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GLOFITAMAB STEP-UP DOSING (SUD): UPDATED EFFICACY DATA SHOW HIGH COMPLETE RESPONSE RATES IN HEAVILY PRETREATED RELAPSED/REFRACTORY (R/R) NON-HODGKIN LYMPHOMA (NHL) PATIENTS (PTS)
Author(s): ,
Carmelo Carlo-Stella
Affiliations:
Humanitas University and Humanitas Research Hospital,Milan,Italy
,
Martin Hutchings
Affiliations:
Rigshospitalet,Copenhagen,Denmark
,
Fritz C. Offner
Affiliations:
Universitair Ziekenhuis Gent,Ghent,Belgium
,
Franck Morschhauser
Affiliations:
Hôpital Claude Huriez and Centre Hospitalier Régional Universitaire de Lille,Lille,France
,
Emmanuel Bachy
Affiliations:
Hospices Civils de Lyon and Université Claude Bernard,Pierre-Bénite,France
,
Michael Crump
Affiliations:
Princess Margaret Hospital,Toronto,Canada
,
Anna Sureda
Affiliations:
Institut Català d'Oncologia Hospitalet, IDIBELL, Universitat de Barcelona,Barcelona,Spain
,
Gloria Iacoboni
Affiliations:
Vall d’Hebron University Hospital,Barcelona,Spain
,
Corinne Haioun
Affiliations:
Hopital Henri Mondor, AP-HP,Créteil,France
,
David Perez-Callejo
Affiliations:
F. Hoffmann-La Roche Ltd,Basel,Switzerland
,
Linda Lundberg
Affiliations:
F. Hoffmann-La Roche Ltd,Basel,Switzerland
,
James Relf
Affiliations:
Roche Products Ltd,Welwyn Garden City,United Kingdom
,
Emma Clark
Affiliations:
Roche Products Ltd,Welwyn Garden City,United Kingdom
,
David Carlile
Affiliations:
Roche Products Ltd,Welwyn Garden City,United Kingdom
,
Emily Piccione
Affiliations:
Genentech, Inc.,South San Francisco, CA,United States
,
Anton Belousov
Affiliations:
F. Hoffmann-La Roche Ltd,Basel,Switzerland
,
Kathryn Humphrey
Affiliations:
Roche Products Ltd,Welwyn Garden City,United Kingdom
Michael J. Dickinson
Affiliations:
Peter MacCallum Cancer Centre, Royal Melbourne Hospital and The University of Melbourne,Melbourne,Australia
EHA Library. Carlo-Stella C. 06/09/21; 325261; EP501
Prof. Carmelo Carlo-Stella
Prof. Carmelo Carlo-Stella
Contributions
Abstract
Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP501

Type: E-Poster Presentation

Session title: Aggressive Non-Hodgkin lymphoma - Clinical

Background
Glofitamab (RG6026), a T-cell-engaging, bispecific, full-length antibody, allows bivalent binding to CD20 (B-cells), and monovalent binding to CD3 (T-cells). In NP30179 (NCT03075696), an ongoing multicenter, Phase I dose-escalation and expansion study, 0.6–25mg glofitamab fixed-dosing with obinutuzumab pretreatment (Gpt), showed high, durable complete responses and manageable safety in heavily pretreated R/R NHL (Dickinson, et al. EHA 2020). Glofitamab SUD, in addition to Gpt, allowed dose escalation up to 30mg to maximize efficacy, while mitigating cytokine release syndrome (CRS) (Hutchings, et al. J Clin Oncol 2021).

Aims
To present updated efficacy data from glofitamab monotherapy SUD cohorts.

Methods
Gpt (1000mg) was given to pts 7 days pre-glofitamab initial dose. Intravenous SUD of glofitamab was given on Day (D) 1 and 8 of Cycle (C) 1 and then at the target dose from C2D1 (2.5/10/16mg or 2.5/10/30mg); treatment continued for up to 12 cycles, every 21 days. Response rates were based on the Lugano criteria (Cheson, et al. J Clin Oncol 2014).

Results
Fifty-two pts received glofitamab SUD; 17 and 35 pts received 2.5/10/16mg and 2.5/10/30mg, respectively. Twenty-eight pts (53.8%) had aggressive NHL (aNHL) and 24 pts had indolent NHL (iNHL). Pts had a median age of 68 (44–85) years and received a median of 3 (1–12) prior lines of therapy. Forty (76.9%) and 38 (73.1%) pts were refractory to their most recent and any prior CD20 therapy, respectively.

After a median follow-up of 6.3 months, an updated efficacy analysis was conducted on December 1, 2020. For pts with aNHL (N=28), the best overall response (OR) and complete metabolic response (CMR) rates were 64.3% and 57.1%, respectively; a trend of improved response was observed with increased target dose, with a CMR rate of 71.4% at 2.5/10/30mg (N=14). Notably, 4/5 pts (80%) with mantle cell lymphoma (2.5/10/16mg, n=2; 2.5/10/30mg, n=2) had CMR. For aNHL, 13/16 CMRs are ongoing, with 8 CMRs lasting >3 months. For pts with iNHL (N=24), OR and CMR rates were 79.2% and 70.8%, respectively; 14/17 CMRs are ongoing, with 10 CMRs lasting >3 months.


