Adult Burkitt LymphomaPhase 2NCT07662928
Epcoritamab in Combination With Dose Adjusted EPOCH-R for High-risk Burkitt Lymphoma (BL), The BEDROCK Study
A Phase 2 study testing Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy in people with Adult Burkitt Lymphoma, run by AIDS Malignancy Consortium at 1 site in United States.
Trial summary
This phase II trial studies how well epcoritamab works in combination with the chemotherapy regimen dose adjusted etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, hydroxydaunorubicin-rituximab (DA-EPOCH-R) in treating patients with high risk Burkitt lymphoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Adult Burkitt Lymphoma
- What is being tested?
- Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 43 participants
- Where
- 1 siteUnited States
- Study dates
- 17 Sep 2026to 30 Apr 2033
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
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
- Histologically and immunophenotypically (via at least a core or ideally, incisional or excisional biopsy) documented BL at the treating institution. All stages of BL are eligible
- High-risk adult BL patients, as defined by:
- Stage I with any ONE of the following:
- A single lesion 10 cm or greater
- Elevated lactate dehydrogenase (LDH)
- Total resection of intra-abdominal disease with an elevated LDH after surgery OR
Show all 42Show fewer
- Stage II or higher
- Either of the above PLUS ANY one of the following additional risk factors:
- Involvement of the bone marrow
- Involvement by the peripheral blood by morphology or flow cytometry
- Presence of leptomeningeal disease
- Age ≥ 40 years
- Lactate dehydrogenase > 3× upper limit of normal (ULN)
- Eastern Cooperative Oncology Group (ECOG) performance status 2-3
- Treatment naive or one prior cycle of chemotherapy whether anthracycline based or not
- If HIV positive and had an opportunistic infection within three months, participant must be recovered and willing to take prophylaxis as clinically indicated
- If HIV positive, any CD4 count is acceptable
- A minimum of two HIV-positive participants will be enrolled in Cohort 1 and a minimum of 10 HIV-positive participants will be enrolled in the randomized cohort. Once 18 HIV-negative participants are enrolled, future enrollment will allow only HIV-positive participants
- Known HIV status. Participants may be HIV positive, with documentation of HIV infection by means of any one of the following:
- Documentation of HIV diagnosis in the medical record by a licensed health care provider
- Documentation of receipt of highly active antiretroviral therapy (HAART) (at least three different medications) by a licensed health care provider (documentation may be a record of a HAART prescription in the participant's medical record, a written prescription in the name of the participant for HAART, or pill bottles for HAART with a label showing the participant's name)
- HIV-1 ribonucleic acid (RNA) detection by a licensed HIV-1 RNA assay demonstrating > 1000 RNA copies/mL
- Any licensed HIV screening antibody and/or HIV antibody/antigen combination assay confirmed by a second licensed HIV assay such as a HIV-1 Western blot confirmation or HIV rapid multispot antibody differentiation assay
- NOTE: A "licensed" assay refers to a United States Food and Drug Administration (FDA)-approved assay, which is required for all Investigational New Drug (IND) studies
- Participants without HIV infection must have evidence of a negative result using any licensed HIV screening antibody assay and/or HIV antibody/antigen combination assay within 12 months before enrollment
- If HIV positive, participant should have concurrent treatment with effective HAART or intend to start HAART shortly after enrollment
- Measurable disease (unless marrow-only disease is present), defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter) as ≥ 15 mm (≥ 1.5cm) by computed tomography (CT) or positron emission tomography (PET) scan or calipers by clinical exam or evaluable by bone marrow. Tumor measurement can be assessed by treating physician. An official radiology reading does not need to be completed prior to enrollment
- Adequate cardiac function defined as an ejection fraction on echocardiogram (ECHO) or multigated acquisition (MUGA) scan that is at or above 45% within six weeks before enrollment
- Age ≥ 18 years
- ECOG performance status ≤ 3. Patients with ECOG 3 must have poor performance status secondary to BL
- Absolute neutrophil count: ≥ 1,000/mcL unless attributed to BL (assessed within 2 weeks of enrollment)
- Platelets: ≥ 100,000/mcL unless attributed to BL (assessed within 2 weeks of enrollment)
- Total bilirubin: ≤ institutional upper limit of normal (ULN) (assessed within 2 weeks of enrollment) unless attributed to Gilbert's on antiretroviral therapy (ART) in which case the direct bilirubin should be < institutional ULN
- Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT)(serum glutamic pyruvate transaminase [SGPT]): ≤ 3 × institutional ULN (assessed within 2 weeks of enrollment), or if attributed to hepatic involvement by BL, the direct bilirubin should be < 2x institutional ULN and the AST(SGOT)/ALT(SGPT): ≤ 5 × institutional ULN
- Creatinine: ≤ institutional ULN OR glomerular filtration rate (GFR): ≥ 50 mL/min/1.73 m^2 (assessed within 2 weeks of enrollment)
