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    Clinical Trial Results:
    A Phase IIa, Open-label, Multicenter Study of Single-agent MOR00208, an Fc-Optimized Anti-CD19 Antibody, in Patients with Relapsed or Refractory B-Cell Non-Hodgkin’s Lymphoma

    Summary
    EudraCT number
    2012-002659-41
    Trial protocol
    BE   IT   HU   ES   DE   PL  
    Global end of trial date
    06 Apr 2022

    Results information
    Results version number
    v2(current)
    This version publication date
    21 Apr 2023
    First version publication date
    05 Jan 2019
    Other versions
    v1
    Version creation reason
    • New data added to full data set
    Availability of final CSR

    Trial information

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    Trial identification
    Sponsor protocol code
    MOR208C201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01685008
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Morphosys AG
    Sponsor organisation address
    Semmelweisstrasse 7, Planegg, Germany, 82152
    Public contact
    Medical Information, Morphosys AG, +1 844 667-1992, medinfo@morphosys.com
    Scientific contact
    Medical Information, Morphosys AG, +1 844 667-1992, medinfo@morphosys.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    15 Jun 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Apr 2022
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Apr 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to assess the antitumor activity of single-agent MOR00208 in adult patients with relapsed or refractory NHL who have received at least 1 prior therapy containing rituximab as one of the treatments.
    Protection of trial subjects
    This trial was designed, conducted and reported in accordance with the International Conference on Harmonisation (ICH) Guidelines for Good Clinical Practice (GCP), applicable local regulations (including European Directive 2001/20/EC), and following the ethical principles laid down in the Declaration of Helsinki. Specific ICH adopted and other relevant international guidelines and recommendations were taken into account as far as meaningfully possible. Safety monitoring for all patients enrolled in the study included laboratory safety assessments (haematology, blood chemistry, urinalysis, coagulation, and anti-MOR00208 antibodies) and clinical evaluations (physical examinations, vital signs, 12-lead ECG) as detailed in the Schedule of Assessments.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 Apr 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 12
    Country: Number of subjects enrolled
    United States: 20
    Country: Number of subjects enrolled
    Belgium: 2
    Country: Number of subjects enrolled
    Germany: 7
    Country: Number of subjects enrolled
    Hungary: 16
    Country: Number of subjects enrolled
    Italy: 19
    Country: Number of subjects enrolled
    Poland: 16
    Worldwide total number of subjects
    92
    EEA total number of subjects
    72
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    43
    From 65 to 84 years
    46
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    This was a Phase IIa open-label, multicenter safety and efficacy study of MOR00208, that was planned to enroll approximately 40 to 120 adult patients with refractory or relapsed NHL who have received at least 1 prior therapy containing rituximab.

    Pre-assignment
    Screening details
    Patients were male or female ≥ 18 years of age, with a histologically confirmed diagnosis of FL, other indolent NHL (e.g., MZL/MALT), DLBCL, or MCL. Patients must have had progression of their NHL after at least 1 prior rituximab-containing regimen, and had at least 1 site of measurable disease on an MRI or CT scan.

    Period 1
    Period 1 title
    Screening Period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    MOR00208
    Arm description
    A total of 113 patients were screened; of these, 21 were screening failures and did not receive treatment with MOR00208. 92 patients completed screening and received at least one dose of study drug.
    Arm type
    Experimental

    Investigational medicinal product name
    MOR00208
    Investigational medicinal product code
    MOR00208
    Other name
    MOR208, XmAb5574, tafasitamab
    Pharmaceutical forms
    Solution for infusion in administration system
    Routes of administration
    Intravenous use
    Dosage and administration details
    MOR00208 drug product is a lyophilisate supplied in single-use 20 mL glass vials. Each vial contains 200 mg of MOR00208 for reconstitution with 5 mL water for injection. Intravenous infusions were administered at the study site, beginning on Cycle 1 Day 1.

    Number of subjects in period 1
    MOR00208
    Started
    92
    Completed
    92
    Period 2
    Period 2 title
    Main Study Treatment (Cycles 1-2)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    MOR00208
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    MOR00208
    Investigational medicinal product code
    MOR00208
    Other name
    MOR208, XmAb5574, tafasitamab
    Pharmaceutical forms
    Solution for infusion in administration system
    Routes of administration
    Intravenous use
    Dosage and administration details
    MOR00208 drug product is a lyophilisate supplied in single-use 20 mL glass vials. Each vial contains 200 mg of MOR00208 for reconstitution with 5 mL water for injection. Intravenous infusions were administered at the study site, beginning on Cycle 1 Day 1.

