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Study of the Combination of VELCADE, Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Patients With Newly Diagnosed Non-Germinal Center B-Cell Subtype of Diffuse Large B-Cell Lymphoma

A Randomized, Open-Label, Multicenter Phase 2 Study of the Combination of VELCADE, Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Patients With Newly Diagnosed Non-Germinal Center B-Cell Subtype of Diffuse Large B-Cell Lymphoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01040871
Enrollment
164
Registered
2009-12-30
Start date
2010-01-31
Completion date
2012-08-31
Last updated
2014-01-13

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

Conditions

Diffuse Large B-Cell Lymphoma

Brief summary

This is a randomized, open-label, active-control, parallel-group, multicenter, multinational Phase 2 Study of the efficacy and safety of VELCADE, Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone (VR-CAP) or Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) in Patients With Newly Diagnosed Non-Germinal Center B-Cell (non-GCB) Subtype of Diffuse Large B-Cell Lymphoma (DLBCL)

Interventions

DRUGVELCADE

VELCADE intravenous on Days 1, 4, 8, and 11 of a 21 day (3 week) cycle for 6 cycles.

DRUGRituximab

Rituximab intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles

DRUGCyclophosphamide

Intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles

DRUGDoxorubicin

Intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles

DRUGPrednisone

Orally on Day 1 to Day 5 of a 21 day (3 week) cycle for 6 cycles

DRUGVincristine

Intravenous on Day 1 of a 21 day (3 week) cycle for 6 cycles

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. * Newly Diagnosed non-GCB subtype of DLBCL (Stage II, III or IV). * At least 1 measurable site of disease. * Eastern Cooperative Oncology Group (ECOG) performance status 0-2 * Female subjects must be postmenopausal (for at least 6 months), surgically sterile, abstinent, or, if sexually active, be practicing an effective method of birth control before entry and throughout the study; and have a negative pregnancy test at screening. * Male subjects must agree to use a double barrier method of birth control

Exclusion criteria

* Prior treatment with VELCADE. * Prior extended radiotherapy or chemotherapy for lymphoma * More than 150 mg/m2 of prior doxorubicin * Major surgery within 3 weeks of study. * Peripheral neuropathy or neuralgia of Grade 2 or worse. * Active CNS lymphoma * Diagnosed or treated for a malignancy other than NHL, with some exceptions * Pregnant or breast feeding * Active systemic infection * Documented of suspected human immunodeficiency virus (HIV)/AIDS * Uncontrolled or severe cardiovascular disease * Known allergies, hypersensitivity or intolerance to study drugs * Serious medical condition that could interfere with study * Concurrent treatment with another investigational agent

Design outcomes

Primary

MeasureTime frameDescription
Complete Response (CR) Rate6 cyclesComplete response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, and end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma. 1. Complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. 2. PET scan was negative. 3. The spleen and/or liver, if enlarged before therapy on the basis of physical examination or CT scan, was not palpable on physical examination and was considered normal size by imaging studies; all splenic and hepatic nodules related to lymphomas disappeared. 4. If bone marrow was involved before treatment, the infiltrate cleared on repeated bone marrow biopsy. 5. No new sites of disease were detected.

Secondary

MeasureTime frameDescription
Rate of Durable ResponseMedian follow up approx. 12 monthsProportion of subjects who achieved a CR or PR with duration of at least 6 months. Duration of response (CR or PR) was calculated from the date of initial documentation of a response to the date of first documented evidence of disease progression or death due to disease progression. Response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma.
Rate of Durable Complete ResponseMedian follow up approx 12 monthsProportion of subjects who achieved a CR with duration of at least 6 months
Subsequent Anti-lymphoma Therapy Rate at 1-year1 yearKaplan-meier estimate of subsequent anti-lymphoma therapy at 1-year. Time to subsequent anti-lymphoma therapy was measured from the date of randomization to the start date of new 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.
Overall Response Rate6 cyclesOverall response = Complete Response (CR) + Partial Response (PR) Response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, and end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma. Complete Response: see primary endpoint Partial Response: At least a 50% decrease in the sum of the product of the diameters (SPD) of up to 6 of the largest dominant nodes or nodal masses.
Overall Survival Rate at 1-year1 yearKaplan-meier estimate of overall survival at 1-year measured from date of randomization.
Change in Fatigue and Patient Utility Scores18-24 months
Progression-free Survival (PFS)Rate at 1-year1 yearKaplan-meier estimate of progression-free survival at 1-year. Progression-free survival was defined as the interval between the date of randomization and the date of first documented evidence of disease progression or death.

Countries

Belgium

Participant flow

Pre-assignment details

164 participants were randomized, three participants did not receive study treatment (2 in the VR-CAP and 1 in the R-CHOP arm) for a total of 161 treated.

