MEN1703 (SEL24) to Treat Relapsed or Refractory Aggressive B-cell Non-Hodgkin Lymphoma (JASPIS-01)

Official title

An Open Label, Phase 2 Clinical Trial of MEN1703 as Monotherapy and in Combination With Glofitamab in Patients With Relapsed or Refractory Aggressive B-cell Non-Hodgkin Lymphoma

Overview

The goal of the study is to assess the safety and anti-lymphoma activity of MEN1703 (Dapolsertib hydrochloride) when given as a single-agent or combined with glofitamab to patients with relapsed/refractory (R/R) aggressive B-cell non-Hodgkin lymphoma. The study will be open to groups at the same time: * Group 1 - patients who have not had anti-CD3xCD20 bispecific antibody therapy but who have had at least 2 prior lines of systemic treatment for aggressive B-cell non-Hodgkin lymphoma * Group 2 - patients who have exhausted all standard treatment options including at least 2 prior lines of systemic treatment for aggressive B-cell non-Hodgkin lymphoma Group 1 patients will be treated for a maximum of 12 cycles. One cycle is 21 days. Group 2 with be treated until the disease progresses, therefore treatment duration is dependent on the number of treatment cycles a participant receives prior to progression.

Detailed description

The study consists of 3 parts, to investigate MEN1703 (Dapolsertib hydrochloride) in combination with glofitamab in patients who are naïve to treatment with an anti-CD3xCD20 bispecific antibody (group 1) or MEN1703 alone in patients who have exhausted all standard treatment options (group 2).

Part 1 (safety run-in) and Part 2 (enrichment): patients who are naïve to treatment with an anti-CD3xCD20 bispecific antibody (group 1) will receive either 150 mg or 125 mg of MEN1703 along with glofitamab. Patients who have exhausted all standard treatment options (group 2) will receive 125 mg of MEN1703 as a single-agent.

Part 3 (optional randomized comparison): Patients who are naïve to treatment with an anti-CD3xCD20 bispecific antibody therapy will be randomized to receive either MEN1703 (Dapolsertib hydrochloride) at a dose selected from part 2 in combination with glofitamab or glofitamab alone.

Interventions

• Drug MEN1703
  MEN1703 (Dapolsertib hydrochloride) is a potent dual inhibitor of proviral integration site for Moloney murine leukemia virus (PIM) kinases and Fms-like tyrosine kinase 3 (FLT3).
• Drug Glofitamab
  Glofitamab is a bispecific monoclonal antibody that binds bivalently to CD20 expressed on the surface of B-cells and monovalently to CD3 in the T-cell receptor complex expressed on the surface of T-cells.

Primary outcome measures

• Part 1: Incidence and severity of adverse events (AE) [Time frame: 12 months]
• Part 2 and Part 3: Complete response (CR) (group 1) [Time frame: 12 months]
• Part 2 and Part 3: Overall response rate (group 2) [Time frame: 12 months]

Secondary outcome measures (12)

• Part 2 and Part 3, Incidence and severity of AE [Time frame: 12 months]
• Maximum Plasma Concentration (Cmax) [Time frame: 12 months]
• Maximum Plasma Concentration (Tmax) [Time frame: 12 months]
• Area Under the Concentration Time-Curve (AUC) [Time frame: 12 months]
• Impact of treatment on patient reported outcomes (PRO) [Time frame: 12 months]
• Impact of treatment on quality of life (QOL) [Time frame: 12 months]
• Overall survival (OS) [Time frame: 12 months]
• Progression-free survival (PFS) [Time frame: 12 months]
• Duration of Response (DoR) [Time frame: 12 months]
• Duration of Complete Response (DoCR) [Time frame: 12 months]
• Time to response [Time frame: 12 months]
• Time to next treatment [Time frame: 12 months]

Eligibility criteria

Inclusion criteria

• Age ≥18 years old
• Documented histological confirmation of aggressive B-cell non-Hodgkin lymphoma including DLBCL NOS and transformed indolent B-cell lymphoma
• Relapsed or refractory disease having received at least 2 prior lines of systemic treatment and, naïve to anti-CD3xCD20 bispecific antibody treatment (group 1) or exhausted all standard, available treatment options (group 2)
• At least 1 measurable site of disease based on computed tomography (CT) or positron emission tomography (PET)-CT scan with involvement of 2 or more clearly demarcated lesions and or nodes.
• Availability of lymph node tissue at Screening (or archival sample) (part 2 participants only)
• Life expectancy of ≥12 weeks.
• Eastern Cooperative Oncology Group (ECOG) Performance Status 0, 1 or 2
• Adequate organ function at Screening
• Adequate hematologic function

