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Safety and Efficacy Trial of Epcoritamab Combinations in Subjects With B-cell Non-Hodgkin Lymphoma (B-NHL) (EPCORE™ NHL-2)

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Genmab

Status and phase

Active, not recruiting
Phase 2
Phase 1

Conditions

Follicular Lymphoma
Diffuse Large B-Cell Lymphoma

Treatments

Drug: rituximab and lenalidomide
Drug: gemcitabine and oxaliplatin
Drug: rituximab, cytarabine, dexamethasone, and oxaliplatin/carboplatin
Biological: Epcoritamab
Drug: rituximab and bendamustine
Drug: rituximab, ifosfamide, carboplatin, and etoposide phosphate
Drug: Lenalidomide
Drug: rituximab, cyclophosphamide, reduced dose of doxorubicin, vincristine, and prednisone
Drug: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone

Study type

Interventional

Funder types

Industry

Identifiers

NCT04663347
2020-000845-15 (EudraCT Number)
2023-504805-35-00 (Registry Identifier)
283235 (Other Identifier)
GCT3013-02
NL74222.056.20 (Registry Identifier)

Details and patient eligibility

About

The purpose of this trial is to measure the safety and effectiveness of epcoritamab (EPKINLY™), either by itself or together with other therapies, when treating subjects with B-cell non-Hodgkin Lymphoma (B-NHL). The aim of the first part of the trial is to identify the most appropriate dose of epcoritamab, and the aim of the second part of the trial is to assess the selected epcoritamab dose in a larger group of participants with B-NHL. All participants in this trial will receive either epcoritamab alone, or epcoritamab combined with another standard treatment regimen, with a total of 10 different treatment arms being studied.

Trial details include:

  • The total trial duration will be up to 6 years.
  • The treatment duration for each participant depends upon which arm of treatment they are assigned to receive, but will be no more than 3 years.
  • The visit frequency for each participant depends upon which arm of treatment they are assigned to receive, but will be weekly to start for all participants, then will decrease to either: every 2 weeks, or every 3 weeks, or every 4 weeks, or every 8 weeks.
  • All participants will receive active drug; no one will be given placebo.

Participants who receive treatment with epcoritamab will have it injected right under the skin. Participants will receive a different regimen of epcoritamab depending upon which arm of treatment they are assigned.

Participants who receive standard treatments will have IV infusions and/or oral administration of those treatments. Participants will receive a different standard treatment regimen depending upon which arm of treatment they are assigned.

Full description

A phase 1b/2, open-label, multinational, interventional trial to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics/biomarkers, immunogenicity, and preliminary efficacy of epcoritamab in combination with other standard of care (SOC) agents in participants with B-NHL.

All participants in the trial will receive epcoritamab, as monotherapy or in combination. The following regimens will be investigated:

  • Arm 1: epcoritamab + rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in participants with previously untreated diffuse large B-cell lymphoma (DLBCL)
  • Arm 2: epcoritamab + rituximab and lenalidomide (R2) in participants with relapsed/refractory (R/R) follicular lymphoma (FL)
  • Arm 3: epcoritamab + rituximab and bendamustine (BR) in participants with previously untreated FL
  • Arm 4: epcoritamab + rituximab, cytarabine, dexamethasone, and oxaliplatin/ carboplatin (R-DHAX/C) in participants with R/R DLBCL eligible for autologous stem cell transplant (ASCT)
  • Arm 5: epcoritamab + gemcitabine and oxaliplatin (GemOx) in participants with R/R DLBCL ineligible for ASCT due to age, performance status (PS), or comorbidity
  • Arm 6: epcoritamab + R2 in participants with previously untreated FL
  • Arm 7: epcoritamab maintenance in participants with FL who achieve a complete response (CR) or a partial response (PR) with SOC treatment
  • Arm 8: epcoritamab + reduced dose of R-CHOP (R mini-CHOP) in participants with previously untreated DLBCL who are ineligible to receive full-dose anthracycline
  • Arm 9: epcoritamab + lenalidomide for second-line treatment in participants with R/R FL who progressed within 24 months of initiation of first-line anti-CD20-containing immunochemotherapy
  • Arm 10: epcoritamab + rituximab, ifosfamide, carboplatin, and etoposide phosphate (R-ICE) in participants with R/R DLBCL eligible for ASCT

The trial consists of two parts: Part 1 ('Dose Escalation') and Part 2 ('Dose Expansion'). The primary objective of Part 1 is safety, and it includes Arm 1-5 and Arm 10. Part 2 includes all 10 arms (Arm 1-10) and the primary goal of all arms, except Arm 7, is preliminary efficacy. For Arm 7, the primary goal is safety. Patients in Arm 1-5 and Arm 10 can only participate in either Part 1 or Part 2. Dose Limiting Toxicities (DLTs) will be assessed in Part 1 and for a selected number of patients in Arm 8 during a 28-day period ('safety-run phase'). The arms are conducted in parallel.

