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Study of the Combination of Rituximab, Cyclophosphamide, Doxorubicin, VELCADE, and Prednisone or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Patients With Newly Diagnosed Mantle Cell Lymphoma

A Randomized, Open-Label, Multicenter Phase 3 Study of the Combination of Rituximab, Cyclophosphamide, Doxorubicin, VELCADE, and Prednisone (VcR-CAP) or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) in Patients With Newly Diagnosed Mantle Cell Lymphoma Who Are Not Eligible for a Bone Marrow Transplant

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00722137
Enrollment
487
Registered
2008-07-25
Start date
2008-05-01
Completion date
2017-06-17
Last updated
2018-07-12

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

Conditions

Mantle Cell Lymphoma

Brief summary

This is a randomized, open-label, multicenter, prospective study to compare the efficacy and safety of the combination of VcR-CAP to that of R-CHOP in participants who have newly diagnosed mantle cell lymphoma grade II, III or IV and who are ineligible to undergo bone marrow transplantation.

Detailed description

The drug being tested in this study were combination of VcR-CAP and R-CHOP. Combination of VcR-CAP and R-CHOP is being tested to treat people who had mantle cell lymphoma (MCL). The study enrolled 487 patients. Participants were randomly assigned (by chance, like flipping a coin) to one of the two treatment groups in a 1:1 ratio: Treatment Group A (VcR-CAP) Treatment Group B (R-CHOP) The study included a screening phase, a treatment phase, a short-term follow-up phase, and a long-term follow-up phase. The screening phase was up to 28 days (56 days for bone marrow evaluation) prior to randomization. This multi-center trial was conducted worldwide. The total study duration from randomization of the first patient until the last progression-free survival (PFS) event required for the final analysis was expected to be approximately 42 months (24 months for enrollment and 18 months for follow-up) and survival follow-up every 12 weeks until death.

Interventions

DRUGRituximab 375 mg/m^2

Intravenous rituximab 375 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles.

DRUGCyclophosphamide 750 mg/m^2

Intravenous cyclophosphamide 750 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles

DRUGDoxorubicin 50 mg/m^2

Intravenous doxorubicin 50 mg/m\^2 on Day 1 of a 21-day (3 week) cycle for 6 cycles

DRUGVELCADE 1.3 mg/m^2

Intravenous VELCADE 1.3 mg/m\^2 on Days 1,4,8, and 11of a 21-day (3 week) cycle for 6 cycles

DRUGPrednisone 100 mg/m^2

Oral prednisone 100 mg/m\^2 on Day 1 to Day 5 of a 21-day (3 week) cycle for 6 cycles

DRUGVincristine 1.4 mg/m^2

Intravenous vincristine 1.4 mg/m\^2 on Day 1of a 21-day (3 week) cycle for 6 cycles. Maximum of 2 mg. Participants could receive 8 cycles if a response was initially documented at the Cycle 6 assessment.