Participants by arm

ArmCount
VR-CAP
VELCADE, Rituximab, Cyclophosphamide, Doxorubicin and Prednisone
84
R-CHOP
Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisone
80
Total164

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event62
Overall StudyDeath13
Overall Studydrug supply issue10
Overall StudyLack of Efficacy11
Overall StudyRandomized and Not Treated21
Overall StudyWithdrawal by Subject20

Baseline characteristics

CharacteristicVR-CAPR-CHOPTotal
Age, Continuous56.5 years
STANDARD_DEVIATION 15
57.8 years
STANDARD_DEVIATION 13.83
57.2 years
STANDARD_DEVIATION 14.41
Region of Enrollment
Argentina
2 participants1 participants3 participants
Region of Enrollment
Belgium
4 participants1 participants5 participants
Region of Enrollment
Brazil
2 participants3 participants5 participants
Region of Enrollment
Canada
3 participants3 participants6 participants
Region of Enrollment
Czech Republic
3 participants4 participants7 participants
Region of Enrollment
France
2 participants4 participants6 participants
Region of Enrollment
Germany
13 participants8 participants21 participants
Region of Enrollment
India
2 participants4 participants6 participants
Region of Enrollment
Ireland
2 participants0 participants2 participants
Region of Enrollment
Italy
2 participants6 participants8 participants
Region of Enrollment
Korea, Republic of
6 participants6 participants12 participants
Region of Enrollment
Malaysia
5 participants3 participants8 participants
Region of Enrollment
Mexico
0 participants1 participants1 participants
Region of Enrollment
Portugal
5 participants7 participants12 participants
Region of Enrollment
Russian Federation
22 participants14 participants36 participants
Region of Enrollment
Singapore
2 participants1 participants3 participants
Region of Enrollment
Spain
5 participants2 participants7 participants
Region of Enrollment
Turkey
4 participants12 participants16 participants
Sex: Female, Male
Female
43 Participants33 Participants76 Participants
Sex: Female, Male
Male
41 Participants47 Participants88 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
73 / 8272 / 79
serious
Total, serious adverse events
31 / 8227 / 79

Outcome results

Primary

Complete Response (CR) Rate

Complete response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, and end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma. 1. Complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. 2. PET scan was negative. 3. The spleen and/or liver, if enlarged before therapy on the basis of physical examination or CT scan, was not palpable on physical examination and was considered normal size by imaging studies; all splenic and hepatic nodules related to lymphomas disappeared. 4. If bone marrow was involved before treatment, the infiltrate cleared on repeated bone marrow biopsy. 5. No new sites of disease were detected.

Time frame: 6 cycles

Population: All randomized subjects with non-GCB DLBCL who received at least 1 dose of any study drug, had at least 1 measurable lesion at baseline, and had at least 1 post-baseline response assessment

ArmMeasureValue (NUMBER)
VR-CAPComplete Response (CR) Rate64.5 percentage of participants
R-CHOPComplete Response (CR) Rate63.5 percentage of participants
p-value: 0.91595% CI: [0.529, 2.037]Cochran-Mantel-Haenszel
Secondary

Change in Fatigue and Patient Utility Scores

Time frame: 18-24 months

Secondary

Overall Response Rate

Overall response = Complete Response (CR) + Partial Response (PR) Response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, and end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma. Complete Response: see primary endpoint Partial Response: At least a 50% decrease in the sum of the product of the diameters (SPD) of up to 6 of the largest dominant nodes or nodal masses.

Time frame: 6 cycles

Population: All randomized subjects with non-GCB DLBCL who received at least 1 dose of any study drug, had at least 1 measurable lesion at baseline, and had at least 1 post-baseline response assessment

ArmMeasureValue (NUMBER)
VR-CAPOverall Response Rate93.4 percentage of participants
R-CHOPOverall Response Rate98.6 percentage of participants
Secondary

Overall Survival Rate at 1-year

Kaplan-meier estimate of overall survival at 1-year measured from date of randomization.

Time frame: 1 year

Population: Intent to Treat Population

ArmMeasureValue (NUMBER)
VR-CAPOverall Survival Rate at 1-year94.1 percentage of partipants
R-CHOPOverall Survival Rate at 1-year84.2 percentage of partipants
Secondary

Progression-free Survival (PFS)Rate at 1-year

Kaplan-meier estimate of progression-free survival at 1-year. Progression-free survival was defined as the interval between the date of randomization and the date of first documented evidence of disease progression or death.

Time frame: 1 year

Population: Intent to Treat Population

ArmMeasureValue (NUMBER)
VR-CAPProgression-free Survival (PFS)Rate at 1-year78.9 percentage of partipants
R-CHOPProgression-free Survival (PFS)Rate at 1-year83.9 percentage of partipants
Secondary

Rate of Durable Complete Response

Proportion of subjects who achieved a CR with duration of at least 6 months

Time frame: Median follow up approx 12 months

ArmMeasureValue (NUMBER)
VR-CAPRate of Durable Complete Response44.7 percentage of participants
R-CHOPRate of Durable Complete Response47.3 percentage of participants
Secondary

Rate of Durable Response

Proportion of subjects who achieved a CR or PR with duration of at least 6 months. Duration of response (CR or PR) was calculated from the date of initial documentation of a response to the date of first documented evidence of disease progression or death due to disease progression. Response was evaluated by an Independent Radiology Review Committee using available computed tomography (CT) and positron emission tomography (PET) scans collected at Baseline, end of cycle 3, end of cycle 6 (or end of treatment) based on the Revised Response Criteria for Malignant Lymphoma.

Time frame: Median follow up approx. 12 months

ArmMeasureValue (NUMBER)
VR-CAPRate of Durable Response53.9 percentage of participants
R-CHOPRate of Durable Response67.6 percentage of participants
Secondary

Subsequent Anti-lymphoma Therapy Rate at 1-year

Kaplan-meier estimate of subsequent anti-lymphoma therapy at 1-year. Time to subsequent anti-lymphoma therapy was measured from the date of randomization to the start date of new 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: 1 year

Population: Intent to Treat Population

ArmMeasureValue (NUMBER)
VR-CAPSubsequent Anti-lymphoma Therapy Rate at 1-year71.1 percentage of participants
R-CHOPSubsequent Anti-lymphoma Therapy Rate at 1-year80.2 percentage of participants

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