M-CHOP in Richter´s Syndrome (GELLC-9Richter)
CHOP Plus Mosunetuzumab as First Line in Patients With Richter´s Syndrome: a Phase II Study of the Spanish CLL Group
The purpose of the study is to assess the efficacy, safety and tolerability of mosunetuzumab combined with CHOP in patients with untreated DLBCL-RS syndrome, identifying biological factors to address the probability of response.
In addition, efficacy and tolerability of maintenance with mosunetuzumab in patients not receiving an allo-SCT will be ascertained.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The primary study objective and associated endpoint is to evaluate the efficacy of mosunetuzumab combined with CHOP (M-CHOP) after the end of induction (EoI) in patients with RS who have never received therapy.
Primary endpoint will be complete remission (CR) evaluated by an independent review committee according to modified Lugano classification using PET/CT scan after the EoI visit. CR is defined as a score of 1, 2 or 3 for lymph nodes and extra-lymphatic sites at PET without new lesions and no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow. All PET evaluable in patients with at least one dose of mosunetuzumab will be included in the efficacy population.
The secondary study objectives and associated endpoints are:
- To evaluate the efficacy of mosunetuzumab combined with CHOP (M-CHOP) after the end of induction (EoI) and maintenance (EoM) in patients with therapy naive RS.
- Overall response rate (ORR), defined as the proportion of participants with a complete response (CR) or partial response (PR) at the end of induction (EoI) and maintenance (EoM), as determined by local and independent review committee according to modified Lugano classification using PET/CT scan and IWCLL criteria (Hallek 2018).
- Complete remission (CR) at the EoM will be defined as a score of 1, 2 or 3 (no uptake above background) for lymph nodes and extralymphatic sites at PET without new lesions and no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow. In addition, patients need to have a normal blood count with normal/immunohistochemistry (IHC)-negative bone marrow morphology as per iwCLL criteria (Hallek 2018). All PET evaluable patients with at least one dose of mosunetuzumab will be included in the efficacy population.
- Best overall response: the best response is defined as the achievement of a PET score of 1-3 associated with a normal blood count with normal/immunohistochemistry (IHC)-negative bone marrow morphology as per iwCLL criteria, or a PET score of 1-3 associated with incomplete recovery in blood and normal/immunohistochemistry (IHC)-negative bone marrow morphology evaluated at any time during the treatment induction or maintenance, whichever occurs first.
- Minimal residual disease (MRD) response rate determined by the proportion of patients with MRD-negativity (defined as < 1 CLL cell in 10,000 leukocytes), assessed by flow cytometry in responders (CR/PR) in peripheral blood (PB) and/or bone marrow (BM) after the EoI and EoM.
- Progression free survival (PFS), defined as the time from the first study treatment to the first occurrence of disease progression or death from any cause, whichever occurs first. PFS will be assessed by the investigator, using the Lugano criteria.
- Overall survival (OS), defined as the time from first dose to death from any cause.
- Duration of response (DoR), defined as the time from best overall response (the first occurrence of a documented objective response) to disease progression by Lugano criteria or death from any cause, whichever occurs first.
To determine the incidence and severity of adverse events
- Incidence of adverse events (AEs): number and percentage of patients with 1 or more AE.
- Severity of AEs according to NCI CTCAE v5.0. For events of CSR, severity will be determined by ASTCT CSR consensus grading criteria. For events of TLS, the presence of laboratory and/or clinical TLS will be determined according to Howard criteria.
To evaluate the study treatment exposure:
- Treatment duration
- Total dose received
- Number of cycles and dose modifications
- Treatment interruptions and discontinuations
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Ana Méndez
- Phone Number: + 34 942 203450
- Email: administracion@gellc.es
Study Contact Backup
- Name: Yago Parga
- Phone Number: +34 672 82 18 66
- Email: gerente@gellc.es
Study Locations
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Barcelona, Spain
- Not yet recruiting
- H. Vall d'Hebron
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Contact:
- Pau Abrisqueta
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Barcelona, Spain
- Recruiting
- H. Clínic i Provincial
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Contact:
- Pablo Mozas
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Barcelona, Spain
- Recruiting
- ICO Duran i Reynals
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Contact:
- Ana Oliveira
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Las Palmas De Gran Canaria, Spain
- Recruiting
- C. H. U. de Gran Canaria Dr. Negrín
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Contact:
- Alexia Suárez Cabrera
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Madrid, Spain
- Recruiting
- H. U. 12 de Octubre
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Contact:
- Javier de la Serna
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Madrid, Spain
- Recruiting
- H. U. La Princesa
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Contact:
- Luis Miguel Juárez
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Marbella, Spain
- Recruiting
- H. Costa del Sol
-
Contact:
- María Ángeles Medina
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Murcia, Spain
- Recruiting
- H. G. U. Morales Meseguer
-
Contact:
- Dolores García Malo
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Oviedo, Spain
- Not yet recruiting
- H. U. Central de Asturias
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Contact:
- Ángel Ramírez Páyer
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Salamanca, Spain, 37007
- Recruiting
- H. U. de Salamanca
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Contact:
- Almudena Navarro Bailón
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San Sebastián, Spain
- Recruiting
- H. U. de Donostia
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Contact:
- Izaskun Zeberio Echechipia
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Santander, Spain
- Recruiting
- H. U. Marqués de Valdecilla
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Contact:
- Ana Méndez
- Phone Number: +34 942 203450
- Email: administracion@gellc.es
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Santiago De Compostela, Spain
- Recruiting
- C. H. U. de Santiago
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Contact:
- Adrián Mosquera
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Sevilla, Spain
- Recruiting
- H. U. Virgen del Rocío
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Contact:
- Fátima de la Cruz
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Valencia, Spain
- Recruiting
- H. C. U. de Valencia
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Contact:
- Mª José Terol
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Zaragoza, Spain
- Not yet recruiting
- H. Lozano Blesa
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Contact:
- Teresa Olave
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients meeting all the following inclusion criteria will be eligible for participation in the study:
- Capable of giving signed informed consent as described in Section 13.2, which includes compliance with the requirements and restrictions listed in the Informed Consent Form and this protocol.
- Aged between 18 and 79 years at the time of signing the Informed Consent Form
- Ability to comply with the study protocol and procedures and required hospitalizations, in the investigator's judgement.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of ≤2.
- Adult patients with previously untreated, histologically proven Richter's syndrome, diffuse large B cell variants, following WHO 2008 criteria (Swerdlow SH, 2008).
- Screening flow cytometry or immunohistochemistry (IHC) evidence of CD20 positive disease as per central review (dim expression of CD20 is acceptable)
Adequate BM function independent of growth factor or transfusion at screening as follows unless cytopenia is clearly due to marrow involvement of CLL:
- Platelet count ≥75 x 109/L; in cases of thrombocytopenia clearly due to marrow involvement of CLL (per the discretion of the investigator), platelet count should be ≥ 30 x 109/L.
