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Non-Hodgkin's LymphomaPhase 1NCT02961881

A Phase 1b Open-Label Study Investigating the Safety and Pharmacokinetics of Administration of Subcutaneous Blinatumomab for the Treatment of Relapsed/Refractory Indolent Non-Hodgkin's Lymphoma

A Phase 1 study testing blinatumomab in people with Non-Hodgkin's Lymphoma, run by Amgen at 17 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Primary Objective: To evaluate the safety and tolerability of subcutaneous (SC) blinatumomab dose administrations Secondary Objectives: To determine pharmacokinetics (PK) with continuous intravenous (cIV) and SC administrations To estimate the maximum tolerated dose (MTD) tested for blinatumomab administered… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-Hodgkin's Lymphoma
What is being tested?
blinatumomab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
17 sitesin 6 countries
Study dates
18 Sep 2017to 2 Sep 2021
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject or subject's legally acceptable representative has provided informed consent.
  • Age greater than or equal to 18 years old at the time of informed consent
  • Subjects must have a histologically determined B cell NHL subtype as defined in the bullets below.
  • In addition, they must have disease that is primary refractory after initial therapy or have relapsed disease.
  • Follicular Lymphoma I, II, IIIA
  • Marginal zone lymphoma (extranodal, nodal or splenic). Subjects with gastric mucosa-
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  • associated lymphoid tissue must have progressed after Helicobacter pylori therapy and
  • radiation. Subjects with splenic marginal zone lymphoma must have prior splenectomy.
  • Lymphoplasmocytic lymphoma
  • Mantle cell lymphoma ([MCL] with the exception of aggressive MCL, defined as Ki67 > 30%,
  • or blastoid histology)
  • Small lymphocytic lymphoma
  • Subjects without standard therapy alternatives, or contraindicated for standard therapy by investigator, or subjects unwilling to receive standard therapy. Disease status must be 1 of the following:
  • Primary refractory (at least 1 prior line of therapy)
  • Relapsed within 1 year of first response
  • Responded to initial therapy for ≥ 1 year and relapsed after 2 or more lines of therapy, including an anti-CD20 monoclonal antibody
  • Measurable disease that has not been previously irradiated on positron emission tomography- computed tomography (PET-CT), or computed tomography (CT), of at least 1.5 cm within the last 21 days before the start of IP treatment.
  • Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2
  • Life expectancy greater than or equal to 3 months as determined by treating physician.
  • Subjects must have adequate organ and marrow at screening as defined below:
  • peripheral neutrophils >500/µL prior to start of treatment
  • hemoglobin ≥8 g/dL
  • Platelets greater than or equal to 50,000 mcL
  • aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) < 5 × upper limit of normal (ULN
  • Total bilirubin less than or equal to 1.5 x upper limit of normal (ULN)
  • Creatinine clearance greater than or equal to 50 mL/min (Cockcroft-Gault)

Who cannot join

  • Currently receiving treatment in another investigational device or drug study, or less than 30 days between ending treatment on another investigational device or drug study(ies) and start of IP treatment. Other investigational procedures while participating in this study are excluded.
  • Known hypersensitivity to immunoglobulins or any other component of the study drug
  • Subject likely to not be available to complete all protocol required study visits or procedures to the best of the subject and investigator's knowledge
  • History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to subject safety or interfere with the study evaluation procedures or completion.
  • Subjects who have had treatments with anti-cancer agents including rituximab or obinutuzumab and/or other monoclonal antibody or radioimmunotherapy within 6 weeks before the starting IP treatment.
  • Autologous stem cell transplantation within 12 weeks before the starting IP treatment or past history of allogeneic stem cell transplantation.
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  • Subjects who have received anti-CD 19 targeted therapies, chimeric antigen receptor T-cell or other cellular therapies for the treatment of their lymphoma .
  • Subjects with suspected or known brain metastases should be excluded from this clinical study because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • Infection with human immunodeficiency virus (HIV) or chronic infection with hepatitis B virus or hepatitis C virus.
  • History of or current relevant central nervous system pathology such as epilepsy, recurrent seizures, paresis, aphasia, apoplexia, severe brain injuries, cerebellar disease, organic brain syndrome or psychosis.
  • History of malignancy other than their lymphoma with the exception of:
  • Malignancy treated with curative intent and with no known active disease present for ≥ 3 years before enrollment and felt to be at low risk for recurrence by the treating physician.
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
  • Adequately treated cervical carcinoma in situ without evidence of disease.
  • Adequately treated breast ductal carcinoma in situ without evidence of disease
  • Prostatic intraepithelial neoplasia without evidence of prostate cancer.
  • Adequately treated urothelial papillary noninvasive carcinoma or carcinoma in situ.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or uncontrolled systemic fungal bacteria, viral, or other infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • A female who is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 48 hours (Period 1) or 96 hours (Period 2), respectively, after the last dose of blinatumomab (Female subjects of childbearing potential should only be included in the study after a confirmed menstrual period and a negative highly sensitive urine or serum pregnancy test).
  • A female of childbearing potential unwilling to use highly effective method of contraception during treatment and for an additional 48 hours (Period 1) or 96 hours (Period 2), respectively, after the last dose of blinatumomab.

