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QUILT-3.002: ALT-803 in Patients With Relapse/Refractory iNHL in Conjunction With Rituximab

Primary Purpose

Relapsed/Refractory Indolent B Cell Non-Hodgkin Lymphoma

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Rituximab
ALT-803
Sponsored by
Altor BioScience
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed/Refractory Indolent B Cell Non-Hodgkin Lymphoma focused on measuring Lymphoma, indolent B Cell, non-Hodgkin Lymphoma, Cancer, Immunotherapy, Relapsed, Refractory, Rituximab, Interleukin-15, Absolute Lymphocyte Count, White Blood Cell, Follicular Lymphoma, Marginal Zone Lymphoma, Small Lymphocytic Lymphoma, Lymphoplasmacytic Lymphoma, anti-CD20

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of iNHL (Follicular lymphoma grade 1, 2, 3a; marginal zone lymphoma; small lymphocytic lymphoma or lymphoplasmacytic lymphoma) after treatment with at least 1 or more prior rituximab-containing regimens.

    • Anti-CD20 mAb-refractory disease is defined as progressive disease while on rituximab (or another treatment of an anti-CD20 monoclonal antibody) or progression within 6 months of rituximab-containing (or another treatment of an anti-CD20 antibody-containing) therapy.
    • Anti-CD20 mAb-sensitive disease is defined by a response to a prior rituximab-containing (or another treatment of an anti-CD20 monoclonal antibody) regimen, and relapse more than 6 months from the last administration of rituximab-containing (or another treatment of an anti-CD20 antibody-containing) therapy.
  • Measurable disease:

    • At least one lymph node group ≥ 1.5 cm in longest transverse dimension. Patients with cutaneous only disease may be enrolled if they have a clearly measurable skin lesion.
    • Relapsed or Refractory iNHL that has progressed during or following 1 or more prior systemic rituximab-containing (or another treatment of an anti-CD20 antibody-containing) regimens for lymphoma

PRIOR/CONCURRENT THERAPY:

  • No anti-lymphoma treatments within 28 days before the start of study treatment.
  • Must have recovered from side effects of prior treatments.

PATIENT CHARACTERISTICS:

Performance Status

• ECOG 0, 1, or 2

Renal Function • Glomerular Filtration Rate (GFR) > 40mL/min or Serum creatinine ≤ 1.5 X ULN

Bone Marrow Reserve

  • Platelets ≥30,000/uL
  • Hemoglobin ≥ 8g/dL
  • Absolute Lymphocytes ≥800/uL
  • ANC/AGC ≥750/uL

Hepatic Function

  • Total bilirubin ≤ 2.0 X ULN (unless Gilbert's Syndrome or disease infiltration of liver is present)
  • AST, ALT ≤ 3.0 X ULN, or ≤ 5.0 X ULN (if liver lymphoma is present)
  • No positive Hep C serology or active Hep B infection

Cardiovascular

  • No congestive heart failure < 6 months
  • No unstable angina pectoris < 6 months
  • No myocardial infarction < 6 months
  • No history of ventricular arrhythmias or severe cardiac dysfunction
  • No history of uncontrollable supraventricular arrhythmias
  • No NYHA Class > II CHF
  • No marked baseline prolongation of QT/QTc interval

Pulmonary

• Normal clinical assessment of pulmonary function

Other

  • Negative serum pregnancy test if female and of childbearing potential
  • Women who are not pregnant or nursing
  • Subjects, both females and males, with reproductive potential must agree to use effective contraceptive measures for the duration of the study
  • No known autoimmune disease other than corrected hypothyroidism
  • No known prior organ allograft or allogeneic transplantation
  • Not HIV positive
  • No active CNS involvement with lymphoma
  • No psychiatric illness/social situation that would limit compliance
  • No other illness that in the opinion of the investigator would exclude the subject from participating in the study
  • Must provide informed consent and HIPPA authorization and agree to comply with all protocol-specified procedures and follow-up evaluations
  • No active systemic infection requiring parenteral antibiotic therapy
  • No disease requiring systemic immunosuppressive therapy (inhaled or topical steroids are allowed). Adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent are permitted in the absence of active autoimmune disease.
  • No known histologic transformation from iNHL to DLBCL

