Neoplasms

Blood and Lymph Conditions

Immune System Diseases

All Conditions

Rare Diseases

Lymphoma

Plasmablastic Lymphoma

Lymphoma, Large-Cell, Immunoblastic

Neoplasms by Histologic Type

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Lymphoma, Large B-Cell, Diffuse

Lymphoma, B-Cell

Lymphoma, Non-Hodgkin

Lymphosarcoma

Lymphoma, Large-cell, Immunoblastic

B-cell Lymphoma

Anti-Inflammatory Agents

Antineoplastic Agents

Antiemetics

Gastrointestinal Agents

All Drugs and Chemicals

Anti-Infective Agents

Dexamethasone

Bortezomib

Daratumumab

Dexamethasone acetate

BB 1101

Antibodies

Antibodies, Monoclonal

Immunoglobulins

Glucocorticoids

Hormones

Hormone Antagonists

Antineoplastic Agents, Hormonal

HIV Protease Inhibitors

Protease Inhibitors

Enzyme Inhibitors

Immunologic Factors

Treatment consists of an induction phase (every 21 days) planning one course (cycle 1) of daratumumab as single agent followed by 8 courses (cycles 2-9) of daratumumab in combination with bortezomib and dexamethasone (DVd regimen).

Patients achieving at least a SD after induction will be addressed to the maintenance phase (every 28 days), planning a maximum of 6 cycles (cycles 10-15) of daratumumab as single agent until disease progression, unacceptable toxicity, withdrawal of consent and/or the investigator decision.

Induction phase planning one course (cycle 1) of daratumumab as single agent followed by 8 courses (cycles 2-9) of daratumumab in combination with bortezomib and dexamethasone (DVd regimen).

Patients achieving at least a SD after induction will be addressed to the maintenance phase, planning a maximum of 6 cycles (cycles 10-15) of daratumumab as single agent.

Stefania Badiali, Dr.

Lorenza Randi, Dr.

Luca Nassi, Dott.

Luca Nassi, MD

Emanuele Ravano, Dr

Andrés Ferreri

Andrés Ferreri, MD

Luisa Verga, Dr

Salvatrice Mancuso, MD

Luca Arcaini, MD

Francesco Merli, MD

michele.bibas@inmi.it

Michele Bibas, Dr

Luigi Rigacci, Dr

Anna Marina Liberati, Prof

Anna Marina Liberati

Andrés Ferreri, Dr.

It is an open-label, multicenter, phase II, single arm trial to Evaluate Activity and Safety of Daratumumab in combination with Bortezomib and Dexamethasone in patients about 28 patients with Relapsed or Refractory Plasmablastic lymphoma.

This is an open-label, multicenter, phase II, single arm trial. Patients will be recruited over 18 months in 19 FIL centers and it is expected that a total of 28 patients will start treatment. Analysis of the primary endpoint of the study is planned approximately after 12 months from the enrollment of the last patient, regardless of the response to protocol treatment of this patient. The total duration of the study is 30 months (\~2.5 years).

Patients will be enrolled based on the local diagnosis and the local assessment of CD38 expression ≥ 5%. The screening phase of the study includes baseline assessments according to local practice and those required by the study.

Samples coming from the most recent biopsy, and if available also those used for the first diagnosis, are to be collected and sent afterwards, upon request of the FIL Offices, to one of the three FIL designed central laboratories. Central diagnosis review and CD38 assessment will be performed during or at the end of the study conductance; there's no need to wait for central results to start protocol treatment.

Protocol treatment consists of an induction phase planning one course (cycle 1) of daratumumab sc as single agent followed by 8 courses (cycles 2-9) of daratumumab sc in combination with bortezomib sc and dexamethasone (DVd regimen).

Patients achieving at least a SD after induction will be addressed to the maintenance phase, planning a maximum of 6 cycles (cycles 10-15) of daratumumab sc as single agent.

Induction cycles will be administered every 21 days, while maintenance cycles will be administered every 28 days.

Treatment with DVd or daratumumab single agent will be discontinued before completion of planned cycles in case of disease progression, unacceptable toxicity, withdrawal of consent and/or the investigator determines that further therapy is not in the patient best interest (e.g., due to non-compliance, toxicity, etc.). Adverse events according to CTCAE will be monitored from the first dose of induction treatment, throughout maintenance phase and for 30 days after the last dose of protocol treatment with the study drug or 30 days after the last dose of drug in case of early discontinuation from any cause.

Study to Evaluate Combined Treatment of Daratumumab, Bortezomib and Dexamethasone in PBL Patients.

An Open Label, Phase 2 Study to Evaluate Activity and Safety of Daratumumab in Combination With Bortezomib and Dexamethasone in Patients With Relapsed or Refractory Plasmablastic Lymphoma (DALYA Trial)

Response assessment will be done at each restaging. The best overall response will be defined as the best response between the date of beginning of therapy and the last response evaluation. Patients without response assessment (due to whatever reason) will be considered as non-responders.

From the date of starting therapy and the date of disease progression, relapse or death from any cause. Responding patients according to the Lugano classification response Criteria and patients who are lost to follow-up will be censored at their last assessment date.

From the date of starting therapy and the date of death from any cause. Patients alive and those who are lost to follow-up at the time of the final analysis will be censored at the date of the last contact.

For all patients who achieved a response (CR or PR) according to Response Criteria for NHL with PET (Lugano 2014) and it is measured from the date when criteria for response are met (CR or PR) until the date of progression (including death due to progression) or relapse. Patients without relapse or progression or with death from other cause than progression will be censored at their last assessment date.

The safety of daratumumab as single agent and in combination with bortezomib/dexamethasone will be assessed in all patients who have received at least one dose of study medication. Rates of adverse events and of serious adverse events will be will be presented with two sided 95% confidence intervals.

Comparison of ORR and CRR before and after maintenance, and by evaluation of rate of conversion of SD to PR and of SD/PR to CR with daratumumab maintenance.

The extent of CD38 expression evaluated by immunochemistry on the diagnostic biopsy-tissue will be correlated with response measured according to the Lugano 2014 criteria at various timepoints: after induction cycle 1, after induction cycles 3, 6 and 9 (end of induction, EOI); after maintenance cycles 12 and 15 (end of treatment, EOT). correlated with response measured according to the Lugano 2014 criteria at various endpoints.

The impact of daratumumab and bortezomib treatment in immune activation (CD38, CD25, HLA-DR), T cell differentiation (naïve, central memory, effector memory and terminal effector memory T cell subset) and on circulating myeloid-derived suppressor cells (MDSC) as well as Treg will be evaluated by multiparametric flow cytometry (84 multiple staining). Peripheral blood samples will be collected in different timepoints: before treatment start; after cycle 1; after cycle 3 and at EOT.

Janssen-Cilag S.p.A.

Fondazione Italiana Linfomi - ETS

Spots Global Cancer Trial Database for plasmablastic