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RecruitingInterventionalPhase 1

A Phase 1b, Open Label, Global, Multicenter, Dose Determination, Randomized Dose Expansion Study to Determine the Maximum Tolerated Dose, Assess the Safety and Tolerability, Pharmacokinetics and Preliminary Efficacy of Iberdomide (CC-220) in Combination With R-CHOP-21 and CC-99282 in Combination With R-CHOP-21 for Subjects With Previously Untreated Aggressive B-cell Lymphoma

NCT ID: NCT04884035Sponsor: CelgeneLast updated: 2026-06-08

Summary

This is a Phase 1b study consisting of 2 parts: a dose escalation (Part 1) of CC-220 or CC-99282 added to the standard R-CHOP-21 regimen for first-line treatment of a-BCL. The dose escalation (Part 1) will consist of 2 parallel arms in combination with Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP-21); CC-220 and R-CHOP-21 or CC-99282 and R-CHOP-21. Part 1 will be followed by a randomized dose expansion (Part 2) with CC-220 and/or CC-99282 at the Recommended Phase 2 Dose (RP2D) in combination with R-CHOP-21. A polatuzumab-R-CHP regimen in combination with CC-220 or CC-99282 will be explored with the addition of a new cohort only after the RP2D for the CC-220 and/or CC-99282 and R-CHOP-21 combination has been defined.

Arms & interventions

  • DrugCC-220

    CC-220 by mouth at the assigned dose starting on Day 1 for 14 consecutive days of the 21-day treatment cycle for 6 cycles of treatment.

  • DrugRituximab

    Rituximab 375 mg/m2 on Day 1 by intravenous (IV) infusion or 1400 mg (SC) subcutaneous (from Cycle 2) of a 21-day treatment cycle for up to a total of 6 cycles

  • DrugCyclophosphamide

    Cyclophosphamide 750mg/m2 on Day 1 by IV infusion of a 21-day treatment cycle for up to a total of 6 cycles

  • DrugDoxorubicin

    Doxorubicin 50 mg/m2 IV infusion on Day 1 of a 21-day treatment cycle for up to a total of 6 cycles

  • DrugVincristine

    Vincristine 1.4 mg/m2 (maximum of 2.0 mg total) IV intravenous on Day 1 of a 21-day treatment cycle for up to a total of 6 cycles

  • DrugPrednisone

    Prednisone 100 mg PO on Days 1 through 5 of each 21-day treatment or 100mg IV on Day 1 is also acceptable for up to a total of 6 cycles

  • DrugCC-99282

    CC-99282 by mouth at the assigned dose starting on Day 1 for 7 consecutive days of the 21-day treatment cycle for 6 cycles of treatment.

  • DrugPolatuzumab vedotin

    Polatuzumab vedotin 1.8 mg/kg on Day 1 by intravenous (IV) infusion of a 21-day treatment cycle for up to a total of 6 cycles

  • DrugRituximab

    Rituximab 375 mg/m2 on Day 1 by intravenous (IV) infusion of a 21-day treatment cycle for up to a total of 6 cycles

Outcome measures

Primary

  • Maximum Tolerated Dose (MTD) - Part 1

    Frequency of dose-limiting toxicities (DLT) associated with addition of iberdomide (CC-220) to R-CHOP-21 therapy and the addition of CC-99282 to R-CHOP-21 therapy

    Time frame: During the first 2 cycles of treatment (each cycle is 21 days)

  • Recommended Phase 2 Dose (RP2D) - Part 1

    Defined as the dose that will be selected for dose expansion based on MTD

    Time frame: During the first cycle of treatment (each cycle is 21 days)

  • Safety and tolerability of CC-220 and CC-99282 at RP2D - Part 2

    AEs evaluated using NCI CTCAE criteria, v. 5.0, including treatment -emergent adverse events (TEAEs) and laboratory assessments

    Time frame: From the first dose of any IP until 28 days after the last dose of IP

  • Maximum Tolerated Dose (MTD) - Part 2A

    Frequency of DLTs associated with addition of iberdomide (CC-220) to polatuzumab-R-CHP therapy and the addition of CC-99282 to polatuzumab-R-CHP therapy

    Time frame: During the first cycle of treatment (each cycle is 21 days)

  • Recommended Phase 2 Dose (RP2D) - Part 2A

    Defined as the dose that will be selected for dose expansion based on MTD

    Time frame: During the first cycle of treatment (each cycle is 21 days)

