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Brief Title: Lenalidomide and Epcoritamab for the Treatment of Previously Untreated Follicular Lymphoma
Official Title: A Phase 2 Study of Epcoritamab and Lenalidomide (E-Len) in Patients With Previously Untreated Follicular Lymphoma (FL)
Study ID: NCT06112847
Brief Summary: This phase II trial tests how well lenalidomide and epcoritamab works in treating patients with follicular lymphoma that has not been previously treated. Although follicular lymphoma is incurable, prognosis has improved for both early and advanced stage disease, largely attributed to therapeutic advances. Lenalidomide may stimulate or suppress the immune system in different ways and stop cancer cells from growing and by preventing the growth of new blood vessels that cancer cells need to grow. Epcoritamab is a bispecific monoclonal antibody that binds to two different antigens (the part of the target that the antibody attaches to), at the same time. This dual action allows bispecific antibodies to improve target specificity by binding two antigens on the same cell to recruit and activate immune cells to kill cancer cells. Lenalidomide and epcoritamab, when given together, may be more effective in treating patients with follicular lymphoma than if they were given alone.
Detailed Description: PRIMARY OBJECTIVE: I. To assess efficacy (complete response \[CR\] rate) of epcoritamab and lenalidomide (E-Len) in patients with de novo follicular lymphoma (FL). SECONDARY OBJECTIVES: I. To further assess efficacy of the combination (objective response rate \[ORR\], progression free survival \[PFS\], duration of response). II. To characterize the adverse event profile of the combination. EXPLORATORY OBJECTIVES: I. To characterize the T-cell population balance in patients treated with E-Len. II. To evaluate the predictive role of genetic mutations on durability of response to E-Len (including m7 Follicular Lymphoma International Prognostic Index \[FLIPI\] score). III. To evaluate minimal residual disease (MRD) dynamics on treatment. OUTLINE: Patients receive lenalidomide orally (PO) once daily (QD) on days 1-21 of each cycle and epcoritamab subcutaneously (SC) on days 1, 8, 15, and 21 of cycles 1-3 and on day 1 of each subsequent cycle. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Patients may be re-treated with study treatment at any point during the follow-up period as long as they did not progress during treatment or stop due to unacceptable toxicity. Patients also undergo computed tomography (CT), positron emission tomography (PET)/CT, or magnetic resonance imaging (MRI) as well as bone marrow biopsy throughout the trial. Patients undergo blood sample collection on trial and during follow-up. After completion of study treatment, patients are followed for safety on days 7, 30, and 60, for active response every 6 months for up to 2 years, and then for survival every 6 months.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
City of Hope Medical Center, Duarte, California, United States
City of Hope at Irvine Lennar, Irvine, California, United States
Name: Swetha Kambhampati
Affiliation: City of Hope Medical Center
Role: PRINCIPAL_INVESTIGATOR