A Phase 3 interventional study of Ofatumumab and Rituximab in Non-Hodgkin's Lymphoma, sponsored by Novartis Pharmaceuticals. Terminated at 155 sites in 16 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-05-16.
Sponsored by Novartis Pharmaceuticals · Phase 3, Interventional, and Treatment
This was a multi-center, parallel, active comparator controlled, open-label, randomized (1:1) phase III study of single agent ofatumumab compared to single agent rituximab in subjects with rituximab-sensitive indolent B-cell non hodgkin lymphoma that has relapsed at least 6 months after completing treatment with single agent rituximab or a rituximab-containing regimen. Subjects must have attained a Complete Response or Partial Response to their last prior rituximab containing therapy lasting at least six months beyond the end of rituximab therapy. Subjects were to receive four weekly doses of single agent ofatumumab (1000 mg) or rituximab (375 mg/m2), followed by ofatumumab (1000 mg) or rituximab (375 mg/m2) every 2 months for four additional doses. Therefore, subjects were to receive a total of eight doses of anti-CD20 antibody over 9 months. Subjects were evaluated for response after completion of the first four doses of therapy, after six doses of therapy, and after completion of study therapy. Subjects were to be followed until the end of the designated follow-up period (total study duration of 200 weeks) or until they meet the withdrawal criteria.
The primary objective of the study OMB157D 2303 was to demonstrate the efficacy of Arzerra based on the primary endpoint (Progression-free survival (PFS) as assessed by the IRC) in patients with Indolent B-cell Non-Hodgkin's Lymphoma Relapsed After Rituximab-Containing Regimen.
The Independent Data Monitoring Committee (IDMC) met on November 22, 2015 and recommended the termination of the study due to futility (cut-off date = 12Jun2015). The IDMC reviewed analyses results for progression free survival (PFS), overall response rate (ORR), and overall survival (OS). Novartis accepted this recommendation and the study was closed.
Final analysis was performed (cut-off date =19 Dec 2016). As the study was stopped for futility, the primary objective was not met and some secondary endpoints, supportive of primary objective (Duration of Response (DOR), time to next therapy, and pharmacokinetics) were removed as secondary end points.
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Indolent NHL subtypes defined according to World Health Organization guidelines:
One or more of the following indications for treatment:
One or more of the following lymphoma-related symptoms:
Exclusion Criteria:
Screening laboratory values:
Because the effects of ofatumumab on fetuses and nursing infants are not known, the following are ineligible for study entry:
Four weekly doses of single agent ofatumumab (1000 mg), followed by ofatumumab (1000 mg) every two months for four additional doses.
Biological: Ofatumumab
Four weekly doses of single agent rituximab (375 mg/m2), followed by rituximab (375 mg/m2) every two months for four additional doses.
Biological: Rituximab
liquid concentrate for solution for infusion in glass vials containing 50 mL of solution at a concentration of 20mg/ml to provide 1000 mg per vial.
Also known as: Arzerra
sourced locally from commercial stock
Also known as: Mabthera, Rituxan
Four weekly doses of single agent ofatumumab (1000 mg), followed by ofatumumab (1000 mg) every two months for four additional doses.
Also known as: Arzerra
Four weekly doses of single agent rituximab (375 mg/m2), followed by rituximab (375 mg/m2) every two months for four additional doses.
Also known as: Mabthera, Rituxan
Progression-free Survival (PFS) - Number of Participants With PFS Events
Disease response assessed by modified 2007 Revised Response Criteria for Malignant Lymphoma. Nodal disease, PD: 1)prev. normal node (\<=1.5cm x \<=1.0cm) that incr. to \>2.0 x ≥1.5cm; 2)≥50% incr. from nadir product of perpendicular diameter (PPD) of any prev. involved node with long axis \>1.5cm at baseline (BL) (must incr. by ≥0.5mm \& to \>2.0cm) OR ≥50% incr. from nadir in long axis of any prev. inv. node with long axis of \>1.5cm at BL (long axis must incr. by ≥0.5mm \& to \>2.0cm); or 3)≥50% incr. from nadir in the sums of prod. of diameters (SPD) of target nodes \& ≥1 node with long axis \>1.5cm. Extranodal, PD 1)any new lesion \>2.0 x ≥1.5cm not attributed to non-lymphoma causes; 2)≥50% incr. from nadir PPD of any targ. les. \& \>5mm incr. in either axis \& les. must measure \>1.5cm x ≥1.5cm OR ≥50% incr. from nadir in long axis of any targ. les. \& \>5mm incr. in either axis \& les. must measure \>1.5cm x ≥1.5cm; or 3)≥50% incr. from nadir in SPD of targ. nodes \& ≥1 node with long axis \>1.5cm.
