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Phase 2 Study With PQR309 in Relapsed or Refractory Lymphoma Patients

Primary Purpose

Lymphoma, Non-Hodgkin Lymphoma

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
PQR309
Sponsored by
PIQUR Therapeutics AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma

Eligibility Criteria

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

Inclusion Criteria

  1. Histologically confirmed diagnosis* of relapsed or refractory lymphoma, received at least two prior lines of therapy regardless of transformation status. Patients with relapsed chronic lymphoid leukemia (CLL) are eligible if they have received one or more prior lines of any approved standard therapy * archival biopsies may be used if obtained up to a year prior to enrollment; re-biopsy is strongly recommended if last biopsy was obtained more than a year ago.
  2. Only for patients in the Phase 2 part: At least one measurable nodal or extra-nodal lesion defined as follows: Clearly measurable (i.e. well-defined boundaries) in at least two perpendicular dimensions on imaging scan with > 1.5 cm in longest transverse diameter.
  3. Age ≥ 18 years
  4. Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 (See Appendix 2).
  5. Adequate organ system functions defined as:

    1. Absolute neutrophil count (ANC) ≥1.0x109/l
    2. Platelets ≥ 75x109/l
    3. Haemoglobin ≥ 85g/L
    4. Adequate hepatic function, defined as total bilirubin ≤ 1.5 times the upper limit of normal (ULN) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN
    5. Adequate renal function, defined as serum creatinine ≤ 1.5 times ULN
    6. Fasting glucose < 7.0 mmol/L
  6. Ability and willingness to swallow and retain oral medication.
  7. Willingness and ability to comply with the trial procedures
  8. Female and male patients with reproductive potential must agree to use effective contraception from screening until 90 days after discontinuation of PQR309
  9. Signed informed consent1.5 cm in longest transverse diameter.

3. Age >18 years 4. Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 5. Adequate organ system functions defined as:

  1. Absolute neutrophil count (ANC) >1.0x109/l
  2. Platelets > 75x109/l

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).

Sites / Locations

  • Medizinische Klinik und Poliklinik III

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PQR309

Arm Description

PQR309 being taken continuously on daily basis (60,80mg) or intermittent (120mg, 140mg, 160mg) dosing

Outcomes

Primary Outcome Measures

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

Secondary Outcome Measures

Incidence of serious adverse events (SAEs), incidence and severity of all adverse events (AEs)
Continuous and intermittent dosing
Change in pulse rate
Continuous and intermittent dosing
Change in blood pressure
Continuous and intermittent dosing
Change in body temperature
Continuous and intermittent dosing
Change in ECOG (Eastern Cooperative Oncology Group) Performance Status
Continuous and intermittent dosing
Change in bodyweight/kg
Continuous and intermittent dosing
Change in haematology
Continuous and intermittent dosing
Change in blood chemistry
Continuous and intermittent dosing
Change in haemostasis
Continuous and intermittent dosing
Change in ECG (electrocardiogram)
Continuous and intermittent dosing
Change in urine analysis
Continuous and intermittent dosing
Change in HbA1c
Continuous and intermittent dosing
Change in Cmax
Continuous and intermittent dosing
Change in tmax
Continuous and intermittent dosing
Change in AUC0-24 •
Continuous and intermittent dosing
Change in AUClast,
Continuous and intermittent dosing
Change in AUC0-∞,
Continuous and intermittent dosing
Change in t1/2 •
Continuous and intermittent dosing
Change in RAC •
Continuous and intermittent dosing

Full Information

First Posted
April 14, 2016
Last Updated
June 27, 2019
Sponsor
PIQUR Therapeutics AG
Collaborators
University Hospital, Basel, Switzerland, University Hospital Munich, University Hospital Freiburg, Charite University, Berlin, Germany, University of Stuttgart
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1. Study Identification

Unique Protocol Identification Number
NCT03127020
Brief Title
Phase 2 Study With PQR309 in Relapsed or Refractory Lymphoma Patients
Official Title
Open-Label, Non-Randomized Phase 2 Study With Safety Run-in Evaluating Efficacy and Safety of PQR309 in Patients With Relapsed or Refractory Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
June 2016 (Actual)
Primary Completion Date
March 21, 2019 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PIQUR Therapeutics AG
Collaborators
University Hospital, Basel, Switzerland, University Hospital Munich, University Hospital Freiburg, Charite University, Berlin, Germany, University of Stuttgart

