Treatment for Mantle Cell Lymphoma using Ibrutinib and ASCT
Autologous Transplantation After a Rituximab/Ibrutinib/Ara-c Containing iNduction in Generalized Mantle Cell Lymphoma - a Randomized European Mcl Network Trial
This study is testing three different treatment plans for people with Mantle Cell Lymphoma to see which one helps them live longer without the cancer coming back.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 870 (estimated) |
| Ages | 18 Years to 65 Years |
| Sex | All |
| Sponsor | European Mantle Cell Lymphoma Network Academic / other |
| Drugs / interventions | ibrutinib, radiation, chemotherapy |
| Locations | 112 sites (Aalborg and 111 other locations) |
| Trial ID | NCT02858258 on ClinicalTrials.gov |
What this trial studies
This clinical trial aims to compare three different treatment approaches for patients with generalized Mantle Cell Lymphoma (MCL). Participants will receive either R-CHOP/R-DHAP followed by autologous stem cell transplantation (ASCT), or a combination of R-CHOP with ibrutinib followed by ASCT and maintenance therapy with ibrutinib. The primary goal is to determine which treatment regimen leads to the best failure-free survival rates. Secondary objectives include assessing overall survival and the safety profile of the treatments.
Who should consider this trial
Good fit: Ideal candidates for this study are adults aged 18 to 65 with untreated, histologically confirmed Mantle Cell Lymphoma.
Not a fit: Patients with MCL who are not suitable for high-dose treatment or those with advanced age or significant comorbidities may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could establish a new standard of care for treating Mantle Cell Lymphoma, potentially improving patient outcomes.
How similar studies have performed: Other studies have shown promising results with similar treatment approaches, particularly the use of ibrutinib in combination with chemotherapy for MCL.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: All patients must meet the following criteria: * Histologically confirmed diagnosis of MCL according to WHO classification * suitable for high-dose treatment including high-dose Ara-C * Stage II-IV (Ann Arbor) * Age ≥ 18 years and ≤ 65 years * Previously untreated MCL * At least 1 measurable lesion; in case of bone marrow infiltration only, bone marrow aspiration and biopsy is mandatory for all staging evaluations. * ECOG/WHO performance status ≤ 2 * The following laboratory values at screening (unless related to MCL): * Absolute neutrophil count (ANC) ≥1000 cells/µL * Platelets ≥100,000 cells/µL * Transaminases (AST and ALT) ≤3 x upper limit of normal (ULN) * Total bilirubin ≤2 x ULN unless due to known Morbus Meulengracht \[Gilbert-Meulengracht-Syndrome\]) * Creatinine ≤2 mg/dL or calculated creatinine clearance ≥ 50 mL/min * Written informed consent form according to ICH/EU GCP and national regulations * Sexually active men and women of child-bearing potential must agree to use highly effective contraceptives (eg, condoms, implants, injectables, combined oral contraceptives, intrauterine devices, sexual abstinence, or sterilized partner) while on study; this should be maintained for 90 days after the last dose of study drug. Exclusion Criteria: Any potential subject who meets any of the following criteria will be excluded from participating in the study. * Major surgery within 4 weeks prior to randomization. * Requires anticoagulation with warfarin or equivalent vitamin K antagonists (eg phenprocoumon). * History of stroke or intracranial hemorrhage within 6 months prior to randomization. * Requires treatment with strong CYP3A4/5 inhibitors. * Any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator's opinion, could compromise the subject's safety, interfere with the absorption or metabolism of ibrutinib capsules, or put the study outcomes at undue risk. * Vaccinated with live, attenuated vaccines within 4 weeks prior to randomization. * Known CNS involvement of MCL * Clinically significant hypersensitivity (eg, anaphylactic or anaphylactoid reactions to the compound of ibrutinib itself or to the excipients in its formulation) * Known anti-murine antibody (HAMA) reactivity or known hypersensitivity to murine antibodies * Previous lymphoma therapy with radiation, cytostatic drugs, anti-CD20 antibody or interferon except prephase therapy according to trial protocol * Serious concomitant disease interfering with a regular therapy according to the study protocol: * Cardiac (Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification or LVEF below LLN ) * Pulmonary (e.g. chronic lung disease with hypoxemia) * Endocrinological (e.g. severe, not sufficiently controlled diabetes mellitus) * Renal insufficiency (unless caused by the lymphoma): creatinine \> 2x normal value and/or creatinin clearance \< 50 ml/min) * Impairment of liver function (unless caused by the lymphoma): transaminases \> 3x normal or bilirubin \> 2,0 mg/dl unless due to morbus Meulengracht (Gilbert-Meulengracht-Syndrome) * Patients with unresolved hepatitis B or C infection or known HIV positive infection (mandatory test) * Prior organ, bone marrow or peripheral blood stem cell transplantation * Concomitant or previous malignancies within the last 3 years other than basal cell skin cancer or in situ uterine cervix cancer * Pregnancy or lactation * Any psychological, familiar, sociological, or geographical condition potentially hampering compliance with the study protocol and follow up schedule * Subjects not able to give consent * Subjects without legal capacity who are unable to understand the nature, scope, significance and consequences of this clinical trial * Participation in another clinical trial within 30 days before randomization in this study.
