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出境医 / 临床实验 / Abexinostat and Ibrutinib in Diffuse Large B-cell Lymphoma and Mantle Cell Lymphoma

Abexinostat and Ibrutinib in Diffuse Large B-cell Lymphoma and Mantle Cell Lymphoma

Study Description
Brief Summary:
The purpose of this study is to test the safety of abexinostat at different doses to find out if it can work with ibrutinib to stop the cancer from growing.

Condition or disease Intervention/treatment Phase
Diffuse Large B-cell Lymphoma Mantle Cell Lymphoma Drug: Abexinostat Drug: Ibrutinib Phase 1 Phase 2

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: This is a phase I with dose expansion, open label single institution trial. The first stage is a standard 3+3 dose escalation trial. In the second stage, the dose expansion cohort will accrue patients at the MTD abexinostat and ibrutinib previously determined.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I Study of Abexinostat and Ibrutinib in Diffuse Large B-cell Lymphoma and Mantle Cell Lymphoma
Actual Study Start Date : May 29, 2019
Estimated Primary Completion Date : May 2022
Estimated Study Completion Date : May 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: Abexinostat and Ibrutinib
The investigational agents to be used in this study are ibrutinib and abexinostat. Ibrutinib will be administered once daily on a 28-day cycle. Abexinostat will be administered orally twice daily (approximately 4-6 hours apart) for 7 days a week given every other week on a 28-day cycle.
Drug: Abexinostat
Two doses of the abexinostat will be tested: 30 mg/m2 and 45 mg/m2 orally twice daily, 7 days/week given every other week during a 28-day cycle.

Drug: Ibrutinib
Ibrutinib will be given at the FDA-approved dose for mantle cell lymphoma (MCL) of 560 mg orally daily for 28 day cycle.

Outcome Measures
Primary Outcome Measures :
  1. the MTD of abexinostat when combined with ibrutinib [ Time Frame: 1 year ]
    a standard 3+3 dose escalation scheme will be used. For any given dose an initial cohort of 3 patients will be treated at that dose. The dose level will be escalated if none of the 3 patients exhibits any DLT.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient is ≥ 18 years of age at the time of signing Informed Consent
  • Patient is able and willing to adhere to the study visit schedule and other protocol requirements
  • Patient has histologically confirmed diagnosis of R/R mantle cell lymphoma or diffuse large B cell lymphoma

    • Diffuse large B cell lymphoma patients must have received at least 1 prior regimen and received, declined, or is ineligible for autologous or allogeneic stem cell transplant.
    • Diffuse large B cell lymphoma patients must have non-germinal center subtype disease applying the Hans classification algorithm using immunohistochemistry markers CD10, BCL6, and MUM1 (8).
    • Mantle cell lymphoma patients must have received at least 1 line of therapy
    • Allogeneic stem cell transplant recipients be greater than 6 months post transplant, not on immunosuppression for prevention of graft versus host disease for >3 months and without active graft versus host disease
    • Autologous stem cell transplant recipients must have adequate bone marrow recovery and are transfusion independent
    • Patients with transformed DLBCL from an antecedent or simultaneous indolent B-cell Non-Hodgkin lymphoma are permitted.
  • Patient has at least one measurable lesion (≥ 1.5 cm) according to RECIL
  • Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Patient has adequate bone marrow and organ function by:
  • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L independent of growth factor support
  • Platelets ≥100 x 10^9/L independent of transfusion

    °For patients with documented bone marrow involvement of underlying MCL or DLBCL at time of study enrollment, platelets must be ≥75 x 10^9/L independent of transfusion

  • Hemoglobin (Hgb) ≥ 9.0 g/dL

    °For patients with documented bone marrow involvement of underlying MCL or DLBCL at time of study enrollment, Hgb must be ≥ 8.0 g/dL

  • International Normalized Ratio (INR) ≤ 1.5
  • Creatinine clearance > 25 mL/min as determined by the Cockcroft-Gault equation or a 24-hour urine collection
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ ULN (or ≤3 x ULN if liver involved with disease Total serum bilirubin ≤ 1.5 ULN unless bilirubin rise is due to Gilbert"s syndrome or of non-hepatic origin
  • Normal serum potassium level with or without supplementation.
  • Left Ventricular Ejection Fraction (LVEF) ≥ 50%
  • Women of childbearing potential and men who are sexually active must be practicing a highly effective method of birth control during and after the study consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trial. For females, these restrictions apply for 30 days month after the last dose of study drug. For males, these restrictions apply for 120 days after the last dose of study drug. Refer to section 9.7 "Reproductive toxicity" for additional details
  • Women of childbearing potential must have a negative urine pregnancy test at Screening and within 7 days of treatment initiation
  • Men must agree to not donate sperm during and 12 months after the study. Women should not donate ova/ooctyes for the purposes of
  • Patient is able to swallow and retain oral medications

