Mayo Clinic, Rochester, MN
Jose Caetano Villasboas , Laura Magnano Mayer , Benoît Tessoulin , Seok-Goo Cho , Michal Taszner , Silvana Novelli , Stefano Luminari , Michele Merli , Ana Jiménez Ubieto , Michelle Poon , David Tucker , Jan Andrzej Walewski , Cristina Ivanescu , Aafia Chaudhry , Hesham Mohamed , Srikanth R. Ambati , James Harnett , Siddhesh Kamat , Tae Min Kim
Background: In ELM-2 (NCT03888105), a Ph 2, single arm, open label trial, odronextamab demonstrated robust efficacy, generally manageable safety, and overall maintenance of patient-reported outcomes (PROs) in R/R FL pts (Villasboas et al. ASH 2023). In FL, pts with disease progression within 2 yrs of frontline chemoimmunotherapy (POD24) are hard to treat with poor clinical outcomes, representing an unmet need. We report PROs by POD24 status in pts with Grade 1–3a R/R FL from ELM-2. Methods: Pts received IV odronextamab in 21-day cycles (C): 80 mg QW in C1–4, with C1 dose step up to mitigate cytokine release syndrome, then 160 mg Q2W (Q4W if complete response ≥9 mo) until progression. PROs were collected at baseline (BL), Wks 2–4, 10, then Q8W in Yr 1, and Q12W in Yr 2. Post-hoc POD24 subgroup analyses were performed on six EORTC QLQ-C30 scales, the EQ-5D-3L VAS, and FACT-Lym LymS. Estimated mean change from BL (CFB) was analyzed using mixed models for repeated measures (MMRM) through Wk 42 (≥10 pts at last assessment). Published meaningful CFB thresholds were used to define deterioration/improvement in responder analyses. Results: By Jan 31, 2023, 140 pts with R/R FL had received odronextamab. Pts with POD24 (n=70) were younger than pts without POD24 (n=70; median age 57.5 vs 62.0 y), had fewer prior Tx lines (median 2 vs 3), and a higher proportion double refractory to anti-CD20 Ab + alkylator (53% vs 29%). Objective response rate was similar in evaluable pts with (n=63; 79%) and without (n=65; 80%) POD24. PRO questionnaire completion ranged from 52–95% through Wk 42 across groups. Descriptive analyses suggest BL PRO scores were similar by POD24 status, showing good HRQoL/functioning and low symptom burden, and were generally maintained through Wk 42 with minimal between-group differences (overlapping 95% CIs for LS mean CFB [Table]). In both groups, more pts reported PRO maintenance or improvement vs deterioration across visits, except for fatigue at Wk 10 in pts without POD24. Conclusions: In pts with heavily pretreated R/R FL, odronextamab Tx maintained HRQoL, functioning, and symptoms irrespective of POD24 status. Clinical trial information: NCT03888105.
Overall CFB to Wk 42 in PROs by POD24 Status (MMRM). | ||
---|---|---|
LS Mean CFB [95% CI] | ||
POD24 n=70 | No POD24 n=70 | |
EORTC QLQ-C30 | ||
Global health status/QoL* | 0.08 [-2.69, 2.84] | 1.62 [-1.10, 4.35] |
Physical functioning* | -1.12 [-4.28, 2.05] | -1.00 [-3.93, 1.92] |
Role functioning* | 1.17 [-3.38, 5.72] | -4.45 [-9.34, 0.44] |
Fatigue† | -0.76 [-4.30, 2.79] | 4.34 [0.22, 8.47] |
Pain† | -3.05 [-7.84; 1.74] | 3.06 [-2.13, 8.25] |
Appetite loss† | -5.50 [-8.70, -2.30] | 3.95 [-0.09, 7.99] |
EQ-5D-3L VAS* | 3.97 [1.28, 6.65] | 0.78 [-2.41, 3.97] |
FACT-Lym LymS* | 2.63 [1.27, 3.98] | 0.87 [-0.39, 2.13] |
Minimal important difference thresholds: EORTC QLQ-C30 = 10; FACT-Lym LymS = 2.9–5.4; EQ-5D-3L VAS = 7–12
*Negative score: deterioration; †Negative score: improvement.
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