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A Study of ONTAK and CHOP in Newly Diagnosed, Peripheral T-Cell Lymphoma

A Pilot Phase II Study to Determine the Safety and Efficacy of the Combination of ONTAK With CHOP in Peripheral T-Cell Lymphoma.

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00211185
Enrollment
49
Registered
2005-09-21
Start date
2004-03-14
Completion date
2009-12-23
Last updated
2020-03-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lymphoma, T-Cell, Peripheral

Brief summary

Study of ONTAK and CHOP (chemotherapy drugs) to find out their ability to make Peripheral T-cell lymphoma disappear (for any period of time) and potentially lengthen life. The study will also compare what kind of side effects these drugs cause and how often they occur. The hypothesis is that patients with newly diagnosed peripheral T-Cell lymphoma, when given ONTAK + CHOP, will tolerate the treatment and will have a 20% improvement in response rate when compared to CHOP alone.

Interventions

Denileukin diftitox will be administered intravenously (IV) at a dosage of 18 micrograms/kilogram/day (ug/kg/d) on Days 1 and 2 of each 21-Day cycle for a total of 6 cycles, with a maximum of 8 cycles.

DRUGCyclophosphamide

Cyclophosphamide will be administered IV at a dosage of 750 milligrams/meter squared (mg/m\^2) on Day 3 of each 21-day cycle for 6 cycles, with a maximum of 8 cycles.

DRUGDoxorubicin

Doxorubicin will be administered IV at a dosage of 50 mg/m\^2 on Day 3 of each 21-day cycle for 6 cycles, with a maximum of 8 cycles.

DRUGVincristine

Vincristine will be administered IV at a dosage of 1.4 mg/m\^2 on Day 3 of each 21-day cycle for 6 cycles, with a maximum of 8 cycles.

DRUGPrednisone

Prednisone will be administered orally at a dosage of 100 mg on Days 3 to 7 of each 21-day cycle for 6 cycles, with a maximum of 8 cycles.

OTHERPegfilgrastim

Pegfilgrastim will be administered at a dosage of 6 mg subcutaneously on Day 4 to help prevent neutropenia. Alternatively, participants received filgrastim 5 ug/kg/d starting on Day 4 and continued until absolute neutrophil count (ANC) was less than 5000/millimeter squared (mm\^2) for 2 days post-nadir.

Sponsors

Eisai Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Pathological diagnosis of peripheral T-cell lymphoma of one of the following histologies as per the REAL classification: peripheral T-cell lymphoma (unspecified), anaplastic large cell lymphoma CD30+, angioimmunoblastic T-cell lymphoma, nasal/nasal type T/NK cell lymphoma, intestinal T-cell lymphoma, hepatosplenic T-cell lymphoma, subcutaneous panniculitic T-cell lymphoma. * Treatment naïve except for prior radiation or a single cycle of CHOP. * Patients must have at least one clear-cut bidimensionally measurable site by physical exam and/or computed tomography. * Prior radiation therapy for localized disease is allowed as long as the irradiated area is not at the mediastinal area or at the only site of measurable disease. Therapy must be completed at least 4 weeks before the enrollment in study. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. * At least 18 years of age. * Adequate bone marrow reserve, indicated by absolute neutrophil count (ANC) \> or equal to 1000/microL, platelets \> or equal to 50,000/microL (25,000/MicroL if thrombocytopenia secondary to bone marrow involvement by lymphoma), and hemoglobin \> or equal to 8 g/dL. * Adequate liver function, indicated by bilirubin \< or equal to 1.5 times the upper limit of normal (ULN), alanine transaminase (ALT) \< or equal to 2 times the ULN or aspartate transaminase (AST) \< or equal to 2.0 times the ULN, and albumin \> or equal to 3.0 g/dL. * Adequate renal function, indicated by serum creatinine \< or equal to 2.5 mg/dL. * Women of childbearing potential and sexually active males agree to use an accepted and effective method of contraception. * Able to give informed consent.