- All participants will be required to be screened for hepatitis B. Participants with resolved infection (i.e., participants who are hepatitis B surface antigen negative but positive for antibodies to hepatitis B core antigen and/or antibodies to hepatitis B surface antigen must be screened using real-time polymerase chain reaction (PCR) measurement of hepatitis B virus (HBV) DNA levels. Participants who are hepatitis B core positive or PCR positive must begin suppressive therapy. Participants with hepatitis B or PCR positivity must be followed by a hepatologist for serial testing. EXCEPTION: Participants with serologic findings suggestive of HBV vaccination (hepatitis B core antigen positivity as the only serologic marker) AND a known history of prior HBV vaccination, do not need to be tested for HBV DNA by PCR
- For participants with evidence of chronic HBV infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
- Participants with a history of hepatitis C virus (HCV) infection previously treated and cured are eligible. For participants with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load. Participants incidentally found to have hepatitis C during screening with a measurable HCV viral load are not eligible
- Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
- Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants should be class II or better
- Ability to understand and the willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants
- Women of childbearing potential and men must be willing to use contraception during the study treatment and for four months after the last dose of study drug and agree to inform treating physician immediately of suspected pregnancy
Who cannot join
- Brain or spinal cord parenchymal disease
- Prior cytotoxic chemotherapy or radiotherapy for this lymphoma other than the following:
- Palliative radiation for medical emergencies (like cord compression)
- A maximum of one cycle of combination chemotherapy, including EPOCH or cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like therapy. The start of the previous chemotherapy cycle must occur at least 21 days but no more than four weeks prior to the beginning of therapy under this protocol, and such cycle will count towards the maximum of six cycles under this study (i.e., cycle off study will count as Cycle 1).
- OR
- One prior cycle of limited therapy including cyclophosphamide and/or glucocorticoids to improve performance status or hepatic or renal function impaired due to lymphoma involvement. The start of this therapy may occur up to four weeks prior to the beginning of study treatment under this protocol. Cyclophosphamide administration must have been completed at least 14 days prior to initiation of study treatment. Such treatment will not count towards the maximum of six cycles under this study (i.e., participants will receive six cycles on study)
Show all 23Show fewer
- Participants with refractory HIV disease will not be eligible. Refractory HIV will be defined as prior ART exposure and HIV viral load > 1000 copies/uL and no options for HIV control evaluated by HIV genotyping. Participants with HIV viral load > 1000 copies/uL can be enrolled if additional ART will be initiated
- Any prior exposure to liposomal doxorubicin is allowed as long as the left ventricular ejection fraction (LVEF) is ≥ 45%. It is at the discretion of the investigator if prior exposure to doxorubicin for an unrelated malignancy is acceptable
- Participants with peripheral neuropathy Grade ≥ 3 or neuropathic pain Grade ≥ 2
- Participants with known brain metastases from solid tumors will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events (AEs)
- Participants with Hepatitis C (Hepatitis C antibody positive) with cirrhosis, whether Hepatitis C RNA level is measurable or not
- History of allergic reactions, hypersensitivity, or intolerance attributed to compounds of similar chemical or biologic composition to agents used in the study
- Participants must not have any condition that would make participation in this protocol unduly hazardous
- A pregnancy test must be performed within seven days prior to therapy administration in women of childbearing potential. Pregnant women are excluded from this study because the effects of epcoritamab on the developing human fetus are unknown. Because there is an unknown but potential risk for AEs in nursing infants secondary to treatment of the mother with bispecific antibodies and chemotherapy, breastfeeding should be discontinued prior to treatment initiation and will not be permitted during treatment and for four months after the final treatment dose. Both male and female participants must use effective methods of birth control during the course of the study and for three months after stopping treatment. Participants must also agree to not donate eggs or sperm while taking the study drugs and for three months after stopping
- Unable to provide adequate informed consent in the opinion of the Principal Investigator (PI)
- Major surgery, other than diagnostic surgery, occurring within four weeks prior to study entry. Splenectomy will not be considered an exclusionary major surgery
