Informations générales (source: ClinicalTrials.gov)

NCT06284122 En recrutement IDF
A Phase III Randomized, Open-label, International, Multicenter Study Evaluating the Efficacy and Safety of Mosunetuzumab Plus Lenalidomide in Comparison to Anti-CD20 Monoclonal Antibody Plus Chemotherapy in Subjects With Previously Untreated FLIPI 2-5 Follicular Lymphoma (MorningLyte)
Interventional
  • Lymphomes
  • Lymphome folliculaire
Phase 3
The Lymphoma Academic Research Organisation (Voir sur ClinicalTrials)
juin 2024
avril 2034
17 octobre 2024
This study is a phase III, randomized, open-label, international, multicenter, interventional trial, designed to compare the efficacy and safety of mosunetuzumab in combination with lenalidomide versus anti-CD20 monoclonal antibody (mAb) plus chemotherapy in patients with previously untreated FLIPI 2-5 follicular lymphoma.
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Etablissements

Les établissements d'Île-de-France ayant mis à jour leurs données Origine et niveau de fiabilité des données
CLCC RENE HUGUENIN INSTITUT CURIE En recrutement IDF 04/09/2024 13:49:26 Contact (sur clinicalTrials)
Les établissements d'Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données
AP-HP - Hôpital Henri Mondor-Albert Chenevier François LEMONNIER, MD En recrutement IDF Contact (sur clinicalTrials)
CLCC INSTITUT GUSTAVE ROUSSY Vincent RIBRAG, MD En recrutement IDF Contact (sur clinicalTrials)
Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données
CENTRE HENRI BECQUEREL - Service Hématologie - 76038 - Rouen - France Fabrice JARDIN, Pr En recrutement Contact (sur clinicalTrials)
CENTRE HOSPITALIER DE NIORT - Médecine interne - 79021 - Niort - France Gaëlle OLIVIER, MD En recrutement Contact (sur clinicalTrials)
CENTRE HOSPITALIER JEAN ROUGIER - Service d'Oncologie - Hématologie - 46005 - Cahors - France Martin GAUTHIER, MD En recrutement Contact (sur clinicalTrials)
CH ANNECY GENEVOIS - SITE D'ANNECY - Service Hématologie - 74374 - Pringy - France Hannah MOATTI, MD En recrutement Contact (sur clinicalTrials)
CH d'AVIGNON - HOPITAL HENRI DUFFAUT - Service d'Onco-Hématologie - 84000 - Avignon - France Hacène ZERAZHI, MD En recrutement Contact (sur clinicalTrials)
CH DE BRETAGNE ATLANTIQUE - HOPITAL CHUBERT - Service Hématologie - 56017 - Vannes - France Antoine BONNET, MD En recrutement Contact (sur clinicalTrials)
CH DE LA COTE BASQUE - Service Hématologie - 64100 - Bayonne - France Sophie BERNARD, MD En recrutement Contact (sur clinicalTrials)
CH DE VALENCIENNES - HOPITAL JEAN BERNARD - Service Hématologie - 59322 - Valenciennes - France Sabine TRICOT, MD En recrutement Contact (sur clinicalTrials)
CH METROPOLE SAVOIE - SITE CHAMBERY - Service Hématologie - 73011 - Chambéry - France Arthur DONY, MD En recrutement Contact (sur clinicalTrials)
CHD DE VENDEE - Service Hématologie - 85925 - La Roche-sur-Yon - France Nadine MORINEAU, MD En recrutement Contact (sur clinicalTrials)
CHI POISSY SAINT-GERMAIN-EN-LAYE - Service Hématologie - 78303 - Poissy - France Mohammed BOUDERBALA, MD En recrutement Contact (sur clinicalTrials)
CHRU DE LILLE - HOPITAL CLAUDE HURIEZ - Service Hématologie - 59037 - Lille - France Franck MORSCHHAUSER, Pr En recrutement Contact (sur clinicalTrials)
CHU BRABOIS - Service Hématologie - 54511 - Vandœuvre-lès-Nancy - France Pierre FEUGIER, Pr En recrutement Contact (sur clinicalTrials)
CHU BRETONNEAU - Service Cancérologie - Hématologie et Thérapie Cellulaire - 37044 - Tours - France Laurianne DRIEU LA ROCHELLE, MD En recrutement Contact (sur clinicalTrials)