Exclusion criteria

* Diagnosis of Mycosis Fungoides or Sezary Syndrome. * Active Hepatitis B or Hepatitis C infection. * Known HIV infection (HIV testing is not required). * Patients with active infections requiring specific anti-infective therapy are not eligible until all signs of infections have resolved and any continuing treatment if appropriate is given on an outpatient basis. * Previous doxorubicin therapy with cumulative dose of \>100 mg/m2. * Left Ventricular Ejection Fraction (LVEF) \< 50%. * Patients who are pregnant or breast-feeding. * Prior invasive malignancies within past 5 years. * Allergy to or history of allergy to diphtheria toxin or IL-2. * Preexisting severe cardiovascular disease (e.g. CHF, Severe CAD, cardiomyopathy, MI within the past 3 months, arrhythmia) requiring ongoing treatment. * Ongoing antineoplastic chemotherapy, radiation, hormonal (excluding contraceptives) or immunotherapy, or investigational medications within past 30 days. * Patients with deep vein thrombosis within 3 months.

Design outcomes

Primary

MeasureTime frameDescription
Summary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsFrom date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 monthsAn adverse event (AE) was any medical occurrence in a participant who was administered denileukin diftitox and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and did not necessarily have a causal relationship with this treatment. An AE included any side effect, injury, toxicity, sensitivity reaction, or any undesirable clinical or laboratory event that was not normally observed in the participant. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.
Summary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsFrom date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 monthsA treatment-related adverse event was any medical occurrence in a participant who was administered denileukin diftitox and CHOP and was determined to be possibly, probably, or definitely related to study treatment. An AE included any side effect, injury, toxicity, sensitivity reaction, or any undesirable clinical or laboratory event that was not normally observed in the participant. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.
Summary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassFrom date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 monthsTreatment-related AEs were medical occurrences determined to be possibly, probably, or definitely related to study treatment. Severity grading of the AE was according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) severity scale (grades 1 - 5) with grade 3 representing a severe AE. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.
Summary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsFrom date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 monthsA serious adverse event (SAE) was any AE that occurred at any dose and resulted in any of the following outcomes: death, a life-threatening adverse drug experience, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant disability/incapacity, or a congenital anomaly/birth defect. Important medical events that did not result in death, were life-threatening, or required hospitalization were considered a SAE when based upon appropriate medical judgment, jeopardized the participant and required medical or surgical intervention to prevent one of the outcomes listed above. Possibly Related (Poss Rel) applied to AEs judged to be perhaps related to study medication, Probably Related (Prob Rel) applied to AEs judged to have a high degree of certainty as related to study medication, and Definitely Related (Def Rel) related applied to AEs that were judged to be without a doubt related to study medication.