    Number of subjects in period 2
    MOR00208
    Started
    92
    Completed
    75
    Not completed
    17
         Adverse event, serious fatal
    4
         Physician decision
    2
         Adverse event, non-fatal
    3
         Progressive disease
    7
         Protocol deviation
    1
    Period 3
    Period 3 title
    Post Cycle 2 (C3 and Maintenance)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    MOR00208
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    MOR00208
    Investigational medicinal product code
    MOR00208
    Other name
    MOR208, XmAb5574, tafasitamab
    Pharmaceutical forms
    Solution for infusion in administration system
    Routes of administration
    Intravenous use
    Dosage and administration details
    MOR00208 drug product is a lyophilisate supplied in single-use 20 mL glass vials. Each vial contains 200 mg of MOR00208 for reconstitution with 5 mL water for injection. Intravenous infusions were administered at the study site, beginning on Cycle 1 Day 1.

    Number of subjects in period 3
    MOR00208
    Started
    75
    Started Cycle 3 Treatment
    50
    Started Maintenance Phase Treatment
    16
    Completed
    1
    Not completed
    74
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    4
         Physician decision
    10
         Other
    5
         New cancer therapy
    7
         Unspecified
    1
         Progressive disease
    46

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    MOR00208
    Reporting group description
    A total of 113 patients were screened; of these, 21 were screening failures and did not receive treatment with MOR00208. 92 patients completed screening and received at least one dose of study drug.

    Reporting group values
    MOR00208 Total
    Number of subjects
    92 92
    Age categorical
    Age (years)
    Units: Subjects
        Adults (18-64 Years)
    43 43
        Adults (65 and over)
    49 49
    Age continuous
    Age mean and SD
    Units: years
        arithmetic mean (standard deviation)
    65.57 ( 12.225 ) -
    Gender categorical
    Units: Subjects
        Female
    36 36
        Male
    56 56
    Race
    Units: Subjects
        Asian
    1 1
        Black or African American
    1 1
        White
    87 87
        Other
    3 3
    NHL Subtype
    Units: Subjects
        Follicular lymphoma
    34 34
        Diffuse large B-cell lymphoma
    35 35
        Mantle cell lymphoma
    12 12
        Other indolent NHL
    11 11
    Weight
    Units: kg
        arithmetic mean (standard deviation)
    77.10 ( 17.012 ) -
    Height
    n=90 for this characteristic, as height was not collected at Screening (minor protocol noncompliance) for 2 patients in the Safety Population.
    Units: cm
        arithmetic mean (standard deviation)
    169.30 ( 11.954 ) -
    BMI
    n=90 for this characteristic, as height was not collected at Screening (minor protocol noncompliance) for 2 patients in the Safety Population.
    Units: kg/m2
        arithmetic mean (standard deviation)
    26.86 ( 5.133 ) -

    End points

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    End points reporting groups
    Reporting group title
    MOR00208
    Reporting group description
    A total of 113 patients were screened; of these, 21 were screening failures and did not receive treatment with MOR00208. 92 patients completed screening and received at least one dose of study drug.
    Reporting group title
    MOR00208
    Reporting group description
    -
    Reporting group title
    MOR00208
    Reporting group description
    -

    Primary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [1]
    End point description
    Proportion of Patients with Complete Remission (CR) or Partial Remission (PR), assessed as per the 2007 International Working Group (IWG) response criteria
    End point type
    Primary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The primary endpoint for this open-label study was a count of responders; no statistical analyses or comparisons are applicable.
    End point values
    MOR00208
    Number of subjects analysed
    92
    Units: patients
        Complete remission
    6
        Partial remission
    16
    No statistical analyses for this end point

    Secondary: Stable Disease (SD) Rate

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    End point title
    Stable Disease (SD) Rate
    End point description
    Proportion of Patients with Stable Disease
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    92
    Units: patients
    31
    No statistical analyses for this end point

    Secondary: Duration of Response (DoR)