Sites / Locations

  • University of Minnesota Cancer Center
  • Washington University School of Medicine Oncology
  • The Ohio State University
  • Medical University of South Carolina

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Phase I/II ALT-803 w/rituximab for rel/ref iNHL

Arm Description

Outcomes

Primary Outcome Measures

Determination of MTD or MED, Phase II Dose Level Designation
For Phase I Determine the maximum tolerated dose (MTD) level or minimum efficacious dose (MED) and designate the dose level for phase II.
Number of treatment related adverse events as a measure of safety
For Phase 1 and 2 Number and severity of treatment related AEs that occur or worsen after the first dose of study treatment will be collected.
Overall Response Rate
For Phase 1 and 2 Complete response plus partial response of treated patients

Secondary Outcome Measures

Progression-free Survival
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Overall Survival
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Duration of Response
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Blood Cell Counts
For Phase 1 and 2 Evaluation of the effect of ALT-803 on the peripheral ALC and WBC counts, the number and phenotype of peripheral blood T (total and subsets) and NK cells in treated patients.
Levels of specific biomarkers as a predictive measure of efficacy
For Phase 1 and 2 Measures the serum levels of including but not limited to IL-2, IL-4, IL-6, IL-10, IFN-gamma, MCP-1 and TNF-alpha in treated patients.
Immunogenicity
For Phase 1 and 2 Measure the level of anti-ALT-803 neutralizing effects in each patient
Pharmacokinetics as a measure of drug persistence
For Phase 1 and 2 Area under the plasma concentration-time curve from time zero to infinity (AUC) and the half-life of ALT-803 collected from treated patients.
Polymorphism
For Phase 1 and 2 Determine the fcgr3a polymorphism status in each patient to correlate with clinical outcomes.
Mutations
For Phase 1 and 2 Test the recurrent lymphoma mutations in each patient to correlate with clinical outcomes.
Lymph node biopsies
For Phase 1 and 2 Determine the impact of study treatment on the immune cell composition within the tumor microenvironment.

Full Information

First Posted
February 19, 2015
Last Updated
February 11, 2021
Sponsor
Altor BioScience
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1. Study Identification

Unique Protocol Identification Number
NCT02384954
Brief Title
QUILT-3.002: ALT-803 in Patients With Relapse/Refractory iNHL in Conjunction With Rituximab
Official Title
A Phase 1/2 Study of ALT-803 in Patients With Relapse/Refractory Indolent B Cell Non-Hodgkin Lymphoma in Conjunction With Rituximab
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Terminated
Why Stopped
Change in drug product development strategy.
Study Start Date
April 2015 (Actual)
Primary Completion Date
December 31, 2020 (Actual)
Study Completion Date
December 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Altor BioScience

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase I/II, open-label, multi-center, competitive enrollment and dose escalation study of ALT-803 in patients with relapse/refractory indolent B cell non-Hodgkin lymphoma in conjunction with rituximab.
Detailed Description
The purpose of this study is to evaluate the safety and tolerability, identify the Maximum Tolerated Dose (MTD) or the Minimum Efficacious Dose (MED) and designate a dose level for Phase 2. Also characterize the immunogenicity, pharmacokinetic profile, and biomarker serum levels of ALT-803 in treated patients. The effect of ALT-803 on the peripheral absolute lymphocyte counts and white blood cell counts, the number, phenotype and repertoire of peripheral blood T (total and subsets) and NK cells will be evaluated. In addition, a subset of patients will be evaluated for changes in lymph node immune composition. Anti-tumor responses and survival data will also be collected in this trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed/Refractory Indolent B Cell Non-Hodgkin Lymphoma
Keywords
Lymphoma, indolent B Cell, non-Hodgkin Lymphoma, Cancer, Immunotherapy, Relapsed, Refractory, Rituximab, Interleukin-15, Absolute Lymphocyte Count, White Blood Cell, Follicular Lymphoma, Marginal Zone Lymphoma, Small Lymphocytic Lymphoma, Lymphoplasmacytic Lymphoma, anti-CD20

