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Stilgenbauer S, Bosch F, Ilhan O, Kisro J, Mahé B, Mikuskova E, Osmanov D, Reda G, Robinson S, Tausch E, Turgut M, Wójtowicz M, Böttcher S, Perretti T, Trask P, Van Hoef M, Leblond V, Foà R. Safety and efficacy of obinutuzumab alone or with chemotherapy in previously untreated or relapsed/refractory chronic lymphocytic leukaemia patients: Final analysis of the Phase IIIb GREEN study. Br J Haematol 2021; 193:325-338. [PMID: 33605445 DOI: 10.1111/bjh.17326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/21/2020] [Indexed: 02/04/2023]
Abstract
The manageable toxicity profile of obinutuzumab (GA101; G) alone or with chemotherapy in first-line (1L; fit and non-fit) and relapsed/refractory (R/R) patients with chronic lymphocytic leukaemia (CLL) was established in the primary analysis of the Phase IIIb GREEN trial (Clinicaltrials.gov: NCT01905943). The final analysis (cut-off, 31 January 2019) is reported here. Patients received G (1000 mg) alone (G-mono; fit and non-fit patients) or with chemotherapy [fludarabine and cyclophosphamide (FC; fit patients); chlorambucil (non-fit patients); bendamustine (any patient)]. Study endpoints were safety (primary) and efficacy (secondary). Subgroup analyses were performed on prognostic biomarkers in 1L CLL. Overall, 630 patients received 1L and 341 received R/R CLL treatment. At the final analysis, no new safety signals were observed [Grade ≥ 3 adverse events (AEs): 1L 82·7%, R/R 84·5%; serious AEs: 1L 58·1%, R/R 62·5%]. Neutropenia (1L 50·5%, R/R 53·4%) and thrombocytopenia (1L 14·6%, R/R 19·1%) were the most common Grade 3-5 AEs. G-mono-, G-bendamustine and G-FC-treated patients with unmutated immunoglobulin heavy chain trended towards shorter progression-free survival. Achievement of minimal residual disease negativity was greatest in 1L patients treated with G-FC. In this final analysis of the GREEN trial, the safety profile of G was consistent with current risk management strategies. Biomarker analyses supported efficacy in the specific subgroups.
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Affiliation(s)
- Stephan Stilgenbauer
- Department of Internal Medicine III, Ulm University, Ulm and Innere Medizin I, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Francesc Bosch
- Department of Hematology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Osman Ilhan
- Internal Medical Sciences Departments, Ankara University School of Medicine, Ankara, Turkey
| | - Jens Kisro
- Onkologische Schwerpunktpraxis Lübeck, Lübeck, Germany
| | - Béatrice Mahé
- Clinical Hematology, CHU Nantes Hôtel-Dieu, Nantes, France
| | - Eva Mikuskova
- Department of Hemato-oncology II, National Cancer Institute, Bratislava, Slovakia Blokhin
| | - Dzhelil Osmanov
- Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Gianluigi Reda
- UOC Ematologia - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Sue Robinson
- QEII Health Sciences Centre, Halifax, NS, Canada
| | - Eugen Tausch
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Mehmet Turgut
- Department of Internal Medical Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Marcin Wójtowicz
- Clinical Department of Hematology, Hematological Oncology and Internal Diseases, Szpital Wojewodski, Opole, Poland
| | - Sebastian Böttcher
- Department III of Internal Medicine, Rostock University Medical Center, Rostock (current affiliation) and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Thomas Perretti
- PDB Biostatistics -Medical Affairs, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Peter Trask
- Patient Centered Outcomes Research, Genentech Inc, South San Francisco, CA, USA
| | - Marlies Van Hoef