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    End point title
    Duration of Response (DoR)
    End point description
    Time from first response (CR or PR) to first documentation of relapse/progression, for patients who had any response during the study.
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    22 [2]
    Units: Months
        median (confidence interval 95%)
    24.0 (11.1 to 1000000)
    Notes
    [2] - The upper CI was not reached; "1000000" entered as numerical value required.
    No statistical analyses for this end point

    Secondary: Time to Progression (TTP)

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    End point title
    Time to Progression (TTP)
    End point description
    Time from first dosing until documentation of progression or death due to lymphoma
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    76 [3]
    Units: Months
        median (confidence interval 95%)
    5.4 (3.4 to 12.0)
    Notes
    [3] - Patients with documented progression of disease.
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS)
    End point description
    Time from first dosing until progression or death due to any case
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    80 [4]
    Units: Months
        median (confidence interval 95%)
    5.4 (3.2 to 9.9)
    Notes
    [4] - Patients with documented progression or death from any cause.
    No statistical analyses for this end point

    Secondary: Incidence and Severity of Adverse Events (AEs)

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    End point title
    Incidence and Severity of Adverse Events (AEs)
    End point description
    Number of patients with treatment-emergent AEs rated Mild, Moderate, and Severe
    End point type
    Secondary
    End point timeframe
    From first dose until 30 days after last dose of MOR00208, up to 8.5 years
    End point values
    MOR00208
    Number of subjects analysed
    92
    Units: patients
        Mild
    29
        Moderate
    20
        Severe
    6
    No statistical analyses for this end point

    Secondary: Number and Proportion of Patients Who Potentially Developed Anti-MOR00208 Antibodies and Semiquantitative Anti-MOR00208 Antibody Assessments

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    End point title
    Number and Proportion of Patients Who Potentially Developed Anti-MOR00208 Antibodies and Semiquantitative Anti-MOR00208 Antibody Assessments
    End point description
    Number of patients with at least one positive (+ve) post-Baseline sample containing positive anti-MOR00208 antibodies; Baseline (pre-dose) sample has to be tested negative (-ve)
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 3, up to 7 months
    End point values
    MOR00208
    Number of subjects analysed
    92
    Units: patients
        Yes (≥ 1 +ve sample post-Baseline inc last sample)
    0
        No (Baseline and all post-Baseline samples -ve)
    82
        Transient (≥ 1 +ve post-Baseline, -ve last sample)
    0
        Not evaluable (pre-dose sample tested +ve)
    5
        Missing (no post-Baseline measurement available)
    5
    No statistical analyses for this end point

    Secondary: Pharmacokinetic (PK) Parameter: Maximum Serum Concentration Observed (Cmax) of MOR00208

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    End point title
    Pharmacokinetic (PK) Parameter: Maximum Serum Concentration Observed (Cmax) of MOR00208
    End point description
    The highest concentration of MOR00208 measured in serum
    End point type
    Secondary
    End point timeframe
    Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
    End point values
    MOR00208
    Number of subjects analysed
    85 [5]
    Units: μg/mL
        arithmetic mean (standard deviation)
    263.1 ( 111.35 )
    Notes
    [5] - PK parameters were calculated as data permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Time to Maximum Serum Concentration Observed (Tmax) of MOR00208

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    End point title
    PK Parameter: Time to Maximum Serum Concentration Observed (Tmax) of MOR00208
    End point description
    The time to highest concentration of MOR00208 measured in serum
    End point type
    Secondary
    End point timeframe
    Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
    End point values
    MOR00208
    Number of subjects analysed
    85 [6]
    Units: hours
        arithmetic mean (standard deviation)
    5.8 ( 17.46 )
    Notes
    [6] - PK parameters were calculated as data permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Apparent Trough Serum Concentration Before Dosing (Clast) of MOR00208

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    End point title
    PK Parameter: Apparent Trough Serum Concentration Before Dosing (Clast) of MOR00208
    End point description
    The last quantifiable concentration from the first dose of MOR00208
    End point type
    Secondary
    End point timeframe
    Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
    End point values
    MOR00208
    Number of subjects analysed
    85 [7]
    Units: μg/mL
        arithmetic mean (standard deviation)
    81.0 ( 36.66 )
    Notes
    [7] - PK parameters were calculated as data permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Area Under the Concentration Curve From Dose Time Zero to the Time the Last Quantifiable Concentration is Observed (AUC[0-t]) of MOR00208

