LymphomaPhase 1/2FUSION NHL 001NCT02733042
A Study to Determine Dose, Safety, and Efficacy of Durvalumab as Monotherapy and in Combination Therapy in Subjects With Lymphoma or Chronic Lymphocytic Leukemia
A Phase 1/2 study testing Durvalumab, Lenalidomide and Rituximab in people with Lymphoma and Leukemia, Lymphocytic, Chronic, B-Cell, run by Celgene at 66 sites in 7 countries.
Trial summary
This study is designed to determine the recommended phase 2 dose (RP2D), and the safety, and efficacy of durvalumab as monotherapy and when given in combination with lenalidomide and rituximab; ibrutinib; or bendamustine and rituximab at the RP2D in adults with lymphoma or chronic lymphocytic leukemia (CLL). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Lymphoma, Leukemia, Lymphocytic, Chronic, B-Cell
- What is being tested?
- Durvalumab, Lenalidomide and Rituximab
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 106 participants
- Where
- 66 sitesin 7 countries
- Study dates
- 11 May 2016to 21 Aug 2022
- Phase
- Phase 1/2
- 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
- Subject who has histologically confirmed and documented B-cell lymphoma (eg, follicular, diffuse large B-cell, mantle cell, small lymphocytic, or Hodgkin lymphoma) and chronic lymphocytic leukemia.
- Subject who has high-risk chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL).
- Subject who was previously treated with at least one prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy.
- Subject who has the Eastern Cooperative Oncology Group performance status of 0, 1, or 2.
- Subject who is willing and able to undergo biopsy.
- Subject who has documented active relapsed or refractory disease requiring therapeutic intervention.
- Subject with lymphoma who has measurable disease (≥ 2.0 cm in its longest dimension by computed tomography) or chronic lymphocytic leukemia in need of treatment.
- Subject who fulfills the laboratory requirements as per protocol
Who cannot join
- Subject who has central nervous system (CNS) or meningeal involvement by lymphoma.
- Subject who has any histopathologic finding consistent with myelodysplastic syndrome on bone marrow studies.
- Subject who received any prior monoclonal antibodies against programmed cell death-1 (PD-1) or programmed cell death ligand-1 (PD-L1) and/or any prior:
- Arm A only: drugs with immunomodulatory and other properties (eg, lenalidomide, thalidomide);
- Arm B only: ibrutinib or other Bruton's tyrosine kinase (BTK) inhibitor;
- Arms C only: bendamustine
Show all 12Show fewer
- Subject who has active auto-immune disease.
- Subject who has history of organ transplant or allogeneic hematopoietic stem cell transplantation.
- Subject who is seropositive for or active viral infection with hepatitis B virus (HBV) (hepatitis B surface antigen [HBsAg] positive and/or detectable viral DNA)
- Subject who has known seropositivity for or active infection for human immunodeficiency virus (HIV) or hepatitis C virus (HCV).
- Subject who has history of primary immunodeficiency or tuberculosis.
- Subject who other invasive malignancy within 2 years (5 years for Arm A) except for noninvasive malignancies such as cervical carcinoma in situ, non-melanomatous carcinoma of the skin, ductal carcinoma in situ of the breast, or incidental histologic finding of prostate cancer (T1a or T1b using the TNM [tumor, nodes, metastasis] clinical staging system) that has/have been surgically cured.
Trial locations and contacts
66 sites in 7 countries.
