A Study Evaluating the Safety, Efficacy, and Pharmacokinetics of Mosunetuzumab and a Combined Regimen of Mosunetuzumab and Venetoclax in Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia

Phase
Recruitment status
Participants
Lead sponsor
Hoffmann-La Roche
Start date
Number of sites

Summary
This study will assess the safety, tolerability, pharmaokinetics, and preliminary efficacy of mosunetuzumab (Lunsumio) monotherapy in participants with relapsed or refractory (R/R) chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). This study will also allow participants who are currently progressing on a Bruton tyrosine kinase inhibitor (BTKi) and requiring salvage therapy as assessed by the treating physician to continue their BTKi throughout the screening period and for the first three cycles of mosunetuzumab. An additional arm (open to non-US participants only) has been added to assess the safety, tolerability, pharmacokinetics, and preliminary efficacy of mosunetuzumab in combination with venetoclax, a B-cell lymphoma 2 (BCL2) inhibitor.
Short title
A Study Evaluating the Safety, Efficacy, and Pharmacokinetics of Mosunetuzumab and a Combined Regimen of Mosunetuzumab and Venetoclax in Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia
Official title
A Phase IB Open-Label, Multicenter Study Evaluating the Safety, Efficacy, and Pharmacokinetics of Mosunetuzumab and a Combined Regimen of Mosunetuzumab and Venetoclax in Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia

Control arm
Registry reports results
Listing at source
Recruitment status
Phase
Study type
Interventional

Completion date
First posted
Registry last updated
Primary completion date
Start date

Participants
Participant count basis
Planned participants
Protocol amendments
Number of sites

Data monitoring committee
Registry sponsor category
Lead sponsor
Hoffmann-La Roche
Source registry
ClinicalTrials.gov

Registry ID
ClinicalTrials.gov ID
Registry record
Open registry record

Allocation
Randomised
Model
Parallel groups
Purpose
Treatment
Masking
No masking
Sources for study design

  1. Rate of Dose-Limiting Toxicities (DLTs)

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  2. Objective Response Rate (ORR) During Dose Expansion Phase

    Timeframe: Up to 8-12 weeks after the last dose of study drug

  1. Objective Response Rate (ORR) During Dose Escalation Phase

    Timeframe: Up to 8-12 weeks after the last dose of study drug

  2. Progression-Free Survival (PFS)

    Timeframe: From the first study treatment to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 12 months (Arms A and B) or 24 months (Arm C))

  3. Overall Survival (OS)

    Timeframe: From the first dose of study drug to death from any cause (up to approximately 12 months (Arms A and B) or 24 months (Arm C))

  4. Event-Free Survival (EFS)

    Timeframe: Between the date of the first study treatment to the date of disease progression/relapse, death, or start of new anti-leukemic therapy, whichever occurs first (up to approximately 12 months (Arms A and B) or 24 months (Arm C))

  5. Complete Response (CR) Rate

    Timeframe: Up to 8-12 weeks after the last dose of study drug

  6. Duration of Response (DOR)

    Timeframe: From the first occurrence of a documented objective response to disease progression by iwCLL 2018 criteria or death from any cause (up to approximately 12 months (Arms A and B) or 24 months (Arm C))

  7. Duration of Complete Response (DOCR)

    Timeframe: From the first occurrence of a documented complete response to disease progression by iwCLL 2018 criteria or death from any cause (up to approximately 12 months (Arms A and B) or 24 months (Arm C))

  8. Percentage of Participants with Adverse Events (AEs)

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  9. Maximum Serum Concentration (Cmax) of Mosunetuzumab SC

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  10. Minimum Serum Concentration (Cmin) of Mosunetuzumab SC

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  11. Time to Maximum Concentration (Tmax) of Mosunetuzumab SC

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  12. Maximum Serum Concentration (Cmax) of BTKi or Venetoclax

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  13. Minimum Serum Concentration (Cmin) of BTKi or Venetoclax

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  14. Time to Maximum Concentration (Tmax) of BTKi or Venetoclax

    Timeframe: Up to approximately 12 months (Arms A and B) or 24 months (Arm C)

  15. Incidence of Anti-Drug Antibodies (ADAs)

    Timeframe: Baseline through end of study (up to approximately 12 months for Arms A and B, or 24 months for Arm C)

Sources for outcomes

Sex
All
Age groups
Adults, Older adults
Minimum age
18 Years
Healthy volunteers
No

  • Have a diagnosis of CLL requiring treatment according to the International Workshop on CLL (iwCLL) criteria (Hallek et al 2018)
  • Eastern Cooperative Oncology Group (ECOG) performance score (PS) of ≤ 2
  • Adequate bone marrow (BM) function independent of growth factor or transfusion support, within 2 weeks of screening, at screening as defined by the protocol unless cytopenia is clearly due to marrow involvement of CLL
  • Adequate liver function unless directly attributable to the participant's CLL
  • Life expectancy > 6 months
  • For women of childbearing potential: 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)
  • For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agreement to refrain from donating sperm as defined by the protocol

Inclusion Criteria Specific to Arm B:

  • Participants must have been taking a BTKi for at least 12 months, have demonstrated evidence of progressive disease while receiving the BTKi and require additional salvage therapy as assessed by their treating physician. Participants should be able to continue their previously prescribed BTKi at a stable dose throughout the study screening period and for up to three cycles of mosunetuzumab administration

