Skip to content

A Study Of Inotuzumab Ozogamicin Plus Rituximab For Relapsed/Refractory Aggressive Non-Hodgkin Lymphoma Patients Who Are Not Candidates For Intensive High-Dose Chemotherapy

AN OPEN-LABEL, RANDOMIZED, PHASE 3 STUDY OF INOTUZUMAB OZOGAMICIN ADMINISTERED IN COMBINATION WITH RITUXIMAB COMPARED TO DEFINED INVESTIGATOR'S CHOICE THERAPY IN SUBJECTS WITH RELAPSED OR REFRACTORY CD22-POSITIVE AGGRESSIVE NON-HODGKIN LYMPHOMA WHO ARE NOT CANDIDATES FOR INTENSIVE HIGH-DOSE CHEMOTHERAPY

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01232556
Enrollment
338
Registered
2010-11-02
Start date
2011-04-04
Completion date
2014-03-28
Last updated
2019-01-08

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

Conditions

Lymphoma, Non-Hodgkin

Keywords

inotuzumab ozogamicin, aggressive Non-Hodgkin lymphoma, diffuse large b-cell lymphoma, relapsed/refractory lymphoma

Brief summary

The purpose of this study is to evaluate the efficacy of inotuzumab ozogamicin plus rituximab in relapsed/refractory aggressive Non-Hodgkin lymphoma patients who are not candidates for intensive high-dose chemotherapy. Specifically, the goal is to demonstrate the superiority of this combination compared with an active comparator arm (investigator's choice of rituximab+bendamustine or rituximab+gemcitabine) using the primary endpoint of overall survival.

Interventions

DRUGInotuzumab ozogamicin

1.8 mg/m2 on day 2 every 28 days by IV infusion, 3 to 6 cycles

DRUGRituximab

375 mg/m2 on day 1 every 28 days by IV infusion, 3 to 6 cycles

DRUGrituximab + gemcitabine

rituximab 375 mg/m2 on days 1, 8, 15, and 22 of cycle 1, and day 1 of cycles 2 to 6, every 28 days by IV infusion, 3 to 6 cycles; gemcitabine 1000 mg/m2 on days 1, 8, and 15 every 28 days, 3 to 6 cycles

DRUGrituximab +bendamustine

rituximab 375 mg/m2 on day 1 every 28 days by IV infusion, 3 to 6 cycles; bendamustine 120 mg/m2 on days 1 and 2 by IV infusion every 28 days, 3 to 6 cycles

Sponsors

UCB Pharma
CollaboratorINDUSTRY
Pfizer
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

\-

Exclusion criteria

\-

Design outcomes

Primary

MeasureTime frameDescription
Overall SurvivalFrom randomization up to 5 years after last dose or up to final study visit, whichever occurs first.Overall Survival (OS) was defined as the time from randomization to death due to any cause, censoring at the date of last contact or the end of the study. The Kaplan-Meier method was used to determine OS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.
Percentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)Up to 20 weeks after the first dose of study drugIncludes all TEAEs: Any event that occurred after the first dose of study drug and was not present prior to study drug administration or worsened in severity after study drug administration..

