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A Phase 1b Study Evaluating the Safety and Tolerability of ABT-199 in Combination With Rituximab in Subjects With Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

Primary Purpose

Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
ABT-199
Rituximab
Sponsored by
AbbVie
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Small Lymphocytic Lymphoma focused on measuring Safety, Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia, Rituximab, Tolerability, Pharmacokinetics, ABT-199, Cancer, Preliminary, Efficacy, Maximum Tolerated Dose, Venetoclax

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject must be greater then or equal to 18 years of age.
  • Subject must have relapsed Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma.
  • Subject has an Eastern Cooperative Oncology Group performance score of less than or equal to 1.
  • Subject must have adequate bone marrow independent of growth factor support per local laboratory reference range at Screening.
  • Subject must have adequate coagulation, renal, and hepatic function, per laboratory reference range at Screening.

Exclusion Criteria:

  • Chronic lymphocytic leukemia or Small Lymphocytic Lymphoma subject has undergone an allogeneic or autologous stem cell transplant.
  • Subject has uncontrolled autoimmune hemolytic anemia or thrombocytopenia.
  • Subject has tested positive for human immunodeficiency virus.
  • Seropositivity for hepatitis B surface antigen or hepatitis C virus antibody or ribonucleic acid.
  • History of severe allergic or anaphylactic reactions to rituximab.
  • Subject has received a live viral vaccine within 6 months prior to the first dose of study drug.
  • Subject has received a monoclonal antibody for anti-neoplastic intent within 8 weeks prior to the first dose of study drug.
  • Subject has received any of the following within 14 days prior to the first dose of study drug, or has not recovered to less than grade 2 clinically significant adverse effect(s)/toxicity(s) of the previous therapy:

    • Any anti-cancer therapy including chemotherapy, immunotherapy, or radiotherapy;
    • Investigational therapy, including targeted small molecule agents.
  • Subject has a cardiovascular disability status of New York Heart Association Class greater then or equal to 2. Class 2 is defined as cardiac disease in which subjects are comfortable at rest but ordinary physical activity results in fatigue, palpitations, dyspnea or anginal pain.
  • Subject has a significant history of renal, neurologic, psychiatric, pulmonary, endocrinologic, metabolic, immunologic, cardiovascular, or hepatic disease that in the opinion of the investigator would adversely affect his/her participating in this study.
  • Subject has a history of other active malignancies other than CLL/SLL within the past 2 years prior to study entry, with the exception of:

    • Adequately treated in situ carcinoma of the cervix uteri;
    • Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin;
    • Previous malignancy confined and surgically resected (or treated with other modalities) with curative intent.
  • Subject has malabsorption syndrome or other condition that precludes enteral route of administration.
  • Subject exhibits evidence of other clinically significant ongoing or recent condition(s) including, but not limited to:

    • Ongoing systemic infection (viral, bacterial, or fungal);
    • Diagnosis of fever and neutropenia within 1 week prior to study drug administration

Sites / Locations

  • Moores Cancer Center at UC San Diego /ID# 70398
  • Northwestern University Feinberg School of Medicine /ID# 71593
  • North Shore University Hospital /ID# 71813
  • Duke Cancer Center /ID# 71393
  • Peter MacCallum Cancer Ctr /ID# 70394
  • The Royal Melbourne Hospital /ID# 70393

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL)

Outcomes

Primary Outcome Measures

Assess the safety profile, to determine the maximum tolerated dose and Recommended Phase Two Dose of ABT-199 when administered in combination with rituximab (R) in subjects with relapsed chronic lymphocytic leukemia and small lymphocytic lymphoma.
Protocol-defined events, which are attributed as having a reasonable possibility of being related to the administration of ABT-199 and/or rituximab, or can not be attributed by the investigator to a clearly identifiable cause such as tumor progression, concurrent illness, underlying disease or concomitant medication, will be considered a dose limiting toxicity.

Secondary Outcome Measures

Determination of peak concentration (Cmax) of ABT-199 and/or Rituximab.
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Assess the exploratory efficacy of the combination ABT-199 and rituximab.
Tumor response or clinical disease progression (Objective Response Rate)
Determination of trough concentration (Ctrough) of ABT-199 and/or Rituximab
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Determination of area under the concentration versus time curve (AUC) of ABT-199 and/or Rituximab
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Tumor response or clinical disease progression for (Overall Survival)
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Tumor response or clinical disease progression for (Progression Free Survival)
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Tumor response or clinical disease progression for (Time to Tumor Progression)
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Tumor response or clinical disease progression for (Duration Of Response)