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
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
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Non-Hodgkin Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PQR309
Arm Type
Experimental
Arm Description
PQR309 being taken continuously on daily basis (60,80mg) or intermittent (120mg, 140mg, 160mg) dosing
Intervention Type
Drug
Intervention Name(s)
PQR309
Other Intervention Name(s)
PI3K Inhibitor (phosphatidylinositol 3-kinase)
Intervention Description
taken continuously on daily basis (60mg, 80mg) or intermittent dosing (120mg, 140mg, 160mg)
Primary Outcome Measure Information:
Title
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)
Description
Radiological lymphoma Evaluation (CT or other indicated according to institutional Standard practice), clinical examination and bone marrow biopsy
Time Frame
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
Secondary Outcome Measure Information:
Title
Incidence of serious adverse events (SAEs), incidence and severity of all adverse events (AEs)
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day 1, 2, 8, 15, 22, 36 and 50; at the endof treatment and 30 days after last dose.
Title
Change in pulse rate
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in blood pressure
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in body temperature
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in ECOG (Eastern Cooperative Oncology Group) Performance Status
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in bodyweight/kg
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in haematology
Description
Continuous and intermittent dosing
Time Frame
Before 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
Title
Change in blood chemistry
Description
Continuous and intermittent dosing
Time Frame
Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Title
Change in haemostasis
Description
Continuous and intermittent dosing
Time Frame
Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Title
Change in ECG (electrocardiogram)
Description
Continuous and intermittent dosing
Time Frame
Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Title
Change in urine analysis
Description
Continuous and intermittent dosing
Time Frame
Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Title
Change in HbA1c
Description
Continuous and intermittent dosing
Time Frame
Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Title
Change in Cmax
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2,8, 15,22 and 50
Title
Change in tmax
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Title
Change in AUC0-24 •
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Title
Change in AUClast,
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Title
Change in AUC0-∞,
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Title
Change in t1/2 •
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Title
Change in RAC •
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day1, 2, 8, 15,22 and 50
Other Pre-specified Outcome Measures:
Title
Change in insulin/ c-Peptide/ glucose
Description
Continuous and intermittent dosing
Time Frame
During treatment on Day 1, 2, 8,15,22 and 50

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Histologically confirmed diagnosis* of relapsed or refractory lymphoma, received at least two prior lines of therapy regardless of transformation status. Patients with relapsed chronic lymphoid leukemia (CLL) are eligible if they have received one or more prior lines of any approved standard therapy * archival biopsies may be used if obtained up to a year prior to enrollment; re-biopsy is strongly recommended if last biopsy was obtained more than a year ago. Only for patients in the Phase 2 part: At least one measurable nodal or extra-nodal lesion defined as follows: Clearly measurable (i.e. well-defined boundaries) in at least two perpendicular dimensions on imaging scan with > 1.5 cm in longest transverse diameter. Age ≥ 18 years Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 (See Appendix 2). Adequate organ system functions defined as: Absolute neutrophil count (ANC) ≥1.0x109/l Platelets ≥ 75x109/l Haemoglobin ≥ 85g/L Adequate hepatic function, defined as total bilirubin ≤ 1.5 times the upper limit of normal (ULN) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN Adequate renal function, defined as serum creatinine ≤ 1.5 times ULN Fasting glucose < 7.0 mmol/L Ability and willingness to swallow and retain oral medication. Willingness and ability to comply with the trial procedures Female and male patients with reproductive potential must agree to use effective contraception from screening until 90 days after discontinuation of PQR309 Signed informed consent1.5 cm in longest transverse diameter. 3. Age >18 years 4. Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 5. Adequate organ system functions defined as: Absolute neutrophil count (ANC) >1.0x109/l Platelets > 75x109/l Exclusion Criteria: Any of the following conditions precludes enrollment of a patient: Immunosuppression due to: Allogeneic hematopoietic stem cell transplant (HSCT) Any immune-suppressive therapy within 4 weeks prior to trial treatment start Autologous stem cell transplant within 3 months prior to trial treatment start. 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)). 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). Use of any investigational drug within 21 days prior to trial treatment start. Patients who experienced National Cancer Institute (NCI) Common Terminology Criteria For Adverse Events (CTCAE) grade 4 on PI3K/mTOR inhibitors Any major surgery, chemotherapy or immunotherapy within 21 days prior to trial treatment start. Symptomatic or progressing central nervous system (CNS) involvement. Exception: Patients with meningeal involvement can be included upon discussion between the sponsor and the investigator. Persisting toxicities NCI CTCAE ≥2 related to prior anticancer therapy Presence of gastrointestinal disease or any other condition that could interfere significantly with the absorption of the study drug. 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 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. Lack of appropriate contraceptive measures (male and female) Pregnant or lactating women Known HIV infection Significant medical conditions which could jeopardize compliance with the protocol. Uncontrolled diabetes mellitus; patients with controlled diabetes may be enrolled (see fasting glucose levels in inclusion criteria).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Dreyling
Organizational Affiliation
Klinik Universität München
Official's Role
Study Director
Facility Information:
Facility Name
Medizinische Klinik und Poliklinik III
City
Munich
State/Province
Bavaria
ZIP/Postal Code
81377
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase 2 Study With PQR309 in Relapsed or Refractory Lymphoma Patients

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