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A Phase Ib/II Study Investigating the Safety, Tolerability, Pharmacokinetics, and Efficacy of Mosunetuzumab (BTCT4465A) in Combination With CHOP or CHP-Polatuzumab Vedotin in Participants With B-Cell Non-Hodgkin Lymphoma

Registration Number
NCT03677141
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This study will evaluate the safety, pharmacokinetics, and preliminary efficacy of mosunetuzumab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (M-CHOP) and, subsequently, in combination with cyclophosphamide, doxorubicin, and prednisone (CHP) plus polatuzumab vedotin (CHP-pola) in participants with relapsed or refractory (R/R) B-cell non-Hodgkin lymphoma (NHL), and in previously untreated participants with diffuse large B-cell lymphoma (DLBCL).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
117
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingMosunetuzumabParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: M-CHP-Pola Dose-FindingMosunetuzumabParticipants will receive M-CHP-Pola up to the RP2D.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortMosunetuzumabParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase II: M-CHOP 1L DLBCLMosunetuzumabParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Phase II: M-CHP-Pola 1L DLBCLMosunetuzumabParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase Ib: M-CHP-Pola Dose-FindingDoxorubicinParticipants will receive M-CHP-Pola up to the RP2D.
Phase Ib: M-CHP-Pola Dose-FindingPrednisoneParticipants will receive M-CHP-Pola up to the RP2D.
Phase Ib: M-CHP-Pola Dose-FindingTocilizumabParticipants will receive M-CHP-Pola up to the RP2D.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortCyclophosphamideParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortDoxorubicinParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingPolatuzumab VedotinParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingCyclophosphamideParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingDoxorubicinParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingVincristineParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingPrednisoneParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: Mosunetuzumab (M)-CHOP Dose FindingTocilizumabParticipants will receive M-CHOP up to the phase II recommended dose (RP2D).
Phase Ib: M-CHP-Pola Dose-FindingPolatuzumab VedotinParticipants will receive M-CHP-Pola up to the RP2D.
Phase Ib: M-CHP-Pola Dose-FindingCyclophosphamideParticipants will receive M-CHP-Pola up to the RP2D.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortVincristineParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortPrednisoneParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase II: M-CHOP Previously Untreated (1L) DLBCL Safety CohortTocilizumabParticipants with 1L DLBCL will receive mosunetuzumab at the RP2D in combination with CHOP.
Phase II: M-CHP-Pola 1L DLBCLPolatuzumab VedotinParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase II: M-CHP-Pola 1L DLBCLCyclophosphamideParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase II: M-CHP-Pola 1L DLBCLDoxorubicinParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase II: M-CHP-Pola 1L DLBCLPrednisoneParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase II: M-CHP-Pola 1L DLBCLTocilizumabParticipants with 1L DLBCL will receive M-CHP-Pola at a dose determined in the dose finding stage.
Phase II: Rituxumab (R)-CHP-Pola 1L DLBCLPolatuzumab VedotinParticipants with 1L DLBCL will receive R-CHP-Pola at a dose determined in the dose finding stage.
Phase II: Rituxumab (R)-CHP-Pola 1L DLBCLRituxumabParticipants with 1L DLBCL will receive R-CHP-Pola at a dose determined in the dose finding stage.
Phase II: Rituxumab (R)-CHP-Pola 1L DLBCLCyclophosphamideParticipants with 1L DLBCL will receive R-CHP-Pola at a dose determined in the dose finding stage.
Phase II: Rituxumab (R)-CHP-Pola 1L DLBCLDoxorubicinParticipants with 1L DLBCL will receive R-CHP-Pola at a dose determined in the dose finding stage.
Phase II: Rituxumab (R)-CHP-Pola 1L DLBCLPrednisoneParticipants with 1L DLBCL will receive R-CHP-Pola at a dose determined in the dose finding stage.
Phase II: M-CHOP 1L DLBCLCyclophosphamideParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Phase II: M-CHOP 1L DLBCLDoxorubicinParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Phase II: M-CHOP 1L DLBCLVincristineParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Phase II: M-CHOP 1L DLBCLPrednisoneParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Phase II: M-CHOP 1L DLBCLTocilizumabParticipants with 1L DLBCL will receive M-CHOP at a dose determined in the dose finding stage. NOTE: No participants were enrolled to this arm.
Primary Outcome Measures
NameTimeMethod
Complete Response (CR) Rate at the Time of Primary Response Assessment (PRA) Based on Positron Emission Tomography - Computed Tomography (PET-CT) as Determined by Independent Review Committee (IRC)6-8 weeks after either C6D1 or last dose of study treatment

