Merck’s Investigational Zilovertamab Vedotin at 1.75 mg/kg Dose Plus Standard of Care Showed Promising Antitumor Activity, Including Complete Response Rate, in Patients With Relapsed/Refractory DLBCL in Phase 2 Portion of waveLINE-003 Trial
“Patients with relapsed or refractory diffuse large B-cell lymphoma continue to experience poor outcomes and an unmet need remains to help provide these patients with additional options to treat their cancer,” said Dr.
“In the Phase 2 portion of the waveLINE-003 trial, the 1.75 mg/kg dose of zilovertamab vedotin with rituximab, gemcitabine and oxaliplatin demonstrated a promising response rate, complete response rate and manageable safety profile in combination with standard of care,” said Dr.
Zilovertamab vedotin is currently being evaluated in patients with previously untreated DLBCL in the Phase 3 waveLINE-010 study (NCT06717347) and in the Phase 2 waveLINE-007 study (NCT05406401). Additionally, we recently initiated the Phase 2 waveLINE-011 study (NCT06890884), which is a randomized, open-label clinical trial evaluating zilovertamab vedotin plus rituximab and cyclophosphamide, doxorubicin and prednisone (R-CHP) versus polatuzumab vedotin with R-CHP for the treatment of patients with DLBCL. The trial is estimated to enroll 594 patients and the primary endpoint is CR rate at end of treatment, with secondary endpoints of progression-free survival (PFS), overall survival (OS), event-free survival, duration of CR and safety. Global recruitment of the waveLINE-011 study has begun, with patients now enrolling.
As announced, data spanning more than 25 types of cancer are being presented from Merck’s broad oncology portfolio and investigational pipeline at the 2025 ASCO Annual Meeting.
Study design and additional data from waveLINE-003
WaveLINE-003 is a Phase 2/3 randomized, multicenter, open-label, dose confirmation and expansion clinical trial (ClinicalTrials.gov, NCT05139017) designed to assess the safety and efficacy of zilovertamab vedotin in combination with standard of care options for the treatment of relapsed or refractory DLBCL after one or more lines of therapy. This study is divided into two parts: dose confirmation (part 1) and efficacy expansion (part 2) and enrolled adult participants with confirmed relapsed or refractory DLBCL after one or more lines of therapy and an
- Zilovertamab vedotin (1.5 mg/kg intravenously [IV]) plus rituximab (375 mg/m2 IV), gemcitabine (1000 mg/m2 IV) and oxaliplatin (100 mg/m2 IV), given every three weeks (Q3W) up to six cycles (n=17), or
- Zilovertamab vedotin (1.75 mg/kg IV) plus R-GemOx Q3W up to six cycles (n=16), or
- Zilovertamab vedotin (2.0 mg/kg IV) plus R-GemOx Q3W up to six cycles (n=7).
Treatment-related adverse events (TRAEs) were reported in 98% of patients (n=40). Grade ≥3 TRAEs occurred in 63% of patients (n=25). At the 1.5 mg/kg dose of zilovertamab vedotin plus R-GemOx, four patients completed treatment, eight discontinued due to progression and one withdrew, with four patients receiving ongoing treatment at data cut-off. At the 1.75 mg/kg dose, eight patients completed treatment, seven discontinued due to progression and one patient discontinued due to physician decision. In the 2.0 mg/kg dose cohort, three patients completed treatment, three patients discontinued treatment due to adverse events (AEs) (treatment-related sepsis and respiratory failure), and one patient withdrew due to physician decision. One patient died after discontinuing treatment due to treatment-related sepsis. The most common AEs were diarrhea, nausea, anemia and platelet count decrease, while the most common Grade ≥3 AEs were neutropenia, neutrophil count decrease, platelet count decrease and anemia.
Seven dose-limiting toxicities occurred across all participants. At the 1.5 mg/kg dose of zilovertamab vedotin plus R-GemOx, one participant had Grade 4 febrile neutropenia. At the 1.75 mg/kg dose, one participant experienced Grade 3 alanine aminotransferase increased and one patient had intestinal obstruction. At the 2.0 mg/kg dose, participants had Grade 3 diarrhea, Grade 4 neutrophil count decrease and Grade 4 thrombocytopenia (one patient each), and one patient experienced both Grade 3 febrile neutropenia and Grade 4 neutrophil count decrease.
The median follow-up for all participants was 9.8 months. At a median follow-up of 18.1 months (range, 2.4 to 23.3 months) in patients receiving the 1.5 mg/kg dose of zilovertamab vedotin (n=15), ORR was 26.7% (3 CR [20.0%], 1 PR [6.7%]) and median DOR was 14.4 months (95% CI, not reached [NR]-NR). At a median follow-up of 9.9 months (range, 4.0 to 30.0 months) for patients receiving the 1.75 mg/kg dose (n=16), ORR was 56.3% (8 CR [50.0%], 1 PR [6.3%]) and median DOR was 8.7 months (95% CI, 2.3-NR). At a median follow-up of 9.3 months (range, 6.0 to 10.0 months) for patients receiving the 2.0 mg/kg dose (n=7), the ORR was 57.1% (3 CR [42.9%], 1 PR [14.3%]) and median DOR was not reached (95% CI, 4.1-NR). Based on these results and accompanying safety data, the recommended Phase 2 dose of zilovertamab vedotin was determined to be 1.75 mg/kg when used with R-GemOx.
About diffuse large B-cell lymphoma
Lymphoma is cancer beginning in the lymphatic system – the network of organs, vessels and tissues that protects the body from infection. There are many subtypes of lymphoma, which is often categorized into two main types – Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Diffuse large B-cell lymphoma, the most common form of NHL, is derived from white blood cells that grow rapidly and uncontrollably, enlarging the lymph nodes and often migrating to other parts of the body. DLBCL accounts for approximately 25-30% of all NHLs worldwide. In the
About zilovertamab vedotin (MK-2140)
Zilovertamab vedotin is an investigational, potential first-in-class ADC that targets ROR1. ROR1 is a transmembrane protein that is overexpressed in multiple hematologic malignancies.
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Merck’s focus on cancer
Every day, we follow the science as we work to discover innovations that can help patients, no matter what stage of cancer they have. As a leading oncology company, we are pursuing research where scientific opportunity and medical need converge, underpinned by our diverse pipeline of more than 25 novel mechanisms. With one of the largest clinical development programs across more than 30 tumor types, we strive to advance breakthrough science that will shape the future of oncology. By addressing barriers to clinical trial participation, screening and treatment, we work with urgency to reduce disparities and help ensure patients have access to high-quality cancer care. Our unwavering commitment is what will bring us closer to our goal of bringing life to more patients with cancer. For more information, visit https://www.merck.com/research/oncology/.
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