Enrollment

543 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria

  1. Measurable disease defined as ≥1 measurable nodal lesion (long axis >1.5 cm and short axis >1.0 cm) or ≥1 measurable extra-nodal lesion (long axis >1.0 cm) on computed tomography (CT) or magnetic resonance imaging (MRI)
  2. Eastern Cooperative Oncology Group (ECOG) PS score of 0, 1 or 2
  3. Acceptable organ function at screening
  4. CD20-positive non-Hodgkin lymphoma (NHL) at most recent representative tumor biopsy
  5. If of childbearing potential subject must practicing a highly effective method of birth control
  6. A man who is sexually active with a woman of childbearing potential must agree to use a barrier method of birth control

Arm 1:

  • Newly diagnosed DLBCL
  • DLBCL, not otherwise specified (NOS)
  • "Double-hit" or "triple-hit" DLBCL
  • FL Grade 3B

Arm 2: R/R FL

Arm 3: Newly diagnosed, previously untreated FL grade 1-3A

Arm 4:

  • Documented R/R DLBCL and eligible for HDT-ASCT
  • DLBCL, NOS
  • "Double-hit" or "triple-hit" DLBCL
  • FL Grade 3B

Arm 5:

  • Documented R/R DLBCL and ineligible for HDT-ASCT
  • DLBCL, NOS
  • "Double-hit" or "triple-hit" DLBCL
  • FL Grade 3B

Arm 6: Newly diagnosed, previously untreated FL grade 1-3A

Arm 7:

  • FL Grade 1-3A
  • If PR or CR per Lugano criteria following first-line or second-line treatment with SOC regimen, and last dose of SOC within 6 months prior to enrollment.

Arm 8:

  • Newly diagnosed DLBCL who are not fit to receive full-dose anthracycline
  • T-cell/histiocyte rich DLBCL
  • "Double-hit" or "triple-hit" DLBCL
  • FL Grade 3B

Arm 9:

  • R/R FL
  • Progressed within 24 months of initiating first-line treatment

Arm 10:

  • Documented R/R DLBCL and eligible for HDT-ASCT
  • DLBCL, NOS
  • "Double-hit" or "triple-hit" DLBCL
  • FL Grade 3B

Key Exclusion Criteria

  1. Chemotherapy, radiation therapy, or major surgery within 4 weeks prior to the first dose of epcoritamab
  2. Any prior treatment with a bispecific antibody targeting CD3 and CD20.
  3. Treatment with CAR-T therapy within 100 days prior to first dose of epcoritamab
  4. Clinically significant cardiovascular disease
  5. Evidence of significant, uncontrolled concomitant diseases that could affect compliance with the protocol or interpretation of results
  6. CNS lymphoma or known CNS involvement by lymphoma at screening as confirmed by MRI/CT scan of the brain and, if clinically indicated, by lumbar puncture
  7. Positive tests for hepatitis B virus or hepatitis C virus indicating acute or chronic infection
  8. Known history of seropositivity of human immunodeficiency virus (HIV)
  9. Active tuberculosis or history of completed treatment for active tuberculosis within the past 12 months
  10. Neuropathy > grade 1
  11. Receiving immunostimulatory agent
  12. Prior allogeneic HSCT
  13. Current seizure disorder requiring anti-epileptic therapy

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

543 participants in 10 patient groups

Arm 1 - Epcoritamab + R-CHOP
Experimental group
Description:
In participants with previously untreated DLBCL.
Treatment:
Biological: Epcoritamab
Drug: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Arm 2 - Epcoritamab + R2
Experimental group
Description:
In participants with R/R FL.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab and lenalidomide
Arm 3 - Epcoritamab + BR
Experimental group
Description:
In participants with previously untreated FL.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab and bendamustine
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Arm 4 - Epcoritamab + R-DHAX/C
Experimental group
Description:
In participants with R/R DLBCL eligible for ASCT.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab, cytarabine, dexamethasone, and oxaliplatin/carboplatin
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Arm 5 - Epcoritamab + GemOx
Experimental group
Description:
In participants with R/R DLBCL ineligible ASCT.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: gemcitabine and oxaliplatin
Arm 6 - Epcoritamab + R2
Experimental group
Description:
In participants with previously untreated FL.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab and lenalidomide
Arm 7 - Epcoritamab maintenance
Experimental group
Description:
In participants with FL who achieved a CR or PR after receiving SOC treatment in 1L or 2L.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Arm 8 - Epcoritamab + R mini-CHOP
Experimental group
Description:
In participants with previously untreated DLBCL who are ineligible to receive full-dose anthracycline.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab, cyclophosphamide, reduced dose of doxorubicin, vincristine, and prednisone
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Arm 9 - Epcoritamab + Lenalidomide
Experimental group
Description:
In participants with R/R FL who progressed within 24 months of initiation of first-line anti-CD20-containing immunochemotherapy.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: Lenalidomide
Biological: Epcoritamab
Biological: Epcoritamab
Arm 10 - Epcoritamab + R-ICE
Experimental group
Description:
In participants with R/R DLBCL eligible for ASCT.
Treatment:
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Biological: Epcoritamab
Drug: rituximab, ifosfamide, carboplatin, and etoposide phosphate
Biological: Epcoritamab
Biological: Epcoritamab

Trial contacts and locations

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Genmab A/S Trial Information

Data sourced from clinicaltrials.gov

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