Where this trial is running
Aalborg and 111 other locations
- Aalborg University Hospital, Dept of Hematology — Aalborg, Denmark (Not_yet_recruiting)
- Aarhus University Hospital, Dept of Hematology — Aarhus C, Denmark (Not_yet_recruiting)
- Rigshospitalet, Clinic of Hematology — Copenhagen, Denmark (Not_yet_recruiting)
- Herlev Hospital, Department of Hematology L121 — Herlev, Denmark (Not_yet_recruiting)
- Odense University Hospital, Dept of Hematology X — Odense C, Denmark (Not_yet_recruiting)
- Sjaelland University Hospital, Dept of Hematology — Roskilde, Denmark (Not_yet_recruiting)
- Zentralklinik Augsburg, II. Med. Klinik, Hämatologie int. Onkologie — Augsburg, Germany (Recruiting)
- Onkologische Gemeinschaftspraxis Dr. Janssen/Dr. Reichert in der Ubbo-Emmius-Klinik — Aurich, Germany (Recruiting)
- Klinikum Bayreuth, Klinik f. Onkologie und Hämatologie — Bayreuth, Germany (Recruiting)
- Vivantes Klinikum Am Urban, Klinik f. Innere Medizin, Hämatologie und Onkologie — Berlin, Germany (Recruiting)
- Charité Univ.-Medizin Berlin, Med. Klinik - Hämatologie, Onkologie und Tumorimmunologie — Berlin, Germany (Not_yet_recruiting)
- Helios Klinikum Berlin-Buch, Hämatologie, Onkologie und Tumorimmunologie — Berlin, Germany (Recruiting)
- Knappschaftskrankenhaus Bochum-Langendreer — Bochum, Germany (Recruiting)
- Universitätsklinikum Bonn — Bonn, Germany (Recruiting)
- Diako ev. Diakonie-KH gGmbH, Med. Klinik II, Hämatologie und Onkologie — Bremen, Germany (Recruiting)
- Klinikum Chemnitz gGmbH, Klinik f. Innere Medizin II — Chemnitz, Germany (Recruiting)
- Uniklinik Köln, Klinik I für Innere Medizin — Cologne, Germany (Recruiting)
- DONAUISAR Klinikum Deggendorf, Innere Medizin II — Deggendorf, Germany (Recruiting)
- St.-Johannes-Hospital — Dortmund, Germany (Recruiting)
- Gemeinschaftspraxis Dr. Mohm und Prange-Krex - Fachärzte für Innere Medizin und Hämatologie und Onkologie — Dresden, Germany (Recruiting)
- Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden — Dresden, Germany (Recruiting)
- Universitätsklinikum Düsseldorf, Klinik f. Hämatologie, Onkologie und klinische Immunologie — Düsseldorf, Germany (Recruiting)
- Marien Hospital Düsseldorf — Düsseldorf, Germany (Recruiting)
- Helios Klinikum Erfurt GmbH, Zentrum f. Innere Medizin u. internistische Onkologie, Hämostaseologie — Erfurt, Germany (Recruiting)
- Universitätsklinikum Erlangen, Med. Klinik 5, Hämatologie und internistische Onkologie — Erlangen, Germany (Recruiting)
- St.-Antonius-Hospital Eschweiler, Klinik für Hämatologie und Onkologie — Eschweiler, Germany (Recruiting)
- Universitätsklinikum Essen, Klinik f. Hämatologie — Essen, Germany (Recruiting)
- Universitätsklinikum Freiburg, Klinik f. Innere Medizin, Hämatologie, Onkologie u. Stammzelltransplantation — Freiburg im Breisgau, Germany (Recruiting)
- Universitätsmedizin Göttingen, Zentrum f. Innere Medizin, Klinik f. Hämatologie und Medizinische Onkologie — Göttingen, Germany (Recruiting)
