A Study Evaluating the Efficacy and Safety of Mosunetuzumab in Combination With Lenalidomide in Comparison to Rituximab in Combination With Lenalidomide With a US Extension of Mosunetuzumab in Combination With Lenalidomide in Participants With Follicular Lymphoma (Celestimo)
Relapsed or Refractory Follicular Lymphoma
About this trial
This is an interventional treatment trial for Relapsed or Refractory Follicular Lymphoma
Eligibility Criteria
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
- Histologically documented CD20+ FL (Grades 1-3a)
- Requiring systemic therapy assessed by investigator based on tumor size and/or Groupe d'Etude des Lymphomes Folliculaires criteria
- Received at least one prior systemic lymphoma therapy, which included prior immunotherapy or chemoimmunotherapy
- Availability of a representative tumor specimen and the corresponding pathology report at the time of relapse/persistence for confirmation of the diagnosis of FL. Pretreatment sample of at least 1 core-needle, excisional or incisional tumor biopsy is required. Cytological or fine-needle aspiration samples are not acceptable. Fresh pretreatment biopsy is preferred. Patients who are unable to undergo biopsy procedures may be eligible for study enrollment if an archival tumor tissue sample (preferably from the most recent relapse/persistence) as paraffin blocks or at least 15 unstained slides, or in accordance with local regulatory requirements, can be sent to the Sponsor.
- Adequate hematologic function (unless due to underlying lymphoma, per the investigator)
- Agreement to comply with all local requirements of the lenalidomide risk minimization plan, which includes the global pregnancy prevention program.
- For women of childbearing potential: Agreement to remain abstinent (refrain from heterosexual intercourse) or use 2 adequate methods of contraception, including at least 1 method with a failure rate of < 1% per year, for at least 28 days prior to Day 1 of Cycle 1, during the treatment period (including periods of treatment interruption), and for at least 28 days after the last dose of lenalidomide, 3 months after the final dose of tocilizumab (if applicable), mosunetuzumab, and 12 months after final dose of rituximab. Women must refrain from donating eggs during this same period.
- For men: Agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures and agreement to refrain from donating sperm, as defined: With female partners of childbearing potential or pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 28 days after last dose of lenalidomide, 3 months after the final dose of tocilizumab (if applicable), mosunetuzumab and 12 months after the final dose of rituximab. Men must refrain from donating sperm during this same period.
Exclusion Criteria:
- Grade 3b FL
- History of transformation of indolent disease to diffuse-large B cell lymphoma
- Documented refractoriness to lenalidomide, defined as no response (partial response or complete response) or relapse within 6 months of therapy
- Active or history of CNS lymphoma or leptomeningeal infiltration
- Prior standard or investigational anti-cancer therapy as specified: Lenalidomide exposure within 12 months prior to Day 1 of Cycle 1; Chimeric antigen receptor T cell therapy within 30 days prior to Day 1 of Cycle 1; Radioimmunoconjugate within 12 weeks prior to Day 1 of Cycle 1; Monoclonal antibody or antibody-drug conjugate within 4 weeks prior to Cycle 1 Day 1; Treatment with any anti-cancer agent (investigational or otherwise) within 4 weeks or 5 half-lives of the drug, whichever is shorter, prior to first dose of study treatment
- Clinically significant toxicity (other than alopecia) from prior treatment that has not resolved to Grade </= 1 (per National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0) prior to Day 1 of Cycle 1
- Treatment with systemic immunosuppressive medications, including, but not limited to prednisone (> 20 mg), azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor agents within 2 weeks prior to Day 1 of Cycle 1
- History of solid organ transplantation
- History of severe allergic or anaphylactic reaction to humanized, chimeric or murine monoclonal antibodies
- Known sensitivity or allergy to murine products
