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A Study of TRU-016 in Combination With Rituximab and Bendamustine in Subjects With Relapsed Indolent Lymphoma

Primary Purpose

B-cell Small Lymphocytic Lymphoma Recurrent

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TRU-016
Bendamustine
Rituximab
Sponsored by
Aptevo Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Small Lymphocytic Lymphoma Recurrent focused on measuring follicular lymphoma, small lymphocytic lymphoma, marginal zone lymphoma, non-Hodgkin's lymphoma, indolent lymphoma

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Age 18 years or older
  2. Histologically confirmed diagnosis of indolent non-Hodgkin's B-cell lymphoma (ie, follicular lymphoma, small lymphocytic lymphoma, and marginal zone lymphoma) that has relapsed (relapsed is defined as confirmed progressive disease (PD) after receiving the most recent prior therapy, or failure to achieve at least a partial response (PR) while receiving the most recent prior therapy)
  3. At least one prior line of therapy for indolent lymphoma
  4. Bi-dimensionally measurable disease with at least one lesion measuring >=1.5 cm in a single dimension
  5. Eastern Cooperative Oncology Group (ECOG) performance status of <= 2
  6. Creatinine clearance of >40 mL/min as calculated by the

Cockcroft-Gault method as follows:

(140 - age) * (weight in kg [* 0.85 if female] / 72 * serum creatinine level) 7. Adequate hepatic function, indicated as follows:

  • aspartate aminotransferase (AST) of <2.5 x upper limit of normal (ULN)
  • alanine aminotransferase (ALT) of <2.5 x ULN
  • total bilirubin of <= 1.5 x ULN 8. Absolute neutrophil count (ANC) >=1000/mm3 (1000/µL) 9. Platelet count >= 100,000/mm3 10. Female subjects of child-bearing potential and male subjects must use an acceptable form of birth control for the duration of their study participation and for 6 months after completing study drug dosing; acceptable forms of birth control, unless dictated otherwise by local regulatory authorities 11. For women of childbearing potential, a negative serum pregnancy test result obtained during the screening period and a negative urine pregnancy test result within 24 hours before first administration of study drug 12. Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information

Exclusion Criteria

  1. Diagnosis of grade 3b follicular lymphoma or transformed lymphoma of any grade
  2. Previously received TRU-016
  3. Prior treatment with rituximab if subject discontinued rituximab due to unresolved toxicity
  4. Refractory to bendamustine, defined as follows:

    • progression within 6 months of last dose of bendamustine
    • failed to achieve at least a PR while receiving bendamustine
    • discontinued bendamustine due to toxicity
    • received bendamustine within 6 months prior to first dose of study drug
  5. Received chemotherapy, radiotherapy, or immunotherapy including investigational agents within 28 days prior to the first dose of study drug
  6. Received therapeutic corticosteroids at doses equivalent to >10 mg prednisone per day for longer than 5 days within 14 days prior to the first dose of study drug, except if needed as a pre-medication
  7. Received filgrastim or equivalent within 14 days prior to screening (ie, collection of samples for laboratory tests) or pegfilgrastim within 28 days prior to screening (ie, collection of samples for laboratory tests)
  8. Prior allogeneic bone marrow transplant
  9. Prior autologous bone marrow transplant within 12 months prior to the first dose of study drug
  10. Received blood or platelet infusion within 7 days prior to screening (ie, collection of samples for laboratory tests)
  11. Previous or concurrent additional malignancy except non-invasive, non-melanomatous skin cancer or in situ carcinoma of the cervix, or other solid tumors if the subject has been disease-free for a minimum of 2 years prior to the first dose of study drug
  12. Known central nervous system or leptomeningeal lymphoma
  13. Any significant concurrent medical diseases or conditions, including but not limited to the following:

    • Clinically significant pulmonary dysfunction requiring oxygen therapy
    • An active infection (viral, bacterial, or fungal) requiring systemic therapy; subjects receiving prophylactic therapy are eligible
  14. Known allergy to mannitol
  15. History of positive serology for human immunodeficiency virus (HIV)
  16. Positive serology for hepatitis B (surface antigen or core antibody) Note: If a positive test result for hepatitis B core antibody is due to immunoglobulin treatment, the subject may be enrolled if the hepatitis B viral deoxyribonucleic acid (DNA) is negative.
  17. Positive serology for hepatitis C
  18. Pregnant or breastfeeding
  19. Other severe, acute, or chronic medical or psychiatric condition, laboratory abnormality, or difficulty complying with protocol requirements that may increase the risk associated with study participation or study drug administration or may interfere with safety
  20. Any condition that, in the investigator's opinion, makes the subject unsuitable for study participation

Sites / Locations

  • Site Reference ID/Investigator# 61543
  • Site Reference ID/Investigator# 61542
  • Site Reference ID/Investigator# 61523
  • Site Reference ID/Investigator# 61522
  • Site Reference ID/Investigator# 61544
  • Site Reference ID/Investigator# 61524

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TRU-016+bendamustine+rituximab

Arm Description

Two dose levels (10 and 20 mg/kg) of TRU 016 combined with rituximab 375 mg/m2 and bendamustine 90 mg/m2 were evaluated during up to 6 cycles (28 days each). TRU-016 was administered by intravenous (IV) infusion on Days 1 and 15 of each cycle. Rituximab was administered by IV infusion on Day 2 of each cycle. Bendamustine was administered by IV infusion on Days 1 and 2 of each cycle. Subjects received study treatment for up to 6 cycles.

