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NCT02951156: Javelin DLBCL

Avelumab In Combination Regimens That Include An Immune Agonist, Epigenetic Modulator, CD20 Antagonist and/or Conventional Chemotherapy in Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma (R/R DLBCL)

Terminated Phase 3 Results posted Last updated 17 December 2020
What this trial tests

Phase 3 trial testing Avelumab in Diffuse Large B-Cell Lymphoma in 29 participants. Terminated before completion.

Timeline
16 December 2016
Primary endpoint
2 December 2019
2 December 2019

Quick facts

Lead sponsorPfizer
PhasePhase 3
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment29
Start date16 December 2016
Primary completion2 December 2019
Estimated completion2 December 2019
Sites29 locations across Italy, Belgium, United Kingdom, Poland, South Korea, Australia, United States, Spain

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer — full company profile →

Who can join

18 and older, any sex, with Diffuse Large B-Cell Lymphoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants With Dose Limiting Toxicities (DLT) Primary · Day 1 Cycle 1 up to 4 Weeks

AEs occurring in first 4 weeks of treatment,attributable to 1 of study drugs. Hematology:1)Grade 4 neutropenia,2)Grade \>=3 febrile neutropenia with single temperature of \>38.3 degrees Celsius (C)/sustained temperature of \>=38.0 degrees C for more than 1 hour with/without associated sepsis,3)Grade \>=3 neutropenic infection,4)Grade 4 thrombocytopenia/Grade 3 thrombocytopenia with clinically significant bleeding,5)Grade 4 anemia 6)Any grade \>=3 non-hematology toxicity except:transient Grade 3 flu like symptoms/fever controlled with standard medical management;transient Grade 3 fatigue,locali

GroupValue95% CI
Avelumab+Rituximab+Utomilumab1
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab0
Objective Response Rate (ORR) as Assessed by Investigator Per Lugano Response Classification Criteria Primary · Randomization until date of PD, start of new anticancer therapy, discontinuation from study or death due to any cause, whichever occurred first (maximum up to 36 months)

ORR was defined as percentage of participants with complete response (CR) or partial response (PR), as assessed by investigator per lugano response classification criteria. CR was defined as a score of 1 (no uptake above background), 2 (uptake less than or equal to \[\<=\] mediastinum), or 3 (uptake less than \[\<\] mediastinum but \<=liver) with or without a residual mass on PET 5-point scale (5-PS), for lymph nodes and extralymphatic sites; no new lesions; no evidence of fluorodeoxyglucose (FDG)-avid disease in bone marrow. PR was defined as \>=50% decrease in SPD of up to six of the largest

GroupValue95% CI
Avelumab+Rituximab+Utomilumab11.10.3 – 48.2
Avelumab+Azacitidine+Utomilumab00.0 – 33.6
Avelumab+Bendamustine+Rituximab27.36.0 – 61.0
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) Greater Than or Equal to (>=) Grade 3, As Per National Cancer Institute Common Terminology Criteria For Adverse Events (NCI-CTCAE), Version 4.03 Secondary · From first dose of study treatment up to at least 30 days after the last dose of study treatment or initiation of new anti-cancer therapy (up to 36 months)

AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. As per NCI-CTCAE version 4.03,severity was graded as Grade 1:asymptomatic/mild symptoms,clinical/diagnostic observations only, intervention not indicated; Grade 2:moderate, minimal, local/noninvasive intervention indicated,limiting age-appropriate instrumental activities of daily life (ADL); Grade 3:severe/medically significant but not immediately life-threatening, hospitalization/prolongation of existing hospitalization indicated, disabling, limiting self-care

GroupValue95% CI
Avelumab+Rituximab+Utomilumab4
Avelumab+Azacitidine+Utomilumab7
Avelumab+Bendamustine+Rituximab10
Number of Participants With Laboratory Abnormalities As Per National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTCAE), Version 4.03 Secondary · From first dose of study treatment up to at least 30 days after the last dose of study treatment or initiation of new anti-cancer therapy (up to 36 months)

