Non-Hodgkin's LymphomaPhase 3NCT01200758
A Study of Rituximab (MabThera) Subcutaneous (SC) Versus Rituximab (MabThera) Intravenous in Participannts With Follicular Non-Hodgkin's Lymphoma
A Phase 3 study testing Rituximab SC, Rituximab IV and Cyclophosphamide in people with Non-Hodgkin's Lymphoma, run by Hoffmann-La Roche at 152 sites in 30 countries.
Trial summary
This two-stage, multi-center, randomized, controlled, open-label study will investigate the pharmacokinetics, efficacy and safety of rituximab SC versus rituximab IV in participants with previously untreated follicular non-Hodgkin's lymphoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-Hodgkin's Lymphoma
- What is being tested?
- Rituximab SC, Rituximab IV and Cyclophosphamide
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 410 participants
- Where
- 152 sitesin 30 countries
- Study dates
- 15 Feb 2011to 31 Oct 2017
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Cluster of differentiation 20 (CD20)-positive, follicular Non-Hodgkin's lymphoma grade 1, 2, 3a. A tumor biopsy must have been performed within 6 months before study entry with material available for central review
- No prior treatment
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Who cannot join
- Grade 3b follicular lymphoma
- Transformation to high-grade lymphoma secondary to follicular lymphoma
- Types of Non-Hodgkin's lymphoma other than follicular lymphoma
- Presence or history of central nervous system (CNS) disease
- Corticoid therapy during the last 4 weeks, except prednisone treatment less than (<) 20 milligrams per day (mg per day)
- Known active bacterial, viral, fungal, or mycobacterial, or any major episode of infections requiring hospitalization or treatment with IV antibiotics within 4 weeks of start of study medication, or oral antibiotics within 2 weeks prior to start of study medication
Trial locations and contacts
152 sites in 30 countries.
152 sites in 30 countries
Germany20 sites
Onkologische Schwerpunktpraxis Kurfürstendamm
Berlin, 10707
Gemeinschaftspraxis PD Dr. med. Marcel Reiser und Dr. med. Ildiko Kátay
Cologne, 50674
Klinikum Darmstadt GmbH; Med. Klinik V; Onkologie & Hämatologie
Darmstadt, 64283
Gemeinschaftspraxis Dr. med. J. Mohm und Dr. med. G. Prange-Krex; Fachaerzte fuer Innere Medizin
Dresden, 01307
PIOH PD Dr. R. Schnell - Dr. H. Schulz - Dr. M. Hellmann
Frechen, 50226
Universitätsklinikum Gießen und Marburg GmbH Standort Gießen Medizinische Klinik I
Giessen, 35392
Universitätsklinikum Greifswald Klinik für Innere Medizin C und Poliklinik
Greifswald, 17475
Internistisch-Onkologische Gemeinschaftspraxis; Dres. Rohrberg, Hurtz, Schma usw.
Halle, 06110
Medizinische Hochschule; Zentrum Innere Medizin; Abt. Hämatologie u. Onkologie
Hanover, 30625
St. Vincentius Kliniken Ag; Medizinische Klinik Abt. 2
Karlsruhe, 76137
UKSH Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie
Kiel, 24105
Onkologische Gemeinschaftspraxis
Magdeburg, 39104
Gemeinschaftspraxis Fr. Dr. med. Balser & Hr. Dr. med. Weidenbach
Marburg, 35037
Medizinisches Versorgungszentrum MOP
München, 80335
Praxis Dr.med. Jens Uhlig
Naunhof, 04683
Praxis Dr. Clemens Müller-Naendrup (Onkologische Schwerpunktpraxis im MVZ 2 GmbH)
Olpe, 57462
Prosper-Hospital, Medizinische Klinik I
Recklinghausen, 45659
Praxis Dr. Fenchel
Saalfeld, 07318
Caritas Kilinik St. Theresia; Abt. Innere Medizin
Saarbrücken, 66113
Praxis für Hämatologie & Onkologie
Saarbrücken, 66113
France12 sites
Polyclinique Bordeaux Nord Aquitaine; Chimiotherapie Radiotherapie
Bordeaux, 33077
Hopital Henri Mondor; Hematologie Clinique
Créteil, 94010
Chu Site Du Bocage;Hematologie Clinique
Dijon, 21079
Clinique Victor Hugo; Chimiotherapie
Le Mans, 72015
Institut J Paolii Calmettes; Onco Hematologie 1
Marseille, 13273
Hopital Saint Eloi; Hematologie Oncologie Medicale
Montpellier, 34295
Hopital Hotel Dieu Et Hme;Hopital De Jour
Nantes, 44093
Hopital Saint Louis ; Service d Oncologie Medicale Fougere 6 (Pr Misset)
Paris, 75475
Hopital De Haut Leveque; Hematologie Clinique
Pessac, 33604
Ch Lyon Sud; Hemato Secteur Jules Courmont
Pierre-Bénite, 69495
Hopital De La Miletrie; Hematologie Et Oncologie Medicale
Poitiers, 86021
Hopital Bretonneau; Hematologie Therapie Cellulaire
Tours, 37044
Spain11 sites
Hospital del Mar; Servicio de Hematologia
Barcelona, 08003
Hospital Universitari Vall d'Hebron; Servicio de Hematologia
Barcelona, 08035
Hospital Clínic i Provincial; Servicio de Hematología y Oncología
Barcelona, 08036
Hospital Duran i Reynals; Servicio de Hematologia
Barcelona, 08907
Hospital Universitario Puerta del Mar; Servicio de Hematologia
Cadiz, Cadiz, 11009
Hospital Universitario de la Princesa; Servicio de Hematologia
Madrid, 28006
Hospital Ramon y Cajal; Servicio de Hematologia
Madrid, 28034
Hospital Universitario Virgen de Arrixaca; Servicio de Hematologia
Murcia, 30120
Hospital Clinico Universitario de Salamanca;Servicio de Hematologia
Salamanca, 37007
Hospital Universitario Virgen del Rocio; Servicio de Hematologia
Seville, 41013
Hospital Universitario la Fe; Servicio de Oncologia
