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A Study to Compare How Well Odronextamab Combined With Chemotherapy Works and How Safe it is Against Rituximab Combined With Chemotherapy, in Patients With Previously Untreated Diffuse Large B-cell Lymphoma

Phase 3
Active, not recruiting
Conditions
Diffuse Large B-cell Lymphoma (DLBCL)
Interventions
Registration Number
NCT06091865
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching an experimental drug called odronextamab, referred to as study drug, when used in combination with chemotherapy. The study is focused on patients with diffuse large B-cell lymphoma (DLBCL) that have not been treated before (called "previously untreated"). Patients with DLBCL that have come back after treatment (called "relapsed"), or have not responded to treatment (called "refractory"), can also participate in this study.

This study will be made up of Part 1A, Part 1B, and Part 2.The aim of Part 1A and Part 1B of the study is to see how safe and tolerable the study drug in combination with chemotherapy is and to determine the dose and schedule of the study drug to be combined with chemotherapy in Part 2 of the study.

The aim of Part 2 of the study is to see how effective the combination of the study drug with chemotherapy is in comparison with the combination of rituximab (the comparator drug), and chemotherapy, the current standard of care treatment approved for DLBCL. Standard of care means the usual medication expected and used when receiving treatment for a condition.

The study is looking at several other research questions, including:

* What side effects may happen from taking the study drug when combined with chemotherapy

* How much study drug is in the blood at different times

* Whether the body makes antibodies against the study drug (which could make the study drug less effective or could lead to side effects)

* The impact from the study drug on quality of life and ability to complete routine daily activities

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
904
Inclusion Criteria
  1. Previously untreated participants for lymphoma with documented cluster of differentiation 20+ (CD20+) DLBCL, as described in the protocol OR relapsed or refractory DLBCL, for whom next available standard of care therapy is not available or deemed ineligible according to the investigator (Part 1A only)
  2. Measurable disease with at least one nodal lesion or at least one extranodal lesion, as described in the protocol
  3. Eastern Cooperative Oncology Group (ECOG) performance status ≤2
  4. Life expectancy ≥ 12 months
  5. International Prognostic Index (IPI) of 3 to 5 (part 1 only) and ≥2 (part 2) for untreated DLBCL only;
  6. Adequate hematologic and organ function, as defined in the protocol.

KEY

Exclusion Criteria
  1. Primary central nervous system (CNS) lymphoma or known involvement by non-primary CNS NHL and history or current relevant CNS pathology
  2. Another active malignancy, significant active disease or medical condition, as described in the protocol
  3. Peripheral neuropathy Grade ≥3
  4. Treatment with any systemic anti-lymphoma therapy, except for participants with relapsed/refractory (R/R) DLBCL and participants with DLBCL transformed from an indolent follicular lymphoma after treatment with systemic anti-lymphoma therapy.
  5. Any other therapy or investigational treatment within 28 days or 5 half-lives of the drug, whichever is shorter, prior to the start of study treatment
  6. Recent major surgery, prior organ transplantation, or standard radiotherapy, as described in the protocol
  7. Allergy/hypersensitivity to study drugs, as described in the protocol
  8. Infections such as any active infection (bacterial, viral, fungal, mycobacterial, parasitic or other), active Coronavirus disease (COVID-19) infection, uncontrolled infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV), Cytomegalovirus (CMV) infection, as described in the protocol.

Note: Other protocol-defined Inclusion/ Exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Odronextamab + CHOPDoxorubicinPart 1, includes dose escalation (Part 1A), and randomized exploration of 2 regimens of odronextamab -cyclophosphamide, doxorubicin, vincristine, prednisone (Odro-CHOP) dose optimization (Part 1B).
Odronextamab + CHOPVincristinePart 1, includes dose escalation (Part 1A), and randomized exploration of 2 regimens of odronextamab -cyclophosphamide, doxorubicin, vincristine, prednisone (Odro-CHOP) dose optimization (Part 1B).
Odronextamab + CHOPPrednisone/PrednisolonePart 1, includes dose escalation (Part 1A), and randomized exploration of 2 regimens of odronextamab -cyclophosphamide, doxorubicin, vincristine, prednisone (Odro-CHOP) dose optimization (Part 1B).
Rituximab + CHOPPrednisone/PrednisolonePart 2 is the randomized controlled portion, participants will receive either Odro-CHOP or R-CHOP.
Odronextamab + CHOPCyclophosphamidePart 1, includes dose escalation (Part 1A), and randomized exploration of 2 regimens of odronextamab -cyclophosphamide, doxorubicin, vincristine, prednisone (Odro-CHOP) dose optimization (Part 1B).
Rituximab + CHOPRituximabPart 2 is the randomized controlled portion, participants will receive either Odro-CHOP or R-CHOP.
Rituximab + CHOPCyclophosphamidePart 2 is the randomized controlled portion, participants will receive either Odro-CHOP or R-CHOP.
Rituximab + CHOPDoxorubicinPart 2 is the randomized controlled portion, participants will receive either Odro-CHOP or R-CHOP.
Rituximab + CHOPVincristinePart 2 is the randomized controlled portion, participants will receive either Odro-CHOP or R-CHOP.
Odronextamab + CHOPOdronextamabPart 1, includes dose escalation (Part 1A), and randomized exploration of 2 regimens of odronextamab -cyclophosphamide, doxorubicin, vincristine, prednisone (Odro-CHOP) dose optimization (Part 1B).
Primary Outcome Measures
NameTimeMethod
Incidence of dose limiting toxicities (DLTs)Up to 35 days