CHU DE BORDEAUX - HOPITAL HAUT-LEVEQUE - CENTRE FRANCOIS MAGENDIE - Service d'Hématologie et Thérapie Cellulaire - 33604 - Pessac - France François-Xavier GROS, MD En recrutement Contact (sur clinicalTrials)
CHU DE GRENOBLE - Service Hématologie - 38700 - La Tronche - France Sylvain CARRAS, MD En recrutement Contact (sur clinicalTrials)
CHU DE LIMOGES - HOPITAL DUPUYTREN - Service Hématologie Clinique et Thérapie Cellulaire - 87042 - Limoges - France Julie ABRAHAM, MD En recrutement Contact (sur clinicalTrials)
CHU DE MONTPELLIER - Département d'Hématologie Clinique - 34090 - Montpellier - France Guillaume CARTRON, Pr En recrutement Contact (sur clinicalTrials)
CHU DE NANTES - Service Hématologie - 44093 - Nantes - France Thomas GASTINNE, MD En recrutement Contact (sur clinicalTrials)
CHU DE POITIERS - HOPITAL DE LA MILETRIE - Service d'Oncologie Hématologique et Thérapie Cellulaire - 86021 - Poitiers - France Stéphanie GUIDEZ, MD En recrutement Contact (sur clinicalTrials)
CHU DE REIMS - HOPITAL ROBERT DEBRE - Service Hématologie - 57092 - Reims - France Eric DUROT, MD En recrutement Contact (sur clinicalTrials)
CHU DIJON BOURGOGNE - Service Hématologie Clinique - 21000 - Dijon - France Amandine DURAND, MD En recrutement Contact (sur clinicalTrials)
CHU ESTAING - Service Thérapie Cellulaire et Hématologie Clinique - 63003 - Clermont-Ferrand - France Romain GUIEZE, Pr En recrutement Contact (sur clinicalTrials)
CHU JEAN MINJOZ - Service Hématologie - 25030 - Besançon - France Adrien CHAUCHET, MD En recrutement Contact (sur clinicalTrials)
CHU LYON-SUD - Hématologie - 69495 - Pierre-Bénite - France Emmanuel BACHY, Pr En recrutement Contact (sur clinicalTrials)
CHU PONTCHAILLOU - Hématologie Clinique - 35033 - Rennes - France Roch HOUOT, Pr En recrutement Contact (sur clinicalTrials)
GH REGION MULHOUSE ET SUD ALSACE - HOPITAL EMILE MULLER - Service Hématologie - 68100 - Mulhouse - France Bernard DRENOU, MD En recrutement Contact (sur clinicalTrials)
HOPITAL SAINT VINCENT-DE-PAUL - Service Hématologie - 59020 - Lille - France Sandy AMORIM, MD En recrutement Contact (sur clinicalTrials)
HOPITAL SAINT-LOUIS - Service Hématologie - 75475 - Paris - France Catherine THIEBLEMONT, Pr En recrutement Contact (sur clinicalTrials)
INSTITUT BERGONIE - Service d'Oncologie Médicale - 33076 - Bordeaux - France Fontanet BIJOU, MD En recrutement Contact (sur clinicalTrials)
Institut de Cancérologie et d'Hématologie Universitaire de Saint-Étienne - Service Hématologie - 42270 - Saint-Priest-en-Jarez - France Ludovic FOUILLET, MD En recrutement Contact (sur clinicalTrials)
INSTITUT DE CANCEROLOGIE STRASBOURG EUROPE - Unité de Recherche Clinique - 67033 - Strasbourg - France Luc-Matthieu FORNECKER, Pr En recrutement Contact (sur clinicalTrials)
INSTITUT PAOLI CALMETTES - Service Hématologie - 13273 - Marseille - France Gabriel BRISOU, MD En recrutement Contact (sur clinicalTrials)
IUCT ONCOPOLE - Service Hématologie - 31059 - Toulouse - France Loïc YSEBAERT, MD En recrutement Contact (sur clinicalTrials)

Critères

Tous
Inclusion Criteria:

1. Patient with histologically proven previously untreated CD20+ follicular lymphoma
grade 1, 2, or 3a (including patient watched during up to 10 years after initial
diagnosis) as assessed by the investigators according to the World Health
Organization (WHO) 2016 classification12, or classical follicular lymphoma according
to the WHO 2022 classification13. Diagnostic tissue must be available for central
pathology review, exploratory endpoints and secondary data use. (Patients with
absolute lymphocyte count > 20 G/L must be discussed with the Sponsor before
screening/inclusion).

2. FLIPI 2-5.

3. All Ann Arbor stages (including stage I if FLIPI ≥ 2).

4. Must need treatment as evidenced by at least one of the following criteria:

- Bulky disease defined as:

- a nodal or extranodal mass/lesion > 7 cm in its largest diameter or,

- involvement of at least 3 nodal or extranodal sites (each with a diameter
greater than > 3 cm)

- Presence of at least one of the following B symptoms:

- fever (> 38°C) of unclear etiology

- night sweats

- weight loss greater than 10% within the prior 6 months

- Symptomatic splenomegaly

- Any compressive syndrome (for example, but not restricted to- ureteral,
orbital, gastrointestinal)

- Any one of the following cytopenias due to lymphoma:

- hemoglobin < 10g/dL (6.25 mmol/L)

- platelets <100 x 109/L, or

- absolute neutrophil count (ANC) < 1.5 x 109/L

- Pleural or peritoneal serous effusion (irrespective of cell content)

- β2microglobulin > ULN or lactate dehydrogenase (LDH) > ULN

5. At least one bi-dimensionally measurable nodal lesion, defined as > 1.5 cm in its
longest dimension, or at least one bi-dimensionally measurable extra nodal lesion,
defined as > 1.0 cm in its longest dimension (and 18F-2-fluoro-2-deoxy-D-glucose
(FDG)-avid lesion).

6. Patient who understood and voluntarily signed and dated an informed consent prior to
any study-specific assessments/procedures.

7. Must be ≥ 18 years at the time of signing the informed consent form (ICF).

8. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2.

9. Estimated minimum life expectancy of 3 months.

10. Adequate hematological function within 28 days prior to signing informed consent,
including:

- Absolute neutrophil count (ANC) ≥ 1 x 109/L

- Platelet count ≥ 75 x 109/L, or ≥ 30 x 109/L if bone marrow infiltration or
splenomegaly

- Hemoglobin ≥ 8.0 g/dL (5 mmol/L) unless related to bone marrow infiltration or
splenomegaly. Transfusion is allowed before starting treatment (no required
window)

11. Normal laboratory values:

- Measured or estimated creatinine clearance ≥ 40 mL/min calculated by
institutional standard method (MDRD or Cockcroft-Gault)

- aspartate aminotransferase (AST) or alanine aminotransférase (ALT) ≤ 2.5 x the
upper limit of normal (ULN), except in patients with documented liver or
pancreatic involvement by lymphoma ≤ 5 x ULN

- Serum total bilirubin ≤ 1.5 x ULN (or ≤ 3 x ULN for patients with Gilbert
syndrome), except in patients with documented liver or pancreatic involvement
by lymphoma ≤ 3 x ULN

12. left ventricular ejection fraction (LVEF) within normal range (i.e. > 50% as
evaluated by Transthoracic Echocardiography or > 45% as evaluated by isotopic method
(MUGA scan)).

13. Patients should be able to receive adequate prophylaxis and/or therapy for
thromboembolic events (aspirin, low molecular weight heparin or direct oral
anticoagulants).

Patients with a curative anticoagulation therapy can be enrolled. A patient with
deep vein thrombosis due to compressive syndrome is eligible if a curative
anticoagulation therapy has been started at least 1 week before initiating study
treatment: low molecular weight heparin possible at treatment onset, then direct
oral anticoagulants according to local practices.

14. Must be able to adhere to the study visit schedule and other protocol requirements.

15. Negative SARS-CoV-2 test within 7 days prior to randomization. Rapid antigen test is
also acceptable. If a patient has a positive SARS-CoV-2 test before randomization,
another test should be done and be negative within 7 days before initiation of
treatment.

