A Phase Ib/II Study Evaluating the Safety, Tolerability and Anti-Tumor Activity of Polatuzumab Vedotin (DCDS4501A) in Combination With Rituximab or Obinutuzumab, Cyclophosphamide, Doxorubicin, and Prednisone in Patients With B-Cell Non-Hodgkin's Lymphoma
Overview
- Phase
- Phase 1
- Intervention
- Cyclophosphamide
- Conditions
- Lymphoma, Non Hodgkin
- Sponsor
- Genentech, Inc.
- Enrollment
- 85
- Locations
- 11
- Primary Endpoint
- Number of Participants With Adverse Events in Diffuse Large B-Cell Lymphoma (DLBCL) Population
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
This multicenter, open-label, dose-escalation study will evaluate the safety, tolerability, pharmacokinetics, and anti-tumor activity of polatuzumab vedotin in combination with rituximab or obinutuzumab, cyclophosphamide, doxorubicin, and prednisone (CHP chemotherapy) in participants with non-Hodgkin's lymphoma (NHL). Participants will receive escalating doses of polatuzumab vedotin intravenously (IV) every 3 weeks in combination with standard doses of rituximab plus CHP chemotherapy (R-CHP) or obinutuzumab plus CHP chemotherapy (G-CHP). Participants will be treated for a total of six or eight cycles in accordance with local institutional practice. Two parallel treatment arms will explore doses of polatuzumab vedotin in combination with R-CHP or G-CHP. The maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D) of polatuzumab vedotin in combination with R-CHP will be identified before it is combined with G-CHP. Once the MTD or RP2D is determined, polatuzumab vedotin will be dosed at MTD or RP2D -1 in combination with G-CHP to start the dose escalation of this combination.
Investigators
Eligibility Criteria
Inclusion Criteria
- •All Participants:
- •At least one bi-dimensionally measurable lesion, defined as greater than (\>) 1.5 centimeters (cm) in its longest dimension
- •Life expectancy of at least 24 weeks
- •Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
- •Adequate hematologic function (unless inadequate function is due to underlying disease, as established by extensive bone marrow involvement or is due to hypersplenism secondary to the involvement of the spleen by lymphoma per the investigator)
- •Agreement to use highly effective contraception measures. Women of childbearing potential must agree to remain abstinent or use contraceptive measures that result in a failure rate of \<1 percent (%) per year during the treatment period and for at least 12 months for R-CHP arm or for at least 18 months for G-CHP arm after the last dose of study drug. Men must agree to remain abstinent or to use a condom plus an additional contraceptive method that together result in a failure rate of \<1% per year during the treatment period and for at least 5 months after the last dose of study drug
- •Dose-Escalation Portion of the Study:
- •Histologically confirmed B-cell NHL: Participants with newly diagnosed B-cell NHL or relapsed/refractory B-cell NHL are eligible
- •No more than one prior systemic treatment regimen for B-cell NHL (single agent anti-cluster of differentiation \[CD\] 20 monoclonal antibody therapy will not be counted as a prior treatment regimen)
- •No prior treatment with anthracyclines
Exclusion Criteria
- •Dose-Escalation Portion of the Study:
- •Diagnosis of primary mediastinal DLBCL
- •Expansion Portion of the Study:
- •Participants with transformed lymphoma
- •Prior therapy for NHL
- •All Participants:
- •Prior stem cell transplant
- •History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products
- •Contraindication to receive any of the individual components of R-CHP or G-CHP
- •Current Grade greater than (\>) 1 peripheral neuropathy
Arms & Interventions
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Obinutuzumab
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (1.4mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (1.0mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Rituximab
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Obinutuzumab
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (1.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Rituximab
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Rituximab
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Cyclophosphamide
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Doxorubicin
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Polatuzumab Vedotin
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisolone
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisone
Polatuzumab Vedotin (2.4mg) + R-CHP
Dose Escalation: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Rituximab
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Cyclophosphamide
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Doxorubicin
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Polatuzumab Vedotin
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisolone
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Prednisone
Expansion: Polatuzumab Vedotin (1.8mg) + R-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with R-CHP.
