A Phase 1/2 interventional study of DI-Leu16-IL2 in B-cell Non-Hodgkin Lymphoma, sponsored by Alopexx Oncology, LLC. Terminated at 5 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-11-24.
Sponsored by Alopexx Oncology, LLC · Phase 1/2, Interventional, and Treatment
This dose-escalation study is designed for determining the safety, tolerability, pharmacokinetics (PK), biological, and clinical activity of DI-Leu16-IL2 administered to participants with cluster of differentiation 20 (CD20) positive NHL that have failed standard rituximab-containing therapy.
The participants will be enrolled during dose escalation and during 2 expansion cohorts of up to 12 participants each.
The dose escalation portion of the trial will incorporate a modified accelerated titration design. Therefore, the trial will enroll 3 participants per dose level with a doubling of the dose at each level during the accelerated stage of the study (skipping every other dose level). Once the first instance of any Grade 3 or higher treatment related toxicity (with some notable exceptions) is observed on the first cycle, the accelerated stage will end and the trial will revert to a conventional design using cohorts of 3 or 6 participants (standard 3+3 design), with single step 2 milligrams (mg)/square meter (m\^2) increments.
To further explore the clinical efficacy, additional participants (up to 12 per cohort) may be enrolled at the optimal biologic dose (OBD) or maximum tolerated dose (MTD).
At the end of the study, participants may be enrolled into an open-label extension study (AO-101-EXT [NCT02151903]), at the discretion of the investigator.
5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.
This study's enrollment of 24 is below the median of 40 across 4,508 interventional studies indexed under Lymphoma.
Browse Lymphoma studies →Alopexx Oncology, LLC is the lead sponsor of 2 studies on the registry; none are open to participants now.
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Participants who have received a prior allogeneic stem cell transplant are eligible if:
Adequate baseline functions:
Exclusion Criteria:
Participants will receive DI-Leu16-IL2 0.5 mg/m\^2 subcutaneously (SC) for 3 consecutive days every 3 weeks (21-day cycle) for a total of 4 cycles.
Drug: DI-Leu16-IL2
Participants will receive DI-Leu16-IL2 1.0 mg/m\^2 SC for 3 consecutive days every 3 weeks (21-day cycle) for a total of 4 cycles.
Drug: DI-Leu16-IL2
Participants will receive DI-Leu16-IL2 2.0 mg/m\^2 SC for 3 consecutive days every 3 weeks (21-day cycle) for a total of 4 cycles.
Drug: DI-Leu16-IL2
Participants will receive DI-Leu16-IL2 4.0 mg/m\^2 SC for 3 consecutive days every 3 weeks (21-day cycle) for a total of 4 cycles
Drug: DI-Leu16-IL2
Participants will receive DI-Leu16-IL2 6.0 mg/m\^2 SC for 3 consecutive days every 3 weeks (21-day cycle) for a total of 4 cycles.
Drug: DI-Leu16-IL2
DI-Leu16-IL2 will be administered per dose and schedule specified in the arm.
Maximum Tolerated Dose (MTD) of DI-Leu16-IL2
The MTD was determined based on toxicities from the first 2 cycles of treatment. The MTD was the highest dose tested with no more than 1 participant out of 6 experienced a dose-limiting toxicity (DLT). All non-hematologic adverse events (AEs) and all hematologic AEs of greater than Grade 3 were considered relevant to determining DLTs. DLTs included absolute lymphocyte count (ALC) Grade 3 and 4 (if ALC does not resolve to baseline grade according to Common Terminology Criteria for Adverse Events (CTCAE) v4 within 5 days post the final injection per cycle of DI-Leu16-IL2), and absolute neutrophil count (ANC) Grade 3 (If ANC does not resolve to at least Grade 2 within 5 days post the final injection per cycle of DI-Leu16-IL2) and Grade 4 (any).
