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Study to Investigate the Safety and Tolerability of Odronextamab in Patients With CD20+ B-Cell Malignancies (ELM-1)

Primary Purpose

Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Odronextamab multiple dose levels
Odronextamab multiple dose levels
Sponsored by
Regeneron Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Hodgkin Lymphoma focused on measuring Diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma (FL), Aggressive lymphoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  1. Have documented CD20+ B-cell malignancy, with active disease not responsive to prior therapy, for whom no standard of care options exists, and for whom treatment with an anti-CD20 antibody may be appropriate:

    • Part A (IV administration) B-NHL confirmed by National Cancer Institute (NCI) working group criteria
    • Part B (SC administration): Confirmed diagnosis of B-NHL requiring therapy as defined by WHO classification 2017
  2. Patients with B-NHL must have had prior treatment with an anti-CD20 antibody therapy. Patients with CLL (Part A only) are not required to have received prior treatment with an anti-CD20 antibody therapy as defined in the protocol.

    • For the inclusion in the disease-specific expansion cohort enrolling DLBCL patients after failure of CAR-T therapy, the patient must have recovered from the toxicities of the lymphodepletion therapy and CAR-T infusion.
    • For inclusion in Part B, patients must have FL grade 1-3a or DLBCL (with or without prior CAR-T) per the criteria above, and:
    • Patients with FL grade 1-3a and DLBCL must have received at least 2 prior lines of systemic therapy, including an anti-CD20 antibody and an alkylating agent
  3. All patients must have at least one bi-dimensionally measurable lesion ≥1.5 cm) documented by CT or MRI scan, if CT scan is not feasible.
  4. Eastern Cooperative Oncology Group (ECOG) performance status ≤1
  5. Life expectancy of at least 6 months
  6. Adequate bone marrow function as described in the protocol
  7. Adequate organ function as described in the protocol
  8. Willingness to undergo mandatory tumor biopsy pretreatment, if in the opinion of the investigator, the patient has an accessible lesion that can be biopsied without significant risk to the patient.
  9. Willing and able to comply with clinic visits and study-related procedures
  10. Provide signed informed consent or legally acceptable representative

Key Exclusion Criteria:

  1. Primary central nervous system (CNS) lymphoma or known or suspected CNS involvement by non-primary CNS NHL
  2. History of or current relevant CNS pathology such as

    • Epilepsy, seizure, paresis, aphasia, apoplexia, severe brain injuries, cerebellar disease, organic brain syndrome, psychosis, or
    • Evidence for presence of inflammatory lesions and/or vasculitis on cerebral MRI
  3. Standard anti-lymphoma chemotherapy (non-biologic) or radiotherapy within 28 days prior to first administration of study drug
  4. Infection with human immunodeficiency virus (HIV) or chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), or cytomegalovirus (CMV) infection [(as noted by detectable levels on a blood polymerase chain reaction (PCR) assay)].

    1. Patients with hepatitis B (HepBsAg+) who have controlled infection (serum hepatitis B virus deoxyribonucleic acid (DNA) that is below the limit of detection AND receiving anti-viral therapy for hepatitis B) are permitted upon consultation with the physician managing the infection.
    2. Patients who show detectable levels of CMV at screening will need to be treated with appropriate antiviral therapy and demonstrate at least 2 undetectable levels of CMV by PCR assay (at least 7 days apart) before being re-considered for eligibility.
  5. Patients who have received a live vaccination within 28 days of first dose of study treatment

Note: Other protocol Inclusion/Exclusion criteria apply

Sites / Locations

  • University of California, Irvine
  • Stanford University
  • H. Lee Moffitt Cancer Center
  • Massachusetts General Hospital
  • Beth Israel Deaconess Medical Center
  • Dana Farber Cancer Institute (Massachusetts General Hospital and Beth Israel)
  • Mayo Clinic
  • Rutgers Cancer Institute of New Jersey
  • Memorial Sloan Kettering Cancer Center
  • Weill Cornell Medical College
  • Centre Henri Becquerel
  • CHU Hôpital Lyon Sud
  • Institut Gustave Roussy
  • Universitatsklinikum Wurzburg
  • Assuta Ashdod University Hospital
  • Meir Medical Center
  • The Chaim Sheba Medical Center
  • Hadassah Medical Center
  • Rambam Health Care Campus - Hematology and Bone Marrow Transplantation Institute
  • Lady Davis Carmel Medical Center
  • Royal Cornwall Hospitals NHS Trust
  • The Christie NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Part A

