This study is being done to evaluate if ME-401 can improve the treatment of patients with diffuse large b-celllymphoma (DLBCL). Many patients with DLBCL that are treated with the standard of care (R-CHOP) are cured. However, a little less than half of patients will have their cancer come back despite being treated. Once DLBCL comes back, it is much harder to treat and treatment is much more aggressive. This study will combine ME-401 with R-CHOP. There are 2 parts to this study: part1 referred to as phase I and part 2 referred to as phase 2. The goal of the phase I study is to find the safest dose to give patients in combination with R-CHOP. The goal of the phase 2 study is to use the safest dose (found in phase 1) in combination with R-CHOP to see if it decreases the rate of cancer coming back after it is treated.
This study is a multi-institution, open-label, phase I/II study designed to evaluate the safety and efficacy of R-CHOP + ME-401 for participants with newly diagnosed DLBCL. Objectives for the phase I portion of this study are as follows: Primary objectives: * To determine the recommended phase 2 dose (RP2D) of ME-401in combination with R-CHOP for participants with newly diagnosed DLBCL. * To describe tolerability of ME-401 in combination with R-CHOP for participants with newly diagnosed DLBCL. Objectives for the phase II portion of this study are as follows: * To estimate the clinical activity of ME-401 in combination with R-CHOP in participants with newly diagnosed DLBCL, as measured by 1 year PFS rate * To estimate the response rates (complete and partial remission),duration of response (DOR), time to progression (TTP), and overall survival (OS) with ME-401 plus R-CHOP. * To characterize treatment-related AEs in participants treated with ME-401 plus R-CHOP.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
13
ME-401 (60 mg) will be given by mouth every 21 days for 6 cycles on days 1-4 (dose level 1) OR days 1-7 (dose level 2) of a 21 day cycle. Dose escalation will be performed in a standard 3+3 design
375 mg/m2 IV/subcutaneous rituximab day 1 of 21-day cycle. First dose of rituximab will be given IV and subsequent doses can be either IV or SQ based on institutional guidelines.
750 mg/m2 IV Cyclophosphamide day 1 of 21-day cycle
50 mg/m2 IV Doxorubicin day 1 of 21-day cycle
1.4 mg/m2 (max 2 mg) IV Vincristine
100mg PO Prednisone Days 1-5 of 21-day cycle
Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
Phase I: Number of Clinically Significant Non-hematologic Grade 3 or 4 Treatment-related AEs or Hematologic Grade 3 or 4 Treatment Related AEs
Dose limiting toxicity (DLT) as defined by non-hematologic clinically significant grade 3 or 4 treatment-related AEs or hematologic grade 3 or 4 treatment related AEs that are clinically significant during the first cycle, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0.
Time frame: Up to 24 months after treatment
Phase II: Progression Free Survival (PFS) Assessed by Lugano Criteria
PFS, as defined as time from study treatment initiation to documented disease progression per Lugano Criteria, or death from any cause, whichever occurs first.
Time frame: 24 months (2 years)
Phase I: Number of Treatment-related AEs
Number of treatment-related AEs in Phase I. Participants will be followed for toxicity for 30 days after treatment has been discontinued or until death, whichever occurs first. The clinical course of each event will be followed until resolution, stabilization, or until it has been determined that the study treatment or participation is not the cause with a cut off of 24 months after completion of therapy.
Time frame: Up to 24 months after treatment
Phase II: Number of Treatment-related AEs
Number of treatment-related AEs in Phase II Participants will be followed for toxicity for 30 days after treatment has been discontinued or until death, whichever occurs first. The clinical course of each event will be followed until resolution, stabilization, or until it has been determined that the study treatment or participation is not the cause with a cut off of 24 months after completion of therapy.
Time frame: Up to 24 months after treatment
Phase II: Number of Days Treatment is Delayed
Number of days treatment is delayed
Time frame: Up to 24 months after treatment
Phase II: Overall Response (OR) Assessed by Lugano Criteria
OR assessed by Lugano criteria. OR is defined as achieving either CR or PR at any stage from time of commencement of protocol treatment to time of treatment cessation for whatever reason
Time frame: 24 months (2 years)
Complete Response (CR) Assessed by Lugano Criteria
CR assessed by Lugano criteria
Time frame: 24 months (2 years)
Partial Response (PR) Assessed by Lugano Criteria
PR assessed by Lugano criteria
Time frame: 24 months (2 years)
Phase II: Duration of Response (DoR)
DoR defined as the time from documented response (CR or PR) to the time of confirmed disease progression or death due to any cause, whichever occurs first
Time frame: 24 months (2 years)
Phase II: Overall Survival (OS)
OS defined as the time from first dose of study treatment to death from any cause
Time frame: 24 months (2 years)
Phase II: Time to Treatment Failure
Time to Treatment Failure defined as the time from study entry to any treatment failure.
Time frame: 24 months (2 years)
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