Intervention: Rituximab
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Cyclophosphamide
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Doxorubicin
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Obinutuzumab
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Polatuzumab Vedotin
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisolone
Expansion: Polatuzumab Vedotin (1.8mg) + G-CHP
Dose Expansion: Participants will receive a total of six to eight 21-day cycles of polatuzumab vedotin in combination with G-CHP.
Intervention: Prednisone
Outcomes
Primary Outcomes
Number of Participants With Adverse Events in Diffuse Large B-Cell Lymphoma (DLBCL) Population
Time Frame: Baseline up to 5 years
An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. AEs were reported based on the national cancer institute common terminology criteria for AEs, Version 4.0 (NCI-CTCAE, v4.0). Reported are the number of subjects with AEs, Grade 3-5 AEs, and Serious Adverse Events (SAEs).
Number of Participants With Adverse Events in Non-DLBCL Population
Time Frame: Baseline up to 5 years
An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. AEs were reported based on the national cancer institute common terminology criteria for AEs, Version 4.0 (NCI-CTCAE, v4.0). Reported are the number of subjects with AEs, Grade 3-5 AEs, and Serious Adverse Events (SAEs).
Number of Participants With Dose Limiting Toxicities (DLTs) in DLBCL Population
Time Frame: Cycle (Cy) 1 Day 1 (D1) to Cy 2 D1 (cycle length=21 days)
All dose-escalation cohorts will consist of at least 3 participants. If a DLT is observed in 1 participant at a given dose level during the DLT observation period before dose escalation, additional participants will be enrolled at that dose level for a total of at least 6 participants. DLT assessment forms part of determining the Maximum Tolerated Dose (MTD). The highest dose level resulting in DLTs in less than one-third of a minimum of 6 participants will be declared the MTD.
Number of Participants With DLTs in Non-DLBCL Population
Time Frame: Cycle (Cy) 1 Day 1 (D1) to Cy 2 D1 (cycle length=21 days)
All dose-escalation cohorts will consist of at least 3 participants. If a DLT is observed in 1 participant at a given dose level during the DLT observation period before dose escalation, additional participants will be enrolled at that dose level for a total of at least 6 participants. DLT assessment forms part of determining the Maximum Tolerated Dose (MTD). The highest dose level resulting in DLTs in less than one-third of a minimum of 6 participants will be declared the MTD.
Secondary Outcomes
- Percentage of Participants With Objective Response (CR or Partial Response [PR]), as Assessed by Investigator Using Cheson Criteria for DLBCL Population(At the end of treatment (Month 6))
- Percentage of Participants With Objective Response (CR or Partial Response [PR]), as Assessed by Investigator Using Cheson Criteria for Non-DLBCL Population(At the end of treatment (Month 6))
- Number of Participants With Anti-Polatuzumab Vedotin Antibodies(Baseline up to Month 9 (assessed prior to polatuzumab vedotin infusion [0 hour; Hr] on Day 2 [D2] of Cy 1 and 2, D1 of Cy 4, treatment completion/early termination [Month 6], and at 3 months post-treatment [Month 9]; cycle length=21 days))
- Number of Participants With Anti-Obinutuzumab Antibodies(Baseline up to Month 9 (assessed prior to obinutuzumab infusion [0 Hr] on D1 of Cy 1, 2, 4 and at 3 months post-treatment [Month 9]; cycle length=21 days))
- Plasma Levels of Cyclophosphamide(End of cyclophosphamide infusion (infusion time=1-24 Hr), 3 and 23 hours post end of cyclophosphamide infusion on D1 of Cy 1 and 3 (cycle length=21 days))
