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HOVON 141/VISION 试验方案描述:一项前瞻性、多中心、随机 II 期试验,评估伊布替尼联合维奈托克治疗伴有或不伴有 TP53 异常的肌酐清除率≥30 mL/min 的复发/难治性慢性淋巴细胞白血病(RR-CLL)患者的疗效。

Protocol description of the HOVON 141/VISION trial: a prospective, multicentre, randomised phase II trial of ibrutinib plus venetoclax in patients with creatinine clearance ≥30 mL/min who have relapsed or refractory chronic lymphocytic leukaemia (RR-CLL) with or without TP53 aberrations.

机构信息

Department of Internal Medicine, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, Zuid-Holland, The Netherlands.

Department of Hematology, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands

出版信息

BMJ Open. 2020 Oct 15;10(10):e039168. doi: 10.1136/bmjopen-2020-039168.

Abstract

INTRODUCTION

Literature is scarce on the combination treatment of ibrutinib and venetoclax (IV) is scarce in relapsed or refractory chronic lymphocytic leukaemia (RR-CLL). Especially, the possibility of stopping ibrutinib in RR-CLL patients in deep remission is unclear.

METHODS AND ANALYSIS

In the HOVON 141/VISION trial, patients with RR-CLL are treated with 12 cycles of IV after a short induction with ibrutinib. Patients reaching undetectable minimal residual disease (uMRD) after 12 cycles of IV are randomised 1:2 to continue ibrutinib or stop treatment. The persistence of uMRD after stopping IV is studied. In addition, in patients who become positive for MRD again after stopping, IV treatment is reinitiated. The efficacy of this approach with regard to progression-free survival 12 months after randomisation is the primary endpoint of the study.

ETHICS AND DISSEMINATION

This protocol respects the Helsinki declaration and has been approved by the ethical committee of the Amsterdam Medical Center. Study findings will be disseminated through peer-reviewed papers. All patients who fulfil the inclusion criteria and no-exclusion criteria, and have signed the informed consent form are included in the study.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Registry (NCT03226301).

摘要

简介

在复发或难治性慢性淋巴细胞白血病(RR-CLL)中,伊布替尼和维奈托克联合治疗的相关文献较为匮乏。特别是,RR-CLL 患者在深度缓解后停止伊布替尼治疗的可能性尚不清楚。

方法与分析

在 HOVON 141/VISION 试验中,RR-CLL 患者在接受伊布替尼短期诱导治疗后接受 12 个周期的 IV 治疗。接受 12 个周期 IV 治疗后达到不可检测的微小残留病(uMRD)的患者随机分为 1:2 继续接受伊布替尼或停止治疗。研究停止 IV 后 uMRD 的持续情况。此外,对于停止治疗后再次出现 MRD 阳性的患者,重新开始 IV 治疗。这种方法在随机分组后 12 个月时无进展生存期的疗效是该研究的主要终点。

伦理与传播

本方案符合《赫尔辛基宣言》,并已获得阿姆斯特丹医学中心伦理委员会的批准。研究结果将通过同行评审的论文进行传播。所有符合纳入标准和排除标准且已签署知情同意书的患者均纳入研究。

试验注册

ClinicalTrials.gov 注册(NCT03226301)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e53/7566731/673e71e54c82/bmjopen-2020-039168f01.jpg

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