- ANC ≥1 x 109/L unless neutropenia is clearly due to marrow involvement of CLL (per the discretion of the investigator)
- Total hemoglobin ≥ 9 g/dL unless anemia is due to marrow involvement of CLL (per the discretion of the investigator)
- Measured or estimated creatinine clearance ≥ 45 mL/min by institutional standard method.
- Life expectancy > 3 months
For women of childbearing potential (WOCBP): agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of < 1% per year, and agreement to refrain from donating eggs, during the treatment period and for at least 3 months after the last dose of mosunetuzumab and 3 months after the last dose of tocilizumab (if applicable).
- It is recommended to remain abstinent or use contraception for 12 months after the final dose of cyclophosphamide, doxorubicin, or vincristine.
- A woman is considered to be of childbearing potential (WOCBP) if she is postmenarchal, has not reached a postmenopausal state (≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and is not permanently infertile due to surgery (i.e., removal of ovaries, fallopian tubes, and/or uterus) or another cause as determined by the investigator (e.g., Müllerian agenesis). The definition of childbearing potential may be adapted for alignment with local guidelines or regulations.
Examples of contraceptive methods with a failure rate of < 1% per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.
Exclusion Criteria:
Pregnant or breastfeeding or intending to become pregnant during the study or within 3 months after the final dose of mosunetuzumab.
a) WOCBP must have a negative serum pregnancy test result within 14 days prior to initiation of study treatment. If a serum pregnancy test has not been performed within 14 days prior to receiving first study treatment, a negative urine pregnancy test result (performed within 7 days prior to study treatment) must be available.
Participants who have received any of the following treatments prior to study entry:
a) Treatment with mosunetuzumab or other CD20/CD3-directed bispecific antibodies.
Participants who have received any of the following treatments, whether investigational or approved, given to treat RS, within the respective time periods prior to initiation of study treatment:
- Autologous SCT within 100 days prior to first mosunetuzumab administration.
- Allogeneic stem cell transplant for CLL
- CAR T-cell therapy for CLL within 100 days before first study treatment
- Systemic corticosteroid treatment ≤ 20 mg/day prednisone or equivalent to control symptoms related to disease progression for a maximum of 5 days before starting C1D1 and inhaled corticosteroids are permitted.
- Central nervous system (CNS) involvement as documented by spinal fluid cytology or imaging.
- Transformation of CLL to prolymphocytic leukemia.
History of prior malignancy, except for conditions as listed below if patients have recovered from the acute side effects incurred as a result of previous therapy:
- Malignancies treated with curative intent and with no known active disease present for ≥ 2 years before enrollment.
- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
- Adequately treated cervical carcinoma in situ without evidence of disease.
- Surgically/adequately treated low grade, early stage, localized prostate cancer without evidence of disease.
Any of the following laboratory abnormalities:
- Calculated creatinine Clearance < 45 mL/min (by institutional standard method.).
- Absolute neutrophil count (ANC) < 1.0 x 109/L, unless secondary to bone marrow involvement by CLL.
- Platelet count <75 x 109/L except if thrombocytopenia is clearly due to marrow involvement of CLL (per the discretion of the investigator) for which exclusion criteria would be platelet count < 30 x 109/L.
- Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetictransaminase (SGOT) or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) >2.5 x upper limit of normal (ULN).
- Serum total bilirubin > 1.5 x ULN, except in cases of Gilbert's syndrome.
- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibody therapy (or recombinant antibody-related fusion proteins)
- Contraindication to tocilizumab.
Presence of any autoimmune disorder including autoimmune hemolytic anemia or autoimmune thrombocytopenia active at the moment of first dose of therapy.
a) Participants with a history of disease-related immune thrombocytopenic purpura or autoimmune hemolytic anemia may be eligible.
History of autoimmune disease, including, but not limited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener granulomatosis, Sjögren syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis. Exceptions include the following:
- Participants with a history of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone may be eligible.
- Participants with controlled Type 1 diabetes mellitus who are on an insulin regimen are eligible for the study.
- Participants with a remote history of, or well-controlled autoimmune disease, with a treatment-free interval from immunosuppressive therapy for 12 months may be eligible after review and discussion with the Coordinators.
- History of solid organ transplantation
- Participants with infections requiring IV treatment with antibiotics or hospitalization (Grade 3 or 4) within the last 4 weeks prior to enrollment or known active bacterial, viral (including SARS-CoV-2), fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment.
- History of confirmed progressive multifocal leukoencephalopathy (PML)
- Positive serologic HIV test at screening
- Positive test results for chronic hepatitis B infection (defined as positive hepatitis B surface antigen [HBsAg] serology). Participants with occult or prior hepatitis B infection (defined as positive total hepatitis B core antibody and negative HBsAg) may be included if hepatitis B virus (HBV) DNA is undetectable at the time of screening. These participants must be willing to undergo monthly DNA testing and appropriate prophylactic antiviral therapy as indicated.
- Acute or chronic hepatitis C virus (HCV) infection. Participants who are positive for HCV antibody must be negative for HCV by polymerase chain reaction (PCR) to be eligible for study participation.
- Known or suspected chronic active Epstein Barr Virus infection (CAEBV).
- Patients with history of macrophage activation syndrome (MAS)/hemophagocytic lymphohistiocytosis (HLH)
- Received a live, attenuated vaccine within 4 weeks before first dose of study treatment, or in whom it is anticipated that such a live attenuated vaccine will be required during the study period or within 5 months after the final dose of study treatment.
- Left ventricular ejection fraction (LVEF) <50% by multiple-gated acquisition (MUGA) scan or echocardiogram.
Evidence of any significant, concomitant disease that could affect compliance with the protocol or interpretation of results, including, but not limited to:
- significant cardiovascular disease (e.g., New York Heart Association Class III or IV cardiac disease, myocardial infarction within the previous 3 months, unstable arrhythmia, or unstable angina)
- significant pulmonary disease (such as obstructive pulmonary disease or history of bronchospasm)
- clinically significant history of liver disease, including viral or other hepatitis, or cirrhosis.
- current or past history of CNS disease, such as stroke, epilepsy, CNS vasculitis, or neurodegenerative disease.
- Participants with a history of stroke who have not experienced a stroke or transient ischemic attack in the past year and have no residual neurologic deficits as judged by the investigator are allowed.
- Participants with a history of epilepsy who have had no seizures in the past 2 years with or without anti-epileptic medications can be eligible.
- Recent major surgery within 4 weeks prior to first study treatment administration, with the exception of protocol-mandated procedures (e.g., tumor biopsies and bone marrow biopsies)
- Participants who are in dependence to the Sponsor or an investigator.
- Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes an individual's safe participation in and completion of the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: M-CHOP (Mosunetuzumab combined with CHOP)
M-CHOP (Mosunetuzumab IV combined with CHOP) Investigational medicinal product (IMP) for this study is mosunetuzumab which will be provided by the Sponsor CHOP regimen, dexamethasone, rasburicase, acetaminophen/paracetamol, diphenhydramine methylprednisolone, allopurinol and tocilizumab are considered non-investigational medicinal products (NIMPs). |
Cycle 1: d8, 1 mg; d15, 2 mg Cycle 2 and beyond: 30 mg Cyclophosphamide will be administered at a dose of 750 mg/ m2 IV on Day 1 of Cycle 1-6, every 21 days. Doxorubicin will be administered at a dose of 50 mg/m2 IV on Day 1 of Cycle 1-6, during induction treatment. Vincristine will be administered at a dose of 1.4 mg/m2 (maximum 2 mg) IV infusion in 50 ml sodium chloride 0.9% over 10 minutes on Day 1 of Cycle 1-6, every 21 days. Methylprednisolone will be administered at fixed dose of dose 80 mg IV on Day 1 of Cycle 1-6, every 21 days. Prednisone will be administered at a dose of 60 mg/m2 orally on Days 2-5 of Cycle 1-6, every 21 days. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Complete remission (CR)
Time Frame: 8-12 weeks after the end of induction
|
The number and percentage of patients with CR will be analyzed at 8-12 weeks after the end of induction (as primary endpoint by Lugano criteria) and at the end of maintenance (as secondary endpoint by Lugano and iwCLL criteria). CR is defined as a score of 1, 2 or 3 (no uptake above background) for lymph nodes and extra-lymphatic sites at PET/CT without new lesions and no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow. In addition, to evaluate CR as per iwCLL criteria at the end of maintenance, patients need to have a normal blood count with normal/immunohistochemistry (IHC)-negative bone marrow morphology. |
8-12 weeks after the end of induction
|
|
Overall Response Rate (ORR)
Time Frame: 8-12 weeks after the end of induction
|
The number and percentage of patients with a CR or PR will be analyzed 3 weeks after the end of induction (EoI) and 8-12 weeks the end of maintenance (EoM).
The analysis will be performed in the ITT population
|
8-12 weeks after the end of induction
|
|
Minimal-residual disease (MRD)
Time Frame: 8-12 weeks after the end of induction
|
The number and percentage of patients with MRD-negativity (defined as < 1 CLL cell in 10,000 leukocytes), assessed by flow cytometry in responders (CR/PR) in PB and/or BM at 3 weeks after the EoI and 8-12 weeks after the EoM. Response endpoints will be summarized using descriptive statistics along with 2-sided 95% CIs for proportions (CR, ORR, MRD) using the Clopper-Pearson exact method |
8-12 weeks after the end of induction
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free survival (PFS)
Time Frame: Up to 10 months
|
The time from the first dose of study treatment to the first occurrence of disease progression (assessed by the local investigator per Lugano criteria (PET) or death from any cause, whichever occurs first).
|
Up to 10 months
|
|
Overall Survival (OS)
Time Frame: Up to 21 months
|
OS is defined as the time from first dose to death from any cause.
Participants who do not die during the study will be censored at the last follow-up.
This analysis will be performed in the ITT population
|
Up to 21 months
|
|
Duration of Response (DoR)
Time Frame: Up to 4 years
|
DOR, defined as the time from best overall response (the first occurrence of a documented objective response) to disease progression (by Lugano) or death from any cause, whichever occurs first.
Participants who do not experience disease progression, relapse, or die during the study will be censored at the date of their last tumor assessment.
Only patients with a CR or PR will be included in the analysis.
|
Up to 4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Yuan Y, Hess KR, Hilsenbeck SG, Gilbert MR. Bayesian Optimal Interval Design: A Simple and Well-Performing Design for Phase I Oncology Trials. Clin Cancer Res. 2016 Sep 1;22(17):4291-301. doi: 10.1158/1078-0432.CCR-16-0592. Epub 2016 Jul 12.
- Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK, Langston AA, Nastoupil LJ, Rajotte M, Rolston KV, Strasfeld L, Flowers CR. Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol. 2018 Oct 20;36(30):3043-3054. doi: 10.1200/JCO.18.00374. Epub 2018 Sep 4.
- Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA; Alliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Espanol de Medula Osea; German High-Grade Lymphoma Study Group; German Hodgkin's Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014 Sep 20;32(27):3059-68. doi: 10.1200/JCO.2013.54.8800.
- Bargou R, Leo E, Zugmaier G, Klinger M, Goebeler M, Knop S, Noppeney R, Viardot A, Hess G, Schuler M, Einsele H, Brandl C, Wolf A, Kirchinger P, Klappers P, Schmidt M, Riethmuller G, Reinhardt C, Baeuerle PA, Kufer P. Tumor regression in cancer patients by very low doses of a T cell-engaging antibody. Science. 2008 Aug 15;321(5891):974-7. doi: 10.1126/science.1158545.
- Kochenderfer JN, Dudley ME, Feldman SA, Wilson WH, Spaner DE, Maric I, Stetler-Stevenson M, Phan GQ, Hughes MS, Sherry RM, Yang JC, Kammula US, Devillier L, Carpenter R, Nathan DA, Morgan RA, Laurencot C, Rosenberg SA. B-cell depletion and remissions of malignancy along with cytokine-associated toxicity in a clinical trial of anti-CD19 chimeric-antigen-receptor-transduced T cells. Blood. 2012 Mar 22;119(12):2709-20. doi: 10.1182/blood-2011-10-384388. Epub 2011 Dec 8.
- Chen F, Teachey DT, Pequignot E, Frey N, Porter D, Maude SL, Grupp SA, June CH, Melenhorst JJ, Lacey SF. Measuring IL-6 and sIL-6R in serum from patients treated with tocilizumab and/or siltuximab following CAR T cell therapy. J Immunol Methods. 2016 Jul;434:1-8. doi: 10.1016/j.jim.2016.03.005. Epub 2016 Apr 3.
- Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. 2019 Apr;25(4):625-638. doi: 10.1016/j.bbmt.2018.12.758. Epub 2018 Dec 25.
- Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD, Jaffe ES. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016 May 19;127(20):2375-90. doi: 10.1182/blood-2016-01-643569. Epub 2016 Mar 15.
- Maloney DG, Liles TM, Czerwinski DK, Waldichuk C, Rosenberg J, Grillo-Lopez A, Levy R. Phase I clinical trial using escalating single-dose infusion of chimeric anti-CD20 monoclonal antibody (IDEC-C2B8) in patients with recurrent B-cell lymphoma. Blood. 1994 Oct 15;84(8):2457-66.
- Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Dohner H, Hillmen P, Keating M, Montserrat E, Chiorazzi N, Stilgenbauer S, Rai KR, Byrd JC, Eichhorst B, O'Brien S, Robak T, Seymour JF, Kipps TJ. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018 Jun 21;131(25):2745-2760. doi: 10.1182/blood-2017-09-806398. Epub 2018 Mar 14.