Inclusion Criteria Specific to Arm C:

  • Non-US participants only

  • Pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of mosunetuzumab and tocilizumab or within 30 days after the final dose of venetoclax (if applicable)
  • Participants who have received any of the following treatments prior to study entry: treatment with mosunetuzumab or other CD20/CD3-directed bispecific antibodies; allogenic stem cell transplant
  • Participants who have received any of the following treatments, whether investigational or approved, within the respective time periods prior to initiation of study treatment: radiotherapy within 2 weeks prior to the first dose of study treatment; autologous stem cell transplant within 100 days prior to first study treatment; CAR T-cell therapy within 30 days before first study treatment; prior use of any monoclonal antibodies, radioimmunoconjugates, or antibody-drug conjugates for anti-CLL treatment within 4 weeks before first dose of study treatment; systemic immunosuppressive medications (including but not limited to cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor agents) within 2 weeks prior to the first dose of study treatment; any other anti-cancer therapy, whether investigational or approved, including but not limited to chemotherapy within 4 weeks prior to initiation of study treatment (except for participants enrolled in Arm B, where overlapping therapy is permitted; other prior cancer immunotherapy not explicitly defined by the protocol is to be discussed with the medical monitor to determine eligibility
  • Received a live, attenuated vaccine within 4 weeks before the first dose of study treatment, or in whom it is anticipated that such a vaccine will be required during the study period or within 5 months after the final dose of study treatment
  • Transformation of CLL to aggressive non-Hodgkin's lymphoma (NHL)
  • History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibody therapy (or recombinant antibody-related fusion proteins)
  • Contraindication to tocilizumab
  • History of prior malignancy except for conditions defined by the protocol
  • Participants with infections requiring intravenous (IV) treatment with antibiotics or hospitalization 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
  • Evidence of any significant concomitant disease that could affect compliance with the protocol or interpretation of results
  • 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)
  • Positive SARS-CoV-2 test within 7 days prior to enrollment

Exclusion Criteria Specific to Arm C:

  • Have received venetoclax therapy within 12 months prior to first study treatment administration
  • Participants with known infection with HIV or human T-cell leukemia virus 1 (HTLV1)
  • HIV testing will be performed in countries where mandatory testing by health authorities is required
  • HTLV testing is required in participants from endemic countries
  • Participants with uncontrolled autoimmune hemolytic anemia or immune thrombocytopenia
  • Participants who have received the following: strong and moderate CYP3A inhibitors within 7 days prior to the initiation of study treatment; strong and moderate CYP3A inducers within 7 days prior to the initiation of study treatment; steroid therapy for anti-neoplastic intent with the exception of inhaled steroids for asthma, topical steroids, or replacement/stress corticosteroids within 7 days prior to the first dose of study drug administration
  • Have consumed grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges), or star fruit within 3 days prior to the first dose of study drug and throughout venetoclax administration
  • Inability to swallow a large number of tablets
  • Malabsorption syndrome or other condition that precludes enteral route of administration
  • Known allergy to both xanthine oxidase inhibitors and rasburicase
Sources for eligibility

  • Mayo Clinic RochesterRochester, United StatesRecruiting
  • Memorial Sloan-Kettering Cancer CenterNew York, United StatesWithdrawn
  • The James Cancer Hospital and Solove Research InstituteColumbus, United StatesRecruiting
  • Uni of Texas - Md Anderson Cancer CenterHouston, United StatesWithdrawn
  • Huntsman Cancer Institute at The University of UtahSalt Lake City, United StatesRecruiting
  • Princess Alexandra Hospital WoolloongabbaWoolloongabba, AustraliaRecruiting
  • Peter MacCallum Cancer CenterEast Melbourne, AustraliaCompleted
  • Monash Medical CentreMelbourne, AustraliaRecruiting
  • Peking University People's HospitalBeijing, ChinaRecruiting
  • Southern Medical University Nanfang HospitalGuangzhou, ChinaRecruiting
  • The First Affiliated Hospital of Nanchang UniversityNanchang, ChinaRecruiting
  • Tianjin Institute of Hematology & Blood Diseases HospitalTianjin, ChinaRecruiting
  • Chu de Clermont FerrandClermont-Ferrand, FranceWithdrawn
  • IUCT OncopoleToulouse, FranceWithdrawn
  • Universitätsklinikum AugsburgAugsburg, GermanyRecruiting
  • Uniklinik KolnCologne, GermanyWithdrawn
  • Universitätsklinikum UlmUlm, GermanyWithdrawn
  • A.O. Spedali Civili Di Brescia-P.O. Spedali CiviliBrescia, ItalyRecruiting
  • Osp. San RaffaeleMilan, ItalyRecruiting
  • Asst Grande Ospedale Metropolitano NiguardaMilan, ItalyRecruiting
  • Azienda Ospedaliera Di Perugia Ospedale s. Maria Della MisericordiaSant'Andrea Delle Fratte (PG), ItalyRecruiting
  • Uniwersyteckie Centrum KliniczneGda?sk, PolandRecruiting
  • PRATIA MCM KrakówKrakow, PolandRecruiting
  • Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we WroclawiuWroc?aw, PolandRecruiting
  • Seoul National University HospitalSeoul, South KoreaRecruiting

And 6 more, listed on the interactive page.

Sources for sites

Sources for references

Related records

Drugs (4)

Lead sponsors (1)

Targets (6)