Lymphoma, Large-Cell, Diffuse
Conditions
Brief summary
The purpose of this trial is to determine the effect of ofatumumab in patients with Diffused Large B-Cell Lymphoma (DLBCL) ineligible for transplant or relapsed after autologous transplant
Interventions
8 weekly intra-venous (i.v.) infusions, 1 x 300mg and 7 x 1000mg
Sponsors
Study design
Eligibility
Inclusion criteria
Patients with DLBCL * and relapse after complete remission or disease progression after partial remission who are ineligible for autologous stem cell transplantation * and relapse after complete remission or disease progression after partial remission following autologous stem cell transplantation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Objective Response | 6-month period from start of treatment (up to Week 24) | Objective response of ofatumumab treatment was assessed according to the revised response criteria for malignant lymphoma. Participants with objective response were defined as responders with complete remission (CR) or partial remission (PR) of disease. CR is defined as the disappearance of all evidence of disease, and PR is defined as the regression of measurable disease with no new sites of disease. |
| Number of Participants Classified as Responders and Non-responders for Objective Response | 6-month period from start of treatment (up to Week 24) | According to the revised response criteria for malignant lymphoma, responders included participants with CR and PR, and non-responders included participants with stable disease (SD) and progressive disease (PD). Participants not evaluable (NE) were also considered to be non-responders. PD is defined as any new lesion or an increase by more than or equal to 50% of previously involved sites from baseline. SD is defined as failure to attain CR, PR, or PD. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Next Diffuse Large B-Cell Lymphoma (DLBCL) Therapy | From date of start of treatment to 5 years or withdrawal | Time to next DLBCL therapy was defined as the time from the first infusion date to the time of the first administration of the next DLBCL treatment other than ofatumumab. If the participants were lost to follow-up, the endpoint was censored, and the censoring date was the date of the last attended visit at which the endpoint was assessed. |
| Overall Survival (OS) | From date of start of treatment to 5 years or withdrawal | Overall survival is defined as the time from first infusion to death. Overall survival was a secondary endpoint in the study. However, since many participants withdrew from the study after developing disease progression overall survival could not be reliably estimated. |
| Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Screening visit (=<14 days before treatment start), Visit 12 (Month 6), Visit 13 (Month 9), Visit 14 (Month 12), and Visit 18 (Month 24) | HAHA are indicators of immune response to ofatumumab. Blood samples were collected from participants at Visits 1, 12, 13, 14, and 18 and analyzed in batches. The number of participants with positive results at each visit is reported. |
| Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | Baseline and Visit 10 (Week 8), Visit 11 (Week 11), Visit 12 (Month 6), Visit 13 (Month 9), Visit 14 (Month 12), Visit 15 (Month 15), Visit 16 (Month 18), Visit 17 (Month 21), Visit 18 (Month 24), Visit 19 (Month 30), Visit 20 (Month 36) | B cells (CD45+CD19+ and CD45+CD20+) were measured in peripheral blood samples by flow cytometry. Percent change from Baseline = (value at the indicated visits minus the value at Baseline divided by the value at Baseline) \* 100. |
| Number of Participants Who Experienced at Least One Adverse Event (AE) | Time frame is from date of start of treatment to 2 years or withdrawal | An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product that does not necessarily have a causal relationship with this treatment. The protocol-defined AE reporting period was from the first infusion (Visit 2/Week 0) to Visit 18 (Month 24 of follow-up) or time of withdrawal (treatment and follow-up). |
| Duration of Response | From date of start of treatment to 2 years or withdrawal | The duration of response was defined as the time from the initial response (CR or PR) to the time of relapse, progression, or death. If the participant was lost to follow-up, the endpoint was censored, and the censoring date was the date of the last attended visit at which the endpoint was assessed. |
| AUC(0-inf) and AUC(0-168) for Ofatumumab at the Eighth Infusion | Visit 9 (Week 7; up to 11 months after last dose) | AUC is defined as the area under the ofatumumab concentration-time curve as a measure of drug exposure. AUC(0-168) is the AUC from the start of infusion to 168 hours after the start of the infusion; AUC(0-inf) is the AUC from the start of infusion extrapolated to infinity. |
| Cmax and Ctrough for Ofatumumab at the First and Eighth Infusions | Visit 2 (Week 0) and Visit 9 (Week 7) | Cmax is defined as the maximum concentration of drug in serum samples. Ctrough is defined as the minimum observed concentration prior to the start of the next dose. No drug is present prior to the first infusion; therefore, there are no Ctrough results for the first dose. |