Laboratory parameters included hematological and biochemistry: Hematological parameters included: anemia, haemoglobin increased, lymphocyte count decreased, lymphocyte count increased, neutrophil count decreased, platelet count decreased and white blood cells decreased. Biochemistry parameters included alanine aminotransferase increased, alkaline phosphatase increased, aspartate aminotransferase increased, blood bilirubin increased, cholesterol high, creatine kinase(cpk) increased, creatinine increased, gamma glutamyl transferase(ggt) increased, hypercalcemia, hyperglycemia, hyperkalemia, hype

Anemia
GroupValue95% CI
Avelumab+Rituximab+Utomilumab6
Avelumab+Azacitidine+Utomilumab8
Avelumab+Bendamustine+Rituximab10
Hemoglobin increased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab0
Lymphocyte count decreased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab4
Avelumab+Azacitidine+Utomilumab7
Avelumab+Bendamustine+Rituximab9
Lymphocyte count increased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab0
Neutrophil count decreased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab2
Avelumab+Azacitidine+Utomilumab2
Avelumab+Bendamustine+Rituximab9
Platelet count decreased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab4
Avelumab+Azacitidine+Utomilumab3
Avelumab+Bendamustine+Rituximab8
White blood cell decreased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab1
Avelumab+Azacitidine+Utomilumab4
Avelumab+Bendamustine+Rituximab8
Alanine aminotransferase increased
GroupValue95% CI
Avelumab+Rituximab+Utomilumab2
Avelumab+Azacitidine+Utomilumab5
Avelumab+Bendamustine+Rituximab2
Number of Participants With Electrocardiogram (ECG) Abnormalities Secondary · From first dose of study treatment up to at least 30 days after the last dose of study treatment or initiation of new anti-cancer therapy (up to 36 months)

ECG abnormalities included: 1) QT interval, QT interval corrected using Bazett's formula (QTcB) and QT interval corrected using Fridericia's formula (QTcF): increase from baseline greater than (\>) 30 millisecond (ms) or 60 ms; absolute value \>450 ms, \>480 ms and \>500 ms; 2) heart rate (HR): absolute value \<=50 beats per minute (bpm) and decrease from baseline \>=20 bpm; absolute value \>=120 bpm and increase from baseline \>=20 bpm; 3) PR interval: absolute value \>=220 ms and increase from baseline \>=20 ms; 4) QRS interval: absolute value \>=120 ms.

QT: Increase from baseline >30 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab4
Avelumab+Azacitidine+Utomilumab4
Avelumab+Bendamustine+Rituximab4
QT: Increase from baseline >60 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab1
Avelumab+Azacitidine+Utomilumab3
Avelumab+Bendamustine+Rituximab2
QT: >450 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab2
Avelumab+Azacitidine+Utomilumab2
Avelumab+Bendamustine+Rituximab2
QT: >480 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab1
Avelumab+Bendamustine+Rituximab1
QT: >500 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab0
QTcB: Increase from baseline >30 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab1
Avelumab+Azacitidine+Utomilumab3
Avelumab+Bendamustine+Rituximab4
QTcB: Increase from baseline >60 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab1
Avelumab+Azacitidine+Utomilumab1
Avelumab+Bendamustine+Rituximab0
QTcB: >450 ms
GroupValue95% CI
Avelumab+Rituximab+Utomilumab4
Avelumab+Azacitidine+Utomilumab5
Avelumab+Bendamustine+Rituximab9
Duration of Response (DOR) as Assessed by Investigator Per Lugano Response Classification Criteria Secondary · First response (CR or PR) to date of PD, start of new anti-cancer therapy, discontinuation from the study, censoring date or death due to any cause, whichever occurred first (maximum up to 36 months)

Investigator assessed DOR: was defined for participants with OR as time from first documentation of OR to time of first documentation of disease progression/death due to any cause, whichever occurred first. CR: score of 1(no uptake above background),2(uptake \<=mediastinum),or 3(uptake \<mediastinum but \<=liver) with or without a residual mass on PET 5-PS,for lymph nodes extralymphatic sites;no new lesions;no evidence of FDG-avid disease in bone marrow. PR: \>=50% decrease in SPD of up to 6 of largest dominant lymph nodes,no increase in size of other nodes,liver,spleen volume,\>=50% decrease