Time frame: First 2 cycles of treatment (each cycle = 21 days)
Number of Participants With a DLT
All non-hematologic AEs and all hematologic AEs of greater than Grade 3 were considered relevant to determining DLTs. DLTs included ALC Grade 3 and 4 (if ALC does not resolve to baseline grade according to CTCAE v4 within 5 days post the final injection per cycle of DI-Leu16-IL2), and ANC Grade 3 (If ANC does not resolve to at least Grade 2 within 5 days post the final injection per cycle of DI-Leu16-IL2) and Grade 4 (any).
Time frame: First 2 cycles of treatment (each cycle = 21 days)
Number of Participants With Best Overall Response (BOR) Assessed Per International Workshop for Non-Hodgkin Lymphoma (NHL) Response Criteria
BOR included complete response (CR), unconfirmed CR (CRu), partial response (PR), stable disease (SD), and progressive disease (PD). CR: 1) Disappearance of all detectable clinical and radiological evidence of disease; 2) lymph nodes (LN) regressed to normal size; 3) other organs (spleen, liver, kidneys) that were enlarged before therapy must have decreased in size; 4) clear bone marrow (BM) infiltrate. CRu: must meet CR criteria 1 and 3, as well as ≥1 of following: residual LN mass \>1.5 cm in greatest transverse diameter; individual nodes that were previously confluent regressed by \>75% in sum of product diameters (SPD); or indeterminate BM. PR: 6 largest dominant nodes or nodal masses decreased by ≤50% in SPD; no increase in size of other nodes; liver or spleen; splenic and hepatic nodules regressed ≥50% in SPD; and no new disease. SD: less than a PR but not PD. PD: 50% increase from nadir in SPD of any abnormal node for PR or nonresponders and appearance of any new lesion.
Time frame: First dose of study drug until first appearance of CR, CRu, PR, SD, or PD (up to 6 months)
Tumor Measurement: Percent Change From Baseline in Sum of Product of Diameters at the End of Study
Sum of product diameters sums the product of the 2 tumor measurements on each lesion. If only 1 measurement was available, it was used as the longest length and the product of the lengths in the sum. Baseline value is the last non-missing measurement prior to receiving study drug injection. None of the participants were considered evaluable in 'DI-Leu16-IL2 0.5 mg/m\^2' arm for this outcome measure at the end of study, and therefore, data were not collected for that arm.
Time frame: Baseline, end of study (EOS) (up to approximately 3 years)
Tumor Measurement: Percent Change From Baseline in Sum of Longest Diameters at the End of Study
Sum of longest diameters is the sum of the longest measured length of each tumor lesion. Baseline value is the last non-missing measurement prior to receiving study drug injection. None of the participants were considered evaluable in 'DI-Leu16-IL2 0.5 mg/m\^2' arm for this outcome measure at the end of study, and therefore, data were not collected for that arm.
Time frame: Baseline, EOS (up to approximately 3 years)
Number of Participants With Anti-DI-Leu16-IL2 Antibodies
Time frame: First dose of study drug up to EOS (up to approximately 3 years)
| Milestone | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Started | 3 | 3 | 9 | 7 | 2 |
| Received at least 1 dose of study drug | 3 | 3 | 9 | 7 | 2 |
| Completed | 0 | 3 | 4 | 0 | 0 |
| Not completed | 3 | 0 | 5 | 7 | 2 |
| Withdrew: Withdrawal by subject | 1 | 0 | 2 | 1 | 1 |
| Withdrew: Physician decision | 0 | 0 | 0 | 1 | 0 |
| Withdrew: Progressive disease | 2 | 0 | 3 | 5 | 1 |
The MTD was determined based on toxicities from the first 2 cycles of treatment. The MTD was the highest dose tested with no more than 1 participant out of 6 experienced a dose-limiting toxicity (DLT). All non-hematologic adverse events (AEs) and all hematologic AEs of greater than Grade 3 were considered relevant to determining DLTs. DLTs included absolute lymphocyte count (ALC) Grade 3 and 4 (if ALC does not resolve to baseline grade according to Common Terminology Criteria for Adverse Events (CTCAE) v4 within 5 days post the final injection per cycle of DI-Leu16-IL2), and absolute neutrophil count (ANC) Grade 3 (If ANC does not resolve to at least Grade 2 within 5 days post the final injection per cycle of DI-Leu16-IL2) and Grade 4 (any).
