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Phase 2 Study With PQR309 in Relapsed or Refractory Lymphoma Patients

Phase 2
Completed
Conditions
Lymphoma
Non-Hodgkin Lymphoma
Interventions
Registration Number
NCT03127020
Lead Sponsor
PIQUR Therapeutics AG
Brief Summary

The main goal of this study is to determine the Maximum Tolerated Dose (MTD) and the Recommended Phase II Dose (RP2D) as well as preliminary antitumor activity of PQR309 administered orally, as once daily capsules continuously and on intermittent schedule, in patients with relapsed or refractory lymphomas.

Detailed Description

Open-label, non-randomized, multicentre phase 2 study with a safety run-in evaluating efficacy and safety of PQR309 in patients with relapsed or refractory lymphoma.

The maximum tolerated dose (MTD) of PQR309 in patients with advanced solid tumours was defined as 80 mg once daily given continuously (q.d. schedule) in a previous phase 1 study \[8\]. The safety run-in of this study will follow a modified 3 + 3 design to evaluate the safety of 60 and 80 mg PQR309 in patients with relapsed or refractory lymphoma administered p.o. once daily during a DLT (dose-limiting toxicity) period of 28 days.

In the safety run-in, three patients will be treated at 60 mg PQR309 for 28 days. Enrollment and treatment of all three patients may occur simultaneously as 80 mg PQR309 p.o. qd was established as the MTD maximum tolerated dose in solid tumours. Unless a DLT (dose-limiting toxicity) is observed in any of the three patients during the first 28 days of treatment, the investigators and the sponsor will decide to escalate the dose to 80 mg.Intermittent dosing schedules may be evaluated if, based on the overall evaluation of all the clinical and PK (pharmacokinetic) data from this and other studies with PQR309, data emerge during the step 1 of the phase 2 expansion in this PQR309 002A study, indicating that daily dosing of PQR309 is not adequately tolerated or inefficacious.

Intermittent dosing schedules may be evaluated if, based on the overall evaluation of all the clinical and PK (pharmacokinetic) data from this and other studies with PQR309, data emerge during the step 1 of the phase 2 expansion in this PQR309 002A study, indicating that daily dosing of PQR309 is not adequately tolerated or inefficacious.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9
Inclusion Criteria

Not provided

Exclusion Criteria

Any of the following conditions precludes enrollment of a patient:

  1. Immunosuppression due to:

    • Allogeneic hematopoietic stem cell transplant (HSCT)
    • Any immune-suppressive therapy within 4 weeks prior to trial treatment start
  2. Autologous stem cell transplant within 3 months prior to trial treatment start.

  3. Concomitant anticancer therapy (e.g. chemotherapy, radiotherapy, hormonal therapy, immunotherapy, biological response modifier, signal transduction inhibitors and steroids (steroids as maintenance for adrenal insufficiency are allowed)).

  4. Concomitant treatment with medicinal products that increase the pH (reduce acidity) of the upper gastrointestinal tract, including, but not limited to, proton-pump inhibitors (e.g. omeprazole), H2-antagonists (e.g. ranitidine) and antacids. Patients may be enrolled in the study after a wash-out period sufficient to terminate their effect (section 11.1.3.7).

  5. Use of any investigational drug within 21 days prior to trial treatment start.

  6. Patients who experienced National Cancer Institute (NCI) Common Terminology Criteria For Adverse Events (CTCAE) grade 4 on PI3K/mTOR inhibitors

  7. Any major surgery, chemotherapy or immunotherapy within 21 days prior to trial treatment start.

  8. Symptomatic or progressing central nervous system (CNS) involvement. Exception: Patients with meningeal involvement can be included upon discussion between the sponsor and the investigator.

  9. Persisting toxicities NCI CTCAE ≥2 related to prior anticancer therapy

  10. Presence of gastrointestinal disease or any other condition that could interfere significantly with the absorption of the study drug.

  11. Severe/unstable angina, myocardial infarction or coronary artery bypass within the last 3 years prior to trial treatment start, symptomatic congestive heart failure New York Heart Association (NYHA) Class 3 or 4, hypertension BP>150/100mmHg

  12. A serious active infection (e.g. chronic active hepatitis) at the time of treatment, or another serious underlying medical condition that could impair the ability of the patient to receive treatment.

  13. Lack of appropriate contraceptive measures (male and female)

  14. Pregnant or lactating women

  15. Known HIV infection

  16. Significant medical conditions which could jeopardize compliance with the protocol.

  17. Uncontrolled diabetes mellitus; patients with controlled diabetes may be enrolled (see fasting glucose levels in inclusion criteria).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
PQR309PQR309PQR309 being taken continuously on daily basis (60,80mg) or intermittent (120mg, 140mg, 160mg) dosing
Primary Outcome Measures
NameTimeMethod
Assessment of Change of Tumor Response Criteria in lymphoma patients During Treatment with PQR309 in patients with relapsed or refractory lymphoma according to Cheston Criteria (5)28 days prior to first treatment (baseline), during study treatment every 8 weeks during first 6 months and every 6 months afterwards up to 48 months

Radiological lymphoma Evaluation (CT or other indicated according to institutional Standard practice), clinical examination and bone marrow biopsy

Secondary Outcome Measures
NameTimeMethod
Incidence of serious adverse events (SAEs), incidence and severity of all adverse events (AEs)During treatment on Day 1, 2, 8, 15, 22, 36 and 50; at the endof treatment and 30 days after last dose.

Continuous and intermittent dosing

Change in ECOG (Eastern Cooperative Oncology Group) Performance StatusBefore treatment on Day 1,2 and after treatment started on Day 1,8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in bodyweight/kgBefore treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in haematologyBefore treatment on Day 1,2 and after treatment started on Day 1, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in blood chemistryBefore treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment

Continuous and intermittent dosing

Change in haemostasisBefore treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment

Continuous and intermittent dosing

Change in ECG (electrocardiogram)Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment

Continuous and intermittent dosing

Change in urine analysisBefore treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment

Continuous and intermittent dosing

Change in HbA1cBefore treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment

Continuous and intermittent dosing

Change in CmaxDuring treatment on Day1, 2,8, 15,22 and 50

Continuous and intermittent dosing

Change in tmaxDuring treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Change in AUC0-24 •During treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Change in pulse rateBefore treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in AUC0-∞,During treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Change in blood pressureBefore treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in body temperatureBefore treatment on Day 1,2 and after treatment started on Day 1, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment

Continuous and intermittent dosing

Change in t1/2 •During treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Change in AUClast,During treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Change in RAC •During treatment on Day1, 2, 8, 15,22 and 50

Continuous and intermittent dosing

Trial Locations

Locations (1)

Medizinische Klinik und Poliklinik III

🇩🇪

Munich, Bavaria, Germany

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