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Trattamento Venetoclax (26 cicli) con 6 cicli o 12 cicli di Epcoritamab in pazienti con LLC o LLC recidivante o refrattaria (AETHER)

Uno studio prospettico randomizzato di fase I/II sul trattamento con Venetoclax (26 cicli) con 6 cicli o 12 cicli di Epcoritamab in pazienti con leucemia linfocitica cronica recidivante o refrattaria o piccolo linfoma linfocitico

In this study, efficacy and safety of 2 regimens that combine the CD3-CD20 T cell engager epcoritamab with venetoclax will be tested in relapsed/refractory CLL and SLL patients. The trial starts with phase I part to establish the recommended dose level (RDL) of epcoritamab in the combination with venetoclax for the phase II trial.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

112

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

      • Melbourne, Australia
        • Reclutamento
        • AU-Melbourne-ALFRED
      • Melbourne, Australia
        • Reclutamento
        • AU-Melbourne-MONASH
      • Melbourne, Australia
        • Reclutamento
        • AU-Melbourne-SVHM
      • Antwerp, Belgio
        • Reclutamento
        • BE-Antwerpen-ZNASTUIVENBERG
      • Roeselare, Belgio
        • Reclutamento
        • BE-Roeselare-AZDELTA
      • Aalborg, Danimarca
        • Ritirato
        • DK-Aalborg-ALBOGUH
      • Copenhagen, Danimarca
        • Reclutamento
        • DK-Copenhagen-RIGSHOSPITALET
      • Odense, Danimarca
        • Reclutamento
        • DK-Odense-OUH
      • Berlin, Germania
        • Ritirato
        • DE-Berlin-HELIOSBERLINBUCH
      • Cologne, Germania
        • Reclutamento
        • DE-Köln-UKKOELN
      • Freiburg im Breisgau, Germania
        • Reclutamento
        • DE-Freiburg-UNIKLINIKFREIBURG
      • Greifswald, Germania
        • Ritirato
        • DE-Greifswald-UNIGREIFSWALD
      • Halle, Germania
        • Reclutamento
        • DE-Halle-UMH
      • Kiel, Germania
        • Reclutamento
        • DE-Kiel-UKSH
      • Münster, Germania
        • Reclutamento
        • DE-Munster-GEMEINSCHAFTSPRAXIS
      • Stuttgart, Germania
        • Reclutamento
        • DE-Stuttgart-RBK
      • Ulm, Germania
        • Reclutamento
        • DE-Ulm-UNIKLINKULM
      • 's-Hertogenbosch, Olanda
        • Reclutamento
        • NL-Den Bosch-JBZ
      • Alkmaar, Olanda
        • Ritirato
        • NL-Alkmaar-NWZ
      • Amersfoort, Olanda
        • Reclutamento
        • NL-Amersfoort-MEANDERMC
      • Amsterdam, Olanda
        • Reclutamento
        • NL-Amsterdam-AMC
      • Dordrecht, Olanda
        • Reclutamento
        • NL-Dordrecht-ASZ
      • Ede, Olanda
        • Reclutamento
        • NL-Ede-ZGV
      • Eindhoven, Olanda
        • Reclutamento
        • NL-Eindhoven-CATHARINA
      • Groningen, Olanda
        • Reclutamento
        • NL-Groningen-UMCG
      • Leeuwarden, Olanda
        • Reclutamento
        • NL-Leeuwarden-MCL
      • The Hague, Olanda
        • Reclutamento
        • NL-Den Haag-HAGA
      • Tilburg, Olanda
        • Reclutamento
        • NL-Tilburg-ETZ
      • Utrecht, Olanda
        • Reclutamento
        • NL-Utrecht-UMCUTRECHT

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Documented relapsed or refractory CLL or SLL (SLL in phase II part only) following at least one systemic 1st-line treatment

  • Requiring treatment according to IWCLL criteria (appendix A);

  • Age at least 18 years;

  • ECOG/WHO performance status 0-2;

  • In case of prior venetoclax treatment, enrollment can only occur at least 24 months after end of treatment and patients must not have progressed during venetoclax treatment;

  • Adequate BM function defined as:

    • Hemoglobin >5.6 mmol/l or Hb > 9 g/dL, unless low Hb is directly attributable to CLL infiltration of the BM, proven by BM biopsy;
    • Absolute neutrophil count (ANC) >1.0 x 109/L (1,000/μL), unless low ANC is directly attributable to CLL infiltration of the BM, proven by BM biopsy;
    • Platelet count >30 x 109/L (30,000/μL), unless low platelets is directly attributable to CLL infiltration in the BM;
  • Estimated Glomerular Filtration Rate (eGFR) (MDRD) or estimated creatinine clearance (CrCl) ≥ 50ml/min (Cockcroft-Gault appendix F);