Sponsors

Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
CollaboratorINDUSTRY
Millennium Pharmaceuticals, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Male or female patients 18 years or older (the patient must be at least the legal age limit to be able to give informed consent within the jurisdiction the study is taking place) * Diagnosis of mantle cell lymphoma MCL (Stage II, III or IV) as evidenced by lymph node histology and either expression of cyclin D1 (in association with CD20 and CD5) or evidence of t(11;14) translocation, such as by cytogenetics, fluorescent in situ hybridization (FISH) or polymerase chain reaction (PCR). Patients with a diagnosis of Stage I MCL will not be permitted to enter study. \- Paraffin embedded biopsy tissue block (preferably of lymph node origin) must be sent to the central laboratory for confirmation of MCL diagnosis prior to randomization. In China, a paraffin embedded lymph node biopsy tissue block must be sent for central confirmation of sample adequacy, prior to randomization * At least 1 measurable site of disease * No prior therapies for MCL * Not eligible for bone marrow transplantation as assessed by the treating physician (e.g., age or the presence of co-morbid conditions that may have a negative impact on the tolerability to transplantation). * Eastern Cooperative Oncology Group ECOG status ≤2 * Absolute neutrophil count (ANC) ≥1500 cells/µL, * Platelets ≥100,000 cells/µL or ≥75,000 cells/µL if thrombocytopenia is considered by the investigator to be secondary to MCL (e.g., due to bone marrow infiltration or sequestration from splenomegaly). * Alanine transaminase ≤3 x upper limit of normal (ULN) * Aspartate transaminase ≤3 x ULN * Total bilirubin ≤1.5 x ULN, * Calculated creatinine clearance ≥20 mL/min. * Female patients must be post menopausal for at least 1 year (must not have had a natural menses for at least 12 months), surgically sterile, or practicing an effective method of birth control (e.g., prescription oral contraceptives, contraceptive injections, intrauterine device, double-barrier method, contraceptive patch, male partner sterilization) and have a negative serum βHCG or urine pregnancy test at screening. They must also be prepared to continue birth control measures for at least 6 months after terminating treatment. * Male patients must agree to use an acceptable method of contraception (for themselves or female partners as listed above) for the duration of the study. * All patients (or their legally acceptable representatives) must have signed an informed consent document indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study. * In order to participate in the pharmacogenomics component of this study, patients (or their legally acceptable representative) must have signed the informed consent form for pharmacogenomics research indicating willingness to participate in the pharmacogenomics component of the study. Acquisition of tumor sample collections is required for all patients (where available); all other sample collections are optional

Exclusion criteria

* Prior treatment with VELCADE * Prior antineoplastic (including unconjugated therapeutic antibodies), experimental or radiation therapy, radioimmunoconjugates or toxin immunoconjugates for the treatment of MCL. In the event that a patient has received doxorubicin for the treatment of any condition, other than MCL, the maximum dose and exposure received prior to entry into this study should not exceed 150 mg/m2. \- short course (maximum of 10 days, not exceeding 100 mg/day) prednisone or equivalent steroids are allowed to treat symptoms in patients with advanced disease who enter the screening phase and are waiting to be randomized. * Major surgery (at the discretion of the treating physician and in consultation with the sponsor's medical monitor) within 2 weeks before randomization * Peripheral neuropathy or neuropathic pain of Grade 2 or worse (as per the investigators assessment) * Diagnosed or treated for a malignancy other than MCL within 1 year of randomization, or who were previously diagnosed with a malignancy other than MCL and have any radiographic or biochemical marker evidence of malignancy. Patients with completely resected basal cell carcinoma, squamous cell carcinoma of the skin, or in situ malignancy are not excluded. * Active systemic infection requiring treatment and patients with known diagnosis of human immunodeficiency virus HIV or active hepatitis B (carriers of hepatitis B are permitted to enter study) * History of allergic reaction attributable to compounds containing boron, mannitol, or hydroxybenzoates * Known anaphylaxis or immunoglobulin E (IgE)-mediated hypersensitivity to murine proteins or to any component of rituximab including polysorbate 80 and sodium citrate dihydrate * Female or male patients of child-bearing potential who will not use adequate contraception during the course of the study. * Serious medical (e.g., pericardial disease, cardiac failure \[New York Heart Association; NYHA Class III or IV, Attachment 12 or left ventricular ejection fraction; LVEF \<50%\], active peptic ulceration, uncontrolled diabetes mellitus, or acute diffuse infiltrative pulmonary disease), or psychiatric illness likely to interfere with participation in this clinical study * Concurrent treatment with another investigational agent.

Design outcomes

Primary

MeasureTime frameDescription
Progression Free Survival (PFS)Median duration of follow-up of 40 monthsPFS was defined as the interval between the date of randomization and the date of progressive disease (PD) or death, whichever occurred first. PD was based on the assessment of an Independent Review Committee.

