A Study Evaluating the Safety and Efficacy of Venetoclax (GDC-0199) Plus Bendamustine + Rituximab (BR) in Comparison With BR or Venetoclax Plus Rituximab in Participants With Relapsed and Refractory Follicular Non-Hodgkin's Lymphoma (fNHL)
Follicular Lymphoma
About this trial
This is an interventional treatment trial for Follicular Lymphoma
Eligibility Criteria
Inclusion Criteria:
- Participants must have histologically confirmed follicular lymphoma (FL) of Grade 1, 2, or 3a
- Participants must have received at least one prior therapy for FL
- For participants potentially receiving chemotherapy: if the participant has received prior bendamustine, response duration must have been greater than (>) 1 year
- At least one bi-dimensionally measurable lesion on imaging scan defined as >1.5 centimeters (cm) in its longest dimension
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
- Adequate hematologic function
- For female participants of childbearing potential and male participants with female partners of childbearing potential, agreement to use one highly effective form of non-hormonal contraception or two effective forms of non-hormonal contraception throughout the course of study treatment and for at least 30 days after the last dose of venetoclax and 12 months after the last dose of rituximab, whichever is longer
- Confirmed availability of archival or freshly biopsied tumor tissue meeting protocol-defined specifications prior to study enrollment
Exclusion Criteria:
- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products
- Contraindication to potential treatment agents
- Ongoing corticosteroid use >30 milligrams per day (mg/day) of prednisone or equivalent. Participants receiving corticosteroid treatment with less than equal to (</=) 30 mg/day of prednisone or equivalent must be documented to be on a stable dose of at least 4 weeks duration prior to randomization (Cycle 1 Day 1)
- Primary central nervous system (CNS) lymphoma
- Vaccination with live vaccines within 28 days prior to treatment
- Chemotherapy or other investigational therapy within five half-lives of a biologic agent with a minimum of 28 days prior to the start of Cycle 1
- History of other malignancy that could affect compliance with the protocol or interpretation of results
- Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results or that could increase risk to the participant
- Significant cardiovascular disease (such as New York Heart Association Class III or IV cardiac disease, congestive heart failure, myocardial infarction within the previous 6 months, unstable arrhythmias, or unstable angina) or significant pulmonary disease (including obstructive pulmonary disease and history of bronchospasm)
- Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment or any major episode of infection requiring treatment with intravenous antibiotics or hospitalization (relating to the completion of the course of antibiotics) within 4 weeks prior to Cycle 1 Day 1
- Requires the use of warfarin
- Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis
- Presence of positive test results for hepatitis B surface antigen or hepatitis C virus (HCV) antibody
- Participants who are positive for HCV antibody must be negative for HCV by polymerase chain reaction (PCR) to be eligible for study participation
- Participants with occult or prior hepatitis B virus (HBV) infection may be included if HBV deoxyribonucleic acid (DNA) is undetectable at screening. These participants must be willing to undergo monthly HBV DNA test until at least 12 months after the last treatment cycle
- Known infection with human immunodeficiency virus (HIV) or human T-cell leukemia virus 1 (HTLV-1)
- Pregnant or lactating
- Recent major surgery (within 6 weeks before the start of Cycle 1 Day 1), other than for diagnosis
Sites / Locations
- Southern Cancer Center, PC
- Arizona Cancer Center
- UCLA School of Medicine; Hematology/Oncology
- Nothwest Georgia Oncology Centers P.C
- Northwestern University
- University of Illinois at Chicago College of Medicine
- Primary Healthcare Associates SC - Harvey
