Cutaneous T-cell lymphomas (CTCL) are a heterogeneous group of lymphomas characterized by a primary involvement of the skin. Among them, mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes. SS is defined as erythroderma (erythema of the entire skin surface), and circulating tumor blood cells. The circulating tumor T cells express CD4 and may lose expression of CD7 and CD26, while exhibiting in most cases aberrant expression of CD158k (KIR3DL2), which is a surface marker of Sézary cells. CCR8 is a surface marker of tumor-infiltrating regulatory T cells. It has recently be observed that CCR8 was expressed by tumor cells in CTCL and other peripheral T-cell lymphomas. CCR8 is expressed by skin resident-memory T cells which are believed to be the tumor cell-of-origin in mycosis fungoides. Domain Therapeutics (DT) showed the in vitro efficacy of their proprietary anti-CCR8 mAb DT7012 in the depletion of CTCL cells. Therapeutic depletion of CCR8-expressing cells by DT-7012 could eliminate tumor cells and activate the anti-tumor immunity in CTCL. We hypothesize that treatment with DT-7012 is effective in the treatment of relapsed or refractory (R/R) CTCL as advanced MF and SS.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
This study use the Bayesian one-stage time-to-event continual reassessment method (TITE-CRM) design for dose finding phase I clinical trials, using an empirical dose-toxicity model with linear weights. A maximum total of 30 patients with CTCL, given 4 candidate dose levels (0.3; 1.0; 3.0; 10.0 mg/kg) will be dose-assigned starting from 1mg/kg dose level, in cohorts of 1 patient and including safety rules notably to ensure staggered accrual.
Dose limiting toxicity (DLT) defined by any treatment-emergent adverse event (TEAE) not attributable to the disease or disease-related processes
Any Grade ≥ 3 non-hematologic toxicity lasting at least 7 days is considered DLT, EXCEPT for: * Isolated laboratory findings with no clinical signs or symptoms, * Grade 3 fatigue, nausea, vomiting, diarrhea, or other manageable constitutional symptom that is responsive to supportive therapy and resolves to Grade ≤ 2 (or baseline if baseline is Grade ≥ 2) within 72 hours Any Grade ≥ 3 hematologic toxicity is considered DLT, EXCEPT for: * Grade 3 neutropenia (without fever and not requiring growth factor support) lasting for less than 7 days, * Grade 3 thrombocytopenia without clinically significant bleeding or requiring platelet transfusion, * Grade 3 leukopenia/lymphopenia, * Grade 3 anemia that does not require transfusion.
Time frame: Up to 12 months
Incidence of Adverse events
Adverse Events (AEs), Serious Adverse Events (SAEs), Drug related AEs, Drug related SAEs, Adverse Events of Special Interest (AESI)
Time frame: Up to 12 months
Objective Response Rate
Time frame: At 3 months
Complete Response (CR)
Time frame: At 3 months
Partial Response (PR)
Time frame: At 3 months
Maximum concentration (Cmax) of DT-7012
At each administration
Time frame: Up to 12 months
Trough concentration (Cmin) of DT-7012
At each administration
Time frame: Up to 12 months
Area under the curve (AUC₀-₇) for the first administration
from time 0 to day 7
Time frame: Up to 12 months
Area under the curve (AUC₀-₇) for the fourth administration
from time 0 to day 7
Time frame: Up to 12 months
Accumulation index (AI)
Expressed as the ratio of concentrations between the fourth and first administration
Time frame: Up to 12 months
Accumulation index (AI)
Expressed as the ratio of AUC between the fourth and first administration
Time frame: Up to 12 months
Presence of anti-drug antibodies
Time frame: Up to 12 months
Presence of pruritus
Assessed by a visual analogue scale (VAS)
Time frame: At 3 months
Presence of pruritus
Assessed by a visual analogue scale (VAS)
Time frame: At 6 months
Presence of pruritus
Assessed by a visual analogue scale (VAS)
Time frame: At 12 months
Health Related Quality of Life
By a standardized skin-specific questionnaire (SkinDex29). Total score varies from 0 to 100. The higher the score the lower the quality of life
Time frame: At 3 months
Health Related Quality of Life
By a standardized skin-specific questionnaire (SkinDex29). Total score varies from 0 to 100. The higher the score the lower the quality of life
Time frame: At 6 months
Health Related Quality of Life
By a standardized skin-specific questionnaire (SkinDex29). Total score varies from 0 to 100. The higher the score the lower the quality of life
Time frame: At 12 months
Health Related Quality of Life
By the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30). Total score varies from 0 to 100. The higher the score the lower the quality of life.
Time frame: At 3 months
Health Related Quality of Life
By the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30). Total score varies from 0 to 100. The higher the score the lower the quality of life.
Time frame: At 6 months
Health Related Quality of Life
By the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30). Total score varies from 0 to 100. The higher the score the lower the quality of life.
Time frame: At 12 months
Time to next treatment (TTNT)
Time from initiation of DT-7012 until the time of initiation of any systemic treatment or total-skin treatment (phototherapy or TSEB).
Time frame: Up to 12 months
Disease control rate
Defined as complete, partial response or stable disease
Time frame: At 3 months
Disease control rate
Defined as complete, partial response or stable disease
Time frame: At 6 months
Disease control rate
Defined as complete, partial response or stable disease
Time frame: At 12 months
Duration of response (DoR)
Time from measurement of CR/PR (whichever is first recorded) until the date of documented recurrent or progressive disease, assessed in responder patients only
Time frame: Up to 12 months
Progression-Free-Survival
Defined with the time from the first DT-7012 administration to progressive disease, relapse, death, or last follow-up.
Time frame: Up to 12 months
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