The CR rate was defined as the percentage of participants with CR. Assessments were made according to the Lugano 2014 Response Criteria.

Secondary Outcome Measures
NameTimeMethod
Polatuzumab Vedotin Antibody-conjugated Monomethyl Auristatin E (acMMAE) Serum ConcentrationsC1D1-C6D1
Polatuzumab Vedotin Unconjugated Mono-methyl Auristatin E (MMAE) Serum ConcentrationsC1D1-C6D1
Mosunetuzumab Serum ConcentrationsC1D1-C5D1
Time to Deterioration in Physical Functioning and Fatigue as Measured by the European Organization for Research and Treatment of Cancer Quality of Life - Core 30 Questionnaire (EORTC QLQ-C30)C1D1 through follow-up period (to begin 2 years after PRA or at the time of study drug discontinuation)
Polatuzumab Vedotin Serum ConcentrationsC2D1, C6D1
CR Rate at PRA Based on CT Only as Determined by the Investigator (Phase II)6-8 weeks after C6D1 or last dose of study treatment
Overall Response Rate (ORR) at PRA Based on PET-CT as Determined by the Investigator (Phase II)6-8 weeks after C6D1 or last dose of study treatment

ORR is defined as a CR or PR at the time of primary assessment based on PET-CT, as determined by the investigator.

ORR at PRA Based on CT Only as Determined by the Investigator (Phase II)6-8 weeks after C6D1 or last dose of study treatment

ORR is defined as a CR or PR at the time of primary assessment based on CT only, as determined by the investigator.

Best ORR Based on PET-CT and/or CT Scan as Determined by the Investigator (Phase II)Up to approximately 50 months

Best ORR was defined as CR or PR at any time on study and based on PET-CT or CT only as determined by the investigator.

Duration of Response (DOR) as Determined by the Investigator (Phase II)Up to approximately 50 months

DOR is defined as the time from the first occurrence of a documented objective response to disease progression or relapse as determined by the investigator, or death from any cause, whichever occurs first. The range values (min-max) are based on censored observations (if a participant did not experience disease progression or death prior to the end of the trial DOR was censored on the date of the last tumor assessment).

Progression-free Survival (PFS) as Determined by the Investigator (Phase II)Up to approximately 50 months

PFS is defined as the time from randomization to the first occurrence of disease progression or relapse as determined by the investigator, or death from any cause, whichever occurs first. The earliest contributing event to PFS is reported. The range (min-max) values are based on censored observations (participants without a baseline-evaluable tumor assessment were censored at the date of randomization or first study treatment, plus 1 day).

PFS at 1 Year as Determined by the Investigator (Phase II)1 year

PFS at 1 year is defined as the proportion of participants with disease progression or relapse as determined by the investigator, or death from any cause within 1 year of randomization.

Event-free Survival (EFS) as Determined by the Investigator (Phase II)Up to 50 months

EFS is defined as the time from randomization to the first occurrence of disease progression or relapse, as determined by the investigator, initiation of new anti-lymphoma therapy (NALT), or death from any cause, whichever occurs first. The range values (min-max) are based on censored observations (if a participant did not experience disease progression or death prior to the end of the trial DOR was censored on the date of the last tumor assessment).

Time to Deterioration in Lymphoma Symptoms as Measured by the Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) SubscaleC1D1 through follow-up period (to begin 2 years after PRA or at the time of study drug discontinuation)
Baseline Prevalence and Incidence of Treatment Emergent Anti-drug Antibodies (ADA) to MosunetuzumabCycles 1, 2, 6, 16, and at early discontinuation visit or at PRA (6-8 weeks after either C6D1 or last dose of study treatment)

Participants are considered to have treatment-induced ADA responses if they are ADA negative or missing data at baseline and then develop an ADA response following study drug administration. Participants are considered to have treatment-enhanced ADA responses if they are ADA positive at baseline and the titer of one or more post baseline samples is at least 4-fold greater than the titer of the baseline sample. Patients are considered to be negative for ADAs if they are ADA negative at all timepoints or if they are ADA positive at baseline but do not have any post-baseline samples with a titer that is at least 4-fold greater than the titer of the baseline sample (treatment unaffected).

Baseline Prevalence and Incidence of Treatment Emergent ADA to Polatuzumab VedotinCycles 1, 2, 6, and at early discontinuation visit or at PRA (6-8 weeks after either C6D1 or last dose of study treatment)

Participants are considered to have treatment-induced ADA responses if they are ADA negative or missing data at baseline and then develop an ADA response following study drug administration. Participants are considered to have treatment-enhanced ADA responses if they are ADA positive at baseline and the titer of one or more post baseline samples is at least 4-fold greater than the titer of the baseline sample. Patients are considered to be negative for ADAs if they are ADA negative at all timepoints or if they are ADA positive at baseline but do not have any post-baseline samples with a titer that is at least 4-fold greater than the titer of the baseline sample (treatment unaffected).

Trial Locations

Locations (41)

University of Alabama Birmingham

🇺🇸

Birmingham, Alabama, United States

Banner MD Anderson Cancer Center

🇺🇸

Gilbert, Arizona, United States

University of California; Moores Cancer Center

🇺🇸

La Jolla, California, United States

University of California, Los Angeles (UCLA) - Hematology/Oncology Santa Monica

🇺🇸

Santa Monica, California, United States

Georgetown University Medical Center

🇺🇸

Washington, District of Columbia, United States

University of Miami Miller School of Medicine

🇺🇸

Miami, Florida, United States

University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Scott and White Hospital; Cancer Center

🇺🇸

Temple, Texas, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Medical College of Wisconsin, Inc.

🇺🇸

Milwaukee, Wisconsin, United States

Uniklinikum Salzburg, LKH; Univ.Klinik f. Innere Medizin III der PMU

🇦🇹

Salzburg, Austria

LKH Steyr

🇦🇹

Steyr, Austria

Medizinische Universität Wien, Allgemeines Krankenhaus der Stadt Wien

🇦🇹

Wien, Austria

Hanusch-Krankenhaus

🇦🇹

Wien, Austria

CHU Henri Mondor; Service d'Oncologie Medicale

🇫🇷

Creteil, France

Centre Leon Berard

🇫🇷

Lyon, France

Hôpital Saint-Louis

🇫🇷

Paris, France

Centre Henri Becquerel- Centre de Lutte Contre le Cancer

🇫🇷

Saint Herblain, France

Gustave Roussy

🇫🇷

Villejuif, France

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Pusan National University Yangsan Hospital

🇰🇷

Gyeongsangnam-do, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Maria Sklodowska-Curie Memorial Cancer Centre

🇵🇱

Gliwice, Poland

Ma?opolskie Centrum Medyczne

🇵🇱

Kraków, Poland

Wojewodzki Szpital Specjalistyczny im. Janusza Korczaka

🇵🇱

Slupsk, Poland

Instytut Hematologii i Transfuzjologii; Klinika Zaburze? Hemostazy i Chorób Wewn?trznych

🇵🇱

Warsaw, Poland

Katedra i Klinika Hematologii; Nowotworów Krwi i Transplantacji Szpiku

🇵🇱

Wroc?aw, Poland

Institut Catala d?Oncologia Hospital Germans Trias i Pujol

🇪🇸

Badalona, Barcelona, Spain

Clinica Universidad de Navarra

🇪🇸

Pamplona, Navarra, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Seville, Sevilla, Spain

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Hospital San Pedro de Alcantara; Servicio de Hematología

🇪🇸

Caceres, Spain

Hospital General Universitario Gregorio Marañon

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

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