Linperlisib in Combination With CHOP in Previously Untreated Peripheral T-Cell Lymphoma

Study Overview
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Brief Summary
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This phase Ib/II, single arm, open label, multicenter study is conducted to evaluate the efficacy and safety of linperlisib in combination with CHOP for newly diagnosed PTCL patients, and explore the reasonable dosage of linperlisib when combined with CHOP regimen.

Official Title
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Linperlisib in Combination With CHOP in Previously Untreated Peripheral T-Cell Lymphoma：a Single-Arm, Open Lable， Multicenter Clinical Trial（LINCH Study）

Conditions
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Peripheral T-cell Lymphoma

Intervention / Treatment
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* Drug: Linperlisib in combination with CHOP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically confirmed PTCL, including ALK positive anaplastic large cell lymphoma (ALCL) with an IPI score of ≥ 2, ALK negative ALCL, peripheral T-cell lymphoma non-specific type (PTCL NOS), angioimmunoblastic T-cell lymphoma (AITL), enteropathy related T-cell lymphoma and liver spleen T-cell lymphoma; PTCL patients with CD30 expression<10%, or PTCL patients with CD30 expression ≥ 10% who are unable to receive BV treatment; Has not received anti-tumor treatment in the past; There is at least one measurable lesion: the longest diameter (LDi) of the lymph node lesion is greater than 1.5 cm, or the LDi of one extra lymph node lesion is greater than 1 cm (according to the 2014 Lugano classification); Age range from 18 to 70 years old, regardless of gender; Whole body physical condition score (ECOG) 0-2; Expected survival time>3 months; Adequate bone marrow and organ functions; Not accompanied by hemophagocytic syndrome; If the patient is accompanied by clinically diagnosed hemophagocytic syndrome, after targeted anti hemophagocytic syndrome drug treatment, the researcher evaluates the patient's general physical condition to determine whether they can be enrolled. Volunteer to participate in clinical research and sign an informed consent form, willing to follow and capable of completing all trial procedures. Exclusion Criteria: Received PI3K inhibitor treatment before enrollment; A history of other primary invasive malignant tumors that have not been relieved or have not been relieved for more than 3 years; Involvement of the central nervous system (meninges or brain parenchyma); Individuals who are known to have allergies to any medication in the study Participated in clinical trials of other drugs within 4 weeks prior to the start of the study; Pregnant or lactating women; Individuals with active infections, excluding fever related to tumor B symptoms; Concomitant diseases and medical history: There are many factors affecting oral medicine (such as inability to swallow, chronic diarrhea and Bowel obstruction); Individuals with a history of abuse of psychotropic substances who are unable to quit or have mental disorders; Subjects with any severe and/or uncontrollable diseases, including: Poor blood pressure control (systolic blood pressure ≥ 150mm Hg or diastolic blood pressure ≥ 100 mmHg); Suffering from ≥ Level 2 myocardial ischemia or infarction, arrhythmia (including QTc ≥ 450ms (male), QTc ≥ 470ms (female)), and ≥ Level 2 congestive heart failure (New York Heart Association (NYHA) classification); Active interstitial pneumonia or other chronic lung diseases, leading to severe impairment of lung function, defined as FEV1 and DLCOc<60% of normal predicted values; A history of interstitial pneumonia caused by COVID-19. Liver abnormalities: I. Decompensated cirrhosis (Child Pugh liver function rating of B or C) II Known clinically significant history of liver disease. Including viral hepatitis, known carriers of hepatitis B virus (HBV) must exclude active HBV infection, i.e. HBV DNA positivity (>2500 copies/mL or>500IU/mL, and greater than the upper limit of normal values); Known hepatitis C virus infection (HCV) and HCV RNA positivity (>1 × 103 copies/mL). Note: hepatitis B HBsAg positive subjects who meet the inclusion conditions, whether their HBV DNA is measurable or not, need to continue antiviral treatment (nucleoside analogues are recommended) and regularly monitor HBV DNA; For subjects with positive HBcAb but negative HBsAg in hepatitis B, HBV DNA should be monitored regularly and preventive antiviral treatment should be recommended; Hepatitis C patients need to regularly monitor HCV RNA. Renal failure requiring hemodialysis or Peritoneal dialysis; Subjects with uncontrolled Pleural effusion, pericardial effusion, or ascites requiring repeated drainage; Poor control of diabetes (Fasting blood sugar (FBG)>10mmol/L); Urinary routine examination indicates that urine protein is ≥++, and it is confirmed that 24-hour urine protein quantification is greater than 1.0 g; . Have a history of immune deficiency, including positive Diagnosis of HIV/AIDS, or have other acquired or congenital immune deficiency diseases, or have a history of organ transplantation; . According to the judgment of the researcher, there are serious accompanying diseases that pose a serious threat to the patient's safety or affect the patient's ability to complete the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Linperlisib in combination with CHOP<br>Patients will receive six cycles of induction therapy of linperlisib in combination with CHOP regimen. All patients with CR and PR after induction therapy receive linperlisib maintenance therapy every 28 days until disease progression or other reasons lead to discontinuation, and the duration of linperlisib maintenance does not exceed 24 months. | Drug: Linperlisib in combination with CHOP<br>* Patients will receive six cycles of induction therapy of linperlisib in combination with CHOP regimen. All patients with CR and PR after induction therapy receive linperlisib maintenance therapy every 28 days until disease progression or other reasons lead to discontinuation, and the duration of linperlisib maintenance does not exceed 24 months.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dose-limiting toxicity (DLT, Phase Ib) | To identify the DLT | The first cycle of linperlisib in combination with R-CHOP regimen (21 days) | 
| Complete remission rate (CR rate) based on the 2014 Lugano evaluation criteria (Phase II) | To investigate the antitumor efficacy | Up to 18 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall response rate (ORR) | To investigate the antitumor efficacy | Up to 18 weeks | 
| Duration of complete remission | To investigate the antitumor efficacy | From date of complete remission to the study treatment until the date of the first documented progression or date of death from any cause, whichever came first, assessed up to 24 months | 
| Duration of remission (DOR) | To investigate the antitumor efficacy | From date of remission to the study treatment until the date of the first documented progression or date of death from any cause, whichever came first, assessed up to 24 months | 
| Progression free survival (PFS) | To investigate the antitumor efficacy | From date of the first injection until the date of the first documented progression or date of death from any cause, whichever came first, assessed up to 24 months | 
| Overall survival (OS) | To investigate the antitumor efficacy | From date of the first injection until the date of death from ant cause, assessed up to 24 months | 
| Incidence and severity of adverse events (AE) and Serious adverse event (SAE), as well as abnormal laboratory inspection indicators; Quality of Life (QOL). | To identify the incidence of AE, SAE and QOL. | Through study completion, an average of 2 years |