Part 1A

Incidence of treatment emergent adverse events (TEAEs)Up to 2 years

Part 1

Severity of TEAEsUp to 2 years

Part 1

Progression free survival (PFS), assessed by independent central review (ICR)Up to 5 years

Part 2

Secondary Outcome Measures
NameTimeMethod
Complete response (CR) assessed by ICRUp to 22 weeks

Part 2

Overall survival (OS)Up to 5 years

Part 2

Best Overall response (BOR) as assessed by local investigatorsUp to 22 weeks

Part 1 and Part 2

CR as assessed by local investigatorsUp to 22 weeks

Part 1 and Part 2

Duration of response (DOR) as assessed by local investigatorsUp to 5 years

Part 1 and Part 2

Odronextamab concentrations in serum when administered with CHOPUp to 22 weeks

Part 1 and Part 2

Incidence of anti-drug antibodies (ADA) to odronextamab over the study durationUp to 22 weeks

Part 1 and Part 2

Titer of ADA to odronextamab over the study durationUp to 22 weeks

Part 1 and Part 2

Incidence of neutralizing antibodies (NAb) to odronextamab over the study durationUp to 22 weeks

Part 1 and Part 2

PFS assessed by local investigator reviewUp to 5 years

Part 2

EFS assessed by local investigator reviewUp to 5 years

Part 2

BOR assessed by ICRUp to 22 weeks

Part 2

DOR assessed by ICRUp to 5 years

Part 2

Incidence of TEAEsUp to 2 years

Part 2

Severity of TEAEsUp to 2 years

Part 2

Measurable Residual Disease (MRD) statusUp to 22 weeks

Part 2

Duration of MRD-negativityUp to 5 years

Part 2

Event-free survival (EFS) assessed by ICRUp to 5 years

Part 2

Change in physical functioning as measured by European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C) 30Up to 5 years

Part 2 The EORTC QLQ-C30 includes 5 functional scales (physical, role, cognitive, emotional and social functioning), 3 symptom scales (fatigue, pain and nausea/vomiting), a GHS/QoL scale, and six single items (constipation, diarrhea, insomnia, shortness of breath, appetite loss and financial difficulties). For the functioning scales and global health status / QoL, scores range from 1 = "very poor" to 7 = "excellent" with higher scores indicate better functioning; for the symptom scales, scores range from 1 = "not at all" to 4 = "very much" higher scores indicate higher symptom burden.

Change in patient reported outcomes, as measured by EORTC QLQ-C30Up to 5 years

Part 2 The EORTC QLQ-C30 includes 5 functional scales (physical, role, cognitive, emotional and social functioning), 3 symptom scales (fatigue, pain and nausea/vomiting), a GHS/QoL scale, and six single items (constipation, diarrhea, insomnia, shortness of breath, appetite loss and financial difficulties). For the functioning scales and global health status / QoL, scores range from 1 = "very poor" to 7 = "excellent" with higher scores indicate better functioning; for the symptom scales, scores range from 1 = "not at all" to 4 = "very much" higher scores indicate higher symptom burden.

Change in patient reported outcomes, as measured by Functional Assessment of Cancer Therapy - Lymphoma Subscale (FACT-LymS)Up to 5 years

Part 2 The FACT-Lym lymphoma subscale (LymS) includes 15 items to assess NHL-related symptoms and concerns. All questions are answered on a 5-point scale ranging from "not at all" (0) to "very much" (4). Higher scores are associated with a worse quality of life.