Exclusion criteria

• Primary central nervous system (CNS) lymphoma or CNS involvement by lymphoma at screening.
• Received anti-cancer treatments, including cytotoxic chemotherapy, radiotherapy, hormonal therapy, biologic, immunotherapy, or investigational drugs within 14 days or 5 half-lives (whichever is shorter) before the first dose of study drug. Prior treatment with CAR-T cell or an anti-CD3xCD20 bispecific antibody therapy (permitted for Group 2 only), requires a wash out period of ≥4 weeks.
• Concurrent participation in another therapeutic clinical study.
• Ongoing clinically significant toxicity (for example, alopecia is not clinically significant) from any prior anti-cancer therapy that has not resolved to Grade 1 or less prior to the first dose of study drug.
• Prior treatment with a PIM inhibitor.
• Group 1 only: Any prior therapy with a bispecific antibody targeting CD3 and CD20.
• Known risk of allergy to the study drugs, MEN1703 (group 1 and 2) or glofitamab (group 1) or their excipients
• Contraindication to all uric acid lowering agents.
• Major surgery within 1 month prior to first dose of study drug.
• Hematopoietic stem cell transplant within 4 months prior to first dose of study drug.
• Requires systemic immune-modulating therapy (regardless of dose) or has confirmed history or current autoimmune disease or other diseases resulting in permanent immunosuppression.
• Exposed to live or live attenuated vaccine(s) within 4 weeks prior to signing the informed consent form (ICF).
• Evidence of ongoing and uncontrolled systemic bacterial, fungal, or viral infection, except for documented Grade Common Terminology Criteria for Adverse Events (CTCAE) ≤2 infections with evidence of improvement or without evidence of worsening infection.
• Known human immunodeficiency virus (HIV) infection
• Current active liver disease from any cause
• Ongoing drug-induced pneumonitis.
• Ongoing inflammatory bowel disease.
• Active known second malignancy
• Received an agent known to be a sensitive CYP2D6 substrate or a CYP2D6 substrate with a narrow therapeutic range, a strong or moderate CYP2D6 inhibitor, or a BCRP inhibitor within 14 days or 5 half-lives (whichever is shorter), prior to the first dose of study drug.
• Cardiac dysfunction is defined as myocardial infarction within 6 months of study entry, New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled dysrhythmias, or poorly controlled angina.
• Receiving treatment for active, ongoing thromboembolic event. Note: Does not apply to prophylactic treatment to prevent or avoid reoccurrence of a prior resolved event. To review with Medical Monitor where further risk assessment is needed.
• History of serious ventricular arrhythmia (e.g., VT or VF, ≥3 beats in a row), or QT interval corrected for heart rate (QTc) ≥480 ms.

Note: QTc values up to 500 ms will be acceptable where patient's medical history e.g., bundle branch block, is known to cause mild QTc prolongation and the condition is well controlled.

• Any disease, syndrome or condition which may significantly affect drug intake via oral route.
• Planning to become pregnant or breastfeed during treatment and for 1 month after the last dose of study drug.
• Any other prior or current medical condition, intercurrent illness, surgical history, physical or 12-lead electrocardiogram (ECG) findings, laboratory abnormalities, or extenuating circumstance (e.g., alcohol or drug addiction) that, in the investigator's opinion, could jeopardize patient safety or interfere with the objectives of the study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Poland · 13 centers

• Wojewódzki Szpital Specjalistyczny w Białej Podlaskiej — Biała Podlaska
• IN-VIVO Bydgoszcz Sp. z o.o. — Bydgoszcz
• Klinika Hematologii I Transplantologii Uck — Gdansk
• Szpitale Pomorskie Sp. z o.o. — Gdynia
• Narodowy Instytut Onkologii im. Marii Skłodowskiej Curie, Państwowy Instytut Badawczy — Gliwice
• Pratia Hematologia Sp. z o.o. — Katowice
• Pratia MCM Kraków — Krakow
• SP ZOZ Szpital Uniwersytecki w Krakowie — Krakow
• … and 5 more centers

Spain · 10 centers

• Hospital Universitari Vall D Hebron — Barcelona
• Clinica Universidad De Navarra — Madrid
• MD Anderson Cancer Center — Madrid
• Hospital Universitario Puerta de Hierro Majadahonda — Madrid
• Hospital Clínico Uni versitario Virgen de la Arrixaca — Murcia
• Clinica Universidad De Navarra — Pamplona
• Hospital Universitario De Navarra — Pamplona
• Hospital Universitario De Salamanca — Salamanca
• … and 2 more centers

France · 7 centers

• Centre Hospitalier Le Mans — Le Mans
• CHU de Lille - Hôpital Claude Huriez — Lille
• CHU de Limoges - CHU Dupuytren — Limoges
• Hospices Civils De Lyon - Hôpital Lyon Sud — Lyon
• CHU Montpellier - Hôpital Saint Eloi — Montpellier
• APHP - Hôpital Pitié-Salpêtrière — Paris
• CHU de Bordeaux - Hôpital Haut-Lévêque — Pessac

United Kingdom · 6 centers

• Beatson West of Scotland Cancer Centre — Glasgow
• The Royal Marsden Hospital — London
• The Christie NHS Foundation Trust — Manchester
• Plymouth Hospitals NHS Trust — Plymouth
• The Royal Marsden Hospital — Sutton
• St George's Hospital — Tooting

Identifiers

NCT: NCT06534437 · JASPIS-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