Exclusion Criteria:

  • Patients previously treated with ibrutinib or HDAC inhibitor
  • Patient has a history of non-compliance to medical regimen or inability to grant consent
  • Patient is concurrently using other approved or investigational antineoplastic agent
  • Patient has not recovered to Grade 1 or better (except alopecia) from related side effects of any prior antineoplastic therapy
  • Patient has had major surgery or a wound that has not fully healed within 4 weeks of starting study drugs.
  • Patients who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study
  • Patient has evidence of active graft versus host disease (GVHD)
  • Patient has active central nervous system (CNS) disease or meningeal involvement.
  • Patient has history of stroke or intracranial hemorrhage ≤ 6 months from starting study drugs.
  • Patient has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)
  • Patient has clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification, Left Ventricular Ejection Fraction (LVEF) <50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO), unstable angina pectoris, symptomatic pericarditis, QTcF > 480 msec on the screening ECG (using the QTcF formula), or history of congenital long QT syndrome.
  • Patient has a concurrent active malignancy.
  • Malignancies treated with a curative intent with an expected life expectancy ≥ 5 years or a non-competing life expectancy risk are eligible (i.e. adequately treated basal or squamous cell carcinoma, non-melanomatous skin cancer, early stage breast cancer, treated prostate cancer or any other cancer from which the patient has been disease free for ≥ 3 years).
  • Patient with known history of human immunodeficiency virus (HIV), or any uncontrolled active systemic infection.
  • Patients with acute viral hepatitis or a history of chronic or active HBV or HCV infection.

    • Hepatisis B surface antigen and core antibody testing are required at screening. If Hepatisis B surface antigen is positive then HBV PCR is required and if positive, then patient will be excluded.
    • Hepatisis C antibody testing is required at screening. If positive, Hepatisis C PCR is required and if positive, pHepatisis C PCR is required and if positive, then patient will be excluded.
  • Patient has hepatic failure (Child-Pugh Class C)
  • Patient is currently receiving increasing or chronic treatment (> 10 days) with corticosteroids or another immunosuppressive agent. Patients requiring chronic therapy with steroids may take no more than 10mg daily of prednisone or equivalent.
  • Patient requires chronic treatment with a strong cytochrome P450 (CYP) 3A4 inhibitors, and inducers, or drugs known to induce Torsades de Pointes and the treatment cannot be discontinued or switched to a different medication prior to starting study drug (Appendix 1 and 3).
  • Patients with known bleeding diathesis (e.g. von Willebrand "s disease) or hemophilia
  • Patient is currently receiving warfarin or other Vitamin K antagonist. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed. Refer to Section 9.5 for Concomitant medication
  • Vaccinated with live, attenuated vaccines within 4 weeks of randomization
  • Patients with any life-threatening illness, medical condition or organ system dysfunction that in the opinion of the investigator could compromise the subject"s safety, interfere with absorption of metabolism of study drugs or put the study outcomes at undue risk.
  • Women who are pregnant or breastfeeding.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Gottfried von Keudell, MD 212-639-3748 vonkeudg@mskcc.org
Contact: Maria Palomba, MD 212-639-7186