- Myocardial infarction within six months prior to study entry, New York Heart Association Class II or greater heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities
- Known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in one second (FEV1) is < 50% of predicted normal. Note that FEV1 testing also is required for participants suspected of having COPD and participants must be excluded if FEV1 is < 50% of predicted normal
- Known moderate or severe persistent asthma, or a history of asthma within the last two years, or currently has uncontrolled asthma of any classification. Participants who currently have controlled intermittent asthma or controlled mild persistent asthma are allowed to participate in the study
- Participants who are receiving any other investigational agents
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to epcoritamab, or other agents used in this study
- Participants on cobicistat, indinavir, or ritonavir, or agents that are strong CYP3A4 inhibitors as these increase the toxicity of doxorubicin and vincristine. If on a strong CYP3A4 inhibitor regimen prior to study enrollment, participants must be switched to alternative drugs ideally one week prior to administration of study therapy. Exceptions must be noted on the eligibility form. All concomitant medications must be reviewed by the study chair or co-chair prior to enrollment by email
- Participants with uncontrolled intercurrent illness or any other significant condition(s) that would make participation in this protocol unreasonably hazardous
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
Memorial Sloan Kettering Cancer Center
New York, New York, 10021
Ariela Noy, MD, 464-608-3727, noya@mskcc.org
About this study
Official title: Epcoritamab in Combination With Dose Adjusted R-EPOCH for High Risk Burkitt Lymphoma (BL) (BEDROCK Study)
This phase II trial studies how well epcoritamab works in combination with the chemotherapy regimen dose adjusted etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, hydroxydaunorubicin-rituximab (DA-EPOCH-R) in treating patients with high risk Burkitt lymphoma. Epcoritamab binds to a protein called CD3, which is found on T cells (a type of white blood cell). It also binds to a protein called CD20, which is found on B cells (another type of white blood cell) and some lymphoma cells. This may help the immune system kill cancer cells. Epcoritamab is a type of bispecific T-cell engager. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill cancer cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's DNA and may kill cancer cells. It may also lower the body's immune response. Doxorubicin is in a class of medications called anthracyclines. Doxorubicin damages the cell's DNA and may kill cancer cells. It also blocks a certain enzyme needed for cell division and DNA repair. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Giving epcoritamab in combination with the DA-EPOCH-R regimen may be an effective treatment for patients with high risk Burkitt lymphoma.
Read the detailed description
PRIMARY OBJECTIVES:
- To demonstrate the feasibility of adding epcoritamab to dose adjusted etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, hydroxydaunorubicin-rituximab (DA-EPOCH-R) in the first line treatment of high-risk Burkitt lymphoma (BL) patients with at least one adverse risk factor. (Cohort 1) II. To compare one-year overall survival (OS) of DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 2)
SECONDARY OBJECTIVES:
- To assess response rates and two-year OS. (Cohort 1 and 2) II. To assess one-year progression-free survival (PFS) and event-free survival (EFS) of risk adapted DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 1 and 2) III. To assess the safety profile and tolerability of proposed treatments including tumor lysis syndrome, infection, cytokine release syndrome (CRS), and immune effector cell associated neurotoxicity syndrome (ICANS). (Cohort 1 and 2) IV. To assess overall response rate (ORR) and duration of response (DoR) of DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 1 and 2) V. To assess any influence of human immunodeficiency virus (HIV) including HIV viral load and CD4 counts on the outcomes including toxicities. (Cohort 1 and 2)
EXPLORATORY OBJECTIVES:
- To assess the predictability of circulating tumor deoxyribonucleic acid (ctDNA) to predict outcomes in this setting.
II. To assess the predictability of cell free deoxyribonucleic acid (cfDNA) in the cerebrospinal fluid (CSF) to predict outcomes in this setting.
OUTLINE: Patients are assigned to 1 of 2 cohorts.
COHORT 1: Patients receive epcoritamab subcutaneously (SC) on days 1, 8, and 15 OR days 2, 9, and 16 OR days 3, 10, and 17 OR days 8 and 15 of cycle 1 at the determination of the investigators. Patients then receive epcoritamab SC on days 1, 8, and 15 of each cycle thereafter. Patients also receive DA-EPOCH-R consisting of etoposide, doxorubicin, and vincristine IV over 96 hours on days 1-4, prednisone or equivalent orally (PO) twice daily (BID) on days 1-5, cyclophosphamide IV over 1 hour on day 5, and rituximab IV on day 1 or days 1-2 of each cycle. Cycles repeat every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity. NOTE: Patients who have received one cycle of DA-EPOCH or CHOP-like therapy off study receive only cycles 1-5).