Full Information

First Posted
June 26, 2012
Last Updated
June 5, 2023
Sponsor
AbbVie
Collaborators
Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01682616
Brief Title
A Phase 1b Study Evaluating the Safety and Tolerability of ABT-199 in Combination With Rituximab in Subjects With Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Official Title
A Phase 1b Study Evaluating the Safety and Tolerability of ABT-199 in Combination With Rituximab in Subjects With Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
July 25, 2012 (Actual)
Primary Completion Date
June 23, 2022 (Actual)
Study Completion Date
June 23, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AbbVie
Collaborators
Genentech, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 1b, open-label, multicenter study evaluating the safety and tolerability of ABT-199 in combination with rituximab in up to 50 subjects with Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma. The primary objectives of this study are to assess the safety profile, to determine the maximum tolerated dose and establish the Recommended Phase Two Dose of ABT-199 when administered in combination with rituximab. The dose escalation portion of the study will include approximately 30 subjects. Once the recommended phase two dose and schedule have been determined, up to 20 additional subjects will be enrolled in an expanded safety portion of the study. Subjects who meet criteria for CR, CRi, or MRD-negative PR during the study may discontinue ABT 199. If disease progression occurs, as defined by iwCLL NCI/WG criteria for tumor response, or MRD progression, subjects may re-initiate ABT-199.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia
Keywords
Safety, Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia, Rituximab, Tolerability, Pharmacokinetics, ABT-199, Cancer, Preliminary, Efficacy, Maximum Tolerated Dose, Venetoclax