GroupValue95% CI
Avelumab+Rituximab+Utomilumab1.811.81 – 1.81
Avelumab+Bendamustine+RituximabNANA – NA
Time to Tumor Response (TTR) as Assessed by Investigator Per Lugano Response Classification Criteria Secondary · From the date of randomization to the first documentation of objective response (CR or PR) (maximum up to 36 months)

TTR was defined for participants who achieved objective response as time from randomization to first documentation of objective tumor response (CR or PR) that was subsequently confirmed. CR was defined as a score of 1 (no uptake above background), 2 (uptake \<= mediastinum), or 3 (uptake \<mediastinum but \<=liver) with or without a residual mass on PET 5-PS, for lymph nodes and extralymphatic sites; no new lesions; no evidence of FDG-avid disease in bone marrow. PR was defined as \>=50% decrease in SPD of up to six of the largest dominant lymph nodes, no increase in size of other nodes, liver

GroupValue95% CI
Avelumab+Rituximab+Utomilumab1.81.8 – 1.8
Avelumab+Bendamustine+Rituximab1.91.7 – 2.6
Disease Control Rate as Assessed by the Investigator Per Lugano Response Classification Criteria Secondary · From the date of randomization to the first documentation of PD, study discontinuation, start of new anti-cancer therapy or death due to any cause, whichever occurred first (maximum up to 36 months)

Disease control rate was defined as percentage of participants with disease control. Disease Control (DC) was defined as the best overall response of CR, PR, or stable disease (SD). CR: score of 1 (no uptake above background), 2 (uptake \<= mediastinum), or 3 (uptake less than \<mediastinum but \<=liver) with or without a residual mass on PET 5-PS, for lymph nodes and extralymphatic sites; no new lesions; no evidence of FDG-avid disease in bone marrow. PR: \>=50% decrease in SPD of up to six of the largest dominant lymph nodes, no increase in size of other nodes, liver, or spleen volume, a \>=

GroupValue95% CI
Avelumab+Rituximab+Utomilumab22.22.8 – 60.0
Avelumab+Azacitidine+Utomilumab00 – 33.6
Avelumab+Bendamustine+Rituximab36.410.9 – 69.2
Progression-Free Survival (PFS) as Assessed by the Investigator Per Lugano Response Classification Criteria Secondary · From the date of randomization to progression of disease, study discontinuation, censoring date or death due to any cause, whichever occurred first (up to 36 months)

Investigator assessed PFS was defined as time (in months) from date of randomization to the first documentation of disease progression or death (due to any cause), whichever occurred first. PFS data was censored on the date of the last adequate tumor assessment for participants who had no an event (PD or death), for participants who start a new anti-cancer therapy prior to an event or for participants with an event after 2 or more missing or inadequate post-baseline tumor assessment. Participants without an adequate baseline or post-baseline tumor assessment were censored on the date of random

GroupValue95% CI
Avelumab+Rituximab+Utomilumab1.80.6 – 3.5
Avelumab+Azacitidine+Utomilumab1.50.3 – 1.8
Avelumab+Bendamustine+Rituximab2.71.3 – NA
Overall Survival Secondary · From the date of randomization to discontinuation from the study or death, whichever occurred first (maximum up to 36 months)

Overall survival was defined as the time (in months) from the date of randomization to the date of death due to any cause. Participants last known to be alive were censored at date of last contact. Analysis was performed using Kaplan-Meier method.

