- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05366218
Tafasitamab (MOR00208) in Pediatric Patients With Relapsed or Refractory Acute B Lineage Leukemia (Anti-CD19-ALL)
A Prospective Phase I/II, Single-Arm, Open-Label, Multicentre Study to Evaluate the Safety and Efficacy of Tafasitamab (MOR00208) in Pediatric Patients With Relapsed or Refractory Acute B Lineage Leukemia
The objective of the trial is to evaluate the safety, clinical toxicity and in vivo immunological effects of MOR00208 in pediatric patients with acute lymphoblastic leukemia who showed newly emerging or persistent MRD after a first stem cell transplantation, received stem cell transplantation without having reached a sufficient molecular remission prior to transplant (defined as MRD ≥10E-4) irrespective of MRD after SCT or underwent a second or subsequent stem cell transplantation irrespective of MRD after SCT.
Part I: to determine the recommended dose of MOR00208 in pediatric patients Part II: to evaluate the time until hematological relapse or increase of MRD
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Acute lymphoblastic leukemia is the most common malignancy in children. In patients with > 2nd relapse or in patients who relapse after previous stem cell transplantation (SCT), conventional chemotherapy or even subsequent SCT results only in low probabilities for event free survival (1-year EFS ~30%) with a generally poor prognosis. Major cause of death is a subsequent relapse. To date there is no standard therapy available. The aim of this study is to establish an antibody approach as an additional therapy. Therefore, the safety and efficacy of the anti-CD19-antibody tafasitamab in such pediatric very high-risk patients will be evaluated. Patients will be included in the following stages of disease: newly emerging or persistent minimal residual disease (MRD) after a first SCT; SCT without having reached a sufficient molecular remission prior to transplant (defined as MRD ≥10E-4) irrespective of MRD after SCT; underwent a second or subsequent SCT irrespective of MRD after SCT. Tafasitamab will be used as a relapse prophylaxis as well as a treatment for patients with low detectable low MRD. The treatment is intended to reduce the likelihood of overt relapse after SCT in a collective of patients at highest risk of relapse, thereby improving the long-term survival of these patients. The bi-weekly application of anti-CD19-antibody has already shown promising results in compassionate use settings in pediatric patients. Furthermore, the safety of tafasitamab has already been analyzed in multiple studies in adults and has proven to be well tolerable. As a control group published data for these patient groups will be used with a combined 1-year EFS of 30% in which patients have been treated at the current standard of care.
The study consists of 2 parts:
The first part will evaluate safety along with the maximum tolerated dose of tafasitamab in pediatric patients. This will involve intra- and inter-individual dose escalation using pre-determined dose levels before the dose-finding phase is completed. If dose-limiting drug side effects occur during this dose-finding phase, additional patients will be included in the interindividual dose escalation until the maximum tolerated dose of tafasitamab is defined for the remainder of the study. For this dose-finding phase, a minimum of six and a maximum of 25 patients will be included.
Immediately thereafter, the second study phase begins, in which all patients from the dose-finding phase who have not experienced a dose-limiting toxicity, as well as additional enrolled patients, receive the defined maximum tolerated dose of tafasitamab. In this phase of the study, in addition to the continued recording of drug side effects, the efficacy of tafasitamab will be assessed using defined endpoints. A minimum evaluable number of 18 patients is planned for the assessment of these endpoints; to compensate for possible patient dropout during the study, recruitment of a minimum of 20 patients and a maximum of 39 patients, depending on the course of the dose-finding phase, is planned.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
- Name: Peter Lang, Prof.
- Phone Number: 0049 7071 2984744
- Email: peter.lang@med.uni-tuebingen.de
Study Contact Backup
- Name: Michael Abele, Dr.
- Phone Number: 0049 7071 2984744
- Email: michael.abele@med.uni-tuebingen.de
Study Locations
-
-
-
Berlin, Germany, 13353
- Recruiting
- Universitätsmedizin Berlin, Campus Virchow Klinikum
-
Contact:
- Sandra Cyrull, Dr.
-
Contact:
- Arend von Stackelberg, Dr.
-
Essen, Germany, 45147
- Not yet recruiting
- Universitätsklinikum
-
Contact:
- Stefan Schönberger, Dr.
-
Contact:
- Michaela Höfs, Dr.