- Global Product Development - Medical Affairs, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Véronique Leblond
- Clinical Hematology, Sorbonne Université, AP-HP Hôpital Pitié Salpêtrière, Paris, France
| | - Robin Foà
- Division of Hematology, Sapienza University, Rome, Italy
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de Jong J, Hellemans P, De Wilde S, Patricia D, Masterson T, Manikhas G, Myasnikov A, Osmanov D, Córdoba R, Panizo C, de Zwart L, Snoeys J, Chauhan V, Jiao J, Sukbuntherng J, Ouellet D. A drug-drug interaction study of ibrutinib with moderate/strong CYP3A inhibitors in patients with B-cell malignancies. Leuk Lymphoma 2018; 59:2888-2895. [PMID: 29846137 DOI: 10.1080/10428194.2018.1460474] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This was an open-label, multicenter, phase-1 study to evaluate the drug interaction between steady-state ibrutinib and moderate (erythromycin) and strong (voriconazole) CYP3A inhibitors in patients with B-cell malignancies and to confirm dosing recommendations. During cycle 1, patients received oral ibrutinib 560 mg qd alone (Days 1-4 and 14-18), and ibrutinib 140 mg (Days 5-13; 19-27) plus erythromycin 500 mg tid (Days 5-11) and voriconazole 200 mg bid (Days 19-25). Twenty-six patients (median [range] age: 64.5 [50-88] years) were enrolled. Geometric mean ratio (90% confidence intervals) after co-administration of ibrutinib 140 mg with erythromycin and voriconazole was 74.7 (53.97-103.51) and 143.3 (107.77-190.42), respectively, versus ibrutinib 560 mg alone. The most common (≥20%) adverse events were diarrhea (27%) and neutropenia (23%). The results demonstrate that ibrutinib 140 mg with voriconazole or erythromycin provides exposure within the clinical range for patients with B-cell malignancies.
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Affiliation(s)
- Jan de Jong
- a Janssen Research & Development , San Diego , CA , USA
| | | | | | | | - Tara Masterson
- c Janssen Research & Development , Spring House , PA , USA
| | - Georgii Manikhas
- d St. Petersburg City Oncology Hospital , St. Petersburg , Russian Federation
| | | | - Dzhelil Osmanov
- f N.N. Blokhin Russian Academy of Medical Sciences , Moscow , Russian Federation
| | - Raúl Córdoba
- g START Madrid, University Hospital Fundacion Jimenez Diaz, Health Research Institute IIS-FJD , Madrid , Spain
| | | | | | - Jan Snoeys
- b Janssen Research & Development , Beerse , Belgium
| | - Vijay Chauhan
- i Janssen Research & Development , Raritan , NJ , USA
| | - James Jiao
- i Janssen Research & Development , Raritan , NJ , USA
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Jurczak W, Moreira I, Setty Govindbabu K, Munhoz E, Echeveste MA, Giri P, Castro N, Pereira J, Luiza A, Alexeev S, Osmanov D, Zhu P, Alexandrova S, Zubel A, Harlin O, Amersdorffer J. Equivalent efficacy of a biosimilar rituximab and reference rituximab in previously untreated advanced follicular lymphoma: Extended results of ASSIST-FL, a confirmatory phase III study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kim WS, Buske C, Ogura M, Jurczak W, Sancho JM, Zhavrid E, Kim JS, Hernández-Rivas JÁ, Prokharau A, Vasilica M, Nagarkar R, Osmanov D, Kwak LW, Lee SJ, Lee SY, Bae YJ, Coiffier B. Efficacy, pharmacokinetics, and safety of the biosimilar CT-P10 compared with rituximab in patients with previously untreated advanced-stage follicular lymphoma: a randomised, double-blind, parallel-group, non-inferiority phase 3 trial. Lancet Haematol 2017; 4:e362-e373. [PMID: 28712940 DOI: 10.1016/s2352-3026(17)30120-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Studies in patients with rheumatoid arthritis have shown that the rituximab biosimilar CT-P10 (Celltrion, Incheon, South Korea) has equivalent efficacy and pharmacokinetics to rituximab. In this phase 3 study, we aimed to assess the non-inferior efficacy and pharmacokinetic equivalence of CT-P10 compared with rituximab, when used in combination with cyclophosphamide, vincristine, and prednisone (CVP) in patients with newly diagnosed advanced-stage follicular lymphoma. METHODS In this ongoing, randomised, double-blind, parallel-group, active-controlled study, patients aged 18 years or older with Ann Arbor stage III-IV follicular lymphoma were assigned 1:1 to CVP plus intravenous infusions of 375 mg/m2 CT-P10 or rituximab on day 1 of eight 21-day cycles. Randomisation was done by the investigators using an interactive web or voice response system and a computer-generated randomisation schedule, prepared by a clinical research organisation. Randomisation was balanced using permuted blocks and was stratified by country, gender, and Follicular Lymphoma International Prognostic Index score (0-2 vs 3-5). Study teams from the sponsor and clinical research organisation, investigators, and patients were masked to treatment assignment. The study was divided into two parts: part 1 assessing equivalence of pharmacokinetics (in the pharmacokinetics subset), and part 2 assessing efficacy in all randomised patients (patients from the pharmacokinetics subset plus additional patients enrolled in part 2). Equivalence of pharmacokinetics was shown if the 90% CIs for the geometric mean ratio of CT-P10 to rituximab in AUCτ and CmaxSS were within the bounds of the equivalence margin of 80% and 125%. Non-inferiority of response was shown if the one-sided 97·5% CI lay on the positive side of the -7% margin, using a one-sided test done at the 2·5% significance level. The primary efficacy endpoint was the proportion of patients who had an overall response over eight cycles and was assessed in the efficacy population (all randomised patients). The primary pharmacokinetic endpoints were area under the serum concentration-time curve at steady state (AUCτ) and maximum serum concentration at steady state (CmaxSS) at cycle 4, assessed in the pharmokinetic population. This trial is registered with ClinicalTrials.gov, number NCT02162771. FINDINGS Between July 28, 2014, and Dec 29, 2015, 140 patients were enrolled. Here we report data for the eight-cycle induction period, up to week 24. The proportion of patients with an overall response in the efficacy population was 64 (97·0%) of 66 patients in the CT-P10 treatment group and 63 (92·6%) of 68 patients in the rituximab treatment group (4·3%; one-sided 97·5% CI -4·25), which lay on the positive side of the predefined non-inferiority margin. The ratio of geometric least squares means (CT-P10/rituximab) was 102·25% (90% CI 94·05-111·17) for AUCτ and 100·67% (93·84-108·00) for CmaxSS, with all CIs within the bioequivalence margin of 80-125%. Treatment-emergent adverse events were reported for 58 (83%) of 70 patients in the CT-P10 treatment group and 56 (80%) of 70 in the rituximab treatment group. The most common grade 3 or 4 treatment-emergent adverse event in each treatment group was neutropenia (grade 3, 15 [21%] of 70 patients in the CT-P10 group and seven [10%] of 70 patients in the rituximab group). The proportion of patients who experienced at least one treatment-emergent serious adverse event was 16 (23%) of 70 patients in the CT-P10 group and nine (13%) of 70 patients in the rituximab group. INTERPRETATION In this study, we show that CT-P10 exhibits non-inferior efficacy and pharmacokinetic equivalence to rituximab. The safety profile of CT-P10 was comparable to that of rituximab. CT-P10 might represent a new therapeutic option for advanced-stage follicular lymphoma. FUNDING Celltrion, Inc.