1N Part B

2N Part B

Arm Description

DLBCL post CAR-T

FL

DLBCL

Outcomes

Primary Outcome Measures

Safety/overall frequency of adverse events (AEs)
Part A and B
Safety/dose limiting toxicities (DLTs)
Part A and B
Antitumor activity as measured by the objective response rate (ORR)
Expansion Cohorts: • Diffuse large B-cell lymphoma (DLBCL) after failure of CAR-T therapy Part A

Secondary Outcome Measures

Pharmacokinetics (Concentration of odronextamab)
Peak plasma concentration (Cmax) of odronextamab Part A and B
Incidence of anti-drug antibodies (ADA) to odronextamab
Part A and B
Titer of ADA to odronextamab
Part A and B
Incidence of neutralizing antibodies (NAb) to odronextamab over time
Part A and B
Objective response rate (ORR)
For dose escalation portion and expansion cohorts: Aggressive lymphoma expansion cohort 2 FL grade 1-3a expansion cohorts 1 and 2 (Part A) For dose escalation and dose expansion cohorts: FL grade 1-3a DLBCL DLBCL post CAR T failure (Part B)
Progression-free survival
Part A and B
Overall Survival
Part A and B
Duration of response (DOR)
Part A and B
Minimal residual disease (MRD) for patients with CLL
Part A
Duration of Complete Response (DOCR)
Part B