Valencia, 46026
Italy10 sites
A.O. Spedali Civili Di Brescia-P.O. Spedali Civili;U.O. Ematologia
Brescia, Lombardy, 25123
Uni Degli Studi Di Genova; 1A Divisione Di Ematologia
Genoa, Liguria, 16132
Irccs Istituto Europeo Di Oncologia (IEO); Emato-Oncologia
Milan, Lombardy, 20141
A.O. Universitaria Federico II Di Napoli; Oncologia Ed Endocrinologia Clinica
Naples, Campania, 80131
Azienda Ospedaliera Ospedale S.Carlo; Ematologia
Potenza, Basilicate, 85100
AUSL - IRCCS Santa Maria Nuova; U.O. Day Hospital di Oncologia
Reggio Emilia, Emilia-Romagna, 42100
Ospedale S. Eugenio; Divisione Di Ematologia
Rome, Lazio, 00144
IRCCS Ospedale Casa Sollievo Della Sofferenza; Ematologia E Trapianto Di Midollo Osseo
San Giovanni Rotondo, Apulia, 71013
Ospedale Ca Foncello; Ematologia
Treviso, Veneto, 31100
Ospedale Di Vicenza; Nefrologia, Ematologia
Vicenza, Veneto, 36100
Russia7 sites
Clinical Oncology Dispensary of Ministry of Health of Tatarstan
Kazan', 420029
N.N.Blokhin Russian Cancer Research Center; Dept. of Chemotherapy & Hemoblastosis
Moscow, 115478
Haematology Research Center; Haematology
Moscow, 125167
Penza Regional Oncology Dispensary
Penza, 440071
Research Inst. of Hematology & Blood Transfusion ; Hematology
Saint Petersburg, 191024
St. Petersburg State Medical University n.a. I.P. Pavlov; Hematology, transfusiology and transplanta
Saint Petersburg, 197022
Russian Scientific Center of Radiology and Surgical Technologies; Dept of Radiology
St.Petersburg, Pesochny, 197758
United Kingdom7 sites
Ninewells Hospital & Medical School; Ward 34
Dundee, DD1 9SY
Maidstone & Tonbridge Wells Hospital; Kent Oncology Center
Maidstone, ME16 9QQ
Derriford Hospital; Department of Haematology
Plymouth, PL6 8DH
Queen's Hospital; Oncology
Romford, RM7 0AG
Southampton General Hospital
Southampton, SO16 6YD
Pinderfields General Hospital; Dept of Haematology
Wakefield, WF1 4DG
New Cross Hospital; Dept. Of Haematology
Wolverhampton, WV10 0QP
Canada6 sites
Queen Elizabeth II Health Sciences Centre; Oncology
Halifax, Nova Scotia, B3H 2Y9
Cite de La Sante de Laval; Hemato-Oncologie
Laval, Quebec, H7M 3L9
CHU de Quebec - Hopital de l'Enfant-Jesus; Unite de Recherche en Hematologie et Oncologie
Québec, G1J 1Z4
Centre de sante et de services sociaux Rimouski Neigette
Rimouski, Quebec, G5L 5T1
Centre Hospitalier Universitaire de Sherbrooke
Sherbrooke, Quebec, J1H 5N4
Centre hospitalier regional de Trois-Rivieres
Trois-Rivières, Quebec, G8Z 3R9
Denmark6 sites
Aarhus Universitetshospital, Hæmatologisk Afdeling R
Aarhus, 8000
Herlev Uni Hospital; Hæmatologisk Afdeling L 121
Herlev, 2730
Rigshospitalet; Hæmatologisk Klinik
København Ø, 2100
Odense Universitetshospital; Hæmatologisk Afdeling
Odense C, 5000
Sygehus Syd Roskilde; Onkologisk/haematologisk ambulatorium
Roskilde, 4000
Vejle Hospital; Dept of Medicine, Division of Hematology
Vejle, 7100
Romania6 sites
Spitalul Clinic Judetean de Urgenta Brasov,Clinica de Hematologie
Brasov, 500326
Fundeni Clinical Inst. ; Hematology Dept
Bucharest, 022328
Spitalul Clinic Judetean de Urgenta Sf. Spiridon Iasi, Clinica de Hematologie
Iași, 700111
Institutul Regional de Oncologie Iasi; Clinica de Hematologie
Iași, 700483
Spitalul Clinic Judetean de Urgenta Targu-Mures; compartiment Hematologie
Târgu Mureş, 540136
Spitalul Clinic municipal de Urgenta Timisoara; Clinica de Hematologie
Timișoara, 300079
Australia5 sites
Gosford Hospital; Cancer Care Services
Gosford, New South Wales, 2250
Royal Brisbane and Women's Hospital
Herston, Queensland, 4029
Gold Coast Hospital; Haematology Department
Southport, Queensland, 4215
Wollongong Hospital; Cancer Services
Wollongong, New South Wales, 2500
Queen Elizabeth Hospital; Haematology
Woodville South, South Australia, 5011
Brazil5 sites
Nucleo de Hematologia e Transplante de Medula Ossea de Minas Gerais
Belo Horizonte, Minas Gerais, 30140-001
Hospital das Clinicas - UFRGS
Porto Alegre, Rio Grande do Sul, 90035-003
Hospital Sao Lucas - PUCRS
Porto Alegre, Rio Grande do Sul, 90610-000
Santa Casa de Misericordia de Sao Paulo; Hematologia e Hemoterapia
São Paulo, São Paulo, 01221-020
Hospital das Clinicas - FMUSP
São Paulo, São Paulo, 05403-000
South Africa5 sites
National Hospital; Oncotherapy Dept
Bloemfontein, 9301
Durban Oncology Center
Durban, 4091
University of Witwatersrand/Johannesburg Hospital; Dept. of ocnology
Johannesburg, 2193
Cancercare
Kraaifontein, 7570
King Edward VIII; Department of Haematology
KwaKhangela, 4013
Turkey (Türkiye)5 sites
Adana Baskent University Hospital; Medical Oncology
Adana, 01120
Istanbul University Cerrahpasa Medical Faculty; Hematology Department
Istanbul, 34098
Bilim University School of Medicine; Hematology
Istanbul, 34394
Dokuz Eylul Uni ; Hematology
Izmir, 35100
Ege Uni Medical School; Hematology
Izmir, 35100
Bulgaria4 sites
UMHAT Dr Georgi Stranski; Hematology
Pleven, 5800
Umhat S. George; Hematology
Plovdiv, 4002
Specialised Hospital For Treatment Of Hematological Diseases; Hematology
Sofia, 1756
Mhat Sveta Marina; Dept. of Haematology
Varna, 9010