Secondary

MeasureTime frameDescription
Percentage of Participants With A Best Overall Response of CR, Unconfirmed CR (unCR), PR, or Unconfirmed PR (unPR) Per NCI International Response Criteria for NHLUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment). Partial Response (PR) requires the following: 1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses. 2. No increase in the size of other nodes, liver, or spleen. 3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter. 4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present. 5. No new sites of disease. unCR and unPR means didn't have confirmatory assessment (including bone marrow assessment for CR). The 95% CI was determined using the exact method based on binomial distribution.
Duration of ResponseUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.The duration of overall response is measured from the first date of response until the first date that the progressive disease (PD) or death is objectively documented. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.
Progression-Free Survival (PFS)From randomization up to 2 years or final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.PFS is defined as time from date of randomization to date of progressive disease (PD, including investigator's claim of clinical progression), date of death from any cause, or initiation of a new treatment for the lymphoma due to persistent/refractory disease. The Kaplan-Meier method was used to determine PFS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression. PD requires the following: 1. Appearance of any new lesion more than 1.5 cm in any axis during or at the end of treatment, even if other lesions are decreasing in size. 2. At least a 50% increase from nadir in the sum of the product diameters of any previously involved nodes, or in a single involved node, or the size of other lesions. 3. At least a 50% increase in the longest diameter of any single previously identified node more than 1 cm in its short axis.
Health Related Quality of Life as Assessed by the Functional Assessment of Cancer Therapy for Lymphoma (FACT-Lym) QuestionnaireAssessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reportedFACT-Lym is a questionnaire that begins with 27 items covering four core Health-Related Quality of Life subscales: Physical Well-being (7 items), Social/Family Well-being (7), Emotional Well-being (6), and Functional Well-being (7). The FACT-Lym also includes an additional concerns subscale (15 items). It also asks participants about their concerns about lumps and swelling, fevers, infections, weight, appetite, emotional stability and treatment. The participants were requested to circle one number on a 0 to 4 points scale per line to indicate how true each statement has been for him/her during the past 7 days. FACT-Lym total score, which was reported, was derived based on FACT-Lym scoring guideline (Version 4). The range of FACT-Lym total score is 0 to 168. Higher scores mean better outcomes. The average post-baseline FACT-Lym total scores were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.
Health Status as Assessed by the European Quality of Life 5 Dimension (EQ-5D) QuestionnaireAssessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reportedEQ-5D consists of a descriptive system and an EQ visual analogue scale. The descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, extreme problems. The scale, the best state is marked 100 and the worst state is marked 0, is to help the participant to say how good or bad a health state is. EQ-5D index, which was reported, was derived based on US weight. The range of EQ-5D index is -0.109 to 1.00. Higher scores mean better outcomes. The average post-baseline scores for EQ-5D index were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.
Percentage of Participants With A Best Overall Response of CR or Partial Response (PR) Per NCI International Response Criteria for NHLUp to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment). Partial Response (PR) requires the following: 1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses. 2. No increase in the size of other nodes, liver, or spleen. 3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter. 4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present. 5. No new sites of disease. The 95% CI was determined using the exact method based on binomial distribution.

Countries

Belgium, Bulgaria, Canada, Croatia, Czechia, France, Germany, Hungary, India, Ireland, Japan, Lithuania, Mexico, Poland, Puerto Rico, Russia, Singapore, Slovakia, Spain, Sweden, Taiwan, Thailand, Ukraine, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Inotuzumab Ozogamicin+Rituximab
Participants received rituximab 375 mg/m\^2 via IV infusion on Day 1 and inotuzumab ozogamicin 1.8 mg/m\^2 via IV infusion on Day 2 of each 28-day cycle for a maximum of 6 cycles.
166
Rituximab+Gemcitabine or Rituximab+Bendamustine
Participants received either R-bendamustine (rituximab 375 mg/m\^2 via IV infusion on Day 1 and bendamustine 120 mg/m\^2 via IV infusion on Days 1 and 2 in 28-day cycles for a maximum of 6 cycles) or R-gemcitabine (rituximab 375 mg/m\^2 via IV infusion on Days 1, 8, 15 and 22 of Cycle 1 and on Day 1 for all other cycles, and gemcitabine 1000 mg/m\^2 via IV infusion on Days 1, 8 and 15 of each 28-day cycle for a maximum of 6 cycles). Choice of therapy was at the discretion of the investigator.
172
Total338

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath9797
Overall StudyLost to Follow-up02
Overall StudyOther64
Overall StudyTerminated by Sponsor3551
Overall StudyWithdrawal by Subject2117

Baseline characteristics

CharacteristicInotuzumab Ozogamicin+RituximabRituximab+Gemcitabine or Rituximab+BendamustineTotal
Age, Continuous68.6 Years
STANDARD_DEVIATION 12.29
66.9 Years
STANDARD_DEVIATION 11.4
67.7 Years
STANDARD_DEVIATION 11.86
Sex: Female, Male
Female
75 Participants75 Participants150 Participants
Sex: Female, Male
Male
91 Participants97 Participants188 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
155 / 164158 / 167
serious
Total, serious adverse events
61 / 16463 / 167

Outcome results

Primary

Overall Survival

Overall Survival (OS) was defined as the time from randomization to death due to any cause, censoring at the date of last contact or the end of the study. The Kaplan-Meier method was used to determine OS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.

Time frame: From randomization up to 5 years after last dose or up to final study visit, whichever occurs first.

Population: ITT Population.