- Area Under the Concentration-Time Curve (AUC) of Polatuzumab Vedotin(Pre-polatuzumab vedotin infusion (Hr 0), 30 minutes (min) post-infusion (infusion time=30-90 min) on D 2 of Cy 1, 2 & D1 of Cy 3, 4; Cy 1 Days 8 & 15; Cy 3 Day 8; at end of treatment (Month 6), at Month 3 follow-up (Month 9) (cycle length=21 days))
- Maximum Concentration (Cmax) of Polatuzumab Vedotin(Pre-polatuzumab vedotin infusion (Hr 0), 30 min post-infusion (infusion time=30-90 min) on D 2 of Cy 1, 2 & D1 of Cy 3, 4; Cy 1 Days 8 & 15; Cy 3 Day 8; at end of treatment (Month 6), at Month 3 follow-up (Month 9) (cycle length=21 days))
- Clearance (CL) of Polatuzumab Vedotin(Pre-polatuzumab vedotin infusion (Hr 0), 30 min post-infusion (infusion time=30-90 min) on D 2 of Cy 1, 2 & D1 of Cy 3, 4; Cy 1 Days 8 & 15; Cy 3 Day 8; at end of treatment (Month 6), at Month 3 follow-up (Month 9) (cycle length=21 days))
- Terminal Half-Life (t1/2) of Polatuzumab Vedotin(Pre-polatuzumab vedotin infusion (Hr 0), 30 min post-infusion (infusion time=30-90 min) on D 2 of Cy 1, 2 & D1 of Cy 3, 4; Cy 1 Days 8 & 15; Cy 3 Day 8; at end of treatment (Month 6), at Month 3 follow-up (Month 9) (cycle length=21 days))
- Steady-State Volume of Distribution (Vss) of Polatuzumab Vedotin(Pre-polatuzumab vedotin infusion (Hr 0), 30 min post-infusion (infusion time=30-90 min) on D 2 of Cy 1, 2 & D1 of Cy 3, 4; Cy 1 Days 8 & 15; Cy 3 Day 8; at end of treatment (Month 6), at Month 3 follow-up (Month 9) (cycle length=21 days))
- Plasma Levels of Doxorubicin(2, 24 hours post end of doxorubicin infusion (infusion time=15 min) on D1 of Cy 1 and 3 (cycle length=21 days))
- Peripheral Neuropathy Symptom Severity: Therapy-Induced Neuropathy Assessment Scale (TINAS) Overall Neuropathy Severity Score(Weekly up to Month 6 (22 weeks). TINAS data were collected daily, though for the analysis purpose for each participant, only the first record of each week was selected.)
- Peripheral Neuropathy Symptom Interference: TINAS Numbness/Tingling Item Score(Weekly up to Month 6 (22 weeks). TINAS data were collected daily, though for the analysis purpose for each participant, only the first record of each week was selected.)
- Duration of Response, as Assessed by Investigator Using Cheson Criteria for DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Event Free Survival, as Assessed by Investigator Using Cheson Criteria for DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Event Free Survival, as Assessed by Investigator Using Cheson Criteria for Non-DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Relative Dose Intensity of Polatuzumab Vedotin (Ratio of the Amount of Drug Actually Administered to the Amount Planned) for DLBCL Population(6 months)
- Duration of Response, as Assessed by Investigator Using Cheson Criteria for Non-DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Progression Free Survival, as Assessed by Investigator Using Cheson Criteria for DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Progression Free Survival, as Assessed by Investigator Using Cheson Criteria for Non-DLBCL Population(Screening up to disease progression or death, whichever occurs first (up to approximately 2.75 years))
- Relative Dose Intensity of Polatuzumab Vedotin (Ratio of the Amount of Drug Actually Administered to the Amount Planned) for Non-DLBCL Population(6 months)
- Overall Survival for DLBCL Population(Screening up to death due to any cause (up to approximately 6 years))
- Overall Survival for Non-DLBCL Population(Screening up to death due to any cause (up to approximately 6 years))