Vitalize Trial: A Phase 2b, Open-Label, Multicenter, Randomized Parallel-Group, Two-Stage, Study of the Novel Immunotherapeutic, Maveropepimut-S, and Pembrolizumab with and without Intermittent Low-Dose Cyclophosphamide, in Subjects with Relapsed/Refractory Diffuse Large B-Cell Lymphoma

Background Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in adults, and up to 40% of patients are refractory to front-line therapy or experience a relapse. In the relapsed/refractory (r/r) setting, novel treatment options are available, but many patients relapse following or are ineligible for such treatment options, due in part to their safety profiles. Thus, more effective, better tolerated therapeutic options are needed. Maveropepimut-S (MVP-S) leverages the DPX platform, a non-aqueous, lipid-based delivery system, to educate a specific, and persistent T cell-based immune response to HLA-restricted peptides of survivin, a cancer-associated protein commonly upregulated in advanced DLBCL. In a prior study in patients with r/r DLBCL (SPiReL), MVP-S with pembrolizumab and low dose, intermittent cyclophosphamide (CPA) led to durable complete and partial responses, and persistent, survivin-specific T cells, particularly in patients with PD-L1+ disease. Importantly, treatment was well-tolerated. Further exploration of the regimen in r/r DLBCL is warranted to confirm and extend these encouraging results. Methods The VITALIZE trial (NCT04920617) is a phase 2b, open-label, randomized trial of MVP-S and pembrolizumab, with or without intermittent low-dose CPA. Eligible patients have r/r persistent or progressive DLBCL following ≥ 2 lines of prior systemic therapy and are ineligible for, or have relapsed after, ASCT and/or CAR-T. Using a Simon's two-stage design, patients are randomized (1:1) to: Arm 1: MVP-S, pembrolizumab and CPA or Arm 2: MVP-S and pembrolizumab and will be treated for up to 2 years. The primary objective of the study is centrally assessed ORR, and secondary endpoints include PFS, DoR, DCR, OS and safety. Exploratory objectives include characterization of outcomes based on PD-L1 expression, and survivin-specific immunogenicity in baseline and on-treatment blood and tissue samples. This study will enroll up to 102 eligible patients at 65 global study sites. As of now, 21 sites are actively recruiting in US, Canada, Australia, New-Zealand, and France. Enrollment has begun. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal