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Study of KW-0761 Versus Vorinostat in Relapsed/Refractory CTCL

Open-Label, Multi-Center, Randomized Study of Anti-CCR4 Monoclonal Antibody KW-0761 (Mogamulizumab) Versus Vorinostat in Subjects With Previously Treated Cutaneous T-Cell Lymphoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01728805
Enrollment
372
Registered
2012-11-20
Start date
2012-11-30
Completion date
2021-02-17
Last updated
2024-04-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cutaneous T-Cell Lymphoma

Keywords

Cutaneous T-Cell Lymphoma (CTCL), myocis fungoides (MF), Sezary Syndrome (SS)

Brief summary

The purpose of this study is to compare the progression free survival of KW-0761 versus vorinostat for subjects with relapsed or refractory CTCL.

Detailed description

Phase 3 randomized study to compare the progression free survival of subjects with relapsed/refractory CTCL who receive KW-0761 versus those who receive vorinostat. Subjects who progress on vorinostat will be allowed to cross over to KW-0761 upon progression.

Interventions

BIOLOGICALKW-0761

1.0 mg/kg weekly x 4 in cycle 1 then every other week until progression

DRUGVorinostat

Sponsors

Kyowa Kirin, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Male and female subjects ≥ 18 years of age at the time of enrollment, except in Japan where subjects must be ≥ 20 years of age at the time of enrollment * Histologically confirmed diagnosis of mycosis fungoides (MF) or Sezary Syndrome (SS) * Stage IB, II-A, II-B, III and IV * Subjects who had failed at least one prior course of systemic therapy. Psoralen plus ultraviolet light therapy (PUVA) is not considered to be a systemic therapy * Eastern Cooperative Oncology Group (ECOG) performance status score of ≤ 1 at study entry * Resolution of all clinically significant toxic effects of prior cancer therapy to grade ≤1 by the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0 (NCI-CTCAE, v.4.0) * Adequate hematological, renal and hepatic function * Subjects previously treated with anti-CD4 antibody or alemtuzumab were eligible provided their CD4+ cell counts were ≥ 200/mm3 * Subjects with mycosis fungoides (MF) and a known history of non-complicated staphylococcus infection/colonization were eligible provided they continued to receive stable doses of prophylactic antibiotics * Women of childbearing potential (WOCBP) must have had a negative pregnancy test within 7 days of receiving study medication * WOCBP and male subjects as well as their female partners of childbearing potential must have agreed to use effective contraception throughout the study and for 3 months after the last dose of KW-0761

Exclusion criteria

* Prior treatment with KW-0761 or vorinostat. * Large cell transformation. However, subjects with a history of LCT but without current aggressive disease and no current evidence of LCT on pathology in skin and lymph nodes would be eligible. * Diagnosed with a malignancy in the past two years. However, subjects with non-melanoma skin cancers, melanoma in situ, localized cancer of the prostate with current PSA of \<0.1 ng/mL, treated thyroid cancer or cervical carcinoma in situ or ductal/lobular carcinoma in situ of the breast within the past two years could enroll as long as there was no current evidence of disease. * Clinical evidence of central nervous system (CNS) metastasis. * Psychiatric illness, disability or social situation that would have compromised the subject's safety or ability to provide consent, or limited compliance with study requirements. * Significant uncontrolled intercurrent illness * Known or tested positive for human immunodeficiency virus (HIV), human T-cell leukemia virus (HTLV-1), hepatitis B or hepatitis C. * Active herpes simplex or herpes zoster. Subjects on prophylaxis for herpes who started taking medication at least 30 days prior to study entry, and had no active signs of active infection, and whose last active infection was more than 6 months ago, could enter the study, and should have continued to take the prescribed medication for the duration of the study. * Experienced allergic reactions to monoclonal antibodies or other therapeutic proteins. * Known active autoimmune disease were excluded. (For example, Grave's disease; systemic lupus erythematosus; rheumatoid arthritis; Crohn's disease; psoriasis). * Was pregnant (confirmed by beta human chorionic gonadotrophin \[β-HCG\]) or lactating. * History of allogeneic transplant.