- Known hypersensitivity to biopharmaceuticals produced in Chinese hamster ovary (CHO) cells or any component of the mosunetuzumab, rituximab, tocilizumab, lenalidomide, or thalidomide formulation, including mannitol
- History of erythema multiforme, Grade >/= 3 rash, or blistering following prior treatment with immunomodulatory derivatives
- History of interstitial lung disease, drug-induced pneumonitis, and autoimmune pneumonitis
- Known active bacterial, viral, fungal, or other infection, or any major episode of infection requiring treatment with IV antibiotics within 4 weeks of Day 1 of Cycle 1
- Known or suspected chronic active Epstein-Barr virus (EBV) infection
- Known or suspected history of hemophagocytic lymphohistiocytosis
- Clinically significant history of liver disease, including viral or other hepatitis, or cirrhosis
- Active Hepatitis B infection
- Active Hepatitis C infection
- Known history of HIV positive status
- History of progressive multifocal leukoencephalopathy (PML)
- Administration of a live, attenuated vaccine within 4 weeks before first dose of study treatment or anticipation that such a live attenuated vaccine will be required during the study
- Other malignancy that could affect compliance with the protocol or interpretation of results
- Active autoimmune disease requiring treatment
- History of autoimmune disease, including, but not limited to: myocarditis, pneumonitis, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis
- Prior allogeneic stem cell transplantation
- Contraindication to treatment for thromboembolism prophylaxis
- Evidence of any significant, uncontrolled concomitant disease that could affect compliance with the protocol or interpretation of results, including, but not limited to, significant cardiovascular disease (e.g., New York Heart Association Class III or IV cardiac disease, myocardial infarction within the previous 6 months, unstable arrhythmia, or unstable angina) or significant pulmonary disease (such as obstructive pulmonary disease or history of bronchospasm)
- Major surgical procedure other than for diagnosis within 28 days prior to Day 1 of Cycle 1 Day 1 or anticipation of a major surgical procedure during the course of the study
- Pregnant or lactating or intending to become pregnant during the study
- Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in and completion of the study, or which could affect compliance with the protocol or interpretation of results
Sites / Locations
- City of Hope Comprehensive Cancer CenterRecruiting
- cCare
- Fort Wayne Medical Oncology and Hematology, IncRecruiting
- Johns Hopkins Uni ; Sidney Kimmel Comprehensive Care CenterRecruiting
- University of Michigan Health System; UMH Internal Medicine/Hematology-OncologyRecruiting
- Cancer & Hematology Center of West MichiganRecruiting
- Washington University; Wash Uni. Sch. Of MedRecruiting
- MD Anderson Cancer Center at CooperRecruiting
- NYU Long Island HospitalRecruiting
- NYU Langone Ambulatory Care CenterRecruiting
- Duke University Medical CenterRecruiting
- Wake Forest Univ Health Svcs; Section on Hem and OncRecruiting
- MD Anderson Cancer Center
- Kadlec Clinic Hematology and OncologyRecruiting
- Calvary Mater Newcastle
- Princess Alexandra Hospital Woolloongabba; Clinical Hematology and Medical OncologyRecruiting
- Royal Adelaide Hospital; Haematology Clinical Trials
- Geelong Hospital; Andrew Love Cancer Centre
- ICTR Curitiba
- Hospital das Clinicas - UFRGS
- Hospital Mae de Deus
- Hospital Alemao Oswaldo CruzRecruiting
- Peking University First HospitalRecruiting
- Beijing Cancer Hospital
- Peking University Third HospitalRecruiting
- The First Hospital of Jilin UniversityRecruiting
- Cancer Center, Sun Yat-sen University of Medical Sciences; Department of Medical OncologyRecruiting
- Harbin Medical University Cancer HospitalRecruiting
- The 1st Affiliated Hospital of Nanchang UnversityRecruiting
- Jiangsu Province Hospital
- Fudan University Shanghai Cancer Center; Medical OncologyRecruiting
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineRecruiting
- Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical SciencesRecruiting
- Tianjin Cancer Hospital
- Union Hospital Tongji Medical College Huazhong University of Science and Technology
