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A Dose Escalation Study of Glofitamab (RO7082859) as a Single Agent and in Combination With Obinutuzumab, Administered After a Fixed, Single Pre-Treatment Dose of Obinutuzumab in Participants With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma

NCT03075696

Description:

This is a Phase I/II, multicenter, open-label, dose-escalation study designed to evaluate the efficacy, safety, tolerability and pharmacokinetics (PK) of a novel T-Cell bispecific (TCB), glofitamab, administered by intravenous (IV) infusion as a single agent and in combination with obinutuzumab, following pre-treatment with a one-time, fixed dose of obinutuzumab. This entry-to-human study is divided in 3 parts: dose escalation (Parts I and II) and dose expansion (Part III). Single-participant dose-escalation cohorts will be used in Part I, followed by conversion to multiple participant dose-escalation cohorts (Part II), in order to define a tentative maximum tolerated dose (MTD) or optimal biological dose (OBD). The expansion cohorts (Part III) will be initiated when the tentative MTD/OBD is defined, to further evaluate the safety, PK and therapeutic activity of glofitamab.

Related Conditions:
  • B-Cell Non-Hodgkin Lymphoma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Dose Escalation Study of Glofitamab (RO7082859) as a Single Agent and in Combination With Obinutuzumab, Administered After a Fixed, Single Pre-Treatment Dose of Obinutuzumab in Participants With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma
  • Official Title: A Multicenter, Open-Label, Phase I/II Study to Evaluate the Safety, Efficacy, Tolerability and Pharmacokinetics of Escalating Doses of Glofitamab (RO7082859) as a Single Agent and in Combination With Obinutuzumab Administered After a Fixed, Single Dose Pre-Treatment of Obinutuzumab (Gazyva®/Gazyvaro™) in Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma

Clinical Trial IDs

  • ORG STUDY ID: NP30179
  • SECONDARY ID: 2016-001185-28
  • NCT ID: NCT03075696

Conditions

  • Non-Hodgkin's Lymphoma

Interventions

DrugSynonymsArms
GlofitamabRO7082859Part I: Dose Escalation
ObinutuzumabRO5072759, GA101, Gazyva®, GazyvaroPart I: Dose Escalation
TocilizumabActemra®, Roactemra®Part I: Dose Escalation

Purpose

This is a Phase I/II, multicenter, open-label, dose-escalation study designed to evaluate the efficacy, safety, tolerability and pharmacokinetics (PK) of a novel T-Cell bispecific (TCB), glofitamab, administered by intravenous (IV) infusion as a single agent and in combination with obinutuzumab, following pre-treatment with a one-time, fixed dose of obinutuzumab. This entry-to-human study is divided in 3 parts: dose escalation (Parts I and II) and dose expansion (Part III). Single-participant dose-escalation cohorts will be used in Part I, followed by conversion to multiple participant dose-escalation cohorts (Part II), in order to define a tentative maximum tolerated dose (MTD) or optimal biological dose (OBD). The expansion cohorts (Part III) will be initiated when the tentative MTD/OBD is defined, to further evaluate the safety, PK and therapeutic activity of glofitamab.

Trial Arms

NameTypeDescriptionInterventions
Part I: Dose EscalationExperimentalParticipants (single participant cohorts) will receive obinutuzumab (Gpt) 1000 milligrams (mg) single dose IV infusion on Day -7 (pre-treatment) followed by glofitamab IV infusion on Day 1 and Day 8 of Cycle 1. From Cycle 2 onwards, ascending doses of glofitamab will be administered on Day 1 of every 2 week cycle up to Cycle 12 (24 weeks) or until unacceptable toxicity or disease progression. Glofitamab dosing will be initiated at 5 micrograms (mcg) (flat dose) followed by doses of 15 mcg, 45 mcg, 135 mcg, 405 mcg and 810 mcg.
  • Glofitamab
  • Obinutuzumab
  • Tocilizumab
Part II: Dose EscalationExperimentalIn each treatment regimen, participants will receive obinituzumab (Gpt) 1000 milligrams (mg) IV infusion on Day -7 (pre-treatment); or 2000 mg either administered on Day -7, or split into two 1000 mg doses on Days -1 and -7. The first glofitamab IV infusion will be given on Day 1 of Cycle 1 and a total of 12 cycles will be administered. Monotherapy, glofitamab as a single agent: ascending doses of glofitamab administered on Day 1 of every 2 or 3 week cycle until either the MTD/OBD is defined. Combination Therapy: From Cycle 2 onwards, a fixed dose of 1000 mg obinutuzumab will be administered via IV infusion in combination with ascending doses of glofitamab on Day 1 of every 3 week cycle until either the MTD/OBD is defined. Step-up dosing: Q3W, participants will receive an initial low dose of glofitamab on C1D1, followed by a higher dose on C1D8; the total dose in C1 will not exceed the previously determined MTD. Higher doses may be explored from C2 or later cycles.
  • Glofitamab
  • Obinutuzumab
  • Tocilizumab
Part III: Dose ExpansionExperimentalPart III will start once MTD/OBD is defined. Participants will receive Gpt 1000 mg single dose IV infusion on Day -7 (pre-treatment), followed by glofitamab at a fixed dose regimen or step-up dose regimen on a Q2W or Q3W dosing schedule as determined in Part II. A total of 12 cycles will be administered. Combination Therapy: From Cycle 2 onwards, a fixed dose of 1000 mg obinutuzumab will be administered via IV infusion in combination with glofitamab at the dosing regimen determined in Part II.
  • Glofitamab
  • Obinutuzumab
  • Tocilizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Depending upon study part, a history or status of: 1) a histologically-confirmed
             hematological malignancy that is expected to express cluster of differentiation
             (CD)20; 2) relapse after or failure to respond to at least one prior treatment
             regimen; and 3) no available treatment options that are expected to prolong survival
             (e.g., standard chemotherapy or autologous stem cell transplant [ASCT])

