B-cell Non-Hodgkin Lymphoma (NHL) Clinical Trial
— ELM-2Official title:
An Open-Label Study to Assess the Anti-Tumor Activity and Safety of REGN1979, an Anti CD20 x Anti-CD3 Bispecific Antibody, in Patients With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma
Primary objective is to assess the anti-tumor activity of single agent odronextamab as measured by the objective response rate (ORR) according to the Lugano Classification of response in malignant lymphoma (Cheson, 2014) and as assessed by independent central review in each of the following B-cell non-Hodgkin lymphoma (B-NHL) subgroups: - In patients with follicular lymphoma (FL) grade 1-3a *1,2 - In patients with diffuse large B-cell lymphoma (DLBCL) *1,2 - In patients with mantle cell lymphoma (MCL) that has relapsed after or is refractory to a BTK inhibitor. This cohort will also include patients who have relapsed or have disease refractory to prior systemic therapy, or patients who have demonstrated intolerance to BTK inhibitor therapy, and who have progressed after other systemic therapy. - In patients with marginal zone lymphoma (MZL) *1 - In patients with other B-NHL subtypes *1 Secondary objectives are: - To assess the anti-tumor activity of single agent odronextamab in each of 5 disease-specific cohorts, as measured by: - ORR according to the Lugano Classification and as assessed by local investigator evaluation - Complete response (CR) rate according to the Lugano Classification and as assessed local by local investigator evaluation and independent central review - Progression-free survival (PFS)*3 - Overall survival (OS) - Duration of response (DOR)*3 - Disease control rate (DCR)*3 - To evaluate the safety and tolerability of odronextamab - To assess the pharmacokinetics (PK) of odronextamab - To assess the immunogenicity of odronextamab - To assess the effect of odronextamab on patient reported outcomes, including health-related quality of life (HRQL), as measured by the validated instruments European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym), and EuroQoL 5 Dimensions 3 Levels (EQ-5D-3L) - 1 that has relapsed after or is refractory to at least 2 prior lines of systemic therapy - 2 including an anti-CD20 antibody and an alkylating agent - 3 according to Lugano Classification and as assessed by independent central review and local investigator evaluation
Status | Recruiting |
Enrollment | 512 |
Est. completion date | February 5, 2028 |
Est. primary completion date | December 19, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Key Inclusion Criteria: - For the FL grade 1-3a cohort only: Central histopathologic confirmation of the FL Grade 1 to 3a diagnosis must be obtained before study enrollment. Patients with FL grade 3b are ineligible for this cohort but may be included in the "other B-NHL" cohort. Follicular lymphoma subtyping is based on the World Health Organization (WHO) classification (Swerdlow, 2017). - Disease-specific cohorts that has relapsed after or is refractory to at least 2 prior lines of systemic therapy as defined in the protocol - DLBCL cohort: Patients with DLBCL that has relapsed after or is refractory to at least 2 prior lines of systemic therapy as defined in the protocol - MCL after BTK inhibitor therapy cohort: New enrollment is paused until further notice - MZL cohort: Patients with MZL that have relapsed or is refractory to at least 2 prior lines of systemic therapy. - Other B-NHL cohort: Patients with B-NHL other than FL grade 1-3a, DLBCL, MCL, or MZL that has relapsed after or is refractory to at least 2 prior lines of systemic therapy as defined in the protocol. New enrollment stopped for patients with Burkitt lymphoma and Burkitt-like lymphoma. - Patients should in the judgment of the investigator require systemic therapy for lymphoma at the time of study enrollment - Measurable disease on cross sectional imaging as defined in the protocol documented by diagnostic imaging (computed tomography (CT), or magnetic resonance imaging (MRI) - Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 - Adequate bone marrow, hepatic, and renal function as defined in the protocol Key Exclusion Criteria: - Primary central nervous system (CNS) lymphoma or known involvement by non-primary CNS Non-Hodgkin Lymphoma (NHL) (suspected CNS lymphoma should be evaluated by lumbar puncture, as appropriate, in addition to the mandatory head CT or MRI). - Treatment with any systemic anti-lymphoma therapy within 5 half-lives or within 28 days prior to first administration of study drug, whichever is shorter. - History of allogeneic stem cell transplantation - Prior treatment with any chimeric antigen receptor T-cell (CAR-T) therapy - Continuous systemic corticosteroid treatment with more than 10 mg per day of prednisone or anti-inflammatory equivalent within 72 hours of start of study drug - History of neurodegenerative condition or CNS movement disorder. Patients with a history of seizure within 12 months prior to study enrollment are excluded - Another malignancy except B-NHL in the past 5 years, with the exception of non-melanoma skin cancer that has undergone potentially curative therapy or in situ cervical carcinoma, or any other tumor that has been deemed to be effectively treated with definitive local control and with curative intent. - Uncontrolled infection with human immunodeficiency virus (HIV), hepatitis B or hepatitis C infection; cytomegalovirus (CMV) infection as noted by detectable levels on a blood polymerase chain reaction (PCR) assay as defined in the protocol or other uncontrolled infections - Known hypersensitivity to both allopurinol and rasburicase - Prior treatment with an anti-CD20 x anti-CD3 bispecific therapy Note: Other protocol-defined Inclusion/Exclusion criteria apply |
Country | Name | City | State |
---|---|---|---|
Australia | Border Medical Oncology, Albury Wodonga Regional Cancer Centre | East Albury | |
Australia | Epworth Hospital | East Melbourne | |
Australia | Penninsula & South Eastern Haemotology and Oncology Group | Frankston | |
Australia | Andrew Love Cancer Center | Geelong | |
Australia | Olivia Newton John Cancer Centre | Heidelberg | |
Australia | The Tweed Hospital | Murdoch | |
Australia | Royal Perth Hospital | Perth | |
Australia | Andrew Love Cancer Center | Tweed Heads | |
Canada | Cross Cancer Center | Edmonton | Alberta |
Canada | QEII Health Science Center | Halifax | Nova Scotia |
China | Peking Union Medical College Hospital | Beijing | |
China | Peking University Cancer Hospital (Beijing Cancer Hospital) (Beijing Institute for Cancer Research) | Beijing | Beijing |
China | Peking University Third Hospital | Beijing | |
China | Sun Yat-Sen University Cancer Center (Cancer Prevention and Treatment Center, Sun Yat-sen University) | Canton | |
China | The First Bethune Hospital Of Jilin University | Changchun | Jilin |
China | West China Hospital of Sichuan University | Chengdu | Sichuan |
China | Second Affiliated Hospital of Army Medical University, PLA | Chongqing | |
China | The First Affiliated Hospital, Zhejiang University School of Medicine | Hangzhou | Zhejiang |
China | The Second Affiliated Hospital of Zhejiang University School of Medicine | Hangzhou | Zhejiang |
China | Harbin Medical University Cancer Hospital | Heilongjiang | |
China | Fudan University Cancer Hospital | Shanghai | |
China | The First Affiliated Hospital of Soochow University | Suzhou | Jiangsu |
China | Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences | Tianjin | |
China | Tianjin Medical University Cancer Institute & Hospital | Tianjin | |
China | Renmin Hospital of Wuhan University | Wuhan | |
China | Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology | Wuhan | Wuhan Hubei Province |
China | The First Affiliated Hospital of Xi 'an Jiaotong University | Xi'an | |
China | The First Affiliated Hospital of Zhengzhou University | Zhengzhou | Henan |