Colombia4 sites
Fundacion Cardioinfantil
Bogotá
Centro Medico Imbanaco
Cali
Hospital Pablo Tobon Uribe
Medellin-Antioquia
Oncólogos de Occidente
Pereira, 600004
Georgia4 sites
M.Zodelava's Hematology Center
Tbilisi, 0112
Mediclub
Tbilisi, 0160
Institute of Hematology and Transfusiology
Tbilisi, 0177
Chemotherapy and Immunotherapy Clinic Medulla
Tbilisi, 0186
Mexico4 sites
Centro Estatal De Cancerologia De Chihuahua; Servicio De Hematologia Banco De Sangre
Chihuahua City, 31000
Hospital General De Culiacan; Servicio De Hematologia
Culiacán, 80230
Hospital Universitario Dr. Jose E. Gonzalez; Haematology
Monterrey, 64460
Centro de Estudios Clinicos de Queretaro (CECLIQ)
Querétaro, 76000
Belgium3 sites
UZ Antwerpen
Edegem, 2650
CHU Sart-Tilman
Liège, 4000
Sint Augustinus Wilrijk
Wilrijk, 2610
Bosnia and Herzegovina3 sites
University Clinical Center of the Republic of Srpska, Clinic for Internal Disease, Hematology Dept
Banja Luka, 88000
University Clinical Center Sarajevo, Clinic for Hematology
Sarajevo, 71000
University Clinical Centre Tuzla, Clinic for Oncology, Hematology and Radiotherapy
Tuzla, 75000
Malaysia3 sites
Ampang Hospital; Department of Haematology
Ampang, 68000
University Malaya Medical Center; Hematology Unit of Department of Internal Medicine
Kuala Lumpur, FED. Territory of Kuala Lumpur, 59100
Sarawak General Hospital; Department of Radiotherapy, Oncology and Palliative care
Sarawak, Sarawak, 93586
Peru3 sites
Instituto;Oncologico Miraflores
Lima, 18
Oncosalud Sac; Oncología
Lima, 41
Hospital Maria Auxiliadora
Lima, Lima 29
Singapore3 sites
National University Hospital; National University Cancer Institute, Singapore (NCIS)
Singapore, 119228
Singapore General Hospital; Department of Haematology
Singapore, 169608
National Cancer Centre; Medical Oncology
Singapore, 169610
Thailand3 sites
National Cancer Inst.
Bangkok, 10400
Siriraj Hospital; Division of Hematology, Department of Medicine
Bangkok, 10700
Srinagarind Hospital, Khon Kaen Uni ; Dept of Medicine
Khon Kaen, 40002
Croatia2 sites
UHC Rijeka
Rijeka, 51000
University Hospital Center Zagreb; Haematology Department
Zagreb, 10000
Greece2 sites
Laiko General Hospital of Athens; A Propedeutical Clinic of Internal Medicine
Athens, 115 27
Attiko Hospital; Haematology Clinic
Athens, 124 62
New Zealand2 sites
Canterbury Health Laboratories; Haematology
Christchurch, 8011
Palmerston North Hospital; Regional Cancer Treatment Service
Palmerston North, 4442
North Macedonia2 sites
University Clinic for Hematology; HSCT Department
Skopje, 1000
University Clinic of Hematology Skopje, Hospital Care Department
Skopje, 1000
Serbia2 sites
Institute of Hematology
Belgrade, 11000
Clinical Center Vojvodine; Clinic for Hematology
Novi Sad, 21000
Slovakia2 sites
St. Elisabeths Cancer Center
Bratislava, 812 50
National Cancer Inst. ; Dept. of Chemotherapy
Bratislava, 833 10
Finland1 site
Helsinki University Central Hospital; Dept of Oncology
Helsinki, 00029
About this study
Official title: A Two-Stage Phase III, International, Multi-Center, Randomized, Controlled, Open-Label Study to Investigate the Pharmacokinetics, Efficacy and Safety of Rituximab SC in Combination With CHOP or CVP Versus Rituximab IV in Combination With CHOP or CVP in Patients With Previously Untreated Follicular Lymphoma Followed by Maintenance Treatment With Either Rituximab SC or Rituximab IV
This two-stage, multi-center, randomized, controlled, open-label study will investigate the pharmacokinetics, efficacy and safety of rituximab SC versus rituximab IV in participants with previously untreated follicular non-Hodgkin's lymphoma. Participants will be randomized to receive 375 milligrams per meter square (mg/m^2) rituximab as IV infusion or 1400 milligrams (mg) rituximab SC. In addition, participants will receive standard chemotherapy. Participants who achieved a complete or partial response (PR) after 8 treatment cycles, will receive maintenance treatment for a further maximum number of 12 cycles. Maintenance treatment cycles will be repeated every 8 weeks. This is a two-stage study. Stage 1 was designed to confirm the chosen rituximab SC dose resulting in comparable rituximab serum Ctrough levels compared with rituximab IV, when given as part of induction treatment every 3 weeks. Enrollment for Stage 2 started after the rituximab SC dose was established in Stage 1. Stage 2 aimed to further investigate the efficacy and safety of rituximab SC compared with rituximab IV. The anticipated time on study treatment is 96 weeks.
- Conditions
- Non-Hodgkin's Lymphoma
- Being tested
- Rituximab SC, Rituximab IV, Cyclophosphamide, Doxorubicin, Vincristine
- Medical subject headings
- Lymphoma, Non-Hodgkin
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Rituximab SCDrug
Also called MabThera
First cycle of rituximab IV infusion (375 mg/m^2) + 7 cycles of rituximab SC (1400 mg; rituximab induction) in administered every 3 weeks. Participants achieving at least PR entered rituximab SC (1400 mg) maintenance therapy once every 8 weeks for 24 months.