Secondary

  • Best overall response rate (ORR)

    Time frame: Up to 4 years

  • Complete Metabolic Response Rate (CMRR)

    Time frame: Up to 4 years

  • Time to Response (TTR)

    Time frame: Up to 4 years

  • Duration of Response (DOR)

    Time frame: Up to 4 years

  • Progression-free Survival (PFS)

    Time frame: Up to 4 years

  • Overall Survival (OS)

    Time frame: Up to 4 years

  • Pharmacokinetics - Cmax for CC-220

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days)

  • Pharmacokinetics - Ctrough for CC-220

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days

  • Pharmacokinetics - Tmax for CC-220

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days

  • Pharmacokinetics - Cmax for CC-99282

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days

  • Pharmacokinetics - Ctrough for CC-99282

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days

  • Pharmacokinetics - Tmax for CC-99282

    Time frame: At Cycle 1 Day 7, Cycle 1 Day 15, and Cycle 2 Day 7 (each cycle is 21 days

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: * Participants must satisfy the following criteria to be enrolled in the study: 1. Is ≥ 18 years of age at the time of signing the informed consent form (ICF). 2. Participant has histologically confirmed (per local evaluation) diagnosis of de novo, previously untreated, a-BCL according to 2016 WHO classification. 3. Participant has International Prognostic Index (IPI) score 0-5 in Part 1 and IPI 2-5 in Part 2. For the CELMoD and polatuzumab-R-CHP cohort, the subject must also have IPI score 0 to 5 in Part 2A and IPI 2 to 5 in Part 2B. 4. Participants must have measurable disease defined by at least one FDG-avid lesion for FDG-avid subtype and one bi-dimensionally measurable (\> 1.5 cm in longest diameter) disease by computed tomography (CT) or magnetic resonance imaging (MRI), as defined by the Lugano classification (Cheson, 2014). 5. Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. 6. Participants must have the following laboratory values: 1. Absolute neutrophil count (ANC) ≥ 1.5 x 109/L or ≥ 1.0 x 109/L in case of documented bone marrow involvement (\> 50% or tumor cells), without growth factor support for 7 days (14 days if peg-G-CSF) 2. Hemoglobin (Hb) ≥ 8 g/dL 3. Platelets (PLT) ≥ 75 x 109/L or ≥ 50 x 109/L in case of documented bone marrow involvement (\>50% or tumor cells), without transfusion for 7 days 4. Aspartate aminotransferase / serum glutamic oxaloacetic transaminase (AST/SGOT) and alanine aminotransferase / serum glutamate pyruvic transaminase (ALT/SGPT) ≤ 2.5 x upper limit of normal (ULN). In the case of documented liver involvement by lymphoma, ALT/SGPT and AST/SGOT must be ≤ 5.0 x ULN. 5. Serum total bilirubin ≤ 2.0 mg/dL except in cases of Gilbert's syndrome, then ≤ 5.0 mg/dl. Subjects receiving polatuzumab vedotin must have serum total bilirubin \< 1.5 × ULN (26 μmol/L) (corresponding to mild degree as per National Cancer Institute Organ Dysfunction Working Group \[NCI ODWG\] criteria) except in cases of Gilbert's syndrome, then ≤ 3.0 mg/dl (51 μmol/L). 6. Estimated serum creatinine clearance (CrCl) of ≥ 50 mL/min using the modification of diet in renal disease (MDRD) formula. 7. All participants must: 1. Have an understanding that the study drug could have a potential teratogenic risk. 2. Agree to follow all requirements defined in the Pregnancy Prevention Program for CC-220 or CC-99282 Pregnancy Prevention Plan for Participants in Clinical trials. 8. Females of childbearing potential (FCBP) must: a. Have two negative pregnancy tests as verified by the investigator prior to starting study therapy. 9. Male participants must: 1. Practice true abstinence or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study. Exclusion Criteria: * The presence of any of the following will exclude a participant from enrollment: 1. Any significant medical condition, active infection (including SARS-CoV-2 suspected or confirmed), laboratory abnormality, or psychiatric illness that would prevent the participant from participating in the study. 2. Any condition including the presence of laboratory abnormalities, which places the participant at unacceptable risk if he/she were to participate in the study. 3. Any other subtype of lymphoma. 4. Documented or suspected CNS involvement by lymphoma. 5. Persistent diarrhea or malabsorption ≥ Grade 2 (NCI CTCAE v5.0), despite medical management. 6. Peripheral neuropathy ≥ Grade 2 (NCI CTCAE v5.0). 7. Subjects with a history of progressive multifocal leukoencephalopathy. 8. Chronic systemic immunosuppressive therapy or corticosteroids 9. Impaired cardiac function or clinically significant cardiac disease, including any of the following: a. Left ventricular ejection fraction (LVEF) \< 45% as determined by multigated acquisition (MUGA) scan or echocardiogram (ECHO) 10. Major surgery ≤ 2 weeks prior to starting CC-220 or CC-99282; participant must have recovered from any clinically significant effects of recent surgery. 11. Any condition causing inability to swallow tablets. 12. Known seropositivity for or active viral infection with human immunodeficiency virus (HIV) 13. Known chronic active hepatitis B (hepatitis B virus surface antigen \[HBsAg\] positive and/or hepatitis B core antibody \[anti-HBc\] positive with viral DNA positive) or C (positive serology requiring treatment and/or with evidence of liver damage) infection 14. History of other malignancy, unless being free of the disease for ≥ 3 years; exceptions to the ≥ 3-year time limit include history of the following: 1. Localized nonmelanoma skin cancer 2. Carcinoma in situ of the cervix 3. Carcinoma in situ of the breast 4. Incidental histologic finding of prostate cancer (T1a or T1b as per Tumor Node Metastasis \[TNM\] staging system) or prostate cancer that has been treated with curative intent. 15. Hypersensitivity to the active substance or to murine proteins, or to any of the other excipients of rituximab or polatuzumab vedotin. 16. Known hypersensitivity to any component of CHOP/CHP regimen. 17. Known allergy to thalidomide, pomalidomide, or lenalidomide.

