Phase 3
N=41
Study to Evaluate Safety and Efficacy of Blinatumomab in Subjects With Relapsed/Refractory (R/R) Aggressive B-Cell NHL
B-Cell Non Hodgkin Lymphoma
Bottom Line
View on ClinicalTrials.gov: NCT02910063 ↗Enrolled (actual)
41
Serious AEs
48.8%
Results posted
Jan 2021
Primary outcome: Primary: Phase 2: Percentage of Participants Who Achieved Complete Metabolic Response (CMR) — 22.0 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Blinatumomab (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Amgen
- Primary completion
- Mar 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 2: Percentage of Participants Who Achieved Complete Metabolic Response (CMR) |
22.0 | — |
| PRIMARY Phase 3: Number of Participants Who Achieved Complete Metabolic Response (CMR) |
— | — |
| SECONDARY Phase 2: Overall Survival (OS) |
11.2 | — |
| SECONDARY Phase 2: Objective Response Rate (ORR) |
36.6 | — |
| SECONDARY Phase 2: Progression Free Survival (PFS) |
2.9 | — |
| SECONDARY Phase 2: Duration of Response (DOR) |
6.1 | — |
| SECONDARY Phase 2: Percentage of Participants Who Experienced Successful Mobilization |
40.0 | — |
| SECONDARY Phase 2: Percentage of Participants Who Had Allogeneic or Autologous Post-baseline Hematopoietic Stem Cell Transplant (HSCT) |
6.7; 53.3 | — |
| SECONDARY Phase 2: Cumulative Incidence Function Estimate of 100-day Mortality After HSCT Presented as Percentage of Participants That Died Not Due to Relapse, With Relapse and Death Due to Relapse as Competing Events |
0.0 | — |
| SECONDARY Phase 2: Blinatumomab Steady State Concentrations (Css) |
249; 804; 3470 | — |
| SECONDARY Phase 2: Blinatumomab Clearance (CL) |
1.78 | — |
| SECONDARY Phase 2: Half-life of Blinatumomab |
— | — |
| SECONDARY Phase 2: Number of Participants Who Experienced a Treatment-emergent Adverse Event (TEAE) |
41; 37; 29; 12; 20; 7 | — |
| SECONDARY Phase 3: Objective Response Rate (ORR) |
— | — |
| SECONDARY Phase 3: Progression Free Survival (PFS) |
— | — |
| SECONDARY Phase 3: Duration of Response (DOR) |
— | — |
| SECONDARY Phase 3: Percentage of Participants Who Experienced Successful Mobilization |
— | — |
| SECONDARY Phase 3: Percentage of Participants Who Had Allogeneic or Autologous Post-baseline Hematopoietic Stem Cell Transplant (HSCT) |
— | — |
| SECONDARY Phase 3: Percentage of Participants Who Died Within 100 Days After Hematopoietic Stem Cell Transplantation (HSCT) That Was Not Due to Relapse |
— | — |
| SECONDARY Phase 3: Change From Baseline in Patient Reported Clinical Outcome Assessments Quality of Life (QOLCOA) Scores |
— | — |
| SECONDARY Phase 3: Number of Participants Who Experienced a Treatment-emergent Adverse Event (TEAE) |
— | — |
| SECONDARY Phase 3: Serum Blinatumomab Steady State Concentration (Css) |
— | — |
| SECONDARY Phase 3: Blinatumomab Clearance (CL) |
— | — |
| SECONDARY Phase 3: Half-life of Blinatumomab |
— | — |
Summary
This is a phase 2/3 open label, multicenter trial testing blinatumomab monotherapy for the treatment of subjects with Relapsed/Refractory (R/R) aggressive B-NHL not achieving CMR after 2 cycles of standard platinum-based chemotherapy regimens administered as S1. This study incorporates multiple interim analyses for futility, efficacy, and unblinded sample-size re-estimation. In the phase 3 part of the study, blinatumomab will be compared to Investigator's Choice chemotherapy.
In March 2019, decision made to not proceed with phase 3.
Eligibility Criteria
Inclusion Criteria
- Biopsy proven aggressive B-cell Non-Hodgkin Lymphoma (B-NHL), including diffuse large B-cell lymphoma (DLBCL) not otherwise specified (NOS), follicular lymphoma Grade 3B, PMBCL, T-cell rich B-cell lymphoma, or DLBCL that represents transformation of indolent non-Hodgkin's Lymphoma (NHL), (including follicular, marginal zone, and lymphoplasmacytoid lymphoma) excluding chronic lymphocytic leukemia or Hodgkin Lymphoma. The following histologies are not eligible:
- Lymphoblastic lymphoma
- Burkitt lymphoma
- Mantle cell lymphoma Any histologies not specifically mentioned must be discussed with medical monitor.
- Refractory (no prior CR/CMR) or relapsed (prior CMR) following front line treatment of standard multiagent chemotherapy containing an anthracycline AND an approved anti-CD20 agent. For subjects with refractory disease and who have received radiotherapy, PET positivity should be demonstrated no less than 6 weeks after the last dose of radiotherapy
- Biopsy proven confirmation of relapsed disease.
- Received a minimum of 2 cycles of standard of care platinum-based chemotherapy in the S1 setting and had a response of progressive metabolic disease (PMD), no metabolic response (NMR), partial metabolic response (PMR) as centrally assessed by PET-/ CT scan or received at least 1 cycle of S1 chemotherapy and had evidence of PMD as centrally assessed. A pre-salvage scan is required to be submitted to the central reader if a subject had only 1 cycle of pre-salvage chemotherapy.
- Radiographically measurable disease with a demarcated nodal lesion at least 1.5 cm in its largest dimension or a target extranodal lesion at least 1.0 cm in its largest dimension
- Eastern Cooperative Oncology Group performance status less than or equal to 2
- Intention to proceed to high dose chemotherapy (HDT) and autologous hematopoietic stem cell transplant (HSCT)
- Laboratory parameters:
Hematology:
- Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L
- Platelets ≥ 75 x 10^9/L
Chemistry:
- Creatinine clearance ≥ 50 mL/min
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) < 3X upper limit of normal (ULN)
- Total bilirubin (TBL) < 2x ULN (unless Gilbert's disease or if liver involvement with lymphoma)
Exclusion Criteria
- CMR following S1 chemotherapy
- Treatment within 30 days prior to randomization with another investigational device or drug study (ies).
- Prior anti-CD19-directed therapies
- Prior HDT with autologous HSCT
- Prior allogeneic HSCT
- Clinically relevant central nervous system (CNS) pathology such as epilepsy, paresis, aphasia, stroke, severe brain injury, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis
- Evidence of CNS involvement by NHL
- Known infection with human immunodeficiency virus or chronic infection with hepatitis B virus (hepatitis B surface antigen positive) or hepatitis C virus (anti hepatitis C virus positive)
- History of malignancy other than B-NHL within the past 3 years with the exception of:
- Malignancy treated with curative intent and with no known active disease present for ≥ 3 years before enrollment
- Adequately treated non-melanoma skin cancer or lentigo maligna
- Adequately treated cervical carcinoma in situ
- Adequately treated breast ductal carcinoma in situ
- Prostatic intraepithelial neoplasia without evidence of prostate cancer
- Adequately treated urothelial papillary non-invasive carcinoma or carcinoma in situ
- Known sensitivity to immunoglobulins or any of the components to be administered during dosing.
- Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required procedures.
- History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.
- Female subjects who are pregnant o
Data sourced from ClinicalTrials.gov (NCT02910063). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.