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JOURNAL ONKOLOGIE – STUDIE
R-Pola-Glo

Rituximab in Combination With Glofitamab and Polatuzumab Vedotin in Patients With Previously Untreated Aggressive B-cell Lymphoma Ineligible for R-CHOP

Rekrutierend

NCT-Nummer:
NCT05798156

Studienbeginn:
März 2023

Letztes Update:
21.12.2023

Wirkstoff:
Glofitamab, Rituximab, Obinutuzumab, Polatuzumab Vedotin

Indikation (Clinical Trials):
Lymphoma, Lymphoma, Large B-Cell, Diffuse

Geschlecht:
Alle

Altersgruppe:
Erwachsene (18+)

Phase:
Phase 2

Sponsor:
Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest

Collaborator:
Charite University, Berlin, Germany, University of Salzburg, Arbeitsgemeinschaft medikamentoese Tumortherapie, Roche Pharma AG, Zentrum für Klinische Studien Leipzig, Hoffmann-La Roche,

Studienleiter

Salah-Eddin Al-Batran, Prof. Dr.
Study Chair
Institut fuer Klinische Krebsforschung IKF GmbH

Kontakt

Björn Chapuy, Univ.-Prof. Dr. med.
Kontakt:
Phone: +49 30 450 613423
E-Mail: bjoern.chapuy@charite.de» Kontaktdaten anzeigen

Studienlocations
(3 von 24)

Hautkrebszentrum Kiel am Universitätsklinikum Schleswig-Holstein Campus Kiel
UKSH, Campus Kiel, Rosalind-Franklin-Straße 7
24105 Kiel
(Schleswig-Holstein)
DeutschlandNoch nicht rekrutierend» Google-Maps
Ansprechpartner:
Christiane Pott, Prof. Dr. med.» Ansprechpartner anzeigen
Alle anzeigen

Studien-Informationen

Brief Summary:

In the present trial the chemotherapy- light treatment concept R-Pola-Glo will be evaluated

that combines the anti-CD20 antibody rituximab (R) with the ADC polatuzumab vedotin (Pola)

and the (BiMabs) glofitamab (Glo) in elderly and/or medical unfit and previously untreated

patients with aggressive B-cell lymphoma. The outcome and feasibility data obtained here will

be used for further clinical development of this new chemolight triple combination.

Ein-/Ausschlusskriterien

Inclusion Criteria:

1. Patient has provided written informed consent and is able and willing to comply with

the study protocol and protocol mandated hospitalizations according to ICH and local

regulations.

2. Patient is above 60 years of age

3. Patient is not eligible for a fully dosed R-CHOP

4. Patient has histologically confirmed aggressive B-cell lymphoma.

5. Patient has at least one measurable FDG PET-positive lymphoma manifestation; defined

as lesional maximum FDG uptake higher than the maximum FDG uptake in unaffected liver

parenchyma as measured in a reference volume-of-interest with >10 mL

6. Baseline biopsy material is available for central review.

7. Female patients considered as women of childbearing potential (WOCBP, see section

5.2.7 for definition) and male patients with female partners considered as WOCBP must:

1. agree to either remain completely abstinent (refrain from heterosexual

intercourse) or to use at least one effective contraceptive methods that results

in a failure rate of < 1% per year

2. refrain from donating ova (female patients) or donating sperm (male patients)

3. in case of male patients with pregnant female partners, remain abstinent (refrain

from heterosexual intercourse) or use contraceptive measures such as a condom to

avoid exposing the embryo.

8. Patient did not receive any prior lymphoma therapy.

9. Patient has an ECOG performance status of ≤ 2.

10. Patient has with treatment a life expectancy (in the opinion of the investigator) of

at least 12 weeks.

11. Patient has adequate liver function

12. Patient as adequate hematological function

13. Patient has adequate renal function

14. Patients has negative serologic and/or polymerase chain reaction (PCR) test results

for:

- Acute or chronic hepatitis B (HBV) infection.

- Hepatis C virus (HCV) and human immunodeficiency virus (HIV)

15. Patient has no active SARS-CoV-2 infection.

Exclusion Criteria:

Medical conditions:

1. Patient with chronic lymphocytic leukemia (CLL), acute lymphoblastic leukemia (ALL)

(including CD20+ ALL), lymphoblastic lymphoma, Richter's transformation, Burkitt

lymphoma.