- Tongji Hospital Tongji Medical College Huazhong University of Science and TechnologyRecruiting
- The First Affiliated Hospital of Xiamen University
- Zhejiang Cancer HospitalRecruiting
- The First Affiliated Hospital of Zhengzhou UniversityRecruiting
- Centre Hospitalier de La Cote Basque; Hematologie
- Ch De Chambery; Hematologie Oncologie
- Hopital Henri Mondor; Hematologie Clinique
- Hopital Claude Huriez; Hematologie
- Institut Paoli Calmettes
- CHU Saint Eloi; Service d'Hématologie Clinique
- CHU NANTES - Hôtel Dieu; Service d'Hematologie Clinique
- Centre Antoine Lacassagne;B4 Hematologie Cancerologie
- CHU de Nîmes - Hôpital Carémeau
- Hôpital Saint-Louis; Service d'Hématologie
- Hopital Saint Antoine; Hematologie Clinique
- Hopital De Haut Leveque; Hematologie Clinique
- Ch Lyon Sud; Hemato Secteur Jules CourmontRecruiting
- Hopital De La Miletrie; Hematologie Et Oncologie Medicale
- CHU de Reims
- CHU Pontchaillou
- Centre Henri Becquerel; Service HématologieRecruiting
- ICLN;Hopital De Jour Rdc
- ICANS
- Universitätsklinikum Augsburg; II. Med. Klinik
- Sozialstiftung Bamberg - Klinikum am Bruderwald, Med. Klinik V; Hämatologie und intern. Onkologie
- Vivantes Klinikum Am Urban Klinik für Innere Medizin Hämatologie und Onkologie
- CAMPUS BENJAMIN FRANKLIN CharitéCentrum 14 Med.Klinik f.Hämatologie u.Onkologie
- Klinikum Chemnitz gGmbH, Klinik für Innere Medizin III, Hämatologie und Onkologie
- BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie-Onkologie
- Marien-Hospital Klinik f.Hämatologie Onkologie u.Palliativmedizin
- Medizinische Klinik IV, Hämatologie Universitätsklinikum Gießen
- Universitätsklinikum Halle; Klinik für Innere Medizin IV; Hämatologie und Onkologie
- Uniklinik Heidelberg, Medizinische Klinik & Poliklinik VRecruiting
- Universitaetsklinikum des Saarlandes; medizinische Klinik und Poliklinik; Innere Medizin I
- Westpfalz-Klinikum GmbH; Innere Medizin 1, Hämatologie und internistischen Onkologie
- Uni-Klinikum-Schleswig-Holstein; Klinik für Innere Medizin II; Hämatologie und Onkologie
- Universitaetsklinikum Schleswig Holstein - Campus Luebeck; Haematologie, Onkologie
- Klinikum der Universität München, Campus Großhadern; Medizinische Klinik und Poliklinik III
- Klinik und Poliklinik f. Innere Medizin III des Universitätsklinikums Regensburg
- Universitätsklinik Rostock; Klinik für Innere Med. III, Abteilung Hämatologie/OnkologieRecruiting
- Universtitätsklinikum Ulm; Klinik für Innere Medizin IIIRecruiting
- A.O. Universitaria Policlinico S.Orsola-Malpighi Di Bologna
- U.O. Ematologia AUSL Ravenna
- Ospedale Maggiore Di Milano; U.O. Ematologia I - Padiglione Marcora
- Ospedale Di Circolo E Fondazione Macchi; Ematologia
- Ospedali Riuniti Umberto I; Clinica di Ematologia
- Giovanni Paolo II/I.R.C.C.S. Istituto Tumori
- Ospedale V. Cervello; U.O. Ematologia E Trapianti
- Azienda Ospedaliera Universitaria Careggi
- Ematologia/immunologia Clinica Azienda Ospedaliera Policlinico di Padova
- Aichi Cancer Center
- National Cancer Center Hospital East
- Hokkaido University Hospital
- Kumamoto University Hospital
- University Hospital Kyoto Prefectural University of Medicine
- Mie University Hospital
- Tohoku University Hospital
- Okayama University Hospital
- Osaka Metropolitan University Hospital
- Kindai University Hospital
- National Cancer Center Hospital
- The Cancer Institute Hospital of JFCR
- Pusan National University Hospital
- Seoul National University Bundang HospitalRecruiting
- Seoul National University HospitalRecruiting
- Severance Hospital, Yonsei University Health System
- Asan Medical Center
- Samsung Medical Center
- Seoul St Mary's HospitalRecruiting
- Uniwersyteckie Centrum KliniczneRecruiting
- Szpitale Pomorskie Sp. z o. o.; Oddzia? Hematologii i Transplantologii SzpikuRecruiting
- Pratia Onkologia Katowice
- Oddzial Kliniczny Hematologii SPZOZ MSWiA z Warminsko-Mazurskim Centrum Onkologii w Olsztynie
- Uniwersytecki Szpital Kliniczny w Poznaniu; Oddzial Hematologii i Transplantacji Szpiku
- Instytut Hematologii i Transfuzjologii; Klinika HematologiiRecruiting
- Uniwersytecki Szpital Kliniczny; Klinika Hematologii, Nowotworów Krwi i Transplantacji SzpikuRecruiting
- FSBI "National Medical Research Center of Oncology N.N. Blokhin?