66 sites in 7 countries
United States19 sites
Emory University
Atlanta, Georgia, 30322
University of Colorado Cancer Center
Aurora, Colorado, 80045
Northwestern University Feinberg School of Medicine
Chicago, Illinois, 60611
The Ohio State University
Columbus, Ohio, 43210
Shands Cancer Center University of Florida
Gainesville, Florida, 32610
Banner MD Anderson Cancer Center
Gilbert, Arizona, 85234
John Theurer Cancer Center at Hackensack University Medical Center
Hackensack, New Jersey, 07601
MD Anderson Cancer Center
Houston, Texas, 77030-4009
Houston Methodist Cancer Center
Houston, Texas, 77030
MD Anderson Cancer Center
Houston, Texas, 77030
Weill Cornell Medical College
New York, New York, 10065
University of Oklahoma Peggy and Charles Stephenson Cancer Center
Oklahoma City, Oklahoma, 73104
Jefferson Medical Oncology Associates
Philadelphia, Pennsylvania, 19107
Mayo Clinic
Rochester, Minnesota, 55905
Local Institution - 005
Rochester, New York, 14642
University of Rochester
Rochester, New York, 14642
Pinnacle Oncology Hematology
Scottsdale, Arizona, 85258
Washington University School of Medicine
St Louis, Missouri, 63110
Moffitt Cancer Center
Tampa, Florida, 33612
France13 sites
Centre Hospitalier Universitaire d'Avicennes
Bobigny, 93009
Hopital Henri Mondor
Créteil, 94010
Centre Hospitalier
Dijon, 21079
Institut Paoli Calmettes
Marseille, 13273
CHU Montpellier
Montpellier, 34295
Local Institution - 102
Montpellier, 34295
Centre Hospitalier Universitaire de Nantes
Nantes, 44093
Local Institution - 105
Nantes, 44093
Hopital Haut Leveque
Pessac, 33604
Centre Hospitalier Lyon-Sud
Pierre-Bénite, 69495
Local Institution - 103
Pierre-Bénite, 69495
CHRU Rennes
Rennes, 35033
Centre Henri Becquerel
Rouen, 76038
United Kingdom11 sites
St James University Hospital
Leeds, LS9 7TF
UCL Cancer Institute
London, WC1E 6BT
Christie Hospital NHS Trust
Manchester, M20 4BX
Local Institution - 404
Manchester, M20 4BX
Local Institution - 407
Nottingham, Nottinghamshire, NG5 1PB
Nottingham University Hospitals NHS Trust
Nottingham, Ng5 1PB
Local Institution - 406
Oxford, 0X3 7LE
Oxford University Hospitals NHS Trust- Churchill Hospital-Oxford Centre for Respiratory Medicine
Oxford, 0X3 7LE
Local Institution - 402
Plymouth, Devon, PL6 8DH
Derriford Hospital
Plymouth, PL6 8DH
Southampton University Hospitals NHS Trust
Southampton, SO16 6YD
Italy9 sites
University of Bologna
Bologna, 40138
Local Institution - 306
Brescia, 25123
Spedali Civili Di Brescia
Brescia, 25123
IEO- Istituto Europeo di Oncologia
Milan, 20144
A.O. Ospedale Ca Granda - Niguarda
Milan, 20162
Istituto Nazionale Per Lo Studio E La Cura Dei Tumori Fondazione Giovanni Pascale
Napoli, Campania, 80131
Local Institution - 304
Napoli, Campania, 80131
I.R.C.C.S. Policlinico San Matteo
Pavia, 27100
IRCCS Humanitas Clinical Institute
Rozzano (milano), 20089
Germany5 sites
Universitatsklinikum Essen
Essen, 45122
UKG Universitatsklinikum Gottingen
Göttingen, 37099
Universitatsklinikum des Saarlandes
Homburg-Saar, 66421
Universitatsklinik Koln
Köln, 50924
Medizinische Klinik III Klinikum der Universität München-Großhadern
München, 81377
Netherlands5 sites
VU Academic Medical Center, Amsterdam
Amsterdam, 1081 HV
UMC Groningen
Groningen, 9713 GZ
Leids Universitair Medisch Centrum
Leiden, 2333 ZA
Erasmus Medical Center
Rotterdam, 3015 CN
Local Institution - 501
Rotterdam, 3015 CN
Japan4 sites
Local Institution - 602
Chuo-ku, Tokyo, 104-0045
National Cancer Center Hospital
Chūōku, 104-0045
Tokai University Hospital
Isehara City, Kanagawa, 259-1193
Aichi Cancer Center
Nagoya, 464-8681
About this study
Official title: A Phase 1/2, Open-label, Multi-center Study to Assess the Safety and Tolerability of Durvalumab (Anti-PDL1 Antibody) as Monotherapy and in Combination Therapy in Subjects With Lymphoma or Chronic Lymphocitic Leukemia
This study is designed to determine the recommended phase 2 dose (RP2D), and the safety, and efficacy of durvalumab as monotherapy and when given in combination with lenalidomide and rituximab; ibrutinib; or bendamustine and rituximab at the RP2D in adults with lymphoma or chronic lymphocytic leukemia (CLL).