| Half-life (T1/2) for Ofatumumab at the Eighth Infusion | Visit 9 (Week 7; up to 11 months after last dose) | t1/2 is defined as terminal half-life and is the time required for the amount of drug in the body to decrease by half. |
| Clearance (CL) of Ofatumumab at the Eighth Infusion | Visit 9 (Week 7; up to 11 months after last dose) | CL is the clearance of drug from serum, which is defined as the volume of serum from which the drug is cleared per unit time. |
| Volume of Distribution at Steady State (Vss) of Ofatumumab at the Eighth Infusion | Visit 9 (Week 7; up to 11 months after the last dose) | Vss is the volume of distribution at steady state of ofatumumab. |
| Percent Change From Screening in Complement (CH50) Levels | Screening and post-baseline visits (last visit was to occur 24 months post first dose) | CH50 was mistakenly registered as an outcome measure with the protocol record. Samples were not collected, and no analysis will take place. Thus, no data will be reported for this outcome measure. |
| Progression-free Survival (PFS) | From date of start of treatment to 2 years or withdrawal | PFS was defined as the time from treatment start until progression or death. |
Countries
United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Ofatumumab Participants received 8 weekly iv infusions of ofatumumab: first infusion of 300 mg, followed by 7 infusions of 1000 mg | 81 |
| Total | 81 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 6 |
| Overall Study | Death | 3 |
| Overall Study | Disease Progression | 47 |
| Overall Study | Insurance Expired | 1 |
| Overall Study | Participant Refusal | 1 |
| Overall Study | Protocol Violation | 3 |
| Overall Study | Received Alternate Anticancer Therapy | 8 |
| Overall Study | Took Prohibited Medication | 2 |
| Overall Study | Withdrew Consent | 1 |
Baseline characteristics
| Characteristic | Ofatumumab |
|---|---|
| Age, Continuous | 64.9 Years STANDARD_DEVIATION 14.51 |
| Number of Participants with the Indicated Prior Therapy Ineligible for ASCT | 56 participants |
| Number of Participants with the Indicated Prior Therapy Prior ASCT | 25 participants |
| Race/Ethnicity, Customized Asian | 2 participants |
| Race/Ethnicity, Customized Hispanic or Latino | 2 participants |
| Race/Ethnicity, Customized Missing | 1 participants |
| Race/Ethnicity, Customized White | 76 participants |
| Sex: Female, Male Female | 36 Participants |
| Sex: Female, Male Male | 45 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 68 / 81 |
| serious Total, serious adverse events | 33 / 81 |
Outcome results
Number of Participants Classified as Responders and Non-responders for Objective Response
According to the revised response criteria for malignant lymphoma, responders included participants with CR and PR, and non-responders included participants with stable disease (SD) and progressive disease (PD). Participants not evaluable (NE) were also considered to be non-responders. PD is defined as any new lesion or an increase by more than or equal to 50% of previously involved sites from baseline. SD is defined as failure to attain CR, PR, or PD.
Time frame: 6-month period from start of treatment (up to Week 24)
Population: FAS
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Ofatumumab | Number of Participants Classified as Responders and Non-responders for Objective Response | Responders with CR | 2 participants |
| Ofatumumab | Number of Participants Classified as Responders and Non-responders for Objective Response | Responders with PR | 7 participants |
| Ofatumumab | Number of Participants Classified as Responders and Non-responders for Objective Response | Non-responders with SD | 14 participants |
| Ofatumumab | Number of Participants Classified as Responders and Non-responders for Objective Response | Non-responders with PD | 34 participants |
| Ofatumumab | Number of Participants Classified as Responders and Non-responders for Objective Response | Non-responders with NE | 24 participants |
Number of Participants With Objective Response
Objective response of ofatumumab treatment was assessed according to the revised response criteria for malignant lymphoma. Participants with objective response were defined as responders with complete remission (CR) or partial remission (PR) of disease. CR is defined as the disappearance of all evidence of disease, and PR is defined as the regression of measurable disease with no new sites of disease.
Time frame: 6-month period from start of treatment (up to Week 24)
Population: Full Analysis Set (FAS): all participants who were exposed to study drug irrespective of their compliance to the planned course of treatment
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Ofatumumab | Number of Participants With Objective Response | 9 participants |
AUC(0-inf) and AUC(0-168) for Ofatumumab at the Eighth Infusion
AUC is defined as the area under the ofatumumab concentration-time curve as a measure of drug exposure. AUC(0-168) is the AUC from the start of infusion to 168 hours after the start of the infusion; AUC(0-inf) is the AUC from the start of infusion extrapolated to infinity.
