Recruiting
Phase 2/Phase 3
A Study of Zilovertamab Vedotin (MK-2140) in Combination With Standard of Care in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (rrDLBCL) (MK-2140-003)
Condition(s) studied
DLBCLDiffuse Large B-Cell Lymphoma
Investigational drug(s) / intervention(s)
Zilovertamab vedotinRituximabGemcitabineOxaliplatinBendamustineGranulocyte Colony-Stimulating Factor (G-CSF)
Zilovertamab vedotin: Intravenous (IV) Infusion 1.5 mg/kg, 1.75 mg/kg, 2.0 mg/kg, 2.25 mg/kg, 2.5 mg/kg
Rituximab: IV Infusion 375 mg/m\^2
Gemcitabine: IV Infusion 1000 mg/m\^2
Oxaliplatin: IV Infusion 100 mg/m\^2
Bendamustine: IV Infusion 90 mg/m\^2
Granulocyte Colony-Stimulating Factor (G-CSF): Prophylactic G-CSF will be administered at each cycle of zilovertamab vedotin as per the institutional guidelines.
Study summary
The purpose of this Phase 2/3, randomized, multisite, open-label, dose confirmation, and expansion study is to evaluate the safety, and efficacy of zilovertamab vedotin (ZV) in combination with standard of care options for the treatment of rrDLBCL. This study will be divided into 2 parts: Dose Confirmation (Part 1) and Efficacy Expansion (Part 2) and will enroll participants who are at least 18 years of age with rrDLBCL. The hypotheses are: ZV in combination with rituximab, gemcitabine, and oxaliplatin (R-GemOx) is superior to R-GemOx with respect to progression-free survival (PFS) per Lugano response criteria by blinded independent review committee (BICR); and that ZV in combination with bendamustine rituximab (BR) is superior to BR with respect to PFS per Lugano response criteria by BICR.
With protocol amendment 4 (effective: 04-April-2024), enrollment in Cohort B (study arms Bendamustine Rituximab \[BR\] and ZV + BR) is discontinued. No efficacy outcome analysis and hypothesis testing will be conducted for Cohort B.
Eligibility
Inclusion Criteria:
* Has a histologically confirmed diagnosis of Diffuse Large B-Cell Lymphoma (DLBCL).
* Has radiographically measurable DLBCL per the Lugano Response Criteria, as assessed locally by the investigator.
* Has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2 within 7 days prior to study treatment initiation.
* Has adequate organ function.
* Is able to provide new or archival tumor tissue sample not previously irradiated.
Zilovertamab vedotin plus R-GemOx, or R-GemOx study arms:
* Has relapsed or refractory DLBCL and is ineligible for or have failed autologous stem-cell transplant (ASCT) and have failed at least 1 line of prior therapy.
* Has post-chimeric antigen receptor T (post-CAR-T) cell therapy failure or is ineligible for CAR-T cell therapy.
Not applicable with protocol amendment 4: Zilovertamab vedotin plus Bendamustine Rituximab (BR), and Bendamustine Rituximab study arms:
* Has relapsed or refractory DLBCL and is ineligible for or have failed ASCT and have failed at least 2 lines of prior therapy.
* Has post-CAR-T therapy failure or is ineligible for CAR-T cell therapy.
Exclusion Criteria:
* Not applicable with protocol amendment 4: Has history of transformation of indolent disease to DLBCL
* Has received solid organ transplant at any time.
* Has received a diagnosis of primary mediastinal B-cell lymphoma (PMBCL).
* Has clinically significant (ie, active) cardiovascular disease or serious cardiac arrhythmia requiring medication.
* Has ongoing graft-versus-host disease (GVHD) of any grade, or is receiving treatment for their GVHD.
* Has clinically significant pericardial or pleural effusion.
* Has ongoing Grade \>1 peripheral neuropathy.
* Has a history of a second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 2 years.
* Has a demyelinating form of Charcot-Marie-Tooth disease.
* Has contraindication to any of the study intervention components including but not limited to prior anaphylactic reaction.
* Has received prior systemic anticancer therapy, including investigational agents within 4 weeks prior to the first dose of study intervention.
* Has received prior radiotherapy within 4 weeks of start of study intervention. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis.
* Has ongoing corticosteroid therapy.
* Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention.
* Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks before the first dose of study intervention.
* Has known active central nervous system (CNS) lymphoma involvement or active CNS involvement by lymphoma. Participants with prior CNS involvement are eligible if their CNS disease is in radiographic, cytological (for cerebrospinal fluid disease), and clinical remission.
* Has an active infection requiring systemic therapy.
* Has a known history of human immunodeficiency virus (HIV) infection.
* Has a known active Hepatitis C virus infection.
* Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study.
Primary outcome measure(s)
- Number of participants who experienced dose-limiting toxicities (DLTs) in Part 1 — Up to ~6 weeks
The CTCAE, Version 5.0 will be used to grade the severity of AEs in this study. DLTs will be reported for Part 1 of this study.
- Number of participants who experienced an adverse event (AE) — Up to ~68 months
An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an AE. The number of participants who experienced an AE will be reported.
- Number of participants who discontinued study treatment due to an AE — Up to ~68 months
An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an AE. The number of participants who discontinued study treatment due to an AE will be reported.