16. Negative HIV test before randomization, with the following exception:

Patients with a positive HIV test before randomization are eligible provided they
are stable on antiretroviral therapy for at least 4 weeks, have a CD4 count ≥ 200/
µL, have an undetectable viral load, and have not had a history of opportunistic
infection attributable to AIDS within the last 12 months.

17. For women of childbearing potential (WOCBP) (refer to section 14.7): must have a
negative result for pregnancy test (highly sensitive serum) at screening and within
7 days before initiation of study treatment, and agree to abstain from breastfeeding
during study participation, and for at least 28 days after the final dose of
lenalidomide (if applicable), 3 months after the final dose of mosunetuzumab and
tocilizumab (if applicable), 6 months after the final dose of chemotherapies (if
applicable), 12 months after the final dose of rituximab (if applicable), and 18
months after the final dose of obinutuzumab (if applicable).

18. For men (refer to section 14.7): Agreement to remain abstinent (refrain from
heterosexual intercourse) or use a condom, and agreement to refrain from donating
sperm, as defined below: with a female partner of childbearing potential or pregnant
female partner, men must remain abstinent or use a condom during the treatment
period (including periods of treatment interruption), and for at least 28 days after
the final dose of lenalidomide (if applicable), 2 months after the final dose of
tocilizumab (if applicable), 6 months after the final dose of chemotherapies (if
applicable), 12 months after the final dose of rituximab (if applicable), and 3
months after the final dose of obinutuzumab (if applicable).

19. Patient covered by any social security system (France).

20. Patient who understands and speaks one of the country official languages, unless
local regulation authorizes independent translators.



1. Grade 3b follicular lymphoma according to the WHO 2016 classification12, or
follicular large B-cell lymphoma according to the WHO 2022 classification13.

2. Suspicion or clinical evidence of transformed lymphoma at enrollment by investigator
assessment (e.g., high SUV in at least one lesion that was not biopsied, and
discordant with SUV of biopsied lesion (at least double of the average SUV), LDH >
2.5 x ULN especially in a context of rapidly progressive disease, etc. (Please
contact the Sponsor to discuss any possible inclusion in borderline cases or any
doubt)

3. Prior localized radiotherapy for the FL.

4. Prior history of another lymphoma.

5. Uncontrolled symptomatic pleural or serous effusion requiring urgent treatment
within 48 hours (patients with controlled disease after adequate pleural/serous
drainage and/or effective pleurX™ or similar system are eligible).

6. Uncontrolled symptomatic ureterohydronephrosis resulting in renal failure (patients
with adequate management i.e. ureteral catheter or double J stent allowing renal
failure control are eligible).

7. Symptomatic lymphomatous epidural lesion (patients whose disease is controlled by
neurosurgery or short course of steroids are eligible).

8. Use of any standard or experimental anti-cancer drug therapy within 42 days of the
start (Day 1) of study treatment.

9. Systemic immunosuppressive medications (including, but not limited to,
cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis
factor agents) or corticosteroid > 1mg/kg/day prednisone or equivalent within 10
days prior to first dose of study treatment. Systemic corticosteroid treatment < 20
mg/day of prednisone or equivalent, inhaled corticosteroids and mineralocorticoids
for management of orthostatic hypotension is permitted. A single dose of
dexamethasone for nausea or B symptoms is permitted.

10. Received a live, attenuated vaccine within 4 weeks before the first dose of study
treatment, or in whom it is anticipated that such a live attenuated vaccine will be
required during the study period or within 5 months after the final dose of study
treatment.

11. Major surgery (excluding surgical documentation of FL) within 28 days prior to
signing informed consent.

12. Seropositive for or active viral infection with Hepatitis B virus (HBV):

- HBsAg positive

- HBsAg negative, anti-HBs positive and/or anti-HBc positive and detectable viral
DNA (Patients who are HBsAg negative, anti-HBs positive and/or anti-HBc
positive but viral DNA negative are eligible. They should be treated and
perform testing at regular interval; Patients who are seropositive due to a
history of hepatitis B vaccine (anti-HBs positive) are eligible).