- Wierda WG, Kipps TJ, Mayer J, Stilgenbauer S, Williams CD, Hellmann A, Robak T, Furman RR, Hillmen P, Trneny M, Dyer MJ, Padmanabhan S, Piotrowska M, Kozak T, Chan G, Davis R, Losic N, Wilms J, Russell CA, Osterborg A; Hx-CD20-406 Study Investigators. Ofatumumab as single-agent CD20 immunotherapy in fludarabine-refractory chronic lymphocytic leukemia. J Clin Oncol. 2010 Apr 1;28(10):1749-55. doi: 10.1200/JCO.2009.25.3187. Epub 2010 Mar 1. Erratum In: J Clin Oncol. 2010 Aug 1;28(22):3670.
- Fischer K, Cramer P, Busch R, Stilgenbauer S, Bahlo J, Schweighofer CD, Bottcher S, Staib P, Kiehl M, Eckart MJ, Kranz G, Goede V, Elter T, Buhler A, Winkler D, Kneba M, Dohner H, Eichhorst BF, Hallek M, Wendtner CM. Bendamustine combined with rituximab in patients with relapsed and/or refractory chronic lymphocytic leukemia: a multicenter phase II trial of the German Chronic Lymphocytic Leukemia Study Group. J Clin Oncol. 2011 Sep 10;29(26):3559-66. doi: 10.1200/JCO.2010.33.8061. Epub 2011 Aug 15.
- Goede V, Fischer K, Busch R, Engelke A, Eichhorst B, Wendtner CM, Chagorova T, de la Serna J, Dilhuydy MS, Illmer T, Opat S, Owen CJ, Samoylova O, Kreuzer KA, Stilgenbauer S, Dohner H, Langerak AW, Ritgen M, Kneba M, Asikanius E, Humphrey K, Wenger M, Hallek M. Obinutuzumab plus chlorambucil in patients with CLL and coexisting conditions. N Engl J Med. 2014 Mar 20;370(12):1101-10. doi: 10.1056/NEJMoa1313984. Epub 2014 Jan 8.
- Klinger M, Brandl C, Zugmaier G, Hijazi Y, Bargou RC, Topp MS, Gokbuget N, Neumann S, Goebeler M, Viardot A, Stelljes M, Bruggemann M, Hoelzer D, Degenhard E, Nagorsen D, Baeuerle PA, Wolf A, Kufer P. Immunopharmacologic response of patients with B-lineage acute lymphoblastic leukemia to continuous infusion of T cell-engaging CD19/CD3-bispecific BiTE antibody blinatumomab. Blood. 2012 Jun 28;119(26):6226-33. doi: 10.1182/blood-2012-01-400515. Epub 2012 May 16.
- Abrisqueta P, Delgado J, Alcoceba M, Oliveira AC, Loscertales J, Hernandez-Rivas JA, Ferra C, Cordoba R, Yanez L, Medina A, Motllo C, Iacoboni G, Villacampa G, Gonzalez M, Bosch F. Clinical outcome and prognostic factors of patients with Richter syndrome: real-world study of the Spanish Chronic Lymphocytic Leukemia Study Group (GELLC). Br J Haematol. 2020 Sep;190(6):854-863. doi: 10.1111/bjh.16748. Epub 2020 Jun 9.
- Olszewski AJ, Phillips TJ, Hoffmann MS, Armand P, Kim TM, Yoon DH, Mehta A, Greil R, Westin J, Lossos IS, Munoz JL, Sit J, Wei MC, Yang A, Chen V, Purev E, Yee DL, Jaeger U. Mosunetuzumab in combination with CHOP in previously untreated DLBCL: safety and efficacy results from a phase 2 study. Blood Adv. 2023 Oct 24;7(20):6055-6065. doi: 10.1182/bloodadvances.2023010840.
- Almasri NM, Duque RE, Iturraspe J, Everett E, Braylan RC. Reduced expression of CD20 antigen as a characteristic marker for chronic lymphocytic leukemia. Am J Hematol. 1992 Aug;40(4):259-63. doi: 10.1002/ajh.2830400404.
- Atwell S, Ridgway JB, Wells JA, Carter P. Stable heterodimers from remodeling the domain interface of a homodimer using a phage display library. J Mol Biol. 1997 Jul 4;270(1):26-35. doi: 10.1006/jmbi.1997.1116.
- Badoux XC, Keating MJ, Wang X, O'Brien SM, Ferrajoli A, Faderl S, Burger J, Koller C, Lerner S, Kantarjian H, Wierda WG. Fludarabine, cyclophosphamide, and rituximab chemoimmunotherapy is highly effective treatment for relapsed patients with CLL. Blood. 2011 Mar 17;117(11):3016-24. doi: 10.1182/blood-2010-08-304683. Epub 2011 Jan 18.
- Baliakas P, Jeromin S, Iskas M, Puiggros A, Plevova K, Nguyen-Khac F, Davis Z, Rigolin GM, Visentin A, Xochelli A, Delgado J, Baran-Marszak F, Stalika E, Abrisqueta P, Durechova K, Papaioannou G, Eclache V, Dimou M, Iliakis T, Collado R, Doubek M, Calasanz MJ, Ruiz-Xiville N, Moreno C, Jarosova M, Leeksma AC, Panayiotidis P, Podgornik H, Cymbalista F, Anagnostopoulos A, Trentin L, Stavroyianni N, Davi F, Ghia P, Kater AP, Cuneo A, Pospisilova S, Espinet B, Athanasiadou A, Oscier D, Haferlach C, Stamatopoulos K; ERIC, the European Research Initiative on CLL. Cytogenetic complexity in chronic lymphocytic leukemia: definitions, associations, and clinical impact. Blood. 2019 Mar 14;133(11):1205-1216. doi: 10.1182/blood-2018-09-873083. Epub 2019 Jan 2.
- Bottcher S, Ritgen M, Fischer K, Stilgenbauer S, Busch RM, Fingerle-Rowson G, Fink AM, Buhler A, Zenz T, Wenger MK, Mendila M, Wendtner CM, Eichhorst BF, Dohner H, Hallek MJ, Kneba M. Minimal residual disease quantification is an independent predictor of progression-free and overall survival in chronic lymphocytic leukemia: a multivariate analysis from the randomized GCLLSG CLL8 trial. J Clin Oncol. 2012 Mar 20;30(9):980-8. doi: 10.1200/JCO.2011.36.9348. Epub 2012 Feb 13.
- Burger JA, Kipps TJ. Chemokine receptors and stromal cells in the homing and homeostasis of chronic lymphocytic leukemia B cells. Leuk Lymphoma. 2002 Mar;43(3):461-6. doi: 10.1080/10428190290011921.
