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A Phase I Study of LP-108 in Patients With Relapsed or Refractory B-cell Lymphoma

Primary Purpose

Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
LP-108 tablet
Sponsored by
The First Affiliated Hospital with Nanjing Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Hodgkin Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Per 2017 revised WHO lymphoma classification criteria, subject must have either:

    • (Arm A) Diagnosed with relapsed or refractory CLL and require treatment in the opinion of the Investigator.
    • (Arm B) Diagnosed with relapsed or refractory non-Hodgkin's lymphoma associated with B-cell proliferation (such as SLL \ MCL \ FL \ MZL \ DLBCL \ WM, etc.) in need of treatment.
  • Subject has an Eastern Cooperative Oncology Group (ECOG) performance score less than or equal to 1.
  • Subject must have adequate bone marrow function independent of growth factor support per local laboratory reference range at Screening.
  • Subject must have adequate coagulation, renal, and hepatic function, per local laboratory reference range at Screening.
  • All acute toxicity from previous anti-tumor treatment or surgery has been alleviated to NCI CTCAE 5.0 ≤ Grade 1.
  • All enrolled patients should take medically approved contraceptives during the entire treatment period and within 90 days after the end of treatment.
  • Subjects must be willing to provide valid diagnostic evidence or accept bone marrow biopsy before treatment and accept bone marrow biopsy after treatment start.
  • Patients with NHL who have undergone autologous stem cell transplantation must complete the transplantation operation for more than 6 months when enrolled, and have sufficient bone marrow function without relying on growth factor stimulation.
  • Volunteer and sign informed consent, willing to follow trial protocol.

Exclusion Criteria:

  • According to the 2017 revised WHO Lymphoma Classification Criteria, patients diagnosed with the following diseases: Burkitt lymphoma or Burkitt-like lymphoma, lymphoblastic lymphoma/leukemia, and post-transplant lymphoproliferative disease(PTLD) .
  • Previously received other BCL-2 protein family inhibitors.
  • CLL subject has undergone an allogeneic or autologous stem cell transplant or NHL subject has undergone an allogeneic stem cell transplant.
  • Subjects who have received the following treatments within 4 weeks or 5 half-lives before the first dose of LP-108:

    • Antitumor therapies including myelosuppressive chemotherapy, targeted therapy, biological therapy and / or immunotherapy;
    • Any investigational treatment;
    • Patients who have undergone major surgery, severe trauma or radiotherapy.
  • Subjects who have received the following treatments within 2 weeks before the first dose of LP-108:

    • Steroids or traditional herbal medicine for antitumor purposes;
    • Strong and moderate CYP3A4/5 inhibitors and inducers, P-gp inhibitors and CYP2C8 sensitive substrates;
    • All drugs that may cause QTc interval prolongation or torsional tachycardia.
  • Have had malignancies other than the indications targeted in this study in the past three years, except for basal cell carcinoma of the skin and cervical carcinoma in situ treated radically.
  • Any serious and / or uncontrolled systemic disease.
  • Poor cardiovascular function, in line with New York Heart Association (NYHA) cardiac function classification ≥ 2 or QTcF greater than 480ms on ≥ 3 independent ECG.
  • Disease states where clinical manifestations may be difficult to control, including

    • HIV, HBV, HCV, syphilis positive or active bacterial and fungal infections;
    • Disease affects the central nervous system with obvious symptoms;
    • Autoimmune hemolytic anemia or Idiopathic thrombocytopenic purpura.
  • Any gastrointestinal conditions that may severely affect the study drug absorption or pharmacokinetic parameters.
  • Patients who were unable to discontinue taking CYP2C8 substrate repaglinide to control type 2 diabetes during the study.
  • Subjects who cannot tolerate urine collection, venipuncture, lymph node biopsy, and bone marrow aspiration.

Sites / Locations

  • the First Affiliated Hospital of Nanjing Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

R/R CLL

R/R NHL

Arm Description

Relapsed or Refractory Chronic Lymphocytic Leukemia Patients

Relapsed or Refractory B-cell Non-Hodgkin Lymphoma Patients, including SLL, FL, MZL, MCL, DLBCL, WM.