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    End point title
    PK Parameter: Area Under the Concentration Curve From Dose Time Zero to the Time the Last Quantifiable Concentration is Observed (AUC[0-t]) of MOR00208
    End point description
    Area under the concentration curve. The time curve from time zero (0) to the time that the last concentration above the lower limit of quantification (LLQ) is observed.
    End point type
    Secondary
    End point timeframe
    Estimated from first dose (samples taken on first day of dosing at pre-dose, end of infusion, after 1 hour, 4 hours, 24 hours, and pre-dose on Day 8)
    End point values
    MOR00208
    Number of subjects analysed
    85 [8]
    Units: h*μg/mL
        arithmetic mean (standard deviation)
    21942.5 ( 11847.35 )
    Notes
    [8] - PK parameters were calculated as data permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Apparent Terminal Rate Constant (λz) of MOR00208

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    End point title
    PK Parameter: Apparent Terminal Rate Constant (λz) of MOR00208
    End point description
    Apparent terminal rate constant calculated from the regression analysis (slope) from the log-transformed measured concentrations on the terminal phase of the time-point concentration curve
    End point type
    Secondary
    End point timeframe
    Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
    End point values
    MOR00208
    Number of subjects analysed
    12 [9]
    Units: 1/h
        arithmetic mean (standard deviation)
    0.00214 ( 0.000665 )
    Notes
    [9] - PK parameters were calculated as data permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Apparent Terminal Half-life (t[1/2]) of MOR00208

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    End point title
    PK Parameter: Apparent Terminal Half-life (t[1/2]) of MOR00208
    End point description
    Apparent terminal half-life calculated from ln(2)/λz
    End point type
    Secondary
    End point timeframe
    Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
    End point values
    MOR00208
    Number of subjects analysed
    12 [10]
    Units: days
        arithmetic mean (standard deviation)
    14.75111 ( 4.680075 )
    Notes
    [10] - PK parameters were calculated as permitted for the PK Population.
    No statistical analyses for this end point

    Secondary: Absolute Change From Baseline in Measurements of B-cell Populations

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    End point title
    Absolute Change From Baseline in Measurements of B-cell Populations
    End point description
    Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: B-cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    70 [11]
    Units: 10^6/L
    median (confidence interval 95%)
        Cycle 1 Day 8
    -13.60 (-50.250 to -1.000)
        Cycle 1 Day 15
    -15.00 (-55.940 to -3.000)
        Cycle 1 Day 22
    -14.00 (-57.000 to -4.500)
        Cycle 2 Day 1
    -14.00 (-51.710 to -3.600)
        Cycle 2 Day 15
    -24.00 (-61.000 to -12.000)
        Cycle 2 Day 28
    -27.68 (-59.000 to -8.000)
        Cycle 3 Day 1
    -36.00 (-117.990 to 0.000)
        Cycle 3 Day 15
    -36.50 (-135.720 to 0.000)
        Cycle 3 Day 28
    -46.00 (-94.000 to -8.370)
        Study Completion/Early Termination
    -15.00 (-69.820 to 4.000)
    Notes
    [11] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Measurements of B-cell Populations

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    End point title
    Percent Change From Baseline in Measurements of B-cell Populations
    End point description
    Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: B-cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    70 [12]
    Units: percentage change from baseline
    median (confidence interval 95%)
        Cycle 1 Day 8
    -42.07 (-70.588 to -2.793)
        Cycle 1 Day 15
    -50.00 (-79.422 to -32.353)
        Cycle 1 Day 22
    -55.88 (-82.625 to -27.500)
        Cycle 2 Day 1
    -55.63 (-80.000 to -27.273)
        Cycle 2 Day 15
    -73.80 (-83.542 to -57.407)
        Cycle 2 Day 28
    -76.47 (-86.458 to -38.095)
        Cycle 3 Day 1
    -79.63 (-94.585 to -3.666)
        Cycle 3 Day 15
    -72.07 (-93.953 to -33.333)
        Cycle 3 Day 28
    -80.00 (-95.833 to -53.191)
        Study Completion/Early Termination
    -49.31 (-85.444 to 2.941)
    Notes
    [12] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Absolute Change From Baseline in Measurements of T-cell Populations

