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
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
Study locations (17)
University Hospital (University Of Alabama Hospital)
Birmingham, Alabama, 35233
Mayo Clinic - Arizona
Scottsdale, Arizona, 85259
City Of Hope National Medical Center
Duarte, California, 91010
Mayo Clinic - Jacksonville
Jacksonville, Florida, 32224
Mayo Clinic Jacksonville - PPDS
Jacksonville, Florida, 32224
Northwest Georgia Oncology Centers PC
Marietta, Georgia, 30060
University Of Kansas Medical Center
Kansas City, Kansas, 66160
Cancer Center Of Kansas-Wichita
Wichita, Kansas, 67214
Mayo Clinic - Rochester
Rochester, Minnesota, 55905-0001
HealthPartners Cancer Research Center
Saint Louis Park, Minnesota, 55426
University of Nebraska - Fred and Pamela Buffet Center
Omaha, Nebraska, 68198
Roswell Park Cancer Institute
Buffalo, New York, 14263
Levine Cancer Institute
Charlotte, North Carolina, 28204
Atrium Health Wake Forest Baptist
Winston-Salem, North Carolina, 27157
MD Anderson Cancer Center
Houston, Texas, 77003
Intermountain Medical Oncology
Murray, Utah, 84107
Intermountain Cancer Center - St George
St. George, Utah, 84790
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)