13. Known seropositive for, or active infection hepatitis C virus (HCV) (Patients who
are positive for HCV antibody with a negative viral RNA are eligible).

14. Known or suspected hypersensitivity to biopharmaceuticals produced in Chinese
hamster ovarian (CHO) cells or any component of the mosunetuzumab, Anti-CD20 mAb,
tocilizumab, lenalidomide formulation, including mannitol; or to any of the
excipients.

15. History of solid organ transplantation or allogeneic stem cell transplant (SCT).

16. Active autoimmune disease requiring treatment.

17. History of autoimmune disease, including, but not limited to, myasthenia gravis,
myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis,
inflammatory bowel disease, vascular thrombosis associated with antiphospholipid
syndrome, Wegener granulomatosis, Sjögren syndrome, Guillain-Barré syndrome,
multiple sclerosis, vasculitis, or glomerulonephritis

- Participants with a history of autoimmune-related hypothyroidism on a stable
dose of thyroid replacement hormone may be eligible.

- Participants with controlled Type 1 diabetes mellitus who are on an insulin
regimen are eligible for the study.

- Participants with a history of disease-related immune thrombocytopenic purpura
or autoimmune hemolytic anemia may be eligible.

- Participants with a remote history of, or well-controlled autoimmune disease,
with a treatment-free interval from immunosuppressive therapy for 12 months may
be eligible after review and discussion with the Primary investigator.

18. Participants with any active infection such as known active bacterial, viral
(including SARS-CoV-2), fungal, mycobacterial, parasitic, or other infection
(excluding fungal infections of nail beds), known or suspected chronic active
Epstein-Barr virus (EBV) infection, are excluded.

19. Evidence of any significant, concomitant disease that could affect compliance with
the protocol or interpretation of results, including, but not limited to:

- significant cardiovascular disease [e.g., Objective Class C or D heart diseases
(cf. Classes of Heart Failure | American Heart Association), myocardial
infarction within the previous 6 months, unstable arrhythmia, or unstable
angina)

- significant pulmonary disease (such as obstructive pulmonary disease or history
of bronchospasm)

- clinically significant history of liver disease, including viral or other
hepatitis, or cirrhosis

- current or past history of central nervous system (CNS) disease, such as
stroke, epilepsy, CNS vasculitis, or neurodegenerative disease. Participants
with a history of stroke who have not experienced a stroke or transient
ischemic attack in the past 1 year and have no residual neurologic deficits as
judged by the investigator are allowed. Participants with a history of epilepsy
who have had no seizures in the past 2 years with or without anti-epileptic
medications can be eligible.

20. History of confirmed progressive multifocal leukoencephalopathy (PML).

21. Known or suspected history of hemophagocytic lymphohistiocytosis (HLH).

22. History of erythema multiforme, Grade ≥3 rash, or blistering rash following prior
treatment with immunomodulatory derivatives.

23. History of interstitial lung disease (ILD), drug-induced pneumonitis, and autoimmune
pneumonitis.

24. Active malignancy other than the one treated in this research. Prior history of
malignancies unless the patient has been free of the disease for ≥ 3 years. However,
patients with the following history/concurrent conditions are eligible:

- Localized non-melanoma skin cancer.

- Carcinoma in situ of the cervix.

- Carcinoma in situ of the breast.

- Incidental histologic finding of prostate cancer (T1a or T1b as per Tumor Node
Metastasis (TNM) staging system) or prostate cancer that has been treated with
curative intent.

25. Presence or history of CNS or meningeal involvement by lymphoma.

26. Pregnant, planning to become pregnant or lactating WOCBP.

27. Any significant medical conditions, including the presence of laboratory abnormality
or psychiatric illness which places the patient at unacceptable risk if he/she were
to participate in the study, and likely to interfere with participation in this
clinical study (according to the investigator's decision) or which confounds the
ability to interpret data from the study.

28. Person deprived of his/her liberty by a judicial or administrative decision.

29. Person hospitalized without consent.

30. Adult person under legal protection.

Nota bene: for 28., if there is an individual benefit for such patients, an Ethics
Committee will have to be informed case by case.