Design outcomes

Primary

MeasureTime frameDescription
Progression Free SurvivalFrom date of randomization at every visit until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 36 monthsProgression was defined as follows, based on Olsen (2011): * Lymph nodes: ≥ 50% increase in SPD from baseline of lymph nodes, any new node \> 1.5 cm in the long axis or \> 1 cm in the short axis if 1-1.5 cm in the long axis that is proven to be N3 histologically, or \> 50% increase from nadir in SPD of lymph nodes in those with PR * Skin: ≥ 25% increase in skin disease from baseline, new tumors (T3) in patients with T1, T2 or T4 only skin disease, or in those with CR or PR, increase of skin score of greater than the sum of nadir plus 50% baseline score * Blood: B0 to B2, \> 50% increase from baseline and at least 5,000 neoplastic cells/μL36, or \> 50% increase from nadir and at least 5,000 neoplastic cells/μL * Viscera: \> 50% increase in size (SPD) of any organs involved at baseline, new organ involvement, or \> 50% increase from nadir in the size (SPD) of any previous organ involvement in those with PR

Secondary

MeasureTime frameDescription
Overall Response Rateat the end of cycle 1 (26-28 days), and then every other cycle in Year 1 (cycle 3, 5, 7, 9, 11, 13), and every 16 weeks (cycle 17, 21, etc.) in Year 2 and beyond until progression up to 36 monthsThe ORR was defined as the count of subjects who had a confirmed CR or PR, defined as documented CR or PR per Global Composite Response Score that was confirmed by a subsequent observation at least 4 weeks later. Overall Response Rate was determined based on the response in all compartments (lymph nodes, skin, peripheral blood, and viscera), referencing Olsen, 2011 as follows: Complete Response (CR) = complete disappearance of all clinical evidence of disease; Partial Response (PR) = regression of measurable disease; Stable Disease (SD) = failure to attain CR, PR, or PD; Progressive Disease (PD) = PD in any compartment; Relapse = recurrence of disease in prior CR in any compartment.
Quality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreCycle 1, 3, and 5* Skindex-29 rates 29 items assessing 3 domains (emotions, symptoms, & functioning) on a linear scale from 0 (never) to all the time (100). Higher scores = higher impact of skin disease. * FACT-G rates 27 items in 4 domains (physical well-being, social/family well-being, emotional well-being, functional well-being) on a 5-point scale from 0 (not at all) to 4 (very much). Higher scores = better QoL. * EuroQoL lvl 3 (Eq-5D-3L) rates mobility, self-care, usual activities, pain/discomfort and anxiety/depression on 3 levels - no problems, some problems, extreme problems. Score is calculated using a set of item weights to derive a single score ranging from -0.109 to 1, with 1 representing full health. LS mean (and 95% CI) of the overall change from baseline across time points through 6-month assessment (including End of Cycles 1, 3, and 5 time points only) are calculated from MMRM with treatment, disease type, disease stage, and region as fixed effects and baseline score as a covariate.
Pruritis EvaluationCycle 1, 3, and 5The Itchy QoL is a validated pruritus specific quality of life instrument. It includes 22 pruritus-specific questions covering three major domains: symptoms, functioning, and emotions. The scale ranges from Never (1) to All The Time (5). The subscale scores consist of the average of the responses to the items in a given subscale. The overall score is the average of the responses to all items. Higher Itchy QoL scores indicate worse quality of life. LS mean (and 95% CI) of the overall change from baseline across time points through 6-month assessment (including End of Cycles 1, 3, and 5 time points only) are calculated from MMRM with treatment, disease type, disease stage, and region as fixed effects and baseline score as a covariate.