- Overall survival (OS) — Up to ~35 months
OS, defined as the time from randomization to death due to any cause will be reported.
- Progression-free survival (PFS) — Up to ~35 months
PFS, defined as the time from randomization to the first documented disease progression per Lugano response criteria as assessed by BICR or death due to any cause, whichever occurs first will be presented.
Trial sites (135)
| Facility | City | Region | Status |
| Palo Verde Hematology/ Oncology Center, Ltd. ( Site 0175) |
Glendale |
Arizona |
Recruiting |
| Beverly Hills Cancer Center ( Site 0184) |
Beverly Hills |
California |
Active Not Recruiting |
| Bass Medical Group ( Site 0166) |
Walnut Creek |
California |
Recruiting |
| Innovative Clinical Research Institute ( Site 0122) |
Whittier |
California |
Completed |
| Boca Raton Regional Hospital- Lynn Cancer Institute ( Site 0163) |
Boca Raton |
Florida |
Recruiting |
| Clermont Oncology Center ( Site 0174) |
Clermont |
Florida |
Recruiting |
| BRP-Hialeah Hospital ( Site 0182) |
Hialeah |
Florida |
Recruiting |
| Illinois Cancer Specialists ( Site 8000) |
Niles |
Illinois |
Recruiting |
| Saint Elizabeth Medical Center Edgewood ( Site 0165) |
Edgewood |
Kentucky |
Recruiting |
| University of Kentucky Chandler Medical Center ( Site 0158) |
Lexington |
Kentucky |
Recruiting |
| Norton Women's and Children's Hospital-Norton Cancer Institute - St. Matthews ( Site 0133) |
Louisville |
Kentucky |
Recruiting |
| University of Maryland ( Site 0123) |
Baltimore |
Maryland |
Active Not Recruiting |
| Dana-Farber Cancer Institute-Lymphoma ( Site 0111) |
Boston |
Massachusetts |
Active Not Recruiting |
| University of Massachusetts Medical School ( Site 0119) |
Worcester |
Massachusetts |
Active Not Recruiting |
| Corewell Health ( Site 0162) |
Grand Rapids |
Michigan |
Recruiting |
| St. Vincent Frontier Cancer Center-Research ( Site 0108) |
Billings |
Montana |
Recruiting |
| Oncology Hematology West, PC dba Nebraska Cancer Specialists ( Site 0188) |
Grand Island |
Nebraska |
Recruiting |
| Oncology Hematology West, PC dba Nebraska Cancer Specialists ( Site 0177) |
Omaha |
Nebraska |
Recruiting |
| Comprehensive Cancer Centers of Nevada ( Site 0168) |
Las Vegas |
Nevada |
Recruiting |
| Atlantic Health System ( Site 0116) |
Morristown |
New Jersey |
Completed |
| Presbyterian Rust Jorgensen Cancer ( Site 9506) |
Rio Rancho |
New Mexico |
Active Not Recruiting |
| New York Medical College ( Site 0113) |
Valhalla |
New York |
Recruiting |
| Alliance Cancer Specialists (ACS) ( Site 8001) |
Horsham |
Pennsylvania |
Recruiting |
| Tennessee Cancer Specialists ( Site 7000) |
Knoxville |
Tennessee |
Recruiting |
| Vanderbilt University Medical Center-Vanderbilt-Ingram Cancer Center ( Site 0156) |
Nashville |
Tennessee |
Completed |
| Blue Ridge Cancer Care ( Site 0169) |
Roanoke |
Virginia |
Active Not Recruiting |
| Hospital Italiano de Buenos Aires ( Site 2203) |
Ciudad Autonoma de Buenos Aires |
Buenos Aires |
Active Not Recruiting |
| Instituto de Investigaciones Clínicas Mar del Plata ( Site 2205) |
Mar del Plata |
Buenos Aires |
Completed |
| Hospital Aleman ( Site 2200) |
Buenos Aites |
Buenos Aires F.D. |
Active Not Recruiting |
| Hospital Privado Universitario de Córdoba ( Site 2202) |
Córdoba |
Córdoba Province |
Active Not Recruiting |
| Instituto Alexander Fleming ( Site 2201) |
CABA |
Argentina |
Active Not Recruiting |
| Townsville University Hospital ( Site 1800) |
Townsville |
Queensland |
Active Not Recruiting |
| Grampians Health ( Site 1802) |
Ballarat |
Victoria |
Recruiting |
| Royal Perth Hospital-Haematology ( Site 1801) |
Perth |
Western Australia |
Recruiting |
| Hospital Erasto Gaertner ( Site 2302) |
Curitiba |
Paraná |
Recruiting |
| Liga Norte Riograndense Contra o Câncer ( Site 2305) |
Natal |
Rio Grande do Norte |
Recruiting |
| Hospital Paulistano ( Site 2300) |
São Paulo |
Brazil |
Active Not Recruiting |
| Princess Margaret Cancer Centre-Division of Medical Oncology and Hematology ( Site 0200) |
Toronto |
Ontario |
Completed |
| Biocenter ( Site 2401) |
Concepción |
Biobio |
Recruiting |
| IC La Serena Research ( Site 2405) |
La Serena |
Coquimbo Region |
Active Not Recruiting |
+ 95 more sites — see the full list on the official registry below.