Locations
Layout table for location information
United States, New Jersey
Memoral Sloan Kettering Basking Ridge Recruiting
Basking Ridge, New Jersey, United States, 07920
Contact: Gottfried von Keudell, MD    212-639-3748      
Memoral Sloan Kettering Monmouth Recruiting
Middletown, New Jersey, United States, 07748
Contact: Gottfried von Keudell, MD    212-639-3748      
United States, New York
Memorial Sloan Kettering Commack Recruiting
Commack, New York, United States, 11725
Contact: Gottfried von Keudell, MD    212-639-3748      
Memorial Sloan Kettering Westchester Recruiting
Harrison, New York, United States, 10604
Contact: Gottfried von Keudell, MD    212-639-3748      
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Gottfried von Keudell, MD    212-639-3748      
Contact: Maria Palomba, MD    212-639-7186      
Memorial Sloan Kettering Rockville Centre Recruiting
Rockville Centre, New York, United States, 11570
Contact: Gottfried von Keudell, MD    212-639-3748      
United States, Pennsylvania
Lehigh Valley Health Network Recruiting
Allentown, Pennsylvania, United States, 18103
Contact: Don Park, MD    610-402-7880      
Sponsors and Collaborators
Memorial Sloan Kettering Cancer Center
Janssen Scientific Affairs, LLC
Xynomic Pharmaceuticals, Inc.
Investigators
Layout table for investigator information
Principal Investigator: Gottfried von Keudell, MD Memorial Sloan Kettering Cancer Center
Tracking Information
First Submitted Date  ICMJE May 3, 2019
First Posted Date  ICMJE May 6, 2019
Last Update Posted Date May 6, 2021
Actual Study Start Date  ICMJE May 29, 2019
Estimated Primary Completion Date May 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 3, 2019)
the MTD of abexinostat when combined with ibrutinib [ Time Frame: 1 year ]
a standard 3+3 dose escalation scheme will be used. For any given dose an initial cohort of 3 patients will be treated at that dose. The dose level will be escalated if none of the 3 patients exhibits any DLT.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Abexinostat and Ibrutinib in Diffuse Large B-cell Lymphoma and Mantle Cell Lymphoma
Official Title  ICMJE Phase I Study of Abexinostat and Ibrutinib in Diffuse Large B-cell Lymphoma and Mantle Cell Lymphoma
Brief Summary The purpose of this study is to test the safety of abexinostat at different doses to find out if it can work with ibrutinib to stop the cancer from growing.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description:
This is a phase I with dose expansion, open label single institution trial. The first stage is a standard 3+3 dose escalation trial. In the second stage, the dose expansion cohort will accrue patients at the MTD abexinostat and ibrutinib previously determined.
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Diffuse Large B-cell Lymphoma
  • Mantle Cell Lymphoma
Intervention  ICMJE
  • Drug: Abexinostat
    Two doses of the abexinostat will be tested: 30 mg/m2 and 45 mg/m2 orally twice daily, 7 days/week given every other week during a 28-day cycle.
  • Drug: Ibrutinib
    Ibrutinib will be given at the FDA-approved dose for mantle cell lymphoma (MCL) of 560 mg orally daily for 28 day cycle.
Study Arms  ICMJE Experimental: Abexinostat and Ibrutinib
The investigational agents to be used in this study are ibrutinib and abexinostat. Ibrutinib will be administered once daily on a 28-day cycle. Abexinostat will be administered orally twice daily (approximately 4-6 hours apart) for 7 days a week given every other week on a 28-day cycle.
Interventions:
  • Drug: Abexinostat
  • Drug: Ibrutinib
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: May 3, 2019)
40
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE May 2022
Estimated Primary Completion Date May 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Patient is ≥ 18 years of age at the time of signing Informed Consent
  • Patient is able and willing to adhere to the study visit schedule and other protocol requirements
  • Patient has histologically confirmed diagnosis of R/R mantle cell lymphoma or diffuse large B cell lymphoma

    • Diffuse large B cell lymphoma patients must have received at least 1 prior regimen and received, declined, or is ineligible for autologous or allogeneic stem cell transplant.
    • Diffuse large B cell lymphoma patients must have non-germinal center subtype disease applying the Hans classification algorithm using immunohistochemistry markers CD10, BCL6, and MUM1 (8).
    • Mantle cell lymphoma patients must have received at least 1 line of therapy
    • Allogeneic stem cell transplant recipients be greater than 6 months post transplant, not on immunosuppression for prevention of graft versus host disease for >3 months and without active graft versus host disease
    • Autologous stem cell transplant recipients must have adequate bone marrow recovery and are transfusion independent
    • Patients with transformed DLBCL from an antecedent or simultaneous indolent B-cell Non-Hodgkin lymphoma are permitted.
  • Patient has at least one measurable lesion (≥ 1.5 cm) according to RECIL
  • Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Patient has adequate bone marrow and organ function by:
  • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L independent of growth factor support
  • Platelets ≥100 x 10^9/L independent of transfusion

    °For patients with documented bone marrow involvement of underlying MCL or DLBCL at time of study enrollment, platelets must be ≥75 x 10^9/L independent of transfusion

  • Hemoglobin (Hgb) ≥ 9.0 g/dL

    °For patients with documented bone marrow involvement of underlying MCL or DLBCL at time of study enrollment, Hgb must be ≥ 8.0 g/dL

  • International Normalized Ratio (INR) ≤ 1.5
  • Creatinine clearance > 25 mL/min as determined by the Cockcroft-Gault equation or a 24-hour urine collection
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ ULN (or ≤3 x ULN if liver involved with disease Total serum bilirubin ≤ 1.5 ULN unless bilirubin rise is due to Gilbert"s syndrome or of non-hepatic origin
  • Normal serum potassium level with or without supplementation.
  • Left Ventricular Ejection Fraction (LVEF) ≥ 50%
  • Women of childbearing potential and men who are sexually active must be practicing a highly effective method of birth control during and after the study consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trial. For females, these restrictions apply for 30 days month after the last dose of study drug. For males, these restrictions apply for 120 days after the last dose of study drug. Refer to section 9.7 "Reproductive toxicity" for additional details
  • Women of childbearing potential must have a negative urine pregnancy test at Screening and within 7 days of treatment initiation
  • Men must agree to not donate sperm during and 12 months after the study. Women should not donate ova/ooctyes for the purposes of
  • Patient is able to swallow and retain oral medications

Exclusion Criteria:

  • Patients previously treated with ibrutinib or HDAC inhibitor
  • Patient has a history of non-compliance to medical regimen or inability to grant consent
  • Patient is concurrently using other approved or investigational antineoplastic agent
  • Patient has not recovered to Grade 1 or better (except alopecia) from related side effects of any prior antineoplastic therapy
  • Patient has had major surgery or a wound that has not fully healed within 4 weeks of starting study drugs.
  • Patients who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study
  • Patient has evidence of active graft versus host disease (GVHD)
  • Patient has active central nervous system (CNS) disease or meningeal involvement.
  • Patient has history of stroke or intracranial hemorrhage ≤ 6 months from starting study drugs.
  • Patient has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)
  • Patient has clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification, Left Ventricular Ejection Fraction (LVEF) <50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO), unstable angina pectoris, symptomatic pericarditis, QTcF > 480 msec on the screening ECG (using the QTcF formula), or history of congenital long QT syndrome.
  • Patient has a concurrent active malignancy.
  • Malignancies treated with a curative intent with an expected life expectancy ≥ 5 years or a non-competing life expectancy risk are eligible (i.e. adequately treated basal or squamous cell carcinoma, non-melanomatous skin cancer, early stage breast cancer, treated prostate cancer or any other cancer from which the patient has been disease free for ≥ 3 years).
  • Patient with known history of human immunodeficiency virus (HIV), or any uncontrolled active systemic infection.
  • Patients with acute viral hepatitis or a history of chronic or active HBV or HCV infection.

    • Hepatisis B surface antigen and core antibody testing are required at screening. If Hepatisis B surface antigen is positive then HBV PCR is required and if positive, then patient will be excluded.
    • Hepatisis C antibody testing is required at screening. If positive, Hepatisis C PCR is required and if positive, pHepatisis C PCR is required and if positive, then patient will be excluded.
  • Patient has hepatic failure (Child-Pugh Class C)
  • Patient is currently receiving increasing or chronic treatment (> 10 days) with corticosteroids or another immunosuppressive agent. Patients requiring chronic therapy with steroids may take no more than 10mg daily of prednisone or equivalent.
  • Patient requires chronic treatment with a strong cytochrome P450 (CYP) 3A4 inhibitors, and inducers, or drugs known to induce Torsades de Pointes and the treatment cannot be discontinued or switched to a different medication prior to starting study drug (Appendix 1 and 3).
  • Patients with known bleeding diathesis (e.g. von Willebrand "s disease) or hemophilia
  • Patient is currently receiving warfarin or other Vitamin K antagonist. Therapy with heparin, low molecular weight heparin (LMWH), or fondaparinux is allowed. Refer to Section 9.5 for Concomitant medication
  • Vaccinated with live, attenuated vaccines within 4 weeks of randomization
  • Patients with any life-threatening illness, medical condition or organ system dysfunction that in the opinion of the investigator could compromise the subject"s safety, interfere with absorption of metabolism of study drugs or put the study outcomes at undue risk.
  • Women who are pregnant or breastfeeding.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Gottfried von Keudell, MD 212-639-3748 vonkeudg@mskcc.org
Contact: Maria Palomba, MD 212-639-7186
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03939182
Other Study ID Numbers  ICMJE 19-080
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Yes
Plan Description: Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.
Supporting Materials: Statistical Analysis Plan (SAP)
Supporting Materials: Informed Consent Form (ICF)
Responsible Party Memorial Sloan Kettering Cancer Center
Study Sponsor  ICMJE Memorial Sloan Kettering Cancer Center
Collaborators  ICMJE
  • Janssen Scientific Affairs, LLC
  • Xynomic Pharmaceuticals, Inc.
Investigators  ICMJE
Principal Investigator: Gottfried von Keudell, MD Memorial Sloan Kettering Cancer Center
PRS Account Memorial Sloan Kettering Cancer Center
Verification Date May 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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