Full Information

First Posted
November 7, 2014
Last Updated
September 6, 2023
Sponsor
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02290951
Brief Title
Study to Investigate the Safety and Tolerability of Odronextamab in Patients With CD20+ B-Cell Malignancies
Acronym
ELM-1
Official Title
An Open-Label, Multi-Center Phase 1 Study to Investigate the Safety and Tolerability of REGN1979, an Anti-CD20 x Anti-CD3 Bispecific Monoclonal Antibody, in Patients With CD20+ B-Cell Malignancies Previously Treated With CD20-Directed Antibody Therapy (ELM-1)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 9, 2015 (Actual)
Primary Completion Date
December 2, 2025 (Anticipated)
Study Completion Date
December 2, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Regeneron Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study has two parts with distinct study objectives and study design. In part A, odronextamab is studied as an intravenous (IV) administration with a dose escalation and a dose expansion phase for B-NHL and CLL. The dose escalation phase for B-NHL and the CLL study are closed at the time of protocol amendment 17. In part B, odronextamab is studied as a subcutaneous (SC) administration with a dose finding and a dose expansion phase for B-NHL.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia
Keywords
Diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma (FL), Aggressive lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part A
Arm Type
Experimental
Arm Description
DLBCL post CAR-T
Arm Title
1N Part B
Arm Type
Experimental
Arm Description
FL
Arm Title
2N Part B
Arm Type
Experimental
Arm Description
DLBCL
Intervention Type
Drug
Intervention Name(s)
Odronextamab multiple dose levels
Other Intervention Name(s)
REGN1979
Intervention Description
Administered by intravenous (IV) infusion
Intervention Type
Drug
Intervention Name(s)
Odronextamab multiple dose levels
Other Intervention Name(s)
REGN1979
Intervention Description
Administered by subcutaneous (SC) injection
Primary Outcome Measure Information:
Title
Safety/overall frequency of adverse events (AEs)
Description
Part A and B
Time Frame
Up to 24 months
Title
Safety/dose limiting toxicities (DLTs)
Description
Part A and B
Time Frame
Up to 28 days
Title
Antitumor activity as measured by the objective response rate (ORR)
Description
Expansion Cohorts: • Diffuse large B-cell lymphoma (DLBCL) after failure of CAR-T therapy Part A
Time Frame
Through study completion, an average of 24 months
Secondary Outcome Measure Information:
Title
Pharmacokinetics (Concentration of odronextamab)
Description
Peak plasma concentration (Cmax) of odronextamab Part A and B
Time Frame
Up to 10 months
Title
Incidence of anti-drug antibodies (ADA) to odronextamab
Description
Part A and B
Time Frame
Over time; up to approximately 15 months
Title
Titer of ADA to odronextamab
Description
Part A and B
Time Frame
Over time; up to approximately 15 months
Title
Incidence of neutralizing antibodies (NAb) to odronextamab over time
Description
Part A and B
Time Frame
Over time; Up to approximately 15 months
Title
Objective response rate (ORR)
Description
For dose escalation portion and expansion cohorts: Aggressive lymphoma expansion cohort 2 FL grade 1-3a expansion cohorts 1 and 2 (Part A) For dose escalation and dose expansion cohorts: FL grade 1-3a DLBCL DLBCL post CAR T failure (Part B)
Time Frame
Through study completion, an average of 24 months
Title
Progression-free survival
Description
Part A and B
Time Frame
Up to 48 months
Title
Overall Survival
Description
Part A and B
Time Frame
Until death or lost to follow-up/ withdrawal, approximately up to 48 months
Title
Duration of response (DOR)
Description
Part A and B
Time Frame
Until progression, approximately up to 48 months
Title
Minimal residual disease (MRD) for patients with CLL
Description
Part A
Time Frame
Up to 24 months
Title
Duration of Complete Response (DOCR)
Description
Part B
Time Frame
Until progression, approximately up to 48 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Have documented CD20+ B-cell malignancy, with active disease not responsive to prior therapy, for whom no standard of care options exists, and for whom treatment with an anti-CD20 antibody may be appropriate: Part A (IV administration) B-NHL confirmed by National Cancer Institute (NCI) working group criteria Part B (SC administration): Confirmed diagnosis of B-NHL requiring therapy as defined by WHO classification 2017 Patients with B-NHL must have had prior treatment with an anti-CD20 antibody therapy. Patients with CLL (Part A only) are not required to have received prior treatment with an anti-CD20 antibody therapy as defined in the protocol. For the inclusion in the disease-specific expansion cohort enrolling DLBCL patients after failure of CAR-T therapy, the patient must have recovered from the toxicities of the lymphodepletion therapy and CAR-T infusion. For inclusion in Part B, patients must have FL grade 1-3a or DLBCL (with or without prior CAR-T) per the criteria above, and: Patients with FL grade 1-3a and DLBCL must have received at least 2 prior lines of systemic therapy, including an anti-CD20 antibody and an