Time frame: Visit 9 (Week 7; up to 11 months after last dose)
Population: FAS. Data are provided for the number of participants attending each visit for whom the parameter value could be calculated. Participants contributing AUC(0-inf) data also contributed AUC(0-168) data.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Ofatumumab | AUC(0-inf) and AUC(0-168) for Ofatumumab at the Eighth Infusion | AUC(0-inf), n=30 | 720388 micrograms*hour/milliliter (µg.h/mL) | Geometric Coefficient of Variation 79 |
| Ofatumumab | AUC(0-inf) and AUC(0-168) for Ofatumumab at the Eighth Infusion | AUC(0-168), n=46 | 110193 micrograms*hour/milliliter (µg.h/mL) | Geometric Coefficient of Variation 27 |
Clearance (CL) of Ofatumumab at the Eighth Infusion
CL is the clearance of drug from serum, which is defined as the volume of serum from which the drug is cleared per unit time.
Time frame: Visit 9 (Week 7; up to 11 months after last dose)
Population: FAS. Data are presented for the number of participants at each visit for whom the parameter can be calculated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Ofatumumab | Clearance (CL) of Ofatumumab at the Eighth Infusion | 9.1 milliliters per hour (mL/h) | Geometric Coefficient of Variation 28 |
Cmax and Ctrough for Ofatumumab at the First and Eighth Infusions
Cmax is defined as the maximum concentration of drug in serum samples. Ctrough is defined as the minimum observed concentration prior to the start of the next dose. No drug is present prior to the first infusion; therefore, there are no Ctrough results for the first dose.
Time frame: Visit 2 (Week 0) and Visit 9 (Week 7)
Population: FAS. Data are provided for the number of participants attending each visit.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Ofatumumab | Cmax and Ctrough for Ofatumumab at the First and Eighth Infusions | First infusion Cmax; 300 mg, n=74 | 109 micrograms per milliliter (µg/mL) | Geometric Coefficient of Variation 42 |
| Ofatumumab | Cmax and Ctrough for Ofatumumab at the First and Eighth Infusions | Eighth infusion Cmax; 1000 mg, n=48 | 839 micrograms per milliliter (µg/mL) | Geometric Coefficient of Variation 24 |
| Ofatumumab | Cmax and Ctrough for Ofatumumab at the First and Eighth Infusions | Eighth infusion Ctrough; 1000 mg, n=48 | 497 micrograms per milliliter (µg/mL) | Geometric Coefficient of Variation 34 |
Duration of Response
The duration of response was defined as the time from the initial response (CR or PR) to the time of relapse, progression, or death. If the participant was lost to follow-up, the endpoint was censored, and the censoring date was the date of the last attended visit at which the endpoint was assessed.
Time frame: From date of start of treatment to 2 years or withdrawal
Population: FAS. Only participants with CR or PR were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Ofatumumab | Duration of Response | 9.5 months |
Half-life (T1/2) for Ofatumumab at the Eighth Infusion
t1/2 is defined as terminal half-life and is the time required for the amount of drug in the body to decrease by half.
Time frame: Visit 9 (Week 7; up to 11 months after last dose)
Population: FAS. Data are provided for the number of participants at each visit for whom the parameter could be calculated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Ofatumumab | Half-life (T1/2) for Ofatumumab at the Eighth Infusion | 637 hours | Geometric Coefficient of Variation 51 |
Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits
B cells (CD45+CD19+ and CD45+CD20+) were measured in peripheral blood samples by flow cytometry. Percent change from Baseline = (value at the indicated visits minus the value at Baseline divided by the value at Baseline) \* 100.
