Asociación Madrileña de Hematología y Hemoterapia

ENSAYO CLÍNICO

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Response-adaptive to Epcoritamab In FIrst Relapse: A Phase II, response-adaptive, Open-Label, Multicenter Study to Evaluate the Efficacy of Eptoritamab in Patients with Relapse/Refractory Large B Cell Lymphoma

ESTADO CLÍNICO
Reclutando
FASE/S DEL ENSAYO
Fase II
PATOLOGÍA
Trasplante de progenitores hematopoyéticos, Linfoma
CENTRO INVESTIGADOR
H. Fundación Jiménez Díaz
INVESTIGADOR PRINCIPAL
Raúl Córdoba Mascuñano
CENTRO INVESTIGADOR
H.U. Infanta Leonor
INVESTIGADOR PRINCIPAL
María Stefania Infante
CENTRO INVESTIGADOR
H.G.U. Gregorio Marañón
INVESTIGADOR PRINCIPAL
Mariana Bastos Oreiro
CENTRO INVESTIGADOR
H.U. 12 de Octubre
INVESTIGADOR PRINCIPAL
Ana Jimenez Ubieto
FECHA DE APERTURA
Mayo, 2025
FECHA DE CIERRE
,
CRITERIOS DE INCLUSIÓN
Written informed consent must be obtained before any study-specific assessment is performed.
Female patients of child-bearing potential must have a negative urine or serum pregnancy test at screening and agree to use highly effective methods of contraception (e.g., established use of oral, injected or implanted combined (estradiol and progesterone containing) hormonal contraception; placement of an intrauterine device (IUD) or intrauterine system (IUS) upon enrollment according to the recommendations provided by Clinical Trial Facilitation Group (CTFG), during the treatment period and for 4 months after the last dose of study medication. Moreover, the patient must agree to ongoing pregnancy testing during the course of the study, and after study therapy has ended. This applies even if the patient practices complete and continued sexual abstinence.
Male patients must use a reliable method of contraception (if sexually active with a female of child-bearing potential) upon enrollment according to the recommendations provided by CTFG, during the treatment period, and for 4 months following the last dose of investigational drug or agreement to remain abstinent. Agreement to refrain from donating blood or sperm during the study participation and for 4 months after the last dose of study medication
Women must agree not to donate blood or oocytes during the course of the study and for 4 months after the last dose of study medication. Restrictions concerning blood donation apply as well to females who are not of childbearing potential. Men must also not donate sperm during the trial and for 4 months after receiving the last dose of study drug.
Females of childbearing potential must refrain from breastfeeding during the course of the study and for 4 months after the last dose of study medication
Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
Not included in other clinical trial or treated with an experimental drug
Age >18 years
Patients with Relapse/Refractory histologically confirmed LBCL, including, Diffuse Large B Cell Lymphoma (DLBCL); Primary Mediastinal Large B Cell Lymphoma (PMBCL), High-grade B-cell lymphoma (HGBCL); and grade 3B Follicular Lymphoma
Patients must have received adequate first-line therapy including at a minimum: an anti-CD20 monoclonal antibody (rituximab or obinutuzumab), and CHOP (cyclophosphamide, hydroxydaunomycin, oncovin, and prednisone) or CHOP-like chemotherapy
At the investigator's discretion, the patient should not be a candidate for 1st relapse CAR-T therapy or unwilling to receive CAR-T therapy
Patients must be autologous stem cell transplantation (ASCT)-ineligible: Age 65 and/or HTC-CI 3 or or unwilling to receive transplant
PET positive disease
Performance status according to Eastern Cooperative Oncology Group (ECOG) 0 to 2.
Patients meeting with the following hematology values: Hemoglobin 8 g/dl (transfusion support permitted but not within 7 days of screening lab collection); Absolute neutrophil count (ANC) 1 X 10E9/L (growth factor support allowed in case of bone marrow involvement); Absolute lymphocyte count 0.1 x 10E9/L; Platelet count 70 x 10E9/L (unless secondary to bone marrow involvement, OR 50 x 10E9/L if documented bone marrow involvement). Platelet transfusions permitted but not within 7 days of screening lab collection.
CRITERIOS DE EXCLUSIÓN
Patients who received more than one prior line of systemic therapy
Presence of severe infection that is uncontrolled or requiring IV antimicrobials for management
History of HIV infection or acute or chronic active hepatitis B or C infection. Individuals with positive HIV serology may be included if negative viral load and CD4 >200/mm3. For being included, patients should have controlled disease and been on treatment for at least 1 year. Individuals with history of hepatitis infection with positive antibodies (anti-HB and anti-HV) might be included if negative viral load (negative hepatitis B PCR). Patients who are HBcAb positive must receive HBV prophylaxis while on treatment. Patients with positive HbsAg are excluded. Patients who are hepatitis B PCR positive will be excluded. Patients who are hepatitis C RNA positive will be excluded.
Females who are pregnant or breastfeeding
Richters transformation or prior chronic lymphocytic leukemia (CLL).
Treatment with radiotherapy, chemotherapy, immunotherapy, immunosuppressive therapy, or any investigational agent for the purposes of treating cancer within 4 weeks prior to Cycle 1 Day 1
Recent major surgery (within 4 weeks before the start of Cycle 1 Day 1) other than for diagnosis
Vaccination with a live vaccine or COVID-19 vaccination within 4 weeks prior to treatment
History of hypersensitivity to any of the study drugs or their ingredients or to drugs with similar structure. History of severe allergic or anaphylactic reactions to human, humanized, chimeric, or murine monoclonal antibodies
Close affiliation with the investigator (e.g. a close relative) or persons working at the study site
Patients with detectable Central Nervous System (CNS) lymphoma
Significant organ function impairment: creatinine clearance calculated by Cockcroft-Gault 45 ml/min; direct bilirubin level < 2 x ULN (except in patients with Gilberts syndrome); alanine transaminase (ALT) and aspartate aminotransferase (AST) >3 × ULN or >5 × ULN in cases of documented liver involvement; clinically relevant pleural effusion; left ventricular ejection fraction (LVEF) 45%
Serious accompanying disorder leading to impaired organ function causing significant clinical problems and reduced life expectancy of less than 3 months
Have a history of deep venous thrombosis/embolism, threatening thromboembolism or known thrombophilia or are at a high risk for a thromboembolic event in the opinion of the investigator and who are not willing/able to take venous thromboembolic event prophylaxis during the entire treatment period
Known clinically significant cardiac disease, including: Onset of unstable angina pectoris within 6 months of signing the patient informed consent form; Acute myocardial infarction within 6 months of signing the patient informed consent form; Congestive heart failure (grade III or IV as classified by the New York Heart Association; Left ventricular ejection fraction 45%.
Known past or current malignancy other than inclusion diagnosis, except for: Cervical carcinoma of Stage 1B or less; Non-invasive basal cell or squamous cell skin carcinoma; Non-invasive, superficial bladder cancer; Localized low grade prostate cancer (up to Gleason score 6); DCIS of the breast; Other malignancy that has been treated with curative intent and has remained in remission for 3 years
Previous ASCT
Prior anti-CD3 and CD20 bispecific antibodies therapy or prior treatment with tafasitamab.
DESCRIPCIÓN
The primary objective of the study is to evaluate the efficacy of Epcoritamab monotherapy by central evaluation as second line treatment for LBCL patients
PALABRAS CLAVE
donor lymphocyte infusion, lymphoma

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