alkylating agent All patients must have at least one bi-dimensionally measurable lesion ≥1.5 cm) documented by CT or MRI scan, if CT scan is not feasible. Eastern Cooperative Oncology Group (ECOG) performance status ≤1 Life expectancy of at least 6 months Adequate bone marrow function as described in the protocol Adequate organ function as described in the protocol Willingness to undergo mandatory tumor biopsy pretreatment, if in the opinion of the investigator, the patient has an accessible lesion that can be biopsied without significant risk to the patient. Willing and able to comply with clinic visits and study-related procedures Provide signed informed consent or legally acceptable representative Key Exclusion Criteria: Primary central nervous system (CNS) lymphoma or known or suspected CNS involvement by non-primary CNS NHL History of or current relevant CNS pathology such as Epilepsy, seizure, paresis, aphasia, apoplexia, severe brain injuries, cerebellar disease, organic brain syndrome, psychosis, or Evidence for presence of inflammatory lesions and/or vasculitis on cerebral MRI Standard anti-lymphoma chemotherapy (non-biologic) or radiotherapy within 28 days prior to first administration of study drug Infection with human immunodeficiency virus (HIV) or chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), or cytomegalovirus (CMV) infection [(as noted by detectable levels on a blood polymerase chain reaction (PCR) assay)]. Patients with hepatitis B (HepBsAg+) who have controlled infection (serum hepatitis B virus deoxyribonucleic acid (DNA) that is below the limit of detection AND receiving anti-viral therapy for hepatitis B) are permitted upon consultation with the physician managing the infection. Patients who show detectable levels of CMV at screening will need to be treated with appropriate antiviral therapy and demonstrate at least 2 undetectable levels of CMV by PCR assay (at least 7 days apart) before being re-considered for eligibility. Patients who have received a live vaccination within 28 days of first dose of study treatment Note: Other protocol Inclusion/Exclusion criteria apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trial Management
Organizational Affiliation
Regeneron Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
University of California, Irvine
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
H. Lee Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Dana Farber Cancer Institute (Massachusetts General Hospital and Beth Israel)
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Rutgers Cancer Institute of New Jersey
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Centre Henri Becquerel
City
Rouen
State/Province
Haute-Normandie
ZIP/Postal Code
76038
Country
France
Facility Name
CHU Hôpital Lyon Sud
City
Lyon
ZIP/Postal Code
69495
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
State/Province
Île-de-France
ZIP/Postal Code
94800
Country
France
Facility Name
Universitatsklinikum Wurzburg
City
Wurzburg
State/Province
Bayern
ZIP/Postal Code
97080
Country
Germany
Facility Name
Assuta Ashdod University Hospital
City
Ashdod
State/Province
HaDarom
ZIP/Postal Code
7747629
Country
Israel
Facility Name
Meir Medical Center
City
Kfar Saba
State/Province
HaMerkaz
ZIP/Postal Code
44281
Country
Israel
Facility Name
The Chaim Sheba Medical Center
City
Tel-Hashomer
State/Province
HaMerkaz
ZIP/Postal Code
5265601
Country
Israel
Facility Name
Hadassah Medical Center
City
Jerusalem
State/Province
Yerushalayim
ZIP/Postal Code
9112001
Country
Israel
Facility Name
Rambam Health Care Campus - Hematology and Bone Marrow Transplantation Institute
City
Haifa
ZIP/Postal Code
3109601
Country
Israel
Facility Name
Lady Davis Carmel Medical Center
City
Haifa
ZIP/Postal Code
3436212
Country
Israel
Facility Name
Royal Cornwall Hospitals NHS Trust
City
Truro
State/Province
Cornwall
ZIP/Postal Code
tr1 3lq
Country
United Kingdom
Facility Name
The Christie NHS Foundation Trust
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
35366963
Citation
Bannerji R, Arnason JE, Advani RH, Brown JR, Allan JN, Ansell SM, Barnes JA, O'Brien SM, Chavez JC, Duell J, Rosenwald A, Crombie JL, Ufkin M, Li J, Zhu M, Ambati SR, Chaudhry A, Lowy I, Topp MS. Odronextamab, a human CD20xCD3 bispecific antibody in patients with CD20-positive B-cell malignancies (ELM-1): results from the relapsed or refractory non-Hodgkin lymphoma cohort in a single-arm, multicentre, phase 1 trial. Lancet Haematol. 2022 May;9(5):e327-e339. doi: 10.1016/S2352-3026(22)00072-2. Epub 2022 Apr 1.
Results Reference
derived
PubMed Identifier
34997701
Citation
Zhu M, Olson K, Kirshner JR, Khaksar Toroghi M, Yan H, Haber L, Meagher C, Flink DM, Ambati SR, Davis JD, DiCioccio AT, Smith EJ, Retter MW. Translational findings for odronextamab: From preclinical research to a first-in-human study in patients with CD20+ B-cell malignancies. Clin Transl Sci. 2022 Apr;15(4):954-966. doi: 10.1111/cts.13212. Epub 2022 Jan 7.
Results Reference
derived

Learn more about this trial

Study to Investigate the Safety and Tolerability of Odronextamab in Patients With CD20+ B-Cell Malignancies

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