COHORT 2: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive DA-EPOCH-R as in Cohort 1 above.
ARM II: Patients receive epcoritamab and DA-EPOCH-R as in Cohort 1 above.
All patients also undergo multi-gated acquisition scan (MUGA) or echocardiogram (ECHO) during screening, as well as positron emission tomography (PET)/computed tomography (CT), and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and magnetic resonance imaging (MRI) as clinically indicated.
After completion of study treatment, patients are followed every 4 months for 2 years.
- Conditions
- Adult Burkitt Lymphoma
- Being tested
- Biospecimen Collection, Bone Marrow Aspiration, Bone Marrow Biopsy, Computed Tomography, Cyclophosphamide
- Medical subject headings
- Burkitt Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Biospecimen CollectionProcedure or surgery
Also called Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Undergo collection of blood and CSF
Bone Marrow AspirationProcedure or surgery
Undergo bone marrow biopsy/aspiration
Bone Marrow BiopsyProcedure or surgery
Also called Biopsy of Bone Marrow, Biopsy, Bone Marrow
Undergo bone marrow biopsy/aspiration
Computed TomographyProcedure or surgery
Also called CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography
Undergo PET/CT
CyclophosphamideDrug
Also called (-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Asta B 518, B 518
Given IV
DoxorubicinDrug
Also called Adriablastin, Hydroxydaunomycin, Hydroxyl Daunorubicin, Hydroxyldaunorubicin
Given IV
Echocardiography TestProcedure or surgery
Also called EC, Echocardiography
Undergo ECHO
EpcoritamabBiological
Also called Anti-CD20/CD3 Bispecific Antibody GEN3013, DuoBody-CD3xCD20, Epcoritamab-bysp, Epkinly
Given SC
EtoposideDrug
Also called Demethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Lastet, Toposar
Given IV
Magnetic Resonance ImagingProcedure or surgery
Also called Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan
Undergo MRI
Multigated Acquisition ScanProcedure or surgery
Also called Blood Pool Scan, Equilibrium Radionuclide Angiography, Gated Blood Pool Imaging, Gated Heart Pool Scan
Undergo MUGA
Positron Emission TomographyProcedure or surgery
Also called Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure)
Undergo PET/CT
PrednisoneDrug
Also called .delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, Cortancyl
Given PO
RituximabBiological
Also called ABP 798, ABP-798, ABP798, BI 695500
Given IV
VincristineDrug
Also called LCR, Leurocristine, VCR, Vincrystine
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Cohort 1 (epcoritamab, DA-EPOCH-R) | Experimental | Patients receive epcoritamab SC on days 1, 8, and 15 OR days 2, 9, and 16 OR days 3, 10, and 17 OR days 8 and 15 of cycle 1 at the determination of the investigators. Patients then receive epcoritamab SC on days 1, 8, and 15 of each cycle thereafter. Patients also receive DA-EPOCH-R consisting of etoposide, doxorubicin, and vincristine IV over 96 hours on days 1-4, prednisone or equivalent PO BID on days 1-5, cyclophosphamide IV over 1 hour on day 5, and rituximab IV on day 1 or days 1-2 of each cycle. Cycles repeat every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity. NOTE: Patients who have received one cycle of DA-EPOCH or CHOP-like therapy off study receive only cycles 1-5).
Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. Receives: Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspiration; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Drug: Cyclophosphamide; Drug: Doxorubicin; Procedure: Echocardiography Test; Biological: Epcoritamab; Drug: Etoposide; Procedure: Magnetic Resonance Imaging; Procedure: Multigated Acquisition Scan; Procedure: Positron Emission Tomography; Drug: Prednisone; Biological: Rituximab; Drug: Vincristine |
| Cohort 2 Arm I (DA-EPOCH-R) | Active comparator | Patients receive DA-EPOCH-R as in Cohort 1 above.
Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. Receives: Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspiration; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Drug: Cyclophosphamide; Drug: Doxorubicin; Procedure: Echocardiography Test; Drug: Etoposide; Procedure: Magnetic Resonance Imaging; Procedure: Multigated Acquisition Scan; Procedure: Positron Emission Tomography; Drug: Prednisone; Biological: Rituximab; Drug: Vincristine |
| Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) | Experimental | Patients receive epcoritamab and DA-EPOCH-R as in Cohort 1 above.
Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. Receives: Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspiration; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Drug: Cyclophosphamide; Drug: Doxorubicin; Procedure: Echocardiography Test; Biological: Epcoritamab; Drug: Etoposide; Procedure: Magnetic Resonance Imaging; Procedure: Multigated Acquisition Scan; Procedure: Positron Emission Tomography; Drug: Prednisone; Biological: Rituximab; Drug: Vincristine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of participants who complete at least Cycle 3 among 10 participants (Feasibility)
A cycle with at least one dose of epcoritamab 48 mg will be considered complete.
Measured: Up to 3 cycles (one cycles = 21 days)
Overall survival
Kaplan-Meier method will be used to estimate survival rates for pre-specified time points along with 95% confidence intervals (CI).
Measured: From date of study registration and the date of death from any cause, assessed up to 2 years after completion of study treatment
Secondary outcomes (10)
Progression-free survival
Kaplan-Meier method will be used to estimate survival rates for pre-specified time points along with 95% CI.
Measured: From date of study registration and the date of progression or the date of death from any cause, assessed up to 2 years after completion of study treatment
Incidence of dose-limiting toxicities
Will be based on National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Safety analysis will include detailed tabulations of adverse events (AEs) by type, grade, and treatment attribution.
Measured: Up to 6 cycles (one cycles = 21 days)
Incidence of treatment-emergent adverse events
Will be based on NCI CTCAE version 5.0. Safety analysis will include detailed tabulations of AEs by type, grade, and treatment attribution.
Measured: Up to 2 years after completion of study treatment
Overall response rate
Defined as proportion of participants with complete response (CR) or partial response (PR). Responses will be assessed by Lugano criteria. Will be estimated along with corresponding 95% CI using Fisher's exact method.
Measured: Up to 2 years after completion of study treatment
Duration of response
Medians and quartiles will be estimated using Kaplan-Meier method for responders. Swimmer's plot will be used for visualization.
Measured: From the date of documented response (CR or PR) and the date of progression or the date of death from any cause, assessed up to 2 years after completion of study treatment
Incidence and severity of tumor lysis syndrome
Safety analysis will include detailed tabulations of AEs by type, grade, and treatment attribution.
Measured: Up to 2 years after completion of study treatment
Incidence and severity of infection
Safety analysis will include detailed tabulations of AEs by type, grade, and treatment attribution.
Measured: Up to 2 years after completion of study treatment
Incidence and severity of cytokine release syndrome
Will be defined by the 2019 American Society for Transplantation and Cellular Therapy (ASTCT) harmonized system. Safety analysis will include detailed tabulations of AEs by type, grade, and treatment attribution.
Measured: Up to 2 years after completion of study treatment
Incidence and severity of immune effector cell associated neurotoxicity syndrome
Will be defined by the 2019 ASTCT harmonized system. Safety analysis will include detailed tabulations of AEs by type, grade, and treatment attribution.
Measured: Up to 2 years after completion of study treatment
Patterns of HIV viral load and CD4 and CD19 recovery
Descriptive statistics will be used for summarizing endpoints and linear regression, logistic regression, and Cox proportional hazards regression models will be used to examine association between outcome and biomarkers.
Measured: Up to 2 years after completion of study treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jun 2026
- Study start17 Sep 2026 (estimated)
- Primary completion30 May 2031 (estimated)
- Study completion30 Apr 2033 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Adult Burkitt LymphomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Model description
- Feasibility followed by Randomized Phase II
- Masking
- None (open label)
- Enrolment
- 43 participants (estimated)
Sponsor and investigators
- Lead sponsor
- AIDS Malignancy Consortium
- Sponsor type
- Research network
- Responsible party
- Sponsor
- Investigators
- Ariela Noy, Principal investigator, AIDS Malignancy Consortium
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07662928
- Sponsor's protocol ID
- AMC-119
- Other IDs
- NCI-2026-02319, AMC-119, AMC-119, UM1CA121947
- Status last verified
- Oct 2026
- First submitted
- 17 Jun 2026
- Last updated
- 16 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Epcoritamab in Combination With Dose Adjusted R-EPOCH for High Risk Burkitt Lymphoma (BL) (BEDROCK Study)
- ClinicalTrials.gov ID
- NCT07662928
- Acronym / sponsor ID
- AMC-119
- Conditions
- Adult Burkitt Lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 43 participants (estimated)
- Lead sponsor
- AIDS Malignancy ConsortiumResearch network
- Collaborators
- National Cancer Institute (NCI), Memorial Sloan Kettering Cancer Center
- Study start
- 17 Sep 2026 (estimated)
- Primary completion
- 30 May 2031 (estimated)
- Study completion
- 30 Apr 2033 (estimated)
- First posted
- 23 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial studies how well epcoritamab works in combination with the chemotherapy regimen dose adjusted etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, hydroxydaunorubicin-rituximab (DA-EPOCH-R) in treating patients with high risk Burkitt lymphoma. Epcoritamab binds to a protein called CD3, which is found on T cells (a type of white blood cell). It also binds to a protein called CD20, which is found on B cells (another type of white blood cell) and some lymphoma cells. This may help the immune system kill cancer cells. Epcoritamab is a type of bispecific T-cell engager. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill cancer cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's DNA and may kill cancer cells. It may also lower the body's immune response. Doxorubicin is in a class of medications called anthracyclines. Doxorubicin damages the cell's DNA and may kill cancer cells. It also blocks a certain enzyme needed for cell division and DNA repair. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Giving epcoritamab in combination with the DA-EPOCH-R regimen may be an effective treatment for patients with high risk Burkitt lymphoma.
