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A Study of HDM2005 in Combination With Standard of Care in Patients With Diffuse Large B-Cell Lymphoma

Not Applicable
Recruiting
Conditions
Diffuse Large B Cell Lymphoma (DLBCL)
Interventions
Registration Number
NCT07124936
Lead Sponsor
Hangzhou Zhongmei Huadong Pharmaceutical Co., Ltd.
Brief Summary

The purpose of this phase 1b/2 study is to evaluate the safety, tolerability, and antitumor activity of HDM2005 in combination with standard of care in participants with diffuse large B-cell lymphoma. This study will include two arms: Cohort A (HDM2005 + R-GemOx) will enroll participants with relapsed/refractory DLBCL. Cohort B (HDM2005 + R-CHP) will enroll participants with untreated DLBCL. The study will consist of two parts: dose-escalation part and dose-expansion part.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
97
Inclusion Criteria
  1. Male or female aged 18-75 years.

  2. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

  3. Life expectancy >12 weeks.

  4. Histologically confirmed diffuse large B-cell lymphoma (DLBCL).

    a. Cohort B: International Prognostic Index (IPI) score of 2-5.

  5. Prior treatment:

    1. Cohort A: At least one (≥1) line of prior systemic therapy.
    2. Cohort B: Has received no prior treatment for DLBCL.
  6. At least one bi-dimensionally measurable (≥1.5 cm) nodal lesion, or one bi-dimensionally measurable (≥1 cm) extranodal lesion, as measured on computed tomography (CT) scan.

  7. Adequate organ system and hematologic function as defined in protocol.

Exclusion Criteria
  1. Known active central nervous system (CNS) lymphoma.
  2. Prior of allogeneic hematopoietic stem cell transplantation and has acute or ongoing graft-versus-host disease (GVHD) of any grade.
  3. Known additional malignancy that is progressing or has required active treatment within the past 3 years.
  4. History of severe bleeding disorders.
  5. History of interstitial lung disease or radiation pneumonitis.
  6. Prior solid organ transplant.
  7. Ongoing Grade >1 treatment-related adverse events.
  8. Current or history of clinically significant cardiovascular and cerebrovascular diseases.
  9. Active infection requiring systemic therapy.
  10. Concurrent active HBV or HCV infection or known history of human immunodeficiency virus (HIV) infection.
  11. Prior ROR1-targeted therapy.
  12. Ongoing corticosteroid therapy.
  13. Current active autoimmune disease or history of autoimmune disease requiring treatment.
  14. History of drug anaphylaxis or severe food allergy.
  15. Any history or current evidence of disease, treatment, or laboratory abnormality as determined by the investigator that may affect the study results, interfere with the subject's full participation in the study, or be contrary to the subject's best interests.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Participants with r/r DLBCL (Cohort A)HDM2005Participants with r/r DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8) plus 1000 mg/ m\^2 gemcitabine (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8), 100 mg/ m\^2 oxaliplatin, and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 of each 3-week cycle for up to 6-8 cycles.
Participants with r/r DLBCL (Cohort A)Rituximab or Rituximab biosimilarParticipants with r/r DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8) plus 1000 mg/ m\^2 gemcitabine (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8), 100 mg/ m\^2 oxaliplatin, and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 of each 3-week cycle for up to 6-8 cycles.
Participants with r/r DLBCL (Cohort A)GemcitabineParticipants with r/r DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8) plus 1000 mg/ m\^2 gemcitabine (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8), 100 mg/ m\^2 oxaliplatin, and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 of each 3-week cycle for up to 6-8 cycles.
Participants with r/r DLBCL (Cohort A)OxaliplatinParticipants with r/r DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8) plus 1000 mg/ m\^2 gemcitabine (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6-8), 100 mg/ m\^2 oxaliplatin, and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 of each 3-week cycle for up to 6-8 cycles.
Participants with untreated DLBCL (Cohort B)HDM2005Participants with untreated DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6) plus 750 mg/m\^2 cyclophosphamide (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), 50 mg/m\^2 doxorubicin (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 and 2 Cycle 1 and Day 1 Cycle 2 to 6 of each 3-week cycle for up to 6 cycles. Participants will also receive 100 mg prednisone or prednisolone via oral tablet per day during Days 1-5 of each 3-week cycle for up to 6 cycles.
Participants with untreated DLBCL (Cohort B)Rituximab or Rituximab biosimilarParticipants with untreated DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6) plus 750 mg/m\^2 cyclophosphamide (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), 50 mg/m\^2 doxorubicin (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 and 2 Cycle 1 and Day 1 Cycle 2 to 6 of each 3-week cycle for up to 6 cycles. Participants will also receive 100 mg prednisone or prednisolone via oral tablet per day during Days 1-5 of each 3-week cycle for up to 6 cycles.
Participants with untreated DLBCL (Cohort B)CyclophosphamideParticipants with untreated DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6) plus 750 mg/m\^2 cyclophosphamide (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), 50 mg/m\^2 doxorubicin (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 and 2 Cycle 1 and Day 1 Cycle 2 to 6 of each 3-week cycle for up to 6 cycles. Participants will also receive 100 mg prednisone or prednisolone via oral tablet per day during Days 1-5 of each 3-week cycle for up to 6 cycles.
Participants with untreated DLBCL (Cohort B)DoxorubicinParticipants with untreated DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6) plus 750 mg/m\^2 cyclophosphamide (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), 50 mg/m\^2 doxorubicin (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 and 2 Cycle 1 and Day 1 Cycle 2 to 6 of each 3-week cycle for up to 6 cycles. Participants will also receive 100 mg prednisone or prednisolone via oral tablet per day during Days 1-5 of each 3-week cycle for up to 6 cycles.
Participants with untreated DLBCL (Cohort B)PrednisoneParticipants with untreated DLBCL will receive a dose of HDM2005 (1.8 mg/kg or 2.0 mg/kg, on Day 2 Cycle 1 and Day 1 Cycle 2 to 6) plus 750 mg/m\^2 cyclophosphamide (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), 50 mg/m\^2 doxorubicin (on Day 2 Cycle 1 and Day 1 Cycle 2 to 6), and 375 mg/m\^2 rituximab or rituximab biosimilar administered by intravenous (IV) infusion on Day 1 and 2 Cycle 1 and Day 1 Cycle 2 to 6 of each 3-week cycle for up to 6 cycles. Participants will also receive 100 mg prednisone or prednisolone via oral tablet per day during Days 1-5 of each 3-week cycle for up to 6 cycles.
Primary Outcome Measures
NameTimeMethod
Number of participants who experience dose-limiting toxicities (DLTs) in dose-escalation partUp to ~3 weeks