2. Patient ≤ 60 years

3. Patient with known active infection, or reactivation of a latent infection, whether

bacterial (e.g., tuberculosis), viral (including, but not limited to severe pneumonia,

COVID-19, Epstein-Barr virus [EBV], cytomegalovirus [CMV], hepatitis B, hepatitis C,

and HIV], fungal, mycobacterial, or other pathogens (excluding fungal infections of

nail beds) or any major episode of infection requiring hospitalization or treatment

with IV antibiotics (for IV antibiotics this pertains to completion of last course of

antibiotic treatment) within 4 weeks prior to study enrollment.

4. Patient with current > Grade 1 peripheral neuropathy.

5. Patient with history of confirmed progressive multifocal leukoencephalopathy (PML).

6. Patient with history of leptomeningeal disease.

7. Patient with current or history of CNS lymphoma.

8. Patient with current or history of CNS disease, such as stroke, epilepsy, CNS

vasculitis, or neurodegenerative disease with exceptions.

9. Patient with another invasive malignancy in the last 2 years (with the exception of

basal cell carcinoma and tumors deemed by the Investigator to be of low likelihood for

recurrence), with the exception of malignancies with a negligible risk of metastasis

or death (e.g., 5-year OS rate 90%), such as adequately-treated carcinoma in situ of

the cervix, non-melanoma skin carcinoma, localized prostate cancer, ductal carcinoma

in situ, or Stage I uterine cancer.

10. Patient with significant or extensive history of cardiovascular disease (such as New

York Heart Association (NYHA) Class ≥ II cardiac disease, congestive heart failure,

myocardial infarction or cerebrovascular accident within the past 3 months, unstable

arrhythmias, or unstable angina or history of multiple cardiovascular events) or

significant pulmonary disease (including obstructive pulmonary disease and history of

bronchospasm).

11. Patient with active or history of autoimmune disease or immune deficiency, including,

but not limited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus

erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid

antibody syndrome, Wegener granulomatosis, Sjögren's syndrome, Guillain-Barré

syndrome, or multiple sclerosis (see addendum for a more comprehensive list of

autoimmune diseases and immune deficiencies), with exceptions.

12. Patient with uncontrolled pleural effusion, pericardial effusion, or ascites requiring

recurrent drainage procedures (once monthly or more frequently).

13. Patient with history of idiopathic pulmonary fibrosis, organizing pneumonia (e.g.,

bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic.

Prior/Concomitant Therapy:

14. Patient received treatment with any other standard anti-cancer

radiotherapy/chemotherapy including investigational therapy (defined as treatment for

which there is currently no regulatory authority approved indication) within 4 weeks

or five times the elimination half-life of the product, whichever is longer, prior to

study enrollment.

15. Patient with prior solid organ transplantation.

16. Patient with prior allogeneic stem cell transplantation.

17. Patient with prior treatment with targeted therapies (e.g., tyrosine kinase

inhibitors, systemic immunotherapeutic/immunostimulating agents, including, but not

limited to, CD137 agonists or immune checkpoint blockade therapies, including

anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapeutic antibodies, radio-immunoconjugates,

antibody-drug conjugates, immune/cytokines, and monoclonal antibodies) within 4 weeks

or five half-lives of the drug, whichever is shorter, prior to study enrollment.

18. Patient with toxicities from prior anti-cancer therapy including immunotherapy that

did not resolve to ≤ Grade 1 except for alopecia, endocrinopathy managed with

replacement therapy and stable vitiligo.

19. Patient with any history of immune related ≥ Grade 3 AE except for endocrinopathy

managed with replacement therapy.

20. Patient with ongoing corticosteroid use 25 mg/day of prednisone or equivalent within 4

weeks prior and during study treatment.

21. Patient with treatment with systemic immunosuppressive medication (including, but not

limited to, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-TNF

agents) within 2 weeks prior to initiation of study treatment, or anticipation of need

for systemic immunosuppressive medication during study treatment, with exceptions.

22. Patient who received administration of a live, attenuated vaccine within 4 weeks prior

to study enrollment infusion or anticipation that such a live, attenuated vaccine will

be required during the study or within 5 months after the last dose of study

treatment.

Other Exclusions:

23. Patient with history of illicit drug or alcohol abuse within 12 months prior to

screening, in the Investigator's judgment.

24. Patient with history of severe allergic anaphylactic reactions to chimeric or

humanized monoclonal antibodies or recombinant antibody-related fusion proteins.

25. Patient with known hypersensitivity to Chinese hamster ovary (CHO) cell products or to

any component of the rituximab, obinutuzumab, polatuzumab vedotin and/or glofitamab

formulation and/or to the contrast agents used in the study.

26. Female patient is pregnant or breast feeding. Female patients of childbearing

potential must have a negative serum pregnancy test result within 7 days prior to

initiation of study treatment.

27. Patient who has been incarcerated or involuntarily institutionalized by court order or

by the authorities § 40 Abs. 1 S. 3 Nr. 4 AMG.

28. Patients who are unable to consent because they do not understand the nature,

significance and implications of the clinical trial and therefore cannot form a

rational intention in the light of the facts [§ 40 Abs. 1 S. 3 Nr. 3a AMG].

29. Patients who are dependent on the sponsor, the investigator or the trial site.

Studien-Rationale

Primary outcome:

1. 1 year progression-free survival (PFS) rate (Time Frame - 12 months):
defined as the time from the day of inclusion until disease progression (PD) or relapse after complete remission (CR), or death due to any cause, whichever occurs first



Secondary outcome:

1. Event-free survival (EFS) (Time Frame - 54 months):
defined as the time from the day of inclusion until progressive disease or relapse after complete remission, initiation of subsequent systemic antilymphoma treatment, radiation of single PET-CT positive lesions or death due to any cause, whichever occurs first.

2. Overall survival (OS) (Time Frame - 54 months):
defined as the time from the day of inclusion until death due to any cause

3. Response rate at different timepoints (Time Frame - 6 weeks, 18 weeks, 36 weeks):
Response rates after 2 cycles (during target dose phase), 6 cycles (end of target dose phase before start of consolidation phase) and 12 cycles (end of treatment following completion of consolidation phase). i.e., complete remission (CR) rate, partial remission (PR) rate, overall remission rate (ORR: CR+PR), stable disease (SD) rate and progressive disease (PD) rate

4. Relapse rate (Time Frame - 54 months):
defined as the number of patients with relapse, divided by the number of patients achieving C

5. Conversion rate of PR to CR (Time Frame - 54 months):
defined as the number of patients achieving mCR at the end of study treatment (including consolidation phase) divided by the number of patients achieving PR after end of target dose phase (before start of consolidation phase)

6. Duration of response (DoR) (Time Frame - 54 months):
defined as the time from documentation of CR until relapse or lymphoma associated death without documented relapse

7. Rate and type of adverse events (AEs) and serious adverse events (SAEs) (Time Frame - 54 months)

8. Rate of secondary malignancies (Time Frame - 54 months):
defined as the number of patients with secondary malignancies divided by the number of analyzable patients

9. Treatment-related death rate (Time Frame - 54 months):
defined as the number of treatment related deaths during therapy or up to 2 months after the end of study treatment, but before the start of further treatment, divided by the number of analyzable patients

10. Protocol adherence (Time Frame - 54 months):
number and duration of R-Pola-Glo cycles, number and duration of glofitamab maintenance, cumulative and relative doses of rituximab, glofitamab and polatuzumab.

11. Patient-reported outcomes for quality of life (QoL): EORTC QLQ-C30 (Time Frame - 54 months):
measured by EORTC QLQ-C30 (a 30-item questionnaire developed by the European Organisation for Research and Treatment of Cancer). All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level.

12. Patient-reported outcomes for quality of life (QoL): FACT-Lym (Time Frame - 54 months):
measured by FACT-Lym (Functional Assessment of Cancer Therapy - Lymphoma; scores from 0 - 4; The higher the score, the better the QOL)

Geprüfte Regime

  • Glofitamab:
    Glofitamab is a fully humanized, engineered monoclonal bivalent antibody of the IgG1 isotype.
  • Rituximab:
    Rituximab is a genetically engineered chimeric mouse/human anti-CD20 monoclonal antibody
  • Obinutuzumab:
    Obinutuzumab is a fully humanized, glycoengineered type II monoclonal antibody of the IgG1 isotype that binds to an epitope on CD20
  • Polatuzumab vedotin:
    Polatuzumab vedotin is an antibody-drug-conjugate that contains a humanized IgG1 anti-CD79b monoclonal antibody (MCDS4409A) and a potent anti-mitotic agent (MMAE) linked through a protease-cleavable linker.

Quelle: ClinicalTrials.gov


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