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A Phase I Study of AC0010 in Patients With CLL/ SLL, MCL, DLBCL and Other NHL

Primary Purpose

B-cell Lymphoma

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
AC0010MA
Sponsored by
Hangzhou ACEA Pharmaceutical Research Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Lymphoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged between 18 years and 75 years (included), and patients is over 60 years cannot have more than 3 kinds of heart, lung, liver and kidney complications
  • Histological confirmed CLL/SLL, MCL, non-GCB DLBCL
  • Measurable disease (NHL: At least 1 measurable site of disease [>1.5 centimeter [cm] in the long axis regardless of short axis measurement or >1.0 cm in the short axis regardless of long axis measurement, and clearly measurable in 2 perpendicular dimensions])
  • In dose escalation phase, other NHL (FL、WM、MZL、BL) patients who are relapsed refractory disease after at least 1 line of previous systemic therapy could be enrolled
  • Could supply stored For Formalin Fixed and Paraffin-Embedded (FFPE) slides or block to the lab for testing or could accept biopsy in the screening.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 2
  • Any of the following hematology values within 14 days prior to inclusion and prior to the first dose of study drug :
  • Absolute neutrophil count (ANC) >= 750 cells/µL(0.75 x 109/L) without growth factors within 7 days prior to the first dose of study drug
  • Spontaneous Platelets count > 50,000 cells/mm3, exclude transfusion dependent thrombocytopenia
  • Adequate heart, liver, lung and renal function:
  • Alkaline phosphatase (ALP) <5* ULN
  • Creatinine determined by serum creatinine levels <=1.5 * ULN or a calculated creatinine clearance of >= 50 mL/min
  • LVEF≥50% as determined by Ultrasonic Cardiogram (UCG)
  • Any prior treatment (chemotherapy, radiotherapy or ) must be completed over 30 days or 5 *half life from the screening; all toxicities related to prior anticancer therapies must be recovered to grade ≤ 1 (CTCAE v 4.03)
  • Patients without central nervous system involvement
  • Life expectancy of more than 6 months
  • Women of childbearing potential must have a negative serum beta human chorionic gonadotropin (β-hCG) or urine pregnancy test negative at Screening
  • Women without pregnant or breastfeeding

Exclusion Criteria:

  • Past history of major surgery within 4 weeks before signing the Informed consent form (ICF)
  • Patents with Central nervous system (CNS) lymphoma
  • Patients with prolymphocytic leukemia, patients with Richter's syndrome or suspected with Richter's syndrome
  • Known with primary mediastinal lymphoma • Previous treated with tyrosine kinase inhibitors (TKIs) (including BTK inhibitor) or within 3 months received mono-antibody treatment prior to the first dose of study drug
  • Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) unless the patient has been free of the disease for ≥ 3 years
  • Use of any standard or experimental anti-cancer drug therapy within 30 days prior to the first dose of study drug
  • Autotransplantation within 6 months prior to the first dose of study drug
  • Known received allogeneic stem cell transplantation
  • History of stroke or intracranial hemorrhage within 6 months prior to the first dose of study drug
  • Requires treatment with anticoagulation with warfarin or equivalent vitamin K antagonists
  • Condition that requires treatment with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor
  • Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months prior to the first dose of study drug, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification
  • ECG showed abnormal PR, QT and QRS interval (defined as: 12 lead electrocardiogram QT interval corrected Bazett (QTcB) > 430 ms (male) or 450 ms (female), PR> 240 ms, QRS> 110 ms), and electrocardiogram in rhythm, conduction and morphology appeared on the clinical significance of abnormal, such as complete left bundle branch block, myocardial infarction occurred within 6 months; risk factors cause QTc prolongation such as heart failure, arrhythmia, hypokalemia, congenital long QT syndrome, family history of long QT syndrome or first-degree relatives had less than 40 years of history of sudden death or bradycardia (heart rate less than 50 beats per minute)
  • Known HIV, active Hepatitis C Virus (HCV; RNA polymerase chain reaction (PCR)-positive) or active Hepatitis B Virus infection (HBs Ag positive or DNA PCR-positive) or any uncontrolled active systemic infection requiring intravenous (IV) antibiotics
  • All toxicities related to prior anticancer therapies recovered to grade ≤ 1 (exclude any grade alopecia)
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 times upper limit of normal (ULN) and total bilirubin >1.5xULN
  • Blood urea nitrogen (BUN) or Cr >1.5x upper limits of normal (ULN)
  • Uncontrolled pericardial effusion and pleural effusion
  • History of Parkinson's disease; cerebellar disorders or other motor related diseases; patients with a history of pancreatitis
  • Investigator judgment that patient is unsuitable to participate in study
  • Uncontrolled pleural and pericardial effusion.
  • Pregnant and lactating women.

