The purpose of the study is to examine efficacy and safety of epcoritamab with and without lenalidomide in newly diagnosed elderly patients with Diffuse Large B-Cell Lymphoma (DLBCL) who cannot tolerate anthracycline therapy. Epcoritamab (also known as EPKINLY™, GEN3013 and DuoBody®-CD3xCD20) is an antibody that has already been tested in several clinical studies. All patients will receive active treatment. There is an equal chance of receiving epcoritamab or epcoritamab plus lenalidomide.
This is an open-label, multicenter, global phase-2 trial evaluating the efficacy and safety of epcoritamab monotherapy and epcoritamab plus lenalidomide in elderly patients who are deemed anthracycline ineligible. The trial is designed in two stages: * Stage 1 which includes a safety run-in phase in each arm * Stage 2, an expansion of the selected treatment from Stage 1
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
111
Epcoritamab will be administered by subcutaneous (SC) injections in 28-day cycles for up to 12 cycles.
Lenalidomide will be administered orally (capsules; starting dose of 10 or 20 mg) once daily on Day 1 to Day 21 of each 28-day cycle for up to 12 cycles.
Complete Response (CR) rate
Percentage of participants achieving CR. Assessed by the Investigator per Lugano criteria
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Duration of response (DOR)
Defined as the time between date of first response to the date of first documented tumor progression or death (due to any cause) whichever occurs first
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Duration of complete response (DOCR)
Defined as the time between the date of first CR to the date of the first documented tumor progression or death due to any cause, whichever comes first
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Time to response (TTR)
Defined as the time from first dose to first documentation of objective tumor response (CR or PR)
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 1 year
Overall Response Rate (ORR)
Defined as the percentage of patients who achieve best overall response of complete response (CR) or partial response (PR) determined by Lugano criteria
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Progression-free survival (PFS)
Defined as the time from first dose to date of PD or death (due to any cause) whichever occurs first
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UW Cancer Center at ProHealth Care
Waukesha, Wisconsin, United States
Kepler Universitätsklinikum
Linz, Austria
LKH - Universitätsklinikum der PMU Salzburg
Salzburg, Austria
Klinikum Wels-Grieskirchen GmbH
Wels, Austria
Institut Jules Bordet
Anderlecht, Belgium
ZNA
Antwerp, Belgium
UZ Brussels
Jette, Belgium
UZ Leuven
Leuven, Belgium
AZ Delta
Roeselare, Belgium
Vitaz
Temse, Belgium
...and 64 more locations
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Time to next anti-lymphoma therapy (TTNT)
Defined as the time from first dose to administration of subsequent anti-lymphoma therapy
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Rate of minimal residual disease (MRD) negativity
Percentage of participants with at least 1 post-screening MRD negative result
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 2 years
Overall survival (OS)
Defined at the timeframe from first dose to death
Time frame: From randomization (for patients enrolled in stage 1) or from first dose (for patients enrolled in stage 2) and up to 3 years
Incidence and severity of adverse events (AEs)
An adverse event is defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment
Time frame: From screening until end of the safety follow-up period (60 days after last dose)
Incidence of clinically significant shifts in laboratory parameters
Clinical laboratory parameters assessed: hematology, chemistry, coagulation, tumor lysis, cardiac enzymes, immunoglobulins, and urinalyses
Time frame: From screening until end of the safety follow-up period (60 days after last dose)
Incidence of anti-drug antibodies (ADAs) to epcoritamab in plasma
To evaluate immunogenicity
Time frame: From first dose until treatment discontinuation (assessed up to 12 months)
Evaluate patient-reported outcomes (PROs) related to lymphoma symptoms
Changes in lymphoma symptoms as measured by the Functional Assessment of Cancer Therapy Lymphoma (FACT-Lym). Scale from 0-168 obtained by summing individual subscale scores. Higher scores for the scales indicate better quality of life
Time frame: From cycle 1, day 1 until 90 days after last dose (each cycle is 28 days)
Assess pharmacokinetics (PK) of epcoritamab
Total body clearance of drug from the plasma (CL)
Time frame: From first dose and at multiple time points until treatment discontinuation (assessed up to 12 months)
Assess pharmacokinetics (PK) of epcoritamab
Maximum observed concentration (Cmax)
Time frame: From first dose and at multiple time points until treatment discontinuation (assessed up to 12 months)
Assess pharmacokinetics (PK) of epcoritamab
Time to reach Cmax (Tmax)
Time frame: From first dose and at multiple time points until treatment discontinuation (assessed up to 12 months)
Assess pharmacokinetics (PK) of epcoritamab
Terminal Elimination Half-Life (t 1/2)
Time frame: From first dose and at multiple time points until treatment discontinuation (assessed up to 12 months)