  • Adequate liver function as indicated:

    • Serum aspartate transaminase (ASAT) and alanine transaminase (ALAT) ≤ 3.0 x upper limit of normal (ULN);
    • Bilirubin ≤1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or controlled autoimmune hemolytic anemia);
  • Prothrombin time (PT)/International normal ratio (INR) <1.5x ULN and activated partial thromboplastin time (aPTT) <1.5 x ULN; unless receiving anticoagulation;

  • Negative serological testing for hepatitis B virus (HBV) (Hepatitis B surface antigen (HBsAg) negative and hepatitis B core antibody (anti-HBc) negative) and hepatitis C virus (hepatitis C antibody). Patients who are positive for anti-HBc or hepatitis C antibody may be included if they have a negative PCR within 6 weeks before enrollment. Those who are PCR positive will be excluded; Please note: For patients positive for anti-HBc, HBV-DNA PCR has to be repeated every month until 12 months after last dose of study treatment.

  • Patient is able and willing to adhere to the study visit schedule and other protocol requirements;

  • Patient is capable of giving informed consent;

  • Written informed consent.

Exclusion Criteria:

  • Active CLL/SLL directed therapy within the last 14 days;

  • Prior treatment with a CD3 × CD20 bispecific antibody or CAR T-cell therapy

  • Transformation of CLL (Richter's transformation);

  • Prior allogeneic stem cell transplantation and/or solid organ transplantation;

  • Patient with a history of confirmed progressive multifocal leukoencephalopathy (PML);

  • Malignancies other than CLL currently requiring systemic therapy or not treated in curative intention or showing signs of progression after curative treatment;

  • Known allergy to xanthine oxidase inhibitors and/or rasburicase;

  • History of drug-specific hypersensitivity or anaphylaxis to any study drug (including active product or excipient components);

  • Active bleeding or uncontrolled severe bleeding diathesis (e.g., hemophilia or severe von Willebrand disease);

  • Active fungal, bacterial, and/or viral infection CTCAEgrade > 1; Please note: active controlled as well as chronic/recurrent infections are at risk of reactivation/infection during treatment;

  • Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled: infection, auto-immune hemolysis, immune thrombocytopenia, diabetes, hypertension, hyperthyroidism or hypothyroidism etc.);

  • Patient known to be HIV-positive;

  • Patient requiring treatment with a strong cytochrome P450 (CYP) 3A inhibitor/inducer (see appendix J) or anticoagulant therapy with warfarin or phenoprocoumon or other vitamin K antagonists;

  • CTCAE grade III-IV cardiovascular disease including but not limited to:

    • Unstable or uncontrolled disease/condition related to or affecting cardiac function, eg, unstable angina, congestive heart failure grade III or IV as classified by the New York Heart Association (see appendix E), uncontrolled clinically significant cardiac arrhythmia (CTCAE grade II or higher), or clinically significant electrocardiogram (ECG) abnormalities.
    • Myocardial infarction, intracranial bleed, or stroke within the past 6 months.
    • Screening 12-lead ECG showing a baseline QT interval as corrected by Fridericia's formula (QTcF) >480 msec. NOTE: this criterion does not apply to subjects with a left bundle branch block.
    • Stroke or intracranial hemorrhage within 6 months prior to registration.
  • Severe pulmonary dysfunction (CTCAE grade III-IV, see appendix D);

  • Severe neurological or psychiatric disease (CTCAE grade III-IV, see appendix D);

  • Neuropathy > CTCAE grade II

  • Patient who has difficulty with or are unable to swallow oral medication, or have significant gastrointestinal disease that would limit absorption of oral medication;

  • Vaccination with live vaccines within 28 days prior to registration;

  • Use of any other experimental drug or therapy within 28 days of registration;

  • Major surgery within 28 days prior to registration;

  • Pregnant women and nursing mothers;

  • Fertile men or women of childbearing potential unless: (1) surgically sterile or ≥ 2 years after the onset of menopause; (2) willing to use a highly effective contraceptive method such as oral contraceptives, intrauterine device, sexual abstinence or combination of male condom with either cap, diaphragm, or sponge with spermicide (double barrier methods) during study treatment and for 12 months after last dose of epcoritamab and 30 days after last dose of venetoclax;

  • Previous participation in the HOVON 139 CLL or HOVON 140 CLL trial and eligible for and willing to participate in the HOVON 159 CLL trial;

  • Current participation in other clinical trial with medicinal products;

  • Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Arm A

6 cycles epcoritamab + 26 cycles venetoclax

Number of cycles of epcoritamab is either 6 (cycle 1-6) or 12 (cycle 1-12). Patients will be treated until they have received the total number of assigned treatment cycles or until progression, or severe toxicity, whichever comes first.