GroupValue95% CI
Avelumab+Rituximab+Utomilumab14.80.9 – NA
Avelumab+Azacitidine+Utomilumab4.00.3 – 11.3
Avelumab+Bendamustine+Rituximab5.21.3 – NA
Concentration Verses Time Summary of Avelumab Secondary · 1 hour Post dose Day 2 Cycle 1, 144 hour Post dose Day 8 of Cycle 1, 0 hour Post dose Day 16 of Cycle 1, Day 1 of Cycle 4 and Cycle 6
Cycle 1 Day 2
GroupValue95% CI
Avelumab+Rituximab+Utomilumab183.29± 83.809
Avelumab+Azacitidine+Utomilumab198.43± 29.387
Avelumab+Bendamustine+Rituximab193.30± 29.702
Cycle 1 Day 8
GroupValue95% CI
Avelumab+Rituximab+Utomilumab75.14± 21.357
Avelumab+Azacitidine+Utomilumab68.44± 18.553
Avelumab+Bendamustine+Rituximab65.33± 17.913
Cycle 1 Day 16
GroupValue95% CI
Avelumab+Rituximab+Utomilumab25.33± 13.197
Avelumab+Azacitidine+Utomilumab26.53± 9.237
Avelumab+Bendamustine+Rituximab19.36± 7.810
Cycle 4 Day 1
GroupValue95% CI
Avelumab+Rituximab+Utomilumab25.00± 4.667
Avelumab+Azacitidine+Utomilumab62.00± NA
Avelumab+Bendamustine+Rituximab120.88± 165.187
Cycle 6 Day 1
GroupValue95% CI
Avelumab+Azacitidine+Utomilumab7.57± NA
Avelumab+Bendamustine+Rituximab39.43± 18.327
Number of Participants With Anti-Drug Antibodies (ADA) Against Avelumab by Never and Ever Positive Status Secondary · Baseline: 2 hours pre-dose of first dose of avelumab, Post baseline: post first dose up to up to 30 Days after the end of treatment (maximum up to 36 months)

ADA never-positive was defined as no positive ADA results at any time point. ADA ever-positive was defined as at least one positive ADA result at any time point.

Baseline: ADA ever-positive
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab1
Baseline: ADA never-positive
GroupValue95% CI
Avelumab+Rituximab+Utomilumab8
Avelumab+Azacitidine+Utomilumab9
Avelumab+Bendamustine+Rituximab10
Post Baseline: ADA ever-positive
GroupValue95% CI
Avelumab+Rituximab+Utomilumab0
Avelumab+Azacitidine+Utomilumab0
Avelumab+Bendamustine+Rituximab0
Post Baseline: ADA never-positive
GroupValue95% CI
Avelumab+Rituximab+Utomilumab8
Avelumab+Azacitidine+Utomilumab9
Avelumab+Bendamustine+Rituximab11

Adverse events — posted to ClinicalTrials.gov

Time frame: Baseline up to follow up (36 months). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Avelumab+Rituximab+Utomilumab
Serious: 3/8 (38%)
Deaths: 4/8
Avelumab+Azacitidine+Utomilumab
Serious: 6/9 (67%)
Deaths: 8/9
Avelumab+Bendamustine+Rituximab
Serious: 7/11 (64%)
Deaths: 6/11

Serious adverse events (25 terms)

ReactionSystemAvelumab+Rituximab+Utomilu…Avelumab+Azacitidine+Utomi…Avelumab+Bendamustine+Ritu…
Disease progressionGeneral disorders
AnaemiaBlood and lymphatic system disorders
BronchitisInfections and infestations
DeathGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
FatigueGeneral disorders
Febrile neutropeniaBlood and lymphatic system disorders
Herpes zosterInfections and infestations
HypercalcaemiaMetabolism and nutrition disorders
Laryngeal oedemaRespiratory, thoracic and mediastinal disorders
Non-Hodgkin's lymphomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Ophthalmic herpes zosterInfections and infestations
PainGeneral disorders
PneumoniaInfections and infestations
PyrexiaGeneral disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
SepsisInfections and infestations
Septic shockInfections and infestations
Small intestinal obstructionGastrointestinal disorders
Superior vena cava syndromeVascular disorders
SyncopeNervous system disorders
ThrombocytopeniaBlood and lymphatic system disorders
Urinary tract infectionInfections and infestations
Gastrointestinal haemorrhageGastrointestinal disorders
Other adverse events (132 terms — click to expand)

ReactionSystemAvelumab+Rituximab+Utomilu…Avelumab+Azacitidine+Utomi…Avelumab+Bendamustine+Ritu…
ConstipationGastrointestinal disorders
NeutropeniaBlood and lymphatic system disorders
AnaemiaBlood and lymphatic system disorders
FatigueGeneral disorders
NauseaGastrointestinal disorders
Back painMusculoskeletal and connective tissue disorders
ChillsGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
Lymphocyte count decreasedInvestigations
PyrexiaGeneral disorders
ThrombocytopeniaBlood and lymphatic system disorders
Alanine aminotransferase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
AstheniaGeneral disorders
Blood alkaline phosphatase increasedInvestigations
Blood creatine phosphokinase increasedInvestigations
CoughRespiratory, thoracic and mediastinal disorders
DiarrhoeaGastrointestinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Gamma-glutamyltransferase increasedInvestigations
HypokalaemiaMetabolism and nutrition disorders
HypophosphataemiaMetabolism and nutrition disorders
HypotensionVascular disorders
LeukopeniaBlood and lymphatic system disorders
Neutrophil count decreasedInvestigations
Platelet count decreasedInvestigations
PruritusSkin and subcutaneous tissue disorders
RashSkin and subcutaneous tissue disorders
StomatitisGastrointestinal disorders
Upper respiratory tract infectionInfections and infestations
VomitingGastrointestinal disorders
Abdominal discomfortGastrointestinal disorders
Abdominal distensionGastrointestinal disorders
Abdominal painGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
Acute kidney injuryRenal and urinary disorders
Amylase increasedInvestigations
AnxietyPsychiatric disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Atrial fibrillationCardiac disorders

Most-reported serious reactions: Disease progression, Anaemia, Bronchitis, Death, Decreased appetite, Dyspnoea, Fatigue, Febrile neutropenia.

Data from ClinicalTrials.gov NCT02951156 adverse events section.

Sponsor's own description

Study B9991011 is a multi-center, international, randomized, open label, 2 component (Phase 1b followed by Phase 3), parallel-arm study of avelumab in combination with various agents for the treatment of Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL).

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Immune checkpoint inhibitors: recent progress and potential biomarkers.
    Darvin P, Toor SM, Sasidharan Nair V, Elkord E. · · 2018 · cited 1495× · PMID 30546008 · DOI 10.1038/s12276-018-0191-1
  2. PD-1 and PD-L1 Checkpoint Signaling Inhibition for Cancer Immunotherapy: Mechanism, Combinations, and Clinical Outcome.
    Alsaab HO, Sau S, Alzhrani R, Tatiparti K, et al · · 2017 · cited 1206× · PMID 28878676 · DOI 10.3389/fphar.2017.00561
  3. Antibodies to watch in 2020.
    Kaplon H, Muralidharan M, Schneider Z, Reichert JM. · · 2020 · cited 332× · PMID 31847708 · DOI 10.1080/19420862.2019.1703531
  4. Antibodies to watch in 2019.
    Kaplon H, Reichert JM. · · 2019 · cited 324× · PMID 30516432 · DOI 10.1080/19420862.2018.1556465
  5. Immune checkpoint therapy in liver cancer.
    Xu F, Jin T, Zhu Y, Dai C. · · 2018 · cited 299× · PMID 29843754 · DOI 10.1186/s13046-018-0777-4
  6. Study and analysis of antitumor resistance mechanism of PD1/PD-L1 immune checkpoint blocker.
    Wang Z, Wu X. · · 2020 · cited 147× · PMID 32875727 · DOI 10.1002/cam4.3410
  7. The Use of Immune Checkpoint Inhibitors in Oncology and the Occurrence of AKI: Where Do We Stand?
    Franzin R, Netti GS, Spadaccino F, Porta C, et al · · 2020 · cited 142× · PMID 33162990 · DOI 10.3389/fimmu.2020.574271
  8. Immune checkpoint blockade and CAR-T cell therapy in hematologic malignancies.
    Wang H, Kaur G, Sankin AI, Chen F, et al · · 2019 · cited 138× · PMID 31186046 · DOI 10.1186/s13045-019-0746-1

Verify or expand the search:

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Trials by the same sponsor.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02951156.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing