E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
- relapsed/refractory follicular lymphoma (FL) patients
- relapsed/refractory aggressive (DLBCL) lymphoma patients
- relapsed/refractory other indolent lymphoma patients
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10016906 |
E.1.2 | Term | Follicle centre lymphoma, follicular grade I, II, III refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012822 |
E.1.2 | Term | Diffuse large B-cell lymphoma refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015824 |
E.1.2 | Term | Extranodal marginal zone B-cell lymphoma (MALT type) refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003912 |
E.1.2 | Term | B-cell small lymphocytic lymphoma refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10003903 |
E.1.2 | Term | B-cell lymphoma refractory |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
to assess the anti-lymphoma activity of an anti-PD-L1 (atezolizumab) associated with a BCL-2 inhibitor (GDC-199, venetoclax) and an anti-CD20 monoclonal antibody (obinutuzumab) in three separate cohorts:
- relapsed/refractory follicular lymphoma (FL) patients
- relapsed/refractory aggressive (DLBCL) lymphoma patients
- relapsed/refractory other indolent lymphoma patients
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E.2.2 | Secondary objectives of the trial |
- to evaluate safety and tolerability of atezolizumab+ venetoclax+obinutuzumab for relapsed/refractory B-cell lymphomas
- to assess the efficacy of the combination of obinutuzumab+ atezolizumab+venetoclax
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Histologically documented CD20-positive follicular lymphoma (WHO grade 1, 2, or 3a) patients
OR
- patients with either histologically documented CD20-positive Diffuse large-cell lymphoma (including transformations of low-grade lymphoma into DLBCL) or follicular lymphoma CD20+ grade 3b, or primary cutaneous DLBCL leg type, or primary mediastinal (thymic) large B-cell lymphoma, or high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, or unclassifiable B-cell lymphoma with features intermediate between DLBCL and Hodgkin (WHO classification)
OR
- Relapsed/refractory indolent lymphoma (marginal zone (MZL) or lymphocytic lymphoma (LL) or measurable mucosa-associated lymphoid tissue (MALT) lymphoma)
- Relapsed/refractory NHL after ≥1 prior R-containing regimen with no curative option
- Aged 18 years or more with no upper age limit
- ECOG performance status 0, 1 or 2
- Bi-dimensionally measurable disease defined by at least one single node or tumor lesion > 1.5 cm assessed by CT scan, or PET scan without IV contrast at diagnosis with at least one
hypermetabolic lesion
- Life expectancy ≥ 3 months
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E.4 | Principal exclusion criteria |
- indolent lymphoma, waldenström macroglobulinemia, unmeasurable MALT lymphoma, and Mantle Cell Lymphoma (MCL) lymphoma
- known CD20 negative status at last biopsy done (Biopsy at relapse/progression is mandatory)
- central nervous system or meningeal involvement by lymphoma
- prior history of Progressive Multifocal Leukoencephalopathy (PML)
- documented infection with HIV
- active hepatitis B OR positive serology to hepatitis B
- active hepatitis C infection
- known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds)
- active immune-related disease criteria
- LVEF < 45% as determined by echocardiography or multiple uptake gated acquisition (MUGA) scan
- any serious active disease or co-morbid medical condition
- clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis
- any of the following laboratory abnormalities unless secondary to underlying lymphoma:
- Hemoglobin < 9 g/dL
- Absolute neutrophil count (ANC) < 1,000 cells/mm3 (1.0 G/L) unless due to lymphoma
- Platelet count < 75,000/mm3 (75 x 109/L) unless due to lymphoma
- Serum SGOT/AST or SGPT/ALT 3.0 x upper limit of normal (ULN) unless disease involvement
- Serum total bilirubin > 2.0 mg/dL (34 µmol/L), except if disease related or in case of Gilbert syndrome
- Calculated creatinine clearance (Cockcroft-Gault formula or MDRD) of < 50 mL /min
- International normalized ratio (INR) ≤ 1.5 x ULN for patients not receiving therapeutic anticoagulation
- Partial thromboplastin time (PTT) or activated PTT (aPTT) > 1.5 x ULN
- Prior history of malignancies other than lymphoma unless the subject has been free of the disease for ≥ 3 years. Excepted non-melanoma skin tumors or any surgically removed stage 0 (in situ) carcinoma
- contraindication to any drug contained in the study treatment regimen
- previous treatment with obinutuzumab, atezolizumab or venetoclax
- use of any standard or experimental anti-cancer drug therapy within 28 days prior to first administration of study drug
- use of warfarin prior to first administration of study drug and throughout all treatment period
- corticosteroids within 4 weeks prior to first administration of study drug, unless administered at a cumulated dose equivalent to ≤ 3.5mg/kg (within these 4 weeks).
- use of the following agents prior to first administration of study drug:
- strong and moderate CYP3A inhibitors (including grapefruit juice)
- strong and moderate CYP3A inducers
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E.5 End points |
E.5.1 | Primary end point(s) |
Overall Metabolic Response Rate (OMRR) according to Lugano 2014 response criteria |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
end of induction = 8 cycles of obinutuzumab, atezolizumab and venetoclax or at premature treatment discontinuation (if patient did not complete 8 cycles) |
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E.5.2 | Secondary end point(s) |
- number of SAE
- Progression Free Survival (PFS)
- Overall Survival (OS)
- Duration of Response (DoR)
- Overall Metabolic Response Rate (OMRR)
- Best Response (BR)
- Long-term safety (second cancer, immune-related disease)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
- number of SAE = 28 days after end of treatment (EOT)
- Progression Free Survival (PFS) = end of study
- Overall Survival (OS) = end of study
- Duration of Response (DoR) = end of study
- Overall Metabolic Response Rate (OMRR)
- after 4 and 8 cycles according to LYRIC (LYmphoma Response to Immunomodulatory therapy Criteria)
- after 4 cycles (M3) and at EOT (M18) according to Lugano 2014 response criteria
- Best Response (BR) = end of study
- Long-term safety (second cancer, immune-related disease) = end of study
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 25 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLP
patients will be followed until the last patient included will have been followed up for one year after his last intake of study medication |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |