100 Samodzielny Publiczny Szpital Kliniczny Nr 1 Lublin Poland 20-081
    101 Szpital Specjalistyczny im Jędrzeja Śniadeckiego w Nowym Saczu Nowy Sącz Poland 33-300
    102 SPZOZ Ministerstwa Spraw Wewnętrznych z Warminsko-Mazurskim Centrum Onkologii w Olsztynie Olsztyn Poland 10-228
    103 Centrum Medyczne Pratia Poznan Skorzewo Poland 60-185
    104 Samodzielny Publiczny Szpital Kliniczny nr 1 im. prof. Tadeusza Sokolowskiego Szczecin Poland 71252
    105 Specjalistyczny Szpital Onkologiczny Nu-Med Tomaszów Mazowiecki Poland 97-200
    106 MICS Centrum Medyczne Torun Toruń Poland 87-100
    107 Centrum Medyczne Warszawskiego Uniwersytetu Medycznego Warszawa Poland 02-097
    108 Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy Warszawa Poland 02-781
    109 Specjalistyczny Szpital im. dra Alfreda Sokołowskiego w Wałbrzychu Wałbrzych Poland 58-309
    110 Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu Wroclaw Poland 50-367
    111 Hospital de Braga Braga Portugal 4710-243
    112 Centro Hospitalar Lisboa Ocidental - Hospital São Fracisco Xavier Lisboa Portugal 1449-005
    113 Instituto Portugues de Oncologia do Porto Francisco Gentil Porto Portugal 4200-072
    114 Centro Hospitalar de Vila Nova de Gaia/Espinho, E.P.E. Vila Nova de Gaia Portugal 4434-502
    115 Auxilio Mutuo Cancer Center San Juan Puerto Rico 00918
    116 Spitalul Clinic Coltea Bucuresti Romania 030167
    117 Ovidius Clinical Hospital OCH Ovidiu Romania 905900
    118 FNsP F. D. Roosevelta Banska Bystrica Banska Bystrica Slovakia 975 17
    119 Narodny onkologicky ustav Bratislava Slovakia 833 10
    120 FNsP J.A. Reimana Presov Presov Slovakia 08181
    121 Clinical Haematologist Groote Schuur Hospital (GSH) incorporating UCT Clinical Research Centre Cape Town South Africa 7925
    122 Inkosi Albert Luthuli Central Hospital Durban South Africa 4091
    123 Netcare Pretoria East Hospital Pretoria South Africa 0181
    124 Clinical Haematology Western Cape South Africa 7580
    125 Hosp. Reina Sofia Cordoba Spain 14004
    126 Hosp. Univ. Infanta Leonor Madrid Spain 28031
    127 Clinica Univ. De Navarra Pamplona Spain 31008
    128 Hosp. Quiron Madrid Pozuelo Pozuelo de Alarcon Spain 28223
    129 Hosp. Clinico Univ. de Salamanca Salamanca Spain 37007
    130 Falu Lasarett Medicinkliniken Falun Falun Sweden 791 82
    131 Sahlgrenska University Hospital Göteborg Sweden 413 45
    132 Universitetssjukhuset Linköping, Hematologkliniken, Linköping Linkoping Sweden 581 85
    133 Sunderby Sjukhus Luleå Sweden 97180
    134 Akademiska Sjukhuset Uppsala Sweden 752 37
    135 Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung Taiwan 80756
    136 China Medical University Hospital Taichung Taiwan 404
    137 Chi Mei Medical Center - Liu Ying Tainan Taiwan 736
    138 National Taiwan University Hospital Taipei Taiwan 100
    139 King Chulalongkorn Memorial Hospital Bangkok Thailand 10330
    140 Phramongkutklao Hospital and Medical College Bangkok Thailand 10400
    141 Ramathibodi Hospital Bangkok Thailand 10400
    142 Siriraj Hospital Bangkok Thailand 10700
    143 Maharaj Nakorn Chiang Mai hospital - Faculty of Medicine ChiangMai Thailand 50200
    144 Srinagarind Hospital Khon Kaen Thailand 40002
    145 Ankara Sehir Hastanesi Ankara Sehir Hastanesi Turkey 06800
    146 Ondokuz Mayis Universitesi Tip Fakultesi Atakum Turkey 55270
    147 Trakya University Medical Faculty Edirne Turkey 22030
    148 Medipol Mega University Hospital Istanbul Turkey 34214
    149 Istanbul University Istanbul Turkey 34390
    150 Ege Universitesi Tip Fakultesi Izmir Turkey 35100
    151 Sakarya Egitim Ve Arastırma Hastanesi Korucuk Kampus Sakarya Turkey 54290

    Sponsors and Collaborators

    • Janssen Research & Development, LLC
    • Pharmacyclics LLC.

    Investigators

    • Study Director: Janssen Research & Development, LLC Clinical Trial, Janssen Research & Development, LLC

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Janssen Research & Development, LLC
    ClinicalTrials.gov Identifier:
    NCT05564052
    Other Study ID Numbers:
    • CR109252
    • 2022-000364-21
    • 54179060MCL3004
    First Posted:
    Oct 3, 2022
    Last Update Posted:
    Jan 30, 2023
    Last Verified:
    Jan 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jan 30, 2023