Change in patient reported outcomes, as measured by Patient Global Impression of Severity (PGIS)Up to 5 years

Part 2 The PGIS includes a single-item to assess how a patient perceives the overall severity of cancer symptoms over the past 7 days. Patients will choose the response that best describes the severity of their overall cancer symptoms with options on a 5-point scale ranging from 1 (No symptoms) to 4 (Very Severe).

Change in patient reported outcomes, as measured by Patient Global Impression of Change (PGIC)Up to 5 years

Part 2 The PGIC item includes a single-item to assess how a patient perceives their overall change in health status since the start of study treatment. Patients will choose from response options on a 7-point scale ranging from 1 (Much Better) to 7 (Much worse); 1- Much Better, 2-Moderately Better, 3-A Little Better, 4-About the Same, 5-A Little Worse, 6-Moderately Worse, 7-Much Worse.

Change in patient reported outcomes, as measured by EuroQol-5 Dimension-5 Level Scale (EQ-5D-5L)Up to 5 years

Part 2 The EQ-5D-5L consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D-5L descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: "no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems". The EQ VAS records the participant's self-rated health on a vertical visual analogue scale where the endpoints are labeled "Best imaginable health state" and "Worst imaginable health state".

Change in score of the Functional Assessment of Cancer Therapy-General (FACT-G ) GP5 itemUp to 5 years

Part 2 A single item (GP5) of the validated FACT-G questionnaire will be used to assess from the participant perspective the overall impact of treatment side-effect. The question item is on a 5-point scale ranging from "not at all" (0) to "very much" (4).

Trial Locations

Locations (149)

Seoul St Marys Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital Ampang

🇲🇾

Ampang, Pahang, Malaysia

Hospital General Universitario de Toledo

🇪🇸

Toledo, Spain

Instituto Valenciano de Oncologia

🇪🇸

Valencia, Spain

University Hospital Doctor Peset

🇪🇸

Valencia, Spain

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Yeouido St. Marys Hospital

🇰🇷

Seoul, Korea, Republic of

Centrum Innowacyjnych Terapii Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie

🇵🇱

Lublin, Poland

David Geffen School of Medicine at UCLA

🇺🇸

Los Angeles, California, United States

University of California Irvine Medical Center

🇺🇸

Orange, California, United States

University of California (UC) Davis

🇺🇸

Sacramento, California, United States

Indiana University Melvin and Bren Simon Comprehensive Cancer Center

🇺🇸

Indianapolis, Indiana, United States

St Vincent Ascension at Peyton Manning Childrens Hospital

🇺🇸

Indianapolis, Indiana, United States

Investigative Clinical Research of Indiana

🇺🇸

Noblesville, Indiana, United States

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Cancer and Hematology Centers of Western Michigan

🇺🇸

Grand Rapids, Michigan, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

Stony Brook University Hospital

🇺🇸

Stony Brook, New York, United States

Clinical Research Alliance Inc

🇺🇸

Westbury, New York, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Center for Oncology and Blood Disorders

