Description: 
            
            
              
                
      This is an open-label, single arm, multicenter, dose finding, Phase Ib study in order to
      assess the maximum tolerated dose (MTD) and/or recommended Phase II dose (RP2D) for this
      combination treatment and to evaluate the general safety, tolerability, pharmacokinetic (PK),
      pharmacodynamic, and preliminary anti-tumor activity of this combination treatment in adult
      patients.
      This study includes an additional open-label imaging feasibility sub-study using a tracer in
      adult participants with relpased/refractory B-cell non-Hodgkin's lymphoma to image
      CD8+T-cells at baseline and after treatment with glofitamab, including pre-treatment with
      obinutuzumab.
    
              
             
           
        
      
        
          
      
        
          
Title
- Brief Title: An Open-Label Phase lB/II Study of Glofitamab and Atezolizumab or Polatuzumab Vedotin in Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma
- Official Title: An Open-Label, Multi-Center, Phase IB/II Study of Glofitamab and Atezolizumab or Polatuzumab Vedotin (Plus a Single Pre-Treatment Dose of Obinutuzumab) in Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma
Clinical Trial IDs
- ORG STUDY ID:
                NP39488
- NCT ID:
                NCT03533283
Conditions
Interventions
| Drug | Synonyms | Arms | 
|---|
| Glofitamab | RO7082859 | Atezolizumab | 
| Atezolizumab |  | Atezolizumab | 
| Obinutuzumab |  | Atezolizumab | 
| Tocilizumab | Actemra | Atezolizumab | 
| Polatuzumab Vedotin |  | Polatuzumab Vedotin | 
| 89Zr-Df-IAB22M2C |  | Imaging Sub-study | 
Purpose
      This is an open-label, single arm, multicenter, dose finding, Phase Ib study in order to
      assess the maximum tolerated dose (MTD) and/or recommended Phase II dose (RP2D) for this
      combination treatment and to evaluate the general safety, tolerability, pharmacokinetic (PK),
      pharmacodynamic, and preliminary anti-tumor activity of this combination treatment in adult
      patients.
      This study includes an additional open-label imaging feasibility sub-study using a tracer in
      adult participants with relpased/refractory B-cell non-Hodgkin's lymphoma to image
      CD8+T-cells at baseline and after treatment with glofitamab, including pre-treatment with
      obinutuzumab.
    