Time frame: 200 weeks
Number of Participants With Complete Response (CR)
Complete response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML) and defined as follows: 1) complete disappearance of all detectable clinical evidence of disease (all target nodes regressing to \<=1.5cm in the long axis and all non-target lesions being normal in size by imaging) and disease-related symptoms if present before therapy; 2) the spleen/liver, if considered enlarged due to lymphoma based on CT scan prior to therapy, would be normal and nodules should disappear; and 3) if bone marrow was involved before treatment, the infiltrate must clear on repeat bone marrow biopsy. Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation.
Time frame: 200 weeks
Number of Participants With Overall Response (OR)
The overall response rate (ORR) was defined as the number of participants achieving a CR or partial response (PR). from start of randomization until disease progression, or the start of a new anti-cancer therapy. Disease response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML). Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation. Bone marrow examination to confirm a suspected complete response (CR) was performed within 8 weeks following the onset of a CT scan confirmed CR.
Time frame: 200 weeks
Number of Deaths
The number of deaths were assessed.
Time frame: 200 weeks
Number of Participants With Infection Related Adverse Events
The number of participants with infection related adverse events was assessed.
Time frame: 200 weeks
Number of Participants With Infusion Related Adverse Events Due to Study Drug
The number of participants with infusion related adverse events due to study drug was assessed.
Time frame: 36 weeks + 60 days
Number of Participants With Myelosuppression Adverse Events
The number of participants with myelosuppression adverse events was assessed.
Time frame: 200 weeks
Duration of Response (DOR)
Time frame: 200 weeks
Time to Next Treatment
Time frame: 200 weeks
Pharmacokinetics
Time frame: 70 weeks
| Milestone | Ofatumumab | Rituximab |
|---|---|---|
| Started | 219 | 219 |
| Intent-to-treat (itt) analysis set | 219 | 219 |
| Safety set | 217 | 218 |
| Completed | 29 | 30 |
| Not completed | 190 | 189 |
| Withdrew: Withdrawal by subject | 13 | 11 |
| Withdrew: Physician decision | 2 | 2 |
| Withdrew: Lost to follow-up | 5 | 4 |
| Withdrew: Study terminated | 170 | 172 |
Disease response assessed by modified 2007 Revised Response Criteria for Malignant Lymphoma. Nodal disease, PD: 1)prev. normal node (\<=1.5cm x \<=1.0cm) that incr. to \>2.0 x ≥1.5cm; 2)≥50% incr. from nadir product of perpendicular diameter (PPD) of any prev. involved node with long axis \>1.5cm at baseline (BL) (must incr. by ≥0.5mm \& to \>2.0cm) OR ≥50% incr. from nadir in long axis of any prev. inv. node with long axis of \>1.5cm at BL (long axis must incr. by ≥0.5mm \& to \>2.0cm); or 3)≥50% incr. from nadir in the sums of prod. of diameters (SPD) of target nodes \& ≥1 node with long axis \>1.5cm. Extranodal, PD 1)any new lesion \>2.0 x ≥1.5cm not attributed to non-lymphoma causes; 2)≥50% incr. from nadir PPD of any targ. les. \& \>5mm incr. in either axis \& les. must measure \>1.5cm x ≥1.5cm OR ≥50% incr. from nadir in long axis of any targ. les. \& \>5mm incr. in either axis \& les. must measure \>1.5cm x ≥1.5cm; or 3)≥50% incr. from nadir in SPD of targ. nodes \& ≥1 node with long axis \>1.5cm.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Progression-free Survival (PFS) - Number of Participants With PFS Events | 114 | 117 |
Complete response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML) and defined as follows: 1) complete disappearance of all detectable clinical evidence of disease (all target nodes regressing to \<=1.5cm in the long axis and all non-target lesions being normal in size by imaging) and disease-related symptoms if present before therapy; 2) the spleen/liver, if considered enlarged due to lymphoma based on CT scan prior to therapy, would be normal and nodules should disappear; and 3) if bone marrow was involved before treatment, the infiltrate must clear on repeat bone marrow biopsy. Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Participants With Complete Response (CR) | 36 | 44 |
The overall response rate (ORR) was defined as the number of participants achieving a CR or partial response (PR). from start of randomization until disease progression, or the start of a new anti-cancer therapy. Disease response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML). Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation. Bone marrow examination to confirm a suspected complete response (CR) was performed within 8 weeks following the onset of a CT scan confirmed CR.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Participants With Overall Response (OR) | 110 | 144 |
The number of deaths were assessed.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Deaths | 28 | 30 |
The number of participants with infection related adverse events was assessed.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Participants With Infection Related Adverse Events | 69 | 81 |
The number of participants with infusion related adverse events due to study drug was assessed.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Participants With Infusion Related Adverse Events Due to Study Drug | 178 | 112 |
The number of participants with myelosuppression adverse events was assessed.
| Participants | Ofatumumab | Rituximab |
|---|---|---|
| Number of Participants With Myelosuppression Adverse Events | 24 | 41 |
No measurements were reported for this outcome.
No measurements were reported for this outcome.
No measurements were reported for this outcome.
Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Ofatumumab | — | 38/217 (17.5%) | 177/217 (81.6%) |
| Rituximab | — | 37/218 (17%) | 150/218 (68.8%) |
| Event | Ofatumumab | Rituximab |
|---|---|---|
| Infusion related reactionInjury, poisoning and procedural complications | 5/217 | 0/218 |
| PneumoniaInfections and infestations | 2/217 | 5/218 |
| SepsisInfections and infestations | 1/217 | 3/218 |
| NeutropeniaBlood and lymphatic system disorders | 2/217 | 1/218 |
| Squamous cell carcinoma of skinNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 2/217 | 0/218 |
| Atrial fibrillationCardiac disorders | 1/217 | 2/218 |
| Intestinal obstructionGastrointestinal disorders | 0/217 | 2/218 |
| PyrexiaGeneral disorders | 0/217 | 2/218 |
| CoughRespiratory, thoracic and mediastinal disorders | 0/217 | 2/218 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 0/217 | 2/218 |
| Event | Ofatumumab | Rituximab |
|---|---|---|
| RashSkin and subcutaneous tissue disorders | 42/217 | 11/218 |
| UrticariaSkin and subcutaneous tissue disorders | 41/217 | 3/218 |
| Infusion related reactionInjury, poisoning and procedural complications | 40/217 | 19/218 |
| FatigueGeneral disorders | 21/217 | 28/218 |
| White blood cell count decreasedInvestigations | 12/217 | 23/218 |
| NasopharyngitisInfections and infestations | 14/217 | 22/218 |
| PyrexiaGeneral disorders | 9/217 | 21/218 |
| DiarrhoeaGastrointestinal disorders | 20/217 | 15/218 |
| PruritusSkin and subcutaneous tissue disorders | 20/217 | 14/218 |
| HeadacheNervous system disorders | 11/217 | 20/218 |
| Age, Continuous(Years) | Ofatumumab | Rituximab | Total |
|---|---|---|---|
| Mean | 60.8 ± 11.27 | 60.7 ± 11.84 | 60.8 ± 11.54 |
| Sex: Female, Male(Participants) | Ofatumumab | Rituximab | Total |
|---|---|---|---|
| Female | 115 | 109 | 224 |
| Male | 104 | 110 | 214 |
Showing the first 100 of 155 sites across 16 countries.
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Novartis Pharmaceuticals