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    End point title
    Absolute Change From Baseline in Measurements of T-cell Populations
    End point description
    Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: T-cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    71 [13]
    Units: 10^6/L
    median (confidence interval 95%)
        Cycle 1 Day 8
    41.00 (-3.460 to 89.000)
        Cycle 1 Day 15
    12.00 (-67.000 to 80.000)
        Cycle 1 Day 22
    -10.00 (-70.880 to 34.000)
        Cycle 2 Day 1
    17.50 (-100.000 to 61.000)
        Cycle 2 Day 15
    88.00 (-9.000 to 152.000)
        Cycle 2 Day 28
    99.00 (-17.000 to 250.000)
        Cycle 3 Day 1
    58.00 (-69.000 to 158.500)
        Cycle 3 Day 15
    110.00 (-27.000 to 318.000)
        Cycle 3 Day 28
    102.45 (-40.000 to 243.000)
        Study Completion/Early Termination
    -57.50 (-137.000 to 144.000)
    Notes
    [13] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Measurements of T-cell Populations

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    End point title
    Percent Change From Baseline in Measurements of T-cell Populations
    End point description
    Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: T-cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    71 [14]
    Units: percentage change from baseline
    median (confidence interval 95%)
        Cycle 1 Day 8
    7.28 (-0.394 to 16.991)
        Cycle 1 Day 15
    1.75 (-9.999 to 12.312)
        Cycle 1 Day 22
    -1.63 (-10.213 to 6.436)
        Cycle 2 Day 1
    2.93 (-12.484 to 12.025)
        Cycle 2 Day 15
    10.39 (-1.170 to 22.944)
        Cycle 2 Day 28
    9.91 (-3.321 to 30.339)
        Cycle 3 Day 1
    12.99 (-6.114 to 23.810)
        Cycle 3 Day 15
    20.09 (-7.627 to 34.934)
        Cycle 3 Day 28
    17.34 (-9.783 to 26.905)
        Study Completion/Early Termination
    -8.07 (-14.994 to 26.912)
    Notes
    [14] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Absolute Change From Baseline in Measurements of NK Cell Populations

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    End point title
    Absolute Change From Baseline in Measurements of NK Cell Populations
    End point description
    Actual change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: NK cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    71 [15]
    Units: 10^6/L
    median (confidence interval 95%)
        Cycle 1 Day 8
    -2.20 (-21.000 to 15.000)
        Cycle 1 Day 15
    -23.00 (-43.000 to 11.000)
        Cycle 1 Day 22
    -18.00 (-38.000 to 7.550)
        Cycle 2 Day 1
    -16.32 (-33.000 to 9.890)
        Cycle 2 Day 15
    -19.00 (-32.000 to 16.800)
        Cycle 2 Day 28
    -1.00 (-18.000 to 51.000)
        Cycle 3 Day 1
    -23.00 (-66.000 to -3.000)
        Cycle 3 Day 15
    -33.00 (-70.000 to -2.000)
        Cycle 3 Day 28
    -15.00 (-32.000 to 11.000)
        Study Completion/Early Termination
    -11.00 (-35.000 to 2.000)
    Notes
    [15] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Measurements of NK Cell Populations

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    End point title
    Percent Change From Baseline in Measurements of NK Cell Populations
    End point description
    Relative change from baseline will be summarized descriptively by visit for the pharmacodynamic parameter: NK cell populations
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline) to Cycle 1: Days 8, 15, and 22; Cycles 2 and 3: Days 1, 15, and 28 (each cycle is 28 days); End of Study (up to 7.5 years)
    End point values
    MOR00208
    Number of subjects analysed
    71 [16]
    Units: percentage change from baseline
    median (confidence interval 95%)
        Cycle 1 Day 8
    -1.62 (-18.261 to 11.429)
        Cycle 1 Day 15
    -18.85 (-24.046 to 11.364)
        Cycle 1 Day 22
    -13.38 (-29.688 to 3.027)
        Cycle 2 Day 1
    -11.17 (-23.478 to 5.634)
        Cycle 2 Day 15
    -8.11 (-22.467 to 20.314)
        Cycle 2 Day 28
    -1.92 (-14.762 to 29.730)
        Cycle 3 Day 1
    -14.08 (-26.866 to -1.115)
        Cycle 3 Day 15
    -20.13 (-38.253 to -1.136)
        Cycle 3 Day 28
    -6.10 (-21.697 to 17.000)
        Study Completion/Early Termination
    -11.01 (-28.906 to 6.667)
    Notes
    [16] - Pharmacodynamic samples were collected at timepoints through the study where possible.
    No statistical analyses for this end point

