Abstract 3655

Obinutuzumab (GA101) is a type II glycoengineered, humanized anti-CD20 monoclonal antibody that has increased antibody-dependent cellular cytotoxicity and direct cell death activity but lower complement-dependent cytotoxicity compared with type I anti-CD20 antibodies such as rituximab and ofatumumab. GA101 is in clinical development for the treatment of lymphoma and chronic lymphocytic leukemia. The Phase I/II study BO20999 has evaluated the efficacy and safety of GA101 monotherapy in patients with relapsed/refractory aggressive non-Hodgkin's lymphoma (aNHL). Here, we report updated Phase II results including progression-free survival (PFS) and best overall response (BOR).

Patients (n = 40) were randomized to receive GA101 (D1, D8 and D22, then 3-weekly for total of 9 infusions) at either a high dose (1,600 mg on D1 and D8, then 800 mg thereafter; 1,600/800 mg cohort; n = 19), or a flat low dose of 400 mg (400/400 mg cohort; n = 21).

Baseline patient characteristics were similar for both cohorts (Table 1). The median observation time for all patients was 9.5 months (0.3–26.1 months). BOR rates are given in Table 2, with 8/25 diffuse large B-cell lymphoma (DLBCL) patients (32%) and 4/15 mantle cell lymphoma (MCL) patients (27%) responding to GA101. Among the patients with rituximab-refractory disease, a response was observed in 1/13 patients (7.7%) and 4/12 patients (33.3%) treated in the 400/400 mg and 1,600/800 mg cohorts, respectively. Of these, 4 patients (1,600/800 mg cohort) had a response duration > 6 months, with 2 patients having an ongoing response (response duration: 9.8, 16.5+, 19.5 and 20.0+ months). Median PFS for patients with DLBCL (Figure 1) was 1.9 months (range: 0.3–15.7 months) for the 400/400 mg cohort and 2.7 months (range: 0.2–22.3) months) for the 1,600/800 mg cohort (hazard ratio: 0.70; 95% CI: 0.30–1.66). For the DLBCL subgroup, response duration was 3.1, 3.1+, 5.8, 16.5+ and 19.5 months for the 5 responders in the 1,600/800 mg cohort, compared with 6.3, 8.6 and 9.8 months for the 3 responders in the 400/400 mg cohort. Individual response data indicated that 2 MCL patients had an ongoing response for ≥ 20 months (20.0 and 20.4 months). GA101 was well tolerated in both cohorts. Infusion-related reactions (IRRs; all grades) were the most common adverse event (AE), occurring in 81% of patients in the 400/400 mg cohort and 68% of patients in the 1600/800 mg cohort. Grade 3/4 AEs occurring in >5% of patients across both cohorts included IRRs (10%), tumor lysis syndrome (10%), cardiac failure (not treatment-related; 10%), anemia (14%) and thrombocytopenia (14%) in the 400/400 mg cohort and IRRs (5%) and anemia (5%) in the 1,600/800 mg cohort.
Table 1.

Baseline patient characteristics

Characteristic400/400 mg (n = 21)1,600/800 mg (n = 19)All (n = 40)
Median age, years (range) 70 (43–80) 72 (22–85) 71 (22–85) 
Histology, n    
DLBCL 10 15 25 
MCL 11 15 
Median number of prior treatments, n (range) 4 (1–17) 3 (1–6) 3 (1–17) 
Previous rituximab, n 21 19 40 
Rituximab refractory*, n 13 12 25 
Prior stem cell transplant, n 
Characteristic400/400 mg (n = 21)1,600/800 mg (n = 19)All (n = 40)
Median age, years (range) 70 (43–80) 72 (22–85) 71 (22–85) 
Histology, n    
DLBCL 10 15 25 
MCL 11 15 
Median number of prior treatments, n (range) 4 (1–17) 3 (1–6) 3 (1–17) 
Previous rituximab, n 21 19 40 
Rituximab refractory*, n 13 12 25 
Prior stem cell transplant, n 

DLBCL, diffuse large B-cell lymphoma; MCL, mantle cell lymphoma.

*

Rituximab refractory defined as patients who had a response of < 6 months or who failed to respond to a rituximab-containing regimen (rituximab monotherapy or in combination with chemotherapy) at any point during their treatment history.

Table 2.

Best overall response according to diagnosis and cohort

DLBCLMCL
Response, n (%)400/400 mg (n = 10)1,600/800 mg (n = 15)400/400 mg (n = 11)1,600/800 mg (n = 4)
Complete response (CR) 0 (0.0) 3 (20.0) 2 (18.2) 0 (0.0) 
CR unconfirmed 1 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) 
Partial response 2 (20.0) 2 (13.3) 0 (0.0) 2 (50.0) 
Stable disease 1 (10.0) 1 (6.7) 3 (27.3) 0 (0.0) 
Progressive disease 5 (50.0) 9 (60.0) 6 (54.5) 2 (50.0) 
No response assessment 1 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) 
DLBCLMCL
Response, n (%)400/400 mg (n = 10)1,600/800 mg (n = 15)400/400 mg (n = 11)1,600/800 mg (n = 4)
Complete response (CR) 0 (0.0) 3 (20.0) 2 (18.2) 0 (0.0) 
CR unconfirmed 1 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) 
Partial response 2 (20.0) 2 (13.3) 0 (0.0) 2 (50.0) 
Stable disease 1 (10.0) 1 (6.7) 3 (27.3) 0 (0.0) 
Progressive disease 5 (50.0) 9 (60.0) 6 (54.5) 2 (50.0) 
No response assessment 1 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) 

DLBCL, diffuse large B-cell lymphoma; MCL, mantle cell lymphoma.

Figure 1.

Progression-free survival for patients with diffuse large B-cell lymphoma

Figure 1.

Progression-free survival for patients with diffuse large B-cell lymphoma

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In conclusion, GA101 shows encouraging single-agent efficacy in these heavily pretreated patients with relapsed/refractory aNHL (DLBCL or MCL). A Phase III trial of rituximab plus CHOP vs GA101 plus CHOP in first-line DLBCL has recently started.

Disclosures:

Morschhauser:Roche: Honoraria; Celgene: Consultancy, Honoraria. Cartron:Roche: Consultancy, Honoraria; GSK: Honoraria; LFB: Honoraria. Milpied:Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees. Wenger:Roche: Employment. Wassner-Fritsch:Roche: Employment. Asikanius:Roche: Employment. Salles:Roche: Consultancy, Honoraria.

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Author notes

*

Asterisk with author names denotes non-ASH members.

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