Phase 2 open-label study of MEDI-551 and bendamustine versus rituximab and bendamustine in adults with relapsed or refractory CLL.
Bibliographic record
Abstract
3028 Background: Patients (pts) with relapsed/refractory (RR) chronic lymphocytic leukemia (CLL) need therapies that induce prolonged disease control. MEDI-551, an affinity-optimized anti-CD19 antibody, destroys CLL cells by antibody-dependent cellular cytotoxicity. A phase 2 randomized, open-label study (NCT01466153) is evaluating the clinical activity and safety/tolerability of 2 doses of MEDI-551 + bendamustine compared to rituximab + bendamustine in RR CLL patients. Methods: Pts were initially randomized to receive bendamustine + MEDI-551 2 or 4 mg/kg or rituximab (R). Safety assessments include adverse events (AEs) and laboratory parameters. Disease response was determined using 2008 International Working Group criteria. Results: The safety population comprised 124 pts across all arms. Median age was 66y (range 41–81); with deletion (del) (17p): 9%, del (11q): 22%, del (13q): 31%, trisomy 12: 11%. Median number of treatment cycles: 4 (range 1–6). The most common (≥20%) treatment-related AEs with MEDI-551 were infusion-related reaction (IRR), fatigue and nausea; neutropenia and nausea were most common with R; most treatment-related AEs were grade 1/2; grade 3/4 treatment-related AEs are listed in Table 1. 20% of pts receiving MEDI-551and 18% patients receiving R discontinued treatment due to AEs. An interim analysis of the MEDI-551-treated pts (25 per arm) showed response rates of 48 vs. 64% in the 2 vs. 4 mg/kg arms. Conclusions: MEDI-551 in combination with bendamustine has a manageable toxicity profile that appears to be different compared to rituximab in RR CLL patients. MEDI-551 dosed at 4 mg/kg as compared to 2 mg/kg may have a greater efficacy without any increase in toxicity. Clinical trial information: NCT01466153. Treatment-related grade 3/4 AEs (≥5% of patients). MEDI-551 Rituximab n (%) 2 mg/kg (n=33) 4 mg/kg (n=44) (n=47) Pts reporting ≥1 event 18 (55) 16 (36) 21 (45) Neutropenia 6 (18) 4 (9) 11 (23) Febrile neutropenia 0 1 (2) 5 (11) Thrombocytopenia 0 1 (2) 5 (11) IRR 6 (18) 4 (9) 1 (2) Decreased neutrophils 1 (3) 2 (5) 3 (6) Cytokine release syndrome 2 (6) 0 0 Tumor lysis syndrome 0 2 (5) 0
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".