Sites / Locations

  • Peking Union Medical College HospitalRecruiting
  • The First Affiliated Hospital,Zhejiang UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AC0010MA

Arm Description

This is dose escalation study. Patients will receive AC0010MA 200mg bid,300mg bid,400mg bid or 500mg bid by mouth (the dose escalation whether ended depends on DLT and occupancy) everyday until intolerable toxicity or disease progression

Outcomes

Primary Outcome Measures

Recommended phase II dose
Determine the recommended phase II dose (RP2D) of AC0010 in patients with relapsed or refractory CLL/SLL, MCL, DLBCL and other Non-Hodgkin B-Cell lymphoma

Secondary Outcome Measures

24 hours occupancy of AC0010
AC0010 occupancy of the Bruton's tyrosine kinase (BTK) active site up to 24 hours
Tolerability as measured by adverse events using CTCAE and clinical laboratory parameters
Evaluation of tolerability of AC0010 measured by number, nature and severity of Adverse Events using CTCAE Version 4.03
Tolerability as measured by number of subjects with dose limiting toxicities
Evaluation of tolerability of AC0010 measured by number of subjects with dose limiting toxicities (DLTs)treatment
Maximum tolerated dose (MTD)
Maximum Tolerated Dose (MTD) as measured by the number of dose-limiting toxicities in each dose level
Occupancy of AC0010 after continued treatment
AC0010 occupancy of the BTK active site after continued treatment
Objective Response Rate (ORR)
Safety and efficacy data will take place at the analysis time point
Cmax
Determine peak plasma concentration (Cmax) after oral administration of AC0010
Tmax
Time to reach maximum observed plasma concentration
t1/2
plasma decay half-life
AUC(0-t)
Area under the curve from time zero to the last quantifiable concentration
AUC(0-∞)
Area under the curve from time zero to extrapolated infinity

Full Information

First Posted
February 10, 2017
Last Updated
January 31, 2019
Sponsor
Hangzhou ACEA Pharmaceutical Research Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03060850
Brief Title
A Phase I Study of AC0010 in Patients With CLL/ SLL, MCL, DLBCL and Other NHL
Official Title
A Phase I Study of AC0010 in Patients With Relapsed or Refractory CLL/SLL, MCL, DLBCL and Other Non-Hodgkin B-Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Unknown status
Study Start Date
March 17, 2017 (Actual)
Primary Completion Date
December 14, 2019 (Anticipated)
Study Completion Date
December 14, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hangzhou ACEA Pharmaceutical Research Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open label, dose escalation, phase I study to determine the recommended Phase 2 dose (PR2D) by assessing the DLT, safety and efficacy of AC0010 in patients with B-cell lymphoma.
Detailed Description
This is an open label, dose escalation, phase I study to determine the PR2D by assessing the DLT, safety and efficacy of AC0010 in patients with B-cell lymphoma. This study includes two parts. During Part 1 Dose Escalation, the "3+3" design will be applied. Dose escalation will begin at dose level 1 = 400 mg. This dose escalation will be followed by an exploratory expansion phase in 3 or 4 groups of 15~41 patients each (CLL group, MCL group, non-germinal center B cell-like DLBCL group, and/or FL/WM(macroglobulinemia) group). The study will further evaluate the safety and efficacy of AC0010 in these patients in each group

