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    Clinical Trial Results:
    Phase II single-arm “window-of-opportunity” study of a combination of obinutuzumab (GA-101) and venetoclax (ABT-199) in relapsed or refractory diffuse large B-cell lymphoma (DLBCL)

    Summary
    EudraCT number
    2016-001760-10
    Trial protocol
    AT  
    Global end of trial date
    19 Oct 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    19 Oct 2022
    First version publication date
    19 Oct 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AGMT_NHL-15B
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02987400
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AGMT
    Sponsor organisation address
    Gentzgasse 60/21, Vienna, Austria, 1180
    Public contact
    Daniela Wolkersdorfer, AGMT, +43 6626404412, d.wolkersdofer@agmt.at
    Scientific contact
    Richard Greil, AGMT, +43 5725525801, r.greil@salk.at
    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
    03 Oct 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Oct 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Objective response rate (complete or partial responses; best response) defined by PET/CT scan and bone marrow examination (Lugano Criteria 2014) after 3 cycles.
    Protection of trial subjects
    Safety measurements were assessed at screening, every 3 weeks during and at the end of treatment, and at final visit. All (serious) adverse events occurring during study treatment were collected from signing the informed consent form until 28 days after last study treatment. Recommendations for administration of first and subsequent infusions of Obinutuzumab including premedication and supportive care were given. Guidelines and recommendations for dosage delays and modifications were defined. In general, concomitant medications and therapies necessary for supportive care and safety of the patient were allowed. Antiviral prophylaxis and PJP prophylaxis were recommended at the physician´s discretion. Monitoring and treatment for Hepatitis B reactivation was discussed in the protocol.
    Background therapy
    None
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    04 Jan 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 22
    Worldwide total number of subjects
    22
    EEA total number of subjects
    22
    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)
    12
    From 65 to 84 years
    10
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Between 04-Jan-2017 and 10-Jun-2020 22 patients were enrolled at five sites in Austria.

    Pre-assignment
    Screening details
    One patient received study treatment but was withdrawn from study during the first treatment cycle because inclusion criterion "diagnosis" was not met according to the result of the reference pathology. This patient was replaced and was not included in primary endpoint analysis.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Overall study
    Arm description
    Combination treatment is repeated for up to 3 cycles. The first response assessment (including PET-CT) is performed after the first cycle of obinutuzumab-venetoclax and patients with at least stable disease (SD) or better are given another 2 cycles of therapy and have assessment after a total of 3 cycles. Patients with complete or partial remission (CR, PR) after 3 cycles of therapy go on to transplant or receive 9 further cycles of the combination therapy (if transplant ineligible). Patients with progressive disease at any time-point or stable disease after 3 cycles are taken off study.
    Arm type
    Experimental

    Investigational medicinal product name
    Obinutuzumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Given IV at a dose of 1000 mg on days 1, 8, 15 in cycle 1 and on day 1 of each following cycle. One cycle is 21 days.

    Investigational medicinal product name
    Venetoclax
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Given (prior to Obinutuzumab) at a dose of 800 mg daily p.o. starting from d1, cycle 1. One cycle is 21 days.

    Number of subjects in period 1
    Overall study
    Started
    22
    Response assessment after cycle 3
    12
    Transplant or start of further 9 cycles
    5
    Completed
    3
    Not completed
    19
         Not eligible according to reference pathology
    1
         Stable disease after cylce 3
    1
         Progressive disease
    16
         Patient lost
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Reporting group values
    Overall trial Total
    Number of subjects
    22 22
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    12 12
        From 65-84 years
    10 10
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    63.9 (47 to 79) -
    Gender categorical
    Units: Subjects
        Female
    12 12
        Male
    10 10

    End points

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    End points reporting groups
    Reporting group title
    Overall study
    Reporting group description
    Combination treatment is repeated for up to 3 cycles. The first response assessment (including PET-CT) is performed after the first cycle of obinutuzumab-venetoclax and patients with at least stable disease (SD) or better are given another 2 cycles of therapy and have assessment after a total of 3 cycles. Patients with complete or partial remission (CR, PR) after 3 cycles of therapy go on to transplant or receive 9 further cycles of the combination therapy (if transplant ineligible). Patients with progressive disease at any time-point or stable disease after 3 cycles are taken off study.

    Primary: Response rate

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    End point title
    Response rate [1]
    End point description
    Objective response rate (complete or partial responses) defined by PET/CT scan and bone marrow examination (Lugano Criteria 2014) after 3 cycles
    End point type
    Primary
    End point timeframe
    After 3 cycles of combination therapy
    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: No statistical analysis is provided as this is an one armed, open label, non-comperative study. Overall response rate after 3 cycles of therapy is 5/21 (23.8%).
    End point values
    Overall study
    Number of subjects analysed
    21 [2]
    Units: Subjects
        Complete response
    4
        Partial remission
    1
        Stable disease
    1
        Progressive disease
    6
        NA
    9
    Notes
    [2] - One patient was excluded because inclusion criterion DLBCL was not met acc. to reference pathology.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From inclusion of patient until final visit (28 days after completion or discontinuation of study treatment).
    Adverse event reporting additional description
    Abnormal laboratory value was not assessed as AE unless that value led to discontinuation or delay in treatment, dose modification, therapeutic intervention. Progression of disease was not to be regarded as SAE. Relation to IMPs obinutuzumab and/or venetoclax is given. Deaths during FU are not part of this analysis.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.1
    Reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    All enrolled patients received the IMP and were included in the safety analysis.

    Serious adverse events
    Overall trial
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 22 (22.73%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Investigations
    C-reactive protein increased
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Hyponatraemic seizure
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Splenic infarction
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Overall trial
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    19 / 22 (86.36%)
    Vascular disorders
    Hot flush
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Surgical and medical procedures
    Tooth extraction
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    6 / 22 (27.27%)
         occurrences all number
    7
    General physical health deterioration
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Pain
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Dyspnoea
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Epistaxis
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Oropharyngeal pain
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Stridor
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Upper respiratory tract congestion
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Restlessness
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Sleep disorder
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    2
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Neutrophil count decreased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    4
    Platelet count decreased
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Troponin T increased
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    4
    Weight decreased
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    White blood cell count decreased
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Infusion related reaction
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Cardiac disorders
    Supraventricular extrasystoles
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Tachycardia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Polyneuropathy
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Tremor
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Leukopenia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    2
    Neutropenia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    4
    Thrombocytopenia
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    4
    Eye disorders
    Visual impairment
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Abdominal pain upper
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    5 / 22 (22.73%)
         occurrences all number
    5
    Gastrointestinal pain
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    10 / 22 (45.45%)
         occurrences all number
    10
    Vomiting
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    4
    Muscle spasms
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Pain in extremity
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    3
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Campylobacter infection
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Candida infection
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Pneumonia
         subjects affected / exposed
    2 / 22 (9.09%)
         occurrences all number
    2
    Sinusitis
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Hypercalcaemia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Hypocalcaemia
         subjects affected / exposed
    1 / 22 (4.55%)
         occurrences all number
    1
    Hypokalaemia
         subjects affected / exposed
    3 / 22 (13.64%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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