-
Frankfurt, Germany, 60590
- Not yet recruiting
- Universitätsklinikum, Klinik für Kinder- und Jugendmedizin
-
Contact:
- Peter Bader, Prof.
-
Contact:
- Andrea Jarisch, Dr.
-
Hamburg, Germany, 20246
- Recruiting
- Zentrum für Geburtshilfe, Kinder- und Jugendmedizin
-
Contact:
- Ingo Müller, Prof. Dr.
-
Contact:
- Manon Quedeville, Dr.
-
Kiel, Germany, 24105
- Recruiting
- Universitätsklinikum Schleswig-Holstein, Campus Kiel
-
Contact:
- Gunnar Cario, Prof.
-
Contact:
- Vieth Simon, Prof.
-
Würzburg, Germany, 97080
- Recruiting
- Universitäts-Kinderklinik
-
Contact:
- Matthias Eyrich, Prof.
-
Contact:
- Paul-Gerhardt Schlegel, Prof.
-
-
Baden-Württemberg
-
Freiburg, Baden-Württemberg, Germany, 79106
- Recruiting
- Universitätsklinikum Freiburg
-
Contact:
- Brigitte Strahm, Dr.
-
Contact:
- Carsten Speckmann, Dr.
-
Tübingen, Baden-Württemberg, Germany, 72076
- Recruiting
- University Childrens Hospital
-
Contact:
- Peter Lang, Prof. Dr.
- Phone Number: 004970712984744
- Email: peter.lang@med.uni-tuebingen.de
-
Contact:
- Michael Abele, Dr.
- Phone Number: 0049707184744
- Email: michael.abele@med.uni-tuebingen.de
-
Ulm, Baden-Württemberg, Germany, 89070
- Recruiting
- Klinik für Kinder- und Jugendmedizin
-
Contact:
- Ansgar Schulz, Prof. Dr.
-
Contact:
- Manfred Hönig, Prof. Dr.
-
-
Bayern
-
München, Bayern, Germany, 80337
- Not yet recruiting
- Klinikum Dr. von Haunersches Kinderspital
-
Contact:
- Tobias Feuchtinger, Prof. Dr.
-
Contact:
- Semjon Willer, Dr.
-
-
Nordrhein-Westfalen
-
Düsseldorf, Nordrhein-Westfalen, Germany, 40225
- Recruiting
- Universitatsklinikum Dusseldorf
-
Contact:
- Roland Meisel, Prof. Dr.
-
Contact:
- Sujal Ghosh, Dr.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- B-lineage (CD19 positive) ALL (B, pro-B, pre-B or c-ALL)
Patients must have either
- underwent a first allogeneic stem cell transplantation with newly emerging or persistent MRD load posttransplant or
- have received stem cell transplantation without having reached a sufficient molecular remission prior to transplant (defined as MRD ≥10E-4) irrespective of MRD after SCT or
- underwent a second or subsequent allogeneic stem cell transplantation irrespective of MRD after SCT
Females of childbearing potential (FCBP1) must agree
- to utilize two reliable forms of contraception simultaneously or practice complete abstinence from heterosexual contact for at least 3 months before starting study drug, while participating in the study (including dose interruptions), and for at least 3 months after study treatment discontinuation and must agree to regular pregnancy testing during this timeframe
- to abstain from breastfeeding during study participation and 3 months after study drug discontinuation.
Males must agree
- to use a latex condom during any sexual contact with FCBP while participating in the study and for 3 months following discontinuation from this study, even if he has undergone a successful vasectomy
- to refrain from donating semen or sperm during study participation and for 3 months after discontinuation from this study treatment.
Exclusion Criteria:
- Frank relapse (>5% leukemic blasts)
- Philadelphia chromosome-positive (Ph+) ALL
- Ejection fraction <25% on echocardiography
- Cystatin C-clearance <40ml/min
- Liver function abnormalities with bilirubin >4 mg/dL and elevation of transaminases higher than 400 U/L
- Severe infection (HIV, Chronic active viral hepatitis), tests have to be conducted at screening
- Acute GvHD III-IV or extensive chronic GvHD
- The following immunosuppressive drugs (≥ 1 week of administration): steroids ≥ 1mg/kg body weight, cytostatics (except intrathecal/intracerebroventricular application for CNS treatment)
- Application of other experimental therapy modalities in the last 4 weeks
- Significant psychiatric disabilities, uncontrolled seizure disorders or severe peripheral neuropathy/ leukoencephalopathy
- Signs of autoimmune disease (i.e. idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia)
- Subjects that do not agree to refrain from donating blood while on study drug
- Concurrent severe or uncontrolled medical disease which by assessment of the treating physician could compromise participation in the study
- Women during pregnancy and lactation
- History of hypersensitivity to the investigational medicinal product or to any drug with similar chemical structure or to any excipient present in the pharmaceutical form of the investigational medicinal product.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Tafasitamab
All patients will receive MOR00208 over 2-3 hours i.v.