🇺🇸

Houston, Texas, United States

Community Cancer Trials of Utah

🇺🇸

Ogden, Utah, United States

Prohealth Care Inc

🇺🇸

Waukesha, Wisconsin, United States

Liverpool Hospital

🇦🇺

Liverpool, New South Wales, Australia

Calvary Mater Newcastle

🇦🇺

Waratah, New South Wales, Australia

Icon Cancer Centre - Wesley

🇦🇺

Auchenflower, Queensland, Australia

Pindara Private Hospital

🇦🇺

Benowa, Queensland, Australia

Epworth Freemasons

🇦🇺

East Melbourne, Victoria, Australia

Landeskrankenhaus Hochsteiermark

🇦🇹

Leoben, Styria, Austria

Kepler University Hospital

🇦🇹

Linz, Upper Austria, Austria

Medical University Graz

🇦🇹

Graz, Austria

Medical University of Vienna

🇦🇹

Vienna, Austria

Hanusch Krankenhaus

🇦🇹

Vienna, Austria

Klinikum Wels-Grieskirchen

🇦🇹

Wels, Austria

AZ St.-Elisabeth Herentals vzw

🇧🇪

Herentals, Antwerp, Belgium

Universitair Ziekenhuis (UZ) Gent/ Ghent University Hospital

🇧🇪

Gent, Oost-Vlaanderen, Belgium

Az Delta

🇧🇪

Roeselare, West Vlaanderen, Belgium

Institut Jules Bordet

🇧🇪

Brussels, Belgium

Centre Hospitalier Regional de Verviers

🇧🇪

Verviers, Belgium

Hospital Clinico Universidad de Los Andes

🇨🇱

Santiago, Las Condes, Chile

Inmunocel

🇨🇱

Santiago, Region Metropolitana, Chile

Clinica Alemana de Santiago

🇨🇱

Santiago, Chile

University Hospital Hradec Kralove

🇨🇿

Hradec Kralove, East Bohemia, Czechia

University Hospital Kralovske Vinohrady

🇨🇿

Prague, Czechia

Vseobecna Fakultni Nemocnice V Praze

🇨🇿

Praha, Czechia

Centre Hospitalier Universitaire (CHU) Rennes

🇫🇷

Rennes, Bretagne, France

CHRU de Tours

🇫🇷

Tours, Centre Val De Loire, France

Polyclinique Bordeaux Nord Aquitaine

🇫🇷

Bordeaux Cedex, Gironde, France

Hopital Victor Dupouy Argenteuil

🇫🇷

Argenteuil, Ile De France, France

Avicenne Hospital

🇫🇷

Bobigny, Ile De France, France

Hopital Saint Vincent-de-Paul

🇫🇷

Lille, Nord, France

CHU de Poitiers

🇫🇷

Poitiers, Nouvelle Aquitaine, France

Centre Hospitalier Universitaire (CHU) de Bordeaux

🇫🇷

Pessac, Nouvelle-Aquitaine, France

Nantes University Hospital

🇫🇷

Nantes, Pays De La Loire, France

Centre Hospitalier Metropole Savoie

🇫🇷

Chambery, Savoie, France

Gustave Roussy

🇫🇷

Villejuif, Val De Marne / Ile De France, France

Centre Hospitalier Universitaire Angers

🇫🇷

Angers, France

Change Annecy

🇫🇷

Metz Tessy, France

CHU Nimes Institut de Cancerologie

🇫🇷

Nimes, France

Assistance Publique-Hopitaux de Paris (AP-HP)

🇫🇷

Paris, France

CHU de Saint-Etienne

🇫🇷

Saint-Etienne, France

Robert-Bosch-Krankenhaus

🇩🇪

Stuttgart, Baden-Wurttemberg, Germany

Kliniken Ostalb Stauferklinikum Schwab Gmund

🇩🇪

Mutlangen, Gmund, Germany

Clinic Frankfurt (Oder)

🇩🇪

Frankfurt, Hesse, Germany

University Hospital Essen

🇩🇪

Essen, Nordrhein Westfalen, Germany

Universitaetsmedizin der Johannes Gutenberg Universitaet Mainz KoeR

🇩🇪

Mainz, Rheinland-Pfalz, Germany

Hematological Praxis Dresden

🇩🇪

Dresden, Sachsen, Germany

University Hospital Carl Gustav Carus

🇩🇪

Dresden, Germany

Stadtisches Krankenhaus Kiel

🇩🇪

Kiel, Germany

Beaumont Hospital

🇮🇪

Dublin, Leinster, Ireland

St James Hospital and Trinity College Dublin

🇮🇪

Dublin, Ireland

The Chaim Sheba Medical Center

🇮🇱

Tel-Hashomer, Tel Aviv, Israel

Samson Assuta Ashdod University Hospital

🇮🇱

Ashdod, Israel

Bnai Zion Medical Center

🇮🇱

Haifa, Israel

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Galilee Medical Center

🇮🇱

Nahariya, Israel

The Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori

🇮🇹

Meldola (fc), Forli Cesena, Italy

ASST Monza Ospedale San Gerardo

🇮🇹

Monza, Lombardy, Italy

Istituto Europeo di Oncologia

🇮🇹

Milano, Italy

A.O.U. di Modena

🇮🇹

Modena, Italy

Federico II University

🇮🇹

Napoli, Italy

AOU Maggiore della Carita

🇮🇹

Novara, Italy

Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

Azienda Ospedaliera di Perugia

🇮🇹

Perugia, Italy

Ospedale Santa Maria delle Croci

🇮🇹

Ravenna, Italy

Hematology - Città della Salute e della Scienza di Torino

🇮🇹

Turin, Italy

Santa Maria della Misericordia

🇮🇹

Udine, Italy

St. Vincent Hospital - The Catholic University of Korea

🇰🇷

Suwon-si, Gyeonggi-do, Korea, Republic of

Gachon University Gil Medical Center

🇰🇷

Incheon, Namdong-Gu, Korea, Republic of

Inje University Busan Paik Hospital

🇰🇷

Busan, Korea, Republic of

Dong-A University Hospital

🇰🇷

Busan, Korea, Republic of

Pusan National University Hospital

🇰🇷

Busan, Korea, Republic of

Yeyungnam University Medical Center

🇰🇷

Daegu, Korea, Republic of

Keimyung University Dongsan Hospital

🇰🇷

Daegu, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Tg Ampuan Afzan

🇲🇾

Kuantan, Pahang, Malaysia

Hospital Queen Elizabeth

🇲🇾

Kota Kinabalu, Sabah, Malaysia

Subang Jaya Medical Center

🇲🇾

Subang Jaya, Selangor, Malaysia

University Malaya Medical Centre

🇲🇾

Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia

Uniwersytecki Szpital Kliniczny

🇵🇱

Wroclaw, Dolnoslaskie, Poland

Matopolskie Centrum Medyczne S.C.

🇵🇱

Krakow, Malopolskie, Poland

Pratia Poznan Medical Center

🇵🇱

Poznan, Wielkopolska, Poland

Szpital Uniwersytecki Nr2 Bydgoszcz

🇵🇱

Bydgoszcz, Poland

Uniwersyteckie Centrum Kliniczne, Building of the Non-Invasive Medicine Center

🇵🇱

Gdansk, Poland

Szpital Szpecjalistyczny w Walbrzychu

🇵🇱

Walbrzych, Poland

National University Hospital Singapore

🇸🇬

Singapore, Singapore

National Cancer Centre of Singapore

🇸🇬

Singapore, Singapore

Tan Tock Seng Hospital

🇸🇬

Singapore, Singapore

Hospital Clinico Universitario Santiago de Compostela

🇪🇸

Santiago de Compostela, A Coruna, Spain

Hospital Universitario Central De Asturias

🇪🇸

Oviedo, Asturias, Spain

Son Espases University Hospital

🇪🇸

Palma, Balearic Islands, Spain

Hospital Universitari Parc Tauli

🇪🇸

Sabadell, Barcelona, Spain

Hospital Universitari Mutua Terrassa

🇪🇸

Terrassa, Barcelona, Spain

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Cantabria, Spain

Hospital Universitario Quironsalud Madrid

🇪🇸

Pozuelo de Alarcon, Madrid, Spain

Hospital Universitario de Navarra

🇪🇸

Pamplona, Navarra, Spain

Hospital Sant Pau

🇪🇸

Barcelona, Spain

Hospital Virgen De Las Nieves De Granada

🇪🇸

Granada, Spain

Hospital Universitario Infanta Leonor

🇪🇸

Madrid, Spain

Hospital Universitario Ramon y Cajal

🇪🇸

Madrid, Spain

Fundacion Jimenez Diaz University Hospital

🇪🇸

Madrid, Spain

Hospital Universitario HM Sanchinarro, Servicio de Hematologia

🇪🇸

Madrid, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Changhua Christian Hospital

🇨🇳

Changhua City, Taiwan

Taipei Medical University - Shuang Ho Hospital

🇨🇳

New Taipei City, Taiwan

Chang Gung Medical Foundation Chia Yi Branch

🇨🇳

Puzi City, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei City, Taiwan

Wanfang Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Memorial Hospital- Linkou Branch

🇨🇳

Taoyuan, Taiwan

Chulalongkorn University

🇹🇭

Bangkok, Krung Thep Maha Nakhon [Bangko], Thailand

Sriraj Hospital

🇹🇭

Bangkok, Thailand

Chaing Mai University

🇹🇭

Chiang Mai, Thailand

Faculty of Medicine

🇹🇭

Khon Kaen, Thailand

Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital

🇹🇷

Yenimahalle, Ankara, Turkey

VM Medical Park Mersin Hospital

🇹🇷

Mezitli, Mersin, Turkey

Tekirdag Namik Kemal University Hospital

🇹🇷

Tekirdag, Suleymanpasa, Turkey

Gazi Universitesi

🇹🇷

Besevler, Turkey

Istanbul University Istanbul Faculty of Medicine

🇹🇷

Istanbul, Turkey

Ege University

🇹🇷

Izmir, Turkey

Dokuz Eylul University

🇹🇷

Izmir, Turkey

Sakarya Universty Medical Faculty

🇹🇷

Sakarya, Turkey

Ondokuz Mayis Universitesi Tip Fakultesi Hastanesi

🇹🇷

Samsun, Turkey

NHS Grampian: Aberdeen Royal Infirmary

🇬🇧

Aberdeen, United Kingdom

The Hillingdon Hospitals NHS Foundation Trust

🇬🇧

Uxbridge, United Kingdom

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