France | CHU de Caen | Caen | |
France | Hospital Henri Mondor | Créteil | |
France | Hopital Huriez-CHRU Lille | Lille | |
France | CHU de Nantes | Nantes | |
France | Hopital de la Pitie Salpetriere | Paris | |
France | Hospital Saint-Louis | Paris | |
France | CHU Haut Leveque | Pessac | |
France | Centre Hospitalier Lyon Sud | Pierre Bénite | |
France | Centre Hospitalier Universitaire (CHU) de Poitiers | Poitiers | |
Germany | Klinikum Chemnitz gGmbH Klinik fuer Innere Medizin III | Chemnitz | |
Germany | University Hospital Halle Saale | Halle | |
Germany | Kliniken Ostalb, Stauferklinikum | Mutlangen | |
Germany | Klinik fur Innere Medizin II Schwarzwald Baar Klinikum | Villingen-Schwenningen | |
Germany | Universitätsklinikum Würzburg | Wurzburg | |
Italy | Policlinico Sant'Orsola Malpipghi | Bologna | |
Italy | Azienda Ospedaliera Careggi | Firenze | |
Italy | Ospedale Di Livorno Usl6 | Livorno | |
Italy | ASST Grande Ospedale Metropolitano Niguarda | Milano | |
Italy | Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico | Milano | |
Italy | AOU Maggiore della Carita | Novara | |
Italy | Santa Maria Della Misericordia Hospital | Perugia | |
Italy | Ospedale Santa Maria delle Croci | Ravenna | |
Italy | SC Ematologia Dip to Oncologico e Tecnologie Avanzate_ IRCCS - Arcispedale Santa Maria Nuova | Reggio Emilia | |
Italy | Struttura Complessa di Ematologia e Trapianto di cellule staminali emopoietiche _ IRCCS Casa Sollievo della Sofferenza | San Giovanni Rotondo | |
Italy | A.O. Santa Maria | Terni | |
Italy | Ospedale dell'Angelo | Varese | |
Italy | Ospedale DellAngelo Di Mestre Umberto I | Venice | |
Japan | Chiba Cancer Center | Chiba | |
Japan | National Cancer Center Hospital | Chuo ku | |
Japan | National Hospital Organization National Kyushu Cancer Center | Fukuoka-shi | Hukuoka |
Japan | Tokai University Hospital | Isehara-Shi | |
Japan | National Cancer Center Hospital East | Kashiwa-shi | Chiba-ken |
Japan | Kobe City Medical Center General Hospital | Kobe | Hyogo |
Japan | " University Hospital Kyoto Prefectural University of Medicine" | Kyoto City | Kyoto |
Japan | National Hospital Organization Shikoku Cancer Center | Matsuyama | Ehime |
Japan | Japanese Red Cross Nagasaki Genbaku Hospital | Nagasaki | |
Japan | Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital | Nagoya | Aiti |
Japan | National Hospital Organization Nagoya Medical Center | Nagoya | Aiti |
Japan | Osaka Metropolitan University Hospital | Osaka City | |
Japan | Saitama Medical University International Medical Center | Saitama | |
Japan | Yamagata University Hospital | Yamagata City | |
Korea, Republic of | Dong-A University Hospital | Busan | |
Korea, Republic of | Keimyung University Dongsan Medical Center | Daegu-si | |
Korea, Republic of | National Cancer Center | Goyang-si | |
Korea, Republic of | Ewha Womans University Mokdong Hospital | Seoul | |
Korea, Republic of | Korea University Anam Hospital | Seoul | |
Korea, Republic of | Samsung Medical Center | Seoul | |
Korea, Republic of | Seoul National University Hospital | Seoul | |
Korea, Republic of | Severance Hospital | Seoul | |
Korea, Republic of | The Catholic University of Korea, Seoul St. Mary's Hospital | Seoul | |
Korea, Republic of | Ulsan University Hospital | Ulsan | |
Poland | Uniwersyteckie Centrum Kliniczne | Gdansk | |
Poland | Szpitale Pomorskie spSp. Z.o.o. | Gdynia | |
Poland | Malopolskie Centrum Medyczne S.C | Krakow | |
Poland | Regeneron Study Site | Lodz | |
Poland | Apteka IHiT (Instytut Hematologii I Transfuzjologii | Warszawa | |
Poland | Instytut im. M. Sklodowskiej-Curie | Warszawa | |
Poland | Uniwersytecki Szpital Kliniczny | Wroclaw | |
Singapore | ICON-SOC Farrer Park Hospital | Singapore | |
Singapore | National University Hospital | Singapore | |
Singapore | Raffles Cancer Center | Singapore | |
Singapore | Singapore General Hospital | Singapore | |
Spain | Hospital Clinic I Provincial de Barcelona | Barcelona | |