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
43 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase I/II ALT-803 w/rituximab for rel/ref iNHL
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Rituximab
Other Intervention Name(s)
Rituxin
Intervention Description
Intravenous infusion; Patients will receive a 4-week induction cycle consisting of Rituximab given on Day 1, 8, 15, 22. Eligible patients will receive a consolidation treatment consisting of Rituximab given on Day 78, 134, 190, 246.
Intervention Type
Biological
Intervention Name(s)
ALT-803
Intervention Description
Intravenous infusion for cohort 1, 2 and 3; subcutaneous injection for cohort 4, 5, 6 and 7; Patients will receive a 4-week induction cycle consisting of ALT-803 given on Day 2, 8, 15, 22 for patients in cohort 1, 2, 3, 4 and Day 1, 8, 15 and 22 for patients in cohort 5, 6, 7. Eligible patients will receive a consolidation treatment consisting of ALT-803 given on Day 78, 134, 190, 246.
Primary Outcome Measure Information:
Title
Determination of MTD or MED, Phase II Dose Level Designation
Description
For Phase I Determine the maximum tolerated dose (MTD) level or minimum efficacious dose (MED) and designate the dose level for phase II.
Time Frame
9 months
Title
Number of treatment related adverse events as a measure of safety
Description
For Phase 1 and 2 Number and severity of treatment related AEs that occur or worsen after the first dose of study treatment will be collected.
Time Frame
36 months
Title
Overall Response Rate
Description
For Phase 1 and 2 Complete response plus partial response of treated patients
Time Frame
60 months
Secondary Outcome Measure Information:
Title
Progression-free Survival
Description
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Time Frame
60 months
Title
Overall Survival
Description
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Time Frame
60 months
Title
Duration of Response
Description
For Phase 1 and 2 Of all treated patients will be assessed at least every three months during years 1 and 2, every 4 months during year 3, and then every 6 months (+/- 2 months) during years 4 and 5 from the start of study treatment, or through the point designated as the end of the study follow up (5 years).
Time Frame
60 months
Title
Blood Cell Counts
Description
For Phase 1 and 2 Evaluation of the effect of ALT-803 on the peripheral ALC and WBC counts, the number and phenotype of peripheral blood T (total and subsets) and NK cells in treated patients.
Time Frame
36 months
Title
Levels of specific biomarkers as a predictive measure of efficacy
Description
For Phase 1 and 2 Measures the serum levels of including but not limited to IL-2, IL-4, IL-6, IL-10, IFN-gamma, MCP-1 and TNF-alpha in treated patients.
Time Frame
36 Months
Title
Immunogenicity
Description
For Phase 1 and 2 Measure the level of anti-ALT-803 neutralizing effects in each patient
Time Frame
36 Months
Title
Pharmacokinetics as a measure of drug persistence
Description
For Phase 1 and 2 Area under the plasma concentration-time curve from time zero to infinity (AUC) and the half-life of ALT-803 collected from treated patients.
Time Frame
36 Months
Title
Polymorphism
Description
For Phase 1 and 2 Determine the fcgr3a polymorphism status in each patient to correlate with clinical outcomes.
Time Frame
36 Months
Title
Mutations
Description
For Phase 1 and 2 Test the recurrent lymphoma mutations in each patient to correlate with clinical outcomes.
Time Frame
36 Months
Title
Lymph node biopsies
Description
For Phase 1 and 2 Determine the impact of study treatment on the immune cell composition within the tumor microenvironment.
Time Frame