    Secondary: Evaluation of AEs Stratified by FcγRIIa Polymorphism

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    End point title
    Evaluation of AEs Stratified by FcγRIIa Polymorphism
    End point description
    Incidence of AEs as stratified by FcγRIIa polymorphism subgroups
    End point type
    Secondary
    End point timeframe
    From first dose until 30 days after last dose of MOR00208, up to 8.5 years
    End point values
    MOR00208
    Number of subjects analysed
    74
    Units: adverse events
        Genotype HH
    210
        Genotype HR
    188
        Genotype RR
    61
    No statistical analyses for this end point

    Secondary: Evaluation of AEs Stratified by FcγRIIIa Polymorphism

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    End point title
    Evaluation of AEs Stratified by FcγRIIIa Polymorphism
    End point description
    Incidence of AEs as stratified by FcγRIIIa polymorphism subgroups
    End point type
    Secondary
    End point timeframe
    From first dose until 30 days after last dose of MOR00208, up to 8.5 years
    End point values
    MOR00208
    Number of subjects analysed
    74
    Units: adverse events
        Genotype FF
    110
        Genotype FV
    149
        Genotype VV
    200
    No statistical analyses for this end point

    Secondary: Evaluation of ORR Stratified by FcγRIIa Polymorphism

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    End point title
    Evaluation of ORR Stratified by FcγRIIa Polymorphism
    End point description
    The analysis of the primary endpoint (ORR) will additionally be stratified by FcγRIIa polymorphism subgroups
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    24
    Units: patients
        Genotype HH
    6
        Genotype HR
    8
        Genotype RR
    3
    No statistical analyses for this end point

    Secondary: Evaluation of ORR Stratified by FcγRIIIa Polymorphism

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    End point title
    Evaluation of ORR Stratified by FcγRIIIa Polymorphism
    End point description
    The analysis of the primary endpoint (ORR) will additionally be stratified by FcγRIIIa polymorphism subgroups
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    34
    Units: patients
        Genotype FF
    10
        Genotype FV
    5
        Genotype VV
    2
    No statistical analyses for this end point

    Secondary: PK Parameter: Area Under the Concentration Curve From Dose Time Zero to Infinity (AUC[0-inf]) of MOR00208

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    End point title
    PK Parameter: Area Under the Concentration Curve From Dose Time Zero to Infinity (AUC[0-inf]) of MOR00208
    End point description
    Area under the concentration curve. The time curve from time zero (0) to infinity (inf), where infinity is computed from AUC0-t + [Ct/λZ)]. Ct is calculated from the concentration at the last sampling time at which the sample is above LLQ.
    End point type
    Secondary
    End point timeframe
    Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
    End point values
    MOR00208
    Number of subjects analysed
    91 [17]
    Units: h*μg/mL
        arithmetic mean (standard deviation)
    0 ( 0 )
    Notes
    [17] - The parameter could not be accurately estimated for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Total Body Clearance (CL) of MOR00208

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    End point title
    PK Parameter: Total Body Clearance (CL) of MOR00208
    End point description
    Total body clearance calculated for single or multiple doses: dose(s)/AUC(0-inf)
    End point type
    Secondary
    End point timeframe
    Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
    End point values
    MOR00208
    Number of subjects analysed
    91 [18]
    Units: L/h
        arithmetic mean (standard deviation)
    0 ( 0 )
    Notes
    [18] - The parameter could not be accurately estimated for the PK Population.
    No statistical analyses for this end point

    Secondary: PK Parameter: Apparent Volume of Distribution (Vz) of MOR00208

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    End point title
    PK Parameter: Apparent Volume of Distribution (Vz) of MOR00208
    End point description
    Apparent volume of distribution during the terminal phase, calculated from dose/(AUC(0-inf)*λz)
    End point type
    Secondary
    End point timeframe
    Estimated from final dose (samples collected on the last day of Cycle 3 [C3D28; each cycle is 28 days long], and Follow-up Visits 1 [C3D28 + 4 weeks], 2 [C3D28 + 10 weeks], and 3 [C3D28 + 16 weeks])
    End point values
    MOR00208
    Number of subjects analysed
    91 [19]
    Units: L
        arithmetic mean (standard deviation)
    0 ( 0 )
    Notes
    [19] - The parameter could not be accurately estimated for the PK Population.
    No statistical analyses for this end point

