MT-3724 With Gemcitabine and Oxaliplatin for Relapsed/Refractory Diffuse Large B Cell Non-Hodgkin's Lymphoma

Trial Summary

Official Title

Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Multiple Dose Regimens of MT-3724 With Gemcitabine and Oxaliplatin for the Treatment of Subjects With Relapsed or Refractory B Cell Non-Hodgkin's Lymphoma

Status

Active, not recruiting

Condition

Non-hodgkin Lymphoma,B Cell, Refractory Diffuse Large B-Cell Lymphoma, Relapsed Diffuse Large B-Cell Lymphoma

About the Trial

PK,PD,Safety and Tolerability of Multiple Dose Regimens of MT-3724 With Gemcitabine and Oxaliplatin for the Treatment of Patients With Relapsed/Refractory Diffuse Large B Cell Non-Hodgkin's Lymphoma

This is a multi-center, open-label two-part study evaluating the safety and tolerability of MT-3724 in combination with GEMOX in relapsed or refractory B-cell Lymphoma patients.

Part 1: (MT-3724 Dose Escalation) Define the maximum tolerated dose (MTD) of MT-3724 in combination with standard treatment of GEMOX

Part 2: (MTD Expansion Cohort) Confirm the safety and tolerability of the MTD of MT-3724 from Part 1 in the MTD Expansion Cohort, where MT-3724 will be given at the MTD in combination with GEMOX. In addition, the PK, PD, immunogenicity and tumor response at the MTD of MT-3724 in combination with GEMOX will be more thoroughly evaluated in Part 2.

MT-3724 will be administered as intravenous (IV) infusion over 1 hour. In C1, MT-3724 infusion should be administered on Days 1, 3, 5, 8, 10, 12, 15, 22, 29, and 36 of the 42-day cycle.

In Cycle 2 and beyond, MT-3724 will be administered weekly on Days 1, 8, 15, and 22 of each 28-day cycle.

During the first 2 weeks of C1, no more than two MT-3724 doses can be administered on consecutive days. If MT-3724 is administered on consecutive days, then at least 20 hours (more than 5 half-lives of MT-3724 in plasma) must elapse between the start of the 2 infusions.

For Weeks 3 through 6 of C1 and for C2 and beyond, different dosing days within ± 2 days from scheduled weekly doses may be selected at investigator's discretion.

Treatment -Gemcitabine 1000 mg/m2 will be administered as 30-minute IV infusion. In C1, Gemcitabine will be administered on Day 16 and Day 30 of the 42-day cycle.

In Cycle 2 and beyond, Gemcitabine will be administered on Day 2 and Day 16 of each 28-day cycle.

Treatment -Oxaliplatin 100 mg/m2 will be administered as 2-hour IV infusion after Gemcitabine. In C1, Oxaliplatin will be administered on Day 16 and Day 30 of the 42-day cycle.

In Cycle 2 and beyond, Oxaliplatin will be administered on Day 2 and Day 16 of each 28-day cycle. Oxaliplatin infusion will start one hour after the start of Gemcitabine infusion (unless a delay is warranted at the investigator's discretion).

Continued Treatment with MT-3724 in combination with GEMOX will continue for four cycles of until death, disease progression, unacceptable toxicity, withdrawal of consent or another reason for withdrawal.

After four cycles, the subjects who experience clinical benefit can continue MT-3724 treatment with additional cycles of 28 days each (either alone or in combination with GEMOX) if supported by the investigator's assessment of the benefit-risk ratio, after consultation with sponsor and Medical Monitor

Detailed Info

Brief Summary

The purpose of this study is to evaluate the safety and tolerability of MT-3724 in combination with gemcitabine and oxaliplatin (GEMOX) in subjects with relapsed or refractory B-Cell NHL.

Study Phase

Phase 2

Estimated Enrollment

Study Type

Interventional

Interventions

Drug: MT-3724

Sponsor

Molecular Templates, Inc.