| mg/m^2 | DI-Leu16-IL2 |
|---|---|
| Maximum Tolerated Dose (MTD) of DI-Leu16-IL2 | 4.0 |
All non-hematologic AEs and all hematologic AEs of greater than Grade 3 were considered relevant to determining DLTs. DLTs included ALC Grade 3 and 4 (if ALC does not resolve to baseline grade according to CTCAE v4 within 5 days post the final injection per cycle of DI-Leu16-IL2), and ANC Grade 3 (If ANC does not resolve to at least Grade 2 within 5 days post the final injection per cycle of DI-Leu16-IL2) and Grade 4 (any).
| Participants | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Number of Participants With a DLT | 0 | 0 | 0 | 0 | 2 |
BOR included complete response (CR), unconfirmed CR (CRu), partial response (PR), stable disease (SD), and progressive disease (PD). CR: 1) Disappearance of all detectable clinical and radiological evidence of disease; 2) lymph nodes (LN) regressed to normal size; 3) other organs (spleen, liver, kidneys) that were enlarged before therapy must have decreased in size; 4) clear bone marrow (BM) infiltrate. CRu: must meet CR criteria 1 and 3, as well as ≥1 of following: residual LN mass \>1.5 cm in greatest transverse diameter; individual nodes that were previously confluent regressed by \>75% in sum of product diameters (SPD); or indeterminate BM. PR: 6 largest dominant nodes or nodal masses decreased by ≤50% in SPD; no increase in size of other nodes; liver or spleen; splenic and hepatic nodules regressed ≥50% in SPD; and no new disease. SD: less than a PR but not PD. PD: 50% increase from nadir in SPD of any abnormal node for PR or nonresponders and appearance of any new lesion.
| Participants | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| CR | 0 | 0 | 2 | 1 | 0 |
| CRu | 0 | 0 | 0 | 0 | 0 |
| PR | 0 | 1 | 1 | 0 | 0 |
| SD | 2 | 2 | 1 | 2 | 0 |
| PD | 1 | 0 | 4 | 4 | 2 |
Sum of product diameters sums the product of the 2 tumor measurements on each lesion. If only 1 measurement was available, it was used as the longest length and the product of the lengths in the sum. Baseline value is the last non-missing measurement prior to receiving study drug injection. None of the participants were considered evaluable in 'DI-Leu16-IL2 0.5 mg/m\^2' arm for this outcome measure at the end of study, and therefore, data were not collected for that arm.
| percent change | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Tumor Measurement: Percent Change From Baseline in Sum of Product of Diameters at the End of Study | — | -31.54881 ± 60.445273 | -26.37248 ± 78.719865 | 48.83017 ± 120.291120 | 87.98408 ± 78.864919 |
Sum of longest diameters is the sum of the longest measured length of each tumor lesion. Baseline value is the last non-missing measurement prior to receiving study drug injection. None of the participants were considered evaluable in 'DI-Leu16-IL2 0.5 mg/m\^2' arm for this outcome measure at the end of study, and therefore, data were not collected for that arm.
| percent change | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Tumor Measurement: Percent Change From Baseline in Sum of Longest Diameters at the End of Study | — | -30.657 ± 60.3132 | -27.412 ± 49.2553 | 1.398 ± 43.4731 | 28.516 ± 22.5263 |
No measurements were reported for this outcome.
