Study of Fc-Optimized Anti-CD19 Antibody (MOR00208) to Treat Non-Hodgkin's Lymphoma (NHL)

A Phase IIa, Open-label, Multicenter Study of Single-agent MOR00208, an Fc-optimized Anti-CD19 Antibody, in Patients With Relapsed or Refractory B-Cell Non-Hodgkin's Lymphoma

This is an open-label, multicenter study to characterize the safety and efficacy of the human anti-CD19 antibody MOR00208 in adult patients with relapsed/refractory non-Hodgkin's lymphoma (NHL) who have received at least 1 prior therapy containing rituximab (at least once).

Study Overview

• Status: Completed
• Conditions: Non-Hodgkin Lymphoma
• Intervention / Treatment: Drug: MOR00208 (formerly Xmab 5574)

Detailed Description

The study enrols patients from four different NHL subtypes: follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL) and other indolent NHL (iNHL). The study will employ a two-stage design where the decision to further enrol any NHL subtype in stage 2 will depend on best responses after two or three cycles in stage 1.

• Study Type: Interventional
• Enrollment (Actual): 92
• Phase: Phase 2

Contacts and Locations

Study Locations

• Belgium
  • Brussels #1, Belgium
    • MorphoSys Research Site
  • Brussels #2, Belgium
    • MorphoSys Research Site
  • Edegem, Belgium
    • MorphoSys Research Site
• Germany
  • Berlin, Germany
    • MorphoSys Research Site
  • Mainz, Germany
    • MorphoSys Research Site
  • Ulm, Germany
    • MorphoSys Research Site
• Hungary
  • Budapest #1, Hungary
    • MorphoSys Research Site
  • Budapest #2, Hungary
    • MorphoSys Research Site
  • Debrecen, Hungary
    • MorphoSys Research Site
• Italy
  • Bologna, Italy
    • MorphoSys Research Site
  • Firenze, Italy
    • MorphoSys Research Site
  • Genova, Italy
    • Morphosys
  • Modena, Italy
    • MorphoSys Research Site
  • Novara, Italy
    • MorphoSys Research Site
• Poland
  • Chorzów, Poland
    • MorphoSys Research Site
  • Kraków, Poland
    • MorphoSys Research Site
  • Lódz, Poland
    • MorphoSys Research Site
  • Slupsk, Poland
    • MorphoSys Research Site
• Spain
  • Madrid #1, Spain
    • MorphoSys Research Site
  • Madrid #2, Spain
    • MorphoSys Research Site
  • Madrid #3, Spain
    • MorphoSys Research Site
  • Sevilla, Spain
    • MorphoSys Research Site
• United States
  • Connecticut
    • Norwalk, Connecticut, United States, 06856
      • MorphoSys Research Site
  • New Jersey
    • Hackensack, New Jersey, United States, 07601
      • MorphoSys Research Site
  • Ohio
    • Columbus, Ohio, United States, 43201
      • MorphoSys Research Site
  • Texas
    • Lubbock, Texas, United States, 79410
      • MorphoSys Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Male or female patients ≥ 18 years of age.

2. Histologically-confirmed diagnosis according to Revised European American Lymphoma/World Health Organization classification, of the following B-cell lymphomas:

   1. FL
   2. Other indolent NHL (eg, MZL/MALT)
   3. DLBCL
   4. MCL
3. Patients' NHL must have progressed after at least 1 prior rituximab containing regimen.

4. One site of measurable disease by magnetic resonance imaging (MRI) or computed tomography (CT) scan defined as at least one lesion that measures at least 1.5 × 1.5 cm.

   Exception:

   For patients with MCL only, patients with nonmeasurable disease but evaluable sites (bone marrow, spleen, peripheral blood, gastrointestinal tract) can be enrolled.

5. Patients who have previously received an autologous stem cell transplantation must be at least 4 weeks post-transplant before study drug administration and must have exhibited a full haematological recovery.
6. Discontinued previous monoclonal antibody therapy (except rituximab) or radioimmunotherapy administration for at least 60 days before study drug administration.
7. Off rituximab for at least 14 days before the screening visit and be confirmed to have either no response or have disease progression after rituximab treatment.
8. Patients with DLBCL had a positive [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) scan at baseline (Cheson 2007 response criteria).
9. Life expectancy of > 3 months.
10. Eastern Cooperative Oncology Group (ECOG) performance status of < 3.

11. Laboratory criteria at screening:

    1. Absolute neutrophil count (ANC) ≥ 1.0 × 10^9/L
    2. Platelet count ≥ 75 × 10^9/L without previous transfusion within 10 days of first study drug administration
    3. Haemoglobin ≥ 8.0 g/dL (may have been transfused)
    4. Serum creatinine < 2.0 x upper limit of normal (ULN)
    5. Total bilirubin ≤ 2.0 × ULN
    6. Alanine transaminase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN
12. If a female of childbearing potential, a negative pregnancy test must be confirmed before enrolment and use of double-barrier contraception or oral contraceptive plus barrier contraceptive must be used during the study and for 3 months after the last dose, or confirmation of having undergone clinically documented total hysterectomy and/or oophorectomy, tubal ligation.
13. If a male, an effective barrier method of contraception must be used during the study and for 3 months after the last dose if the patient is sexually active with a female of childbearing potential.
14. Able to comply with all study-related procedures, medication use, and evaluations.
15. Able to understand and give written informed consent and comply with the study protocol.

Exclusion Criteria:

1. Previous treatment with cytotoxic chemotherapy, immunotherapy, radiotherapy or other lymphoma specific therapy within 14 days before the screening visit or patient has not recovered from side effects of previous lymphoma-specific therapy.
2. Treatment with a systemic investigational agent within 28 days before the screening visit.
3. Previous treatment with an anti-CD19 antibody or fragments.
4. Previous allogenic stem cell transplantation.
5. Known or suspected hypersensitivity to the excipients contained in the study drug formulation.
6. Clinically significant cardiovascular disease or cardiac insufficiency, cardiomyopathy, preexisting clinically significant arrhythmia, acute myocardial infarction within 3 months of enrolment, angina pectoris within 3 months of enrolment.

7. Patients with positive hepatitis serology:

   Hepatitis B (HBV): Patients with positive serology for HBV defined as positivity for hepatitis B surface antigen (HBsAg) or total anti-hepatitis B core antibody (anti-HBc). Patients positive for anti-HBc may be included if HBV DNA is not detectable.

   Hepatitis C (HCV): Patients positive HCV serology (defined as positive for anti-HCV antibody [anti-HCV]) unless HCV-ribonucleic acid (RNA) is confirmed negative.

8. History of HIV infection.
9. Any active systemic infection (viral, fungal, or bacterial) requiring active parenteral antibiotic therapy within 4 weeks of study drug administration.
10. Current treatment with immunosuppressive agents other than prescribed corticosteroids (not more than 10-mg prednisone equivalent).
11. Major surgery or radiation therapy within 4 weeks before first study drug administration.
12. Systemic diseases (cardiovascular, renal, hepatic, etc) that would prevent study treatment in the investigator's opinion.
13. History or clinical evidence of central nervous system (CNS), meningeal, or epidural disease, including brain metastasis.
14. Active treatment/chemotherapy for another primary malignancy within the past 5 years (except for ductal breast cancer in situ, non-melanoma skin cancer, prostate cancer not requiring treatment, and cervical carcinoma in situ).
15. Pregnancy or breastfeeding in women and women of childbearing potential not using an acceptable method of birth control.
16. History of noncompliance to medical regimens or patients who are considered potentially unreliable not cooperative.

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

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: MOR00208 (formerly Xmab5574); intravenous Infusion of MOR00208, Fc-Optimized Anti-CD19 Antibody	Drug: MOR00208 (formerly Xmab 5574); Other Names: MOR208