Eligibility

Inclusion Criteria Exclusion Criteria

Gender

Male & Female

Age

18 Years and older

Be adequately informed about the study and fully consent to participation as demonstrated by signing the written informed consent form before any screening procedure.
Be aged ≥18 years on the date of signing the informed consent form.
Have relapsed or refractory B-cell NHL that, in the investigator's opinion, could benefit from MT-3724+GEMOX therapy. At least one histologically documented relapse of NHL, by:
1. Bone marrow biopsy (FNA is not acceptable) or
2. Excisional lymph node biopsy or
3. Core biopsy of any involved organ (FNA not acceptable)
4. CD20-positive histology must have been confirmed at any time during NHL disease course and documented in the medical history
5. If no histology is available after any relapse the investigator can consult the medical monitor to discuss if the patient can be included
All subtypes of B-cell NHL may be considered for Part 1 (MT-3724 dose escalation). Only histologically documented DLBCL (including mixed histology) may be considered for Part 2 (expansion cohort).
Have received all approved therapies for NHL that are applicable for the patient in the opinion of the treating physician.
1. Patients refractory to treatment are eligible.
2. Patient who have progressed following CAR T-cell therapy are also eligible.
Have measurable disease by Lugano Classification for NHL
1. >1.5 cm longest diameter (LDi) for lymph nodes
2. >1 cm LDi for extranodal disease
Have ECOG performance score of ≤2.
Have adequate bone marrow function, as determined by:
1. Absolute neutrophil count (ANC) ≥1,000/mm3 and
2. Platelet count ≥50,000 mm³
Have adequate kidney function, assessed by thecreatinine clearance (CLcr) to be ≥ 50 mL/min either measured or estimated using the Cockcroft-Gault formula. .

a. At the investigator's discretion,calculated estimated CLcr of < 50mL/min may be verified eGFR based on the 24-hour urine collection. Subjects with GFR ≥50 mL/min will be eligible irrespective of the estimated CLcr result.
Have adequate hepatic function, as determined by:
1. Total bilirubin ≤1.5 x ULN, or ≤3 x ULN for subjects with Gilbert's Syndrome and
2. Aspartate aminotransferase (AST) ≤3 x ULN (or ≤ 5.0 x ULN if liver involvement) and
3. Alanine aminotransferase (ALT) ≤3 x ULN (or ≤ 5.0 x ULN if liver involvement).
Have adequate coagulation, as determined by:
1. INR or PT ≤1.5 x ULN
2. aPTT ≤1.5 x ULN
Have adequate serum albumin, as determined by:

a. Albumin ≥ 3.0 g/dL
Women of reproductive potential must have a negative pregnancy test during the screening period within 72 hours before the start of treatment. Women not of reproductive potential are female subjects who are postmenopausal or permanently sterilized (e.g., tubal occlusion, hysterectomy,bilateral salpingectomy).
Subjects of reproductive potential and their partners must agree to either to abstain continuously from heterosexual intercourse or to use a reliable birth control method between signing the informed consent until 6 months following the last dose of MT-3724 or GEMOX . The investigator or a designated associate should advise the subject how to achieve adequate contraception. The following birth control methods may be considered as adequate
1. Condoms (male or female) with or without a spermicidal agent;
2. Diaphragm or cervical cap with spermicide;
3. Intrauterine device;
4. Hormone-based contraception: Established use of oral, injected, or implanted hormonal methods of contraception;
5. True abstinence;
6. Vasectomy is an acceptable method for a male subject or male partner of a female subject.