Read the detailed description
The study was to consist of 3 parts: dose-finding, dose-confirmation, and dose-expansion. In this study, 4 treatment arms were to be investigated:
- Arm A: durvalumab and lenalidomide ± rituximab
- Arm B: durvalumab and ibrutinib
- Arm C: durvalumab and rituximab ± bendamustine
- Arm D: durvalumab (monotherapy)
The study was to start with 3 dose-finding cohorts (Arms A, B, and C) and 1 dose-confirmation cohort (Arm D) in parallel. All treatment arms were to be open for enrollment at study start except in the US, where Arm D was to enroll depending on the availability of treatment slots and following the completion of assessment of responses from the combination therapy arms. For Arms A and C, prior to enrolling participants to receive all 3 drugs, the doublet combinations were to be evaluated. Once the doublet combinations were deemed tolerable, the eventual triplet combinations were to be tested.
On 05 September 2017, the US FDA issued a Partial Clinical Hold on the study Arm A. Following this Partial Clinical Hold no more participants were enrolled into study Arm A. Participants already enrolled and treated in Arm A who were receiving clinical benefit, based on the discretion of the investigator, could continue study treatment after being reconsented. Arm B and C completed dose confirmation. The dose expansion part of the study was not opened.
- Conditions
- Lymphoma, Leukemia, Lymphocytic, Chronic, B-Cell
- Being tested
- Durvalumab, Lenalidomide, Rituximab, Ibrutinib, Bendamustine
- Keywords
- Lymphoma, Chronic Lymphocytic Leukemia, Durvalumab, Anti-PD-L1 Antibody, MEDI4736, Immune Checkpoint, Lymphatic Disease, B-Cell Malignancies, Abscopal Effect, Lenalidomide, Bendamustine, Rituximab, Ibrutinib, Lymphoma, B-Cell, Lymphoma, Non Hodgkin,, Hodgkin Disease, Leukemia, Lymphocytic, Chronic, B-Cell,, Lymphoma, Follicular, Lymphoma, Diffuse Large B-Cell, Lymphoma, Mantle Cell
- Medical subject headings
- Lymphoma, Leukemia, Lymphocytic, Chronic, B-Cell, Lymphatic Diseases, Lymphoma, B-Cell, Lymphoma, Non-Hodgkin, Hodgkin Disease, Lymphoma, Follicular, Lymphoma, Large B-Cell, Diffuse
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DurvalumabDrug
Also called MEDI4736, IMFINZI®
Administered as an IV infusion (250 mL) over approximately 1 hour in duration
LenalidomideDrug
Also called Revlimid®
Administered orally
RituximabDrug
Also called Rituxan®, MabThera®
Administered by intravenous infusion
IbrutinibDrug
Also called Imbruvica®
Administered orally
BendamustineDrug
Also called Treanda®, Bendeka®, Levact®
Administered as a 30-minute intravenous infusion
| Study group | Role | What they receive |
|---|---|---|
| Arm A: Durvalumab + Lenalidomide ± Rituximab | Experimental | Participants assigned to Arm A will receive:
* Durvalumab 1500 mg intravenous (IV) infusion on Day 1 of Cycles 1 through 13 (ie, 12 months) and
* Lenalidomide orally at assigned dose levels (10 mg, 15 mg or 20 mg) once daily on Days 1 to 21 of:
* Cycles 1 through 13 in indolent non-Hodgkin's lymphoma (NHL) or
* All cycles of treatment period until disease progression, unacceptable toxicity, or discontinuation for any other reason in aggressive NHL
* Rituximab 375 mg/m² IV infusion every week in Cycle 1 (Days 2, 8, 15, 22) and on Day 1 of Cycles 2 through 5.