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Response Rate (ORR)	Proportion of patients with Complete Remission (CR; disappearance of all evidence of disease) or Partial Remission (PR; regression of measurable disease and no new sites), assessed as per the 2007 International Working Group (IWG) response criteria by radiographic evaluations (CT, PET, MRI, or other).	From first dose until Follow-up Visit 12, up to 4.5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stable Disease (SD) Rate	Proportion of patients with Stable Disease (failure to attain CR/PR with no progressive disease)	From first dose until Follow-up Visit 12, up to 4.5 years
Duration of Response (DoR)	Time from first CR or PR to first documentation of relapse/progression (any new lesion or increase by ≥ 50% of previously identified site)	From first dose until Follow-up Visit 12, up to 4.5 years
Time to Progression (TTP)	Time from first dosing until documentation of progression or death due to lymphoma	From first dose until Follow-up Visit 12, up to 4.5 years
Progression-free Survival (PFS)	Time from first dosing until progression or death due to any case	From first dose until Follow-up Visit 12, up to 4.5 years
Incidence and Severity of Adverse Events (AEs)	Number of patients with treatment-emergent AEs rated Mild, Moderate, and Severe	From first dose until 30 days after last dose of MOR00208, up to 8.5 years
Number and Proportion of Patients Who Potentially Developed Anti-MOR00208 Antibodies and Semiquantitative Anti-MOR00208 Antibody Assessments	Number of patients with at least one positive (+ve) post-Baseline sample containing positive anti-MOR00208 antibodies; Baseline (pre-dose) sample has to be tested negative (-ve)	From first dose until Follow-up Visit 3, up to 7 months
Pharmacokinetic (PK) Parameter: Maximum Serum Concentration Observed (Cmax) of MOR00208	The highest concentration of MOR00208 measured in serum	Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
PK Parameter: Time to Maximum Serum Concentration Observed (Tmax) of MOR00208	The time to highest concentration of MOR00208 measured in serum	Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
PK Parameter: Apparent Trough Serum Concentration Before Dosing (Clast) of MOR00208	The last quantifiable concentration from the first dose of MOR00208	Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
PK Parameter: Area Under the Concentration Curve From Dose Time Zero to the Time the Last Quantifiable Concentration is Observed (AUC[0-t]) of MOR00208	Area under the concentration curve. The time curve from time zero (0) to the time that the last concentration above the lower limit of quantification (LLQ) is observed.	Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
PK Parameter: Area Under the Concentration Curve From Dose Time Zero to Infinity (AUC[0-inf]) of MOR00208	Area under the concentration curve. The time curve from time zero (0) to infinity (inf), where infinity is computed from AUC0-t + [Ct/λZ)]. Ct is calculated from the concentration at the last sampling time at which the sample is above LLQ.	Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
PK Parameter: Apparent Terminal Rate Constant (λz) of MOR00208	Apparent terminal rate constant calculated from the regression analysis (slope) from the log-transformed measured concentrations on the terminal phase of the time-point concentration curve	Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
PK Parameter: Apparent Terminal Half-life (t[1/2]) of MOR00208	Apparent terminal half-life calculated from ln(2)/λz	Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
PK Parameter: Total Body Clearance (CL) of MOR00208	Total body clearance calculated for single or multiple doses: dose(s)/AUC(0-inf)	Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
PK Parameter: Apparent Volume of Distribution (Vz) of MOR00208	Apparent volume of distribution during the terminal phase, calculated from dose/(AUC(0-inf)*λz)	Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
Absolute Change From Baseline in Measurements of B-cell Populations	Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: B-cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Percent Change From Baseline in Measurements of B-cell Populations	Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: B-cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Absolute Change From Baseline in Measurements of T-cell Populations	Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: T-cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Percent Change From Baseline in Measurements of T-cell Populations	Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: T-cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Absolute Change From Baseline in Measurements of NK Cell Populations	Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: NK cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Percent Change From Baseline in Measurements of NK Cell Populations	Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: NK cell populations	Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
Evaluation of AEs Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells	Incidence of AEs as stratified by presence of CD19 on malignant lymphoma cells detected by tumor biopsy/aspirate during Screening	From first dose until 30 days after last dose of MOR00208, up to 8.5 years
Evaluation of ORR Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells	The analysis of the primary endpoint (ORR) will additionally be stratified by presence of CD19 on malignant lymphoma cells detected by tumor biopsy/aspirate during Screening	From first dose until Follow-up Visit 12, up to 4.5 years
Evaluation of AEs Stratified by FcγRIIa Polymorphism	Incidence of AEs as stratified by FcγRIIa polymorphism subgroups (genotypes HH, HR, or RR)	From first dose until 30 days after last dose of MOR00208, up to 8.5 years
Evaluation of AEs Stratified by FcγRIIIa Polymorphism	Incidence of AEs as stratified by FcγRIIIa polymorphism subgroups (genotypes FF, FV, or VV)	From first dose until 30 days after last dose of MOR00208, up to 8.5 years
Evaluation of ORR Stratified by FcγRIIa Polymorphism	The analysis of the primary endpoint (ORR) will additionally be stratified by FcγRIIa polymorphism subgroups (genotypes HH, HR, or RR)	From first dose until Follow-up Visit 12, up to 4.5 years
Evaluation of ORR Stratified by FcγRIIIa Polymorphism	The analysis of the primary endpoint (ORR) will additionally be stratified by FcγRIIIa polymorphism subgroups (genotypes FF, FV, or VV)	From first dose until Follow-up Visit 12, up to 4.5 years

Collaborators and Investigators

• Sponsor: MorphoSys AG

Publications and helpful links

General Publications

• Jurczak W, Zinzani PL, Gaidano G, Goy A, Provencio M, Nagy Z, Robak T, Maddocks K, Buske C, Ambarkhane S, Winderlich M, Dirnberger-Hertweck M, Korolkiewicz R, Blum KA. Phase IIa study of the CD19 antibody MOR208 in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma. Ann Oncol. 2018 May 1;29(5):1266-1272. doi: 10.1093/annonc/mdy056.

Study record dates

Study Major Dates

• Study Start (Actual): April 23, 2013
• Primary Completion (Actual): April 6, 2022
• Study Completion (Actual): April 6, 2022

Study Registration Dates

• First Submitted: September 3, 2012
• First Submitted That Met QC Criteria: September 10, 2012
• First Posted (Estimated): September 13, 2012

Study Record Updates

• Last Update Posted (Actual): November 7, 2023
• Last Update Submitted That Met QC Criteria: October 11, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Keywords: NHL; CD19; MOR208; MOR00208; Xmab5574; B-Cell Non-Hodgkin´s Lymphoma; Fc-optimized Anti-CD19 Antibody; Tafasitamab
• Additional Relevant MeSH Terms: Immune System Diseases; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Lymphoma; Lymphoma, Non-Hodgkin
• Other Study ID Numbers: MOR208C201; 2012-002659-41 (EudraCT Number)