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Completed

NCT Number: NCT03181126

A Study of Venetoclax in Combination With Navitoclax and Chemotherapy in Subjects With Relapsed/Refractory Acute Lymphoblastic Leukemia or Relapsed/Refractory Lymphoblastic Lymphoma

This dose-escalating study is to determine the safety, pharmacokinetics, and preliminary efficacy of venetoclax in combination with navitoclax and chemotherapy in adult and pediatric participants with relapsed/refractory acute lymphoblastic leukemia (ALL) or relapsed/refractory lymphoblastic lymphoma. A safety expansion cohort of approximately 20 patients may be enrolled in addition to the 50 participants in dose-escalation cohort.

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Key information

Age range

4 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Alfred Hospital /ID# 169576, Melbourne, Victoria, Australia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Must have relapsed or refractory acute lymphoblastic leukemia (ALL) or relapsed or refractory lymphoblastic lymphoma (LL). Refractory is defined as persistent disease after at least 2 courses of chemotherapy.
  • Participants with ALL with Philadelphia chromosome or with an ABL class targetable fusion are eligible.
  • Participants with LL must have radiographic evidence of disease
  • Participants <= 18 years of age who do not have a standard of care treatment option available.
  • Must weigh greater than or equal to 20 kg.
  • Must be able to swallow pills.
  • Must have adequate hepatic and kidney function.
  • Must have adequate performance status:
  • Participants less than or equal to 16 years of age: Lansky greater than or equal to 50
  • Participants greater than 16 years of age: Karnofsky greater than or equal to 50 or Eastern Cooperative Oncology Group (ECOG) less than 3.

Exclusion criteria

  • Participant has central nervous system (CNS) disease with cranial involvement that requires radiation.
  • Participants who are less than 100 days post-transplant, or greater than 100 days post-transplant with active graft versus host disease (GVHD), or are still continuing post-transplant immunosuppressant therapy within 7 days prior to the first dose of study drug.
  • Participants who have received any of the following prior to the first dose of study drug:
  • Inotuzumab within 30 days (if participant received inotuzumab > 30 days prior to Day 1, must have ALT, AST and bilirubin < ULN).
  • A biologic agent (i.e., monoclonal antibodies) for anti-neoplastic intent within 30 days
  • CAR-T infusion or other cellular therapy within 30 days
  • Any anti-cancer therapy including blinatumomab, chemotherapy, radiation therapy targeted small molecule agents or investigational agents within 14 days, or 5 half-lives, whichever is shorter
  • Exception: Philadelphia Chromosome (Ph)+ ALL subjects on TKIs at Screening may enroll and remain on Tyrosine Kinase Inhibitor (TKI) therapy to control disease. Participants on venetoclax at screening may enroll and remain on venetoclax.
  • Steroid therapy for anti-neoplastic intent within 5 days
  • Hydroxyurea that is ongoing (hydroxyurea is permitted up to the first dose)
  • A strong or moderate CYP3A inhibitor or inducer within 7 days
  • Aspirin within 7 days, or 5 half-lives, whichever is longer
  • An excluded antiplatelet/anticoagulant drug or a herbal supplement that affects platelet function within 7 days, or 5 half-lives, whichever is longer
  • Participants with malabsorption syndrome or any other condition that precludes enteral administration.

Treatment and study plan

Navitoclax

Drug

tablet

Other names: ABT-263

Chemotherapy

Drug

peg-asparaginase (or other form of asparaginase, per local standard of care (intravenous) + vincristine (intravenous) + dexamethasone (oral) + tyrosine kinase inhibitor (TKI) (if applicable, oral)

Venetoclax

Drug

tablet

Other names: ABT-199 GDC-0199

Primary outcomes

  1. Cmax of Venetoclax + Navitoclax

    Time frame: Up to approximately 9 months

    Maximum observed plasma concentration (Cmax) of venetoclax + navitoclax

  2. AUC of Venetoclax + Navitoclax

    Time frame: Up to approximately 9 months

    Area under the plasma concentration-time curve (AUC) of venetoclax + navitoclax

  3. Tmax of Venetoclax + Navitoclax

    Time frame: Up to approximately 9 months

    Time to Cmax (Tmax) of Venetoclax + Navitoclax

  4. CL/F of Venetoclax + Navitoclax

    Time frame: Up to approximately 9 months

    Apparent oral clearance (CL/F) of venetoclax + navitoclax

  5. Number of participants with dose-limiting toxicities (DLT)

    Time frame: Up to approximately 28 days after initial dose of study drug

    A DLT is any Grade 3 or higher non-hematologic adverse event (AE) with exceptions outlined in the protocol. AEs and toxicities that occur beyond the DLT assessment period will also be evaluated by the investigator and AbbVie and may be considered as dose-limiting.

Secondary outcomes

  1. Progression-free survival (PFS)

    Time frame: Up to 9 months after the last subject has enrolled into the study

    PFS is defined as the number of days from the date of enrollment to the date of earliest disease progression or death.

  2. Partial Response (PR) rate

    Time frame: Up to 9 months after the last subject has enrolled into the study

    PR defined as no peripheral blasts or peripheral blood absolute blast count decreased by ≥ 50% from baseline, bone marrow with 5 - 25% blasts and at least a 50% decrease in bone marrow blast percent from baseline, no evidence of extramedullary disease.

  3. Number of Participant who Proceed to Stem Cell Transplantation or Chimeric antigen receptor T-cell (CAR-T) Therapy

    Time frame: Up to 9 months after the last subject has enrolled into the study

    Determine the number of participants who proceed to stem cell transplantation or CAR-T therapy.

  4. Overall survival (OS)

    Time frame: Up to 9 months after the last subject has enrolled into the study

    OS is defined as the number of days from the date of enrollment to the date of death.

  5. Objective response rate (ORR)

    Time frame: Up to 9 months after the last subject has enrolled into the study

    The proportion of subjects with objective response rate (complete response [CR] + CR incomplete recovery [CRi] + CR without platelet recovery [CRp]) for ALL subjects and (CR+PR) for LL subjects.

  6. Complete Response (CR) rate

    Time frame: Up to 9 months after the last subject has enrolled into the study

    CR defined as hematologic recovery (absolute neutrophil count [ANC] greater than or equal to 500/μL; platelet counts greater than or equal to 75,000/μL), evidence of trilineage hematopoiesis in the bone marrow and less than 5% blasts in the bone marrow, absence of circulating blasts, and no evidence of extramedullary disease.

Sponsors and collaborators

Lead sponsor

AbbVie

Industry

Registry information

Official study title

A Phase 1 Dose Escalation, Open-Label Study of Venetoclax in Combination With Navitoclax and Chemotherapy in Subjects With Relapsed/Refractory Acute Lymphoblastic Leukemia or Relapsed/Refractory Lymphoblastic Lymphoma

Important dates

Study start
2017
Primary completion
2020
Study completion
2020
First posted
Jun 8, 2017
Registry last updated
Oct 14, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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