ArmMeasureValue (MEDIAN)
Inotuzumab Ozogamicin+RituximabOverall Survival9.5 Months
Rituximab+Gemcitabine or Rituximab+BendamustineOverall Survival9.5 Months
Comparison: Primary null hypothesis: Equality of survival distributions. Sample size sufficient to have power 0.96 for an experimental/control hazard ratio of 0.6.p-value: 0.70895% CI: [0.82, 1.44]Log Rank
Primary

Percentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)

Includes all TEAEs: Any event that occurred after the first dose of study drug and was not present prior to study drug administration or worsened in severity after study drug administration..

Time frame: Up to 20 weeks after the first dose of study drug

Population: Safety Population - included all participants who received at least 1 dose of test article (either inotuzumab ozogamicin administrated in combination with rituximab or investigator's choice). This population only excluded participants who never received any test article.

ArmMeasureGroupValue (NUMBER)
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with Grade 3 or 4 TEAE79.9 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants for study drug discontinuation25.0 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with serious TEAE37.2 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with dose reductions due to TEAEs27.4 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with Grade 5 TEAE14.6 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants for study drug stopped temporarily31.1 Percentage of Participants
Inotuzumab Ozogamicin+RituximabPercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with a TEAE98.8 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants for study drug stopped temporarily46.1 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with a TEAE100.0 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with serious TEAE37.7 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with Grade 3 or 4 TEAE79.6 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with Grade 5 TEAE13.8 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants for study drug discontinuation18.0 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With a Treatment Emergent Adverse Event (TEAE) (Safety Population)% participants with dose reductions due to TEAEs29.3 Percentage of Participants
Secondary

Duration of Response

The duration of overall response is measured from the first date of response until the first date that the progressive disease (PD) or death is objectively documented. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression.

Time frame: Up to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

Population: ITT population; only participants with a CR, unCR, PR, or unPR were included in the analysis

ArmMeasureValue (MEDIAN)
Inotuzumab Ozogamicin+RituximabDuration of Response11.56 Months
Rituximab+Gemcitabine or Rituximab+BendamustineDuration of Response6.93 Months
Comparison: DOR was not part of the formal hypothesis testing strategy.p-value: 0.14295% CI: [0.47, 1.25]Log Rank
Secondary

Health Related Quality of Life as Assessed by the Functional Assessment of Cancer Therapy for Lymphoma (FACT-Lym) Questionnaire

FACT-Lym is a questionnaire that begins with 27 items covering four core Health-Related Quality of Life subscales: Physical Well-being (7 items), Social/Family Well-being (7), Emotional Well-being (6), and Functional Well-being (7). The FACT-Lym also includes an additional concerns subscale (15 items). It also asks participants about their concerns about lumps and swelling, fevers, infections, weight, appetite, emotional stability and treatment. The participants were requested to circle one number on a 0 to 4 points scale per line to indicate how true each statement has been for him/her during the past 7 days. FACT-Lym total score, which was reported, was derived based on FACT-Lym scoring guideline (Version 4). The range of FACT-Lym total score is 0 to 168. Higher scores mean better outcomes. The average post-baseline FACT-Lym total scores were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.

Time frame: Assessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reported

Population: ITT population

ArmMeasureValue (MEAN)
Inotuzumab Ozogamicin+RituximabHealth Related Quality of Life as Assessed by the Functional Assessment of Cancer Therapy for Lymphoma (FACT-Lym) Questionnaire120.07 Unit on a scale
Rituximab+Gemcitabine or Rituximab+BendamustineHealth Related Quality of Life as Assessed by the Functional Assessment of Cancer Therapy for Lymphoma (FACT-Lym) Questionnaire116.96 Unit on a scale
p-value: 0.187995% CI: [-1.52, 7.74]Mixed Models Analysis
Secondary

Health Status as Assessed by the European Quality of Life 5 Dimension (EQ-5D) Questionnaire

EQ-5D consists of a descriptive system and an EQ visual analogue scale. The descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, extreme problems. The scale, the best state is marked 100 and the worst state is marked 0, is to help the participant to say how good or bad a health state is. EQ-5D index, which was reported, was derived based on US weight. The range of EQ-5D index is -0.109 to 1.00. Higher scores mean better outcomes. The average post-baseline scores for EQ-5D index were computed at approximately Week 12. The overall treatment comparisons were estimated at approximately Week 12.