Spain | Hospital de la Santa Creu I Sant Pau | Barcelona | |
Spain | Hospital Universitario Vall De'Hebron | Barcelona | |
Spain | Hospital Universitario Donostia | Donostia | |
Spain | Institut Català d'Oncologia | L'Hospitalet de llobregat | |
Spain | Fundacion Jimenez Diaz University Hospital | Madrid | |
Spain | Hospital Universitario 12 de Octubre | Madrid | |
Spain | Hospital Universitario HM Sanchinarro | Madrid | |
Spain | Hospital Universitario Quiron Salud Madrid | Madrid | |
Spain | MD Anderson Cancer Center | Madrid | |
Spain | Hospital Costa del Sol | Marbella | |
Spain | Hospital Son Espases | Palma | |
Spain | Hospital son Llatzer | Palma de Mallorca | |
Spain | Hospital Universitario de Salamanca | Salamanca | |
Spain | Hospital Universitari i Politecnic La Fe | Valencia | |
Taiwan | Kaosiung Chang Gung Memorial Hospital | Kaohsiung | |
Taiwan | Taipei Medical University - Shuang-Ho Hospital | New Taipei City | |
Taiwan | China Medical University Hospital | Taichung City | |
Taiwan | Chi-Mei Medical Center-Liuying | Tainan | |
Taiwan | National Cheng Kung University Hospital | Tainan City | |
Taiwan | Koo Foundation Sun Yat Sen Cancer Center | Taipei City | |
Taiwan | Mackay Memorial Hospital | Taipei City | |
Taiwan | National Taiwan University Hospital | Taipei City | |
Taiwan | Tri-Service General Hospital | Taipei City | |
Taiwan | Chang Gung Memorial Hospital | Taoyuan | |
United Kingdom | University Hospital of Wales | Cardiff | |
United Kingdom | Western General Hospital | Edinburgh | |
United Kingdom | Kings College Hospital | London | |
United Kingdom | Derriford Hospital | Plymouth | |
United Kingdom | The Royal Marsden Hospital | Sutton | |
United Kingdom | Royal Cornwall Hospital | Truro | |
United States | University of Michigan | Ann Arbor | Michigan |
United States | Beth Israel Deaconess Medical Center | Boston | Massachusetts |
United States | Tufts Cancer Center | Boston | Massachusetts |
United States | Rush University Medical Center | Chicago | Illinois |
United States | Cleveland Clinic | Cleveland | Ohio |
United States | Simmons Comprehensive Cancer Center | Dallas | Texas |
United States | Brook Army Medical Center | Fort Sam Houston | Texas |
United States | John Theurer Cancer Center Hackensack University Medical Center | Hackensack | New Jersey |
United States | University of Iowa Hospital and Clinics | Iowa City | Iowa |
United States | Norton Cancer Institute | Louisville | Kentucky |
United States | Morristown Medical Center | Morristown | New Jersey |
United States | Weill Cornell Medical College | New York | New York |
United States | Stephenson Cancer Center | Oklahoma City | Oklahoma |
United States | University/Academic Hospital Mayo Clinic | Rochester | Minnesota |
United States | SSM Saint Louis University Hospital | Saint Louis | Missouri |
United States | Stony Brook Hospital | Stony Brook | New York |
United States | Wake Forest Baptist Medical Center | Winston-Salem | North Carolina |
Lead Sponsor | Collaborator |
---|---|
Regeneron Pharmaceuticals |
United States, Australia, Canada, China, France, Germany, Italy, Japan, Korea, Republic of, Poland, Singapore, Spain, Taiwan, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | ORR (FL grade 1-3a/MZL) | For each of the 5 disease-specific cohorts according to the Lugano Classification of response in malignant lymphoma (Cheson, 2014) and as assessed by independent central review. | From first patient first dose until all patients have completed 52 weeks of study treatment or have withdrawn from the study | |
Primary | ORR (DLBCL/MCL/Other B-NHL) | For each of the 5 disease-specific cohorts according to the Lugano Classification of response in malignant lymphoma (Cheson, 2014) and as assessed by independent central review. | From first patient first dose until all patients have completed 36 weeks of study treatment or have withdrawn from the study | |