Outcomes

Primary Outcome Measures

Response
Response was assessed by the investigator on the basis of clinical, radiological, and pathological (i.e., bone marrow) criteria, using the IWG criteria (Cheson et al 2007). A CR is a complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. A PR is at least a 50% decrease in sum of the product of the diameters (SPD) of up to 6 of the largest dominant nodes or nodal masses, no increase should be observed in the size of other nodes, liver or spleen, and no new sites of disease should be observed.

Secondary Outcome Measures

Full Information

First Posted
March 15, 2011
Last Updated
June 26, 2017
Sponsor
Aptevo Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT01317901
Brief Title
A Study of TRU-016 in Combination With Rituximab and Bendamustine in Subjects With Relapsed Indolent Lymphoma
Official Title
A Phase 1 Study of TRU-016 in Combination With Rituximab and Bendamustine in Subjects With Relapsed Indolent Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
May 2011 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aptevo Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This was a Phase 1 multicenter study of bendamustine, rituximab and TRU-016 (BRT) in subjects with relapsed indolent B-cell lymphoma. This was a multiple-dose escalation study to determine the maximum-tolerated dose (MTD) of TRU-016 given in combination with rituximab and bendamustine and to determine a safe dosing regimen for the combination in up to 12 subjects with relapsed indolent lymphoma. The originally planned Phase 2 portion, an open-label, randomized study to evaluate the efficacy of BRT compared with BR, was not conducted.
Detailed Description
This study was planned to be conducted in 2 parts: a Phase 1b component designed to determine a safe dosing regimen, and a Phase 2 component designed to evaluate the efficacy of BRT compared to BR in subjects with relapsed indolent lymphoma. The Phase 2 component was not conducted. This was an open-label, non randomized, multiple-dose escalation study to determine the MTD of BRT and to determine a safe dosing regimen for the combination in subjects with relapsed indolent lymphoma. The study consisted of a screening period lasting up to 21 days, a treatment period lasting up to 6 cycles (28 days each), and a 60-day follow-up period. Up to 12 subjects (2 cohorts of 6 subjects each) were planned for enrollment. Two dose levels (10 and 20 mg/kg) of TRU-016 combined with rituximab 375 mg/m2 and bendamustine 90 mg/m2 were evaluated during up to 6 cycles (28 days each). TRU-016 was administered by intravenous (IV) infusion on Days 1 and 15 of each cycle. Rituximab was administered by IV infusion on Day 2 of each cycle. Bendamustine was administered by IV infusion on Days 1 and 2 of each cycle. Subjects received study treatment for up to 6 cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Small Lymphocytic Lymphoma Recurrent
Keywords
follicular lymphoma, small lymphocytic lymphoma, marginal zone lymphoma, non-Hodgkin's lymphoma, indolent lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TRU-016+bendamustine+rituximab
Arm Type
Experimental
Arm Description
Two dose levels (10 and 20 mg/kg) of TRU 016 combined with rituximab 375 mg/m2 and bendamustine 90 mg/m2 were evaluated during up to 6 cycles (28 days each). TRU-016 was administered by intravenous (IV) infusion on Days 1 and 15 of each cycle. Rituximab was administered by IV infusion on Day 2 of each cycle. Bendamustine was administered by IV infusion on Days 1 and 2 of each cycle. Subjects received study treatment for up to 6 cycles.
Intervention Type
Drug
Intervention Name(s)
TRU-016
Other Intervention Name(s)
otlertuzumab
Intervention Description
100 mg TRU-016 lyophilized solution for infusion at 10 or 20 mg/kg (or 6 mg/kg, if necessary) on Days 1 and 15 of each 28 day cycle
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Other Intervention Name(s)
Treanda
Intervention Description
Bendamustine by IV administration on Days 1 and 2 of each 28 day cycle.
Intervention Type
Drug
Intervention Name(s)
Rituximab
Other Intervention Name(s)
rituxan
Intervention Description
Rituximab by IV administration at 375 mg/m^2 on Day 2 of each 28 day cycle.
Primary Outcome Measure Information:
Title
Response
Description
Response was assessed by the investigator on the basis of clinical, radiological, and pathological (i.e., bone marrow) criteria, using the IWG criteria (Cheson et al 2007). A CR is a complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. A PR is at least a 50% decrease in sum of the product of the diameters (SPD) of up to 6 of the largest dominant nodes or nodal masses, no increase should be observed in the size of other nodes, liver or spleen, and no new sites of disease should be observed.
Time Frame
Day 15 and Day 28 of even-numbered cycles

