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). | - Glofitamab
- Atezolizumab
- Obinutuzumab
- Tocilizumab
|
Polatuzumab Vedotin | Experimental | Participants will receive Glofitamab in combination with polatuzumab vedotin up to the MTD. | - Glofitamab
- Obinutuzumab
- Tocilizumab
- Polatuzumab 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. | - Glofitamab
- Obinutuzumab
- 89Zr-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