Secondary

MeasureTime frameDescription
Overall Response in the Intent To Treat (ITT) PopulationFrom the start of the treatment to the date of participant's death assessed up to 5 years 9 monthsResponse rate was defined as the percentage of the ITT population who achieved a Complete Response (CR), Unconfirmed Complete Response (CRu), or Partial Response (PR). The International Working Group recommendations on non-Hodgkin's lymphoma response criteria were used to determine response to therapy. Largely, the protocol defined the response criteria as: 1) CR, loss of all detectable clinical and radiographic evidence of disease and disease-related symptoms if present before therapy; 2) CRu, CR with the caveats, response to therapy was accompanied with a 75% reduction in measurable lesion size and/or an indeterminate bone marrow biopsy (if initially positive); and 3) PR, less than or equal to 50% decrease in the sum of the measurements of tumor diameters, no increase in the size of other nodes, liver, or spleen, hepatic or spleen nodules regressed by at least 50%, and/or no new sites of disease.
Percentage of Participants With Overall SurvivalFrom date of randomization until death, or administrative close of study, whichever came first, assessed up to 5 years 9 monthsOverall Survival (OS) was defined as the time from the date of registration to the date of the participant's death. OS was determined by reviewing all participant's records every 6 months until the study was administratively closed or all participants died, whichever occurred first. Participants who were lost to follow-up but were still alive at the date of last contact were censored at the date of last contact. Participants who did not have a recorded date of death were censored for OS at the last date at which they were known to be alive.
Overall Response in the Efficacy Analyzable (EA) PopulationFrom the start of the treatment to the date of the participant's death assessed up to 5 years 9 monthsResponse rate was defined as the percentage of the EA population who achieved a CR, CRu, or PR. The International Working Group recommendations on non-Hodgkin's lymphoma response criteria were used to determine response to therapy. Largely, the protocol defined the response criteria as: 1) CR, loss of all detectable clinical and radiographic evidence of disease and disease-related symptoms if present before therapy; 2) CRu, CR with the caveats, response to therapy was accompanied with a 75% reduction in measurable lesion size and/or an indeterminate bone marrow biopsy (if initially positive); and 3) PR, less than or equal to 50% decrease in the sum of the measurements of tumor diameters, no increase in the size of other nodes, liver, or spleen, hepatic or spleen nodules regressed by at least 50%, and/or no new sites of disease.
Duration of ResponseFrom the date of the first documented CR (confirmed or unconfirmed) or PR until the date of first documentation of recurrent or PD or death, assessed up to 5 years 9 monthsDuration of response was defined as the length of time from the first date at which the response criteria were met (taking the earliest date at which a PR, CRu, or the confirmed CR occurred) until the date that recurrent or PD or death was accurately documented, per the criteria defined for progression-free survival (PFS). All participants within the EA population who achieved a response per the criteria defined were included in the duration of the response analysis. Participants lost to follow-up prior to PD or death were censored at the date they were last known to still be responding to treatment. Duration of response was estimated using the Kaplan-Meier method with the median duration of response summarized.
Progression-Free SurvivalFrom the date of first dose of study drug until date of first documentation of PD, recurrence, or death from any cause, assessed up to 5 years 9 monthsPFS was defined as the period of time from treatment start to the first documentation of PD, recurrence, or death. PD was defined as a greater than or equal to 50% increase from baseline in the sum of the products of the greatest diameters of any previously identified abnormal node for PRs or non-responders, or the appearance of any new lesions during or at the end of therapy. PFS was censored at the last date for which the response assessment resulted in the absence of PD for participants who did not demonstrate objective progression or recurrence. Participants who withdrew prior to evidence of disease progression or recurrence, PFS was censored at the last date assessment showed an absence of PD.

Countries

United States

Participant flow

Participants by arm

ArmCount
Denileukin Diftitox in Combination With CHOP
Unblinded denileukin diftitox at 18 micrograms/kilogram/day (ug/kg/d) was administered intravenously (IV) on Days 1 and 2 of each 21-day cycle. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) was administered on Day 3 of each 21-day cycle. On Day 4 of each 21-day cycle, pegfilgrastim (a granulocyte colony-stimulating factor (G-CSF)) was started as a prophylaxis to prevent neutropenia. After completion of two 21-day cycles, participants were evaluated for clinical response. Two 21-day cycles with denileukin and CHOP were repeated followed by response evaluations after each set of two 21-day cycles with intent to treat for 6 cycles, with a maximum of 8 cycles.
49
Total49

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath2
Overall StudyDisease progression7
Overall StudyPhysician Decision5
Overall StudyWithdrawal by Subject6

Baseline characteristics

CharacteristicDenileukin Diftitox in Combination With CHOP
Age, Continuous53.7 Years
STANDARD_DEVIATION 13.2
Sex: Female, Male
Female
26 Participants
Sex: Female, Male
Male
23 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
18 / 49
other
Total, other adverse events
49 / 49
serious
Total, serious adverse events
25 / 49

Outcome results

Primary

Summary of All Adverse Events by Frequency in Greater Than 20% of Treated Participants

An adverse event (AE) was any medical occurrence in a participant who was administered denileukin diftitox and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and did not necessarily have a causal relationship with this treatment. An AE included any side effect, injury, toxicity, sensitivity reaction, or any undesirable clinical or laboratory event that was not normally observed in the participant. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.

