About this trial
Single-arm Phase II study evaluating the combination of mogamulizumab (MOGA) added on top of standard of care dose adjusted EPOCH (DA-EPOCH) or CHOEP in patients with newly diagnosed or relapsed/refractory (for CTCL only) aggressive T-cell lymphoma including patients with Adult T-cell leukemia/lymphoma (ATLL).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Male/female patients who are at least 18 years of age on the day of signing informed consent with histologically confirmed diagnosis of T-cell Non-Hodgkin lymphoma (TNHL) will be enrolled in this study.
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 unless compromised by lymphoma with anticipated benefit from chemotherapy as determined and documented by the investigator.
Peripheral T-cell lymphoma not otherwise specified (PTCL nos)
Angioimmunoblastic T-cell lymphoma (AITL)
Disqualifiers
Has received prior systemic anti-cancer therapy including investigational agents ≤ 3 weeks prior to first dose of study treatment on Cycle 1, Day 1. Skin directed treatments, including topicals and radiation within 2 weeks of study treatment. However, patients with rapidly progressive malignant disease may be enrolled prior to this period after discussion with the sponsor investigator.
Has received radiotherapy within 2 weeks of start of study treatment. Patients must have recovered from all radiation-related toxicities, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease.
If patient received major surgery, participants must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment.
Patients on any immunomodulatory drug for concomitant or intercurrent conditions other than T-cell lymphoma or who have received any of these agents within 4 weeks of treatment, including but not limited to the following, will be excluded: low dose or oral methotrexate; azathioprine; iv immunoglobulin; low dose or oral cyclophosphamide; cyclosporine; mycophenolate; infliximab; etanercept; leflunomide; adalimumab; lenalidomide; abatacept; rituximab; anakinra; interferon-β IL-2 and natalizumab. . Concurrent use of topical steroids or therapies for CTCL is allowed as indicated in the protocol.
Trial design
Single group
Treatments tested in this trial
Mogamulizumab
DrugMogamulizumab is a defucosylated, humanized, monoclonal antibody (Mab) with enhanced antibody dependent cellular cytotoxicity that binds to CCR4. The lack of fucose results in the antibody eliciting more potent ADCC than conventionally produced antibodies. Mogamulizumab is devoid of complement dependent cytotoxicity. CC Chemokine receptor 4 is over expressed on the surfaces of cells comprising several T-cell malignancies such as peripheral T-cell lymphoma (PTCL) and CTCL and is a potential target for anti-neoplastic therapy in these disorders.
DA-EPOCH Protocol
DrugEPOCH is an intensive chemotherapy regimen intended for treatment of aggressive non-Hodgkin's lymphoma.
CHOEP protocol
DrugCHOEP is an intensive chemotherapy intended for treatment of aggressive t-cell lymphoma.
Treatment groups
Trial outcomes
Primary outcomes
Complete response after 6 cycles of treatment with the combination Mogamulizumab and standard of care DA-EPOCH or CHOEP
As assessed by the Lugano criteria for PTCL(16) and the global response score for CTCL(17)
Secondary outcomes
Occurrence of toxicity
using the NCI Common Terminology Criteria for Adverse Events version 5 (CTCAE v5) for grading.
Progression free survival (PFS)
Defined as the time from enrollment to earliest of progression, death or follow-up
Overall survival (OS)
defined as time from the time from enrollment to earlier of death or last follow-up
Duration of response
(including both scenarios -censored at the time of subsequent therapy without disease progression, such as stem cell transplant and total duration including after SCT)
Sponsors and contacts
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Yale University
Lead sponsor
Kyowa Kirin, Inc.
Collaborator