- Chigrinova E, Rinaldi A, Kwee I, Rossi D, Rancoita PM, Strefford JC, Oscier D, Stamatopoulos K, Papadaki T, Berger F, Young KH, Murray F, Rosenquist R, Greiner TC, Chan WC, Orlandi EM, Lucioni M, Marasca R, Inghirami G, Ladetto M, Forconi F, Cogliatti S, Votavova H, Swerdlow SH, Stilgenbauer S, Piris MA, Matolcsy A, Spagnolo D, Nikitin E, Zamo A, Gattei V, Bhagat G, Ott G, Zucca E, Gaidano G, Bertoni F. Two main genetic pathways lead to the transformation of chronic lymphocytic leukemia to Richter syndrome. Blood. 2013 Oct 10;122(15):2673-82. doi: 10.1182/blood-2013-03-489518. Epub 2013 Sep 4.
- Dabaja BS, O'Brien SM, Kantarjian HM, Cortes JE, Thomas DA, Albitar M, Schlette ES, Faderl S, Sarris A, Keating MJ, Giles FJ. Fractionated cyclophosphamide, vincristine, liposomal daunorubicin (daunoXome), and dexamethasone (hyperCVXD) regimen in Richter's syndrome. Leuk Lymphoma. 2001 Jul;42(3):329-37. doi: 10.3109/10428190109064589.
- Doessegger L, Banholzer ML. Clinical development methodology for infusion-related reactions with monoclonal antibodies. Clin Transl Immunology. 2015 Jul 17;4(7):e39. doi: 10.1038/cti.2015.14. eCollection 2015 Jul.
- Dreger P; European Group for Blood and Marrow Transplantation (EBMT). The evolving role of stem cell transplantation in chronic lymphocytic leukemia. Hematol Oncol Clin North Am. 2013 Apr;27(2):355-69. doi: 10.1016/j.hoc.2013.01.007.
- Durot E, Michallet AS, Lepretre S, Le QH, Leblond V, Delmer A. Platinum and high-dose cytarabine-based regimens are efficient in ultra high/high-risk chronic lymphocytic leukemia and Richter's syndrome: results of a French retrospective multicenter study. Eur J Haematol. 2015 Aug;95(2):160-7. doi: 10.1111/ejh.12474. Epub 2015 Jan 21.
- Eyre TA, Clifford R, Bloor A, Boyle L, Roberts C, Cabes M, Collins GP, Devereux S, Follows G, Fox CP, Gribben J, Hillmen P, Hatton CS, Littlewood TJ, McCarthy H, Murray J, Pettitt AR, Soilleux E, Stamatopoulos B, Love SB, Wotherspoon A, Schuh A. NCRI phase II study of CHOP in combination with ofatumumab in induction and maintenance in newly diagnosed Richter syndrome. Br J Haematol. 2016 Oct;175(1):43-54. doi: 10.1111/bjh.14177. Epub 2016 Jul 5.
- Fabbri G, Khiabanian H, Holmes AB, Wang J, Messina M, Mullighan CG, Pasqualucci L, Rabadan R, Dalla-Favera R. Genetic lesions associated with chronic lymphocytic leukemia transformation to Richter syndrome. J Exp Med. 2013 Oct 21;210(11):2273-88. doi: 10.1084/jem.20131448. Epub 2013 Oct 14.
- Fink AM, Bottcher S, Ritgen M, Fischer K, Pflug N, Eichhorst B, Wendtner CM, Winkler D, Buhler A, Zenz T, Staib P, Mayer J, Hensel M, Hopfinger G, Wenger M, Fingerle-Rowson G, Dohner H, Kneba M, Stilgenbauer S, Busch R, Hallek M. Prediction of poor outcome in CLL patients following first-line treatment with fludarabine, cyclophosphamide and rituximab. Leukemia. 2013 Sep;27(9):1949-52. doi: 10.1038/leu.2013.190. Epub 2013 Jun 21. No abstract available.
- Grupp SA, Kalos M, Barrett D, Aplenc R, Porter DL, Rheingold SR, Teachey DT, Chew A, Hauck B, Wright JF, Milone MC, Levine BL, June CH. Chimeric antigen receptor-modified T cells for acute lymphoid leukemia. N Engl J Med. 2013 Apr 18;368(16):1509-1518. doi: 10.1056/NEJMoa1215134. Epub 2013 Mar 25. Erratum In: N Engl J Med. 2016 Mar 10;374(10):998. doi: 10.1056/NEJMx160005.
- Kapoor R, Simalti A, Kumar R, Yanamandra U, Das S, Singh J, Nair V. PRES in Pediatric HSCT: A Single-Center Experience. J Pediatr Hematol Oncol. 2018 Aug;40(6):433-437. doi: 10.1097/MPH.0000000000001190.
- Rider AT, Henning GB, Eskew RT Jr, Stockman A. Harmonics added to a flickering light can upset the balance between ON and OFF pathways to produce illusory colors. Proc Natl Acad Sci U S A. 2018 Apr 24;115(17):E4081-E4090. doi: 10.1073/pnas.1717356115. Epub 2018 Apr 9.
- He R, Ding W, Viswanatha DS, Chen D, Shi M, Van Dyke D, Tian S, Dao LN, Parikh SA, Shanafelt TD, Call TG, Ansell SM, Leis JF, Mai M, Hanson CA, Rech KL. PD-1 Expression in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) and Large B-cell Richter Transformation (DLBCL-RT): A Characteristic Feature of DLBCL-RT and Potential Surrogate Marker for Clonal Relatedness. Am J Surg Pathol. 2018 Jul;42(7):843-854. doi: 10.1097/PAS.0000000000001077.
- Hijazi Y, Klinger M, Kratzer A, Wu B, Baeuerle PA, Kufer P, Wolf A, Nagorsen D, Zhu M. Pharmacokinetic and Pharmacodynamic Relationship of Blinatumomab in Patients with Non-Hodgkin Lymphoma. Curr Clin Pharmacol. 2018;13(1):55-64. doi: 10.2174/1574884713666180518102514.
- Hosseini I, Gadkar K, Stefanich E, Li CC, Sun LL, Chu YW, Ramanujan S. Mitigating the risk of cytokine release syndrome in a Phase I trial of CD20/CD3 bispecific antibody mosunetuzumab in NHL: impact of translational system modeling. NPJ Syst Biol Appl. 2020 Aug 28;6(1):28. doi: 10.1038/s41540-020-00145-7.
- Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011 May 12;364(19):1844-54. doi: 10.1056/NEJMra0904569. No abstract available. Erratum In: N Engl J Med. 2018 Sep 13;379(11):1094.
