A Multicenter, Open-Label, First-In-Human, Multiple Expansion Cohort, Phase 1/2 Study to Evaluate the Safety and Efficacy of DR-01 in Adult Subjects With Large Granular Lymphocytic Leukemia or Cytotoxic Lymphomas
DR-01
human anti-CD94 IgG1 monoclonal antibody, non-fucosylated
Dren Bio, Inc.
Multicenter, open-label, FIH Phase 1/2 study.
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Adults >=18 with LGLL or eligible cytotoxic lymphoma, ECOG and disease-specific prior-therapy requirements, adequate organ/coagulation function, and reproductive precautions; disease must be evaluable per protocol response frameworks.
General inclusion (all subjects): 1. Age >=18 years. 2. Able to understand/comply and voluntarily sign informed consent. 3. PT/INR <=1.5 x ULN. 4. aPTT <=1.5 x ULN. 5. Creatinine clearance >=50 mL/min (Cockcroft-Gault). 6. Total bilirubin <=1.5 x ULN (<=3 x ULN with known Gilbert disease). 7. AST/ALT <=2.5 x ULN (<=5 x ULN with liver involvement and Medical Monitor approval). 8. Amylase <1.5 x ULN. 9. Female subjects of childbearing potential must use highly effective contraception from enrollment through at least 12 months after last DR-01 dose. 10. Male subjects must use acceptable effective contraception from enrollment through at least 12 months after last DR-01 dose. LGLL-specific inclusion: 11. ECOG 0-2. 12. Discontinued >=1 prior systemic line due to lack/loss of response after >=4 months exposure or due to intolerance, and still requires therapy. 13. Baseline clinical characteristics evaluable by ECOG E5998 response criteria. 14. T-cell subtype LGLL: pathologic diagnosis with peripheral blood CD3+CD57+ >400/mm3 or CD3+CD8+ >650/mm3 and clonal expansion evidence. 15. CLPD-NK/NK subtype LGLL: pathologic diagnosis with peripheral blood CD3-CD16+/CD56+ cells. Cytotoxic lymphoma-specific inclusion: 16. ECOG 0-1. 17. Failed >=1 prior systemic regimen and still requires therapy. 18. Availability of post-progression tissue sample or consent to baseline biopsy. 19. Histologically confirmed lymphoma (WHO 2016) within eligible cytotoxic histologies listed in protocol (e.g., PCGD-TCL, aggressive epidermotropic CD8+ CTCL, HSTCL, ANKL, ENKTL nasal type, EATL, MEITL, etc., including certain atypical cytotoxic phenotypes with Medical Monitor approval). 20. For Part A: evaluable disease acceptable. 21. For Part B2: evaluable disease by protocol-defined response framework (Lugano measurable disease and/or Olsen/modified T-PLL criteria as applicable to disease presentation).
Reactive/non-target LGL states or severe cytopenias below thresholds, active severe infection/CNS malignancy/HLH, active HIV/HBV/HCV (with limited cured-HCV exception), major recent cardiac/thromboembolic events, recent prohibited anti-cancer/immunosuppressive/transplant/surgery exposures.
Disease-specific exclusions: 1. Reactive LGL lymphocytosis to viral infection or LGL associated with MDS/AML. 2. LGLL/ANKL with neutrophils <250/mm3. 3. Cytotoxic lymphoma with neutrophils <750/mm3. General exclusions (all subjects): 4. Platelets <50,000/mm3 (protocol exception possibility for HSTCL/ANKL with Medical Monitor approval). 5. Active systemic or severe localized infection requiring systemic anti-infectives. 6. Active or suspected malignant CNS involvement. 7. Life-threatening severe malignancy complications (e.g., uncontrolled bleeding, hypoxic/shock pneumonia, DIC). 8. Active known second malignancy except protocol-permitted low-risk/adequately treated exceptions. 9. HIV-1 or HIV-2 infection. 10. Active HBV (HBsAg positive) or active HCV (HCV antibody positive confirmed by RNA); treated HCV with undetectable virus may be eligible. 11. Clinically significant cardiac disease (including CHF >NYHA II, or major cardiac/clotting abnormalities within 6 months prior to C1D1, with limited catheter-related thrombosis exception). 12. Hemophagocytic lymphohistiocytosis (must be ruled out by BM biopsy if suspected). 13. QTcF >475 msec. 14. High-dose biotin supplementation >30 micrograms/day (eligible if reduced to <=30 micrograms/day). 15. Prohibited systemic corticosteroids or other immunosuppressive drugs within protocol window prior to C1D1 (with listed exceptions). 16. Condition requiring hormonal therapy other than protocol-allowed categories. 17. Any other medical/psychiatric/laboratory condition increasing risk or compromising study conduct per investigator/Medical Monitor. 18. Non-biologic anticancer therapy within 14 days or 5 half-lives (whichever less) prior to C1D1. 19. Biologic therapy within 30 days of C1D1. 20. Unresolved toxicities from prior anticancer therapy above allowed thresholds. 21. Autologous HSCT within 40 days, or allogeneic HSCT within 90 days of C1D1. 22. Ongoing immunosuppressive therapy for GVHD post-allogeneic HSCT. 23. Major surgery within 28 days of C1D1.
陳彩雲
李佳玲
4620