A Phase Ib, Open-Label, Dose-Escalation, Multicenter Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, And Efficacy Of Subcutaneous Glofitamab Following Obinutuzumab Pretreatment in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma.
Primary Objective:
To evaluate the safety and tolerability of glofitamab SC administration.
Secondary:
1. To characterize the PK profile of glofitamab SC administration.
2. To evaluate the preliminary efficacy of glofitamab given subcutaneously followed
by IV and/or SC administration.
3. To evaluate potential effects of ADAs.
4. To evaluate the relationship between glofitamab exposure and pharmacodynamic biomarkers.
5. To evaluate the preliminary efficacy of tocilizumab in ameliorating the symptoms of
severe CRS following glofitamab treatment.
Tocilizumab
Glofitamab
- Rutgers Cancer Institute of New Jersey
- Principal Investigator
- Matthew Matasar
- Principal Investigator
Inclusion Criteria
- Depending upon study part: a history or status of a histologically-confirmed
hematological malignancy that is expected to express CD19 and CD20; relapse after or
failure to respond to at least two prior treatment regimens; and no available
treatment options that are expected to prolong survival
- Must have at least one measureable target lesion (>/= 1.5 cm) in its largest dimension
by computed tomography scan
- Able and willing to provide a fresh biopsy from a safely accessible site, per
Investigator's determination, providing the participant has more than one measurable
target lesion
- Eastern Cooperative Oncology Group performance status of 0 or 1
- Life expectancy of >/= 12 weeks
- Adverse events from prior anti-cancer therapy must have resolved to Grade
- Adequate liver, haematological, and renal function
- Negative test results for acute or chronic hepatitis B virus infection
- Negative test results for hepatitis C virus and HIV
- The contraception and abstinence requirements are intended to prevent exposure of an
embryo to the study treatment. The reliability of sexual abstinence for male and/or
female enrollment eligibility needs to be evaluated in relation to the duration of the
clinical study and the preferred and usual lifestyle of the participant. Periodic
abstinence (e.g., calendar, ovulation, symptothermal, or post-ovulation methods) and
withdrawal are not acceptable methods of preventing drug exposure
- Female participants: A female participant is eligible to participate if she is not
pregnant and not breastfeeding, and if at least one of the following applies: women of
non-childbearing potential (WONCBP); women of child bearing potential (WOCBP) who
agree to remain abstinent or use two highly effective contraceptive methods with a
failure rate of <1% per year during the treatment period and for at least 18 months
after obinutuzumab or 3.5 months after the last dose of RO7227166, 2 months after last
dose of glofitamab, or 3 months after the last dose of tocilizumab, whichever is
longer. Examples of contraceptive methods with a failure rate of < 1% per year include
bilateral tubal occlusion/ ligation, male sexual partner who is sterilized,
established proper use of hormonal contraceptives that inhibit ovulation,
hormone-releasing intrauterine devices and copper intrauterine devices. Hormonal
contraceptive methods must be supplemented by a barrier method; have a negative
pregnancy test (blood) within the 7 days prior to the first study treatment
administration
- Male participants: During the treatment period and for at least 3 months after
obinutuzumab, or 3.5 months after the last dose of RO7227166, 2 months after the last
dose of glofitamab, or 2 months after the last dose of tocilizumab whichever is
longer, agreement to: Remain abstinent or use contraceptive measures such as a condom
plus an additional contraceptive method that together result in a failure rate of < 1%
per year, with a partner who is a women of childbearing potential. With pregnant
female partner, remain abstinent or use contraceptive measures such as a condom to
avoid exposing the embryo; refrain from donating sperm during this same period
Exclusion Criteria
- Circulating lymphoma cells, defined by out of range (high) absolute lymphocyte count
or the presence of abnormal cells in the peripheral blood differential signifying
circulating lymphoma cells
- Participants with acute bacterial, viral, or fungal infection at baseline, confirmed
by a positive blood culture within 72 hours prior to obinutuzumab infusion or by
clinical judgment in the absence of a positive blood culture
- Participants with known active infection, or reactivation of a latent infection,
whether bacterial, viral fungal, mycobacterial, or other pathogens (excluding fungal
infections of nail beds) or any major episode of infection requiring hospitalization
or treatment with IV antibiotics
- Pregnant or breast-feeding or intending to become pregnant during the study
- Prior treatment with systemic immunotherapeutic agents, including, but not limited to,
radio-immunoconjugates, antibody-drug conjugates, immune/cytokines or monoclonal
antibodies within 4 weeks or five half-lives of the drug, whichever is shorter, before
obinutuzumab infusion on D-7
- History of treatment-emergent immune-related AEs associated with prior
immunotherapeutic agents and auto-immune disease
- Treatment with standard radiotherapy, any chemotherapeutic agent, or treatment with
any other investigational or approved anti-cancer agent within 4 weeks or 5 half-lives
of the drug, whichever is shorter, prior to obinutuzumab infusion
- Prior solid organ transplantation
- Prior allogeneic stem cell transplant (SCT) and prior chimeric antigen receptor
-T-cell therapy
- Autologous SCT within 100 days prior to obinutuzumab infusion
- History of severe allergic or anaphylactic reactions to monoclonal antibody therapy
and confirmed progressive multifocal leukoencephalopathy
- Current or past history of central nervous system (CNS) lymphoma and CNS disease
- Evidence of significant, uncontrolled concomitant diseases that could affect
compliance with the protocol or interpretation of results, including diabetes
mellitus, history of relevant pulmonary disorders and known autoimmune diseases
- Major surgery or significant traumatic injury < 28 days prior to the Gpt infusion or
anticipation of the need for major surgery during study treatment
- Participants with another invasive malignancy in the last 2 years
- Significant cardiovascular disease
- Administration of a live, attenuated vaccine within 4 weeks before Gpt infusion or
anticipation that such a live attenuated vaccine will be required during the study
- Received systemic immunosuppressive medications (including but not limited to
cyclohosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis
factor agents) within two weeks prior to Gpt, with the exception of corticosteroid
treatment <=25 mg/day of prednisone or equivalent, however there must be documentation
that the participant was on a stable dose of at least a 2-week duration prior to Gpt
infusion. Inhaled and topical steriods are permitted
Please note that we have obtained the inclusion and exclusion criteria information from the National Institutes of Health’s clinical trials web site ClinicalTrials.gov. The listed criteria may not necessarily reflect recent amendments to the protocol and the current criteria.
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