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Lymphoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
AC0010MA
Arm Type
Experimental
Arm Description
This is dose escalation study. Patients will receive AC0010MA 200mg bid,300mg bid,400mg bid or 500mg bid by mouth (the dose escalation whether ended depends on DLT and occupancy) everyday until intolerable toxicity or disease progression
Intervention Type
Drug
Intervention Name(s)
AC0010MA
Other Intervention Name(s)
AC0010
Intervention Description
Participants in the dose escalation cohorts will be treated with AC0010MA every 28 days
Primary Outcome Measure Information:
Title
Recommended phase II dose
Description
Determine the recommended phase II dose (RP2D) of AC0010 in patients with relapsed or refractory CLL/SLL, MCL, DLBCL and other Non-Hodgkin B-Cell lymphoma
Time Frame
On cycle one, up to 28 days
Secondary Outcome Measure Information:
Title
24 hours occupancy of AC0010
Description
AC0010 occupancy of the Bruton's tyrosine kinase (BTK) active site up to 24 hours
Time Frame
24 hours
Title
Tolerability as measured by adverse events using CTCAE and clinical laboratory parameters
Description
Evaluation of tolerability of AC0010 measured by number, nature and severity of Adverse Events using CTCAE Version 4.03
Time Frame
Approximately 36 months
Title
Tolerability as measured by number of subjects with dose limiting toxicities
Description
Evaluation of tolerability of AC0010 measured by number of subjects with dose limiting toxicities (DLTs)treatment
Time Frame
on cycle one, up to 28 days
Title
Maximum tolerated dose (MTD)
Description
Maximum Tolerated Dose (MTD) as measured by the number of dose-limiting toxicities in each dose level
Time Frame
on cycle one, up to 28 days
Title
Occupancy of AC0010 after continued treatment
Description
AC0010 occupancy of the BTK active site after continued treatment
Time Frame
On first 4 cycles,up to 4 months
Title
Objective Response Rate (ORR)
Description
Safety and efficacy data will take place at the analysis time point
Time Frame
Approximately 36 months
Title
Cmax
Description
Determine peak plasma concentration (Cmax) after oral administration of AC0010
Time Frame
Day 1, Day 28, D112
Title
Tmax
Description
Time to reach maximum observed plasma concentration
Time Frame
5 min before-dose and 2, 3, 4, 6, 8, 12, 24 hours post-dose on Day 1, 5 min before-dose and 2, 4, 8, 12 hours post-dose on Day 28, 5 min before-dose on Day 112
Title
t1/2
Description
plasma decay half-life
Time Frame
5 min before-dose and 2, 3, 4, 6, 8, 12, 24 hours post-dose on Day 1, 5 min before-dose and 2, 4, 8, 12 hours post-dose on Day 28, 5 min before-dose on Day 112
Title
AUC(0-t)
Description
Area under the curve from time zero to the last quantifiable concentration
Time Frame
5 min before-dose and 2, 3, 4, 6, 8, 12, 24 hours post-dose on Day 1, 5 min before-dose and 2, 4, 8, 12 hours post-dose on Day 28, 5 min before-dose on Day 112
Title
AUC(0-∞)
Description
Area under the curve from time zero to extrapolated infinity
Time Frame
5 min before-dose and 2, 3, 4, 6, 8, 12, 24 hours post-dose on Day 1, 5 min before-dose and 2, 4, 8, 12 hours post-dose on Day 28, 5 min before-dose on Day 112

