The primary objective is:1. to compare the biodistribution and uptake in DLBCL of 89Zirconium (89Zr)-ofatumumab and 89Zr-rituximab (visual and quantitative).The secondary objectives are: 1. to compare the biodistribution and uptake in DLBCL of 89Zr-…
ID
Source
Brief title
Condition
- Lymphomas non-Hodgkin's B-cell
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary endpoint is:
1. The detection of 89Zr-ofatumumab and 89Zr-rituximab in DLBCL tumor lesions:
* visual (present/absent).
* quantitative (measured in peak Standardized Uptake Value (SUVpeak)).
Secondary outcome
The secondary endpoints are:
1.The detection of FDG in DLBCL tumor lesions:
* visual (present/absent)
* quantitative (in SUVpreak).
2. The detection of 89Zr-ofatumumab and 89Zr-rituximab in normal tissue:
* visual: description of biodistribution
* quantitative (% uptake (of total injected) 89Zr-ofatumumab and
89Zr-rituximab, calculated residence times and calculated organ absorbed doses
for 89Zr-ofatumumab and 89Zr-rituximab)
3. Clinical outcome:
* in categories: complete remission, partial remission, stable disease or
relapsed/progressive disease, using the Revised Response Criteria for Malignant
Lymphoma (RRMCML) for disease assessment, assessed by CT after the second cycle
of therapy / by PET performed after the third cycle of therapy, conform
OMB110928 study protocol.
Other study parameters:
* Pharmacokinetics of 89Zr-ofatumumab and 89Zr-rituximab.
* Assessment of (89Zr-ofatumumab SUVpeak / 18F-FDG SUVpeak) and (89Zr-rituximab
SUVpeak / 18F-FDG SUVpeak ) for the five tumor lesions with the highest
antibody uptake.
Background summary
For patients with a diffuse large B cell lymphoma (DLBCL) the efficacy of the
anti-CD20 monoclonal antibody rituximab combined with salvage chemotherapy in
the second-line setting has decreased due to more effective first-line
treatment with rituximab containing chemo-immunotherapy. We hypothesize that
ofatumumab, a second generation anti-CD20 monoclonal antibody with a different
binding site, has a better efficiency of tumor targeting and can overcome
relative or complete rituximab resistance, improving response rates.
Study objective
The primary objective is:
1. to compare the biodistribution and uptake in DLBCL of 89Zirconium
(89Zr)-ofatumumab and 89Zr-rituximab (visual and quantitative).
The secondary objectives are:
1. to compare the biodistribution and uptake in DLBCL of 89Zr-ofatumumab and
89Zr-rituximab with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) (visual and
quantitative).
2. to quantify biodistribution and dosimetry in normal tissue of
89Zr-ofatumumab and 89Zr-rituximab.
3. to investigate whether increased uptake in DLBCL on immuno-positron emission
tomography (immuno-PET) is associated with clinical efficacy.
Study design
This is a single-center pilot study. Patients will be injected with 10 mg
89Zr-ofatumumab (74 MBq) or 10 mg 89Zr-rituximab (74 MBq) intravenously, on the
first day of the second-line treatment with respectively ofatumumab or
rituximab plus chemotherapy. Immuno-PET scans will be obtained at 1, 72 and 144
hours post injection. A 18F-FDG PET scan, conform the OMB 110928 protocol, will
be performed within a maximum interval of 2 weeks before the first immuno-PET
scan. Patients will undergo blood sampling for pharmocokinetic purposes.
Study burden and risks
Patients will be asked for 2 extra visits to obtain PET-scans and blood
samples. The risk level according to the ICRP-62 model is stated as Category
III *moderate*(effective doses greater than 10mSv (adults), while the social
benefit is regarded as *substantial*. Patients do not require shielding after
injection of 89Zr-labeled ofatumumab or rituximab.
De Boelelaan 1117
1081 HV Amsterdam
NL
De Boelelaan 1117
1081 HV Amsterdam
NL
Listed location countries
Age
Inclusion criteria
Patients to be included must be before initiation of second-line treatment in or conform OMB 110928 study, meeting the following criteria (conform the inclusion criteria of OMB 110928 study protocol):;Patients have refractory or relapsed (see protocol for definition) CD20 positive DLBCL during or after first line treatment with rituximab combined with anthracycline-based chemotherapy, confirmed by biopsy after first line treatment.;Age 18 years or older. Baseline 18F-FDG PET scan with positive lesions, compatible with CT defined anatomical tumor sites. CT-scan showing at least one or more clearly demarcated lesions with a largest diameter * 1.5 cm or 1 clearly demarcated lesion with a largest diameter * 2.0 cm (not previously irradiated). ECOG performance status 0,1 or 2. Patients must be eligible for high dose chemotherapy and autologous stem cell transplantation. Resolution of toxicities from first-line therapy to grade * 1. Patients must be able to adhere to the study appointments and other protocol requirements. Patients must be capable of giving written informed consent and the consent must have been obtained prior to the study related procedures.
Exclusion criteria
Patients are excluded if they meet the following criteria (conform the exclusion criteria of OMB 110928 study protocol):;- any previous therapy for DLBCL, with the exception of first-line treatment with rituximab in combination with anthracycline-based chemotherapy, or radiotherapy as part of the first-line treatment plan or to a limited field at a aximum dose of *10Gy to control life-threatening symptoms.;- received any of the following treatments within 4 weeks prior to start of trial therapy (unless otherwise stated): anti-cancer therapy, radiotherapy (unless limited field at a maximum dose of * 10Gy to control life-threatening symptoms), treatment with any known non-marketed drug substance or experimental therapy within 5 terminal half lives or 4 weeks prior to enrolment (whichever is longer) or currently participating in any other interventional clinical study, glucocorticoid use, unless given in doses *100 mg/day hydrocortisone (or equivalent dose of other glucocorticoids) for < 7 days for exacerbations other than lymphoma (e.g. asthma). ;- Significant cerebrovascular disease. ;- Chronic or active infections with systemic treatment with antibiotics, antifungal or antiviral medication. ;- Other malignancy. ;- Prior treatment with monoclonal antibodies, with the exception of rituximab, within 3 months prior to start of the study.;- Pregnancy or lactation;- Women of childbearing potential or male subjects, unable or unwilling to adhere to the adequate contraception conform study protocol.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2012-001597-29-NL |
CCMO | NL40422.029.12 |