36 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of iNHL (Follicular lymphoma grade 1, 2, 3a; marginal zone lymphoma; small lymphocytic lymphoma or lymphoplasmacytic lymphoma) after treatment with at least 1 or more prior rituximab-containing regimens. Anti-CD20 mAb-refractory disease is defined as progressive disease while on rituximab (or another treatment of an anti-CD20 monoclonal antibody) or progression within 6 months of rituximab-containing (or another treatment of an anti-CD20 antibody-containing) therapy. Anti-CD20 mAb-sensitive disease is defined by a response to a prior rituximab-containing (or another treatment of an anti-CD20 monoclonal antibody) regimen, and relapse more than 6 months from the last administration of rituximab-containing (or another treatment of an anti-CD20 antibody-containing) therapy. Measurable disease: At least one lymph node group ≥ 1.5 cm in longest transverse dimension. Patients with cutaneous only disease may be enrolled if they have a clearly measurable skin lesion. Relapsed or Refractory iNHL that has progressed during or following 1 or more prior systemic rituximab-containing (or another treatment of an anti-CD20 antibody-containing) regimens for lymphoma PRIOR/CONCURRENT THERAPY: No anti-lymphoma treatments within 28 days before the start of study treatment. Must have recovered from side effects of prior treatments. PATIENT CHARACTERISTICS: Performance Status • ECOG 0, 1, or 2 Renal Function • Glomerular Filtration Rate (GFR) > 40mL/min or Serum creatinine ≤ 1.5 X ULN Bone Marrow Reserve Platelets ≥30,000/uL Hemoglobin ≥ 8g/dL Absolute Lymphocytes ≥800/uL ANC/AGC ≥750/uL Hepatic Function Total bilirubin ≤ 2.0 X ULN (unless Gilbert's Syndrome or disease infiltration of liver is present) AST, ALT ≤ 3.0 X ULN, or ≤ 5.0 X ULN (if liver lymphoma is present) No positive Hep C serology or active Hep B infection Cardiovascular No congestive heart failure < 6 months No unstable angina pectoris < 6 months No myocardial infarction < 6 months No history of ventricular arrhythmias or severe cardiac dysfunction No history of uncontrollable supraventricular arrhythmias No NYHA Class > II CHF No marked baseline prolongation of QT/QTc interval Pulmonary • Normal clinical assessment of pulmonary function Other Negative serum pregnancy test if female and of childbearing potential Women who are not pregnant or nursing Subjects, both females and males, with reproductive potential must agree to use effective contraceptive measures for the duration of the study No known autoimmune disease other than corrected hypothyroidism No known prior organ allograft or allogeneic transplantation Not HIV positive No active CNS involvement with lymphoma No psychiatric illness/social situation that would limit compliance No other illness that in the opinion of the investigator would exclude the subject from participating in the study Must provide informed consent and HIPPA authorization and agree to comply with all protocol-specified procedures and follow-up evaluations No active systemic infection requiring parenteral antibiotic therapy No disease requiring systemic immunosuppressive therapy (inhaled or topical steroids are allowed). Adrenal replacement steroid doses ≤ 10 mg daily prednisone equivalent are permitted in the absence of active autoimmune disease. No known histologic transformation from iNHL to DLBCL
Facility Information:
Facility Name
University of Minnesota Cancer Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Washington University School of Medicine Oncology
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
33832946
Citation
Foltz JA, Hess BT, Bachanova V, Bartlett NL, Berrien-Elliott MM, McClain E, Becker-Hapak M, Foster M, Schappe T, Kahl B, Mehta-Shah N, Cashen AF, Marin ND, McDaniels K, Moreno C, Mosior M, Gao F, Griffith OL, Griffith M, Wagner JA, Epperla N, Rock AD, Lee J, Petti AA, Soon-Shiong P, Fehniger TA. Phase I Trial of N-803, an IL15 Receptor Agonist, with Rituximab in Patients with Indolent Non-Hodgkin Lymphoma. Clin Cancer Res. 2021 Jun 15;27(12):3339-3350. doi: 10.1158/1078-0432.CCR-20-4575. Epub 2021 Apr 8.
Results Reference
derived

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QUILT-3.002: ALT-803 in Patients With Relapse/Refractory iNHL in Conjunction With Rituximab

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