Outcomes

Primary Outcome Measures

Determination of dose limiting toxicity (DLT), maximum tolerated dose (MTD), recommended phase two dose (RP2D), and lead-in period regimen
Protocol-defined events, which can not be attributed by the investigator to a clearly identifiable cause such as tumor progression, underlying illness, concurrent illness, or concomitant medication, will be considered a DLT. Dose limiting toxicities of tumor lysis syndrome observed during the lead-in period will be attributed to the lead-in period.
Number of subjects with adverse events and its frequency
Safety Proflie
Determination of plasma peak concentration (Cmax) of LP-108
Blood and urine samples for pharmacokinetic analysis of LP-108 will be collected at designated time points.
Determination of Area Under the Curve (AUC) of LP-108
Blood and urine samples for pharmacokinetic analysis of LP-108 will be collected at designated time points.
Food Effect - Cmax
Blood samples for food effect pharmacokinetic analysis of LP-108 will be collected at designated time points
Food Effect - AUC
Blood samples for food effect pharmacokinetic analysis of LP-108 will be collected at designated time points

Secondary Outcome Measures

Preliminary efficacy assessment
Tumor response or clinical disease progression
Minimal residual disease (MRD)
MRD assessed in the peripheral blood and/or bone marrow (BM) either by four color flow cytometry or NGS, will be measured in CLL subjects achieving CR/CRi.

Full Information

First Posted
April 10, 2020
Last Updated
April 28, 2023
Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Guangzhou Lupeng Pharmaceutical Company LTD., Newave Pharmaceutical Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04356846
Brief Title
A Phase I Study of LP-108 in Patients With Relapsed or Refractory B-cell Lymphoma
Official Title
A Phase I Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of the Oral BCL-2 Inhibitor LP-108 in Patients With Relapsed or Refractory B-cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2020 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Guangzhou Lupeng Pharmaceutical Company LTD., Newave Pharmaceutical Inc

4. Oversight

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

5. Study Description

Brief Summary
This study is a multi-center, open-label, single-arm phase I clinical study of LP-108. Patients with relapsed or refractory chronic lymphocytic leukemia (CLL, arm A) and other B cell non-Hodgkin's lymphoma (NHL, Arm B). Each arm has a dose escalation phase (phase Ia) and expansion phase (phase Ib). During the dose escalation phase, the primary objectives are to define dose-limiting toxicity (DLT), maximum tolerated dose (MTD), and to explore a recommended phase II dose. Dose escalation is based on the classic "3 + 3" design, while accelerated titration is applied to the initial lower doses. After the RP2Ds are determined, additional patients will be enrolled in the expansion phase to further evaluation the safety, PK and preliminary efficacy of LP-108, each therapy can enroll 12-20 subjects.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
74 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
R/R CLL
Arm Type
Experimental
Arm Description
Relapsed or Refractory Chronic Lymphocytic Leukemia Patients
Arm Title
R/R NHL
Arm Type
Experimental
Arm Description
Relapsed or Refractory B-cell Non-Hodgkin Lymphoma Patients, including SLL, FL, MZL, MCL, DLBCL, WM.
Intervention Type
Drug
Intervention Name(s)
LP-108 tablet
Intervention Description
Taken orally within 30 minutes after a meal at the designated dose, once daily.
Primary Outcome Measure Information:
Title
Determination of dose limiting toxicity (DLT), maximum tolerated dose (MTD), recommended phase two dose (RP2D), and lead-in period regimen
Description
Protocol-defined events, which can not be attributed by the investigator to a clearly identifiable cause such as tumor progression, underlying illness, concurrent illness, or concomitant medication, will be considered a DLT. Dose limiting toxicities of tumor lysis syndrome observed during the lead-in period will be attributed to the lead-in period.
Time Frame
Lead-in period (0-4 weeks) plus 3 weeks of study drug administration at the designated cohort dose.
Title
Number of subjects with adverse events and its frequency
Description
Safety Proflie
Time Frame
From first dose of study drug administration until 30 days after study drug discontinue.
Title
Determination of plasma peak concentration (Cmax) of LP-108
Description
Blood and urine samples for pharmacokinetic analysis of LP-108 will be collected at designated time points.
Time Frame
Up to Week 37 for LP-108.
Title
Determination of Area Under the Curve (AUC) of LP-108
Description
Blood and urine samples for pharmacokinetic analysis of LP-108 will be collected at designated time points.
Time Frame
Up to Week 37 for LP-108.
Title
Food Effect - Cmax
Description
Blood samples for food effect pharmacokinetic analysis of LP-108 will be collected at designated time points
Time Frame
Pharmacokinetic (PK) parameter Cmax (maximum plasma concentration of LP-108) between each diet (LP-108 under fasting versus fed conditions),up to week 8 for LP-108.
Title
Food Effect - AUC
Description
Blood samples for food effect pharmacokinetic analysis of LP-108 will be collected at designated time points
Time Frame
Pharmacokinetic (PK) parameter AUC (area under the curve of LP-108) between each diet (LP-108 under fasting versus fed conditions),up to week 8 for LP-108.
Secondary Outcome Measure Information:
Title
Preliminary efficacy assessment
Description
Tumor response or clinical disease progression
Time Frame
Designated dose starting week for clinical disease progression and tumor response; and every 4-12 weeks thereafter until the date of first documented progression or date of death from any cause, whichever came first,.assessed up to 24 months.
Title
Minimal residual disease (MRD)
Description
MRD assessed in the peripheral blood and/or bone marrow (BM) either by four color flow cytometry or NGS, will be measured in CLL subjects achieving CR/CRi.
Time Frame
At least 2 months after the CR, CRi criteria for tumor response are first met. Measured up to 24 months after the last subject has enrolled in the study.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Per 2017 revised WHO lymphoma classification criteria, subject must have either: (Arm A) Diagnosed with relapsed or refractory CLL and require treatment in the opinion of the Investigator. (Arm B) Diagnosed with relapsed or refractory non-Hodgkin's lymphoma associated with B-cell proliferation (such as SLL \ MCL \ FL \ MZL \ DLBCL \ WM, etc.) in need of treatment. Subject has an Eastern Cooperative Oncology Group (ECOG) performance score less than or equal to 1. Subject must have adequate bone marrow function independent of growth factor support per local laboratory reference range at Screening. Subject must have adequate coagulation, renal, and hepatic function, per local laboratory reference range at Screening. All acute toxicity from previous anti-tumor treatment or surgery has been alleviated to NCI CTCAE 5.0 ≤ Grade 1. All enrolled patients should take medically approved contraceptives during the entire treatment period and within 90 days after the end of treatment. Subjects must be willing to provide valid diagnostic evidence or accept bone marrow biopsy before treatment and accept bone marrow biopsy after treatment start. Patients with NHL who have undergone autologous stem cell transplantation must complete the transplantation operation for more than 6 months when enrolled, and have sufficient bone marrow function without relying on growth factor stimulation. Volunteer and sign informed consent, willing to follow trial protocol. Exclusion Criteria: According to the 2017 revised WHO Lymphoma Classification Criteria, patients diagnosed with the following diseases: Burkitt lymphoma or Burkitt-like lymphoma, lymphoblastic lymphoma/leukemia, and post-transplant lymphoproliferative disease(PTLD) . Previously received other BCL-2 protein family inhibitors. CLL subject has undergone an allogeneic or autologous stem cell transplant or NHL subject has undergone an allogeneic stem cell transplant. Subjects who have received the following treatments within 4 weeks or 5 half-lives before the first dose of LP-108: Antitumor therapies including myelosuppressive chemotherapy, targeted therapy, biological therapy and / or immunotherapy; Any investigational treatment; Patients who have undergone major surgery, severe trauma or radiotherapy. Subjects who have received the following treatments within 2 weeks before the first dose of LP-108: Steroids or traditional herbal medicine for antitumor purposes; Strong and moderate CYP3A4/5 inhibitors and inducers, P-gp inhibitors and CYP2C8 sensitive substrates; All drugs that may cause QTc interval prolongation or torsional tachycardia. Have had malignancies other than the indications targeted in this study in the past three years, except for basal cell carcinoma of the skin and cervical carcinoma in situ treated radically. Any serious and / or uncontrolled systemic disease. Poor cardiovascular function, in line with New York Heart Association (NYHA) cardiac function classification ≥ 2 or QTcF greater than 480ms on ≥ 3 independent ECG. Disease states where clinical manifestations may be difficult to control, including HIV, HBV, HCV, syphilis positive or active bacterial and fungal infections; Disease affects the central nervous system with obvious symptoms; Autoimmune hemolytic anemia or Idiopathic thrombocytopenic purpura. Any gastrointestinal conditions that may severely affect the study drug absorption or pharmacokinetic parameters. Patients who were unable to discontinue taking CYP2C8 substrate repaglinide to control type 2 diabetes during the study. Subjects who cannot tolerate urine collection, venipuncture, lymph node biopsy, and bone marrow aspiration.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jianyong Li, Ph.D.
Phone
025-83718836
Email
lijianyonglm@126.com
Facility Information:
Facility Name
the First Affiliated Hospital of Nanjing Medical University
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianyong Li, PhD
Email
lijianyonglm@126.com

12. IPD Sharing Statement

Learn more about this trial

A Phase I Study of LP-108 in Patients With Relapsed or Refractory B-cell Lymphoma

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