Phase III Study of RAD001 Adjuvant Therapy in Poor Risk Patients With Diffuse Large B-Cell Lymphoma (DLBCL) of RAD001 Versus Matching Placebo After Patients Have Achieved Complete Response With First-line Rituximab-chemotherapy

Last updated: June 14, 2017
Sponsor: Novartis Pharmaceuticals
Overall Status: Completed

Phase

3

Condition

Lymphoma, B-cell

Lymphoma

Hematologic Cancer

Treatment

Everolimus Placebo

Everolimus

Clinical Study ID

NCT00790036
CRAD001N2301
2008-000498-40
  • Ages > 18
  • All Genders

Study Summary

Phase III study of RAD001 adjuvant therapy in poor risk patients with Diffuse Large B-Cell Lymphoma (DLBCL) of RAD001 versus matching placebo after patients had achieved complete response with first-line rituximab-chemotherapy

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Patients with previous histologically confirmed Stage III-IV (or Stage II bulkydisease, defined as any tumor mass more than 10 cm in longest diameter), at time oforiginal diagnosis, diffuse large B cell lymphoma (pathology report based on originaltumor tissue/lymph node is acceptable for meeting inclusion criteria, but tumor tissue (slides/block) must be available to be sent for central pathology to confirmdiagnosis).

  2. Patients defined as poor risk with IPI of 3, 4, or 5 at time of original diagnosis.

  3. Patients age ≥ 18 years old.

  4. Patients must have achieved complete remission (CR) based on the revised IWRC (Chesonet al 2007) following first line R-chemotherapy treatment. Radiation therapy (RT)during or after R-chemotherapy is acceptable provided: 1) it ends 4 weeks prior tostart of study drug and, 2) in case of consolidation RT targeted at initial bulkytumor mass, administered after R-chemotherapy, patient is already in CR beforeinitiating RT. Complete remission from R-chemotherapy must be confirmed by clinicaland radiologic evaluation along with bone marrow confirmation (if bone marrow wasinvolved by lymphoma before the R-chemotherapy treatment). Local pathology report onthe bone marrow biopsy is acceptable. If bone marrow was not involved by lymphomabefore R-chemotherapy treatment, then bone marrow confirmation after R-chemotherapy isnot required.

  5. Patients who received a minimum 5 cycles of R-chemotherapy treatment and maximum 8cycles of R-chemotherapy treatment. Any variation of CHOP (R-CHOP-14, R-CHOP-21) isacceptable. Liposomal doxorubicin, epirubicin, or pirarubicin (also known astherarubicin) is acceptable. R-EPOCH is acceptable.

  6. Patients' last treatment with R-chemotherapy must be 6 to 14 weeks prior to start ofstudy drug.

  7. Patients with ECOG performance status (PS) 0, 1, or 2.

  8. Patients willing to provide a portion of his/her tumor tissue from original diagnosisor lymph node to confirm diagnosis.

  9. The following laboratory values obtained ≤ 21 days prior to start of study drug:

  • Absolute neutrophil count ≥ 1000/mm3 (or 1.0 GI/L, SI units)

  • Platelet count ≥ 100,000/mm3 (or 100 GI/L, SI units)

  • Hemoglobin ≥ 9 g/dL (can be achieved by transfusion)

  • Total bilirubin ≤ 2 x ULN (if >2 x ULN direct bilirubin is required and should be ≤1.5 x ULN)

  • AST ≤ 3 x ULN

  • Serum creatinine ≤ 2 x ULN

  1. Women of childbearing potential must have had a negative serum pregnancy test 14 daysprior to the start of study drug plus a negative local urine pregnancy test on Day 1,Cycle 1 prior to treatment and must be willing to use adequate methods ofcontraception during the study and for 8 weeks after study drug administration.

  2. Patients who give a written informed consent obtained according to local guidelines.

  3. Patients capable of swallowing intact study medication tablets and followingdirections regarding taking study drug, or have a daily caregiver who will beresponsible for administering study drug.

Exclusion

Exclusion Criteria:

  1. Patients with evidence of disease according to the revised IWRC (Cheson et al 2007)after completion of the first-line R-chemotherapy treatment, prior to study entry.

  2. Patients receiving ongoing radiation therapy or who received radiation therapy to theresidual tumor masses < 4 weeks from start of study drug.

  3. Patients who have previously received systemic mTOR inhibitor (sirolimus,temsirolimus, everolimus, etc).

  4. Patients with evidence of current central nervous system (CNS) involvement withlymphoma. Patients who have only had prophylactic intrathecal chemotherapy against CNSdisease are eligible.