The CTCAE, Version 5.0 will be used to grade the severity of AEs in this study. DLTs will be reported for dose-escalation part of this study.

Number of participants who experience adverse events (AEs), serious adverse events (SAEs) and adverse events of special interest (AESIs) in dose-escalation partUp to ~54 months

Incidence and grading of adverse events (AEs), serious adverse events (SAEs), and adverse events of special interest (AESIs) (based on the National Cancer Institute's Common Terminology Criteria for Adverse Events \[CTCAE\] version 5.0). Incidence of treatment interruption and dose adjustment due to AEs and changes in laboratory tests, vital signs, physical examination, electrocardiogram (ECG), and Eastern Cooperative Oncology Group (ECOG) performance status score.

Complete response (CR) rate in dose-expansion partUp to ~30 months

CR rate is defined as the percentage of participants who achieve a complete response (CR) per Lugano criteria, as determined by the investigator

RP2D of HDM2005Up to ~30 months

Recommended phase 2 dose of HDM2005 in combination with SoC in patients with r/r DLBCL and untreated DLBCL

Secondary Outcome Measures
NameTimeMethod
Plasma concentration of HDM2005, total antibody and monomethyl auristatin E (MMAE)Up to ~30 months

Plasma concentration of HDM2005, total antibody and MMAE will be reported for each dose level

Time to response (TTR)Up to ~54 months

TTR is defined as the interval from the start of study therapy to the first documentation of CR or PR

Time to progression (TTP)Up to ~54 months

TTP is defined as the interval from the start of study therapy to the earlier of the first documentation of disease progression as determined by the investigator

Overall survival (OS)Up to ~54 months

OS is defined as the time from randomization to death due to any cause

Number of participants positive for anti-drug antibodies (ADA)Up to ~30 months

Number of participants with positive ADA will be assessed

Number of participants who experience adverse events (AEs), serious adverse events (SAEs) and adverse events of special interest (AESIs) in dose-expansion partUp to ~54 months

Incidence and grading of adverse events (AEs), serious adverse events (SAEs), and adverse events of special interest (AESIs) (based on the National Cancer Institute's Common Terminology Criteria for Adverse Events \[CTCAE\] version 5.0). Incidence of treatment interruption and dose adjustment due to AEs and changes in laboratory tests, vital signs, physical examination, electrocardiogram (ECG), and Eastern Cooperative Oncology Group (ECOG) performance status score.

Objective response rate (ORR)Up to ~30 months

ORR is defined as the percentage of participants who achieve a complete response (CR) or partial response (PR) per Lugano criteria as determined by the investigator

Progression-free survival (PFS)Up to ~54 months

PFS is defined as the interval from the start of study therapy to the earlier of the first documentation of disease progression/relapse or death from any cause, whichever occurs first as determined by the investigator

Duration of response (DOR)Up to ~54 months

DOR is defined as the interval from the first documentation of CR or PR until disease progression or death due to any cause, whichever occurs first

Trial Locations

Locations (21)

Peking University Cancer Hospital

🇨🇳

Beijing, Beijing, China

Fujian Cancer Hospital

🇨🇳

Fuzhou, Fujian, China

Sun Yat-sen University Cancer Center

🇨🇳

Guangzhou, Guangdong, China

The Affiliated Tumor Hospital of Guangxi Medical University

🇨🇳

Nanning, Guangxi, China

Affiliated Tumor Hospital of Harbin Medical University

🇨🇳

Ha'erbin, Heilongjiang, China

The First Affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, Henan, China

Henan Cancer Hospital

🇨🇳

Zhengzhou, Henan, China

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

HunanCancer Hospital

🇨🇳

Changsha, Hunan, China

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Peking University Cancer Hospital
🇨🇳Beijing, Beijing, China

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