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged between 18 years and 75 years (included), and patients is over 60 years cannot have more than 3 kinds of heart, lung, liver and kidney complications Histological confirmed CLL/SLL, MCL, non-GCB DLBCL Measurable disease (NHL: At least 1 measurable site of disease [>1.5 centimeter [cm] in the long axis regardless of short axis measurement or >1.0 cm in the short axis regardless of long axis measurement, and clearly measurable in 2 perpendicular dimensions]) In dose escalation phase, other NHL (FL、WM、MZL、BL) patients who are relapsed refractory disease after at least 1 line of previous systemic therapy could be enrolled Could supply stored For Formalin Fixed and Paraffin-Embedded (FFPE) slides or block to the lab for testing or could accept biopsy in the screening. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 2 Any of the following hematology values within 14 days prior to inclusion and prior to the first dose of study drug : Absolute neutrophil count (ANC) >= 750 cells/µL(0.75 x 109/L) without growth factors within 7 days prior to the first dose of study drug Spontaneous Platelets count > 50,000 cells/mm3, exclude transfusion dependent thrombocytopenia Adequate heart, liver, lung and renal function: Alkaline phosphatase (ALP) <5* ULN Creatinine determined by serum creatinine levels <=1.5 * ULN or a calculated creatinine clearance of >= 50 mL/min LVEF≥50% as determined by Ultrasonic Cardiogram (UCG) Any prior treatment (chemotherapy, radiotherapy or ) must be completed over 30 days or 5 *half life from the screening; all toxicities related to prior anticancer therapies must be recovered to grade ≤ 1 (CTCAE v 4.03) Patients without central nervous system involvement Life expectancy of more than 6 months Women of childbearing potential must have a negative serum beta human chorionic gonadotropin (β-hCG) or urine pregnancy test negative at Screening Women without pregnant or breastfeeding Exclusion Criteria: Past history of major surgery within 4 weeks before signing the Informed consent form (ICF) Patents with Central nervous system (CNS) lymphoma Patients with prolymphocytic leukemia, patients with Richter's syndrome or suspected with Richter's syndrome Known with primary mediastinal lymphoma • Previous treated with tyrosine kinase inhibitors (TKIs) (including BTK inhibitor) or within 3 months received mono-antibody treatment prior to the first dose of study drug Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) unless the patient has been free of the disease for ≥ 3 years Use of any standard or experimental anti-cancer drug therapy within 30 days prior to the first dose of study drug Autotransplantation within 6 months prior to the first dose of study drug Known received allogeneic stem cell transplantation History of stroke or intracranial hemorrhage within 6 months prior to the first dose of study drug Requires treatment with anticoagulation with warfarin or equivalent vitamin K antagonists Condition that requires treatment with a strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitor Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months prior to the first dose of study drug, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification ECG showed abnormal PR, QT and QRS interval (defined as: 12 lead electrocardiogram QT interval corrected Bazett (QTcB) > 430 ms (male) or 450 ms (female), PR> 240 ms, QRS> 110 ms), and electrocardiogram in rhythm, conduction and morphology appeared on the clinical significance of abnormal, such as complete left bundle branch block, myocardial infarction occurred within 6 months; risk factors cause QTc prolongation such as heart failure, arrhythmia, hypokalemia, congenital long QT syndrome, family history of long QT syndrome or first-degree relatives had less than 40 years of history of sudden death or bradycardia (heart rate less than 50 beats per minute) Known HIV, active Hepatitis C Virus (HCV; RNA polymerase chain reaction (PCR)-positive) or active Hepatitis B Virus infection (HBs Ag positive or DNA PCR-positive) or any uncontrolled active systemic infection requiring intravenous (IV) antibiotics All toxicities related to prior anticancer therapies recovered to grade ≤ 1 (exclude any grade alopecia) Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 times upper limit of normal (ULN) and total bilirubin >1.5xULN Blood urea nitrogen (BUN) or Cr >1.5x upper limits of normal (ULN) Uncontrolled pericardial effusion and pleural effusion History of Parkinson's disease; cerebellar disorders or other motor related diseases; patients with a history of pancreatitis Investigator judgment that patient is unsuitable to participate in study Uncontrolled pleural and pericardial effusion. Pregnant and lactating women.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wanhong Xu, PhD
Phone
+86 571 28909102
Email
kayla.liu@aceabio.com.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jie Jin, MD
Organizational Affiliation
The First Affiliated Hospital, Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bei Hu, PhD
Facility Name
The First Affiliated Hospital,Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jie Jin, MD
Phone
+86 13505716779
Email
jiej0503@163.com

12. IPD Sharing Statement

Plan to Share IPD
No

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A Phase I Study of AC0010 in Patients With CLL/ SLL, MCL, DLBCL and Other NHL

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