Clinical Trials /

Study of Safety and Efficacy of Iberdomide (CC-220) and CC-99282 Combined With R-CHOP to Treat Lymphom

NCT04884035

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.

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

Not yet recruiting

Phase:

Phase 1

Trial Eligibility

Document

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

  • Lymphoma, B-Cell

Interventions

DrugSynonymsArms
CC-220IberdomideAdministration of CC-220 with R-CHOP-21
RituximabAdministration of CC-220 with R-CHOP-21
CyclophosphamideAdministration of CC-220 with R-CHOP-21
DoxorubicinAdministration of CC-220 with R-CHOP-21
VincristineAdministration of CC-220 with R-CHOP-21
PrednisonePrednisoloneAdministration of CC-220 with R-CHOP-21
CC-99282Administration 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

NameTypeDescriptionInterventions
Administration of CC-220 with R-CHOP-21ExperimentalCC-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-21ExperimentalCC-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