    Secondary: Evaluation of AEs Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells

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    End point title
    Evaluation of AEs Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells
    End point description
    Incidence of AEs as stratified by presence of CD19 on malignant lymphoma cells detected by tumor biopsy/aspirate during Screening
    End point type
    Secondary
    End point timeframe
    From first dose until 30 days after last dose of MOR00208, up to 8.5 years
    End point values
    MOR00208
    Number of subjects analysed
    0 [20]
    Units: adverse events
    Notes
    [20] - CD19 expression could not be measured in sufficient cases for such an analysis to be meaningful.
    No statistical analyses for this end point

    Secondary: Evaluation of ORR Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells

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    End point title
    Evaluation of ORR Stratified by Baseline CD19 Expression on Malignant Lymphoma Cells
    End point description
    The analysis of the primary endpoint (ORR) will additionally be stratified by presence of CD19 on malignant lymphoma cells detected by tumor biopsy/aspirate during Screening
    End point type
    Secondary
    End point timeframe
    From first dose until Follow-up Visit 12, up to 4.5 years
    End point values
    MOR00208
    Number of subjects analysed
    0 [21]
    Units: patients
    Notes
    [21] - CD19 expression could not be measured in sufficient cases for such an analysis to be meaningful.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected from informed consent until 30 days after last dose of MOR00208, up to 8.5 years
    Adverse event reporting additional description
    AEs were detected when volunteered by the patient during or between study visits or through physical examination, laboratory tests, or other assessments. All SAEs are reported, including non-treatment-emergent events. For non-serious AEs, only treatment-emergent events are reported.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.0
    Reporting groups
    Reporting group title
    MOR00208
    Reporting group description
    All patients who received at least one dose of study drug.

    Serious adverse events
    MOR00208
    Total subjects affected by serious adverse events
         subjects affected / exposed
    30 / 92 (32.61%)
         number of deaths (all causes)
    9
         number of deaths resulting from adverse events
    9
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bone cancer
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Fracture
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    11 / 92 (11.96%)
         occurrences causally related to treatment / all
    0 / 12
         deaths causally related to treatment / all
    0 / 8
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Vision blurred
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory failure
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Ureterolithiasis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    3 / 92 (3.26%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    Genital herpes zoster
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Infected bite
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumococcal infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    MOR00208
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    77 / 92 (83.70%)
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    12 / 92 (13.04%)
         occurrences all number
    15
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    9 / 92 (9.78%)
         occurrences all number
    11
    Headache
         subjects affected / exposed
    10 / 92 (10.87%)
         occurrences all number
    15
    Blood and lymphatic system disorders
    Lymphadenopathy
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    9
    Neutropenia
         subjects affected / exposed
    9 / 92 (9.78%)
         occurrences all number
    12
    Thrombocytopenia
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    14
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    9
    Oedema peripheral
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    9
    Fatigue
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    12
    Pyrexia
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    8
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    9
    Constipation
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    7
    Nausea
         subjects affected / exposed
    9 / 92 (9.78%)
         occurrences all number
    11
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    9
    Cough
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    14
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    8
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    7
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    11 / 92 (11.96%)
         occurrences all number
    14
    Bronchitis
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    8

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Jan 2013
    1. A clinical deficiency/information request from FDA dated 05 October 2012. 2. A clinical deficiency/information request from FDA dated 11 October 2012. 3. Minor inconsistencies identified and organizational changes made since release of the original protocol, none of which constitute a change in the conduct or scientific value of the study.
    02 Oct 2013
    1. Organizational issues that came up during the initiation of the first study sites. 2. Minor inconsistencies identified and organizational changes made since the release of the original protocol, none of which constituted a change in the conduct or scientific value of the study.
    15 Apr 2014
    1. New recommendations for the screening of hepatitis B for anti-CD20 antibodies were published. 2. Minor inconsistencies identified and organizational changes were made since the release of the previous amendment, none of which constitute a change in the conduct or scientific value of the study.
    19 Sep 2017
    1. Change of address of sponsor and CRO. 2. Addition of optional prolongation of maintenance treatment for patients beyond Follow-up Visit 12 until progression. 3. Change of sponsor signatories and change of key personnel at sponsor and CRO. 4. Change of data collection as a result of this amendment. 5. Minor editorial changes for clarification of content and removal of inconsistencies.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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