A Single-arm, Multicenter, Prospective Clinical Study of Mitoxantrone Liposome Combined With Chidamide and Azacitidine in the Treatment of Relapsed and Refractory Peripheral T-cell Lymphoma

Launched by SECOND AFFILIATED HOSPITAL, SCHOOL OF MEDICINE, ZHEJIANG UNIVERSITY · Aug 9, 2022

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Eligibility criteria

• Inclusion Criteria:
• • 1. Patients fully understand this study, voluntarily participate in and sign an informed consent form (ICF);
• • 2. Age: 18\~75 years old;
• • 3. Expected survival time ≥ 3 months;
• 4. Histopathologically confirmed PTCL, one of the following subtypes:
• • (1) Peripheral T-cell lymphoma unspecified (PTCL-NOS) (2) Angioimmunoblastic T-cell lymphoma (AITL) (3) Anaplastic large T-cell lymphoma (ALCL), ALK+ (4) Anaplastic large T-cell lymphoma (ALCL), ALK- (5) Other subtypes of PTCL that the researchers believe can be enrolled; 5. Relapsed/refractory patients who have received at least first-line systemic therapy with anthracycline-containing regimens in the past. Relapse was defined as relapse after CR or progression after PR; refractory was defined as previous systemic chemotherapy treatment, 2 cycles of response evaluation as PD, or 4 cycles of response evaluation as SD; 6. There must be at least one evaluable or measurable lesion that meets the Lugano2014 criteria: lymph node lesions, measurable lymph nodes should be \>1.5cm in length; non-lymph node lesions, measurable extranodal lesions should be \>1.0cm in length; 7. ECOG score 0-2 points; 8. Bone marrow function: neutrophil count ≥1.5×109/L, platelet count ≥75×109/L, hemoglobin ≥80g/L (the neutrophil count in patients with bone marrow involvement can be relaxed to ≥1.0×109/L, Platelet count can be relaxed to ≥50×109/L, and hemoglobin can be relaxed to ≥75 g/L); Liver and kidney function: Serum creatinine ≤1.5 times the upper limit of normal; AST and ALT ≤2.5 times the upper limit of normal (for patients with liver involvement ≤5 times the upper limit of normal); total bilirubin ≤1.5 times the upper limit of normal (for liver involvement patients ≤ 3 times the upper limit of normal);
• Exclusion Criteria:
• 1. The subject's previous history of anti-tumor therapy meets one of the following conditions:
• • 1. Those who have received mitoxantrone or mitoxantrone liposome in the past;
• • 2. Have received doxorubicin or other anthracycline therapy in the past, and the total cumulative dose of doxorubicin is more than 360 mg/m2 (1 mg doxorubicin equivalent to 2 mg epirubicin converted from other anthracyclines);
• • 3. Patients who have received autologous hematopoietic stem cell transplantation within 100 days of the first medication, or have received allogeneic hematopoietic stem cell transplantation;
• • 4. Received anti-tumor therapy (including chemotherapy, targeted therapy, hormone therapy, taking traditional Chinese medicine with anti-tumor activity, etc.) or participated in other clinical trials and received clinical trial drugs within 4 weeks before the first use of the study drug;
• • 2. Hypersensitivity to any study drug or its components;
• • 3. Uncontrollable systemic diseases (such as advanced infection, uncontrollable hypertension, diabetes, etc.);
• 4. Cardiac function and disease meet one of the following conditions:
• • 1. Long QTc syndrome or QTc interval \>480 ms;
• • 2. Complete left bundle branch block, second or third degree atrioventricular block;
• • 3. severe, uncontrolled arrhythmia requiring medical treatment;
• • 4. New York College of Cardiology classification ≥ grade III;
• • 5. Cardiac ejection fraction (LVEF) less than 50%;
• • 6. History of myocardial infarction, unstable angina, severe unstable ventricular arrhythmia, or any other arrhythmia requiring treatment, clinically significant pericardial disease within 6 months prior to recruitment, or acute ischemic or active ECG evidence of conduction system abnormalities.
• • 5. Active infection of hepatitis B and C (HBV surface antigen positive and hepatitis B virus DNA more than 1x103 copies/mL; hepatitis C virus RNA more than 1x103 copies/mL);
• • 6. Human immunodeficiency virus (HIV) infection (HIV antibody positive);
• • 7. Past or present with other malignant tumors (except for effectively controlled non-melanoma skin basal cell carcinoma, breast/cervical carcinoma in situ, and other malignant tumors that have been effectively controlled without treatment within the past five years);
• • 8. Suffering from primary or secondary central nervous system (CNS) lymphoma or a history of CNS lymphoma at the time of recruitment;
• • 9. There are obvious gastrointestinal diseases at the time of screening, which may affect the intake, transport or absorption of drugs (such as inability to swallow, chronic diarrhea, intestinal obstruction, etc.);
• • 10. Pregnant, lactating women and patients of childbearing age who are unwilling to take contraceptive measures;
• • 11. Subjects with lymphoma and leukemia (proportion of malignant tumor cells in bone marrow examination\> 20%) Circumstances judged by other investigators to be inappropriate to participate in this study. -