All treatment cycles were 28 days. Receives: Drug: Durvalumab; Drug: Lenalidomide; Drug: Rituximab |
| Arm B: Durvalumab + Ibrutinib | Experimental | Participants assigned to Arm B will receive:
* Durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13
* Ibrutinib orally at assigned dose levels (280 mg, 420 mg, or 560 mg) once daily until disease progression, unacceptable toxicity or discontinuation for any other reason.
All treatment cycles were 28 days. Receives: Drug: Durvalumab; Drug: Ibrutinib |
| Arm C: Durvalumab + Rituximab ± Bendamustine | Experimental | Participants assigned to Arm C will receive:
* Durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13
* Rituximab 375 mg/m² IV infusion on Day 2 of Cycles 1 through 6 (for CLL the rituximab dose will be 375 mg/m² Cycle 1 first dose and 500 mg/m² for each subsequent dose)
* Bendamustine IV infusion at assigned dose levels (70 mg/m² or 90 mg/m²) on Days 1 and 2 of Cycles 1 through 6.
All treatment cycles were 28 days. Receives: Drug: Durvalumab; Drug: Rituximab; Drug: Bendamustine |
| Arm D: Durvalumab Monotherapy | Experimental | Participants assigned to Arm D will receive durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13. All treatment cycles were 28 days. Receives: Drug: Durvalumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Part 1: Number of Participants With Dose Limiting Toxicities (DLTs)
Dose limiting toxicities were evaluated during the DLT evaluation period for participants in the dose finding cohorts. The severity grading was determined according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.03. A DLT is defined as below: Hematologic DLT • Grade 4 neutropenia observed for greater than 5 days duration • Grade 3 neutropenia associated with fever (≥ 38.5 °C) of any duration • Grade 4 thrombocytopenia or Grade 3 thrombocytopenia with bleeding, or any requirement for platelets transfusion • Grade 4 anemia, unexplained by underlying disease • Any other grade 4 hematologic toxicity that does not resolve to participant's pretreatment baseline level within 72 hours. Non-Hematologic DLT • Any non-hematological toxicity ≥ Grade 3 except for alopecia and nausea controlled by medical management • Any treatment interruption greater than 2 weeks due to adverse event.
Measured: Cycle 1 (28 days)
Number of Participants With Treatment-emergent Adverse Events
Treatment-emergent adverse events (TEAEs) are defined as adverse events (AEs) occurring or worsening on or after the first dose of any study treatment (durvalumab, lenalidomide, ibrutinib, bendamustine or rituximab) and within 90 days after last dose of durvalumab or 28 days after the last dose of other study drugs, whichever was later, as well as those serious adverse events made known to the investigator at any time thereafter that were suspected of being related to study treatment. The intensity of AEs was graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03. For all other AEs not described in the CTCAE criteria, the intensity was assessed by the investigator as mild (Grade 1), moderate (Grade 2), severe (Grade 3), life-threatening (Grade 4), or death (Grade 5).
Measured: From first dose of any study drug to 90 days after last dose of durvalumab or 28 days after last dose of other study drugs, up to the data cut-off date of 6 March 2019. Maximum time on treatment was 55.4 weeks for DUR and 130 weeks for other study drugs.
Secondary outcomes (19)
Overall Response Rate (ORR) During Durvalumab Treatment
For lymphoma participants, response evaluation was based on International Working Group (IWG) response criteria for malignant lymphoma (the Lugano Classification). Overall response rate is defined as the percent of participants with best response of complete response (CR) or partial response (PR). For chronic lymphocytic leukemia participants, response evaluation was based on International Workshop on Chronic Lymphocytic Leukemia (IWCLL) guidelines for diagnosis and treatment of CLL. The ORR is defined as the percent of participants with best response of CR, complete response with incomplete marrow recovery (CRi), nodular partial response (nPR), PR, or partial response with lymphocytosis (PRL).