Study locations (17)

University Hospital (University Of Alabama Hospital)

Birmingham, Alabama, 35233

Recruiting
Aditi Saha, Site 162 · Contact

Mayo Clinic - Arizona

Scottsdale, Arizona, 85259

Recruiting
Javier Munoz, Site 154 · Contact

City Of Hope National Medical Center

Duarte, California, 91010

Recruiting
Geoffrey Shouse, Site 169 · Contact

Mayo Clinic - Jacksonville

Jacksonville, Florida, 32224

Withdrawn

Mayo Clinic Jacksonville - PPDS

Jacksonville, Florida, 32224

Recruiting
Muhamad Alhaj Moustafa, Site 160 · Contact

Northwest Georgia Oncology Centers PC

Marietta, Georgia, 30060

Recruiting
Dean Kirkel, Site 161 · Contact

University Of Kansas Medical Center

Kansas City, Kansas, 66160

Recruiting
Marc Hoffmann, Site 159 · Contact

Cancer Center Of Kansas-Wichita

Wichita, Kansas, 67214

Recruiting
Shaker Dakhil, Site 166 · Contact

Mayo Clinic - Rochester

Rochester, Minnesota, 55905-0001

Recruiting
Grzegorz Nowakowski, Site 152 · Contact

HealthPartners Cancer Research Center

Saint Louis Park, Minnesota, 55426

Recruiting
Gordon Ruan, Site 163 · Contact

University of Nebraska - Fred and Pamela Buffet Center

Omaha, Nebraska, 68198

Recruiting
Matthew Lunning, Site 151 · Contact

Roswell Park Cancer Institute

Buffalo, New York, 14263

Withdrawn

Levine Cancer Institute

Charlotte, North Carolina, 28204

Recruiting
Rakhee Vaidya, Site 170 · Contact

Atrium Health Wake Forest Baptist

Winston-Salem, North Carolina, 27157

Recruiting
Rakhee Vaidya, Site 164 · Contact

MD Anderson Cancer Center

Houston, Texas, 77003

Recruiting
Jason Westin, Site 155 · Contact

Intermountain Medical Oncology

Murray, Utah, 84107

Recruiting
Rachel Hu, Site 168 · Contact

Intermountain Cancer Center - St George

St. George, Utah, 84790

Recruiting
Rachel Hu, Site 171 · Contact

References

  • Wu C, Meyer A, Tun AM. Diffuse Large B-Cell Lymphoma Presenting in a Background of Rosai-Dorfman Disease. Case Rep Hematol. 2026 May 17;2026:6560267. doi: 10.1155/crh/6560267. eCollection 2026.(PubMed)