AFM13 in Relapsed/Refractory Cutaneous Lymphomas

Sponsor

Ahmed Sawas (Other)

Overall Status

Completed

CT.gov ID

NCT03192202

Collaborator

(none)

Enrollment

Location

Arms

32.5

Actual Duration (Months)

0.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The investigators plan to investigate AFM13 and evaluate its ability to facilitate and redirect the Natural Killer (NK) cells in eliminating CD30-positive lymphoma targets in the skin and, by inference, other organs involved by the lymphoma.

Condition or Disease	Intervention/Treatment	Phase
Lymphoma, T-Cell, Cutaneous	Drug: AFM13	Phase 1/Phase 2

Detailed Description

This is an open label, Phase Ib/IIa study designed to evaluate the biologic activity of AFM13 in patients with relapsed or refractory CD30-positive lymphomas with cutaneous involvement. Primary cutaneous CD30-positive lymphoproliferative disorders (LPD) represent a spectrum from lymphomatoid papulosis (LyP), to primary cutaneous anaplastic large cell lymphoma (C-ALCL), to transformed mycosis fungoides (TMF).

The most indolent form of primary cutaneous CD30-positive LPD is LyP, which is usually well controlled with low dose oral methotrexate, but control of the disease frequently requires life-long therapy. In contrast, TMF is an aggressive disease which does not have a standard of care, as patients are treated with various modalities of care with variable outcomes). The spectrum of other CD30-positive lymphomas with cutaneous presentation is very broad and involves systemic B and T cell lymphomas with various clinical behaviors.

Redirecting Natural Killer (NK) cells towards these CD30-positive malignancies through direct engagement with AFM13 is expected to induce tumor cell killing through NK cell-mediated and T cell-mediated cytotoxicity (i.e., cytotoxic T lymphocytes (CTL)).

The primary objective of this trial is to study the biologic and immunologic effects induced by the administration of various doses of AFM13, when given as a single agent.

Study Design

Study Type:

Interventional

Actual Enrollment :

18 participants

Allocation:

Non-Randomized

Intervention Model:

Sequential Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

Clinical and Biological Evaluation of the Novel CD30/CD16A Tetravalent Bispecific Antibody (AFM13) in Relapsed or Refractory CD30-Positive Lymphoma With Cutaneous Presentation: A Biomarker Phase Ib/IIa Study

Actual Study Start Date :

Jul 17, 2017

Actual Primary Completion Date :

Apr 1, 2020

Actual Study Completion Date :

Apr 1, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Cohort 1 1.5 mg/kg of AFM13 once weekly for weeks 1-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody
Experimental: Cohort 2 1.5 mg/kg of AFM13 three times per week for weeks 1-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody
Experimental: Cohort 3 0.5 mg/kg of AFM13 three times per week for weeks 1-2. 7.0 mg/kg of AFM13 once weekly for weeks 3-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody
Experimental: Cohort 4 1.5 mg/kg in of AFM13 three times per week for weeks 1-2. 7.0 mg/kg of AFM13 once weekly for weeks 3-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody
Experimental: Cohort 5 7.0 mg/kg of AFM13 once weekly for weeks 1-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody
Experimental: Cohort 6 4.5 mg/kg of AFM13 three times per week for weeks 1-2. 7.0 mg/kg of AFM13 once weekly for weeks 3-8.	Drug: AFM13 AFM13 is a recombinant antibody construct against human CD30 and CD16A. It will be given to patients intravenously at the dose and schedule applicable to the cohort the patient was enrolled in specified in the various arms listed. Other Names: AFM13 recombinant antibody

Outcome Measures

Primary Outcome Measures

Percentage of Intratumoral NK-cells and T-cells infiltration into tumors [Up to 2 years]
Quantified by multiplex Immuno-histochemistry (IHC) using tissue samples
Number of immune cells (NK cells, T cells, and others) in tumor and peripheral blood [Up to 2 years]
Measured by multi-color flow cytometry and immunophenotyping technique
Level of plasma cytokine production plus release in tumor and peripheral blood as a function of treatment [Up to 2 years]
Elisa test will be used to measure cytokine levels

Secondary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 [Up to 2 years]
Incidence of Treatment-Emergent Adverse Events [Safety and Toxicity] broken down by adverse event and CTCAE v4.0 grade of each event.
Overall Response Rate (ORR) [Up to 2 years]
The sum of patients with partial responses and complete responses.
Duration of Response (DOR) after treatment with AFM 13 [Up to 2 years]
The time of initial response until documented tumor progression.
Progression Free Survival (PFS) after treatment with AFM 13 [Up to 2 years]
The length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Age ≥18 years
Histologically confirmed CD30-positive lymphoma with cutaneous involvement
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
Adequate organ and marrow function
Platelets ≥50,000/μL
Absolute neutrophil count ≥ 1,000/μL
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 × 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 or history of a previous malignancy within 3 years prior to first dose of the current study, unless curatively resected basal, squamous cell carcinoma of the skin, or cervical carcinoma in situ.
Active infections including hepatitis B carrier status, hepatitis C virus (HCV) infection (patients must have a negative Hepatitis B and Hepatitis C viral load at screening)
Known HIV-positive status
Any significant medical conditions, 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.