- University of Kansas; Medical Center & Medical pavilion
- Sidney Kimmel Comp Cancer Ctr
- Hackensack University Medical Center
- James P. Wilmot Cancer Center
- University of Pennsylvania; School of Medicine
- Allegheny General Hospital
- University of Pittsburgh
- University of Virginia
- VCU Massey Cancer Center
- West Virginia Uni Med. Center - Robert Byrd Health Science
- Royal Prince Alfred Hospital; Medical Oncology
- St George Hospital
- Royal North Shore Hospital
- Westmead Hospital; Haematology
- Calvary Mater Newcastle
- Townsville General Hospital
- Princess Alexandra Hospital
- Queen Elizabeth Hospital; Haematology
- Royal Hobart Hospital
- Monash Medical Centre
- ZNA Stuivenberg
- AZ Sint Jan
- Cliniques Universitaires St-Luc
- Cross Cancer Institute
- British Columbia Cancer Agency
- University Health Network; Princess Margaret Hospital; Medical Oncology Dept
- Hopital Maisonneuve- Rosemont; Oncology
- Chum Hopital Notre Dame; Centre D'Oncologie
- Jewish General Hospital
- Saskatoon Cancer Centre; Uni of Saskatoon Campus
- Institut de Cancerologie de l'Ouest
- CHU Clermont Ferrand - Hôpital d'Estaing
- Hopital Henri Mondor
- CHU de Dijon - Hopital le Bocage
- Centre Jean Bernard
- CHU Montpellier
- Centre Hospitalier Lyon Sud; Hematolgie
- Klinikum Chemnitz gGmbH; Klinik f. Innere Medizin III
- Städtisches Klinikum Dessau
- BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie-Onkologie
- Universitätsklinik Essen; Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie
- Universitätsklinikum Jena; Klinik für Innere Medizin II
- Universitätsklinikum Köln; Klinik I für Innere Medizin
- Universitätsklinikum Schleswig-Holstein / Campus Lübeck, Med. Klinik I, Hämatologie/Onkologie
- Uni. der Johannes Gutenberg-Universitaet Mainz; III. Medizinische Klinik und Poliklinik
- Universitätsklinikum Ulm; Apotheke
- Universitätsklinikum Würzburg; Medizinische Klinik und Poliklinik II; Hämatologie / Onkologie
- A.O. Universitaria Policlinico S.Orsola-Malpighi Di Bologna
- IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
- Ospedale di Ravenna
- Ospedale Infermi di Rimini
- Asst Papa Giovanni XXIII
- Ospedale Niguarda Milano
- Irccs Policlinico San Matteo; Divisione Di Ematologia
- Azienda Ospedale San Giovanni
- Az. Osp. Di Careggi; Divisione Di Ematologia
- Blackpool Victoria Hospital
- St James University Hospital
- Leicester Royal Infirmary; Dept. of Medical Oncology
- University College London, Department of Haematology
- Royal Marsden Nhs Trust; Consultant Cancer Physician
- Christie Hospital; Breast Cancer Research Office
- Churchill Hospital; Oxford Cancer and Haematology Centre
- Royal Marsden NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Chemotherapy-Containing Cohort:Safety Run-In (Venetoclax + BR)
Chemotherapy-Free Cohort: Arm A (Venetoclax + Rituximab)
Chemotherapy-Containing Cohort: Arm B (Venetoclax + BR)
Chemotherapy-Containing Cohort: Arm C (BR)
Participants will receive venetoclax no more than 600 milligrams (mg) orally once daily continuously along with rituximab 375 milligrams per square meter (mg/m^2) intravenous (IV) infusion on Day 1 of 28-day cycle and bendamustine 90 mg/m^2 IV infusion on Days 1 and 2 of the 28-day cycle. Safety run-in will continue until first 9 participants complete the safety observation window of 28 days. Participants will continue receiving the same treatment as decided for Arm B.
Participants will receive venetoclax 800 mg orally once daily for 1 year along with rituximab 375 mg/m^2 IV infusion on Days 1, 8, 15, 22 of Cycle 1 and Day 1 of Cycles 4, 6, 8, 10, and 12. Each cycle will be of 28 days.
Participants will receive venetoclax at doses decided from safety run-in orally once daily continuously for 1 year along with rituximab 375 mg/m^2 IV infusion on Day 1 of each 28-day cycle and bendamustine 90 mg/m^2 IV infusion on Days 1 and 2 of each 28-day cycle, for 6 cycles.
Participants will receive rituximab 375 mg/m^2 IV infusion on Day 1 of each 28-day cycle and bendamustine 90 mg/m^2 IV infusion on Days 1 and 2 of each 28-day cycle, for 6 cycles.