Collected over First dose of study drug up to EOS (up to approximately 3 years). Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| DI-Leu16-IL2 0.5 mg/m^2 | 0/3 (0%) | 0/3 (0%) | 3/3 (100%) |
| DI-Leu16-IL2 1.0 mg/m^2 | 0/3 (0%) | 2/3 (66.7%) | 3/3 (100%) |
| DI-Leu16-IL2 2.0 mg/m^2 | 0/9 (0%) | 1/9 (11.1%) | 9/9 (100%) |
| DI-Leu16-IL2 4.0 mg/m^2 | 0/7 (0%) | 3/7 (42.9%) | 7/7 (100%) |
| DI-Leu16-IL2 6.0 mg/m^2 | 0/2 (0%) | 1/2 (50%) | 2/2 (100%) |
| Event | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Cytokine release syndromeImmune system disorders | 0/3 | 0/3 | 0/9 | 0/7 | 1/2 |
| AnaemiaBlood and lymphatic system disorders | 0/3 | 1/3 | 0/9 | 0/7 | 0/2 |
| MelaenaGastrointestinal disorders | 0/3 | 1/3 | 0/9 | 0/7 | 0/2 |
| Abdominal infectionInfections and infestations | 0/3 | 1/3 | 0/9 | 0/7 | 0/2 |
| PyrexiaGeneral disorders | 0/3 | 0/3 | 0/9 | 2/7 | 0/2 |
| ThrombocytopeniaBlood and lymphatic system disorders | 0/3 | 0/3 | 0/9 | 1/7 | 0/2 |
| Renal failure acuteRenal and urinary disorders | 0/3 | 0/3 | 0/9 | 1/7 | 0/2 |
| DyspnoeaRespiratory, thoracic and mediastinal disorders | 0/3 | 0/3 | 1/9 | 0/7 | 0/2 |
| Event | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 |
|---|---|---|---|---|---|
| Injection site erythemaGeneral disorders | 2/3 | 3/3 | 7/9 | 6/7 | 2/2 |
| Injection site pruritusGeneral disorders | 3/3 | 3/3 | 6/9 | 4/7 | 1/2 |
| ChillsGeneral disorders | 1/3 | 1/3 | 5/9 | 7/7 | 2/2 |
| FatigueGeneral disorders | 1/3 | 3/3 | 4/9 | 6/7 | 1/2 |
| PyrexiaGeneral disorders | 1/3 | 1/3 | 5/9 | 3/7 | 2/2 |
| PainGeneral disorders | 0/3 | 3/3 | 2/9 | 3/7 | 1/2 |
| ThrombocytopeniaBlood and lymphatic system disorders | 0/3 | 1/3 | 3/9 | 1/7 | 2/2 |
| Alanine aminotransferase increasedInvestigations | 0/3 | 0/3 | 2/9 | 1/7 | 2/2 |
| Blood alkaline phosphatase increasedInvestigations | 0/3 | 0/3 | 2/9 | 1/7 | 2/2 |
| CoughRespiratory, thoracic and mediastinal disorders | 1/3 | 2/3 | 1/9 | 1/7 | 2/2 |
Safety population included all enrolled participants who received at least 1 dose of study drug.
| Age, Continuous(years) | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 | Total |
|---|---|---|---|---|---|---|
| Mean | 51.3 ± 12.22 | 66.7 ± 14.84 | 64.0 ± 11.55 | 59.6 ± 9.61 | 57.5 ± 13.44 | 60.9 ± 11.49 |
| Sex: Female, Male(Participants) | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 | Total |
|---|---|---|---|---|---|---|
| Female | 1 | 1 | 6 | 0 | 2 | 10 |
| Male | 2 | 2 | 3 | 7 | 0 | 14 |
| Tumor Measurement: Sum of Product of Diameters(centimeters (cm)) | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 | Total |
|---|---|---|---|---|---|---|
| Mean | 15.11667 ± 9.726296 | 12.21667 ± 12.110806 | 17.63953 ± 16.388997 | 27.95857 ± 22.005858 | 27.86500 ± 10.896515 | 20.50816 ± 16.836733 |
| Tumor Measurement: Sum of Longest of Diameters(cm) | DI-Leu16-IL2 0.5 mg/m^2 | DI-Leu16-IL2 1.0 mg/m^2 | DI-Leu16-IL2 2.0 mg/m^2 | DI-Leu16-IL2 4.0 mg/m^2 | DI-Leu16-IL2 6.0 mg/m^2 | Total |
|---|---|---|---|---|---|---|
| Mean | 6.000 ± 3.0414 | 6.133 ± 4.3524 | 9.462 ± 5.4068 | 11.100 ± 5.1901 | 10.300 ± 5.6569 | 9.161 ± 4.9829 |
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Alopexx Oncology, LLC