Secondary

MeasureTime frameDescription
Duration of ResponseMedian duration of follow-up of 40 monthsThe duration of treatment response was defined as the time from the date of the first response to the date of PD or death due to PD for those participants with a best response of CR, CRu, or PR as determined by the Independent Review Committee. The duration of response for complete responders was defined as the time from the date of the first response to the date of PD or death due to PD for those participants with a best response of CR or CRu verified by bone marrow and lactate dehydrogenase (LDH).
Time to Next Anti-lymphoma Treatment (TTNT): Median duration of follow-up of 40 monthsThe time to next anti-lymphomatreatment was measured from the date of initiation of study treatment as per protocol to the start date of new anti-lymphoma treatment. Death due to disease progression prior to subsequent therapy was considered as an event. Otherwise, time to next anti lymphoma treatment was censored at the date of death or the last date known to be alive.
Treatment-free Interval (TFI)Median duration of follow-up of 40 monthsThe TFI was defined as the duration from the date of last dose plus 1 day to the start date of the new treatment. Death due to disease progression prior to subsequent therapy was considered as an event. Otherwise, treatment-free interval was censored at the date of death or the last date known to be alive.
Overall Response Rate (ORR)Median duration of follow-up of 40 monthsORR was defined as complete response (CR) + complete response, unconfirmed (CRu) + partial response (PR) as determined by the Independent Review Committee. Response assessment was carried out every 6 weeks for 18 weeks; thereafter, every 8 weeks until PD/initiation of alternate therapy/withdrawal from study/death.
Time to Progression (TTP)Median duration of follow-up of 40 monthsTime to progression was defined as the duration from the date of randomization until the date of first documented evidence of progressive disease (PD) or date of relapse for subjects who experienced complete response (CR) or complete response, unconfirmed (CRu). PD and response were based on the assessment of an Independent Review Committee.
Overall Survival (OS)Median duration of follow-up of 40 monthsOS was measured from the date of randomization to the date of the participant's death. If the participant was alive or the vital status was unknown, OS was censored at the date that the subject was last known to be alive.
18-Month SurvivalUp to month 18 from the time of randomization18-month survival was defined as the estimated probability of survival at 18 months (Kaplan-Meier estimate).
Overall Survival (OS) in Long Term Follow-up PeriodUp to 107.4 monthsOS was measured from the date of randomization to the date of the participant's death. If the participant was alive or the vital status was unknown, OS was censored at the date that the subject was last known to be alive.
Number of Participants Experiencing an Adverse Event (AE)Up to 107.4 monthsAn AE was defined as any untoward medical occurrence associated with the use of a drug, whether or not considered drug related. AEs were collected from the first dose of study drug through 30 days after the last dose of study drug. Treatment was administered for up to 8 cycles (24 weeks) and AEs were collected for up to 30 days following the last dose of study drug.
Overall Complete Response (CR + CRu)Median duration of follow-up of 40 monthsOverall complete response was defined as the number of participants with complete response (CR) and those with unconfirmed complete response (CRu). Response assessment was carried out every 6 weeks for 18 weeks; thereafter, every 8 weeks until PD/initiation of alternate therapy/withdrawal from study/death.

Countries

Austria, Belgium, Brazil, Canada, Chile, China, Colombia, Czechia, Germany, Hungary, India, Israel, Italy, Malaysia, Morocco, Philippines, Poland, Portugal, Romania, Russia, Singapore, South Africa, Spain, Taiwan, Thailand, Tunisia, Turkey (Türkiye), Ukraine, United States

Participant flow

Recruitment details

A total of 487 participants were randomized from 128 centers in 28 countries from 22 May 2008 to 17 June 2017; 244 to the R-CHOP treatment group and 243 to the VcR-CAP treatment group. Of the 487 randomized participants, 242 in the R-CHOP group and 240 in the VcR-CAP group received at least 1 dose of study drug.

Participants by arm

ArmCount
R-CHOP
Rituximab 375 mg/m\^2, Cyclophosphamide 750 mg/m\^2, Doxorubicin 50 mg/m\^2, Vincristine 1.4 mg/m\^2 and Prednisone 100 mg/m\^2 Rituximab: Rituximab intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles. Cyclophosphamide: Cyclophosphamide intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles Doxorubicin: Intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles Prednisone: Prednisone orally on Day 1 to Day 5 of a 21 day (3 week) cycle for 6 cycles Vincristine: Vincristine intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles.
244
VcR-CAP
Rituximab 375 mg/m\^2, Cyclophosphamide 750 mg/m\^2, Doxorubicin 50 mg/m\^2, VELCADE 1.3 mg/m\^2, and Prednisone 100 mg/m\^2 Rituximab: Rituximab intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles. Cyclophosphamide: Cyclophosphamide intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles Doxorubicin: Intravenous on Day of a 21 day (3 week) cycle for 6 cycles VELCADE: VELCADE intravenous on Days 1,4,8, and 11 of a 21 day (3 week) cycle for 6 cycles Prednisone: Prednisone orally on Day 1 to Day 5 of a 21 day (3 week) cycle for 6 cycles.
243
Total487

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event1721
Overall StudyDeath127
Overall StudyOther Reason Unknown34
Overall StudyOvert Disease Progression54
Overall StudyRandomized But Not Treated23
Overall StudyWithdrawal by Subject69

Baseline characteristics

CharacteristicR-CHOPVcR-CAPTotal
Age, Continuous64.4 Years
STANDARD_DEVIATION 8.78
64.2 Years
STANDARD_DEVIATION 9.68
64.3 Years
STANDARD_DEVIATION 9.23
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
68 Participants88 Participants156 Participants
Race (NIH/OMB)
Black or African American
0 Participants3 Participants3 Participants
Race (NIH/OMB)
More than one race
4 Participants1 Participants5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
172 Participants151 Participants323 Participants
Region of Enrollment
Austria
6 Participants4 Participants10 Participants
Region of Enrollment
Belgium
10 Participants16 Participants26 Participants
Region of Enrollment
Brazil
9 Participants13 Participants22 Participants
Region of Enrollment
Canada
6 Participants1 Participants7 Participants
Region of Enrollment
Chile
1 Participants2 Participants3 Participants
Region of Enrollment
China
34 Participants61 Participants95 Participants
Region of Enrollment
Colombia
2 Participants3 Participants5 Participants
Region of Enrollment
Czech Republic
5 Participants9 Participants14 Participants
Region of Enrollment
France
1 Participants2 Participants3 Participants
Region of Enrollment
Germany
7 Participants1 Participants8 Participants
Region of Enrollment
Hungary
5 Participants8 Participants13 Participants
Region of Enrollment
India
9 Participants3 Participants12 Participants
Region of Enrollment
Israel
5 Participants2 Participants7 Participants
Region of Enrollment
Italy
6 Participants3 Participants9 Participants
Region of Enrollment
Japan
11 Participants7 Participants18 Participants
Region of Enrollment
Korea, Republic Of
2 Participants3 Participants5 Participants
Region of Enrollment
Poland
9 Participants10 Participants19 Participants
Region of Enrollment
Portugal
3 Participants4 Participants7 Participants
Region of Enrollment
Romania
9 Participants4 Participants13 Participants
Region of Enrollment
Russia
57 Participants42 Participants99 Participants
Region of Enrollment
Singapore
1 Participants2 Participants3 Participants
Region of Enrollment
Spain
8 Participants6 Participants14 Participants
Region of Enrollment
Taiwan, Province Of China
1 Participants2 Participants3 Participants
Region of Enrollment
Thailand
9 Participants10 Participants19 Participants
Region of Enrollment
Tunisia
3 Participants3 Participants6 Participants
Region of Enrollment
Turkey
5 Participants1 Participants6 Participants
Region of Enrollment
Ukraine
18 Participants16 Participants34 Participants
Region of Enrollment
United States
2 Participants5 Participants7 Participants
Sex: Female, Male
Female
62 Participants65 Participants127 Participants
Sex: Female, Male
Male
182 Participants178 Participants360 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
187 / 242185 / 240
serious
Total, serious adverse events
72 / 24291 / 240

Outcome results

Primary

Progression Free Survival (PFS)

PFS was defined as the interval between the date of randomization and the date of progressive disease (PD) or death, whichever occurred first. PD was based on the assessment of an Independent Review Committee.