Rituximab IVDrug
Also called MabThera
Eight cycles of rituximab IV infusion (375 mg/m^2; rituximab induction) administered every 3 weeks. Participants achieving at least PR during induction, entered rituximab IV maintenance therapy (375 mg/m^2) once every 8 weeks for 24 months.
CyclophosphamideDrug
Eight cycles of cyclophosphamide (750 mg/m^2 IV) administered every 3 weeks.
DoxorubicinDrug
Eight cycles of doxorubicin (50 mg/m^2 IV) administered every 3 weeks.
VincristineDrug
Eight cycles of doxorubicin (1.4 mg/m^2 IV) administered every 3 weeks.
Prednisone/PrednisoloneDrug
Eight cycles of prednisone/prednisolone (100 mg/day or 40 mg/m^2/day IV/orally) administered Days 1 to 5 of every 21 days cycle.
| Study group | Role | What they receive |
|---|---|---|
| Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP) | Active comparator | Eight cycles of rituximab IV infusion (375 mg/m^2; rituximab induction) in combination with up to 8 cycles of cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) or cyclophosphamide, vincristine, prednisolone (CVP) chemotherapy (as per institutional practice) administered every 3 weeks. Participants achieving at least PR during induction, entered rituximab IV maintenance therapy (375 mg/m^2) once every 8 weeks for 24 months. Receives: Drug: Rituximab IV; Drug: Cyclophosphamide; Drug: Doxorubicin; Drug: Vincristine; Drug: Prednisone/Prednisolone |
| Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) | Experimental | First cycle of rituximab IV infusion (375 mg/m^2) + 7 cycles of rituximab SC (1400 mg; rituximab induction) in combination with up to 8 cycles of CHOP or CVP chemotherapy (as per institutional practice) administered every 3 weeks. Participants achieving at least PR entered rituximab SC (1400 mg) maintenance therapy once every 8 weeks for 24 months. Receives: Drug: Rituximab SC; Drug: Cyclophosphamide; Drug: Doxorubicin; Drug: Vincristine; Drug: Prednisone/Prednisolone |
What is being measured
The primary outcome is the main question the study is designed to answer.
Stage I: Trough Serum Concentrations (Ctrough) of IV and SC Rituximab
Measured: Stage I: Cycle (Cy) 7 Day (D) 21 (within 2 hours predose on Cy8) of induction treatment (1 Cy=3 weeks)
Stage II: Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for Non-Hodgkin Lymphoma (NHL)
Overall Response comprised complete response (CR), CR unconfirmed (CRu), or PR. A participant was defined as a responder if they sustained a CR, CRu or PR at the end of induction treatment. Response assessment was based on clinical examination and computed tomography (CT) scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by more than (>) 75% in the sum of the products of greatest diameters (SPD); PR: Greater than or equal to (≥) 50% decrease in SPD of 6 largest dominant nodes or nodal masses. The 95% CI was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Secondary outcomes (24)
Stage I: Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Overall Response comprised CR, CRu, or PR. A participant was defined as a responder if they sustained a CR, CRu or PR at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in the SPD; PR: ≥50% decrease in SPD of 6 largest dominant nodes or nodal masses. The 95% CI was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Overall Response comprised of CR, CRu, or PR. A participant was defined as a responder if they sustained a CR, CRu or PR at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumour response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD; PR: ≥50% decrease in SPD of 6 largest dominant nodes or nodal masses. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I and II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I: Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Complete Response was comprised CR and CRu. A participant was defined as a responder if they sustained a CR or CRu at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage II: Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Complete Response comprised of CR and CRu. A participant was defined as a responder if they sustained a CR or CRu at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Complete Response comprised of CR and CRu. A participant was defined as a responder if they sustained a CR or CRu at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I and II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Complete Response at the End of Maintenance Treatment Assessed Using International Working Group Response Criteria for NHL
Complete Response comprised of CR and CRu. A participant was defined as a responder if they sustained a CR or CRu at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I and II: Baseline up to 57 days after last maintenance dose (last maintenance dose: maintenance Cy12/Study Cy20 [30 months]) (up to data cutoff of 31 Oct 2017 [up to 6 years]) (1 Cy=8 weeks)
Stage I and II (Pooled): Percentage of Participants With Overall Response at the End of Maintenance Treatment Assessed Using International Working Group Response Criteria for NHL
Overall Response comprised of CR, CRu, or PR . A participant was defined as a responder if they sustained a CR, CRu or PR at the end of induction treatment. Response assessment was based on clinical examination and CT scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by >75% in SPD. The 95% CI for the response rates was estimated for one sample binomial using Pearson-Clopper.