          -  Measurable disease, defined as at lease one bi-dimensionally measurable nodal lesion,
             defined as > 1.5 cm in its longest dimension, or at least one bi-dimensionally
             measureable extranodal lesion, defined as > 1.0 cm in its longest dimension

          -  Able to provide a fresh biopsy from a safely accessible site, per investigator
             determination, providing the patient has more than one measurable target lesion

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

          -  Life expectancy of >/=12 weeks

          -  AEs from prior anti-cancer therapy must have resolved to Grade less than or equal to
             (</=) 1

          -  Adequate liver, hematological and renal function

          -  Negative serologic or polymerase chain reaction (PCR) test results for acute or
             chronic Hepatitis B virus (HBV) infection

          -  Negative test results for Hepatitis C virus (HCV) and human immunodeficiency virus
             (HIV)

          -  Negative serum pregnancy test within 7 days prior to study treatment in women of
             childbearing potential. Women who are not of childbearing potential who are considered
             to be post-menopausal (at least 12 months of non-therapy amenorrhea) or surgically
             sterile (absence of ovaries and/or uterus) are not required to have a pregnancy test

        Exclusion Criteria:

          -  Inability to comply with protocol mandated hospitalizations and restrictions

          -  Participants with chronic lymphocytic leukemia (CLL), Burkitt lymphoma and
             lymphoplasmacytic lymphoma

          -  Participants with a known or suspected history of hemophagocytic lymphohistiocytosis
             (HLH)

          -  Participants with acute bacterial, viral, or fungal infection at baseline, confirmed
             by a positive blood culture within 72 hours prior to obinutuzumab infusion or by
             clinical judgment in the absence of a positive blood culture

          -  Participants with known active infection, or reactivation of a latent infection,
             whether bacterial, viral, fungal, mycobacterial, or other pathogens or any major
             episode of infection requiring hospitalization or treatment with IV antibiotics within
             4 weeks of dosing

          -  Prior treatment with systemic immunotherapeutic agents, including, but not limited to,
             radio-immunoconjugates, antibody-drug conjugates, immune/cytokines and monoclonal
             antibodies (e.g., anti-cytotoxic T-lymphocyte-associated protein 4 [anti-CTLA4],
             anti-programmed death 1 [anti-PD1] and anti-programmed death ligand 1 [anti-PDL1])
             within 4 weeks or five half-lives of the drug, whichever is shorter, before
             obinutuzumab infusion on Cycle 1 Day -7

          -  History of treatment-emergent immune-related AEs associated with prior
             immunotherapeutic agents

          -  Documented refractoriness to an obinutuzumab-containing regimen

          -  Treatment with standard radiotherapy, any chemotherapeutic agent, or treatment with
             any other investigational anti-cancer agent, including chimeric antigen receptor
             therapy (CAR-T) within 4 weeks prior to obinutuzumab infusion

          -  Prior solid organ transplantation

          -  Prior allogeneic SCT

          -  Autologous SCT within 100 days prior to obinutuzumab infusion

          -  Participant with history of confirmed progressive multifocal leukoencephalopathy (PML)

          -  Current or past history of central nervous system (CNS) lymphoma

          -  Current or past history of CNS disease, such as stroke, epilepsy, CNS vasculitis, or
             neurodegenerative disease. Participants with a past history of stroke that have not
             experienced a stroke or transient ischemic attack in the past 2 years and have no
             residual neurologic deficits are allowed.