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL)
Intervention Type
Drug
Intervention Name(s)
ABT-199
Other Intervention Name(s)
venetoclax
Intervention Description
ABT-199 is taken continuously once daily. This is a dose escalation study, therefore the dose of ABT-199 will change throughout the study.
Intervention Type
Drug
Intervention Name(s)
Rituximab
Intervention Description
Rituximab will be given by intravenous infusion on day 1 of Months 1, 2, 3, 4, 5, and 6. May be reinitiated for an additional 6 months.
Primary Outcome Measure Information:
Title
Assess the safety profile, to determine the maximum tolerated dose and Recommended Phase Two Dose of ABT-199 when administered in combination with rituximab (R) in subjects with relapsed chronic lymphocytic leukemia and small lymphocytic lymphoma.
Description
Protocol-defined events, which are attributed as having a reasonable possibility of being related to the administration of ABT-199 and/or rituximab, or can not be attributed by the investigator to a clearly identifiable cause such as tumor progression, concurrent illness, underlying disease or concomitant medication, will be considered a dose limiting toxicity.
Time Frame
Continuous dosing at designated dose level up to Month 6. At end of combination treatment, ABT-199 monotherapy may continue up to 8 years following the date of the last subject enrolled. If disease progression occurs, subjects may re-initiate ABT-199.
Secondary Outcome Measure Information:
Title
Determination of peak concentration (Cmax) of ABT-199 and/or Rituximab.
Description
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Time Frame
PK samples collected up to Month 6 for ABT-199 and Rituximab
Title
Assess the exploratory efficacy of the combination ABT-199 and rituximab.
Description
Tumor response or clinical disease progression (Objective Response Rate)
Time Frame
Tumor Assessments will be performed at: Screening, Day 1 on Months 1, 3, 7, and then every 3 months thereafter up to 8 years following the date of the last subject first dose.
Title
Determination of trough concentration (Ctrough) of ABT-199 and/or Rituximab
Description
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Time Frame
PK samples collected up to Month 6 for ABT-199 and Rituximab
Title
Determination of area under the concentration versus time curve (AUC) of ABT-199 and/or Rituximab
Description
Blood samples for analysis of ABT-199 and rituximab will be collected at designated time points.
Time Frame
PK samples collected up to Month 6 for ABT-199 and Rituximab
Title
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Description
Tumor response or clinical disease progression for (Overall Survival)
Time Frame
Tumor Assessments will be performed at: Screening, Day 1 on Months 1, 3, 7, and then every 3 months thereafter up to 8 years following the date of the last subject first dose.
Title
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Description
Tumor response or clinical disease progression for (Progression Free Survival)
Time Frame
Tumor Assessments will be performed at: Screening, Day 1 on Months 1, 3, 7, and then every 3 months thereafter up to 8 years following the date of the last subject first dose.
Title
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Description
Tumor response or clinical disease progression for (Time to Tumor Progression)
Time Frame
Tumor Assessments will be performed at: Screening, Day 1 on Months 1, 3, 7, and then every 3 months thereafter up to 8 years following the date of the last subject first dose.
Title
Assess the exploratory efficacy of the combination ABT-199 and rituximab
Description
Tumor response or clinical disease progression for (Duration Of Response)
Time Frame
Tumor Assessments will be performed at: Screening, Day 1 on Months 1, 3, 7, and then every 3 months thereafter up to 8 years following the date of the last subject first dose.
Other Pre-specified Outcome Measures:
Title
Assess the exploratory pharmacodynamics and pharmacogenetics of the combination of ABT-199 and rituximab.
Description
Minimal residual disease (MRD) will be assessed in the peripheral blood and bone marrow (BM) either by flow cytometry or real-time PCR.
Time Frame
MRD Assessments will be performed at following timepoints: At least 2 months after CR/CRi criteria for tumor response first met, every 12 weeks thereafter until MRD negativity is achieved, and as needed.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must be greater then or equal to 18 years of age. Subject must have relapsed Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma. Subject has an Eastern Cooperative Oncology Group performance score of less than or equal to 1. Subject must have adequate bone marrow independent of growth factor support per local laboratory reference range at Screening. Subject must have adequate coagulation, renal, and hepatic function, per laboratory reference range at Screening. Exclusion Criteria: Chronic lymphocytic leukemia or Small Lymphocytic Lymphoma subject has undergone an allogeneic or autologous stem cell transplant. Subject has uncontrolled autoimmune hemolytic anemia or thrombocytopenia. Subject has tested positive for human immunodeficiency virus. Seropositivity for hepatitis B surface antigen or hepatitis C virus antibody or ribonucleic acid. History of severe allergic or anaphylactic reactions to rituximab. Subject has received a live viral vaccine within 6 months prior to the first dose of study drug. Subject has received a monoclonal antibody for anti-neoplastic intent within 8 weeks prior to the first dose of study drug. Subject has received any of the following within 14 days prior to the first dose of study drug, or has not recovered to less than grade 2 clinically significant adverse effect(s)/toxicity(s) of the previous therapy: Any anti-cancer therapy including chemotherapy, immunotherapy, or radiotherapy; Investigational therapy, including targeted small molecule agents. Subject has a cardiovascular disability status of New York Heart Association Class greater then or equal to 2. Class 2 is defined as cardiac disease in which subjects are comfortable at rest but ordinary physical activity results in fatigue, palpitations, dyspnea or anginal pain. Subject has a significant history of renal, neurologic, psychiatric, pulmonary, endocrinologic, metabolic, immunologic, cardiovascular, or hepatic disease that in the opinion of the investigator would adversely affect his/her participating in this study. Subject has a history of other active malignancies other than CLL/SLL within the past 2 years prior to study entry, with the exception of: Adequately treated in situ carcinoma of the cervix uteri; Basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin; Previous malignancy confined and surgically resected (or treated with other modalities) with curative intent. Subject has malabsorption syndrome or other condition that precludes enteral route of administration. Subject exhibits evidence of other clinically significant ongoing or recent condition(s) including, but not limited to: Ongoing systemic infection (viral, bacterial, or fungal); Diagnosis of fever and neutropenia within 1 week prior to study drug administration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
ABBVIE INC.
Organizational Affiliation
AbbVie
Official's Role
Study Director
Facility Information:
Facility Name
Moores Cancer Center at UC San Diego /ID# 70398
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Northwestern University Feinberg School of Medicine /ID# 71593
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611-2927
Country
United States
Facility Name
North Shore University Hospital /ID# 71813
City
New Hyde Park
State/Province
New York
ZIP/Postal Code
11040
Country
United States
Facility Name
Duke Cancer Center /ID# 71393
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710-3000
Country
United States
Facility Name
Peter MacCallum Cancer Ctr /ID# 70394
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3000
Country
Australia
Facility Name
The Royal Melbourne Hospital /ID# 70393
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35829925
Citation
Badawi M, Chen X, Marroum P, Suleiman AA, Mensing S, Koenigsdorfer A, Schiele JT, Palenski T, Samineni D, Hoffman D, Menon R, Salem AH. Bioavailability Evaluation of Venetoclax Lower-Strength Tablets and Oral Powder Formulations to Establish Interchangeability with the 100 mg Tablet. Clin Drug Investig. 2022 Aug;42(8):657-668. doi: 10.1007/s40261-022-01172-4. Epub 2022 Jul 13.
Results Reference
derived
PubMed Identifier
31023700
Citation
Roberts AW, Ma S, Kipps TJ, Coutre SE, Davids MS, Eichhorst B, Hallek M, Byrd JC, Humphrey K, Zhou L, Chyla B, Nielsen J, Potluri J, Kim SY, Verdugo M, Stilgenbauer S, Wierda WG, Seymour JF. Efficacy of venetoclax in relapsed chronic lymphocytic leukemia is influenced by disease and response variables. Blood. 2019 Jul 11;134(2):111-122. doi: 10.1182/blood.2018882555. Epub 2019 Apr 25.
Results Reference
derived
PubMed Identifier
28089635
Citation
Seymour JF, Ma S, Brander DM, Choi MY, Barrientos J, Davids MS, Anderson MA, Beaven AW, Rosen ST, Tam CS, Prine B, Agarwal SK, Munasinghe W, Zhu M, Lash LL, Desai M, Cerri E, Verdugo M, Kim SY, Humerickhouse RA, Gordon GB, Kipps TJ, Roberts AW. Venetoclax plus rituximab in relapsed or refractory chronic lymphocytic leukaemia: a phase 1b study. Lancet Oncol. 2017 Feb;18(2):230-240. doi: 10.1016/S1470-2045(17)30012-8. Epub 2017 Jan 13.
Results Reference
derived
Links:
URL
https://www.abbvieclinicaltrials.com/study/?id=M13-365#additional-resources-section
Description
clinical study report synopsis

Learn more about this trial

A Phase 1b Study Evaluating the Safety and Tolerability of ABT-199 in Combination With Rituximab in Subjects With Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

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