  5. Patients with transformed follicular lymphoma.

  6. Patients who received ibritumomab tiuxetan (Zevalin®), in order to avoid potentialdelayed kidney toxicities.

  7. Patients who had myelosuppressive chemotherapy or biologic therapy < 3 weeks fromstart of study drug.

  8. Patients receiving chronic systemic immunosuppressive agents. Inhaled and topicalsteroids are acceptable. Patients may be receiving stable (not increased within thelast month) chronic doses of corticosteroids with a maximum dose of 20 mg ofprednisone or ≤5 mg of dexamethasone per day, if they are being given for disordersother than lymphoma such as rheumatoid arthritis, polymyalgia rheumatica, adrenalinsufficiency or asthma.

  9. Patients with active, bleeding diathesis.

  10. Patients with a known history of HIV seropositivity.

  11. Patients with known hypersensitivity to RAD001 (everolimus) or other rapamycins (sirolimus, temsirolimus) or to any of the excipients.

  12. Patients who have any severe and/or uncontrolled medical conditions or otherconditions that could affect their participation in the study such as:

  • unstable angina pectoris, symptomatic congestive heart failure (NYHA II, III,IV), myocardial infarction ≤ 6 months prior to first study drug, seriousuncontrolled cardiac arrhythmia, cerebrovascular accidents ≤ 6 months beforestudy drug start

  • severely impaired lung function as defined as spirometry and DLCO that is ≤ 50%of the normal predicted value and/or O2 saturation that is 88% or less at rest onroom air

  • poorly controlled diabetes as defined by fasting serum glucose >2.0 x ULN

  • any active (acute or chronic) or uncontrolled infection/disorders that impair theability to evaluate the patient or for the patient to complete the study

  • nonmalignant medical illnesses that are uncontrolled or whose control may bejeopardized by this study drug, such as severe hypertension that is notcontrolled with medical management and thyroid abnormalities whose thyroidfunction cannot be maintained in the normal range by medication

  • liver disease such as cirrhosis or decompensated liver disease.

  1. Patients who have a history of another primary malignancy ≤ 3 years, with theexception of non-melanoma skin cancer and carcinoma in situ of uterine cervix.

  2. Female patients who are pregnant or breast feeding, or adults of reproductivepotential who are not using effective birth control methods. If barrier contraceptivesare being used, these must be continued throughout the trial by both sexes.

  3. Patients who are using other investigational agents or who had receivedinvestigational drugs ≤ 4 weeks prior to study drug start.

  4. Patients unwilling to or unable to comply with the protocol.

Study Design

Total Participants: 742
Treatment Group(s): 2
Primary Treatment: Everolimus Placebo
Phase: 3
Study Start date:
July 24, 2009
Estimated Completion Date:
June 15, 2016

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    Cadiz, Andalucía 11009
    Spain

    Site Not Available

  • Novartis Investigative Site

    Sabadell, Barcelona 08208
    Spain

    Site Not Available

  • Novartis Investigative Site

    Santander, Cantabria 39008
    Spain

    Site Not Available

  • Novartis Investigative Site

    Badalona, Catalunya 08916
    Spain

    Site Not Available

  • Novartis Investigative Site

    Barcelona, Cataluña 08028
    Spain

    Site Not Available

  • Novartis Investigative Site

    Valencia, Comunidad Valenciana 46010
    Spain

    Site Not Available

  • Novartis Investigative Site

    Majadahonda, Madrid 28222
    Spain

    Site Not Available

  • Novartis Investigative Site

    Majadanonda, Madrid 28222
    Spain

    Site Not Available

  • Novartis Investigative Site

    Pozuelo de Alarcon, Madrid 28223
    Spain

    Site Not Available

  • Novartis Investigative Site

    Palma De Mallorca, Mallorca 07014
    Spain

    Site Not Available

  • Novartis Investigative Site

    Pamplona, Navarra 31008
    Spain

    Site Not Available

  • Novartis Investigative Site

    San Sebastian, Pais Vasco 20080
    Spain

    Site Not Available

  • Novartis Investigative Site

    Barcellona,
    Spain

    Site Not Available

  • Novartis Investigative Site

    Lugo,
    Spain

    Site Not Available

  • Novartis Investigative Site

    Madrid, 28006
    Spain

    Site Not Available

  • Novartis Investigative Site

    Mallorca,
    Spain

    Site Not Available

  • Novartis Investigative Site

    Pozuelo de Alarcón, 28223
    Spain

    Site Not Available

  • Novartis Investigative Site

    Pozuelo de Alarcón, 28223
    Spain

    Site Not Available

  • Novartis Investigative Site

    Luzern, CH 6000
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zürich, CH 8091
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Basel, 4031
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Bellinzona, 6500
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zuerich, 8091
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Zürich, 8091
    Switzerland