Trial locations and contacts

17 sites in 6 countries.

17 sites in 6 countries

Italy5 sites
  • Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII

    Bergamo, 24127

  • Azienda Ospedaliera Universitaria di Bologna Policlinico S Orsola Malpighi

    Bologna, 40138

  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

    Brescia, 25123

  • IRCCS Ospedale San Raffaele

    Milan, 20132

  • IRCCS Istituto Clinico Humanitas

    Rozzano MI, 20089

Other trials in Italy

United States3 sites
  • Rush University Medical Center

    Chicago, Illinois, 60612

  • City of Hope National Medical Center

    Duarte, California, 91010

  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

Other trials in United States

Australia3 sites
  • Concord Repatriation General Hospital

    Concord, New South Wales, 2139

  • Epworth Healthcare

    East Melbourne, Victoria, 3002

  • St Vincents Hospital Melbourne

    Fitzroy, Victoria, 3065

Other trials in Australia

Germany3 sites
  • Universitaetsklinikum Carl Gustav Carus

    Dresden, 01307

  • Universitätsklinikum Frankfurt/Main

    Frankfurt am Main, 60590

  • Universitatsklinikum Ulm

    Ulm, 89081

Other trials in Germany

France2 sites
  • Hopital Henri Mondor

    Créteil Cedex, 94010

  • Hopital Saint Louis

    Paris, 75475

Other trials in France

United Kingdom1 site
  • Leicester Royal Infirmary

    Leicester, LE1 5WW

Other trials in United Kingdom

About this study

Primary Objective:

  • To evaluate the safety and tolerability of subcutaneous (SC) blinatumomab dose administrations
Read more

Secondary Objectives:

  • To determine pharmacokinetics (PK) with continuous intravenous (cIV) and SC administrations
  • To estimate the maximum tolerated dose (MTD) tested for blinatumomab administered subcutaneously
  • To determine the incidence of anti-blinatumomab antibody formation following SC administration
  • To evaluate efficacy response following treatment with SC blinatumomab administration

Exploratory Objective:

  • To determine the pharmacodynamics (PD) time profiles for B-and T-lymphocytes as well as cytokine profiles during SC administration
  • To evaluate efficacy response following treatment with SC blinatumomab administration using Lugano criteria if positron emission tomography-computed tomography (PET/CT) is used for evaluation
Being tested
blinatumomab
Medical subject headings
Lymphoma, Non-Hodgkin

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • blinatumomabDrug

    Blinatumomab used as both continuous IV infusion and subcutaneous injection

Study groups in NCT02961881
Study groupRoleWhat they receive
blinatumomabExperimentalNot described
Receives: Drug: blinatumomab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Dose Limiting-Toxicities (DLTs) After SC Administration

    The occurrence of any of the following toxicities during the DLT evaluation period was considered a DLT, if judged by the investigator to be related to the administration of blinatumomab:

    • Death
    • Any toxicity, regardless of grade, that lead to a participant's removal from the study by the investigator and/or sponsor
    • Persistent Common Terminology Criteria for Adverse Events (CTCAE) grade >/= 2 non-hematologic adverse events (AEs) that were deemed intolerable by the participant or the treating physician and that did not respond to appropriate medical management within 5 days and lead to treatment discontinuation
    • Recurrent grade 2 seizures
    • All grade 3 and 4 AEs and laboratory abnormalities, which occurred during the SC administration portion of the treatment period with exceptions noted in protocol section 6.2.1.2.3.

    Measured: Day 1 to Day 7 of Week 4

  2. Number of Participants With DLTs CTCAE Grade ≥ 3 After SC Administration

    All toxicities were graded using the CTCAE version 4.0: Grade 1 = mild; Grade 2 = moderate; Grade 3 = severe; Grade 4 = life-threatening; Grade 5 = fatal.

    Measured: Day 1 to Day 7 of Week 4

  3. Number of Participants With Treatment-emergent Adverse Events (TEAEs) After SC Administration

    An AE was defined as any untoward medical occurrence in a clinical study participant. The AE did not necessarily have a causal relationship with study treatment. The definition of AEs included worsening of a pre-existing medical condition.

    TEAEs included AEs starting on or after first dose of investigational product and up to the end of study date. All AEs were graded using the CTCAE version 4.0: Grade 1 = mild; Grade 2 = moderate; Grade 3 = severe; Grade 4 = life-threatening; Grade 5 = fatal.

    Measured: Day 1 to end of study (approximately 17 weeks)

Secondary outcomes (14)
  1. Steady State Serum Concentration (Css) of Blinatumomab After cIV Administration

    Summarized as the observed concentrations collected after 5 half-lives after the start of the IV infusion of each dose (i.e., 9, 28 and 112 μg/day).

    Measured: Once at any timepoint during Day 2 of Weeks 1, 2, 3, 5 and 6

  2. Systemic Clearance (CL) of Blinatumomab After cIV Administration

    Calculated as CL=R0/Css; where R0 is the infusion rate (μg/hr) and Css is the average Css. Both R0 and Css were dose-normalized to 112 μg/day for this calculation.

    Measured: Once at any timepoint during Day 2 of Weeks 1, 2, 3, 5 and 6

  3. Maximum Observed Concentration (Cmax) of Blinatumomab After SC Administration

    Measured: Week 4 Day 1 (pre-dose and 1, 2, 4, 6, 8 and 12 hours post-dose) and Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  4. Time at Which Cmax (Tmax) Occurred of Blinatumomab After SC Administration

    Measured: Week 4 Day 1 (pre-dose and 1, 2, 4, 6, 8 and 12 hours post-dose) and Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  5. Area Under the Concentration-time Curve (AUC) of Blinatumomab After SC Administration for a Dosing Interval t (AUCt)

    Estimated using the linear trapezoidal method; where t is a dosing interval. AUC over the dosing interval, t where t is 12 hours for Cohorts 1 and 2, 24 hours for Cohorts 3 and 4, and 48 hours for Cohort 5.

    Measured: Week 4 Day 1 (pre-dose and 1, 2, 4, 6, 8 and 12 hours post-dose) and Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  6. Minimum Observed Concentration (Cmin) of Blinatumomab After SC Administration

    Measured: Week 4 Day 1 (pre-dose and 1, 2, 4, 6, 8 and 12 hours post-dose) and Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  7. Apparent Clearance (CL/F) of Blinatumomab After SC Administration

    Calculated as CL/F = Dose sc / AUCt-ss (at steady state).

    Measured: Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  8. Volume of Distribution Based on Terminal Phase (Vz/F) of Blinatumomab After SC Administration

    Calculated as Vz/F=CL/F / λz, where λz was the first-order rate constant estimated via linear regression of the terminal log-linear decay phase as determined from the noncompartmental analysis.

    Measured: Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  9. Terminal Half-life (t1/2,z) of Blinatumomab After SC Administration

    Calculated as t1/2,z = ln(2) / λz.

    Measured: Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  10. Accumulation Ratio of Blinatumomab After SC Administration

    Calculated as the ratio of AUCt (last SC dose; Week 4 Day 5) / AUC (first SC dose; Week 4 Day 1).

    Measured: Week 4 Day 1 (pre-dose and 1, 2, 4, 6, 8 and 12 hours post-dose) and Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  11. Bioavailability (F) of SC Blinatumomab

    Calculated as F = (CL * AUCt-ss) / Dose sc.

    Measured: Week 4 Day 5 (pre-dose and 1, 2, 4, 6, 8, 12, 24 and 48 hours post-dose)

  12. Maximum Tolerated Dose (MTD) of SC Blinatumomab

    The MTD was defined as the highest dose level at which </= 1 of 6 participants experienced a DLT.

    Measured: Day 1 to Day 7 of Week 4

  13. Number of Participants With Anti-blinatumomab Antibody Formation After SC Administration

    Measured: Predose at the re-start of cIV infusion (Week 5 Day 1)

  14. Overall Response Rate (ORR) After SC Administration

    Percentage of participants achieving ORR (complete response [CR] + partial response [PR]) was determined by best overall response using Cheson criteria:

    • CR: disappearance of all evidence of disease.
    • PR: regression of measurable disease and no new sites.

    The 95% confidence interval (CI) was calculated using Clopper-Pearson exact CI. Participants were considered as non-responders if there was no response assessment available.

    Measured: Day 1 to end of study (approximately 17 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Nov 2016 (estimated)
  2. Study start18 Sep 2017
  3. Primary completion2 Sep 2021
  4. Study completion2 Sep 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02961881
Sponsor's protocol ID
20140286
Other IDs
2016-002034-76, 2016
Status last verified
May 2023
First submitted
6 Sep 2016
Last updated
2 Feb 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request.

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing blinatumomab in people with Non-Hodgkin's Lymphoma, run by Amgen at 17 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 26 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Italy, United States, Australia, Germany, France and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Feb 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Dose Limiting-Toxicities (DLTs) After SC Administration (time frame: Day 1 to Day 7 of Week 4). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Feb 2024.

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Clinical Trial NCT02961881 | AzTrials