          -  Evidence of significant, uncontrolled concomitant diseases that could affect
             compliance with the protocol or interpretation of results, including diabetes
             mellitus, history of relevant pulmonary disorders and known autoimmune diseases

          -  Participants with another invasive malignancy in the last 2 years (with the exception
             of basal cell carcinoma and tumors deemed by the Investigator to be of low likelihood
             for recurrence)

          -  Significant cardiovascular disease such as New York Heart Association Class III or IV
             cardiac disease, myocardial infarction within the last 6 months, unstable arrhythmias,
             or unstable angina

          -  Administration of a live, attenuated vaccine within 4 weeks before obinutuzumab
             infusion or anticipation that such a live attenuated vaccine will be required during
             the study

          -  Received systemic immunosuppressive medications (including but not limited to
             cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis
             factor agents) within two weeks prior to obinutuzumab infusion. Treatment with
             corticosteroid </= 25 mg/day prednisone or equivalent is allowed. Inhaled and topical
             steroids are permitted.

          -  Any other diseases, metabolic dysfunction, physical examination finding, or clinical
             laboratory finding giving reasonable suspicion of a disease or condition that would
             contraindicate the use of an investigational drug

          -  History of autoimmune disease, including but not limited to myocarditis, pneumonitis,
             myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus, erythematosus,
             rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with
             antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome,
             Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
             Participants with a remote history of, or well controlled autoimmune disease, may be
             eligible to enroll after discussion with and confirmation by the Medical Monitor

          -  In Part III DLBCL dexamethasone cohort, patients with a history of hypersensitivity to
             dexamethasone or systemic corticosteroids will be excluded
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Part I and II: Percentage of Participants With Dose Limiting Toxicities (DLTs)
Time Frame:From Baseline up to 4 weeks
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Part I, II and III: Cmax of Obinutuzumab
Time Frame:Pre-dose of obinutuzumab on Day -7; pre-dose (Hr 0) of glofitamab on Day 1 of Cycle 1
Safety Issue:
Description:
Measure:Part I, II and III: Cmin of Obinutuzumab
Time Frame:Pre-dose of obinutuzumab on Day -7; pre-dose (Hr 0) of glofitamab on Day 1 of Cycle 1
Safety Issue:
Description:
Measure:Part I, II and III: Anti-Drug Antibodies (ADA) to Glofitamab
Time Frame:Pre-dose of obinutuzumab on Day -7; pre-dose (Hr 0) of glofitamab on Day 1 of each cycle from Cycle 2 onwards for a maximum of 8-12 cycles, and at EOT/follow-up visit (up to 5 years)
Safety Issue:
Description:
Measure:Parts I and II: Percentage of Participants With Overall Response (Partial Response [PR] or Complete Response [CR]) as Determined by the Lugano Classification
Time Frame:From Baseline up to end of study or discontinuation due to disease progression (up to 5 years)
Safety Issue:
Description:
Measure:Part I, II and III: Percentage of Participants With PR or CR (Overall Response Rate) as Determined by the Lugano Classifications
Time Frame:From Baseline up to end of study or discontinuation due to disease progression (up to 5 years)
Safety Issue:
Description:
Measure:Part I, II and III: Duration of Response (DOR) as Determined by the Lugano Classification
Time Frame:From first occurrence of documented objective response until disease progression, relapse or death due to any cause (up to 5 years)
Safety Issue:
Description:
Measure:Part I, II and III: Duration of Complete Response (DOCR) as Determined by the Lugano Classification
Time Frame:From the first occurrence of a documented, complete response, until the time of relapse or death from any cause (up to 5 years)
Safety Issue:
Description:
Measure:Part I, II and III: Progression-Free Survival (PFS) as Determined by the Lugano Classification
Time Frame:From first study treatment to the first occurrence of disease progression or death due to any cause (up to 5 years)
Safety Issue:
Description:
Measure:Overall Survival (OS)
Time Frame:From the time of first study treatment to death from any cause (up to 5 years)
Safety Issue:
Description:
Measure:Time to First Overall Response (TFOR)
Time Frame:From time of treatment start to first documented response (up to 5 years)
Safety Issue:
Description:
Measure:Time to First Complete Response (TFCR)
Time Frame:From treatment start to first documented complete response (up to 5 years)
Safety Issue:
Description:
Measure:Health Related Quality of Life (HRQoL) as Assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:From baseline through follow-up or until disease progression (up to 5 years)
Safety Issue:
Description:
Measure:HRQoL as Assessed by the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) Lymphoma Scale
Time Frame:From baseline through follow-up or until disease progression (up to 5 years)
Safety Issue:
Description:

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Hoffmann-La Roche

Last Updated

August 5, 2021