A Study to Evaluate the Safety and Efficacy of Glofitamab in Combination With Rituximab (R) Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) in Circulating Tumor (ct)DNA High-Risk Patients With Untreated Diffuse Large B-Cell Lymphoma
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma
Eligibility Criteria
Inclusion Criteria:
Previously untreated patients with CD20-positive DLBCL, including one of the following diagnoses made according to the 2016 World Health Organization (WHO) classification of lymphoid neoplasms
- DLBCL, not otherwise specified, including GCB and ABC/non-GCB types as well as double-expressor lymphoma (coexpression of MYC and BCL2)
- High-grade B-cell lymphoma (HGBCL) with MYC and BCL2 and/or BCL6 translocations
- Patients with de novo transformed follicular lymphoma (patients with discordant bone marrow involvement, i.e., evidence of low-grade histology in bone marrow) may be considered after discussion with the Medical Monitor
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
- International Prognostic Index (IPI): 2-5
- Life expectancy of at least 6 months
- Adequate biomarker blood samples prior to initiation of R-CHOP on Day 1 of Cycle 1 and on Day 1 of Cycle 2 submitted for screening for determination of ctDNA status
- At least one bi-dimensionally fluorodeoxyglucose (FDG)-avid measurable lymphoma lesion on positron emission tomography/computed tomography (PET/CT) scan
- Left ventricular ejection fraction (LVEF) >=50%, as determined on cardiac multiple-gated acquisition (MUGA) scan or cardiac echocardiogram (ECHO)
- Adequate hematopoietic function
- Contraception use
Additional Inclusion Criterion for ctDNA High-Risk Participants:
- Plasma sample evaluated to be ctDNA high risk
Exclusion Criteria:
- Current diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classic Hodgkin lymphoma (gray-zone lymphoma), primary mediastinal (thymic) large B-cell lymphoma, Burkitt lymphoma, central nervous system (CNS) lymphoma (primary or secondary involvement), primary effusion DLBCL, and primary cutaneous DLBCL
- Contraindication to any of the individual components of R-CHOP, including prior receipt of anthracyclines, history of severe allergic or anaphylactic reactions to murine monoclonal antibodies, or known sensitivity or allergy to murine products
- Prior treatment for indolent lymphoma
- Prior solid organ or allogeneic stem cell transplant
- Prior therapy for DLBCL and high-grade B-cell lymphoma (HGBCL) with the exception of palliative, short-term treatment with corticosteroids
- Pregnant or breastfeeding, or intending to become pregnant during the study or within 12 months after the final dose of R-CHOP, 3 months after the final dose of tocilizumab (if applicable), or 2 months after the final dose of glofitamab
Sites / Locations
- City of Hope Comprehensive Cancer CenterRecruiting
- Stanford Cancer CenterRecruiting
- Stanford Cancer Institute Inpatient Investigational Pharmacy; Pharmacy
- University of IowaRecruiting
- University of MarylandRecruiting
- University of Michigan Health System; UMH Internal Medicine/Hematology-OncologyRecruiting
- Washington University; Wash Uni. Sch. Of MedRecruiting
- Memorial Sloan Kettering Cancer Center Basking RidgeRecruiting
- Memorial Sloan Kettering - MonmouthRecruiting
- Memorial Sloan Kettering BergenRecruiting
- Memorial Sloan-Kettering; Cancer CenterRecruiting
- Memorial Sloan Kettering Cancer Center at WestchesterRecruiting
- Memorial Sloan Kettering Cancer CenterRecruiting
- Memorial Sloan Kettering Cancer Center at NassauRecruiting
- Baylor University Medical CenterRecruiting
- Aarhus Universitetshospital Skejby; BlodsygdommeRecruiting
- Hopital Henri Mondor; Hematologie CliniqueRecruiting
- Centre Henri Becquerel; HematologieRecruiting
- Universitair Medisch Centrum Groningen
- Uniwersyteckie Centrum Kliniczne, Klinika Hematologii i TransplantologiiRecruiting
- Centrum Onkologii Ziemi Lubelskiej im. ?w. Jana z DukliRecruiting
- Oddzial Kliniczny Hematologii SPZOZ MSWiA z Warminsko-Mazurskim Centrum Onkologii w OlsztynieRecruiting
- Uniwersytecki Szpital Kliniczny w Poznaniu; Oddzial Hematologii i Transplantacji SzpikuRecruiting
- Uniwersytecki Szpital Kliniczny; Klinika Hematologii, Nowotworów Krwi i Transplantacji SzpikuRecruiting
- Hospital Clinic i Provincial de Barcelona; HematologyRecruiting
- Hospital General Universitario Gregorio Marañon; Servicio de HematologíaRecruiting
- Hospital Univ. 12 de Octubre; Servicio de HematologiaRecruiting
- Hospital Clinico Universitario de Salamanca;Servicio de HematologiaRecruiting
Arms of the Study
Arm 1
Experimental
Glofitamab + R-CHOP Immunochemotherapy
Participants will receive step-up doses of glofitamab, starting on Day 8 of Cycle 3 (2.5 mg), Day 15 of Cycle 3 (10 mg), then 30 mg glofitamab will be given every three weeks (Q3W) onwards, on Day 8 of Cycles 4-6 and on Day 1 of Cycles 7-10. (cycle length = 21 days) Participants will receive rituximab, cyclophosphamide, doxorubicin, and vincristine Q3W on Day 1 of Cycles 1-6. Prednisone or prednisolone will be administered daily (QD) on Days 1-5 of Cycles 1-6. (cycle length = 21 days)