Trial Arms
| Name | Type | Description | Interventions | 
|---|
| Atezolizumab | Experimental | Participants will receive Glofitamab in combination with Atezolizumab up to the maximum tolerated dose (MTD). | GlofitamabAtezolizumabObinutuzumabTocilizumab
 | 
| Polatuzumab Vedotin | Experimental | Participants will receive Glofitamab in combination with polatuzumab vedotin up to the MTD. | GlofitamabObinutuzumabTocilizumabPolatuzumab Vedotin
 | 
| Imaging Sub-study | Experimental | Participants will undergo positive-emission tomography/computed tomography (PET/CT) at screening, followed by an "Imaging Cycle," to replace Cycle 1 of the main study. Eligible participants will have the option roll-over to the atezolizumab arm of the main study from Cycle 2 onwards. | GlofitamabObinutuzumab89Zr-Df-IAB22M2C
 | 
Eligibility Criteria
        Main Inclusion Criteria
          -  Histologically-confirmed hematologic malignancy that is expected to express CD20
             (Relapsed after or refractory to respond to at least one prior treatment regimen; no
             available treatment options that are expected to prolong survival or patients refusing
             chemotherapy or autologous stem cell transplant (SCT). Note: The expansion part is
             restricted to relapsed/refractory follicular lymphoma (r/r FL) and relapsed/refractory
             diffuse large B cell lymphoma (r/r DLBCL))
          -  At least one measurable target lesion
          -  Fresh pre-treatment biopsy, but if this cannot be taken, a previous archived biopsy
             from metastatic lesion can be taken as replacement if it is not older than 6 months
             and not confounded by major events (progression, treatment)
          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
          -  Adequate organ function (liver, hematological, renal)
          -  Negative test results for hepatitis B virus (HBV), hepatitis C virus (HCV), and human
             immunodeficiency virus (HIV)
        Inclusion Criteria Specific to Imaging Substudy
          -  At least two measurable target lesions
          -  Able to provide two fresh tumor biopsies (baseline and on-treatment)
        Main Exclusion Criteria
          -  Participants with Chronic Lymphocytic Leukemia (CLL), acute lymphoblastic leukemia
             (ALL), lymphoblastic lymphoma, Richter's transformation, CD20-positive ALL, Burkitt
             lymphoma, or lymphoplasmacytic lymphoma
          -  Current > Grade 1 peripheral neuropathy (only for participants being treated in the
             polatuzumab vedotin arm)
          -  Patients with known active infection, or reactivation of a latent infection within 4
             weeks prior to Obinutuzumab (Gpt) infusion
          -  Patient with history of confirmed progressive multifocal leukoencephalopathy (PML)
          -  History of leptomeningeal disease
          -  Current or past history of central nervous system (CNS) lymphoma
          -  Current or past history of CNS disease
          -  Major surgery or significant traumatic injury </=28 days prior to Gpt infusion
          -  Significant cardiovascular disease or significant pulmonary disease
          -  Active or history of autoimmune disease or immune deficiency (with exceptions, e.g.
             hypothyroidism and Diabetes mellitus Type 1)
          -  History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g. bronchiolitis
             obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of
             active pneumonitis on screening chest computed tomography (CT) scan
          -  Treatment with any other standard anti-cancer radiotherapy / chemotherapy including
             investigational therapy within 4 weeks prior to Gpt infusion
          -  Prior solid organ transplantation
          -  Prior allogenic stem cell transplant (SCT)
          -  Autologous SCT within 100 days prior to Gpt infusion
          -  Documented refractoriness to an obinutuzumab-monotherapy regimen
          -  Prior treatment with targeted therapies and systemic
             immunotherapeutic/immunostimulating agents within 4 weeks or 5 half-lives of the drug,
             whichever is shorter, prior to Gpt infusion
          -  Any history of immune related >/= Grade 3 adverse events (AE) with the exception of
             endocrinopathy managed with replacement therapy
          -  Ongoing corticosteroid use >25 milligrams/day of prednisone or equivalent within 4
             weeks prior to and during study treatment
          -  Treatment with systemic immunosuppressive medication
          -  Administration of a live, attenuated vaccine within 4 weeks prior to Gpt infusion or
             anticipation that such a live attenuated vaccine will be required during the study or
             within 5 months after last dose of study treatment
        Exclusion Criteria Specific to Imaging Substudy
          -  Circulating lymphoma cells, defined by out of range (high) absolute lymphocyte count
             and/or the presence of abnormal/malignant cells in the peripheral blood differential
             signifying circulating lymphoma cell
          -  Participants who have had splenectomy or functional asplenia that could compromise
             protocol objectives
      | Maximum Eligible Age: | N/A | 
| Minimum Eligible Age: | 18 Years | 
| Eligible Gender: | All | 
| Healthy Volunteers: | No | 
Primary Outcome Measures
| Measure: | Dose Limiting Toxicities (DLTs) | 
| Time Frame: | Atezolizumab Arm: During DLT period of 21 days (or up to 42 days in the case of cycle delay), starting on Day 1, Cycle 2; Polatuzumab Vedotin Arm: During 5-week DLT period starting Cycle 1, Day 8 | 
| Safety Issue: |  | 
| Description: |  | 
Secondary Outcome Measures
| Measure: | Percentage of Participants with Adverse Events (AEs) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Anti-Drug Antibody (ADA) Formation | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Complete Response (CR) Rate, as Assessed by Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Scan | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Objective Response Rate (ORR) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Disease Control Rate (DCR) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Duration of Response (DOR) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Duration of Complete Response | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Time to First Complete Response (TFCR) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Time to First Overall Response (TFOR) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Progression-Free Survival (PFS) | 
| Time Frame: | Baseline until end of treatment (13 to 14 months), then every 3 months until end of study visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Overall Survival (OS) | 
| Time Frame: | Baseline through end of survival follow-up phase (survival follow-up is every 3 months until death, lost to follow-up, withdrawal of consent, or study termination) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Elimination Half-Life (T1/2) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Area Under the Concentration-Time Curve (AUC) for Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Time to Maximum Observed Serum Concentration (Tmax) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Maximum Observed Serum Concentration (Cmax) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Minimum Serum Concentration (Cmin) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Clearance (CL) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Volume of Distribution at Steady-State (Vss) of Glofitamab Administered in Combination with Atezolizumab or Polatuzumab Vedotin | 
| Time Frame: | At pre-defined intervals through the end of study (EoS) visit (to occur within 4 weeks of disease progression) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | CD8-Positive T Cell Proliferation | 
| Time Frame: | At pre-defined intervals during the study treatment period (up to 17 cycles; Cycle = 21 days) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | CD20-Positive B-Cell Reduction | 
| Time Frame: | At pre-defined intervals during the study treatment period (up to 17 cycles; Cycle = 21 days) | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | SUVmax of 89Zr-Df-IAB22M2C | 
| Time Frame: | From baseline to Day 13 | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | SUVpeak of 89Zr-Df-IAB22M2C | 
| Time Frame: | From baseline to Day 13 | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | SUVmean of 89Zr-Df-IAB22M2C | 
| Time Frame: | From baseline to Day 13 | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Tumor Volume Based on 89Zr-Df-IAB22M2C PET-uptake | 
| Time Frame: | From baseline to Day 13 | 
| Safety Issue: |  | 
| Description: |  | 
| Measure: | Quantitation of CD8+ Cells on Biopsy Samples | 
| Time Frame: | From baseline to Day 13 | 
| Safety Issue: |  | 
| Description: |  | 
Details
| Phase: | Phase 1 | 
| Primary Purpose: | Interventional | 
| Overall Status: | Recruiting | 
| Lead Sponsor: | Hoffmann-La Roche | 
Last Updated
August 20, 2021