    Site Not Available

  • Novartis Investigative Site

    Bangkok, 10330
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Songkla, 90110
    Thailand

    Site Not Available

  • Novartis Investigative Site

    Ankara, 06100
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Antalya, 07070
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Istambul,
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Istanbul, 34093
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Talas,
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Talas / Kayseri, 38039
    Turkey

    Site Not Available

  • Novartis Investigative Site

    Al Ain - Abu Dhabi,
    United Arab Emirates

    Site Not Available

  • Ironwood Cancer and Research Centers SC

    Chandler, Arizona 85224
    United States

    Site Not Available

  • Highlands Oncology Group Dept of Highlands Oncology Grp

    Fayetteville, Arkansas 72703
    United States

    Site Not Available

  • Sutter Health Cancer Research Group California Cancer Care

    Greenbrae, California 94904
    United States

    Site Not Available

  • University of California San Diego - Moores Cancer Center Dept of Moores Cancer Ctr (3)

    La Jolla, California 92093-0658
    United States

    Site Not Available

  • USC/Kenneth Norris Comprehensive Cancer Center Dept.ofNorrisMedicalCenter(4)

    Los Angeles, California 90033
    United States

    Site Not Available

  • Palo Alto Medical Foundation Hematology/Oncology

    Mountain View, California 94040
    United States

    Site Not Available

  • California Pacific Medical Center Medical Research Institute

    San Francisco, California 94120-7999
    United States

    Site Not Available

  • Redwood Regional Medical Group - Santa Rosa Dept. of RRMG (2)

    Santa Rosa, California 94503
    United States

    Site Not Available

  • Stanford University Medical Center Dept. of Stanford University

    Stanford, California 94304
    United States

    Site Not Available

  • University of Colorado Health

    Colorado Springs, Colorado 80909
    United States

    Site Not Available

  • Denver Health & Hospital Authority CACZ885M2301

    Denver, Colorado 80204-4507
    United States

    Site Not Available

  • Rocky Mountain Cancer Centers RMCC

    Greenwood Village, Colorado
    United States

    Site Not Available

  • Hartford Hospital Cancer Clin Research Office

    Hartford, Connecticut 06102
    United States

    Site Not Available

  • University Cancer Institute

    Boynton Beach, Florida 33426
    United States

    Site Not Available

  • Novartis Investigative Site

    Boyton Beach, Florida 33426
    United States

    Site Not Available

  • Novartis Investigative Site

    Miami, Florida 33176
    United States

    Site Not Available

  • Cancer Centers of Florida PA Cancer Centers of FL-Ocoee (2)

    Ocoee, Florida *see dep*
    United States

    Site Not Available

  • Hematology Oncology Associates of Treasure Coast Hematology Onc of the Treasure

    Port Lucie, Florida 34952
    United States

    Site Not Available

  • Hematology Oncology Associates of Treasure Coast

    Port Saint Lucie, Florida 34952
    United States

    Site Not Available

  • University Cancer & Blood Center, LLC

    Athens, Georgia 30607
    United States

    Site Not Available

  • Georgia Health Sciences University Dept. of MCG

    Augusta, Georgia 30912
    United States

    Site Not Available

  • Columbus Regional

    Columbus, Georgia 31904
    United States

    Site Not Available

  • Straub Clinic & Hospital Straub Clinic & Hospital (3)

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Rush University Medical Center Div. of Hematology & Oncology

    Chicago, Illinois 60612
    United States

    Site Not Available

  • Loyola University Medical Center /Cardinal Bernardin Cancer Loyola University (rm 101)

    Maywood, Illinois 60153
    United States

    Site Not Available

  • Indiana University Hospital IU Cancer Center

    Indianapolis, Indiana 46202
    United States

    Site Not Available

  • University of Kansas Cancer Center Univ of Kansas (2)

    Kansas City, Kansas 66160
    United States

    Site Not Available

  • Kentuckiana Cancer Institute Kentuckiana

    Louisville, Kentucky 40202
    United States

    Site Not Available

  • Tulane University Health Sciences Center Office of Clinical Research

    New Orleans, Louisiana 70112
    United States

    Site Not Available

  • St. Agnes Hospital SC

    Baltimore, Maryland 21229
    United States

    Site Not Available

  • Lahey Clinic Dept of Lahey Clinic (3)

    Burlington, Massachusetts 01805
    United States

    Site Not Available

  • Mayo Clinic - Rochester Dept. of MayoClinic-Rochester

    Rochester, Minnesota 55905
    United States

    Site Not Available

  • North Mississippi Hematology /Oncology MS Hem & Onc

    Tupelo, Mississippi 38801
    United States

    Site Not Available

  • Washington University School of Medicine Div. of Medical Oncology

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • Washington University School of Medicine Div. of Medical Oncology

