A Study Evaluating the Safety, Efficacy and Pharmacokinetics of Venetoclax in Combination With Polatuzumab Vedotin Plus Rituximab (R) and Cyclophosphamide, Doxorubicin, Prednisone (CHP) in Participants With Untreated BCL-2 Immunohistochemistry (IHC)-Positive Diffuse Large B-Cell Lymphoma (DLBCL)
Lymphoma, Large B-Cell, Diffuse
About this trial
This is an interventional treatment trial for Lymphoma, Large B-Cell, Diffuse
Eligibility Criteria
Inclusion Criteria:
- Previously untreated participants with CD20-positive DLBCL.
- BCL-2 protein overexpression by IHC, as assessed by local testing.
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2.
- International Prognostic Index (IPI) 2-5.
- Life expectancy of more than 6 months.
- Left ventricular ejection fraction (LVEF) ≥ 50%, as determined on cardiac multiple-gated acquisition (MUGA) scan or cardiac echocardiogram (ECHO).
- Availability of archival or freshly collected tumor tissue prior to study enrollment.
- At least one bi-dimensionally fluorodeoxyglucose-avid measurable lymphoma lesion on PET/CT scan, defined as > 1.5 cm in its longest dimension on CT scan.
- Adequate hematopoietic function.
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception, and agreement to refrain from donating eggs.
- For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agreement to refrain from donating sperm.
Exclusion Criteria:
- Current diagnosis of unclassifiable B-cell lymphoma.
- Prior treatment for indolent lymphoma.
- Current Grade > 1 peripheral neuropathy.
- Prior organ transplantation.
- Prior use of any monoclonal antibody within 3 months and any investigational therapy within 28 days prior to the start of Cycle 1.
- Vaccination with live vaccines within 28 days prior to the start of Cycle 1.
- Prior therapy for DLBCL and High-Grade B-cell Lymphoma (HGBCL) with the exception of palliative, short-term treatment with corticosteroids.
- Recent major surgery (within 6 weeks prior to the start of Day 1 of Cycle 1), other than for diagnosis.
- History of other cancers within 2 years prior to screening.
- Any active infection that, in the opinion of the investigator, would impact participant safety within 7 days prior to Day 1 of Cycle 1.
- Serious infection requiring oral or IV antibiotics within 4 weeks prior to Day 1 of Cycle 1.
- Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the participant's safe participation in and completion of the study.
- Positive test for Hepatitis B/C Viruses (HBV/HCV) and Human T-cell Leukemia Virus (HTLV)-1.
- Known infection with HIV.
- History of progressive multifocal leukoencephalopathy.
- Suspected active or latent tuberculosis.
- Clinically significant history of liver disease, including viral or other hepatitis or cirrhosis.
- Substance abuse, including non-prescription drug and alcohol dependence, within 12 months prior to screening.
- Pregnant or breastfeeding, or intending to become pregnant during the study within 6 months after the final dose of venetoclax, 9 months after the final dose of polatuzumab vedotin, or 12 months after the final dose of rituximab.
- History or presence of an abnormal ECG that is clinically significant in the investigator's opinion.
- Malabsorption syndrome or other condition that would interfere with enteral absorption.
- Blood transfusion within 14 days prior to screening.
Sites / Locations
- NYU Langone Hospitals, NYU Langone Rusk Ambulatory Surgical PharmacyRecruiting
- Memorial Sloan-Kettering Cancer CenterRecruiting
- SARAH CANNON RESEARCH INST.; Tennessee Oncology, PLLC
- Centre Hospitalier Régional Universitaire de Lille (CHRU) - Hôpital Claude HuriezRecruiting
- CHU Montpellier - Saint ELOIRecruiting
- CHU de Nantes; Cancéro-dermatologieRecruiting
- Hôpital Saint-LouisRecruiting
- Centre Hospitalier Lyon Sud; Service d'Oncologie MédicaleRecruiting
- CHU Rennes - Hopital PontchaillouRecruiting
- Centre Henri BecquerelRecruiting
- Istituto Nazionale Tumori Irccs Fondazione g. Pascale;s.c. Ematologia OncologicaRecruiting
- Azienda Ospedaliero-Universitaria Policlinico S. Orsola Malpighi; Dip. Scienze Mediche e Chirurgiche
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori - IRST; Farmacia OncologicaRecruiting
- Ospedale Santa Maria Delle CrociRecruiting
- Azienda Ospedaliero Universitaria Pisana-Ospedale Santa ChiaRecruiting
- Clinica Universidad de NavarraRecruiting
- Hospital de la Santa Creu i Sant Pau; Servicio de DermatologiaRecruiting
- Hospital Universitari Vall d'HebronRecruiting
- Hospital General Univ. Gregorio MaranonRecruiting
- Hospital Universitario La Fe; Servicio de FarmaciaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Venetoclax (Schedule A)
Venetoclax (Schedule B)
Participants enrolled in dosing Schedule A will receive a total of six 21-day cycles of venetoclax treatment for 5 days in combination with Polatuzumab Vedotin + R-CHP (Rituximab, Cyclophosphamide, Doxorubicin and Prednisone) as described below: Schedule A: Participants will self-administer Venetoclax orally (PO) once daily (QD) at a dose of 800 mg for 5 consecutive days as follows: Cycle 1: 5 consecutive days of dosing on Days 4-8. Cycles 2-6: 5 consecutive days of dosing on Days 1-5.
Participants enrolled in dosing Schedule B will receive a total of six 21-day cycles of venetoclax treatment for 10 days in combination with Polatuzumab Vedotin + R-CHP as described below: Schedule B: Participants will self-administer Venetoclax orally (PO) once daily (QD) at a dose of 800 mg for 10 consecutive days as follows: Cycle 1: 10 consecutive days of dosing on Days 4-10. Cycles 2-6: 10 consecutive days of dosing on Days 1-10.