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Phase II Study to Assess AFM13 in Patients With R/R CD30-positive T-cell Lymphoma or Transformed Mycosis Fungoides

Phase 2
Completed
Conditions
Peripheral T Cell Lymphoma
Transformed Mycosis Fungoides
Interventions
Drug: AFM13
Registration Number
NCT04101331
Lead Sponsor
Affimed GmbH
Brief Summary

This is a phase II study to evaluate the antitumor activity and safety of AFM13 given as monotherapy in patients with CD30-positive T-cell lymphoma. The investigational medicinal product AFM13 is a tetravalent bispecific chimeric (anti-human CD30 x anti-human CD16A) recombinant antibody construct which is being developed to treat CD30-positive malignancies.

Patients who suffer from peripheral T-cell lymphoma or transformed mycosis fungoides, whose tumor expresses the surface marker CD30, and who have relapsed after an earlier treatment or have refractory disease will be enrolled into this study if all of the study entry criteria are fulfilled. Dependent on their disease type and the magnitude of CD30 expression, study participants will be assigned to one of 3 study cohorts, each cohort receiving the same treatment of weekly AFM13 infusions (a 200mg dose per infusion).

The main goal of the study is to assess the efficacy of AFM13 treatment as judged by the rate of overall responses. Further goals are to assess the safety of AFM13 treatment, the immunogenicity of AFM13 (as measured by the potential formation of anti-AFM13 antibodies) and the concentration of AFM13 in the blood.

Approx. 1 month after the last dose of AFM13 there will be a final study visit to assess the patients' health status after therapy, followed by quarterly phone contacts to check on their overall health status and long-term survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
108
Inclusion Criteria
  • Histologically confirmed CD30-positive PTCL (most subtypes allowed) or TMF per the revised World Health Organization 2016 classification (Swerdlow, 2016) by central assessment.
  • Cohorts A and B (PTCL cohorts): measurable by the modified Lugano Classification (Cheson, 2014); measurable disease of ≥1.5 cm diameter by computed tomography (CT), assessed locally for eligibility. Note: fluorodeoxyglucose (FDG) avid disease by positron emission tomography (PET) recommended, if possible.
  • Cohort C (TMF cohort): measurable by the Olsen Criteria (Olsen, 2011) including at least 1 cutaneous lymphoma lesion ≥2 cm in diameter, assessed locally for eligibility.
  • Patients must have relapsed or refractory disease AND the following:
  • Cohorts A and B (PTCL): patients must have received at least 1 prior line of systemic therapy. For patients with systemic ALCL, patients must have failed or be intolerant to brentuximab vedotin [BV]; Adcetris®
  • Cohort C (TMF): patients must have received at least 1 prior line of systemic therapy; and have exhausted systemic therapies with regular approval for their disease

Main

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Exclusion Criteria
  • Patients with the following subtypes of lymphoma: T-cell prolymphocytic leukemia; T-cell large granular lymphocytic leukemia; Chronic lymphoproliferative disorder of NK cells; Aggressive NK-cell leukemia; Extranodal NK-/T-cell lymphoma; Indolent T-cell lymphoproliferative disorder of the GI tract:
  • Has had an allogenic tissue hematopoietic cell/solid organ transplant within the last 3 years. Note: Patients who have had a transplant >3 years ago are eligible as long as there are no signs/symptoms of graft versus host disease (GvHD).
  • Requirement for systemic immunosuppressive therapy, e.g. GvHD therapy, <12 weeks prior to the first dose of study drug.
  • Prior treatment with AFM13
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Cohort AAFM13Subjects with Relapsed or Refractory CD30 positive Peripheral T-cell Lymphoma (PTCL).
Primary Outcome Measures
NameTimeMethod
Overall Response Rate Assessed by Independent Review Committee Based on PET-CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 28 months).

