Description:
This is a Phase 1b study consisting of 2 parts: a dose escalation (Part 1) of CC-220 or
CC-99282 added to the standard R-CHOP-21 regimen for first-line treatment of a-BCL. The dose
escalation (Part 1) will consist of 2 parallel arms in combination with Rituximab,
Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP-21); CC-220 and R-CHOP-21
or CC-99282 and R-CHOP-21. Part 1 will be followed by a randomized dose expansion (Part 2)
with CC-220 and/or CC-99282 at the Recommended Phase 2 Dose (RP2D) in combination with
R-CHOP-21.
Title
- Brief Title: Study of Safety and Efficacy of Iberdomide (CC-220) and CC-99282 Combined With R-CHOP to Treat Lymphom
- Official Title: A Phase 1b, Open Label, Global, Multicenter, Dose Determination, Randomized Dose Expansion Study to Determine the Maximum Tolerated Dose, Assess the Safety and Tolerability, Pharmacokinetics and Preliminary Efficacy of Iberdomide (CC-220) in Combination With R-CHOP-21 and CC-99282 in Combination With R-CHOP-21 for Subjects With Previously Untreated, Poor Risk (IPI 3 to 5), Aggressive B-cell Lymphoma
Clinical Trial IDs
- ORG STUDY ID:
CC-220-DLBCL-001
- SECONDARY ID:
2020-005705-71
- NCT ID:
NCT04884035
Conditions
Interventions
Drug | Synonyms | Arms |
---|
CC-220 | Iberdomide | Administration of CC-220 with R-CHOP-21 |
Rituximab | | Administration of CC-220 with R-CHOP-21 |
Cyclophosphamide | | Administration of CC-220 with R-CHOP-21 |
Doxorubicin | | Administration of CC-220 with R-CHOP-21 |
Vincristine | | Administration of CC-220 with R-CHOP-21 |
Prednisone | Prednisolone | Administration of CC-220 with R-CHOP-21 |
CC-99282 | | Administration of CC-99282 with R-CHOP-21 |
Purpose
This is a Phase 1b study consisting of 2 parts: a dose escalation (Part 1) of CC-220 or
CC-99282 added to the standard R-CHOP-21 regimen for first-line treatment of a-BCL. The dose
escalation (Part 1) will consist of 2 parallel arms in combination with Rituximab,
Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP-21); CC-220 and R-CHOP-21
or CC-99282 and R-CHOP-21. Part 1 will be followed by a randomized dose expansion (Part 2)
with CC-220 and/or CC-99282 at the Recommended Phase 2 Dose (RP2D) in combination with
R-CHOP-21.
Trial Arms
Name | Type | Description | Interventions |
---|
Administration of CC-220 with R-CHOP-21 | Experimental | CC-220 to be administered orally in combination with Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisone (R-CHOP-21) for 6 cycles of treatment | - CC-220
- Rituximab
- Cyclophosphamide
- Doxorubicin
- Vincristine
- Prednisone
|
Administration of CC-99282 with R-CHOP-21 | Experimental | CC-99282 to be administered orally in combination with Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisone (R-CHOP-21) for 6 cycles of treatment | - Rituximab
- Cyclophosphamide
- Doxorubicin
- Vincristine
- Prednisone
- CC-99282
|
Eligibility Criteria
Inclusion Criteria:
- Participants must satisfy the following criteria to be enrolled in the study:
1. Is ≥ 18 years of age at the time of signing the informed consent form (ICF).
2. Participant has histologically confirmed (per local evaluation) diagnosis of de
novo, previously untreated, a-BCL according to 2016 WHO classification.
3. Participant has poor-risk disease defined as International Prognostic Index (IPI)
score ≥ 3 (high-intermediate or high-risk).
4. Participants must have measurable disease defined by at least one FDG-avid lesion
for FDGavid subtype and one bi-dimensionally measurable (> 1.5 cm in longest
diameter) disease by computed tomography (CT) or magnetic resonance imaging
(MRI), as defined by the Lugano classification (Cheson, 2014).
5. Participant has an Eastern Cooperative Oncology Group (ECOG) performance status
of 0, 1, or 2.
6. Participants must have the following laboratory values:
1. Absolute neutrophil count (ANC) ≥ 1.5 x 109/L or ≥ 1.0 x 109/L in case of
documented bone marrow involvement (> 50% or tumor cells), without growth
factor support for 7 days (14 days if peg-G-CSF)
2. Hemoglobin (Hb) ≥ 8 g/dL
3. Platelets (PLT) ≥ 75 x 109/L or ≥ 50 x 109/L in case of documented bone
marrow involvement (>50% or tumor cells), without transfusion for 7 days
4. Aspartate aminotransferase / serum glutamic oxaloacetic transaminase
(AST/SGOT) and alanine aminotransferase / serum glutamate pyruvic
transaminase (ALT/SGPT) ≤ 2.5 x upper limit of normal (ULN). In the case of
documented liver involvement by lymphoma, ALT/SGPT and AST/SGOT must be ≤
5.0 x ULN.
5. Serum total bilirubin ≤ 2.0 mg/dL except in cases of Gilbert syndrome, then
≤ 5.0 mg/dl
6. Estimated serum creatinine clearance of ≥ 50 mL/min
7. All participants must:
1. Have an understanding that the study drug could have a potential teratogenic
risk.
2. Agree to follow all requirements defined in the Pregnancy Prevention Program
for CC-220 or CC-99282 Pregnancy Prevention Plan for Participants in
Clinical trials.
8. Females of childbearing potential (FCBP) must:
a. Have two negative pregnancy tests as verified by the investigator prior to
starting study therapy.