Time frame: Baseline and Visit 10 (Week 8), Visit 11 (Week 11), Visit 12 (Month 6), Visit 13 (Month 9), Visit 14 (Month 12), Visit 15 (Month 15), Visit 16 (Month 18), Visit 17 (Month 21), Visit 18 (Month 24), Visit 19 (Month 30), Visit 20 (Month 36)
Population: FAS. Data are provided for the number of participants attending each visit.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 10 (Week 8), n=42 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 11 (Week 11), n=29 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 12 (Month 6), n=18 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 13 (Month 9), n=15 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 14 (Month 12), n=13 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 15 (Month 15), n=12 | -60.7 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 16 (Month 18), n=8 | 6.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 17 (Month 21), n=8 | -6.9 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 18 (Month 24), n=7 | -11.1 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 19 (Month 30), n=2 | 80.8 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD19+, Visit 20 (Month 36), n=2 | 68.6 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 10 (Week 8), n=42 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 11 (Week 11), n=29 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 12 (Month 6), n=18 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 13 (Month 9), n=15 | -100.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 14 (Month 12), n=13 | -100 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 15 (Month 15), n=12 | -57.3 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 16 (Month 18), n=8 | 6.0 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 17 (Month 21), n=8 | -6.9 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 18 (Month 24), n=5 | -11.1 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 19 (Month 30), n=2 | 75.2 percent change in cells |
| Ofatumumab | Median Percent Change From Baseline in CD45+CD19+ and CD45+CD20+ Cells in the Peripheral Blood at the Indicated Visits | CD45+CD20+, Visit 20 (Month 36), n=2 | 68.6 percent change in cells |
Number of Participants Who Experienced at Least One Adverse Event (AE)
An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product that does not necessarily have a causal relationship with this treatment. The protocol-defined AE reporting period was from the first infusion (Visit 2/Week 0) to Visit 18 (Month 24 of follow-up) or time of withdrawal (treatment and follow-up).
Time frame: Time frame is from date of start of treatment to 2 years or withdrawal
Population: FAS
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Ofatumumab | Number of Participants Who Experienced at Least One Adverse Event (AE) | 78 participants |
Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18
HAHA are indicators of immune response to ofatumumab. Blood samples were collected from participants at Visits 1, 12, 13, 14, and 18 and analyzed in batches. The number of participants with positive results at each visit is reported.
Time frame: Screening visit (=<14 days before treatment start), Visit 12 (Month 6), Visit 13 (Month 9), Visit 14 (Month 12), and Visit 18 (Month 24)
Population: FAS. Data are provided for the number of participants attending each visit.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Screening, n=79 | 0 participants |
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Visit 12 (Month 6), n=20 | 0 participants |
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Visit 13 (Month 9), n=16 | 0 participants |
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Visit 14 (Month 12), n=16 | 0 participants |
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | Visit 18 (Month 24), n=8 | 0 participants |
| Ofatumumab | Number of Participants With Positive Human Anti-human Antibodies (HAHA) at Screening and at Visits 12, 13, 14, and 18 | End of Trial/Withdrawal, n=43 | 0 participants |
Overall Survival (OS)
Overall survival is defined as the time from first infusion to death. Overall survival was a secondary endpoint in the study. However, since many participants withdrew from the study after developing disease progression overall survival could not be reliably estimated.
Time frame: From date of start of treatment to 5 years or withdrawal
Population: FAS
Percent Change From Screening in Complement (CH50) Levels
CH50 was mistakenly registered as an outcome measure with the protocol record. Samples were not collected, and no analysis will take place. Thus, no data will be reported for this outcome measure.
Time frame: Screening and post-baseline visits (last visit was to occur 24 months post first dose)
Population: FAS
Progression-free Survival (PFS)
PFS was defined as the time from treatment start until progression or death.
Time frame: From date of start of treatment to 2 years or withdrawal
Population: FAS
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Ofatumumab | Progression-free Survival (PFS) | 2.5 months |
Time to Next Diffuse Large B-Cell Lymphoma (DLBCL) Therapy
Time to next DLBCL therapy was defined as the time from the first infusion date to the time of the first administration of the next DLBCL treatment other than ofatumumab. If the participants were lost to follow-up, the endpoint was censored, and the censoring date was the date of the last attended visit at which the endpoint was assessed.
Time frame: From date of start of treatment to 5 years or withdrawal
Population: FAS
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Ofatumumab | Time to Next Diffuse Large B-Cell Lymphoma (DLBCL) Therapy | NA months |
Volume of Distribution at Steady State (Vss) of Ofatumumab at the Eighth Infusion
Vss is the volume of distribution at steady state of ofatumumab.
Time frame: Visit 9 (Week 7; up to 11 months after the last dose)
Population: FAS. Data are presented for the number of participants attending each visit for whom the parameter can be calculated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Ofatumumab | Volume of Distribution at Steady State (Vss) of Ofatumumab at the Eighth Infusion | 8.3 liters | Geometric Coefficient of Variation 45 |