Measured: Stage I and II: Baseline up to 57 days after last maintenance dose (last maintenance dose: maintenance Cy12/Study Cy20 [30 months]) (up to data cutoff of 31 Oct 2017 [up to 6 years]) (1 Cy=8 weeks)
Stage I and II (Pooled): Percentage of Participants With Disease Progression/Relapse or Death
Disease progression: ≥50% increase from nadir in the SPD of any previously identified abnormal node or appearance of any new lesion during or at the end of therapy or ≥50% increase in the greatest diameter of any previously identified node >1 cm in its short axis or in the SPD of more than one node. Baseline, D1 of all cycles (Cy 1-20) (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), at early withdrawal, at follow-up, every 12 weeks for 96 weeks or until documented disease progression/relapse or death (up to median of 27 months; up to data cutoff of 31 Oct 2017 [up to 6 years])
Measured: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Progression-Free Survival (PFS) Assessed Using International Working Group Response Criteria for NHL
PFS was defined as the time from randomization to disease progression/relapse or death due to any cause. If the specified event (disease progression/relapse, death) did not occur, PFS was censored at the last tumor assessment date showing no disease progression, either during treatment or follow-up. Disease progression: ≥50% increase from nadir in the SPD of any previously identified abnormal node or appearance of any new lesion during or at the end of therapy or ≥50% increase in the greatest diameter of any previously identified node >1 cm in its short axis or in the SPD of more than one node. PFS analysis was performed using Kaplan - Meier curves. Baseline, D1 of all cycles (Cy 1-20) (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), at early withdrawal, at follow-up, every 12 weeks for 96 weeks or until documented disease progression/relapse or death (up to median of 27 months; up to data cutoff of 31 Oct 2017 [up to 6 years])
Measured: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Participants With Disease Progression/Relapse, New Anti-Lymphoma Treatment or Death Assessed Using International Working Group Response Criteria for NHL
Disease progression: ≥50% increase from nadir in the SPD of any previously identified abnormal node or appearance of any new lesion during or at the end of therapy or ≥50% increase in the greatest diameter of any previously identified node >1 cm in its short axis or in the SPD of more than one node. Baseline, D1 of all cycles (Cy 1-20) (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), at early withdrawal, at follow-up, every 12 weeks for 96 weeks or until documented disease progression/relapse or death (up to a median of 27 months; up to data cutoff of 31 Oct 2017 [up to 6 years])
Measured: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Event-Free Survival Assessed Using International Working Group Response Criteria for NHL
Event-free survival was defined as the time from randomization to disease progression/relapse, death or initiation of new NHL therapy. If the specified event (progression/relapse, death or new anti-lymphoma treatment) did not occur, event-free survival was censored at the last tumor assessment date either during treatment or follow up. Event-free survival analysis was performed using Kaplan-Meier curves. Baseline, D1 of all cycles (Cy 1-20) (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), at early withdrawal, at follow-up, every 12 weeks for 96 weeks or until documented disease progression/relapse or death (up to a median of 27 months; up to data cutoff of 31 Oct 2017 [up to 6 years])
Measured: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Percentage of Participants Who Died
Measured: Baseline up to death (up to data cutoff of 31 Oct 2017 [up to 6 years])
Overall Survival (OS)
OS was defined as the time from randomization to death due to any cause. Participants without event were censored at the time of last follow-up information for survival, ie, at the last time known to be alive.
Measured: Baseline up to death (up to data cutoff of 31 Oct 2017 [up to 6 years])
Stage I: Observed Area Under the Serum Concentration-Time Curve (AUC) of Rituximab
AUC is a measure of the serum concentration of the drug over time. It is used to characterize drug absorption. Predose (within 2 hr) and 24 hrs postdose on Cy 7 (D1,3,7,15), predose (0 hr) on Cy 8 D1 (1 Cy=3 weeks); additionally within 15 minutes after end of infusion (infusion duration=30 minutes) on Cy 7 D1 for rituximab IV (up to data cutoff of 11 Apr 2012 [up to 26 months])
Measured: Stage I (Induction): Predose (within 2 hour [hr]) up to data cutoff of 11 Apr 2012 [up to 26 months]) (See detailed timeframe in Outcome Measure description)
Stage I: Maximum Serum Concentrations (Cmax) of IV and SC Rituximab
Predose (within 2 hr) and 24 hrs postdose on Cy7 (D1,3,7,15), predose (0 hr) on Cy8 D1 (1 Cy=3 weeks); additionally within 15 minutes after end of infusion (infusion duration=30 minutes) on Cy7 D1 for rituximab IV (up to data cutoff of 11 Apr 2012 [up to 26 months])
Measured: Stage I (Induction): Predose (within 2hr) up to data cutoff of 11 Apr 2012 [up to 26 months]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Ctrough of Rituximab at Each Induction Treatment Cycle
Stage I and II (Induction): Rituximab IV: Predose (within 2 hr) on D1 of Cy1-8 (1 Cy=3 weeks \& 4 weeks for Cy8); Rituximab SC: Predose (within 2 hr) on D1 of Cy1 \& Cy3-8 (1 Cy=3 weeks and 4 weeks for Cy8), predose (within 2 hr) on D0 of Cy2 (up to data cutoff of 31 Oct 2013 [up to 32 months])
Measured: Stage I and II (Pooled): Predose (within 2hr) up to data cutoff of 31 Oct 2013 [up to 32 months]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Ctrough of Rituximab at Each Maintenance Treatment Cycle
Stage I and II (maintenance): D29 of Cy8 (induction; 1 Cy=4 weeks), predose (within 2 hr) on D1 of Cy9 to 19 (maintenance Cy1 to 12 [1 Cy=8 weeks]; up to data cutoff of 11 Jan 2016 [up to 6 years])
Measured: Stage I and II (maintenance): Predose (within 2hr) up to data cutoff of 11 Jan 2016 [up to 6 years]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Rituximab Levels 12 Weeks, 24 Weeks, and 36 Weeks After the Last Rituximab Administration
Measured: 12 weeks, 24 weeks, and 36 weeks after the last rituximab administration (up to data cutoff of 11 Jan 2016 [up to 6 years])
Percentage of Participants With B-Cell Depletion by Cycle for Induction Phase
Depletion is defined as a cluster of differentiation (CD) 19 value <80 cells per cubic millimeter (cells/mm^3).
Measured: Stage I and II (induction): for rituximab IV - D1 of Cy 1 to 8 (1 Cy=3 weeks); for rituximab SC - D1 of Cy 1 and Cy 3 to 8, D0 of Cy 2
Percentage of Participants With B-Cell Depletion by Cycle for Maintenance Phase
Depletion is defined as a CD19 value <80 cells/mm^3.