Measured: Up to 13 cycles (12 months)
Overall Response Rate During the Entire Study
For lymphoma participants, response evaluation was based on International Working Group (IWG) response criteria for malignant lymphoma (the Lugano Classification) (Cheson, 2014). Overall response rate is defined as the percent of participants with best response of complete response (CR) or partial response (PR). For chronic lymphocytic leukemia participants, response evaluation was based on International Workshop on Chronic Lymphocytic Leukemia (IWCLL) guidelines for diagnosis and treatment of CLL. The ORR is defined as the percentage of participants with best response of CR, complete response with incomplete marrow recovery (CRi), nodular partial response (nPR), PR, or partial response with lymphocytosis (PRL).
Measured: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Time to First Response
Time to response was calculated as the time from first dose of study drug to the first response date (CR or PR for lymphoma participants and CR, CRi, nPR, PR, or PRL for CLL participants).
Measured: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Kaplan-Meier Estimate of Duration of Response
Duration of response is defined for responders only as the time from the first documented response (CR or PR for lymphoma participants or CR, CRi, nPR, PR, or PRL for CLL participants) to disease progression or death (from any cause). For participants with response but no progression, or death, duration of response was censored at the last date that the participant was known to be progression-free.
Measured: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Kaplan-Meier Estimate of Progression-free Survival (PFS)
Progression-free survival was calculated as the time from first dose of study drug to the first documented progression or death (from any cause) during the entire efficacy evaluation period. For participants with no progression or death, PFS was censored at the last assessment date the participant was known to be progression-free.
Measured: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Maximum Observed Plasma Concentration (Cmax) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Time to Maximum Plasma Concentration (Tmax) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUCinf) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Terminal Elimination Phase Half-Life (t½) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Clearance (CL) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Volume of Distribution (Vz) of Durvalumab
Measured: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Maximum Observed Plasma Concentration (Cmax) of Lenalidomide
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Time to Maximum Observed Plasma Concentration (Tmax) of Lenalidomide
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Lenalidomide
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose
Maximum Observed Plasma Concentration (Cmax) of Ibrutinib
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Time to Maximum Observed Plasma Concentration (Tmax) of Ibrutinib
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Ibrutinib
Measured: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose
Change From Baseline in Soluble Programmed Cell Death Ligand-1 (sPD-L1) Concentration
Change from baseline in sPD-L1 could not be calculated as all post-baseline samples were below the lower limit of quantification (<15.60 pg/mL).
Measured: Baseline (Cycle 1 Day 1 predose) and Day 1 of Cycles 2 to 13
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Apr 2016 (estimated)
- Study start11 May 2016
- Primary completion6 Mar 2019
- Study completion21 Aug 2022
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 (1)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- More trials run by CelgeneThe 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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Model description
- Within Arms A, B, and C participants on the dose-finding part were enrolled sequentially according to a 3+3 design. All treatment arms were to be open for enrollment at study start except in the US, where Arm D was to enroll depending on the availability of treatment slots and following the completion of assessment of responses from the combination therapy arms.
- Masking
- None (open label)
- Enrolment
- 106 participants (actual)
Sponsor and investigators
- Lead sponsor
- Celgene
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Bristol-Myers Squibb, Study director, Bristol-Myers Squibb
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02733042
- Sponsor's protocol ID
- MEDI4736-NHL-001
- Other IDs
- 2015-003516-21, 2015
- Acronym
- FUSION NHL 001
- Status last verified
- Oct 2023
- First submitted
- 5 Apr 2016
- Last updated
- 18 Nov 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Casulo C, Santoro A, Cartron G, Ando K, Munoz J, Le Gouill S, Izutsu K, Rule S, Lugtenburg P, Ruan J, Arcaini L, Casadebaig ML, Fox B, Kilavuz N, Rettby N, Dell'Aringa J, Taningco L, Delarue R, Czuczman M, Witzig T. Durvalumab as monotherapy and in combination therapy in patients with lymphoma or chronic lymphocytic leukemia: The FUSION NHL 001 trial. Cancer Rep (Hoboken). 2023 Jan;6(1):e1662. doi: 10.1002/cnr2.1662. Epub 2022 Jul 19.