Overall response by Positron Emission Tomography-Computed Tomography (PET-CT) as defined by achieving complete response and/or partial response assessed by an Independent Review Committee (IRC) utilizing the modified Lugano Classification Revised Staging System for malignant lymphoma (Cheson, 2014).

Secondary Outcome Measures
NameTimeMethod
Complete Response Rate and Partial Response Rate Assessed by Independent Review Committee Based on PET-CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Complete response and/or partial response by Positron Emission Tomography-Computed Tomography (PET-CT) assessed by an Independent Review Committee (IRC) utilizing the modified Lugano Classification Revised Staging System for malignant lymphoma (Cheson, 2014).

Complete Response Rate, Partial Response Rate and Overall Response Rate Assessed by Independent Review Committee Based on CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Overall response by Computed Tomography (CT) as defined by achieving complete response and/or partial response assessed by an Independent Review Committee (IRC) utilizing the modified Lugano Classification Revised Staging System for malignant lymphoma (Cheson, 2014).

Duration of Overall Response Assessed by Investigator Based on PET-CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Duration of response (DOR) defined as the period from first Partial Response (PR) and Complete Response (CR) assessment till first assessment of progressive disease or death. Response assessed by Positron Emission Tomography-Computed Tomography (PET-CT) by the investigator.

Maximum Measured Concentration (Cmax) of AFM13Predose and 1 hour after start of infusion, end of injection (EOI) and 1 hour, 2 hours, 3 hours, 24 hours and 48 hours after EOI on Cycle 1 Day 1 and Day 29.

Maximum measured concentration (Cmax) of the AFM13 in serum. Geometric coefficient of variation is given in percentages.

The Terminal Half-life (t1/2) of AFM13Predose and 1 hour after start of infusion, end of injection (EOI) and 1 hour, 2 hours, 3 hours, 24 hours and 48 hours after EOI on Cycle 1 Day 1 and Day 29.

The terminal half-life (t1/2) of the AFM13. Geometric coefficient of variation is given in percentages.

European Quality of Life 5-dimensional Pain/Discomfort Score (EQ-5D)At baseline and final study visit, up to 199 weeks.

Quality of Life (QoL) as measured by the European QoL 5-dimensional questionnaire (EQ-5D) for Cohorts A. The EQ-5D comprises asks for the current health state in the five dimensions: mobility, self care, usual activities, pain/discomfort, and anxiety/depression. Pain/discomfort scores assessed based on questionnaire. The categories of the response offer three levels pain/discomfort score: "no pain or discomfort" (score of 1), "moderate pain or discomfort" (score of 2), and "extreme pain and discomfort" (score of 3). Scores are presented from baseline to each visit for Cohort A.

Overall Response Rate Assessed by Investigator Based on PET-CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Overall response by Positron Emission Tomography-Computed Tomography (PET-CT) as defined by achieving complete response and/or partial response assessed by the investigator utilizing the modified Lugano Classification Revised Staging System for malignant lymphoma (Cheson, 2014).

Overall Response Rate Assessed by Investigator Based on CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Overall response by Computed Tomography (CT) as defined by achieving complete response and/or partial response assessed by the investigator utilizing the modified Lugano Classification Revised Staging System for malignant lymphoma (Cheson, 2014).

Duration of Overall Response Assessed by Independent Review Committee Based on PET-CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Duration of response (DOR) defined as the period from first Partial Response (PR) and Complete Response (CR) assessment till first assessment of progressive disease or death. Response assessed by Positron Emission Tomography-Computed Tomography (PET-CT) by Independent Review Committee (IRC).

Area Under the Concentration-Time Curve of AFM13 From 0 to Infinity (AUC 0-∞)Predose and 1 hour after start of infusion, end of injection (EOI) and 1 hour, 2 hours, 3 hours, 24 hours and 48 hours after EOI on Cycle 1 Day 1 and Day 29.

Area under concentration (AUC) versus time curve of the AFM13 in serum over time interval from 0 extrapolated to infinity.

