Safety and Efficacy Study of Epcoritamab in Subjects With Relapsed/Refractory Chronic Lymphocytic Leukemia and Richter's Syndrome
About the study
The study is a global, multi-center safety and efficacy trial of epcoritamab, an antibody also known as EPKINLY™ and GEN3013 (DuoBody®-CD3xCD20). Epcoritamab will be tested either in
Relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) as:
* Monotherapy, or
* Combination therapy:
* epcoritamab + venetoclax
* epcoritamab + pirtobrutinib
In Non-United States (US) Participants Only: Treatment-naïve (TN) high risk (HR) (CLL):
• epcoritamab + pirtobrutinib
Combination therapy for Richter's Syndrome (RS):
* epcoritamab + lenalidomide
* epcoritamab + R-CHOP (i.e., rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine \[Oncovin®\] and prednisone).
The study includes participants with R/R or TN HR CLL (non-US participants only)/small lymphocytic lymphoma (SLL) and participants with RS.
The trial consists of two parts, a dose-escalation phase (phase Ib) and an expansion phase (phase II). Participants with RS are only included in the expansion phase.
Epcoritamab will be injected subcutaneously (under the skin). Standard-of-care and combination treatments (venetoclax, pirtobrutinib, lenalidomide, and R-CHOP) will be given either orally (by mouth) or intravenously (in a vein).
Study details include:
* Study duration will be up to 5 years after the last participant's first treatment in the trial.
* The treatment duration for each participant will be between 12 months (1 year) and 24 months (2 years), depending upon the treatment arm assigned.
* The visit frequency will be either weekly, every other week, or monthly, depending upon the part of the study.
All participants will receive active drug; no one will be given placebo.
Who can take part
You may be eligible to participate in the study if you meet the following criteria:
INCLUSION CRITERIA
Key Inclusion Criteria
- Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1 or 2.
- Evidence of CD20 positivity in a sample representative of the disease at Screening.
- Acceptable hematology parameters and organ function based on baseline bloodwork.
- Life expectancy >3 months on standard of care (SOC) for CLL, >3 months for RS.
- For R/R CLL arms - Must have active CLL/SLL disease requiring treatment per iwCLL 2018 criteria.
- For R/R CLL monotherapy arms - Received at least 2 prior lines of systemic anti-neoplastic therapy including a Bruton's tyrosine kinase (BTK) inhibitor or at least 1 prior line of systemic antineoplastic therapy, including treatment with (or intolerance of) a covalent BTK inhibitor (cBTKi) and a B-cell lymphoma 2 (BCL-2) inhibitor.
- For all RS arms - Have tumor biopsy-proven CD20+ Diffuse large B-cell Lymphoma (DLBCL) and a clinical history of CLL/SLL.
- For all RS arms - Must have measurable disease by fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) or magnetic resonance imaging (MRI) scan.
- For all RS arms - Must provide mandatory formalin-fixed, paraffin-embedded (FFPE) tumor biopsy sample.
- For RS - monotherapy arm: Deemed as ineligible for chemoimmunotherapy at investigator's discretion or participant who refuses to receive intensive chemotherapy
- For RS - lenalidomide combination therapy arm
- Deemed as ineligible for chemoimmunotherapy at the investigator's discretion, or participant who refuses to receive intensive chemotherapy.
- Eligible for treatment with lenalidomide.
- Must be willing to use contraception and adhere to the Lenalidomide Pregnancy Risk Minimization Plan
- A woman must agree not to breastfeed a child during treatment and for at least 28 days after discontinuation from study.
- For RS - R-CHOP combination Therapy Arm -
- Eligible for treatment with R-CHOP.
- Females of childbearing potential must use highly effective contraceptive measures while taking R-CHOP and for 12 months after stopping treatment.
- A woman must agree not to breastfeed a child during treatment or until 12 months after last treatment.
- For R/R CLL - venetoclax combination Therapy arm - after receiving at least 1 prior line of systemic antineoplastic therapy.
- Presence of measurable disease.
- Must take prophylaxis for tumor lysis syndrome (TLS).
- For R/R CLL pirtobrutinib combination Therapy arm:
- Must have active CLL/SLL disease requiring treatment per iwCLL 2018 criteria.
- Presence of measurable disease.
- Previous treatment with at least one and a maximum 3 prior lines of therapy including a cBTKi.
- Diagnosis of CLL/SLL that met published iwCLL criteria.
- Non-US Participants Only - Participants with TN HR CLL - Pirtobrutinib Combination Therapy Expansion:
- Diagnosis of CLL/SLL that met published iwCLL criteria 2018.
- Must have active CLL/SLL disease that needs treatment per iwCLL
- Must take prophylaxis for TLS based on their TLS risk evaluation upon initiation of trial drug.
- Must have one or more high-risk features.
- Presence of measurable disease.
EXCLUSION CRITERIA
Key Exclusion Criteria
- Received prior treatment with a CD3×CD20 bispecific antibody.
- Received any prior allogeneic hematopoietic stem cell transplantation (HSCT) or solid organ transplantation.
- Received chimeric antigen receptor (CAR) T-cell therapy within 100 days or an investigational drug within 4 weeks, prior to first dose of trial drug.
- Autoimmune disease or other diseases that require permanent or high-dose immunosuppressive therapy.
- Received vaccination with live vaccines within 28 days.
- Clinically significant cardiac disease.
- Known current malignancy other than inclusion diagnosis.
- Has had major surgery within 4 weeks.
- Known history of human immunodeficiency virus (HIV).
- For R/R CLL arms - Any history of RS or evidence indicating a potential Richter's transformation.
- For R/R CLL - Venetoclax Combination Therapy arm: received venetoclax within 24 months prior to beginning venetoclax ramp-up for this trial or has progressed on venetoclax treatment.
- For all RS arms - Diagnosis of Richter's syndrome not of the DLBCL subtype such as Hodgkin's lymphoma, prolymphocytic leukemia.
- RS - Lenalidomide Combination Therapy and RS Monotherapy Arms - received more than 2 prior lines of therapy for RS.
- R/R CLL - Pirtobrutinib Combination Therapy Arm - Prior exposure to a non-covalent (reversible) BTK inhibitor or a BTK degrader.
- Pirtobrutinib Combination Therapy Expansion Arms:
- History of bleeding disorders or participants requiring therapeutic anticoagulation with warfarin or another vitamin K antagonist
- Require continuous treatment with or have received strong cytochrome P450 (CYP) 3A inhibitors or strong/moderate CYP3A inducers within 4 to 5 half-lives or 14 days prior to the first dose of pirtobrutinib.
NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.
Study Locations
Enter your ZIP code/Postal code/PIN code to locate study sites near you:
How to Apply
Contact the study center to learn if this study is a good match for you.
Study Details
Contition
Relapsed/Refractory Chronic Lymphocytic Leukemia,Small Lymphocytic Lymphoma,Richter's Syndrome,Treatment-naïve High Risk Chronic Lymphocytic Leukemia
Age
18+
Phase
PHASE1/PHASE2
Participants Needed
424
Est. Completion Date
Aug 31, 2029
Treatment Type
INTERVENTIONAL
Sponsor
Genmab
ClinicalTrials.gov NCT Identifier
NCT04623541
Study Number
GCT3013-03
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