Secondary | ORR (FL/MZL) | According to the Lugano Classification, as assessed by local investigator evaluation | First patient first dose until all patients have completed 52 weeks of study treatment or have withdrawn from the study. | |
Secondary | ORR (DLBCL/MCL/Other B-NHL) | According to the Lugano Classification, as assessed by local investigator evaluation | First patient first dose until all patients have completed 36 weeks of study treatment or have withdrawn from the study. | |
Secondary | CR rate (FL grade 1-3a/MZL) | According to the Lugano Classification and as assessed by local investigator evaluation and independent central review | First patient first dose until all patients have completed 52 weeks of study treatment or have withdrawn from the study. | |
Secondary | CR rate (DLBCL/MCL/Other B-NHL) | According to the Lugano Classification and as assessed by local investigator evaluation and independent central review | First patient first dose until all patients have completed 36 weeks of study treatment or have withdrawn from the study. | |
Secondary | PFS | According to the Lugano Classification and as assessed by independent central review and local investigator evaluation | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | |
Secondary | OS | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | ||
Secondary | DOR | According to the Lugano Classification and as assessed by independent central review and local investigator evaluation | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | |
Secondary | DCR (FL grade 1-3a/MZL) | According to the Lugano Classification and as assessed by independent central review and local investigator evaluation | First patient first dose until all patients have completed 52 weeks of study treatment or have withdrawn from the study. | |
Secondary | DCR (DLBCL/MCL/Other B-NHL) | According to the Lugano Classification and as assessed by independent central review and local investigator evaluation | First patient first dose until all patients have completed 36 weeks of study treatment or have withdrawn from the study. | |
Secondary | Incidence and severity of treatment emergent adverse events (TEAEs) | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | ||
Secondary | Pharmacokinetics: Concentration of odronextamab | End of infusion [EOI]; Concentration at a specified time t [Ct]) | 12 weeks following end of treatment | |
Secondary | Incidence of anti-drug antibodies (ADA) to odronextamab over time | 12 weeks following end of treatment | ||
Secondary | Titer of anti-drug antibodies to odronextamab over time | 12 weeks following end of treatment | ||
Secondary | Incidence of neutralizing antibodies (Nab) to odronextamab over time | 12 weeks following end of treatment | ||
Secondary | Changes in scores of patient-reported outcomes as measured by EORTC QLQ-C30 | EORTC QLQ-C30 is a self-reported, 30-item generic questionnaire developed to assess 15 domains: global health status scale, five functional scales (physical, role, emotional, cognitive, and social functioning) and nine symptom scales (fatigue, nausea, vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties). | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | |
Secondary | Changes in scores of patient-reported outcomes as measured by FACT-Lym | Composed of the FACT-G plus the 15-item Lymphoma Subscale (LymS). | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose | |
Secondary | Changes in scores of patient-reported outcomes as measured by EQ-5D-3L | The EQ-5D-3L is a standardized instrument for use as a measure of health outcome. It is a health questionnaire that consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D-3L descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, extreme problems. | First patient first dose to disease progression or death due to any cause, whichever comes first, approximately 194 weeks following the first dose |
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