AFM13 in Treating Patients with CD30 Positive Relapsed or Refractory Cutaneous Lymphoma
This phase Ib/IIa trial studies anti-CD30/CD16A monoclonal antibody AFM13 (AFM13) in treating patients with cutaneous lymphoma that has come back (recurrent) or does not respond to treatment (refractory). Biological therapies, such as AFM13, use substances made from living organisms that may stimulate the immune system in different ways and stop cancer cells from growing.
Inclusion Criteria
- Histologically confirmed CD30-positive lymphoma with cutaneous presentation
- Failure or intolerance to at least one prior therapy for the current disease
- Presence of one or more cutaneous lesions (measuring at least 1 cm x 1 cm in size; if only one lesion is present it should be up to the investigator discretion to determine eligibility)
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Platelets >= 50,000/uL
- Absolute neutrophil count >= 1,000/uL
- Bilirubin < 1.5 x institutional upper limit of normal (ULN) or < 3 x ULN in patients with Gilbert's disease or liver involvement
- Serum albumin >= 2.0 g/dL
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x institutional ULN or, in the case of liver involvement by the primary disease AST/ALT =< 5 x ULN
- Creatinine =< 1.5 x institutional ULN or estimated creatinine clearance of >= 45 mL/min by the Cockcroft-Gault equation or measured creatinine clearance > 45 mL/min
- Females of child bearing potential must have a negative serum pregnancy test with 7 days prior to first dose of treatment; female patients of childbearing potential and all male partners must agree to use double barrier methods of contraception throughout the study period and for at least 30 days following investigational product discontinuation
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria
- Any cancer-related therapy for the current disease within 2 weeks of screening (all supportive care measures are allowed)
- Major surgery within 2 weeks prior to first dose of study drug
- Evidence of active central nervous system (CNS) involvement
- Requirement for systemic immunosuppressive therapy (e.g. graft-versus-host disease [GVHD] therapy within 12 weeks before the first dose of study drug)
- Uncontrolled concurrent serious illness
- Concurrent malignancy requiring cytotoxic or immunotherapy based treatment
- Active infection including hepatitis B-carrier status, hepatitis C virus (HCV) infection (patients with positive serology must have a negative hepatitis [Hep] B and Hep C viral load at screening)
- Known human immunodeficiency virus (HIV)-positive status
- Any significant diseases medical condition, laboratory abnormality, or psychiatric illness that would exclude the subject from participation or interfere with study treatment, monitoring and compliance such as: * Unstable angina pectoris, symptomatic congestive heart failure (New York Heart Association [NYHA] III or IV), myocardial infarction =< 6 months prior to first study drug, clinically significant and uncontrolled cardiac arrhythmia (e.g. atrial fibrillation/flutter ventricular cardiovascular physiology is allowed), cerebrovascular accidents =< 6 months before study drug start * Severely impaired lung function
- Serious, systemic infection requiring treatment =< 7 days before the first dose of study drug
- Any severe, uncontrolled disease or condition, which in the investigator's opinion, may put the subject at significant risk, may confound the study results, or impact the subject's participation in the study
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03192202.
PRIMARY OBJECTIVES:
I. Determine the intratumoral natural killer (NK)-cell and T-cell infiltrate and density.
II. Determine the immunophenotype of immune cells (NK cells, T cells and others) in tumor and peripheral blood.
III. Quantitate the plasma cytokine production and release in tumor and peripheral blood as a function of treatment.
SECONDARY OBJECTIVES:
I. Evaluate the safety and toxicity of AFM13.
II. Determine the clinical efficacy, namely objective response rate (ORR), (including complete response [CR] and partial response [PR]), duration of response (DOR) and progression-free survival (PFS) as defined in the Revised Response Criteria for Malignant Lymphoma 2007 and modified Severity Weighted Assessment Tool (mSWAT).
III. Evaluate the pharmacokinetic profile (PK) of AFM13.
EXPLORATORY OBJECTIVES:
I. Determine the immunogenicity of AFM13.
II. Detect and quantify circulating tumor cells (CTC).
OUTLINE: This is a phase Ib, dose-escalation study followed by a phase IIa study.
Patients receive AFM13 intravenously (IV) over 1-4 hours on day 1 (or over 1 hour on day 1 and then continuously for 5 days) weekly for 8 weeks in the absence of disease progression or unacceptable toxicity. Patients with clinical benefit (stable disease [SD], partial response [PR], complete response [CR]) receive a second 8-week course of treatment with AFM13 beginning after week 11.
After completion of study treatment, patients are followed up at 4 weeks and then every 3 months for 1 year.
Trial PhasePhase I/II
Trial Typetreatment
Lead OrganizationNYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
Principal InvestigatorAhmed Sawas
- Primary IDAAAP4461
- Secondary IDsNCI-2017-01341
- ClinicalTrials.gov IDNCT03192202