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Affiliation(s)
- Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Christian Buske
- Comprehensive Cancer Center Ulm, University Hospital of Ulm, Ulm, Germany
| | - Michinori Ogura
- Department of Haematology, Tokai Central Hospital, Kakamigahara, Gifu, Japan
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Kraków, Poland
| | - Juan-Manuel Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Edvard Zhavrid
- N N Alexandrov Republican Scientific and Practical Centre of Oncology and Medical Radiology, Minsk, Belarus
| | - Jin Seok Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | | | | | - Mariana Vasilica
- Hematology Department, Fundeni Clinical Institute, Bucharest, Romania
| | | | | | - Larry W Kwak
- Toni Stephenson Lymphoma Center and Department of Haematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
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5
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Buske C, Kim W, Kwak L, Coiffier B, Jurczak W, Sancho J, Zhavrid E, Kim J, Hernández Rivas J, Prokharau A, Vasilica M, Nagarkar R, Osmanov D, Lee S, Lee S, Bae Y, Ogura M. A DOUBLE-BLIND, RANDOMIZED PHASE 3 STUDY TO COMPARE EFFICACY AND SAFETY OF CT-P10 TO RITUXIMAB IN COMBINATION WITH CVP IN PATIENTS WITH ADVANCED-STAGE FOLLICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_83] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C. Buske
- CCC Ulm; University Hospital of Ulm; Ulm Germany
| | - W. Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - L. Kwak
- Toni Stephenson Lymphoma Center and Department of Haematology and Hematopoietic Cell Transplantation, City of Hope Duarte; Duarte USA
| | - B. Coiffier
- Department of Hematology; Hospices Civils de Lyon; Lyon France
| | - W. Jurczak
- Department of Haematology; Jagiellonian University; Kraków Poland
| | - J.M. Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol; Badalona Spain
| | - E. Zhavrid
- Department of Haematology; N.N. Alexandrov Republican Scientific and Practical Centre of Oncology and Medical Radiology; Minsk Belarus
| | - J. Kim
- Department of Internal Medicine; Yonsei University College of Medicine, Severance Hospital; Seoul Korea, Republic of
| | | | - A. Prokharau
- Department of Haematology, Minsk City Clinical Oncology Dispensary; Minsk Belarus
| | - M. Vasilica
- Hematology Department; Fundeni Clinical Institute; Bucharest Romania
| | - R. Nagarkar
- Curie Manavata Cancer Centre, Curie Manavata Cancer Centre; Maharashtra India
| | - D. Osmanov
- Department of Chemotherapy of Hemoblastosis, N.N. Blokhin Russian Cancer Research Center; Moscow Russian Federation
| | - S. Lee
- Clinical Development Division; CELLTRION, Inc.; Incheon Korea, Republic of
| | - S. Lee
- Clinical Development Division; CELLTRION, Inc.; Incheon Korea, Republic of
| | - Y. Bae
- Clinical Development Division; CELLTRION, Inc.; Incheon Korea, Republic of
| | - M. Ogura
- Department of Haematology, Tokai Central Hospital, Kakamigahara; Gifu Japan
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6
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Zinzani P, Thieblemont C, Melnichenko V, Osmanov D, Bouabdallah K, Walewski J, Majlis A, Fogliatto L, Caballero Barrigón M, Christian B, Gulbas Z, Özcan M, Salles G, Shipp M, Balakumaran A, Chlosta S, Chatterjee A, Armand P. Efficacy and safety of pembrolizumab in relapsed/refractory primary mediastinal large B-cell lymphoma (rrPMBCL): interim analysis of the KEYNOTE-170 phase 2 trial. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_49] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- P. Zinzani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | | | - V. Melnichenko
- Hematology; The National Medical Surgical Сentre named after N.I. Pirogov, Moscow; Russian Federation
| | - D. Osmanov
- Russian Academy of Medical Sciences; N.N. Blokhin Russian Oncological Research Center; Moscow Russian Federation
| | - K. Bouabdallah
- Hematology and Cell Therapy; Groupe Hospitalier du Haut Leveque; Pessac France
| | - J. Walewski
- Lymphoid Malignancy; Maria Sklodowska-Curie Institute - Oncology Center; Warsaw Poland
| | - A. Majlis
- Hematology, University of Chile; Hospital del Salvador; Santiago Chile
| | - L. Fogliatto
- Hematology; Hospital de Clinicas de Porto Alegre; Porto Alegre Brazil
| | | | - B. Christian
- Division of Hematology; Ohio State University - James Comprehensive Cancer Center; Columbus USA
| | - Z. Gulbas
- Hematologic Oncology; Anadolu Medical Center; Gebze Turkey
| | - M. Özcan
- Division of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - G.A. Salles
- Hospices Civils de Lyon, Cancer Research Center of Lyon; Claude Bernard University Lyon; Pierre Benite France
| | - M.A. Shipp
- Division of Hematologic Neoplasia; Dana-Farber Cancer Institute; Boston USA
| | | | - S. Chlosta
- Clinical Research; Merck & Co., Inc.; Kenilworth USA
| | - A. Chatterjee
- Clinical Research; Merck & Co., Inc.; Kenilworth USA
| | - P. Armand
- Division of Hematologic Neoplasia; Dana-Farber Cancer Institute; Boston USA
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Fowler N, Gopal A, Schuster S, Trotman J, Hess G, Hou J, Yacoub A, Lill M, Martin P, Vitolo U, Spencer A, Radford J, Jurczak W, Morton J, Osmanov D, Caballero D, Deshpande S, Vermeulen J, Damle R, Schaffer M, Balasubramanian S, Cheson B, Salles G. Biomarker analysis of patients with follicular lymphoma treated with ibrutinib in the phase 2 DAWN study. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- N. Fowler
- Department of Lymphoma/Myeloma; The University of Texas MD Anderson Cancer Center; Houston USA
| | - A.K. Gopal
- Seattle Cancer Care Alliance; The University of Washington/Fred Hutchison Cancer Research Center; Seattle USA
| | - S.J. Schuster
- Lymphoma Program; Abramson Cancer Center of the University of Pennsylvania; Philadelphia USA
| | - J. Trotman
- Concord Hospital; University of Sydney, Haematology Department; Sydney Australia
| | - G. Hess
- Department of Hematology/Oncology; Johannes Gutenberg University; Mainz Germany
| | - J. Hou
- Division of Hematology/Oncology; University of Pittsburgh Medical Center and University of Pittsburgh Cancer Institute; Pittsburgh USA
| | - A. Yacoub
- Hematologic Malignancies and Cellular Therapeutics; University of Kansas Medical Center; Kansas City USA
| | - M. Lill
- Stem Cell and Bone Marrow Transplant Program, Cedars-Sinai Medical Center; Los Angeles USA
| | - P. Martin
- Weill Cornell Medical College; Cornell University; New York USA
| | - U. Vitolo
- Hematology; Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino; Turin Italy
| | - A. Spencer
- Central Clinical School; Alfred Hospital-Monash University; Melbourne Australia
| | - J. Radford
- University of Manchester and the Christie NHS Foundation Trust; Manchester Academic Health Science Centre; Manchester UK
| | - W. Jurczak
- Department of Hematology; Jagiellonian University; Krakow Poland
| | - J. Morton
- Clinical Haemato-Oncology; Haematology and Oncology Clinics of Australia; Milton Australia
| | - D. Osmanov
- Blokhin Cancer Research Center; Russian Academy of Medical Sciences; Moscow Russian Federation
| | - D. Caballero
- Instituto Biosanitario de Salamanca; Hospital Clínico Universitario; Salamanca Spain
| | | | - J. Vermeulen
- Research & Development, Janssen; Leiden The Netherlands
| | - R. Damle
- Research & Development, Janssen; Raritan USA
| | - M. Schaffer
- Research & Development, Janssen; Raritan USA
| | | | - B. Cheson
- Lombardi Comprehensive Cancer Center; Georgetown University Hospital; Washington District of Columbia USA
| | - G. Salles
- Haematology Department; Hospices Civils de Lyon-Université de Lyon; Lyon France
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Kim WS, Jurczak W, Sancho JM, Javrid E, Kim JS, Hernandez Rivas JA, Prokharau A, Vasilica M, Nagarkar R, Osmanov D, Buske C, Kwak L, Ogura M, Lee SJ, Lee SY, Bae Y, Coiffier B. Double-blind, randomized phase 3 study to compare efficacy and safety of the biosimilar CT-P10 to rituximab combined with CVP therapy in patients with previously untreated advanced-stage follicular lymphoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.7532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7532 Background: CT-P10 is a biosimilar candidate to the innovator rituximab (RTX). In patients with rheumatoid arthritis, CT-P10 has demonstrated equivalence in pharmacokinetics (PK) and efficacy (Yoo, ACR 2016). This study aimed to demonstrate non-inferiority of efficacy and PK equivalence between CT-P10 and RTX in patients with newly diagnosed advanced follicular lymphoma (AFL) (NCT02162771). PK equivalence was confirmed (Coiffier, ASH 2016). Methods: A total of 140 patients were randomized in a 1:1 ratio to receive CT-P10 or RTX (375 mg/m2 i.v) plus CVP (cyclophosphamide, vincristine, and prednisone) every 3 weeks over 8 cycles. Overall response rate (ORR) according to the 1999 IWG criteria over 24 weeks was assessed by the independent review committee. Results: Noninferiority of CT-P10 to RTX was shown for the primary efficacy endpoint of ORR. The ORR difference was 4.3% (Table) and the lower bound of the 95% confidence interval was -4.25%. B-cell depleted after the 1st infusion and remained as depleted over 8 cycles in both groups. Overall safety profile of CT-P10 was consistent with that of RTX and the proportion of patients with positive anti-drug antibody was similar in both groups (4.3% and 2.9%) for 24 weeks. Neither progressive multifocal leukoencephalopathy nor Hepatitis B virus reactivation was reported in each group. Conclusions: This study demonstrates noninferiority of efficacy of CT-P10 to RTX combined with CVP in previously untreated AFL. CT-P10 was well-tolerated and the safety profile including immunogenicity of CT-P10 was comparable to that of RTX over 8 cycles of induction period. Clinical trial information: NCT02162771. [Table: see text]
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Affiliation(s)
- Won Seog Kim
- Samsung Medical Center, Seoul, Republic of Korea
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Kraków, Poland
| | | | - Edvard Javrid
- N.N. Alexandrov Republican Scientific and Practical Centre of Oncology and Medical Radiology, Minsk, Belarus
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | | | | | | | | | - Dzhelil Osmanov
- N. N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia
| | - Christian Buske
- Institute of Experimental Cancer Research, University of Ulm, Ulm, Germany
| | - Larry Kwak
- Department of Hematology and Hematopietic Cell Transplantation, City of Hope, Duarte, CA
| | - Michinori Ogura
- Department of Hematology, Tokai Central Hospital, Gifu, Japan
| | | | | | - Yunju Bae
- CELLTRION, Inc., Incheon, Republic of Korea
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Sweetenham JW, Walewski J, Nadamanee A, Masszi T, Agura E, Holowiecki J, Abidi MH, Chen AI, Stiff P, Viviani S, Carella A, Osmanov D, Bachanova V, Sureda A, Huebner D, Larsen EK, Hunder NN, Moskowitz CH. Updated Efficacy and Safety Data from the AETHERA Trial of Consolidation with Brentuximab Vedotin after Autologous Stem Cell Transplant (ASCT) in Hodgkin Lymphoma Patients at High Risk of Relapse. Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moskowitz CH, Nademanee A, Masszi T, Agura E, Holowiecki J, Abidi MH, Chen AI, Stiff P, Gianni AM, Carella A, Osmanov D, Bachanova V, Sweetenham J, Sureda A, Huebner D, Sievers EL, Chi A, Larsen EK, Hunder NN, Walewski J. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin's lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2015; 385:1853-62. [PMID: 25796459 DOI: 10.1016/s0140-6736(15)60165-9] [Citation(s) in RCA: 489] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND High-dose therapy followed by autologous stem-cell transplantation is standard of care for patients with relapsed or primary refractory Hodgkin's lymphoma. Roughly 50% of patients might be cured after autologous stem-cell transplantation; however, most patients with unfavourable risk factors progress after transplantation. We aimed to assess whether brentuximab vedotin improves progression-free survival when given as early consolidation after autologous stem-cell transplantation. METHODS We did this randomised, double-blind, placebo-controlled, phase 3 trial at 78 sites in North America and Europe. Patients with unfavourable-risk relapsed or primary refractory classic Hodgkin's lymphoma who had undergone autologous stem-cell transplantation were randomly assigned, by fixed-block randomisation with a computer-generated random number sequence, to receive 16 cycles of 1·8 mg/kg brentuximab vedotin or placebo intravenously every 3 weeks, starting 30-45 days after transplantation. Randomisation was stratified by best clinical response after completion of salvage chemotherapy (complete response vs partial response vs stable disease) and primary refractory Hodgkin's lymphoma versus relapsed disease less than 12 months after completion of frontline therapy versus relapse 12 months or more after treatment completion. Patients and study investigators were masked to treatment assignment. The primary endpoint was progression-free survival by independent review, defined as the time from randomisation to the first documentation of tumour progression or death. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01100502. FINDINGS Between April 6, 2010, and Sept 21, 2012, we randomly assigned 329 patients to the brentuximab vedotin group (n=165) or the placebo group (n=164). Progression-free survival by independent review was significantly improved in patients in the brentuximab vedotin group compared with those in the placebo group (hazard ratio [HR] 0·57, 95% CI 0·40-0·81; p=0·0013). Median progression-free survival by independent review was 42·9 months (95% CI 30·4-42·9) for patients in the brentuximab vedotin group compared with 24·1 months (11·5-not estimable) for those in the placebo group. We recorded consistent benefit (HR <1) of brentuximab vedotin consolidation across subgroups. The most frequent adverse events in the brentuximab vedotin group were peripheral sensory neuropathy (94 [56%] of 167 patients vs 25 [16%] of 160 patients in the placebo group) and neutropenia (58 [35%] vs 19 [12%] patients). At time of analysis, 28 (17%) of 167 patients had died in the brentuximab vedotin group compared with 25 (16%) of 160 patients in the placebo group. INTERPRETATION Early consolidation with brentuximab vedotin after autologous stem-cell transplantation improved progression-free survival in patients with Hodgkin's lymphoma with risk factors for relapse or progression after transplantation. This treatment provides an important therapeutic option for patients undergoing autologous stem-cell transplantation. FUNDING Seattle Genetics and Takeda Pharmaceuticals International.
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Affiliation(s)
| | | | - Tamas Masszi
- Szent Istvan & Szent Laszlo Corporate Hospital Hematology & Stem Cell Dept, Budapest, Hungary
| | - Edward Agura
- Baylor University Medical Center, Dallas, TX, USA
| | - Jerzy Holowiecki
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute of Oncology, Gliwice, Poland
| | | | - Andy I Chen
- Oregon Health and Science University, Portland, OR, USA
| | | | | | - Angelo Carella
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy
| | - Dzhelil Osmanov
- Blokhin Cancer Research Center under the Russian Academy of Medical Sciences, Moscow, Russia
| | | | - John Sweetenham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anna Sureda
- Institut Catala d'Oncologia-Hospital Duran i Reynals, Barcelona, Spain
| | - Dirk Huebner
- Takeda Pharmaceuticals International, Cambridge, MA, USA
| | | | - Andy Chi
- Takeda Pharmaceuticals International, Cambridge, MA, USA
| | | | | | - Jan Walewski
- Maria Sklodowska-Curie Institute and Oncology Center, Warszawa, Poland
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Moskowitz CH, Nademanee A, Masszi T, Agura E, Holowiecki J, Abidi MH, Chen AI, Stiff P, Gianni AM, Carella A, Osmanov D, Bachanova V, Sweetenham J, Sureda A, Huebner D, Sievers EL, Chi A, Larsen EK, Hunder NN, Walewski J. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin's lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2015. [PMID: 25796459 DOI: 10.1016/s0140-6736(1560165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND High-dose therapy followed by autologous stem-cell transplantation is standard of care for patients with relapsed or primary refractory Hodgkin's lymphoma. Roughly 50% of patients might be cured after autologous stem-cell transplantation; however, most patients with unfavourable risk factors progress after transplantation. We aimed to assess whether brentuximab vedotin improves progression-free survival when given as early consolidation after autologous stem-cell transplantation. METHODS We did this randomised, double-blind, placebo-controlled, phase 3 trial at 78 sites in North America and Europe. Patients with unfavourable-risk relapsed or primary refractory classic Hodgkin's lymphoma who had undergone autologous stem-cell transplantation were randomly assigned, by fixed-block randomisation with a computer-generated random number sequence, to receive 16 cycles of 1·8 mg/kg brentuximab vedotin or placebo intravenously every 3 weeks, starting 30-45 days after transplantation. Randomisation was stratified by best clinical response after completion of salvage chemotherapy (complete response vs partial response vs stable disease) and primary refractory Hodgkin's lymphoma versus relapsed disease less than 12 months after completion of frontline therapy versus relapse 12 months or more after treatment completion. Patients and study investigators were masked to treatment assignment. The primary endpoint was progression-free survival by independent review, defined as the time from randomisation to the first documentation of tumour progression or death. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01100502. FINDINGS Between April 6, 2010, and Sept 21, 2012, we randomly assigned 329 patients to the brentuximab vedotin group (n=165) or the placebo group (n=164). Progression-free survival by independent review was significantly improved in patients in the brentuximab vedotin group compared with those in the placebo group (hazard ratio [HR] 0·57, 95% CI 0·40-0·81; p=0·0013). Median progression-free survival by independent review was 42·9 months (95% CI 30·4-42·9) for patients in the brentuximab vedotin group compared with 24·1 months (11·5-not estimable) for those in the placebo group. We recorded consistent benefit (HR <1) of brentuximab vedotin consolidation across subgroups. The most frequent adverse events in the brentuximab vedotin group were peripheral sensory neuropathy (94 [56%] of 167 patients vs 25 [16%] of 160 patients in the placebo group) and neutropenia (58 [35%] vs 19 [12%] patients). At time of analysis, 28 (17%) of 167 patients had died in the brentuximab vedotin group compared with 25 (16%) of 160 patients in the placebo group. INTERPRETATION Early consolidation with brentuximab vedotin after autologous stem-cell transplantation improved progression-free survival in patients with Hodgkin's lymphoma with risk factors for relapse or progression after transplantation. This treatment provides an important therapeutic option for patients undergoing autologous stem-cell transplantation. FUNDING Seattle Genetics and Takeda Pharmaceuticals International.
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Affiliation(s)
| | | | - Tamas Masszi
- Szent Istvan & Szent Laszlo Corporate Hospital Hematology & Stem Cell Dept, Budapest, Hungary
| | - Edward Agura
- Baylor University Medical Center, Dallas, TX, USA
| | - Jerzy Holowiecki
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute of Oncology, Gliwice, Poland
| | | | - Andy I Chen
- Oregon Health and Science University, Portland, OR, USA
| | | | | | - Angelo Carella
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy
| | - Dzhelil Osmanov
- Blokhin Cancer Research Center under the Russian Academy of Medical Sciences, Moscow, Russia
| | | | - John Sweetenham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anna Sureda
- Institut Catala d'Oncologia-Hospital Duran i Reynals, Barcelona, Spain
| | - Dirk Huebner
- Takeda Pharmaceuticals International, Cambridge, MA, USA
| | | | - Andy Chi
- Takeda Pharmaceuticals International, Cambridge, MA, USA
| | | | | | - Jan Walewski
- Maria Sklodowska-Curie Institute and Oncology Center, Warszawa, Poland
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O’Connor OA, Goy A, Orlowski R, Hainsworth JD, Leonard JP, Afanasyev B, Osmanov D, Chen M, Wolff A. A phase I-II trial of the kinesin spindle protein (KSP) inhibitor SB-743921 on days 1 and 15 every 28 days in non-Hodgkin or Hodgkin lymphoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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