History or current evidence of neoplastic disease that is histologically distinct from NHL except cervical carcinoma in situ, superficial noninvasive bladder tumors, curatively treated Stage I-II non-melanoma skin cancer, or any other previous cancer curatively treated >2 years before the start of treatment.
Current evidence of new or growing brain or spinal metastases during screening.
History of allogeneic hematopoietic stem cell transplant within 180 days before the start of treatment.
Current evidence of acute or chronic Graft versus Host Disease.
Current evidence of CTCAE Grade >1 toxicity (except for hair loss, and those toxicities
Current evidence of incomplete recovery from surgery before the start of treatment, or planned surgery at any time during the study until the EoT Visit, except minor elective interventions deemed acceptable by the investigator.
History or current evidence of significant (CTCAE Grade ≥2) infection or wound within 4 weeks before the start of treatment.
Patients with uncontrolled or severe cardiovascular disease, including myocardial infarct or unstable angina within 6 months prior to start of study treatment, New York Heart Association (NYHA) Class II or greater congestive heart failure, serious arrhythmias requiring medication for treatment, clinically significant pericardial disease, or cardiac amyloidosis may not be enrolled.
Patients with a known history of drug abuse or any chronic neurologic, psychiatric, endocrine, metabolic, immunologic, hepatic or renal disease (including a history of hemolytic uremic syndrome) that in the opinion of the Investigator would adversely affect study participation.
Patients with known active Hepatitis C, HIV or a present history of Hepatitis B
Women who are pregnant or breastfeeding
History or current evidence of hypersensitivity to any study drugs, or current evidence of hypersensitivity requiring systemic steroid doses ≥20 mg/day Prednisone equivalent
Received any amount of anti-CD20 MAb therapy within the following periods before the start of treatment
1. Rituximab (Rituxan®): 84 days; if a subject had received rituximab within 37 Weeks before the start of treatment, then a serum rituximab level must be negative (<500 ng/mL) at the screening period
2. Obinutuzumab (Gazyva®): 184 days
3. Ofatumumab (Arzerra®): 88 days
Received therapy for NHL (except anti-CD20 Mab listed above) within 4 weeks before the start of treatment
Any investigational drug treatment from 4 weeks or 5 half-lives of the agent before the start of treatment, whichever is longer, until the EoT Visit
Received radiotherapy to tumor lesions that would be chosen as target lesions (measurable disease) within 4 weeks before the start of treatment, unless the lesion exhibited objective progression between the radiotherapy and the screening according to the Lugano Classification for NHL.

a. Palliative radiotherapy to non-target lesions is allowed at the investigator's discretion after consultation with the Medical Monitor and sponsor.
Received any vaccines within 28 days of the start of treatment, or likely to require vaccines at any time from the start of treatment until 28 days after the last dose of MT-3724. Injectable flu vaccine (inactivated or recombinant) is permitted at the investigator's discretion
Received systemic immune modulators within 2 weeks before the start of treatment including but not limited to systemic corticosteroids >20 mg/day of prednisone equivalent, cyclosporine and tacrolimus. Corticosteroids for pre-medication and NSAIDs are permitted.
Received any investigational drug treatment within 4 weeks or within 5 half-lives of the therapeutic agent before the start of treatment, whichever is longer, until EoT Visit

Location

The following cities have clinical trial sites. Please check back often as locations will be updated.

UC Irvine Health / Chao Family Comprehensive Cancer Center
Orange, California 92868
United States

Sarcoma Oncology
Santa Monica, California 90403
United States

Innovative Clinical Research Institute
Whittier, California 90603
United States

Rush University
Chicago, Illinois 60612
United States

Indiana Blood and Marrow Transplantation
Indianapolis, Indiana 46237
United States

University of Maryland Greenebaum Comprehensive Cancer Center
Baltimore, Maryland 21201
United States

Duke Cancer Center
Durham, North Carolina 27710
United States

Good Samaritan Hospital
Cincinnati, Ohio 45220
United States

UT Southwestern Medical Center Clinical Research
Dallas, Texas 75390
United States

Enrollment

For more information on enrollment in our current clinical trials, please visit clinicaltrials.gov for location information.

Visit clinicaltrials.gov

About Diffuse Large B-Cell Non-Hodgkin's Lymphoma

Diffuse large B-cell lymphoma (DLBCL) is a type of cancer that starts in white blood cells called lymphocytes. There are two types of lymphoma: Hodgkin's and non-Hodgkin's, and the each behave, grow, and respond to treatment differently. There are several types of DLBCL, with the most common being non-Hodgkin's lymphoma.