MOR00208 will be administered on a bi-weekly (every fourteen days) basis with infusions on Days 1 and 15 of each 28-day cycle.
Additional doses will be administered on Day 4, Day 8 and Day 22 of Cycle 1 as well as Day 8 and Day 22 of Cycle 2 and Cycle 3.
|
Antibody vaccination
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Primary endpoint Part I
Time Frame: 49 days
|
Determination of maximum tolerated dose of MOR00208 in pediatric patients
|
49 days
|
Primary endpoint Part II
Time Frame: 545 days
|
Time until hematological relapse (> 5% leukemic blasts) or increase of MRD ≥ 2 log in bone marrow during an observation time of 545 days accounting for competing risks
|
545 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pharmakokinetic of MOR00208
Time Frame: 8 days
|
Mean plasma concentrations of MOR00208 will be calculated and displayed graphically
|
8 days
|
Safety and toxicity of MOR00208 - Part I
Time Frame: 49 days
|
Adverse events will be presented in line listings and also in cumulative tabulations
|
49 days
|
Treatment success
Time Frame: 365 days
|
Rate of patients with treatment success defined as survival without newly emerging MRD or increasing MRD ≥ 2 log in bone marrow or peripheral blood or unacceptable toxicity
|
365 days
|
Overall survival
Time Frame: 545 days
|
OS from date of first dose until end of follow up at 545 days will be analyzed using Kaplan-Meier-Methods, presenting corresponding statistical parameters and 95% confidence limits and Kaplan-Meier survival curves.
Patients alive at 545 days and patients that could not be followed up until 545 days but were seen alive at the last visit will be censored.
|
545 days
|
MRD reduction
Time Frame: 545 days
|
The amount of patients with reduction of at least 1 log at any time point compared to baseline MRD measurement between SCT and start of study treatment will be calculated and displayed graphically.
Rates and 95%-confidence limits are also provided.
|
545 days
|
B cell numbers
Time Frame: 545 days
|
Mean B cell numbers will be calculated and displayed graphically with 95%-confidence limits.
|
545 days
|
Cytotoxic lysis
Time Frame: 545 days
|
Cytotoxic lysis will be calculated and displayed graphically.
|
545 days
|
Safety and toxicity of MOR00208 - Part II
Time Frame: 545 days
|
Adverse events will be presented in line listings and also in cumulative tabulations
|
545 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Peter Lang, Prof., University Childrens Hospital Tübingen
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2022-000557-88
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on ALL, Childhood B-Cell
-
Shenzhen BinDeBio Ltd.Xiangya Hospital of Central South UniversityRecruitingRelapsed B-cell Acute Lymphoblastic Leukemia, Childhood | Refractory B-cell Acute Lymphoblastic Leukemia, Childhood | Relapsed/Refractory B-cell Lymphoma, ChildhoodChina
-
Shenzhen BinDeBio Ltd.Children's Hospital of Fudan UniversityActive, not recruitingRelapsed B-cell Acute Lymphoblastic Leukemia, Childhood | Refractory B-cell Acute Lymphoblastic Leukemia, Childhood | Relapsed/Refractory B-cell Lymphoma, ChildhoodChina
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedChildhood Diffuse Large Cell Lymphoma | Childhood Immunoblastic Large Cell Lymphoma | Childhood Burkitt Lymphoma | Untreated Childhood Acute Lymphoblastic Leukemia | Stage I Childhood Large Cell Lymphoma | Stage I Childhood Small Noncleaved Cell Lymphoma | Stage II Childhood Large Cell Lymphoma | Stage II Childhood Small Noncleaved Cell Lymphoma and other conditionsUnited States
