Phase 1b/3 study of avelumab-based combination regimens in patients with relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL).

Authors

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Robert W. Chen

City of Hope Comprehensive Cancer Center, Duarte, CA

Robert W. Chen , Stephen Maxted Ansell , Pier Luigi Zinzani , Jeffrey L. Vacirca , Armando Lopez-Guillermo , Martin Hutchings , Wojciech Jurczak , Georg Hess , Steven Le Gouill , Fritz Offner , Armando Santoro , Gilles A. Salles , Daria Stypinski , Douglas Laird , Dmitri Pavlov , Giovanna Andreola , Kolette D. Fly , Adrian Woolfson , Graham P Collins

Organizations

City of Hope Comprehensive Cancer Center, Duarte, CA, Mayo Clinic, Rochester, MN, Institute of Hematology “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy, North Shore Hematology Oncology Associates, Setauket, NY, Hospital Clínic de Barcelona, Barcelona, Spain, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark, Jagiellonian University, Kraków, Poland, Johannes Gutenberg Universität, Mainz, Germany, CHU Nantes and UMR892 INSERM, Nantes, France, Ghent University Hospital, Gent, Germany, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Italy, Hospices Civils De Lyon, Cancer Research Center of Lyon, Claude Bernard University Lyon, Lyon, France, Pfizer Inc., San Diego, CA, Pfizer Inc., New York, NY, Pfizer Inc., Milan, Italy, Pfizer Inc., Groton, CT, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Approximately 50% of patients (pts) with advanced DLBCL are refractory to or relapse following first line R-CHOP therapy. Pts with R/R DLBCL have limited treatment options and a poor prognosis. This study assesses immunotherapy-based regimens containing avelumab (a fully human IgG1 anti–PD-L1 antibody) in combination with utomilumab (a novel 4-1BB agonist), azacitidine, rituximab, and/or conventional chemotherapy (CT; bendamustine) in pts with R/R DLBCL. Methods: JAVELIN DLBCL (NCT02951156) is a global, multicenter, randomized, open-label, 2-component(phase 1b followed by phase 3) study of avelumab-based combination regimens in R/R DLBCL. In phase 1b, up to 84 pts will be randomized 1:1:1 to receive avelumab/rituximab/utomilumab, or avelumab/azacitidine/utomilumab, or avelumab/rituximab/bendamustine. The primary phase 1b objectives are preliminary assessments of dose-limiting toxicities (n = 6 per arm) and efficacy (objective response [OR]; n = 28 per arm). One regimen from phase 1b will be selected for phase 3 evaluation in 220 additional pts randomized 1:1 to the chosen regimen or investigator’s choice CT (rituximab/bendamustine or rituximab/gemcitabine/oxaliplatin). The primary phase 3 objective is to demonstrate progression-free survival (PFS) superiority of the avelumab-based regimen over CT. Overall survival is a key secondary endpoint. Eligible pts have completed up to 4 lines of prior rituximab/multiagent CT, and/or have failed autologous stem cell transplantation (ASCT), or are not eligible for intensive CT or ASCT. Other eligibility criteria include ECOG PS ≤1 and no prior therapy with a checkpoint inhibitor. Treatment with avelumab, utomilumab, and azacitidine will be continued until the pt no longer receives clinical benefit; rituximab and bendamustine are limited to 8 and 6 cycles, respectively. OR and PFS will be assessed per Lugano disease classification criteria. Other secondary efficacy endpoints include disease control, duration of response, time to response, and minimal residual disease burden. Safety, PK, immunogenicity, pt-reported outcomes, and biomarkers will also be evaluated. Clinical trial information: NCT02951156

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Sub Track

Non-Hodgkin Lymphoma

Clinical Trial Registration Number

NCT02951156

Citation

J Clin Oncol 35, 2017 (suppl; abstr TPS7575)

DOI

10.1200/JCO.2017.35.15_suppl.TPS7575

Abstract #

TPS7575

Poster Bd #

332b

Abstract Disclosures