Measured: Stage I and II (maintenance): D1 of Cy 9 to 20 (1 Cy=8 weeks) (up to data cutoff of 11 Jan 2016 [up to 6 years])
Stage I and II (Pooled): Percentage of Participants Positive for Human Anti-Chimeric Antibodies (HACAs) to Rituximab
Levels of HACA in serum were detected at Day 1 of each cycle up to Cycle 8 and at follow-up visit. Stage I and II: Baseline: pre-dose (72 hours prior) D1 of Cy1, Cy 3-20, D0 of Cy2 (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), post-baseline: every 12 weeks after last rituximab administration until 96 weeks (a median of 27 months; up to data cutoff of 11 Jan 2016 [up to 6 years])
Measured: Stage I and II: Baseline, post-baseline (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Participants Positive for Human Anti-Human Antibodies (HAHAs) to Rituximab
Levels of HAHA in serum were detected at Day 1 of each cycle up to Cycle 8 and at follow-up visit. Stage I and II: Baseline: pre-dose (72 hours prior) D1 of Cy1, Cy 3-20, D0 of Cy2 (1 Cy=3 weeks for Cy1-8 \& 8 weeks for Cy9-20), post-baseline: every 12 weeks after last rituximab administration until 96 weeks (a median of 27 months; up to data cutoff of 11 Jan 2016 [up to 6 years])
Measured: Stage I and II: Baseline, post-baseline (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Responses Showing Time Saved of Staff as Per Physician/Nurse Opinions With Each Administration of Rituximab SC as Compared to Rituximab IV at the End of Cy 8, 15 and 20
All investigator physicians and nurses involved in this study were asked to provide the staff time that could be saved with each administration of rituximab SC as compared with rituximab IV to participants in routine practice afetr Cy 8, 15, 20 and categorized as less than (<) 1 hr, at least 1 hr but <2 hrs, at least 2 hrs but <3 hrs, at least 3 hrs but <4 hrs, >/=4 hrs. Staff were asked not to consider the time needed for the first IV administration. Analysis was done in all participants to show a comparison on the time saved by staffs when administered via SC and IV.
Measured: After Cycle 8 of induction treatment (24 weeks) and during the maintenance part of the study after 12 months (i.e., Cycle 15), and after the end of the maintenance treatment, (i.e., Cycle 20) (1 Cycle=4 weeks for Cycle 8 and 8 weeks for Cycles 15 and 20)
Percentage of Responses Who Showed Rituximab SC Formulation Convenient as Compared to Rituximab IV Formulation as Assessed by Physician/Nurse Opinion
All investigator physicians and nurses involved in this study were asked to complete question i.e. "Which formulation of rituximab (SC or IV) do you think is more convenient?" based on their experience with the rituximab SC and IV formulations across all participants and presented as rituximab SC is much more convenient; rituximab SC is a little more convenient; both formulations are equally convenient; rituximab IV is a little more convenient; and rituximab IV is much more convenient.
Measured: After Cycle 8 of induction treatment (24 weeks) and during the maintenance part of the study after 12 months (i.e., Cycle 15), and after the end of the maintenance treatment, (i.e., Cycle 20) (1 Cycle=4 weeks for Cycle 8 and 8 weeks for Cycles 15 and 20)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Sep 2010 (estimated)
- Study start15 Feb 2011
- Primary completion12 Jun 2012
- Study completion31 Oct 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Non-Hodgkin's LymphomaStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 410 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01200758
- Sponsor's protocol ID
- BO22334
- Other IDs
- 2010-021377-36
- Status last verified
- Oct 2018
- First submitted
- 10 Sep 2010
- Last updated
- 27 Nov 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Davies A, Merli F, Mihaljevic B, Mercadal S, Siritanaratkul N, Solal-Celigny P, Boehnke A, Berge C, Genevray M, Zharkov A, Dixon M, Brewster M, Barrett M, MacDonald D. Efficacy and safety of subcutaneous rituximab versus intravenous rituximab for first-line treatment of follicular lymphoma (SABRINA): a randomised, open-label, phase 3 trial. Lancet Haematol. 2017 Jun;4(6):e272-e282. doi: 10.1016/S2352-3026(17)30078-9. Epub 2017 May 2.
PubMed 28476440Davies A, Merli F, Mihaljevic B, Siritanaratkul N, Solal-Celigny P, Barrett M, Berge C, Bittner B, Boehnke A, McIntyre C, Macdonald D. Pharmacokinetics and safety of subcutaneous rituximab in follicular lymphoma (SABRINA): stage 1 analysis of a randomised phase 3 study. Lancet Oncol. 2014 Mar;15(3):343-52. doi: 10.1016/S1470-2045(14)70005-1. Epub 2014 Feb 10.
PubMed 24521993Mao CP, Brovarney MR, Dabbagh K, Birnbock HF, Richter WF, Del Nagro CJ. Subcutaneous versus intravenous administration of rituximab: pharmacokinetics, CD20 target coverage and B-cell depletion in cynomolgus monkeys. PLoS One. 2013 Nov 12;8(11):e80533. doi: 10.1371/journal.pone.0080533. eCollection 2013.
PubMed 24265828Shpilberg O, Jackisch C. Subcutaneous administration of rituximab (MabThera) and trastuzumab (Herceptin) using hyaluronidase. Br J Cancer. 2013 Sep 17;109(6):1556-61. doi: 10.1038/bjc.2013.371. Epub 2013 Sep 3.