-
Medical College of WisconsinUniversity of Wisconsin, Madison; AmgenRecruitingB-cell Acute Lymphoblastic Leukemia | B-cell Childhood Acute Lymphoblastic Leukemia | B-Cell ALL, ChildhoodUnited States
-
National Cancer Institute (NCI)TerminatedRecurrent Childhood Acute Lymphoblastic Leukemia | B-cell Childhood Acute Lymphoblastic Leukemia | Childhood Diffuse Large Cell Lymphoma | Childhood Immunoblastic Large Cell Lymphoma | Recurrent Childhood Large Cell Lymphoma | Recurrent Childhood Lymphoblastic Lymphoma | Recurrent Childhood Small... and other conditionsUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)Active, not recruitingAnn Arbor Stage I Childhood Hodgkin Lymphoma | Ann Arbor Stage II Childhood Hodgkin Lymphoma | Childhood Nodular Lymphocyte Predominant B-Cell LymphomaUnited States, Canada, Australia, New Zealand, Puerto Rico, Israel
-
National Cancer Institute (NCI)TerminatedUnspecified Childhood Solid Tumor, Protocol Specific | Peripheral T-cell Lymphoma | Angioimmunoblastic T-cell Lymphoma | Hepatosplenic T-cell Lymphoma | Intraocular Lymphoma | Recurrent Childhood Acute Lymphoblastic Leukemia | Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma | Recurrent Mycosis Fungoides... and other conditionsUnited States
-
Athenex, Inc.RecruitingB-cell Lymphoma | CLL/SLL | ALL, Childhood | DLBCL - Diffuse Large B Cell Lymphoma | B-cell Leukemia | NHL, Relapsed, Adult | ALL, Adult B CellUnited States
-
Fred Hutchinson Cancer CenterNational Cancer Institute (NCI); American Cancer Society, Inc.CompletedExtranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue | Nodal Marginal Zone B-cell Lymphoma | Recurrent Adult Burkitt Lymphoma | Recurrent Adult Diffuse Large Cell Lymphoma | Recurrent Adult Diffuse Mixed Cell Lymphoma | Recurrent Adult Diffuse Small Cleaved Cell Lymphoma and other conditionsUnited States
-
National Cancer Institute (NCI)TerminatedUnspecified Childhood Solid Tumor, Protocol Specific | Peripheral T-cell Lymphoma | Angioimmunoblastic T-cell Lymphoma | Childhood Chronic Myelogenous Leukemia | Cutaneous B-cell Non-Hodgkin Lymphoma | Hepatosplenic T-cell Lymphoma | Intraocular Lymphoma | Recurrent Childhood Acute Lymphoblastic... and other conditionsUnited States, Canada
Clinical Trials on Tafasitamab
-
MorphoSys AGIqvia Pty LtdRecruitingDiffuse Large B-cell LymphomaUnited States
-
Incyte CorporationActive, not recruitingChronic Lymphocytic Leukemia | Non Hodgkin LymphomaUnited States, Spain, France, Italy, Belgium, Germany, Austria
-
MorphoSys AGCompletedDiffuse Large B-cell LymphomaBelgium, Germany, United States, Austria, Czechia, France, Italy, Portugal, Spain
-
International Extranodal Lymphoma Study Group (IELSG)Active, not recruitingMarginal Zone LymphomaItaly, Switzerland, Austria
-
Alvaro Alencar, MDIncyte Corporation; BeiGene; MorphoSys AGNot yet recruiting
-
Zhao WeiliNot yet recruitingDiffuse Large B-cell LymphomaChina
-
Incyte CorporationRecruitingDiffuse Large B-Cell Lymphoma | Large B-Cell LymphomaCroatia, Serbia, Czechia, Finland, Israel, Romania, Denmark, Hungary, Poland, Turkey, Bulgaria, Ireland, Norway, United Kingdom
-
James RubensteinIncyte CorporationRecruitingPrimary Central Nervous System Lymphoma | CNS Lymphoma | Secondary Central Nervous System LymphomaUnited States
-
Memorial Sloan Kettering Cancer CenterIncyte CorporationRecruitingMantle Cell Lymphoma | MCLUnited States
-
MorphoSys AGRecruitingDiffuse Large B Cell LymphomaKorea, Republic of, Czechia, Spain, Israel, Italy, Austria, Poland, United States, France