Time frame: From date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 months

Population: The Safety Population was used and defined as all treated participants. Participants who did not receive at least one dose of study medication were excluded from this population. For this study, the safety population is the same as the Intent to Treat (ITT) population.

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsDyspnea28.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsFatigue63.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsNausea46.9 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsHemoglobin40.8 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsNeuropathy-sensory40.8 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsAlanine transaminase34.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsHyperglycemia34.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsHypoalbuminemia34.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsLeukocytes34.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsFever32.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsHypocalcemia30.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsLymphopenia30.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsAspartate transaminase28.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsPlatelets28.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsAlopecia26.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsNeutrophils26.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsConstipation24.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsEdema-limb20.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Adverse Events by Frequency in Greater Than 20% of Treated ParticipantsHyponatremia20.4 Percentage of participants
Primary

Summary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated Participants

A treatment-related adverse event was any medical occurrence in a participant who was administered denileukin diftitox and CHOP and was determined to be possibly, probably, or definitely related to study treatment. An AE included any side effect, injury, toxicity, sensitivity reaction, or any undesirable clinical or laboratory event that was not normally observed in the participant. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.

Time frame: From date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 months

Population: Safety population

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsDyspnea26.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsEdema-limb16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsFatigue55.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsNausea36.7 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsHemoglobin30.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsLeukocytes30.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsLymphopenia30.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsNeuropathy-sensory26.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsAlanine transaminase24.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsAlopecia22.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsPlatelets22.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsNeutrophils20.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsConstipation18.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsHypoalbuminemia18.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsAspartate transaminase16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsFever16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsHypocalcemia16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsAllergic reaction12.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsAnorexia12.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsTaste alteration12.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of All Treatment-Related Adverse Events by Frequency in Greater Than 10% of Treated ParticipantsFebrile neutropenia10.2 Percentage of participants
Primary

Summary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse Events

A serious adverse event (SAE) was any AE that occurred at any dose and resulted in any of the following outcomes: death, a life-threatening adverse drug experience, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant disability/incapacity, or a congenital anomaly/birth defect. Important medical events that did not result in death, were life-threatening, or required hospitalization were considered a SAE when based upon appropriate medical judgment, jeopardized the participant and required medical or surgical intervention to prevent one of the outcomes listed above. Possibly Related (Poss Rel) applied to AEs judged to be perhaps related to study medication, Probably Related (Prob Rel) applied to AEs judged to have a high degree of certainty as related to study medication, and Definitely Related (Def Rel) related applied to AEs that were judged to be without a doubt related to study medication.

Time frame: From date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 months

Population: Safety population

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsLeukocytes (grade 4) Poss Rel2 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsFebrile neutropenia (grade 3) Prob Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsFebrile neutropenia (grade 3) Poss Rel4 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsFever (grade 3) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsFever (grade 2) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsThrombosis/embolism (grade 3) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsNeutrophils (grade 3) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsNeutrophils (grade 4) Poss Rel3 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsLeft vent. diastolic dysfunct. (grade 1) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsAllergic reaction (grade 4) Def Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsPlatelets (grade 4) Prob Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsPlatelets (grade 4) Poss Rel2 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsDyspnea (grade 3) Prob Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsPneumonitis (grade 3) Prob Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsLung Inf, 0-2 ANC: lung (grade 3) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsLeukocytes (grade 4) Prob Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsLymphopenia (grade 4) Poss Rel2 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsInf, 3-4 ANC: cath-related (grade 3) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsAllergy-other (grade 1) Def Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsInfection-other (grade 3) Poss Rrel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsCardiac ischemia (grade 5) Def Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsTumor lysis syndrome (grade 5) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsCardiopulmonary arrest (grade 4) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsSupra Arrhyth: Sinus Tachy. (grade 4) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsDeath, NOS (grade 5) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsEdema-limb (grade 1) Poss Rel1 Participants
Denileukin Diftitox in Combination With CHOPSummary of Study Drug-Related (Possible, Probable, or Definite) Serious Adverse EventsPain-other (grade 3) Poss Rel1 Participants
Primary