All patients will receive venetoclax cycle 1-26 (a 5 week ramp-up of venetoclax will precede the first cycle). Patients will be treated until they have received the total number of assigned treatment cycles or until progression, or severe toxicity, whichever comes first.

Sperimentale: Arm B

12 cycles epcoritamab + 26 cycles venetoclax

Number of cycles of epcoritamab is either 6 (cycle 1-6) or 12 (cycle 1-12). Patients will be treated until they have received the total number of assigned treatment cycles or until progression, or severe toxicity, whichever comes first.

All patients will receive venetoclax cycle 1-26 (a 5 week ramp-up of venetoclax will precede the first cycle). Patients will be treated until they have received the total number of assigned treatment cycles or until progression, or severe toxicity, whichever comes first.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
• Recommended phase II dose (RP2D) for the combination of venetoclax and epcoritamab based on dose limiting toxicity (DLT)
Lasso di tempo: 6-12 months

endpoint for phase I and both arms

6-12 months
• Undetectable minimal residual disease <10-4 (uMRD) in BM in absence of progression according to IWCLL criteria at 12 weeks after cycle 26
Lasso di tempo: 29 months

endpoint for phase II and both arms

29 months

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
• Minimal residual disease (MRD) status in PB at cycle 4, 6, 9, 12, 15, 18, 21, 24 and 12 weeks after cycle 26; following treatment: every 3 months for the first year, then every 6 months until relapse or until 6 years after registration
Lasso di tempo: 6 years

both arms

6 years
• Progression free survival (PFS), defined as time from registration to the first occurrence of disease progression or death from any cause, whichever occurs first.
Lasso di tempo: 6 years

both arms

6 years
Overall survival (OS), defined as the time from registration to death from any cause.
Lasso di tempo: 6 years

both arms

6 years
Best overall response rate (ORR) defined as the proportion of patients with a complete response (CR), complete response with incomplete marrow recovery (CRi), or partial response (PR) according to IWCLL 2018 criteria.
Lasso di tempo: 6 years

both arms

6 years
• Event free survival (EFS), defined as time from randomization to date start of next CLL treatment, progression or death, whichever comes first.
Lasso di tempo: 6 years

both arms

6 years
• Time to next CLL treatment (TTNT), defined as time from randomization to next new line of treatment.
Lasso di tempo: 6 years

both arms

6 years
• Treatment free survival (TFS), defined as time from date of last protocol treatment to date start of next (new) line of treatment, or death from any cause, whichever comes first.
Lasso di tempo: 6 years

both arms

6 years
Duration of response (DOR), defined as time from first response (i.e., ≥PR and CR) to PD or death from any cause.
Lasso di tempo: 6 years

both arms

6 years
• Depth (level) of minimal residual disease (MRD) measured in BM after cycle 9 and 12 weeks after cycle 26.
Lasso di tempo: 29 months

both arms

29 months
• Depth (level) of minimal residual disease measured in PB at cycle 4, 6, 9, 12, 15, 18, 21, 24, 12 weeks after cycle 26 and thereafter every 3 months for the first year, then every 6 months until relapse or until 6 years after registration
Lasso di tempo: 6 years

both arms

6 years
Safety parameters: Type, frequency, and severity of- adverse events (AEs) and- adverse events of special interest (AESI) and their relationship to study treatment (determined according to CTCAE v5.0).
Lasso di tempo: 6 years

both arms

6 years
Health-related quality of life (QoL) by EORTC QLQ-C30 questionnaires.
Lasso di tempo: 6 years

both arms

6 years
Health-related quality of life (QoL) by QLQ-CLL17 questionnaires.
Lasso di tempo: 6 years

both arms

6 years
Health-related quality of life (QoL) by PRO-CTCAE questionnaires.
Lasso di tempo: 6 years

both arms

6 years

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

15 aprile 2024

Completamento primario (Stimato)

1 marzo 2029

Completamento dello studio (Stimato)

1 dicembre 2032

Date di iscrizione allo studio

Primo inviato

1 febbraio 2023

Primo inviato che soddisfa i criteri di controllo qualità

28 marzo 2023

Primo Inserito (Effettivo)

30 marzo 2023

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

5 ottobre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • HO165 CLL

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

INDECISO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .