Summary

The purpose of this study is to compare the efficacy and safety of glofitamab in combination with polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) vs Pola-R-CHP in participants with previously untreated CD20-positive large B-cell lymphoma (LBCL).

Age: 18 Years to 80 Years old

Gender: All

Start Date: 09/18/2023

Primary Completion Date (Estimated): 10/01/2027

Study Completion Date (Estimated): 10/30/2030

Accepts Healthy Volunteers: No

Trial Purpose and Description

Eligibility Criteria

Age: 18 Years to 80 Years old

Gender: All

Accepts Healthy Volunteers: No

Inclusion criteria:

* Previously untreated participants with CD20-positive LBCL

* Ability to provide tumor tissue

* International prognostic index (IPI) score 2-5

* Eastern cooperative oncology group (ECOG) performance status of 0, 1, or 2

* At least one bi-dimensionally measurable lesion, defined as \> 1.5 cm in its longest dimension as measured by CT or MRI

* Left ventricular ejection fraction (LVEF) \>/=50% on cardiac multiple-gated acquisition (MUGA) scan or cardiac echocardiogram (ECHO)

* Adequate hematologic function

* Negative HIV test at screening with exceptions as defined by the protocol

* Negative SARS-CoV-2 antigen or PCR test

Exclusion criteria:

* Contraindication to any of the individual components of Pola-R-CHP or glofitamab, including prior receipt of anthracyclines, or history of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies, or known sensitivity or allergy to murine products

* Prior solid organ transplantation

* Participants receiving systemic immunosuppressive agent such as, but not limited to cyclosporin, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor agents within 4 weeks prior to first dose of study treatment

* Current Grade \> 1 peripheral neuropathy by clinical examination or demyelinating form of Charcot-Marie-Tooth disease

* History of indolent lymphoma (e.g., Follicular Lymphoma, Marginal Zone Lymphoma, Waldenstrom macroglobulinemia)

* Current diagnosis of the following: Follicular lymphoma grade 3B; transformations of indolent B-cell lymphomas (e.g., de novo transformed follicular lymphoma); mediastinal grey zone lymphoma; primary mediastinal (thymic) large B-cell lymphoma; Burkitt lymphoma; primary large B-cell lymphoma of immune-privileged sites (encompassing primary diffuse large B-cell lymphoma of the CNS, primary large B-cell lymphoma of the vitreoretina and primary large B-cell lymphoma of the testis); primary effusion DLBCL; and primary cutaneous DLBCL, leg type

* Primary or secondary CNS lymphoma at the time of recruitment or history of CNS lymphoma

* Prior treatment with systemic immunotherapeutic agents

* Prior use of any monoclonal antibody for the purposes of treating cancer within 3 months of the start of Cycle 1

* Any investigational therapy for the purposes of treating cancer within 28 days prior to the start of Cycle 1

* Prior radiotherapy to the mediastinal/pericardial region

* Prior therapy for LBCL, with the exception of corticosteriods

* Corticosteroid use \> 30 mg/day of prednisone or equivalent, for purposes other than lymphoma symptom control

* History of other malignant or non-malignant diseases that could affect compliance with the protocol or interpretation of results

* Significant or extensive history of cardiovascular disease

* Recent major surgery (within 4 weeks prior to the start of Cycle 1), other than for diagnosis

* Current or past history of central nervous system (CNS) disease, such as stroke, epilepsy, CNS vasculitis, or neurodegenerative disease

* Known or suspected chronic active Epstein-Barr viral infection

* Known or suspected history of hemophagocytic lymphohistiocytosis (HLH)

* Active autoimmune disease requiring treatment

* Clinically significant liver disease

* Live, attenuated vaccine within 4 weeks before study treatment infusion on Day 1 of Cycle 1 or anticipation that such a live, attenuated vaccine will be required during the study. Live vaccines during the study and until participants B cells recover are prohibited

* Any active infection within 7 days prior to Cycle 1 Day 1 that would impact participant safety

* Suspected active or latent tuberculosis

* Positive test results for chronic hepatitis B infection, hepatitis C, or the human T-lymphotropic virus type 1 (HTLV-1)

* History of progressive multifocal leukoencephalopathy