Detailed description
PRIMARY OBJECTIVES:
- To demonstrate the feasibility of adding epcoritamab to dose adjusted etoposide, prednisone, Oncovin (vincristine), cyclophosphamide, hydroxydaunorubicin-rituximab (DA-EPOCH-R) in the first line treatment of high-risk Burkitt lymphoma (BL) patients with at least one adverse risk factor. (Cohort 1) II. To compare one-year overall survival (OS) of DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 2)
SECONDARY OBJECTIVES:
- To assess response rates and two-year OS. (Cohort 1 and 2) II. To assess one-year progression-free survival (PFS) and event-free survival (EFS) of risk adapted DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 1 and 2) III. To assess the safety profile and tolerability of proposed treatments including tumor lysis syndrome, infection, cytokine release syndrome (CRS), and immune effector cell associated neurotoxicity syndrome (ICANS). (Cohort 1 and 2) IV. To assess overall response rate (ORR) and duration of response (DoR) of DA-EPOCH-R with or without epcoritamab in newly diagnosed high-risk BL with at least one additional high-risk feature. (Cohort 1 and 2) V. To assess any influence of human immunodeficiency virus (HIV) including HIV viral load and CD4 counts on the outcomes including toxicities. (Cohort 1 and 2)
EXPLORATORY OBJECTIVES:
- To assess the predictability of circulating tumor deoxyribonucleic acid (ctDNA) to predict outcomes in this setting.
II. To assess the predictability of cell free deoxyribonucleic acid (cfDNA) in the cerebrospinal fluid (CSF) to predict outcomes in this setting.
OUTLINE: Patients are assigned to 1 of 2 cohorts.
COHORT 1: Patients receive epcoritamab subcutaneously (SC) on days 1, 8, and 15 OR days 2, 9, and 16 OR days 3, 10, and 17 OR days 8 and 15 of cycle 1 at the determination of the investigators. Patients then receive epcoritamab SC on days 1, 8, and 15 of each cycle thereafter. Patients also receive DA-EPOCH-R consisting of etoposide, doxorubicin, and vincristine IV over 96 hours on days 1-4, prednisone or equivalent orally (PO) twice daily (BID) on days 1-5, cyclophosphamide IV over 1 hour on day 5, and rituximab IV on day 1 or days 1-2 of each cycle. Cycles repeat every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity. NOTE: Patients who have received one cycle of DA-EPOCH or CHOP-like therapy off study receive only cycles 1-5).
COHORT 2: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive DA-EPOCH-R as in Cohort 1 above.
ARM II: Patients receive epcoritamab and DA-EPOCH-R as in Cohort 1 above.
All patients also undergo multi-gated acquisition scan (MUGA) or echocardiogram (ECHO) during screening, as well as positron emission tomography (PET)/computed tomography (CT), and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and magnetic resonance imaging (MRI) as clinically indicated.
After completion of study treatment, patients are followed every 4 months for 2 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Feasibility followed by Randomized Phase II
| Arm | Type | Receives |
|---|---|---|
| Cohort 1 (epcoritamab, DA-EPOCH-R) | Experimental | Procedure: Biospecimen Collection, Procedure: Bone Marrow Aspiration, Procedure: Bone Marrow Biopsy, Procedure: Computed Tomography, Drug: Cyclophosphamide, Drug: Doxorubicin, Procedure: Echocardiography Test, Biological: Epcoritamab, Drug: Etoposide, Procedure: Magnetic Resonance Imaging, Procedure: Multigated Acquisition Scan, Procedure: Positron Emission Tomography, Drug: Prednisone, Biological: Rituximab, Drug: VincristinePatients receive epcoritamab SC on days 1, 8, and 15 OR days 2, 9, and 16 OR days 3, 10, and 17 OR days 8 and 15 of cycle 1 at the determination of the investigators. Patients then receive epcoritamab SC on days 1, 8, and 15 of each cycle thereafter. Patients also receive DA-EPOCH-R consisting of etoposide, doxorubicin, and vincristine IV over 96 hours on days 1-4, prednisone or equivalent PO BID on days 1-5, cyclophosphamide IV over 1 hour on day 5, and rituximab IV on day 1 or days 1-2 of each cycle. Cycles repeat every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity. NOTE: Patients who have received one cycle of DA-EPOCH or CHOP-like therapy off study receive only cycles 1-5). Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. |
| Cohort 2 Arm I (DA-EPOCH-R) | Active comparator | Procedure: Biospecimen Collection, Procedure: Bone Marrow Aspiration, Procedure: Bone Marrow Biopsy, Procedure: Computed Tomography, Drug: Cyclophosphamide, Drug: Doxorubicin, Procedure: Echocardiography Test, Drug: Etoposide, Procedure: Magnetic Resonance Imaging, Procedure: Multigated Acquisition Scan, Procedure: Positron Emission Tomography, Drug: Prednisone, Biological: Rituximab, Drug: VincristinePatients receive DA-EPOCH-R as in Cohort 1 above. Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. |
| Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) | Experimental | Procedure: Biospecimen Collection, Procedure: Bone Marrow Aspiration, Procedure: Bone Marrow Biopsy, Procedure: Computed Tomography, Drug: Cyclophosphamide, Drug: Doxorubicin, Procedure: Echocardiography Test, Biological: Epcoritamab, Drug: Etoposide, Procedure: Magnetic Resonance Imaging, Procedure: Multigated Acquisition Scan, Procedure: Positron Emission Tomography, Drug: Prednisone, Biological: Rituximab, Drug: VincristinePatients receive epcoritamab and DA-EPOCH-R as in Cohort 1 above. Patients also undergo MUGA or ECHO during screening, as well as PET/CT, and collection of blood and CSF throughout the study. Patients may also undergo bone marrow biopsy/aspiration during screening and MRI as clinically indicated. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (42 listed)
- Histologically and immunophenotypically (via at least a core or ideally, incisional or excisional biopsy) documented BL at the treating institution. All stages of BL are eligible
- High-risk adult BL patients, as defined by:
- Treatment naive or one prior cycle of chemotherapy whether anthracycline based or not
- If HIV positive and had an opportunistic infection within three months, participant must be recovered and willing to take prophylaxis as clinically indicated
- If HIV positive, any CD4 count is acceptable
Key exclusion criteria (23 listed)
- Brain or spinal cord parenchymal disease
- Prior cytotoxic chemotherapy or radiotherapy for this lymphoma other than the following:
- OR
- One prior cycle of limited therapy including cyclophosphamide and/or glucocorticoids to improve performance status or hepatic or renal function impaired due to lymphoma involvement. The start of this therapy may occur up to four weeks prior to the beginning of study treatment under this protocol. Cyclophosphamide administration must have been completed at least 14 days prior to initiation of study treatment. Such treatment will not count towards the maximum of six cycles under this study (i.e., participants will receive six cycles on study)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Biospecimen CollectionAlso: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen CollectionUndergo collection of blood and CSF | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Bone Marrow AspirationUndergo bone marrow biopsy/aspiration | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Bone Marrow BiopsyAlso: Biopsy of Bone Marrow, Biopsy, Bone MarrowUndergo bone marrow biopsy/aspiration | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Computed TomographyAlso: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial TomographyUndergo PET/CT | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| CyclophosphamideAlso: (-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Asta B 518, B 518Given IV | Drug | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| DoxorubicinAlso: Adriablastin, Hydroxydaunomycin, Hydroxyl Daunorubicin, HydroxyldaunorubicinGiven IV | Drug | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Echocardiography TestAlso: EC, EchocardiographyUndergo ECHO | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| EpcoritamabAlso: Anti-CD20/CD3 Bispecific Antibody GEN3013, DuoBody-CD3xCD20, Epcoritamab-bysp, EpkinlyGiven SC | Biological | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| EtoposideAlso: Demethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Lastet, ToposarGiven IV | Drug | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Magnetic Resonance ImagingAlso: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging ScanUndergo MRI | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Multigated Acquisition ScanAlso: Blood Pool Scan, Equilibrium Radionuclide Angiography, Gated Blood Pool Imaging, Gated Heart Pool ScanUndergo MUGA | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| Positron Emission TomographyAlso: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure)Undergo PET/CT | Procedure or surgery | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| PrednisoneAlso: .delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, CortancylGiven PO | Drug | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| RituximabAlso: ABP 798, ABP-798, ABP798, BI 695500Given IV | Biological | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
| VincristineAlso: LCR, Leurocristine, VCR, VincrystineGiven IV | Drug | Cohort 1 (epcoritamab, DA-EPOCH-R), Cohort 2 Arm I (DA-EPOCH-R), Cohort 2 Arm II (epcoritamab, DA-EPOCH-R) |
Primary outcome
Proportion of participants who complete at least Cycle 3 among 10 participants (Feasibility)
Time frame: Up to 3 cycles (one cycles = 21 days)
A cycle with at least one dose of epcoritamab 48 mg will be considered complete.
Overall survival
Time frame: From date of study registration and the date of death from any cause, assessed up to 2 years after completion of study treatment
Kaplan-Meier method will be used to estimate survival rates for pre-specified time points along with 95% confidence intervals (CI).
10 secondary outcomes
Progression-free survival
Time frame: From date of study registration and the date of progression or the date of death from any cause, assessed up to 2 years after completion of study treatment
Incidence of dose-limiting toxicities
Time frame: Up to 6 cycles (one cycles = 21 days)
Incidence of treatment-emergent adverse events
Time frame: Up to 2 years after completion of study treatment
Overall response rate
Time frame: Up to 2 years after completion of study treatment
Duration of response
Time frame: From the date of documented response (CR or PR) and the date of progression or the date of death from any cause, assessed up to 2 years after completion of study treatment
Incidence and severity of tumor lysis syndrome
Time frame: Up to 2 years after completion of study treatment
Incidence and severity of infection
Time frame: Up to 2 years after completion of study treatment
Incidence and severity of cytokine release syndrome
Time frame: Up to 2 years after completion of study treatment
Incidence and severity of immune effector cell associated neurotoxicity syndrome
Time frame: Up to 2 years after completion of study treatment
Patterns of HIV viral load and CD4 and CD19 recovery
Time frame: Up to 2 years after completion of study treatment
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Oct 2026.
Related trials for Adult Burkitt Lymphoma
RecruitingPhase 1/2
CD19/CD22 Bicistronic Chimeric Antigen Receptor (CAR) T Cells in Children and Young Adults With Recurrent or Refractory B Cell Malignancies
B-NHL, B-Non Hodgkin Lymphoma
Active, not recruitingPhase 1
Cellular Immunotherapy Following Chemotherapy in Treating Patients With Recurrent Non-Hodgkin Lymphomas, Chronic Lymphocytic Leukemia, or B-Cell Prolymphocytic Leukemia
B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classic Hodgkin Lymphoma, B-Cell Prolymphocytic Leukemia
RecruitingPhase 2
A Study Testing the Combination of Dasatinib or Imatinib to Chemotherapy Treatment With Blinatumomab for Children, Adolescents, and Young Adults With Philadelphia Chromosome Positive (Ph+) or ABL-Class Philadelphia Chromosome-Like (Ph-Like) B-cell Acute Lymphoblastic Leukemia (B-ALL)
B Acute Lymphoblastic Leukemia
RecruitingPhase 2
Inotuzumab Ozogamicin and Blinatumomab With or Without Ponatinib in Treating Patients With Newly Diagnosed, Recurrent, or Refractory CD22-Positive B-Lineage Acute Lymphoblastic Leukemia
B Acute Lymphoblastic Leukemia, Philadelphia Chromosome Negative, Recurrent B Acute Lymphoblastic Leukemia
RecruitingObservational study
Toxicity of Intensive First-Line Treatment for Adult Burkitt Lymphoma: A Retrospective Observational Study
Adult Burkitt Lymphoma, Chemotherapy-Related Toxicity
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ariela Noy principal investigator
AIDS Malignancy Consortium
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy in people with Adult Burkitt Lymphoma, run by AIDS Malignancy Consortium at 1 site in United States.
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 42 inclusion and 23 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: opening soon, as of the sponsor's last update on 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of participants who complete at least Cycle 3 among 10 participants (Feasibility) (time frame: Up to 3 cycles (one cycles = 21 days)). The study lists 2 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 16 Oct 2026.