- Universitätsmedizin Greifswald, Klinik u. Poliklinik f. Innere Medizin C, Hämatologie u. Onkologie-, Transplantationszentrum — Greifswald, Germany (Recruiting)
- Katholisches Krankenhaus Hagen gGmbH, St.-Marien-Hospital, Klinik f. Hämatologie und Onkologie — Hagen, Germany (Recruiting)
- Universitätsklinikum Hamburg-Eppendorf (UKE), II. Med. Klinik u. Poliklinik, Onkologie, Hämatologie, KMT — Hamburg, Germany (Recruiting)
- Asklepios Klinik Altona, II. Med.Abt. f. Hämatologie und internistische Onkologie, Stammzelltransplantation — Hamburg, Germany (Recruiting)
- Universitätsklinikum Heidelberg, Med. Klinik - Innere Medizin V - Hämatologie, Onkologie und Rheumatologie — Heidelberg, Germany (Recruiting)
- Universitätsklinikum des Saarlandes, Klinik f. Innere Medizin I Hämatologie & Onkologie — Homburg, Germany (Recruiting)
- Klinikum Idar-Oberstein GmbH, Medizinische Klinik I — Idar-Oberstein, Germany (Recruiting)
- Universitätsmedizin Jena, Klinik f. Innere Medizin II, Abteilung Hämatologie u. Internistische Onkologie — Jena, Germany (Recruiting)
- Städtisches Klinikum Karlsruhe, Med. Klinik III, Hämatologie und Onkologie — Karlsruhe, Germany (Recruiting)
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik f. Innere Medizin II - Hämatologie und Onkologie — Kiel, Germany (Recruiting)
- Gemeinschaftsklinikum Mittelrhein gGmbH, Ev. Stift St. Martin, Klinik f. Innere Medizin — Koblenz, Germany (Recruiting)
- Praxisklinik f. Hämatologie und Onkologie Koblenz — Koblenz, Germany (Recruiting)
- Onkologisch-Hämatologische Praxis Dr. Vehling-Kaiser — Landshut, Germany (Recruiting)
- Klinikum Landshut gGmbH, Med. Klinik III, Hämatologie/Internistische Onkologie — Landshut, Germany (Recruiting)
- Caritas-KHLebach, Gemeinschaftspraxis f. Hämatologie und Onkologie, Onkologisches Zentrum Lebach — Lebach, Germany (Recruiting)
- Universitätsklinikum Leipzig AöR, selbständige Abteilung f. Hämatologie und Internistische Onkologie, Hämostaseologische Ambulanz — Leipzig, Germany (Recruiting)
- Klinikum Lippe GmbH, Onkologie und Hämatologie — Lemgo, Germany (Recruiting)
- Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Med. Klinik A — Ludwigshafen, Germany (Recruiting)
- Universitätsklinikum Magdeburg AöR, Klinik f. Hämatologie und Onkologie — Magdeburg, Germany (Recruiting)
- Universitätsmedizin der Univ. Mainz, III. Med. Klinik u. Poliklinik — Mainz, Germany (Recruiting)
- Johannes Wiesling Klinikum Minden, Klinik f. Hämatologie/Onkologie, Hämostaseologie und Palliativmedizin — Minden, Germany (Recruiting)
+62 more sites — see ClinicalTrials.gov for the full list.
Study contacts
- Principal investigator: Martin Dreyling, Prof. — Klinikum der Universität München
- Study coordinator: Döndü Gözel
- Email: Doendue.Goezel@med.uni-muenchen.de
- Phone: +49 89 4400
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.