- Kater AP, Seymour JF, Hillmen P, Eichhorst B, Langerak AW, Owen C, Verdugo M, Wu J, Punnoose EA, Jiang Y, Wang J, Boyer M, Humphrey K, Mobasher M, Kipps TJ. Fixed Duration of Venetoclax-Rituximab in Relapsed/Refractory Chronic Lymphocytic Leukemia Eradicates Minimal Residual Disease and Prolongs Survival: Post-Treatment Follow-Up of the MURANO Phase III Study. J Clin Oncol. 2019 Feb 1;37(4):269-277. doi: 10.1200/JCO.18.01580. Epub 2018 Dec 3.
- Koren E, Smith HW, Shores E, Shankar G, Finco-Kent D, Rup B, Barrett YC, Devanarayan V, Gorovits B, Gupta S, Parish T, Quarmby V, Moxness M, Swanson SJ, Taniguchi G, Zuckerman LA, Stebbins CC, Mire-Sluis A. Recommendations on risk-based strategies for detection and characterization of antibodies against biotechnology products. J Immunol Methods. 2008 Apr 20;333(1-2):1-9. doi: 10.1016/j.jim.2008.01.001. Epub 2008 Jan 29.
- Langerbeins P, Busch R, Anheier N, Durig J, Bergmann M, Goebeler ME, Hurtz HJ, Stauch MB, Stilgenbauer S, Dohner H, Fink AM, Cramer P, Fischer K, Wendtner CM, Hallek M, Eichhorst B. Poor efficacy and tolerability of R-CHOP in relapsed/refractory chronic lymphocytic leukemia and Richter transformation. Am J Hematol. 2014 Dec;89(12):E239-43. doi: 10.1002/ajh.23841. Epub 2014 Sep 26.
- Lee DW, Gardner R, Porter DL, Louis CU, Ahmed N, Jensen M, Grupp SA, Mackall CL. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014 Jul 10;124(2):188-95. doi: 10.1182/blood-2014-05-552729. Epub 2014 May 29. Erratum In: Blood. 2015 Aug 20;126(8):1048. Dosage error in article text. Blood. 2016 Sep 15;128(11):1533. doi: 10.1182/blood-2016-07-730689.
- Mao Z, Quintanilla-Martinez L, Raffeld M, Richter M, Krugmann J, Burek C, Hartmann E, Rudiger T, Jaffe ES, Muller-Hermelink HK, Ott G, Fend F, Rosenwald A. IgVH mutational status and clonality analysis of Richter's transformation: diffuse large B-cell lymphoma and Hodgkin lymphoma in association with B-cell chronic lymphocytic leukemia (B-CLL) represent 2 different pathways of disease evolution. Am J Surg Pathol. 2007 Oct;31(10):1605-14. doi: 10.1097/PAS.0b013e31804bdaf8.
- Baden LR, Swaminathan S, Angarone M, Blouin G, Camins BC, Casper C, Cooper B, Dubberke ER, Engemann AM, Freifeld AG, Greene JN, Ito JI, Kaul DR, Lustberg ME, Montoya JG, Rolston K, Satyanarayana G, Segal B, Seo SK, Shoham S, Taplitz R, Topal J, Wilson JW, Hoffmann KG, Smith C. Prevention and Treatment of Cancer-Related Infections, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016 Jul;14(7):882-913. doi: 10.6004/jnccn.2016.0093.
- Parikh SA, Rabe KG, Call TG, Zent CS, Habermann TM, Ding W, Leis JF, Schwager SM, Hanson CA, Macon WR, Kay NE, Slager SL, Shanafelt TD. Diffuse large B-cell lymphoma (Richter syndrome) in patients with chronic lymphocytic leukaemia (CLL): a cohort study of newly diagnosed patients. Br J Haematol. 2013 Sep;162(6):774-82. doi: 10.1111/bjh.12458. Epub 2013 Jul 11.
- Panelli MC, White R, Foster M, Martin B, Wang E, Smith K, Marincola FM. Forecasting the cytokine storm following systemic interleukin (IL)-2 administration. J Transl Med. 2004 Jun 2;2(1):17. doi: 10.1186/1479-5876-2-17.
- Paggetti J, Haderk F, Seiffert M, Janji B, Distler U, Ammerlaan W, Kim YJ, Adam J, Lichter P, Solary E, Berchem G, Moussay E. Exosomes released by chronic lymphocytic leukemia cells induce the transition of stromal cells into cancer-associated fibroblasts. Blood. 2015 Aug 27;126(9):1106-17. doi: 10.1182/blood-2014-12-618025. Epub 2015 Jun 22.
- Ramsay AG, Clear AJ, Fatah R, Gribben JG. Multiple inhibitory ligands induce impaired T-cell immunologic synapse function in chronic lymphocytic leukemia that can be blocked with lenalidomide: establishing a reversible immune evasion mechanism in human cancer. Blood. 2012 Aug 16;120(7):1412-21. doi: 10.1182/blood-2012-02-411678. Epub 2012 Apr 30.
- Riches JC, Davies JK, McClanahan F, Fatah R, Iqbal S, Agrawal S, Ramsay AG, Gribben JG. T cells from CLL patients exhibit features of T-cell exhaustion but retain capacity for cytokine production. Blood. 2013 Feb 28;121(9):1612-21. doi: 10.1182/blood-2012-09-457531. Epub 2012 Dec 17.
- Rossi D, Cerri M, Capello D, Deambrogi C, Rossi FM, Zucchetto A, De Paoli L, Cresta S, Rasi S, Spina V, Franceschetti S, Lunghi M, Vendramin C, Bomben R, Ramponi A, Monga G, Conconi A, Magnani C, Gattei V, Gaidano G. Biological and clinical risk factors of chronic lymphocytic leukaemia transformation to Richter syndrome. Br J Haematol. 2008 Jun;142(2):202-15. doi: 10.1111/j.1365-2141.2008.07166.x. Epub 2008 May 19.
- Rossi D, Spina V, Deambrogi C, Rasi S, Laurenti L, Stamatopoulos K, Arcaini L, Lucioni M, Rocque GB, Xu-Monette ZY, Visco C, Chang J, Chigrinova E, Forconi F, Marasca R, Besson C, Papadaki T, Paulli M, Larocca LM, Pileri SA, Gattei V, Bertoni F, Foa R, Young KH, Gaidano G. The genetics of Richter syndrome reveals disease heterogeneity and predicts survival after transformation. Blood. 2011 Mar 24;117(12):3391-401. doi: 10.1182/blood-2010-09-302174. Epub 2011 Jan 25.
- Rossi D, Rasi S, Fabbri G, Spina V, Fangazio M, Forconi F, Marasca R, Laurenti L, Bruscaggin A, Cerri M, Monti S, Cresta S, Fama R, De Paoli L, Bulian P, Gattei V, Guarini A, Deaglio S, Capello D, Rabadan R, Pasqualucci L, Dalla-Favera R, Foa R, Gaidano G. Mutations of NOTCH1 are an independent predictor of survival in chronic lymphocytic leukemia. Blood. 2012 Jan 12;119(2):521-9. doi: 10.1182/blood-2011-09-379966. Epub 2011 Nov 10.