Time frame: Median duration of follow-up of 40 months

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEDIAN)
R-CHOPProgression Free Survival (PFS)437.0 Days
VcR-CAPProgression Free Survival (PFS)751.0 Days
p-value: <0.00195% CI: [0.5, 0.79]Log Rank
Secondary

18-Month Survival

18-month survival was defined as the estimated probability of survival at 18 months (Kaplan-Meier estimate).

Time frame: Up to month 18 from the time of randomization

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEAN)
R-CHOP18-Month Survival83.8 Percentage of Participants
VcR-CAP18-Month Survival84.9 Percentage of Participants
Secondary

Duration of Response

The duration of treatment response was defined as the time from the date of the first response to the date of PD or death due to PD for those participants with a best response of CR, CRu, or PR as determined by the Independent Review Committee. The duration of response for complete responders was defined as the time from the date of the first response to the date of PD or death due to PD for those participants with a best response of CR or CRu verified by bone marrow and lactate dehydrogenase (LDH).

Time frame: Median duration of follow-up of 40 months

Population: The response-evaluable population was defined as all participants who received at least 1 dose of study drug, had \>= 1 measurable tumor mass (\>1.5 cm in the longest dimension and \>1.0 cm in the short axis) at baseline and had at least 1 post-baseline tumor assessment by Independent Review Committee, before any subsequent anti-lymphoma treatment.

ArmMeasureGroupValue (MEDIAN)
R-CHOPDuration of ResponseDuration of response459.0 Days
R-CHOPDuration of ResponseDuration for Complete responders563.0 Days
VcR-CAPDuration of ResponseDuration of response1110.0 Days
VcR-CAPDuration of ResponseDuration for Complete responders1282.0 Days
Secondary

Number of Participants Experiencing an Adverse Event (AE)

An AE was defined as any untoward medical occurrence associated with the use of a drug, whether or not considered drug related. AEs were collected from the first dose of study drug through 30 days after the last dose of study drug. Treatment was administered for up to 8 cycles (24 weeks) and AEs were collected for up to 30 days following the last dose of study drug.

Time frame: Up to 107.4 months

Population: The safety population was defined as all randomized participants who received at least 1 dose of study medication.

ArmMeasureValue (NUMBER)
R-CHOPNumber of Participants Experiencing an Adverse Event (AE)239 Participants
VcR-CAPNumber of Participants Experiencing an Adverse Event (AE)240 Participants
Secondary

Overall Complete Response (CR + CRu)

Overall complete response was defined as the number of participants with complete response (CR) and those with unconfirmed complete response (CRu). Response assessment was carried out every 6 weeks for 18 weeks; thereafter, every 8 weeks until PD/initiation of alternate therapy/withdrawal from study/death.

Time frame: Median duration of follow-up of 40 months

Population: The response-evaluable population was defined as all participants who received \>= 1 dose of study drug, had at least 1 measurable tumor mass (\>1.5 cm in the longest dimension and \>1.0 cm in the short axis) at baseline and had at least 1 post-baseline tumor assessment by Independent Review Committee, before any subsequent anti-lymphoma treatment.

ArmMeasureGroupValue (NUMBER)
R-CHOPOverall Complete Response (CR + CRu)Overall complete response95 Participants
R-CHOPOverall Complete Response (CR + CRu)CR79 Participants
R-CHOPOverall Complete Response (CR + CRu)CRu16 Participants
VcR-CAPOverall Complete Response (CR + CRu)Overall complete response122 Participants
VcR-CAPOverall Complete Response (CR + CRu)CR106 Participants
VcR-CAPOverall Complete Response (CR + CRu)CRu16 Participants
p-value: <0.00795% CI: [1.148, 2.481]Cochran-Mantel-Haenszel Chi-Square
Secondary

Overall Response Rate (ORR)

ORR was defined as complete response (CR) + complete response, unconfirmed (CRu) + partial response (PR) as determined by the Independent Review Committee. Response assessment was carried out every 6 weeks for 18 weeks; thereafter, every 8 weeks until PD/initiation of alternate therapy/withdrawal from study/death.