Geometric coefficient of variation is given in percentages.

Duration of Overall Response Assessed by Independent Review Committee Based on CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Duration of response (DOR) defined as the period from first Partial Response (PR) and Complete Response (CR) assessment till first assessment of progressive disease or death. Response assessed by Computed Tomography (CT) by Independent Review Committee (IRC).

Duration of Overall Response Assessed by Investigator Based on CTTumor assessment performed every 8 weeks for first 3 assessments, then every 12 weeks until documented disease progression (up to 46 months).

Duration of response (DOR) defined as the period from first Partial Response (PR) and Complete Response (CR) assessment till first assessment of progressive disease or death. Response assessed by Computed Tomography (CT) by the investigator.

Number of Subjects With Treatment Related Adverse EventFrom the date of first treatment until the date of the last treatment + 37 days, up to 199 weeks.

Number of subjects who had treatment (AFM13) related Adverse Events.

Volume of Distribution at Steady State (Vss) of AFM13Predose and 1 hour after start of infusion, end of injection (EOI) and 1 hour, 2 hours, 3 hours, 24 hours and 48 hours after EOI on Cycle 1 Day 29.

Volume of distribution at steady state (Vss) of the AFM13. Geometric coefficient of variation is given in percentages.

European Quality of Life 5-dimensional Visual Analogue Scale Scores (EQ-5D)From baseline until final study visit, up to 199 weeks.

Quality of Life (QoL) as measured by the European Quality of Life 5-dimensional questionnaire (EQ-5D) for Cohorts A. Visual Analogue Scale scores assessed based on drawn scale from 0(worst imaginable state) to 100(best imaginable state). Subjects chose their health state on scale based on their situation by themselves. A negative outcome indicates a decrease in score compared to the baseline value.

Number of Subjects Who Developed Anti-drug Antibodies (ADA) During TreatmentPre-dose Day 1 on cycle 1 and end of treatment, up to approximately 46 months.

Number of subjects who had treatment (AFM13) and developed anti-drug antibodies (ADA).

Trial Locations

Locations (69)

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

University of California Los Angeles (UCLA) Health

🇺🇸

Los Angeles, California, United States

Ochsner Clinic Foundation/Precision Cancer Therapies Program

🇺🇸

New Orleans, Louisiana, United States

Emory University Clinic/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

City of Hope Comprehensive Cancer Center

🇺🇸

Duarte, California, United States

University of Michigan Health | Rogel Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Center for Lymphoid Malignancies

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

Abramson Cancer Center of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

University of Washington Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

Royal Adelaide Hospital

🇦🇺

Adelaide, Australia

Flinders Medical Centre

🇦🇺

Bedford Park, Australia

Monash Health-Monash Medical Centre

🇦🇺

Clayton, Australia

Concord Repatriation General Hospital

🇦🇺

Concord, Australia

Gosford Hospital

🇦🇺

Gosford, Australia

Centre Hospitalier Universitaire (CHU) de Bordeaux

🇫🇷

Bordeaux, France

Linear Clinical Research

🇦🇺

Nedlands, Australia

Centre Hospitalier Universitaire de Brest

🇫🇷

Brest, France

CHD Vendée

🇫🇷

La Roche Sur Yon, France

CHU Pontchaillou

🇫🇷

Rennes, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

University Hospital Leipzig

🇩🇪

Leipzig, Germany

Kliniken Essen Sued - Evangelisches Krankenhaus Essen-Werden gGmbH

🇩🇪

Essen, Germany

Universitaetsmedizin Mainz

🇩🇪

Mainz, Germany

Rotkreuzklinikum Muenchen

🇩🇪

Muenchen, Germany

Chonbuk National University Hospital

🇰🇷

Jeonju, Korea, Republic of

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Korea, Republic of

Catholic University of Korea, Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Ulsan University Hospital