Countries

Australia, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, Switzerland, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
KW-0761
anti-CCR4 monoclonal antibody KW-0761 (mogamulizumab) KW-0761: 1.0 mg/kg weekly x 4 in cycle 1 then every other week until progression
186
Vorinostat
vorinostat 400 mg once daily Vorinostat
186
Total372

Baseline characteristics

CharacteristicKW-0761VorinostatTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
87 Participants97 Participants184 Participants
Age, Categorical
Between 18 and 65 years
99 Participants89 Participants188 Participants
Age, Continuous62.8 years63.3 years63.0 years
Race/Ethnicity, Customized
Race/Ethnicity
Not Reported
24 Participants25 Participants49 Participants
Race/Ethnicity, Customized
Race/Ethnicity
Other
37 Participants26 Participants63 Participants
Race/Ethnicity, Customized
Race/Ethnicity
White
125 Participants135 Participants260 Participants
Region of Enrollment
Australia
9 participants7 participants16 participants
Region of Enrollment
Denmark
1 participants2 participants3 participants
Region of Enrollment
France
23 participants24 participants47 participants
Region of Enrollment
Germany
5 participants6 participants11 participants
Region of Enrollment
Italy
14 participants12 participants26 participants
Region of Enrollment
Japan
9 participants6 participants15 participants
Region of Enrollment
Netherlands
0 participants2 participants2 participants
Region of Enrollment
Spain
9 participants8 participants17 participants
Region of Enrollment
Switzerland
2 participants2 participants4 participants
Region of Enrollment
United Kingdom
16 participants14 participants30 participants
Region of Enrollment
United States
98 participants103 participants201 participants
Sex: Female, Male
Female
77 Participants79 Participants156 Participants
Sex: Female, Male
Male
109 Participants107 Participants216 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
40 / 18447 / 18632 / 135
other
Total, other adverse events
178 / 184182 / 186128 / 135
serious
Total, serious adverse events
69 / 18446 / 18640 / 135

Outcome results

Primary

Progression Free Survival

Progression was defined as follows, based on Olsen (2011): * Lymph nodes: ≥ 50% increase in SPD from baseline of lymph nodes, any new node \> 1.5 cm in the long axis or \> 1 cm in the short axis if 1-1.5 cm in the long axis that is proven to be N3 histologically, or \> 50% increase from nadir in SPD of lymph nodes in those with PR * Skin: ≥ 25% increase in skin disease from baseline, new tumors (T3) in patients with T1, T2 or T4 only skin disease, or in those with CR or PR, increase of skin score of greater than the sum of nadir plus 50% baseline score * Blood: B0 to B2, \> 50% increase from baseline and at least 5,000 neoplastic cells/μL36, or \> 50% increase from nadir and at least 5,000 neoplastic cells/μL * Viscera: \> 50% increase in size (SPD) of any organs involved at baseline, new organ involvement, or \> 50% increase from nadir in the size (SPD) of any previous organ involvement in those with PR

Time frame: From date of randomization at every visit until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 36 months

ArmMeasureGroupValue (NUMBER)
KW-0761Progression Free SurvivalRate (%) of Being Alive w/o Progression at 12 mos.38.3 percentage of subjects
KW-0761Progression Free SurvivalRate (%) of Being Alive w/o Progression at 24 mos.14.1 percentage of subjects
KW-0761Progression Free SurvivalRate (%) of Being Alive w/o Progression at 18 mos.28.0 percentage of subjects
KW-0761Progression Free SurvivalRate (%) of Being Alive w/o Progression at 30 mos.4.7 percentage of subjects
KW-0761Progression Free SurvivalRate (%) of Being Alive w/o Progression at 6 mos.55.3 percentage of subjects
VorinostatProgression Free SurvivalRate (%) of Being Alive w/o Progression at 30 mos.7.2 percentage of subjects
VorinostatProgression Free SurvivalRate (%) of Being Alive w/o Progression at 6 mos.28.8 percentage of subjects
VorinostatProgression Free SurvivalRate (%) of Being Alive w/o Progression at 12 mos.15.3 percentage of subjects
VorinostatProgression Free SurvivalRate (%) of Being Alive w/o Progression at 18 mos.7.2 percentage of subjects
VorinostatProgression Free SurvivalRate (%) of Being Alive w/o Progression at 24 mos.7.2 percentage of subjects
Secondary

Overall Response Rate

The ORR was defined as the count of subjects who had a confirmed CR or PR, defined as documented CR or PR per Global Composite Response Score that was confirmed by a subsequent observation at least 4 weeks later. Overall Response Rate was determined based on the response in all compartments (lymph nodes, skin, peripheral blood, and viscera), referencing Olsen, 2011 as follows: Complete Response (CR) = complete disappearance of all clinical evidence of disease; Partial Response (PR) = regression of measurable disease; Stable Disease (SD) = failure to attain CR, PR, or PD; Progressive Disease (PD) = PD in any compartment; Relapse = recurrence of disease in prior CR in any compartment.

Time frame: at the end of cycle 1 (26-28 days), and then every other cycle in Year 1 (cycle 3, 5, 7, 9, 11, 13), and every 16 weeks (cycle 17, 21, etc.) in Year 2 and beyond until progression up to 36 months

Population: The total number of patients analyzed are further broken out by disease type \[mycosis fungoides (MF) and Sezary Syndrome (SS)\]

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
KW-0761Overall Response RateAll Subjects ORR (confirmed CR + PR)52 Participants
KW-0761Overall Response RateDisease Type = MF ORR (confirmed CR + PR)22 Participants
KW-0761Overall Response RateDisease Type = SS ORR (confirmed CR + PR)30 Participants
VorinostatOverall Response RateAll Subjects ORR (confirmed CR + PR)9 Participants
VorinostatOverall Response RateDisease Type = MF ORR (confirmed CR + PR)7 Participants
VorinostatOverall Response RateDisease Type = SS ORR (confirmed CR + PR)2 Participants
Secondary

Pruritis Evaluation

The Itchy QoL is a validated pruritus specific quality of life instrument. It includes 22 pruritus-specific questions covering three major domains: symptoms, functioning, and emotions. The scale ranges from Never (1) to All The Time (5). The subscale scores consist of the average of the responses to the items in a given subscale. The overall score is the average of the responses to all items. Higher Itchy QoL scores indicate worse quality of life. LS mean (and 95% CI) of the overall change from baseline across time points through 6-month assessment (including End of Cycles 1, 3, and 5 time points only) are calculated from MMRM with treatment, disease type, disease stage, and region as fixed effects and baseline score as a covariate.

Time frame: Cycle 1, 3, and 5

Population: The number of participants analyzed were subjects with values at baseline and post-baseline.

ArmMeasureValue (LEAST_SQUARES_MEAN)
KW-0761Pruritis Evaluation-0.5 score on a scale
VorinostatPruritis Evaluation-0.4 score on a scale
Secondary

Quality of Life (QoL) Assessment - Skindex-29 Symptoms Scale Score

* Skindex-29 rates 29 items assessing 3 domains (emotions, symptoms, & functioning) on a linear scale from 0 (never) to all the time (100). Higher scores = higher impact of skin disease. * FACT-G rates 27 items in 4 domains (physical well-being, social/family well-being, emotional well-being, functional well-being) on a 5-point scale from 0 (not at all) to 4 (very much). Higher scores = better QoL. * EuroQoL lvl 3 (Eq-5D-3L) rates mobility, self-care, usual activities, pain/discomfort and anxiety/depression on 3 levels - no problems, some problems, extreme problems. Score is calculated using a set of item weights to derive a single score ranging from -0.109 to 1, with 1 representing full health. LS mean (and 95% CI) of the overall change from baseline across time points through 6-month assessment (including End of Cycles 1, 3, and 5 time points only) are calculated from MMRM with treatment, disease type, disease stage, and region as fixed effects and baseline score as a covariate.

Time frame: Cycle 1, 3, and 5

Population: The number of subjects analyzed in each row is the number of subjects with values at baseline and the specified post-baseline timepoint.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)
KW-0761Quality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreSkindex-29 Across 6-month Assessment-12.6 score on a scale
KW-0761Quality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreFACT-G Across 6-month Assessment4.6 score on a scale
KW-0761Quality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreEQ-5D-3L Across 6-month Assessment0.06 score on a scale
VorinostatQuality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreEQ-5D-3L Across 6-month Assessment0.02 score on a scale
VorinostatQuality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreSkindex-29 Across 6-month Assessment-6.0 score on a scale
VorinostatQuality of Life (QoL) Assessment - Skindex-29 Symptoms Scale ScoreFACT-G Across 6-month Assessment-2.3 score on a scale

Source: ClinicalTrials.gov · Data processed: Mar 18, 2026