PENTIXATHER; YTTRIUM-90 for Primary central nervous system lymphoma | Secondary central nervous system lymphoma

Inclusion criteria

• {"criterion_text":"- Signed informed consent, by the patient or an authorized legal guardian in case the patient is temporarily not competent due to his or her disease, obtained before any study-related activities. Study-related activities are any procedures that are carried out as part of the study, including activities to determine suitability for the study.\n- For male patient whose partner is of child-bearing potential: patient is willing to ensure that he and his partner use effective contraception during the study and for six months after 90Y-PTT treatment.\n- ECOG performance status ≤ 2.\n- Confirmed presence of CXCR4 on technically evaluable tumor lesions documented by a visually CXCR4-positive [68Ga]Ga-PentixaFor PET scan within two months prior to enrolment in the study or during Screening.\n- Blood test results as follows: a. Absolute neutrophil count: > 1.0 x 10^9 /L b. Hemoglobin: ≥ 8 g/dL c. Platelets: ≥ 75 x 10^9/L d. Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP): ≤ 3 x ULN (upper limit of normal) e. Serum creatinine: ≤ 2 x ULN and Cockroft Gault calculated glomerular filtration rate (GFR) ≥ 50 mL/min f. Bilirubin: ≤ 3 x ULN.\n- Patients of either gender aged > 18 years.\n- Body weight ≤ 180 kg.\n- At least one measurable lymphoma manifestation in the CNS, either contrast-enhanced lesion in the brain parenchyma or measurable meningeal lesion.\n- Histologically, cytologically, radiologically or by detection of ctDNA mutation (MYD88/L265P) in cerebrospinal fluid confirmed relapsed/refractory PCNSL or relapsed/refractory SCNSL. Initial histologic confirmation at first diagnosis is mandatory. No peripheral lymphoma evidence is allowed.\n- Recurrent or refractory CNSL a) For recurrent disease, comprising new lesions or recurrent CNSL after a CR at that site, there are no maximum number of recurrences. b) Refractory CNSL comprises patients with non-responding CNSL to frontline therapy, or progressive disease after an initial,partial response (PR).\n- Stored stem cells with at least ≥ 2 x 10^6 CD34+ cells/kg of body weight.\n- If sexually active female patient of childbearing potential: patient agrees to take adequate contraceptive measures during study participation and agrees to continue use of this method for the duration of the study and for six months after the last dose.\n- Female patient without childbearing potential: documented history (e.g., tubal ligation or hysterectomy) or is post-menopausal."}

Exclusion criteria

• {"criterion_text":"- Known or suspected hypersensitivity to study product(s) or related products.\n- Participation in any other clinical study of an approved or non-approved IMP within the last 30 days (or ≤ 5 terminal elimination half-lives of previous IMP, whichever is longer) before screening.\n- Any disorder (e.g., unstable angina pectoris, cardiac arrhythmia (excluding atrial fibrillation and atrial flutter, uncontrolled congestive heart failure), poorly controlled hypertension, poorly controlled diabetes mellitus [HbA1c ≥ 9%], etc.) or laboratory findings, except for conditions associated with CNS lymphoma, which in the investigator's opinion might jeopardize patient's safety or compliance with the protocol.\n- Presence of active infection, or history of serious infection six weeks prior to IMP administration. Patients with uncontrolled human immunodeficiency virus (HIV) infection as well as acute or chronic active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are excluded (Note: Patients on antiretroviral therapy (ART) with controlled HIV infection (defined as sufficient ART compliance, non-measurable HIV and CD4+ T helper cells > 200/microL) may be enrolled, if considered eligible for study treatment by the investigator.).\n- SCNSL with systemic involvement.\n- Brain radiation therapy ≤ 180 days before IMP infusion.\n- Any mental condition rendering the patient unable to understand the nature, scope, and possible consequences of the study, and/or evidence of an uncooperative attitude without designated legal representative.\n- Contraindication for contrast-enhanced MRI as set out in the relevant institutional guidelines (e.g., pacemaker, defibrillator, aneurysm clip, metal in the body, renal insufficiency, severe claustrophobia etc.) or contraindication for the use of gadolinium contrast for MRI.\n- Previous treatment with the IMP.\n- Female who is pregnant, breast-feeding or intends to become pregnant or is of childbearing potential and not using an adequate contraceptive method (adequate contraceptive measures as required by local regulation or practice). A pregnancy test will be performed at the start of the study for all female patients of childbearing potential (i.e., not surgically sterile or two years postmenopausal).\n- Male of reproductive age who or whose partner(s) is not using an adequate contraceptive method (adequate contraceptive measures as required by local regulation or practice)."}

Primary endpoints

• {"endpoint_text":"- Incidence, severity and relationship of (S)AEs (graded in severity according to NCI CTCAE version 5.0)\n- Incidence and severity of DLT\n- Changes from baseline in vital signs.\n- Changes from baseline in laboratory parameters (hematology and biochemistry, urinalysis).\n- Abnormal findings in physical examination\n- Findings 12-lead ECG\n- SCT after treatment\n- Mortality rate at 30 and 90 days post-treatment","definition_or_measurement_approach":"Incidence and severity of AEs/SAEs graded per NCI CTCAE v5.0; DLT incidence and severity (dose-limiting toxicity criteria not further specified in submitted text); changes from baseline measured by vital signs and laboratory parameters (hematology, biochemistry, urinalysis); physical exam findings; 12-lead ECG findings; occurrence of stem cell transplantation (SCT) after treatment; mortality rates measured at 30 and 90 days post-treatment."}

Secondary endpoints

• {"endpoint_text":"- Biodistribution: •\tMaximal uptake (%) for tumor lesion •\tMaximal uptake (%) in discernible organs •\tTAC in discernible thoracic and abdominal organs, target lesion and blood •\tAUC of 90Y-PTT in discernible thoracic and abdominal organs, target lesion and blood •\tAUC of 90Y-PTT in urine\n- Radiation dosimetry: • Organ receiving the highest absorbed dose • Specific absorbed dose per organ and for target lesion • Cumulative absorbed organ/lesion doses\n- Efficacy • ORR at one month and three months • PFS at one month and three months • Rate of CR and PR at one month and three months • PFS at 12 month • OS at one month, 3 months, 12 months","definition_or_measurement_approach":"Biodistribution measured by maximal uptake (%) in tumors and organs, time-activity curves (TAC) and AUC in organs, lesions, blood and urine. Radiation dosimetry measured as highest absorbed organ dose, specific absorbed dose per organ and lesion, cumulative absorbed doses. Efficacy measured by objective response rate (ORR), progression-free survival (PFS), complete response (CR) and partial response (PR) rates, and overall survival (OS) at specified timepoints (1, 3 and 12 months)."}

Germany

Earliest CTIS Part Ii Submission Date

21-03-2024

Latest Decision Or Authorization Date

27-01-2026

Processing Time Days

677

Number Of Sites

2

Number Of Participants

15

Primary sponsor

Full Name

Pentixapharm AG

Organisation Type

Pharmaceutical company

Country Of Registered Address

Germany

Contract research organisations

Name

Pivotal S.L.

Responsibilities

sponsorDuties codes: 10,11,12,13,5,6,7,8

Third parties

• {"country":"Spain","full_name":"Pivotal S.L.","duties_or_roles":"sponsorDuties codes: 10,11,12,13,5,6,7,8","organisation_type":"Pharmaceutical company"}