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Escalating Dose Study in Subjects With Relapsed or Refractory B Cell Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia, and Waldenstrom's Macroglobulinemia

Phase 1
Completed
Conditions
Chronic Lymphocytic Leukemia
Waldenstrom Macroglobulinemia
B Cell Non-Hodgkin's Lymphoma
Interventions
Registration Number
NCT01351935
Lead Sponsor
Celgene
Brief Summary

The purpose of this study is to evaluate the safety and tolerability of AVL-292 as monotherapy in subjects with relapsed or refractory B cell non-Hodgkin lymphoma (B-NHL), chronic lymphocytic leukemia (CLL) or Waldenstrom's macroglobulinemia (WM).

Detailed Description

Bruton's tyrosine kinase (Btk) is non-receptor tyrosine kinase with restricted cellular expression largely limited to B-lymphocytes, monocytes, and mast cells or basophils. Btk is a critical component of the B cell receptor (BCR) signaling network and is crucial for B cell development. Investigation has revealed that some B cell lymphomas and CLL depend on BCR signaling, suggesting that interruption of such signaling could be a promising therapeutic opportunity in B-NHL, CLL and WM.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
113
Inclusion Criteria
  • Women and men ≥18 years of age

  • Body weight ≥50 kg.

  • Confirmed diagnosis of B cellNon-Hodgkin Lymphoma(according to World Health Organization [WHO] classification)including Chronic Lymphocytic Leukemia/Small cell Lymphocytic Leukemia (International Workshop),or Waldenstrom's Macroglobulinemia(Second International Workshop)

  • Have failed ≥1 previous treatment for B-NHL/CLL/WM, and have relapsed or refractory disease following last prior treatment.

  • Eastern Cooperative Oncology Group performance status of ≤ 2 and a life expectancy of at least 3 months.

  • Ability to swallow oral capsules without difficulty

  • Has recovered from adverse toxic effects of prior therapies

  • Meet the following clinical laboratory requirements:

    • Creatinine ≤ 1.5 × upper limit of normal (ULN)
    • Total bilirubin ≤ 1.5 x ULN
    • AST and ALT ≤ 3 × ULN
    • Platelet count ≥ 50,000/µL (non-hodgkin & Waldenstrom's)
    • Platelet count ≥ 30,000/µL (chronic lymphocytic leukemia)
    • Absolute Neutrophil count ≥ 1000/µL
Exclusion Criteria
  • Prior allogeneic bone marrow transplant
  • Autologous stem cell transplant within 3 months of screening
  • Active central nervous system involvement
  • Subjects with autoimmune hemolytic anemia or immune thrombocytopenia
  • Prior treatment with a Btk inhibitor
  • Active uncontrolled infection
  • History of malabsorption
  • Uncontrolled illness, i.e cardiac, endocrine, respiratory, etc.
  • History of myocardial infarction, acute coronary syndromes, coronary angioplasty and/or stenting with in the previous 6 months
  • History of another currently active cancer
  • History of major surgery within 4 weeks or minor surgery within 1 week
  • Other medical or psychiatric illness or organ dysfunction
  • HIV positive
  • Positive for Hepatitis B surface antigen or Hepatitis C-virus

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AVL-292AVL-292-
Primary Outcome Measures
NameTimeMethod
Safety, tolerability,and dose limiting toxicities will be determined using AEs,PE,ophthalmologic examinations,clinical laboratory tests,vital signs, ECGs and echocardiograms/MUGA scans.with in the first 28 days after initiation of once daily oral dosing
Secondary Outcome Measures
NameTimeMethod
Establish recommended Phase 2 dose, after completing dose escalation in Part 1 and evaluating accumulated safety,PK,and PD data from the dose escalation phase (Part1)Completion of Part 1 dose escalation phase of study

After completion of observation for dose limiting toxicities in Part 1 of the study, the accumulated safety, PK, and PD data from Part 1 will be evaluated by the investigators and Sponsor to select a preliminary RP2D for administration to additional subjects to be enrolled into 1 of 3 independent and non-randomized diagnosis-specific expansion cohorts in Part 2 of the study

Evaluate the Pharmacokinetic parameters of AVL-292First 28 days of dosing

Serial blood sampling to enable PK characterization of AVL-292 will be performed for the Cycle1 Day 1 (C1D1) and Cycle 1Day 15 dose administrations. Additional samples will be obtained on C1D8 and C1D22.A non-compartmental model will be evaluated for all subjects.

Evaluate the Pharmacodynamics of AVL-292 by measurement of free BtkFirst 28 days of dosing

The PD activity of AVL-292 will be studied with a quantitative assay using a covalent probe to directly assess free Btk in PBMC lysates.

Characterize preliminary anti-tumor efficacy of AVL-292 in relapsed and/or refractory B-NHL, CLL and WMAfter completion of 28 day cycle of treatment

Efficacy response assessments will be formally assessed within 7 days preceding C2D1, C3D1, C5D1, C7D1, and EOT

Trial Locations

Locations (13)

University of Arizona SPORE

🇺🇸

Tucson, Arizona, United States

Clearview Cancer Institute Oncology Specialties, P.C

🇺🇸

Huntsville, Alabama, United States

University of California San Diego

🇺🇸

La Jolla, California, United States

Mayo Clinic Jacksonville

🇺🇸

Jacksonville, Florida, United States

Mount Sinai School of Medicine and Mount Sinai Graduate School of Biological Sciences

🇺🇸

New York, New York, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Horizon Oncology Center

🇺🇸

Lafayette, Indiana, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Texas Health Sciences Center

🇺🇸

San Antonio, Texas, United States

US Oncology

🇺🇸

The Woodlands, Texas, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

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