Time frame: Assessed at Day 1 of each cycle and 6-9 weeks after the last dose, Cycle 3 (Week 12) reported

Population: ITT population

ArmMeasureValue (MEAN)
Inotuzumab Ozogamicin+RituximabHealth Status as Assessed by the European Quality of Life 5 Dimension (EQ-5D) Questionnaire0.79 Unit on a scale
Rituximab+Gemcitabine or Rituximab+BendamustineHealth Status as Assessed by the European Quality of Life 5 Dimension (EQ-5D) Questionnaire0.77 Unit on a scale
p-value: 0.289295% CI: [-0.02, 0.06]Mixed Models Analysis
Secondary

Percentage of Participants With A Best Overall Response of CR or Partial Response (PR) Per NCI International Response Criteria for NHL

CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment). Partial Response (PR) requires the following: 1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses. 2. No increase in the size of other nodes, liver, or spleen. 3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter. 4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present. 5. No new sites of disease. The 95% CI was determined using the exact method based on binomial distribution.

Time frame: Up to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

Population: ITT Population

ArmMeasureValue (NUMBER)
Inotuzumab Ozogamicin+RituximabPercentage of Participants With A Best Overall Response of CR or Partial Response (PR) Per NCI International Response Criteria for NHL29.5 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With A Best Overall Response of CR or Partial Response (PR) Per NCI International Response Criteria for NHL29.7 Percentage of Participants
Comparison: Third comparison in hierarchical testing strategy was used for power calculation.p-value: 0.843Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With A Best Overall Response of CR, Unconfirmed CR (unCR), PR, or Unconfirmed PR (unPR) Per NCI International Response Criteria for NHL

CR is defined as disappearance of all detectable clinical evidence of disease (including cleared infiltrate on repeat bone marrow aspirate/biopsy if lymphoma involvement of bone marrow before treatment). Partial Response (PR) requires the following: 1. ≥50 % decrease in SPD of the six largest dominant nodes or nodal masses. 2. No increase in the size of other nodes, liver, or spleen. 3. Splenic and hepatic nodules must regress by ≥50% in the SPD, or for single nodules, in the greatest transverse diameter. 4. With the exception of splenic and hepatic nodules, involvement of other organs is usually assessable and no measurable disease should be present. 5. No new sites of disease. unCR and unPR means didn't have confirmatory assessment (including bone marrow assessment for CR). The 95% CI was determined using the exact method based on binomial distribution.

Time frame: Up to 2 years from first study drug dose or up to final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

Population: ITT Population

ArmMeasureValue (NUMBER)
Inotuzumab Ozogamicin+RituximabPercentage of Participants With A Best Overall Response of CR, Unconfirmed CR (unCR), PR, or Unconfirmed PR (unPR) Per NCI International Response Criteria for NHL41.0 Percentage of Participants
Rituximab+Gemcitabine or Rituximab+BendamustinePercentage of Participants With A Best Overall Response of CR, Unconfirmed CR (unCR), PR, or Unconfirmed PR (unPR) Per NCI International Response Criteria for NHL43.6 Percentage of Participants
Comparison: Third comparison in hierarchical testing strategy was used for power calculation.p-value: 0.714Cochran-Mantel-Haenszel
Secondary

Progression-Free Survival (PFS)

PFS is defined as time from date of randomization to date of progressive disease (PD, including investigator's claim of clinical progression), date of death from any cause, or initiation of a new treatment for the lymphoma due to persistent/refractory disease. The Kaplan-Meier method was used to determine PFS. The hazard ratio and corresponding 95% 2-sided confidence interval were calculated using stratified Cox proportional hazard regression. PD requires the following: 1. Appearance of any new lesion more than 1.5 cm in any axis during or at the end of treatment, even if other lesions are decreasing in size. 2. At least a 50% increase from nadir in the sum of the product diameters of any previously involved nodes, or in a single involved node, or the size of other lesions. 3. At least a 50% increase in the longest diameter of any single previously identified node more than 1 cm in its short axis.

Time frame: From randomization up to 2 years or final study visit, whichever occurs first, including but not limited to planned assessments scheduled approximately every 12 weeks.

Population: ITT Population

ArmMeasureValue (MEDIAN)
Inotuzumab Ozogamicin+RituximabProgression-Free Survival (PFS)3.7 Months
Rituximab+Gemcitabine or Rituximab+BendamustineProgression-Free Survival (PFS)3.5 Months
Comparison: Second comparison in hierarchical testing strategy was used for power calculation.p-value: 0.27195% CI: [0.72, 1.19]Log Rank

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