Glofitamab in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) and ≥ 2 prior therapies: Pivotal phase II expansion results.

Authors

null

Michael Dickinson

Peter MacCallum Cancer Centre, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Australia

Michael Dickinson , Carmelo Carlo-Stella , Franck Morschhauser , Emmanuel Bachy , Paolo Corradini , Gloria Iacoboni , Cyrus Khan , Tomasz Wrobel , Fritz Offner , Marek Trneny , Shang-Ju Wu , Guillaume Cartron , Mark Hertzberg , Anna Sureda Balari , David Perez-Callejo , Linda Lundberg , James Relf , Emma Clark , Kathryn Humphrey , Martin Hutchings

Organizations

Peter MacCallum Cancer Centre, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Australia, Humanitas University and IRCCS Humanitas Research Hospital, Milan, Italy, Hôpital Claude Huriez and CHU de Lille, Lille, France, Centre Hospitalier Lyon-Sud, Lyon, France, Università degli Studi di Milano and Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCSS) Istituto Nazionale dei Tumori, Milan, Italy, Vall d´Hebron University Hospital, Barcelona, Spain, Allegheny Health Network, Pittsburgh, PA, Uniwersytet Medyczny we Wrocławiu, Wroclaw, Poland, Universitair Ziekenhuis Gent, Ghent, Belgium, Charles University Hospital, Prague, Czech Republic, National Taiwan University Hospital, Taipei, Taiwan, CHU de Montpellier, Montpellier, France, Prince of Wales Hospital and University of New South Wales, Sydney, NSW, Australia, Institut Català d'Oncologia – Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain, F. Hoffmann-La Roche Ltd., Basel, Switzerland, Roche Products Ltd, Welwyn Garden City, United Kingdom, Rigshospitalet, Copenhagen, Denmark

Research Funding

Other

Background: Glofitamab is a T-cell engaging bispecific antibody (Ab) with a novel 2:1 configuration that confers bivalency for CD20 (B cells) and monovalency for CD3 (T cells). In a Phase I/II study (NCT03075696), escalating glofitamab doses were highly active and well tolerated in pts with R/R B-cell lymphomas, with obinutuzumab pretreatment (Gpt) and Cycle (C) 1 step-up dosing providing effective CRS mitigation. For the first time, we present pivotal Phase II expansion results in pts with R/R DLBCL and ≥2 prior therapies. Methods: All pts had DLBCL (DLBCL NOS, HGBCL, PMBCL, or trFL) and had received ≥2 prior regimens including ≥1 anti-(a) CD20 Ab and ≥1 anthracycline. IV Gpt (1000mg) was given 7 days before the first glofitamab dose. IV glofitamab was then given as step-up doses on Day (D) 1 (2.5mg) and D8 (10mg) of C1 and at the target dose (30mg) on D1 of C2–12 (21-day cycles). The primary endpoint was CR rate (best response during initial treatment) assessed by Independent Review Committee (IRC) using Lugano 2014 criteria. CRS was assessed using ASTCT criteria. Results: As of Sep 14, 2021, 107 pts had received ≥1 dose of study treatment (median age: 66 yrs [21–90]; Ann Arbor stage III–IV disease: 74%; IPI score ≥3: 54%; DLBCL NOS: 74%). Median prior therapies was 3 (2–7); 59% had ≥3 prior therapies and 35% had received prior CAR T-cells (CAR-Ts). Most pts were refractory to a prior aCD20 Ab-containing regimen (85%) and to their most recent regimen (85%). Many were refractory to their initial therapy (59%) and to prior CAR-Ts (32%). After a median follow-up of 9 months (0.1–16), ORR and CR rates by IRC were 50.0% and 35.2%, respectively. CR rates were consistent in pts with and without prior CAR-Ts (32% vs 37%). Median time to CR was 42 days (95% CI: 41–48). The majority of CRs (33/38; 87%) were ongoing at data cut. An estimated 84% of complete responders and 61% of responders remained in response at 9 months. At data cut, the projected 12-month OS rate was 48%, and 92% of complete responders were alive. These results are consistent with earlier Phase I data in 100 pts treated with target glofitamab doses ≥10mg (CR rate: 34%; estimated 20-month CR rate in complete responders: 72%). CRS occurred in 68% of pts, was primarily associated with the initial doses, and was mostly Gr 1 (51%) or Gr 2 (12%); Gr 3 (3%) and Gr 4 (2%) events were uncommon. All but 2 CRS events were resolved at data cut. Glofitamab-related neurologic AEs potentially consistent with ICANS occurred in 3 pts (all Gr 1–2). No glofitamab-related Gr 5 (fatal) AEs occurred. Glofitamab-related AEs leading to discontinuation were uncommon (3 pts, 3%). Conclusions: Fixed-duration glofitamab induces durable complete remissions and has favorable safety in pts with R/R DLBCL and ≥2 prior therapies, including those with prior exposure to CAR-Ts. Glofitamab is a promising new therapy for pts with heavily pretreated and/or highly refractory DLBCL. Clinical trial information: NCT03075696.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Non-Hodgkin Lymphoma

Clinical Trial Registration Number

NCT03075696

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 7500)

DOI

10.1200/JCO.2022.40.16_suppl.7500

Abstract #

7500

Abstract Disclosures