🇰🇷

Ulsan, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Centrum Onkologii - Instytut im. Marii Sklodowskiej-Curie, Klinika Nowotworow Ukladu Chlonnego

🇵🇱

Warsaw, Poland

Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu. Klinika Hematologii, Nowotworow Krwi i Transplantacji Szpiku

🇵🇱

Wrocław, Poland

Instytut Hematologii i Transfuzjologii, Klinika Hematologii

🇵🇱

Warsaw, Poland

Republic Hospital n.a. V.A. Baranov

🇷🇺

Petrozavodsk, Russian Federation

First State Saint-Petersburg Pavlov Medical University

🇷🇺

Saint Petersburg, Russian Federation

Russian Research Institute of Hematology and Transfusiology of the Federal Biomedical Agency

🇷🇺

St. Petersburg, Russian Federation

Regional Clinical Hospital

🇷🇺

Tula, Russian Federation

Duran I Reynals Hospital Catalan Institute Of Oncology

🇪🇸

Barcelona, Spain

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Hospital del Mar

🇪🇸

Barcelona, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Institut Catala d'Oncologia Badalona, Hospital Germans Trias I Pujol

🇪🇸

Barcelona, Spain

Institut Catala d' Oncologia Girona

🇪🇸

Girona, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Institut Catala d'Oncologia Tarragona

🇪🇸

Tarragona, Spain

Hospital Universitario Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre-Centro de Actividades Ambulatorias

🇪🇸

Madrid, Spain

Ankara University Faculty of Medicine, Department of Internal Diseases, Hematology Division

🇹🇷

Ankara, Turkey

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim Arastirma Hastanesi Hematoloji Klinigi Ankara

🇹🇷

Ankara, Turkey

Gazi University Faculty of Medicine, Department of Internal Diseases

🇹🇷

Ankara, Turkey

Sağlık Bilimleri Üniversitesi Gülhane Eğitim ve Araştırm Hastanesi

🇹🇷

Ankara, Turkey

Istanbul Universitesi Istanbul Tip Fakultesi Ic Hastaliklari Anabilim Dali Hematoloji Bilim Dali Fatih

🇹🇷

Istanbul, Turkey

Ege University Medical Faculty

🇹🇷

İzmir, Turkey

Kocaeli University Faculty of Medicine, Department of Internal Diseases, Hematology Division

🇹🇷

İzmit, Turkey

Ondokuz Mayis Universitesi Tip Fakultesi Saglik Uyg. ve Egitim Merkezi

🇹🇷

Samsun, Turkey

Tekirdag Namik Kemal Universitesi Saglik Uygulama ve Arastirma Hastanesi

🇹🇷

Tekirdag, Turkey

KaradenizTeknik Universitesi Tip Fakultesi Farabi Hastanesi

🇹🇷

Trabzon, Turkey

Szpitale Pomorskie Sp. z o.o.. Szpital Morski im. PCK, Oddzial Hematologii i Transplantologii Szpiku

🇵🇱

Gdynia, Poland

Pratia MCM Krakow

🇵🇱

Kraków, Poland

Saratov State Medical University

🇷🇺

Saratov, Russian Federation

GUZ Leningrad Regional Clinical Hospital

🇷🇺

St. Petersburg, Russian Federation

Ist.Ematologia E Oncologia Medica L.E A.Seragnoli

🇮🇹

Bologna, Italy

Azienda Ospedaliera Spedali Civili di Brescia-Universita degli Studi Di Brescia

🇮🇹

Brescia, Italy

Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS

🇮🇹

Meldola, Italy

Azienda Ospedaliera Niguarda Ca' Granda

🇮🇹

Milano, Italy

Azienda Unita Sanitaria Locale di Ravenna - Ospedale S. Maria delle Croci di Ravenna

🇮🇹

Ravenna, Italy

University of Alabama at Birmingham (O'Neal Comprehensive Cancer Center)

🇺🇸

Birmingham, Alabama, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

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