- City Clinical Botkin's Hospital; City Hematological Center
- Regional Clinical Hospital N.A. Semashko; Hematology
- Penza Regional Oncology DispensaryRecruiting
- Hospital de Donostia; Servicio de Oncologia
- Hospital Universitario la Paz; Servicio de Hematologia
- Hospital General Universitario J.M Morales Meseguer; Servicio de Hematología
- Hospital Universitario Virgen del Rocio; Servicio de Hematologia
- Hospital Clinico Universitario de Valencia; Servicio de Onco-hematologia
- Chang Gung Medical Foundation - Kaohsiung; Oncology; Division of Hematology-OncologyRecruiting
- Taipei Veterans General HospitalRecruiting
- National Taiwan Universtiy Hospital; Division of Hematology
- Chang Gung Medical Foundation - Linkou; Division of Hematology- Oncology
- Sanko University Faculty of Medicine
- Gulhane Training and Research HospitalRecruiting
- Hacettepe Uni Medical Faculty; Hematology
- Atakent Acibadem Private Hosptial Halkali Merkez Mh.,
- Marmara Ün?Vers?Tes? ?Stanbul Pend?K E??T?M Ve Ara?Tirma Hastanes?
- Erciyes Uni ; Hematology
- Koc Universitesi (KU) Tip Fakultesi (Koc University School of Medicine)
- Karadeniz Technical Uni School of Medicine; Hematology
- Municipal Noncommercial Institution Regional Center of Oncology
- Municipal Institution Zaporizhzhia Regional Clinical Hospital of Zaporizhzhia Regional Council
- Medical Center named after academician Yuri Prokopovich Spizhenko; Oncochemotherpy Department
- Mykolayiv Regional Hospital
- SIResearch Centre for Radiation Medicine of AMS of Ukraine; Department of Radiation Oncohematology
- National Institute of Cancer
- Royal Cornwall Hospitals NHS Trust
- Gloucestershire Royal Hospital; Haematology Department
- Royal Marsden Hospital - Fulham
- Hammersmith Hospital; Dept of OncologyRecruiting
- Nottingham City Hospital; Dept of Haematology
- Royal Marsden Hospital; Dept of Medical Oncology
- Torbay Hospital; OncologyRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
M + Len (Arm A)
R + Len (Arm B)
M + Len (US Extension Arm C)
Participants will receive mosunetuzumab for 12 cycles, plus lenalidomide from cycles 2-12 (Cycle length = 21 days for Cycle 1; cycle length = 28 days for Cycles 2-12)
Participants will receive weekly rituximab in Cycle 1, then on Day 1 of Cycles 3, 5, 7, 9, and 11. Participants will also receive lenalidomide in Cycles 1-12. (Cycle length = 28 days for Cycles 1-12)
Participants will receive mosunetuzumab for 12 cycles, plus lenalidomide from cycles 2-12 (Cycle length = 21 days for Cycle 1; cycle length = 28 days for Cycles 2-12)