Time frame: Median duration of follow-up of 40 months

Population: The response-evaluable population was defined as all participants who received \>= 1 dose of study drug, had at least 1 measurable tumor mass (\>1.5 cm in the longest dimension and \>1.0 cm in the short axis) at baseline and had at least 1 post-baseline tumor assessment by Independent Review Committee, before any subsequent anti-lymphoma treatment.

ArmMeasureValue (NUMBER)
R-CHOPOverall Response Rate (ORR)204 Participants
VcR-CAPOverall Response Rate (ORR)211 Participants
p-value: 0.27595% CI: [0.749, 2.722]Cochran-Mantel-Haenszel Chi-Square
Secondary

Overall Survival (OS)

OS was measured from the date of randomization to the date of the participant's death. If the participant was alive or the vital status was unknown, OS was censored at the date that the subject was last known to be alive.

Time frame: Median duration of follow-up of 40 months

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEDIAN)
R-CHOPOverall Survival (OS)1714.0 Days
VcR-CAPOverall Survival (OS)NA Days
p-value: 0.17395% CI: [0.59, 1.1]Log Rank
Secondary

Overall Survival (OS) in Long Term Follow-up Period

OS was measured from the date of randomization to the date of the participant's death. If the participant was alive or the vital status was unknown, OS was censored at the date that the subject was last known to be alive.

Time frame: Up to 107.4 months

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEDIAN)
R-CHOPOverall Survival (OS) in Long Term Follow-up Period1695.0 Days
VcR-CAPOverall Survival (OS) in Long Term Follow-up Period2760.0 Days
Secondary

Time to Next Anti-lymphoma Treatment (TTNT)

The time to next anti-lymphomatreatment was measured from the date of initiation of study treatment as per protocol to the start date of new anti-lymphoma treatment. Death due to disease progression prior to subsequent therapy was considered as an event. Otherwise, time to next anti lymphoma treatment was censored at the date of death or the last date known to be alive.

Time frame: : Median duration of follow-up of 40 months

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEDIAN)
R-CHOPTime to Next Anti-lymphoma Treatment (TTNT)756.0 Days
VcR-CAPTime to Next Anti-lymphoma Treatment (TTNT)1353.0 Days
p-value: <0.00195% CI: [0.38, 0.65]Log Rank
Secondary

Time to Progression (TTP)

Time to progression was defined as the duration from the date of randomization until the date of first documented evidence of progressive disease (PD) or date of relapse for subjects who experienced complete response (CR) or complete response, unconfirmed (CRu). PD and response were based on the assessment of an Independent Review Committee.

Time frame: Median duration of follow-up of 40 months

Population: The population consisted of all randomized participants.

ArmMeasureValue (MEDIAN)
R-CHOPTime to Progression (TTP)490.0 Days
VcR-CAPTime to Progression (TTP)929.0 Days
p-value: <0.00195% CI: [0.45, 0.74]Log Rank
Secondary

Treatment-free Interval (TFI)

The TFI was defined as the duration from the date of last dose plus 1 day to the start date of the new treatment. Death due to disease progression prior to subsequent therapy was considered as an event. Otherwise, treatment-free interval was censored at the date of death or the last date known to be alive.

Time frame: Median duration of follow-up of 40 months

Population: All randomized participants who received at least 1 dose of study medication.

ArmMeasureValue (MEDIAN)
R-CHOPTreatment-free Interval (TFI)624.0 Days
VcR-CAPTreatment-free Interval (TFI)1236.0 Days
p-value: =0.00195% CI: [0.38, 0.65]Log Rank

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026