PubMed 24002601
Study at a glance
From the registry record, last updated by the sponsor on 27 Nov 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Two-Stage Phase III, International, Multi-Center, Randomized, Controlled, Open-Label Study to Investigate the Pharmacokinetics, Efficacy and Safety of Rituximab SC in Combination With CHOP or CVP Versus Rituximab IV in Combination With CHOP or CVP in Patients With Previously Untreated Follicular Lymphoma Followed by Maintenance Treatment With Either Rituximab SC or Rituximab IV
- ClinicalTrials.gov ID
- NCT01200758
- Acronym / sponsor ID
- BO22334
- Conditions
- Non-Hodgkin's Lymphoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 410 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- 15 Feb 2011 (actual)
- Primary completion
- 12 Jun 2012 (actual)
- Study completion
- 31 Oct 2017 (actual)
- First posted
- 14 Sep 2010 (estimated)
- Results
- Posted 5 Aug 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This two-stage, multi-center, randomized, controlled, open-label study will investigate the pharmacokinetics, efficacy and safety of rituximab SC versus rituximab IV in participants with previously untreated follicular non-Hodgkin's lymphoma. Participants will be randomized to receive 375 milligrams per meter square (mg/m^2) rituximab as IV infusion or 1400 milligrams (mg) rituximab SC. In addition, participants will receive standard chemotherapy. Participants who achieved a complete or partial response (PR) after 8 treatment cycles, will receive maintenance treatment for a further maximum number of 12 cycles. Maintenance treatment cycles will be repeated every 8 weeks. This is a two-stage study. Stage 1 was designed to confirm the chosen rituximab SC dose resulting in comparable rituximab serum Ctrough levels compared with rituximab IV, when given as part of induction treatment every 3 weeks. Enrollment for Stage 2 started after the rituximab SC dose was established in Stage 1. Stage 2 aimed to further investigate the efficacy and safety of rituximab SC compared with rituximab IV. The anticipated time on study treatment is 96 weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP) | Active comparator | Drug: Rituximab IV, Drug: Cyclophosphamide, Drug: Doxorubicin, Drug: Vincristine, Drug: Prednisone/PrednisoloneEight cycles of rituximab IV infusion (375 mg/m^2; rituximab induction) in combination with up to 8 cycles of cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) or cyclophosphamide, vincristine, prednisolone (CVP) chemotherapy (as per institutional practice) administered every 3 weeks. Participants achieving at least PR during induction, entered rituximab IV maintenance therapy (375 mg/m^2) once every 8 weeks for 24 months. |
| Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) | Experimental | Drug: Rituximab SC, Drug: Cyclophosphamide, Drug: Doxorubicin, Drug: Vincristine, Drug: Prednisone/PrednisoloneFirst cycle of rituximab IV infusion (375 mg/m^2) + 7 cycles of rituximab SC (1400 mg; rituximab induction) in combination with up to 8 cycles of CHOP or CVP chemotherapy (as per institutional practice) administered every 3 weeks. Participants achieving at least PR entered rituximab SC (1400 mg) maintenance therapy once every 8 weeks for 24 months. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Cluster of differentiation 20 (CD20)-positive, follicular Non-Hodgkin's lymphoma grade 1, 2, 3a. A tumor biopsy must have been performed within 6 months before study entry with material available for central review
- No prior treatment
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Key exclusion criteria (6 listed)
- Grade 3b follicular lymphoma
- Transformation to high-grade lymphoma secondary to follicular lymphoma
- Types of Non-Hodgkin's lymphoma other than follicular lymphoma
- Presence or history of central nervous system (CNS) disease
- Corticoid therapy during the last 4 weeks, except prednisone treatment less than (<) 20 milligrams per day (mg per day)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Rituximab SCAlso: MabTheraFirst cycle of rituximab IV infusion (375 mg/m^2) + 7 cycles of rituximab SC (1400 mg; rituximab induction) in administered every 3 weeks. Participants achieving at least PR entered rituximab SC (1400 mg) maintenance therapy once every 8 weeks for 24 months. | Drug | Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) |
| Rituximab IVAlso: MabTheraEight cycles of rituximab IV infusion (375 mg/m^2; rituximab induction) administered every 3 weeks. Participants achieving at least PR during induction, entered rituximab IV maintenance therapy (375 mg/m^2) once every 8 weeks for 24 months. | Drug | Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP) |
| CyclophosphamideEight cycles of cyclophosphamide (750 mg/m^2 IV) administered every 3 weeks. | Drug | Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP), Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) |
| DoxorubicinEight cycles of doxorubicin (50 mg/m^2 IV) administered every 3 weeks. | Drug | Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP), Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) |
| VincristineEight cycles of doxorubicin (1.4 mg/m^2 IV) administered every 3 weeks. | Drug | Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP), Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) |
| Prednisone/PrednisoloneEight cycles of prednisone/prednisolone (100 mg/day or 40 mg/m^2/day IV/orally) administered Days 1 to 5 of every 21 days cycle. | Drug | Stage I and II: Rituximab IV + Chemotherapy (CHOP/CVP), Stage I and II: Rituximab SC + Chemotherapy (CHOP/CVP) |
Primary outcome
Stage I: Trough Serum Concentrations (Ctrough) of IV and SC Rituximab
Time frame: Stage I: Cycle (Cy) 7 Day (D) 21 (within 2 hours predose on Cy8) of induction treatment (1 Cy=3 weeks)
Stage II: Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for Non-Hodgkin Lymphoma (NHL)
Time frame: Stage II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Overall Response comprised complete response (CR), CR unconfirmed (CRu), or PR. A participant was defined as a responder if they sustained a CR, CRu or PR at the end of induction treatment. Response assessment was based on clinical examination and computed tomography (CT) scans. Assessment of tumor response was performed according to the International Working Group response criteria for NHL. CR: complete disappearance of all detectable clinical and radiographic evidence of disease and disappearance of all disease-related symptoms if present before therapy; CRu: CR along with regression in lymph node mass by more than (>) 75% in the sum of the products of greatest diameters (SPD); PR: Greater than or equal to (≥) 50% decrease in SPD of 6 largest dominant nodes or nodal masses. The 95% CI was estimated for one sample binomial using Pearson-Clopper.
24 secondary outcomes
Stage I: Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Overall Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I and II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I: Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage II: Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Complete Response at the End of Induction Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I and II: Baseline up to end of induction treatment Cy8 (24 weeks) (1 Cy=3 weeks)
Stage I and II (Pooled): Percentage of Participants With Complete Response at the End of Maintenance Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I and II: Baseline up to 57 days after last maintenance dose (last maintenance dose: maintenance Cy12/Study Cy20 [30 months]) (up to data cutoff of 31 Oct 2017 [up to 6 years]) (1 Cy=8 weeks)
Stage I and II (Pooled): Percentage of Participants With Overall Response at the End of Maintenance Treatment Assessed Using International Working Group Response Criteria for NHL
Time frame: Stage I and II: Baseline up to 57 days after last maintenance dose (last maintenance dose: maintenance Cy12/Study Cy20 [30 months]) (up to data cutoff of 31 Oct 2017 [up to 6 years]) (1 Cy=8 weeks)
Stage I and II (Pooled): Percentage of Participants With Disease Progression/Relapse or Death
Time frame: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Progression-Free Survival (PFS) Assessed Using International Working Group Response Criteria for NHL
Time frame: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Participants With Disease Progression/Relapse, New Anti-Lymphoma Treatment or Death Assessed Using International Working Group Response Criteria for NHL
Time frame: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Event-Free Survival Assessed Using International Working Group Response Criteria for NHL
Time frame: Baseline up to disease progression or death up to data cutoff of 31 Oct 2017 (up to 6 years) (See detailed timeframe in Outcome Measure description)
Percentage of Participants Who Died
Time frame: Baseline up to death (up to data cutoff of 31 Oct 2017 [up to 6 years])
Overall Survival (OS)
Time frame: Baseline up to death (up to data cutoff of 31 Oct 2017 [up to 6 years])
Stage I: Observed Area Under the Serum Concentration-Time Curve (AUC) of Rituximab
Time frame: Stage I (Induction): Predose (within 2 hour [hr]) up to data cutoff of 11 Apr 2012 [up to 26 months]) (See detailed timeframe in Outcome Measure description)
Stage I: Maximum Serum Concentrations (Cmax) of IV and SC Rituximab
Time frame: Stage I (Induction): Predose (within 2hr) up to data cutoff of 11 Apr 2012 [up to 26 months]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Ctrough of Rituximab at Each Induction Treatment Cycle
Time frame: Stage I and II (Pooled): Predose (within 2hr) up to data cutoff of 31 Oct 2013 [up to 32 months]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Ctrough of Rituximab at Each Maintenance Treatment Cycle
Time frame: Stage I and II (maintenance): Predose (within 2hr) up to data cutoff of 11 Jan 2016 [up to 6 years]) (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Rituximab Levels 12 Weeks, 24 Weeks, and 36 Weeks After the Last Rituximab Administration
Time frame: 12 weeks, 24 weeks, and 36 weeks after the last rituximab administration (up to data cutoff of 11 Jan 2016 [up to 6 years])
Percentage of Participants With B-Cell Depletion by Cycle for Induction Phase
Time frame: Stage I and II (induction): for rituximab IV - D1 of Cy 1 to 8 (1 Cy=3 weeks); for rituximab SC - D1 of Cy 1 and Cy 3 to 8, D0 of Cy 2
Percentage of Participants With B-Cell Depletion by Cycle for Maintenance Phase
Time frame: Stage I and II (maintenance): D1 of Cy 9 to 20 (1 Cy=8 weeks) (up to data cutoff of 11 Jan 2016 [up to 6 years])
Stage I and II (Pooled): Percentage of Participants Positive for Human Anti-Chimeric Antibodies (HACAs) to Rituximab
Time frame: Stage I and II: Baseline, post-baseline (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Participants Positive for Human Anti-Human Antibodies (HAHAs) to Rituximab
Time frame: Stage I and II: Baseline, post-baseline (See detailed timeframe in Outcome Measure description)
Stage I and II (Pooled): Percentage of Responses Showing Time Saved of Staff as Per Physician/Nurse Opinions With Each Administration of Rituximab SC as Compared to Rituximab IV at the End of Cy 8, 15 and 20
Time frame: After Cycle 8 of induction treatment (24 weeks) and during the maintenance part of the study after 12 months (i.e., Cycle 15), and after the end of the maintenance treatment, (i.e., Cycle 20) (1 Cycle=4 weeks for Cycle 8 and 8 weeks for Cycles 15 and 20)
Percentage of Responses Who Showed Rituximab SC Formulation Convenient as Compared to Rituximab IV Formulation as Assessed by Physician/Nurse Opinion
Time frame: After Cycle 8 of induction treatment (24 weeks) and during the maintenance part of the study after 12 months (i.e., Cycle 15), and after the end of the maintenance treatment, (i.e., Cycle 20) (1 Cycle=4 weeks for Cycle 8 and 8 weeks for Cycles 15 and 20)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Nov 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 28476440Davies A, Merli F, Mihaljevic B, Mercadal S, Siritanaratkul N, Solal-Celigny P, Boehnke A, Berge C, Genevray M, Zharkov A, Dixon M, Brewster M, Barrett M, MacDonald D. Efficacy and safety of subcutaneous rituximab versus intravenous rituximab for first-line treatment of follicular lymphoma (SABRINA): a randomised, open-label, phase 3 trial. Lancet Haematol. 2017 Jun;4(6):e272-e282. doi: 10.1016/S2352-3026(17)30078-9. Epub 2017 May 2.
- Derived from this study: PubMed 24521993Davies A, Merli F, Mihaljevic B, Siritanaratkul N, Solal-Celigny P, Barrett M, Berge C, Bittner B, Boehnke A, McIntyre C, Macdonald D. Pharmacokinetics and safety of subcutaneous rituximab in follicular lymphoma (SABRINA): stage 1 analysis of a randomised phase 3 study. Lancet Oncol. 2014 Mar;15(3):343-52. doi: 10.1016/S1470-2045(14)70005-1. Epub 2014 Feb 10.
- Derived from this study: PubMed 24265828Mao CP, Brovarney MR, Dabbagh K, Birnbock HF, Richter WF, Del Nagro CJ. Subcutaneous versus intravenous administration of rituximab: pharmacokinetics, CD20 target coverage and B-cell depletion in cynomolgus monkeys. PLoS One. 2013 Nov 12;8(11):e80533. doi: 10.1371/journal.pone.0080533. eCollection 2013.
- Derived from this study: PubMed 24002601Shpilberg O, Jackisch C. Subcutaneous administration of rituximab (MabThera) and trastuzumab (Herceptin) using hyaluronidase. Br J Cancer. 2013 Sep 17;109(6):1556-61. doi: 10.1038/bjc.2013.371. Epub 2013 Sep 3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Trials study director
Hoffmann-La Roche
152 sites in 30 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Rituximab SC, Rituximab IV and Cyclophosphamide in people with Non-Hodgkin's Lymphoma, run by Hoffmann-La Roche at 152 sites in 30 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Nov 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 152 sites in Germany, France, Spain, Italy, Russia and 25 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 5 Aug 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Stage I: Trough Serum Concentrations (Ctrough) of IV and SC Rituximab (time frame: Stage I: Cycle (Cy) 7 Day (D) 21 (within 2 hours predose on Cy8) of induction treatment (1 Cy=3 weeks)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01200758, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Nov 2018.