PubMed 35852004
Study at a glance
From the registry record, last updated by the sponsor on 18 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1/2, Open-label, Multi-center Study to Assess the Safety and Tolerability of Durvalumab (Anti-PDL1 Antibody) as Monotherapy and in Combination Therapy in Subjects With Lymphoma or Chronic Lymphocitic Leukemia
- ClinicalTrials.gov ID
- NCT02733042
- Acronym / sponsor ID
- FUSION NHL 001 / MEDI4736-NHL-001
- Conditions
- Lymphoma, Leukemia, Lymphocytic, Chronic, B-Cell
- Keywords
- Lymphoma, Chronic Lymphocytic Leukemia, Durvalumab, Anti-PD-L1 Antibody, MEDI4736, Immune Checkpoint, Lymphatic Disease, B-Cell Malignancies
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 106 participants (actual)
- Lead sponsor
- CelgeneIndustry (pharma, biotech, devices)
- Study start
- 11 May 2016 (actual)
- Primary completion
- 6 Mar 2019 (actual)
- Study completion
- 21 Aug 2022 (actual)
- First posted
- 11 Apr 2016 (estimated)
- Results
- Posted 18 Mar 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is designed to determine the recommended phase 2 dose (RP2D), and the safety, and efficacy of durvalumab as monotherapy and when given in combination with lenalidomide and rituximab; ibrutinib; or bendamustine and rituximab at the RP2D in adults with lymphoma or chronic lymphocytic leukemia (CLL).
Detailed description
The study was to consist of 3 parts: dose-finding, dose-confirmation, and dose-expansion. In this study, 4 treatment arms were to be investigated:
- Arm A: durvalumab and lenalidomide ± rituximab
- Arm B: durvalumab and ibrutinib
- Arm C: durvalumab and rituximab ± bendamustine
- Arm D: durvalumab (monotherapy)
The study was to start with 3 dose-finding cohorts (Arms A, B, and C) and 1 dose-confirmation cohort (Arm D) in parallel. All treatment arms were to be open for enrollment at study start except in the US, where Arm D was to enroll depending on the availability of treatment slots and following the completion of assessment of responses from the combination therapy arms. For Arms A and C, prior to enrolling participants to receive all 3 drugs, the doublet combinations were to be evaluated. Once the doublet combinations were deemed tolerable, the eventual triplet combinations were to be tested.
On 05 September 2017, the US FDA issued a Partial Clinical Hold on the study Arm A. Following this Partial Clinical Hold no more participants were enrolled into study Arm A. Participants already enrolled and treated in Arm A who were receiving clinical benefit, based on the discretion of the investigator, could continue study treatment after being reconsented. Arm B and C completed dose confirmation. The dose expansion part of the study was not opened.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 4
- Model description
- Within Arms A, B, and C participants on the dose-finding part were enrolled sequentially according to a 3+3 design. All treatment arms were to be open for enrollment at study start except in the US, where Arm D was to enroll depending on the availability of treatment slots and following the completion of assessment of responses from the combination therapy arms.