Summary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ Class

Treatment-related AEs were medical occurrences determined to be possibly, probably, or definitely related to study treatment. Severity grading of the AE was according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) severity scale (grades 1 - 5) with grade 3 representing a severe AE. Safety was assessed for all participants who received at least one dose of study medication and was monitored throughout the study. Safety evaluations were based on the incidence, intensity, and type of AE, and clinically significant changes in the participant's medical history, physical examination findings, vital signs, and clinical laboratory results. Participants also notified the study staff of any problems that occurred between visits by telephone, and if necessary, were evaluated by the investigator or study staff at an unscheduled interim visit.

Time frame: From date of first dose up to approximately 4 weeks after discontinuation of denileukin diftitox and CHOP, or after early withdrawal for any reason, up to approximately 5 years 9 months

Population: Safety population

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: Alanine transaminase (ALT)4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassPulmonary/Upper Respiratory: Hypoxia2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassAllergy/Immunology: Allergic reaction2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassBlood/Bone Marrow: Hemoglobin8.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassBlood/Bone Marrow: Leukocytes16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassBlood/Bone Marrow: Lymphopenia24.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassBlood/Bone Marrow: Neutrophils16.3 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassBlood/Bone Marrow: Platelets12.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassCardiac Arrhythmia: Supra Arrhyth:Sinus Tachy2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassCardiac General: Cardiac ischemia/infarction2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassCardiac General: Cardiopulmonary arrest2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassCoagulation: Coagulation-other2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassConstitutional symptoms: Fatigue2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassConstitutional symptoms: Fever2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassDeath: Death, NOS2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassInfection: Febrile neutropenia10.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassInfection: Inf, 3-4 ANC: cath-related2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassInfection: Infection-other2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassInfection: Lung Inf, 0-2 ANC: lung2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: Aspartate transaminase (AST)4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: CPK2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: Cholesterol2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: GGT2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: Hypoalbuminemia4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassMetabolic/Laboratory: Hypokalemia2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassPain: Pain-other2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassPulmonary/Upper Respiratory: Dyspnea4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassPulmonary/Upper Respiratory: Pneumonitis2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassSyndromes: Tumor Lysis syndrome2.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPSummary of Treatment-Related Adverse Events Greater Than or Equal to Grade 3 by System Organ ClassVascular: Thrombosis/embolism4.1 Percentage of participants
Secondary

Duration of Response

Duration of response was defined as the length of time from the first date at which the response criteria were met (taking the earliest date at which a PR, CRu, or the confirmed CR occurred) until the date that recurrent or PD or death was accurately documented, per the criteria defined for progression-free survival (PFS). All participants within the EA population who achieved a response per the criteria defined were included in the duration of the response analysis. Participants lost to follow-up prior to PD or death were censored at the date they were last known to still be responding to treatment. Duration of response was estimated using the Kaplan-Meier method with the median duration of response summarized.

Time frame: From the date of the first documented CR (confirmed or unconfirmed) or PR until the date of first documentation of recurrent or PD or death, assessed up to 5 years 9 months

Population: EA population

ArmMeasureValue (MEDIAN)
Denileukin Diftitox in Combination With CHOPDuration of Response29.7 Months
Secondary

Overall Response in the Efficacy Analyzable (EA) Population

Response rate was defined as the percentage of the EA population who achieved a CR, CRu, or PR. The International Working Group recommendations on non-Hodgkin's lymphoma response criteria were used to determine response to therapy. Largely, the protocol defined the response criteria as: 1) CR, loss of all detectable clinical and radiographic evidence of disease and disease-related symptoms if present before therapy; 2) CRu, CR with the caveats, response to therapy was accompanied with a 75% reduction in measurable lesion size and/or an indeterminate bone marrow biopsy (if initially positive); and 3) PR, less than or equal to 50% decrease in the sum of the measurements of tumor diameters, no increase in the size of other nodes, liver, or spleen, hepatic or spleen nodules regressed by at least 50%, and/or no new sites of disease.