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Age 18 years or older Histologically confirmed diagnosis of indolent non-Hodgkin's B-cell lymphoma (ie, follicular lymphoma, small lymphocytic lymphoma, and marginal zone lymphoma) that has relapsed (relapsed is defined as confirmed progressive disease (PD) after receiving the most recent prior therapy, or failure to achieve at least a partial response (PR) while receiving the most recent prior therapy) At least one prior line of therapy for indolent lymphoma Bi-dimensionally measurable disease with at least one lesion measuring >=1.5 cm in a single dimension Eastern Cooperative Oncology Group (ECOG) performance status of <= 2 Creatinine clearance of >40 mL/min as calculated by the Cockcroft-Gault method as follows: (140 - age) * (weight in kg [* 0.85 if female] / 72 * serum creatinine level) 7. Adequate hepatic function, indicated as follows: aspartate aminotransferase (AST) of <2.5 x upper limit of normal (ULN) alanine aminotransferase (ALT) of <2.5 x ULN total bilirubin of <= 1.5 x ULN 8. Absolute neutrophil count (ANC) >=1000/mm3 (1000/µL) 9. Platelet count >= 100,000/mm3 10. Female subjects of child-bearing potential and male subjects must use an acceptable form of birth control for the duration of their study participation and for 6 months after completing study drug dosing; acceptable forms of birth control, unless dictated otherwise by local regulatory authorities 11. For women of childbearing potential, a negative serum pregnancy test result obtained during the screening period and a negative urine pregnancy test result within 24 hours before first administration of study drug 12. Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information Exclusion Criteria Diagnosis of grade 3b follicular lymphoma or transformed lymphoma of any grade Previously received TRU-016 Prior treatment with rituximab if subject discontinued rituximab due to unresolved toxicity Refractory to bendamustine, defined as follows: progression within 6 months of last dose of bendamustine failed to achieve at least a PR while receiving bendamustine discontinued bendamustine due to toxicity received bendamustine within 6 months prior to first dose of study drug Received chemotherapy, radiotherapy, or immunotherapy including investigational agents within 28 days prior to the first dose of study drug Received therapeutic corticosteroids at doses equivalent to >10 mg prednisone per day for longer than 5 days within 14 days prior to the first dose of study drug, except if needed as a pre-medication Received filgrastim or equivalent within 14 days prior to screening (ie, collection of samples for laboratory tests) or pegfilgrastim within 28 days prior to screening (ie, collection of samples for laboratory tests) Prior allogeneic bone marrow transplant Prior autologous bone marrow transplant within 12 months prior to the first dose of study drug Received blood or platelet infusion within 7 days prior to screening (ie, collection of samples for laboratory tests) Previous or concurrent additional malignancy except non-invasive, non-melanomatous skin cancer or in situ carcinoma of the cervix, or other solid tumors if the subject has been disease-free for a minimum of 2 years prior to the first dose of study drug Known central nervous system or leptomeningeal lymphoma Any significant concurrent medical diseases or conditions, including but not limited to the following: Clinically significant pulmonary dysfunction requiring oxygen therapy An active infection (viral, bacterial, or fungal) requiring systemic therapy; subjects receiving prophylactic therapy are eligible Known allergy to mannitol History of positive serology for human immunodeficiency virus (HIV) Positive serology for hepatitis B (surface antigen or core antibody) Note: If a positive test result for hepatitis B core antibody is due to immunoglobulin treatment, the subject may be enrolled if the hepatitis B viral deoxyribonucleic acid (DNA) is negative. Positive serology for hepatitis C Pregnant or breastfeeding Other severe, acute, or chronic medical or psychiatric condition, laboratory abnormality, or difficulty complying with protocol requirements that may increase the risk associated with study participation or study drug administration or may interfere with safety Any condition that, in the investigator's opinion, makes the subject unsuitable for study participation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Stromatt, MD
Organizational Affiliation
Aptevo Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Site Reference ID/Investigator# 61543
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Site Reference ID/Investigator# 61542
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30912
Country
United States
Facility Name
Site Reference ID/Investigator# 61523
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68114
Country
United States
Facility Name
Site Reference ID/Investigator# 61522
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Site Reference ID/Investigator# 61544
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599-7305
Country
United States
Facility Name
Site Reference ID/Investigator# 61524
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109-1023
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24927856
Citation
Gopal AK, Tarantolo SR, Bellam N, Green DJ, Griffin M, Feldman T, Mato AR, Eisenfeld AJ, Stromatt SC, Goy A. Phase 1b study of otlertuzumab (TRU-016), an anti-CD37 monospecific ADAPTIR therapeutic protein, in combination with rituximab and bendamustine in relapsed indolent lymphoma patients. Invest New Drugs. 2014 Dec;32(6):1213-25. doi: 10.1007/s10637-014-0125-2. Epub 2014 Jun 15.
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A Study of TRU-016 in Combination With Rituximab and Bendamustine in Subjects With Relapsed Indolent Lymphoma

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