    St. Louis, Missouri 63110
    United States

    Site Not Available

  • Nevada Cancer Institute Dept. of Nevada Cancer (3)

    Las Vegas, Nevada 89135
    United States

    Site Not Available

  • Dartmouth Hitchcock Medical Center Dartmouth

    Lebanon, New Hampshire 03756
    United States

    Site Not Available

  • Hematology Oncology Associates of Northern New Jersey PA DeptofHem-OncofNorthern NJ (2)

    Morristown, New Jersey 07962
    United States

    Site Not Available

  • University of New Mexico Cancer Center CancerResearch & Treatment (2)

    Albuquerque, New Mexico 87131
    United States

    Site Not Available

  • NYU Langone Arena Oncology Dept.ofArenaOncologyAssoc(2)

    Lake Success, New York 11042
    United States

    Site Not Available

  • Novartis Investigative Site

    Asheville, North Carolina 28801
    United States

    Site Not Available

  • Levine Cancer Institute Oncology

    Charlotte, North Carolina 28203
    United States

    Site Not Available

  • Wake Forest University Baptist Medical Center Dept. of WFUHS

    Winston-Salem, North Carolina 27157
    United States

    Site Not Available

  • Novartis Investigative Site

    Cincinnati, Ohio 45245
    United States

    Site Not Available

  • Novartis Investigative Site

    Cleveland, Ohio 44106-5065
    United States

    Site Not Available

  • Northwest Cancer Specialists Compass Oncology -BKM

    Portland, Oregon 97210
    United States

    Site Not Available

  • Penn State University / Milton S. Hershey Medical Center Dept.ofMiltonS.HersheyMedCtr.

    Hershey, Pennsylvania 17033-0850
    United States

    Site Not Available

  • University of Pittsburgh Medical Center

    Pittsburg, Pennsylvania 15232
    United States

    Site Not Available

  • University of Pittsburgh Medical Center SC-3

    Pittsburgh, Pennsylvania 15213
    United States

    Site Not Available

  • Medical University of South Carolina -Hollings Cancer Center MUSC/HCC (2)

    Charleston, South Carolina 29425
    United States

    Site Not Available

  • Cancer Centers of the Carolinas Cancer Centers of Carolinas (3

    Greenville, South Carolina 29605
    United States

    Site Not Available

  • Low Country Hematology Oncology Dept of Lowcountry Hem/Onc

    Mt. Pleasant, South Carolina 29464
    United States

    Site Not Available

  • University Oncology and Hematology Associates, PLLC

    Chattanooga, Tennessee 37403
    United States

    Site Not Available

  • Family Cancer Center, PLC Family Cancer Center

    Collierville, Tennessee 38017
    United States

    Site Not Available

  • The West Clinic

    Memphis, Tennessee 38120
    United States

    Site Not Available

  • University of Tennessee Cancer Institute SC-2

    Memphis, Tennessee 38104
    United States

    Site Not Available

  • Texas Oncology, P.A. Sammons Cancer Ctr.

    Dallas, Texas 75251
    United States

    Site Not Available

  • The Center for Cancer and Blood Disorders Dept. of The Ctr for C & BD

    Fort Worth, Texas 76104
    United States

    Site Not Available

  • Baylor College of Medicine Dept.of Baylor College of Med.

    Houston, Texas 77030
    United States

    Site Not Available

  • University of Texas/MD Anderson Cancer Center Dept of MD Anderson (18)

    Houston, Texas 77030-4009
    United States

    Site Not Available

  • South Texas Oncology and Hematology, PA South Texas Oncology (2)

    San Antonio, Texas 78258
    United States

    Site Not Available

  • Texas A&M HealthSciencesCtr-Scott & White Memorial Hospital CenterForCancerPrevention&Care

    Temple, Texas 76508
    United States

    Site Not Available

  • Texoma Cancer Center

    Wichita Falls, Texas 76310
    United States

    Site Not Available

  • University of Vermont Office of Clinical Trials Res.

    Burlington, Vermont 05404
    United States

    Site Not Available

  • University of Virginia Health Systems SC-2

    Charlottesville, Virginia 22908-0334
    United States

    Site Not Available

  • Blue Ridge Research Center at Roanoke Neurological Center SC

    Roanoke, Virginia 24018
    United States

    Site Not Available

  • Dean Health System

    Madison, Wisconsin 53717
    United States

    Site Not Available

  • Waukesha Memorial Hospital Cancer Center Dept.ofWaukeshaMemorialHosp.

    Waukesha, Wisconsin 53188
    United States

    Site Not Available

  • Novartis Investigative Site

    Caracas, Distrito Capital 1011
    Venezuela

    Site Not Available

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