Safety and Activity of SNX-5422 Plus Ibrutinib in CLL
A Phase 1, Open-label Study of SNX-5422 and Ibrutinib in Chronic Lymphocytic Leukemia Subjects With a Mutation in Bruton's Tyrosine Kinase
調査の概要
詳細な説明
Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in adults and is not considered curable outside of allogeneic stem cell transplantation.
BTK is a critical kinase in the B cell receptor signaling pathway. This pathway is amplified in CLL and results in amplification of proliferation and anti-apoptotic signals. By inhibiting BTK, ibrutinib eliminates the activation of these pro-survival pathways and microenvironment survival signals. While response to ibrutinib has been high with therapy well-tolerated overall, some patients have relapsed while others have been taken off therapy for toxicity or other reasons. Relapse in CLL can be mediated by at least two separate mechanisms. One is by mutations in BTK, which both decrease ibrutinib's affinity for BTK, and also changes the binding from irreversible to reversible. This is a proof of concept study to investigate whether the addition of SNX-5422 to an established dose of ibrutinib will reduce mutated BTK from CLL cells and/or prevents or delays disease progression of subjects with CLL.
This is an open-label study of SNX-5422 combined with ibrutinib. In each 28 day cycle, SNX-5422 will be dosed in the morning once every other day for 21 days, followed by a 7-day drug-free period. Subjects will continue to receive daily oral ibrutinib at their established dose level in the afternoon every day for 28 days. cycle
研究の種類
段階
- フェーズ 1
連絡先と場所
研究場所
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Ohio
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Columbus、Ohio、アメリカ、43210
- Wexner Medical Center, Ohio State University
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Males or non-pregnant, non-breastfeeding females 18 years-of-age or older
- A diagnosis of CLL as defined by IWCLL 2008 criteria and currently on treatment with ibrutinib without evidence of disease progression.
- No more than 4 prior lines of anti leukemia therapy (not including ibrutinib)
- Presence of mutated BTK in ≥ 4% of peripheral blood or bone marrow CLL cells, or ≥1% and rising on two separate measurements obtained at least 28 days apart.
- Life expectancy of at least 9 months
- Karnofsky performance score 70
- Adequate baseline laboratory assessments
- Signed informed consent form
- Recovered from toxicities of previous anticancer therapy to CTCAE Grade ≤ 1 with the exception of alopecia
- Subjects with reproductive capability must agree to practice adequate contraception methods.
Exclusion Criteria:
- Subjects experiencing toxicity with ibrutinib
- Prior treatment with any Hsp90 inhibitor.
- Major surgery or significant traumatic injury within 4 weeks of starting study treatment.
- Conventional chemotherapy or radiation within 4 weeks.
- The need for treatment with medications with clinically-relevant metabolism by the cytochrome P450 (CYP) 3A4 isoenzyme within 3 hours before or after administration of SNX-5422
- Screening ECG QTc interval 470 msec for females, 450 msec for males.
- At increased risk for developing prolonged QT interval unless corrected to within normal limits prior to first dose of SNX-5422
- Patients with chronic diarrhea or with Grade 2 or greater diarrhea despite appropriate medical management.
- Gastrointestinal diseases or conditions that could affect drug absorption
- Gastrointestinal diseases that could alter the assessment of safety, including irritable bowel syndrome, ulcerative colitis, Crohn's disease, or hemorrhagic coloproctitis.
- History of documented adrenal dysfunction not due to malignancy.
- History of chronic liver disease.
- Active hepatitis A or B.
- Current alcohol dependence or drug abuse.
- Use of an investigational treatment (except for ibrutinib) from 30 days prior to the first dose
- Glaucoma, retinitis pigmentosa, macular degeneration, or any retinal changes detected by ophthalmological examination that are considered clinically important by examiner.
- Psychological or social reasons that would hinder or prevent compliance with the requirements of the protocol or compromise the informed consent process.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:SNX-5422 plus ibrutinib
Open-label administration of SNX-5422 capsules dosed in the morning once every other day for 21 days (11 doses) followed by a 7 day drug free period and daily with the established ibrutinib dose for 28 days of a 28-days cycle.
Subjects will repeat the 28-day schedule until the cancer progresses or the subject is unable to tolerate the therapy
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SNX-5422 カプセルは、28 日間の治療サイクルのうち 21 日間、1 日おきに 56 mg/m2 の SNX-5422 の総用量まで投与されました。
被験者は、各サイクルの28日間、SNX-5422から少なくとも8時間離れた午後に、毎日経口イブルチニブを自己管理します。
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Efficacy of the combination of SNX-5422 and ibrutinib
時間枠:Every 12 weeks up to 52 weeks
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Change in percent of mutated BTK in CLL cells
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Every 12 weeks up to 52 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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有害事象を報告した被験者数
時間枠:無作為化から 52 週間までの各 4 週間サイクルの 28 日目
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有害事象の頻度と重症度
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無作為化から 52 週間までの各 4 週間サイクルの 28 日目
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Time to disease progression
時間枠:Up to 52 weeks
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Elapsed time for each subject from randomization to relapse of disease up to 52 weeks
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Up to 52 weeks
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Clinical Laboratory testing
時間枠:Day 28 of each 4 week cycle from randomization up to 52 weeks
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Absolute values and changes from baseline for each subject using standard clinical chemistry, hematology and urinalysis parameters
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Day 28 of each 4 week cycle from randomization up to 52 weeks
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Electrocardiogram
時間枠:Pre-dose on Day 1 of each 4 week cycle from randomization up to 52 weeks
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Digital 12-lead ECG using standard recording methods at trough drug levels.
All ECG recordings will be analyzed for PR, RR, QT intervals, and for morphology.
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Pre-dose on Day 1 of each 4 week cycle from randomization up to 52 weeks
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- SNX-5422-CLN1-011
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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癌の臨床試験
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Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); Highlight Therapeutics積極的、募集していない平滑筋肉腫 | 悪性末梢神経鞘腫瘍 | 滑膜肉腫 | 未分化多形肉腫 | 骨の未分化高悪性度多形肉腫 | 粘液線維肉腫 | II期の体幹および四肢の軟部肉腫 AJCC v8 | III期の体幹および四肢の軟部肉腫 AJCC v8 | IIIA 期の体幹および四肢の軟部肉腫 AJCC v8 | IIIB 期の体幹および四肢の軟部肉腫 AJCC v8 | 切除可能な軟部肉腫 | 多形性横紋筋肉腫 | 切除可能な脱分化型脂肪肉腫 | 切除可能な未分化多形肉腫 | 軟部組織線維肉腫 | 紡錘細胞肉腫 | ステージ I 後腹膜肉腫 AJCC (American Joint Committee on Cancer) v8 | 体幹および四肢の I 期軟部肉腫 AJCC v8 | ステージ... およびその他の条件アメリカ
SNX-5422 とイブルチニブの臨床試験
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Esanex Inc.National Cancer Institute (NCI)完了