| Arm | Type | Receives |
|---|---|---|
| Arm A: Durvalumab + Lenalidomide ± Rituximab | Experimental | Drug: Durvalumab, Drug: Lenalidomide, Drug: RituximabParticipants assigned to Arm A will receive: * Durvalumab 1500 mg intravenous (IV) infusion on Day 1 of Cycles 1 through 13 (ie, 12 months) and * Lenalidomide orally at assigned dose levels (10 mg, 15 mg or 20 mg) once daily on Days 1 to 21 of: * Cycles 1 through 13 in indolent non-Hodgkin's lymphoma (NHL) or * All cycles of treatment period until disease progression, unacceptable toxicity, or discontinuation for any other reason in aggressive NHL * Rituximab 375 mg/m² IV infusion every week in Cycle 1 (Days 2, 8, 15, 22) and on Day 1 of Cycles 2 through 5. All treatment cycles were 28 days. |
| Arm B: Durvalumab + Ibrutinib | Experimental | Drug: Durvalumab, Drug: IbrutinibParticipants assigned to Arm B will receive: * Durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13 * Ibrutinib orally at assigned dose levels (280 mg, 420 mg, or 560 mg) once daily until disease progression, unacceptable toxicity or discontinuation for any other reason. All treatment cycles were 28 days. |
| Arm C: Durvalumab + Rituximab ± Bendamustine | Experimental | Drug: Durvalumab, Drug: Rituximab, Drug: BendamustineParticipants assigned to Arm C will receive: * Durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13 * Rituximab 375 mg/m² IV infusion on Day 2 of Cycles 1 through 6 (for CLL the rituximab dose will be 375 mg/m² Cycle 1 first dose and 500 mg/m² for each subsequent dose) * Bendamustine IV infusion at assigned dose levels (70 mg/m² or 90 mg/m²) on Days 1 and 2 of Cycles 1 through 6. All treatment cycles were 28 days. |
| Arm D: Durvalumab Monotherapy | Experimental | Drug: DurvalumabParticipants assigned to Arm D will receive durvalumab 1500 mg IV infusion on Day 1 of Cycles 1 through 13. All treatment cycles were 28 days. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Subject who has histologically confirmed and documented B-cell lymphoma (eg, follicular, diffuse large B-cell, mantle cell, small lymphocytic, or Hodgkin lymphoma) and chronic lymphocytic leukemia.
- Subject who has high-risk chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL).
- Subject who was previously treated with at least one prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy.
- Subject who has the Eastern Cooperative Oncology Group performance status of 0, 1, or 2.
- Subject who is willing and able to undergo biopsy.
Key exclusion criteria (12 listed)
- Subject who has central nervous system (CNS) or meningeal involvement by lymphoma.
- Subject who has any histopathologic finding consistent with myelodysplastic syndrome on bone marrow studies.
- Subject who received any prior monoclonal antibodies against programmed cell death-1 (PD-1) or programmed cell death ligand-1 (PD-L1) and/or any prior:
- Subject who has active auto-immune disease.
- Subject who has history of organ transplant or allogeneic hematopoietic stem cell transplantation.
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 |
|---|---|---|
| DurvalumabAlso: MEDI4736, IMFINZI®Administered as an IV infusion (250 mL) over approximately 1 hour in duration | Drug | Arm A: Durvalumab + Lenalidomide ± Rituximab, Arm B: Durvalumab + Ibrutinib, Arm C: Durvalumab + Rituximab ± Bendamustine, Arm D: Durvalumab Monotherapy |
| LenalidomideAlso: Revlimid®Administered orally | Drug | Arm A: Durvalumab + Lenalidomide ± Rituximab |
| RituximabAlso: Rituxan®, MabThera®Administered by intravenous infusion | Drug | Arm A: Durvalumab + Lenalidomide ± Rituximab, Arm C: Durvalumab + Rituximab ± Bendamustine |
| IbrutinibAlso: Imbruvica®Administered orally | Drug | Arm B: Durvalumab + Ibrutinib |
| BendamustineAlso: Treanda®, Bendeka®, Levact®Administered as a 30-minute intravenous infusion | Drug | Arm C: Durvalumab + Rituximab ± Bendamustine |
Primary outcome
Part 1: Number of Participants With Dose Limiting Toxicities (DLTs)
Time frame: Cycle 1 (28 days)
Dose limiting toxicities were evaluated during the DLT evaluation period for participants in the dose finding cohorts. The severity grading was determined according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.03. A DLT is defined as below: Hematologic DLT • Grade 4 neutropenia observed for greater than 5 days duration • Grade 3 neutropenia associated with fever (≥ 38.5 °C) of any duration • Grade 4 thrombocytopenia or Grade 3 thrombocytopenia with bleeding, or any requirement for platelets transfusion • Grade 4 anemia, unexplained by underlying disease • Any other grade 4 hematologic toxicity that does not resolve to participant's pretreatment baseline level within 72 hours. Non-Hematologic DLT • Any non-hematological toxicity ≥ Grade 3 except for alopecia and nausea controlled by medical management • Any treatment interruption greater than 2 weeks due to adverse event.