Time frame: From the start of the treatment to the date of the participant's death assessed up to 5 years 9 months

Population: EA population includes all participants who received at least 2 cycles of study drug treatment, were eligible to participate or ineligible with an exception granted by the principal investigator (PI), had bidimensional lesions at baseline, and had at least 1 disease response assessment form submitted following cycle 2.

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationConfirmed complete response67.6 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationUnconfirmed complete response5.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationPartial response13.5 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationStable disease8.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationDisease progression5.4 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationEarly death0.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Efficacy Analyzable (EA) PopulationInadequate assessment0.0 Percentage of participants
Secondary

Overall Response in the Intent To Treat (ITT) Population

Response rate was defined as the percentage of the ITT population who achieved a Complete Response (CR), Unconfirmed Complete Response (CRu), or Partial Response (PR). The International Working Group recommendations on non-Hodgkin's lymphoma response criteria were used to determine response to therapy. Largely, the protocol defined the response criteria as: 1) CR, loss of all detectable clinical and radiographic evidence of disease and disease-related symptoms if present before therapy; 2) CRu, CR with the caveats, response to therapy was accompanied with a 75% reduction in measurable lesion size and/or an indeterminate bone marrow biopsy (if initially positive); and 3) PR, less than or equal to 50% decrease in the sum of the measurements of tumor diameters, no increase in the size of other nodes, liver, or spleen, hepatic or spleen nodules regressed by at least 50%, and/or no new sites of disease.

Time frame: From the start of the treatment to the date of participant's death assessed up to 5 years 9 months

Population: Intent to treat (ITT) population included all participants who signed an informed consent and were deemed eligible to participate by the investigator based on the screening assessments, and started at least 1 cycle of study treatment. It is the same as the Safety Population (SP) for this study.

ArmMeasureGroupValue (NUMBER)
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationEarly death4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationConfirmed complete response51.0 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationUnconfirmed complete response4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationPartial response10.2 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationStable disease6.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationDisease progression4.1 Percentage of participants
Denileukin Diftitox in Combination With CHOPOverall Response in the Intent To Treat (ITT) PopulationInadequate assessment20.4 Percentage of participants
Secondary

Percentage of Participants With Overall Survival

Overall Survival (OS) was defined as the time from the date of registration to the date of the participant's death. OS was determined by reviewing all participant's records every 6 months until the study was administratively closed or all participants died, whichever occurred first. Participants who were lost to follow-up but were still alive at the date of last contact were censored at the date of last contact. Participants who did not have a recorded date of death were censored for OS at the last date at which they were known to be alive.

Time frame: From date of randomization until death, or administrative close of study, whichever came first, assessed up to 5 years 9 months

Population: ITT population

ArmMeasureValue (NUMBER)
Denileukin Diftitox in Combination With CHOPPercentage of Participants With Overall Survival63.3 Percentage of participants
Secondary

Progression-Free Survival

PFS was defined as the period of time from treatment start to the first documentation of PD, recurrence, or death. PD was defined as a greater than or equal to 50% increase from baseline in the sum of the products of the greatest diameters of any previously identified abnormal node for PRs or non-responders, or the appearance of any new lesions during or at the end of therapy. PFS was censored at the last date for which the response assessment resulted in the absence of PD for participants who did not demonstrate objective progression or recurrence. Participants who withdrew prior to evidence of disease progression or recurrence, PFS was censored at the last date assessment showed an absence of PD.

Time frame: From the date of first dose of study drug until date of first documentation of PD, recurrence, or death from any cause, assessed up to 5 years 9 months

Population: ITT population

ArmMeasureValue (MEAN)Dispersion
Denileukin Diftitox in Combination With CHOPProgression-Free Survival12.4 WeeksStandard Deviation 6.1

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026