9. Male participants must:
1. Practice true abstinence or agree to use a condom during sexual contact with
a pregnant female or a female of childbearing potential while participating
in the study.
Exclusion Criteria:
- The presence of any of the following will exclude a participant from enrollment:
1. Any significant medical condition, active infection (including SARS-CoV-2
suspected or confirmed), laboratory abnormality, or psychiatric illness that
would prevent the participant from participating in the study.
2. Any condition including the presence of laboratory abnormalities, which places
the participant at unacceptable risk if he/she were to participate in the study.
3. Any other subtype of lymphoma.
4. Documented or suspected CNS involvement by lymphoma.
5. Persistent diarrhea or malabsorption ≥ Grade 2 (NCI CTCAE v5.0), despite medical
management.
6. Peripheral neuropathy ≥ Grade 2 (NCI CTCAE v5.0).
7. Chronic systemic immunosuppressive therapy or corticosteroids
8. Impaired cardiac function or clinically significant cardiac disease, including
any of the following:
a. Left ventricular ejection fraction (LVEF) < 45% as determined by multigated
acquisition scan (MUGA) or echocardiogram (ECHO)
9. Major surgery ≤ 2 weeks prior to starting CC-220 or CC-99282; participant must
have recovered from any clinically significant effects of recent surgery.
10. Any condition causing inability to swallow tablets.
11. Known seropositivity for or active viral infection with human immunodeficiency
virus (HIV)
12. Known chronic active hepatitis B (hepatitis B surface antigen [HBsAg] positive
and/or hepatitis B core antibody [anti-HBc] positive with viral DNA positive) or
C (positive serology requiring treatment and/or with evidence of liver damage)
infection
13. History of other malignancy, unless being free of the disease for ≥ 3 years;
exceptions to the ≥ 3-year time limit include history of the following:
1. Localized nonmelanoma skin cancer
2. Carcinoma in situ of the cervix
3. Carcinoma in situ of the breast
4. Incidental histologic finding of prostate cancer (T1a or T1b as per Tumor
Node Metastasis [TNM] staging system) or prostate cancer that has been
treated with curative intent.
14. Hypersensitivity to the active substance or to murine proteins, or to any of the
other excipients of rituximab.
15. Known hypersensitivity to any component of CHOP regimen.
16. Known allergy to thalidomide, pomalidomide, or lenalidomide.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Maximum Tolerated Dose (MTD) - Part 1 |
Time Frame: | During the first two cycles of treatment (each cycle is 21 days) |
Safety Issue: | |
Description: | Frequency of dose-limiting toxicities (DLT) associated with addition of iberdomide (CC-220) to R-CHOP-21 therapy and the addition of CC-99282 to R-CHOP-21 therapy |
Secondary Outcome Measures
Measure: | Best overall response rate (ORR) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The proportion of participants with best overall response achieved during the study as either Complete Response or Partial Response before subsequent anti-lymphoma therapy |
Measure: | Complete Metabolic Response Rate (CMRR) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The proportion of participants experiencing complete metabolic response (CMR) before receiving any subsequent anti-lymphoma therapy |
Measure: | Time to Response (TTR) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The time from entry to the study (enrollment date for Part 1 and randomization date for Part 2) to the date of first documented response (≥ PR) |
Measure: | Duration of Response (DOR) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The time from the earliest date of documented response (≥ PR) to the first occurrence of relapse or progression |
Measure: | Progression-free Survival (PFS) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The time from entry to the study (enrollment date for Part 1 and randomization date for Part 2) to the first occurrence of disease progression or death from any cause |
Measure: | Overall Survival (OS) |
Time Frame: | Up to 4 years |
Safety Issue: | |
Description: | The time from entry to the study (enrollment date for Part 1 and randomization date for Part 2) to death from any cause |
Measure: | Incidence of Adverse Events (AEs) |
Time Frame: | From enrollment until at least 28 days after completion of study treatment |
Safety Issue: | |
Description: | An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a participant during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) should be considered an AE |
Measure: | Pharmacokinetics - Cmax for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Maximum plasma concentration of drug |
Measure: | Pharmacokinetics - Ctrough for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Minimum or trough concentration |
Measure: | Pharmacokinetics - AUC for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Area under the plasma concentration-time curve |
Measure: | Pharmacokinetics - tmax for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Time to maximum plasma concentration |
Measure: | Pharmacokinetics - t½ for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Terminal elimination half-life in plasma |
Measure: | Pharmacokinetics - CL/F for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Apparent total plasma clearance |
Measure: | Pharmacokinetics - V/F for CC-220 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Apparent volume of distribution |
Measure: | Pharmacokinetics - Cmax for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Maximum plasma concentration |
Measure: | Pharmacokinetics - Ctrough for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Minimum or trough concentration |
Measure: | Pharmacokinetics - AUC for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Area under the plasma concentration-time curve |
Measure: | Pharmacokinetics - tmax for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Time to maximum plasma concentration |
Measure: | Pharmacokinetics - t½ for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Terminal elimination half-life in plasma |
Measure: | Pharmacokinetics - CL/F for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Apparent total plasma clearance |
Measure: | Pharmacokinetics - V/F for CC-99282 |
Time Frame: | At Cycle 1 Day 7 and Cycle 2 Day 7 (each cycle is 21 days) |
Safety Issue: | |
Description: | Apparent volume of distribution |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Not yet recruiting |
Lead Sponsor: | Celgene |
Trial Keywords
- Iberdomide
- CC-220
- CC-99282
- Phase 1
- B-Cell Lymphoma
Last Updated
June 9, 2021