As of August 3, 2020, common adverse events (52 pts) were CRS (63.5%), neutropenia (38.5%), and pyrexia (32.7%). CRS was mostly confined to C1: 24/50 pts had CRS after 2.5mg; 20/49 pts after 10mg; 2/16 and 8/32 pts had CRS after 16 and 30mg (C2D1), respectively. Grade [Gr] 1 and 2 CRS was reported in 18 (34.6%) and 12 (23%) pts, respectively; 3 pts had Gr 3 CRS; none had Gr 4/5 events (ASTCT 2019).


Updated data, including biomarker data on baseline CD20 expression and CD8 levels in the tumor, will be presented.

Conclusion
Updated data for glofitamab monotherapy SUD show higher preliminary response rates than previously reported in pts with R/R NHL who have failed multiple lines of therapy. CRS was mostly manageable, of low grade, and confined to the first cycle of treatment. © 2021 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted and previously presented at the 2021 ASCO Annual Meeting. All rights reserved.

Keyword(s): Bispecific, Non-Hodgkin's lymphoma, Refractory, Relapsed lymphoma

Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP501

Type: E-Poster Presentation

Session title: Aggressive Non-Hodgkin lymphoma - Clinical

Background
Glofitamab (RG6026), a T-cell-engaging, bispecific, full-length antibody, allows bivalent binding to CD20 (B-cells), and monovalent binding to CD3 (T-cells). In NP30179 (NCT03075696), an ongoing multicenter, Phase I dose-escalation and expansion study, 0.6–25mg glofitamab fixed-dosing with obinutuzumab pretreatment (Gpt), showed high, durable complete responses and manageable safety in heavily pretreated R/R NHL (Dickinson, et al. EHA 2020). Glofitamab SUD, in addition to Gpt, allowed dose escalation up to 30mg to maximize efficacy, while mitigating cytokine release syndrome (CRS) (Hutchings, et al. J Clin Oncol 2021).

Aims
To present updated efficacy data from glofitamab monotherapy SUD cohorts.

Methods
Gpt (1000mg) was given to pts 7 days pre-glofitamab initial dose. Intravenous SUD of glofitamab was given on Day (D) 1 and 8 of Cycle (C) 1 and then at the target dose from C2D1 (2.5/10/16mg or 2.5/10/30mg); treatment continued for up to 12 cycles, every 21 days. Response rates were based on the Lugano criteria (Cheson, et al. J Clin Oncol 2014).

Results
Fifty-two pts received glofitamab SUD; 17 and 35 pts received 2.5/10/16mg and 2.5/10/30mg, respectively. Twenty-eight pts (53.8%) had aggressive NHL (aNHL) and 24 pts had indolent NHL (iNHL). Pts had a median age of 68 (44–85) years and received a median of 3 (1–12) prior lines of therapy. Forty (76.9%) and 38 (73.1%) pts were refractory to their most recent and any prior CD20 therapy, respectively.

After a median follow-up of 6.3 months, an updated efficacy analysis was conducted on December 1, 2020. For pts with aNHL (N=28), the best overall response (OR) and complete metabolic response (CMR) rates were 64.3% and 57.1%, respectively; a trend of improved response was observed with increased target dose, with a CMR rate of 71.4% at 2.5/10/30mg (N=14). Notably, 4/5 pts (80%) with mantle cell lymphoma (2.5/10/16mg, n=2; 2.5/10/30mg, n=2) had CMR. For aNHL, 13/16 CMRs are ongoing, with 8 CMRs lasting >3 months. For pts with iNHL (N=24), OR and CMR rates were 79.2% and 70.8%, respectively; 14/17 CMRs are ongoing, with 10 CMRs lasting >3 months.


As of August 3, 2020, common adverse events (52 pts) were CRS (63.5%), neutropenia (38.5%), and pyrexia (32.7%). CRS was mostly confined to C1: 24/50 pts had CRS after 2.5mg; 20/49 pts after 10mg; 2/16 and 8/32 pts had CRS after 16 and 30mg (C2D1), respectively. Grade [Gr] 1 and 2 CRS was reported in 18 (34.6%) and 12 (23%) pts, respectively; 3 pts had Gr 3 CRS; none had Gr 4/5 events (ASTCT 2019).


Updated data, including biomarker data on baseline CD20 expression and CD8 levels in the tumor, will be presented.

Conclusion
Updated data for glofitamab monotherapy SUD show higher preliminary response rates than previously reported in pts with R/R NHL who have failed multiple lines of therapy. CRS was mostly manageable, of low grade, and confined to the first cycle of treatment. © 2021 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted and previously presented at the 2021 ASCO Annual Meeting. All rights reserved.

Keyword(s): Bispecific, Non-Hodgkin's lymphoma, Refractory, Relapsed lymphoma

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