Number of Participants With Treatment-emergent Adverse Events
Time frame: From first dose of any study drug to 90 days after last dose of durvalumab or 28 days after last dose of other study drugs, up to the data cut-off date of 6 March 2019. Maximum time on treatment was 55.4 weeks for DUR and 130 weeks for other study drugs.
Treatment-emergent adverse events (TEAEs) are defined as adverse events (AEs) occurring or worsening on or after the first dose of any study treatment (durvalumab, lenalidomide, ibrutinib, bendamustine or rituximab) and within 90 days after last dose of durvalumab or 28 days after the last dose of other study drugs, whichever was later, as well as those serious adverse events made known to the investigator at any time thereafter that were suspected of being related to study treatment. The intensity of AEs was graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03. For all other AEs not described in the CTCAE criteria, the intensity was assessed by the investigator as mild (Grade 1), moderate (Grade 2), severe (Grade 3), life-threatening (Grade 4), or death (Grade 5).
19 secondary outcomes
Overall Response Rate (ORR) During Durvalumab Treatment
Time frame: Up to 13 cycles (12 months)
Overall Response Rate During the Entire Study
Time frame: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Time to First Response
Time frame: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Kaplan-Meier Estimate of Duration of Response
Time frame: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Kaplan-Meier Estimate of Progression-free Survival (PFS)
Time frame: From first dose of any study drug to the end of follow-up, up to the data cutoff date of March 6, 2019; median (minimum, maximum) time on study was 16.7 (0.9, 32.9) months.
Maximum Observed Plasma Concentration (Cmax) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Time to Maximum Plasma Concentration (Tmax) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUCinf) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Terminal Elimination Phase Half-Life (t½) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Clearance (CL) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Volume of Distribution (Vz) of Durvalumab
Time frame: Cycle 1, Day 1 (pre-dose and at end of infusion), and 4, 24, 48, 168 (Day 8), 336 (Day 15), and 508 (Day 22) hours after the end of infusion.
Maximum Observed Plasma Concentration (Cmax) of Lenalidomide
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Time to Maximum Observed Plasma Concentration (Tmax) of Lenalidomide
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Lenalidomide
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose
Maximum Observed Plasma Concentration (Cmax) of Ibrutinib
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Time to Maximum Observed Plasma Concentration (Tmax) of Ibrutinib
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose, and Cycle 1 Day 15 at pre-dose, 1, 2, and 4 hours post-dose.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUClast) of Ibrutinib
Time frame: Cycle 1 Day 1 at predose and 1, 2, 4, and 24 hours post-dose
Change From Baseline in Soluble Programmed Cell Death Ligand-1 (sPD-L1) Concentration
Time frame: Baseline (Cycle 1 Day 1 predose) and Day 1 of Cycles 2 to 13
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Nov 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 35852004Casulo C, Santoro A, Cartron G, Ando K, Munoz J, Le Gouill S, Izutsu K, Rule S, Lugtenburg P, Ruan J, Arcaini L, Casadebaig ML, Fox B, Kilavuz N, Rettby N, Dell'Aringa J, Taningco L, Delarue R, Czuczman M, Witzig T. Durvalumab as monotherapy and in combination therapy in patients with lymphoma or chronic lymphocytic leukemia: The FUSION NHL 001 trial. Cancer Rep (Hoboken). 2023 Jan;6(1):e1662. doi: 10.1002/cnr2.1662. Epub 2022 Jul 19.
- BMS Clinical Trial InformationLink provided by the sponsor.
- BMS Clinical Trial Patient RecruitingLink provided by the sponsor.
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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.
Bristol-Myers Squibb study director
Bristol-Myers Squibb
66 sites in 7 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Durvalumab, Lenalidomide and Rituximab in people with Lymphoma and Leukemia, Lymphocytic, Chronic, B-Cell, run by Celgene at 66 sites in 7 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 8 inclusion and 12 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 18 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 66 sites in United States, France, United Kingdom, Italy, Germany and 2 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 18 Mar 2020). 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?
Part 1: Number of Participants With Dose Limiting Toxicities (DLTs) (time frame: Cycle 1 (28 days)). 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 NCT02733042, which also lists 1 linked publication.
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 18 Nov 2023.