- Rossi D, Rasi S, Spina V, Fangazio M, Monti S, Greco M, Ciardullo C, Fama R, Cresta S, Bruscaggin A, Laurenti L, Martini M, Musto P, Forconi F, Marasca R, Larocca LM, Foa R, Gaidano G. Different impact of NOTCH1 and SF3B1 mutations on the risk of chronic lymphocytic leukemia transformation to Richter syndrome. Br J Haematol. 2012 Aug;158(3):426-9. doi: 10.1111/j.1365-2141.2012.09155.x. Epub 2012 May 10. No abstract available.
- Rossi D, Spina V, Cerri M, Rasi S, Deambrogi C, De Paoli L, Laurenti L, Maffei R, Forconi F, Bertoni F, Zucca E, Agostinelli C, Cabras A, Lucioni M, Martini M, Magni M, Deaglio S, Ladetto M, Nomdedeu JF, Besson C, Ramponi A, Canzonieri V, Paulli M, Marasca R, Larocca LM, Carbone A, Pileri SA, Gattei V, Gaidano G. Stereotyped B-cell receptor is an independent risk factor of chronic lymphocytic leukemia transformation to Richter syndrome. Clin Cancer Res. 2009 Jul 1;15(13):4415-22. doi: 10.1158/1078-0432.CCR-08-3266. Epub 2009 Jun 9.
- Schnaiter A, Paschka P, Rossi M, Zenz T, Buhler A, Winkler D, Cazzola M, Dohner K, Edelmann J, Mertens D, Kless S, Mack S, Busch R, Hallek M, Dohner H, Stilgenbauer S. NOTCH1, SF3B1, and TP53 mutations in fludarabine-refractory CLL patients treated with alemtuzumab: results from the CLL2H trial of the GCLLSG. Blood. 2013 Aug 15;122(7):1266-70. doi: 10.1182/blood-2013-03-488197. Epub 2013 Jul 2.
- Shanafelt TD, Kay NE, Rabe KG, Call TG, Zent CS, Maddocks K, Jenkins G, Jelinek DF, Morice WG, Boysen J, Schwager S, Bowen D, Slager SL, Hanson CA. Brief report: natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia. J Clin Oncol. 2009 Aug 20;27(24):3959-63. doi: 10.1200/JCO.2008.21.2704. Epub 2009 Jul 20.
- Smith EJ, Olson K, Haber LJ, Varghese B, Duramad P, Tustian AD, Oyejide A, Kirshner JR, Canova L, Menon J, Principio J, MacDonald D, Kantrowitz J, Papadopoulos N, Stahl N, Yancopoulos GD, Thurston G, Davis S. A novel, native-format bispecific antibody triggering T-cell killing of B-cells is robustly active in mouse tumor models and cynomolgus monkeys. Sci Rep. 2015 Dec 11;5:17943. doi: 10.1038/srep17943.
- Spiess C, Merchant M, Huang A, Zheng Z, Yang NY, Peng J, Ellerman D, Shatz W, Reilly D, Yansura DG, Scheer JM. Bispecific antibodies with natural architecture produced by co-culture of bacteria expressing two distinct half-antibodies. Nat Biotechnol. 2013 Aug;31(8):753-8. doi: 10.1038/nbt.2621. Epub 2013 Jul 7.
- Sun LL, Ellerman D, Mathieu M, Hristopoulos M, Chen X, Li Y, Yan X, Clark R, Reyes A, Stefanich E, Mai E, Young J, Johnson C, Huseni M, Wang X, Chen Y, Wang P, Wang H, Dybdal N, Chu YW, Chiorazzi N, Scheer JM, Junttila T, Totpal K, Dennis MS, Ebens AJ. Anti-CD20/CD3 T cell-dependent bispecific antibody for the treatment of B cell malignancies. Sci Transl Med. 2015 May 13;7(287):287ra70. doi: 10.1126/scitranslmed.aaa4802.
- Stilgenbauer S, Schnaiter A, Paschka P, Zenz T, Rossi M, Dohner K, Buhler A, Bottcher S, Ritgen M, Kneba M, Winkler D, Tausch E, Hoth P, Edelmann J, Mertens D, Bullinger L, Bergmann M, Kless S, Mack S, Jager U, Patten N, Wu L, Wenger MK, Fingerle-Rowson G, Lichter P, Cazzola M, Wendtner CM, Fink AM, Fischer K, Busch R, Hallek M, Dohner H. Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial. Blood. 2014 May 22;123(21):3247-54. doi: 10.1182/blood-2014-01-546150. Epub 2014 Mar 20.
- Teachey DT, Rheingold SR, Maude SL, et al. Cytokine release syndrome after blinatumomab treatment related to abnormal macrophage activation and ameliorated with cytokine-directed therapy. Blood. 2013;121(26):5154-5157. Blood. 2016 Sep 8;128(10):1441. doi: 10.1182/blood-2016-07-730671. No abstract available.
- Tsimberidou AM, O'Brien S, Khouri I, Giles FJ, Kantarjian HM, Champlin R, Wen S, Do KA, Smith SC, Lerner S, Freireich EJ, Keating MJ. Clinical outcomes and prognostic factors in patients with Richter's syndrome treated with chemotherapy or chemoimmunotherapy with or without stem-cell transplantation. J Clin Oncol. 2006 May 20;24(15):2343-51. doi: 10.1200/JCO.2005.05.0187.
- Tsimberidou AM, Kantarjian HM, Cortes J, Thomas DA, Faderl S, Garcia-Manero G, Verstovsek S, Ferrajoli A, Wierda W, Alvarado Y, O'Brien SM, Albitar M, Keating MJ, Giles FJ. Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte-macrophage-colony stimulating factor (GM-CSF) alternating with methotrexate and cytarabine plus rituximab and GM-CSF in patients with Richter syndrome or fludarabine-refractory chronic lymphocytic leukemia. Cancer. 2003 Apr 1;97(7):1711-20. doi: 10.1002/cncr.11238.
- Tsimberidou AM, Keating MJ. Richter syndrome: biology, incidence, and therapeutic strategies. Cancer. 2005 Jan 15;103(2):216-28. doi: 10.1002/cncr.20773.
- Tsimberidou AM, Wierda WG, Plunkett W, Kurzrock R, O'Brien S, Wen S, Ferrajoli A, Ravandi-Kashani F, Garcia-Manero G, Estrov Z, Kipps TJ, Brown JR, Fiorentino A, Lerner S, Kantarjian HM, Keating MJ. Phase I-II study of oxaliplatin, fludarabine, cytarabine, and rituximab combination therapy in patients with Richter's syndrome or fludarabine-refractory chronic lymphocytic leukemia. J Clin Oncol. 2008 Jan 10;26(2):196-203. doi: 10.1200/JCO.2007.11.8513.
- Tsimberidou AM, Wierda WG, Wen S, Plunkett W, O'Brien S, Kipps TJ, Jones JA, Badoux X, Kantarjian H, Keating MJ; Chronic Lymphocytic Leukemia Research Consortium. Phase I-II clinical trial of oxaliplatin, fludarabine, cytarabine, and rituximab therapy in aggressive relapsed/refractory chronic lymphocytic leukemia or Richter syndrome. Clin Lymphoma Myeloma Leuk. 2013 Oct;13(5):568-74. doi: 10.1016/j.clml.2013.03.012. Epub 2013 Jun 27.
- Viardot A, Goebeler ME, Hess G, Neumann S, Pfreundschuh M, Adrian N, Zettl F, Libicher M, Sayehli C, Stieglmaier J, Zhang A, Nagorsen D, Bargou RC. Phase 2 study of the bispecific T-cell engager (BiTE) antibody blinatumomab in relapsed/refractory diffuse large B-cell lymphoma. Blood. 2016 Mar 17;127(11):1410-6. doi: 10.1182/blood-2015-06-651380. Epub 2016 Jan 11.
- Wang Y, Tschautscher MA, Rabe KG, Call TG, Leis JF, Kenderian SS, Kay NE, Muchtar E, Van Dyke DL, Koehler AB, Schwager SM, Slager SL, Parikh SA, Ding W. Clinical characteristics and outcomes of Richter transformation: experience of 204 patients from a single center. Haematologica. 2020 Mar;105(3):765-773. doi: 10.3324/haematol.2019.224121. Epub 2019 Jun 13.
- Zenz T, Habe S, Denzel T, Mohr J, Winkler D, Buhler A, Sarno A, Groner S, Mertens D, Busch R, Hallek M, Dohner H, Stilgenbauer S. Detailed analysis of p53 pathway defects in fludarabine-refractory chronic lymphocytic leukemia (CLL): dissecting the contribution of 17p deletion, TP53 mutation, p53-p21 dysfunction, and miR34a in a prospective clinical trial. Blood. 2009 Sep 24;114(13):2589-97. doi: 10.1182/blood-2009-05-224071. Epub 2009 Jul 30.
- de Weerdt I, Hofland T, de Boer R, Dobber JA, Dubois J, van Nieuwenhuize D, Mobasher M, de Boer F, Hoogendoorn M, Velders GA, van der Klift M, Remmerswaal EBM, Bemelman FJ, Niemann CU, Kersting S, Levin MD, Eldering E, Tonino SH, Kater AP. Distinct immune composition in lymph node and peripheral blood of CLL patients is reshaped during venetoclax treatment. Blood Adv. 2019 Sep 10;3(17):2642-2652. doi: 10.1182/bloodadvances.2019000360.
Helpful Links
- Cancer Research UK. Chronic lymphosytic leukemia (CLL) incidence by sex and UK country
- Guideline on the evaluation of anticancer medicinal products in man
- Food and Drug Administration. Hematologic malignancies: regulatory considerations for use of minimal residual disease in development of drug and biological products for treatment⎯guidance for industry
- Bayesian optimal interval designs for phase I clinical trials
- Cytokine Release Syndrome after T Cell Immunotherapy Meeting
- National Institute of Health; National Cancer Institute; Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stats facts: leukemia⎯chronic lymphocytic leukemia.
- A risk-based approach to immunogenicity concerns of therapeutic protein products: Part I: considering consequences of the immune response to a protein
- risk-based approach to immunogenicity concerns of therapeutic protein products: Part II: considering host-specific and product-specific factors impacting immunogenicity
- A risk-based approach to immunogenicity concerns of therapeutic protein products: Part III: effects of manufacturing changes in immunogenicity and the utility of animal immunogenicity studies
- BOIN: An R Package for Designing Single-Agent and Drug-Combination Dose-Finding Trials Using Bayesian Optimal Interval Designs
Study record dates
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Study Start (Actual)
Study Start
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Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
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First Submitted That Met QC Criteria
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First Posted
Study Record Updates
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Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
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More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Disease Attributes
- Disease
- Hematologic Diseases
- Leukemia
- Leukemia, B-Cell
- Chronic Disease
- Syndrome
- Leukemia, Lymphocytic, Chronic, B-Cell
- Leukemia, Lymphoid
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Cyclophosphamide
- Prednisone
- Doxorubicin
- Vincristine
Other Study ID Numbers
Other Study ID Numbers
- GELLC-9-Richter
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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NCT00003620CompletedB-cell Chronic Lymphocytic Leukemia | Refractory Chronic Lymphocytic Leukemia | Stage I Chronic Lymphocytic Leukemia | Stage II Chronic Lymphocytic Leukemia | Stage III Chronic Lymphocytic Leukemia | Stage IV Chronic Lymphocytic Leukemia
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NCT00612612TerminatedLeukemia | B-cell Chronic Lymphocytic Leukemia | Prolymphocytic Leukemia | Refractory Chronic Lymphocytic Leukemia | Stage I Chronic Lymphocytic Leukemia | Stage II Chronic Lymphocytic Leukemia | Stage III Chronic Lymphocytic Leukemia | Stage IV Chronic Lymphocytic Leukemia
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NCT01251250WithdrawnRefractory Chronic Lymphocytic Leukemia | Stage II Chronic Lymphocytic Leukemia | Stage III Chronic Lymphocytic Leukemia | Stage IV Chronic Lymphocytic Leukemia
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NCT03204188CompletedLeukemia, Lymphocytic, Chronic, B-Cell | Chronic Lymphocytic Leukemia | Leukemia, Chronic Lymphatic | B-Cell Chronic Lymphocytic Leukemia | Leukemia, Lymphocytic, Chronic | B-Lymphocytic Leukemia, Chronic | Leukemia, Chronic Lymphocytic, B-Cell | Lymphocytic Leukemia, Chronic, B Cell | Lymphocytic Leukemia, Chronic, B-Cell
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NCT01441882CompletedRefractory Chronic Lymphocytic Leukemia | Stage I Chronic Lymphocytic Leukemia | Stage II Chronic Lymphocytic Leukemia | Stage III Chronic Lymphocytic Leukemia | Stage IV Chronic Lymphocytic Leukemia
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NCT01649791TerminatedChronic Lymphocytic Leukemia | B-cell Chronic Lymphocytic Leukemia | Stage 0 Chronic Lymphocytic Leukemia | Stage I Chronic Lymphocytic Leukemia | Stage II Chronic Lymphocytic Leukemia
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NCT00845104WithdrawnB-cell Chronic Lymphocytic Leukemia | Refractory Chronic Lymphocytic Leukemia
Clinical Trials on Mosunetuzumab
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NCT07278921Recruiting
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NCT06828991Recruiting
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NCT05207670Active, not recruiting
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NCT05155345Completed
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