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A Study of the Safety and Pharmacokinetics of Venetoclax in Pediatric and Young Adult Patients With Relapsed or Refractory Malignancies

Primary Purpose

Malignancies, Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
chemotherapy
venetoclax
Sponsored by
AbbVie
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malignancies focused on measuring Cancer, Venetoclax, pediatric, relapsed or refractory, Venclexta

Eligibility Criteria

0 Years - 25 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants must have relapsed or refractory cancer.
  • Participants must have adequate hepatic and kidney function.
  • Participants less than or equal to 16 years of age must have performance status of Lansky greater than or equal to 50% and participants greater than 16 years of age must have performance status of Karnofsky greater than or equal to 50%.
  • Participants with solid tumors (with the exception of neuroblastoma) must have adequate bone marrow function in Part 1.
  • For the fifth cohort during Part 2 Cohort Expansion, participants with solid tumors must have evidence of BCL-2 expression (except participants with TCF3-HLF ALL).

Exclusion Criteria:

  • Participants with primary brain tumors or disease metastatic to the brain.
  • Participants who have central nervous system (CNS) disease with cranial involvement that requires radiation.
  • Participants who have received any of the following within the listed time frame, prior to the first dose of study drug

    • Inotuzumab ozogamicin or gemtuzumab ozogamicin within 30 days
    • Biologic agent (i.e., antibodies) for anti-neoplastic intent within 30 days or 5 half-lives whichever is shorter.
    • CAR-T infusion or other cellular therapy within 30 days
    • Anticancer therapy including chemotherapy, radiation therapy, targeted small molecule agents, investigational agents within 14 days or 5 half-lives, whichever is shorter (Exceptions: Ph+ALL participants on Tyrosine Kinase Inhibitor (TKI) at Screening may enroll and remain on TKI therapy to control disease and TCF3-HLF ALL participants are allowed to have received chemotherapy within 14 days or 5 half-lives, whichever is shorter).
    • Steroid therapy for anti-neoplastic intent within 5 days (with the exception of TCF3-HLF ALL participants).
    • Requires ongoing hydroxyurea (hydroxyurea permitted up to first dose)
  • Participants who are less than 100 days post-transplant, or greater than or equal to 100 days post-transplant with active graft versus host disease (GVHD), or are receiving immunosuppressant therapy within 7 days prior to first dose of study drug.
  • Participants who are less than 6 weeks post-131 I-metaiodobenzylguanidine (mIBG) therapy.
  • Participants who have received the following within 7 days prior to the first dose of study drug:

    • Strong and moderate Cytochrome P450 3A (CYP3A) inhibitors (Part 1 Dose Determination);
    • Strong and moderate CYP3A inducers (Part 1 Dose Determination and Part 2 Cohort Expansion).
  • Participants who have not recovered from clinically significant adverse effect(s)/toxicity(s) of the previous therapy (Exception: Chemotherapy induced side effects that are expected to return to baseline in TCF3-HLF ALL participants).
  • Participants who have active, uncontrolled infections.
  • Participants with malabsorption syndrome or any other condition that precludes enteral administration.

    • Participants with recent positive test for SARS-CoV-2 (COVID-19) and no follow up test with negative result cannot be enrolled. Participants with contact to persons with COVID-19 and participants with signs and symptoms for COVID-19 infection must be tested before enrolling.

Sites / Locations

  • Univ California, San Francisco /ID# 163460
  • Children's Hospital Colorado /ID# 161551
  • Children's Healthcare of Atlan /ID# 161552
  • Dana-Farber Cancer Institute /ID# 163440
  • Memorial Sloan Kettering Cancer Center-Koch Center /ID# 163444
  • Cincinnati Children's Hospital /ID# 161550
  • Children's Hospital of Philadelphia /ID# 163445
  • St Jude Children's Research Hospital /ID# 163447
  • Primary Children's /ID# 164399
  • Seattle Children's Hospital /ID# 163459
  • Medical College of Wisconsin /ID# 163461
  • Sydney Children's Hospital /ID# 163148
  • Queensland Children's Hospital /ID# 163146
  • Women and Childrens Hospital /ID# 163147
  • Royal Children's Hospital /ID# 163104
  • Hospital for Sick Children /ID# 163726
  • CHU Sainte-Justine /ID# 163725
  • AP-HM - Hopital de la Timone /ID# 161465
  • Centre Leon Berard /ID# 163707
  • AP-HP - Hopital Armand-Trousseau /ID# 163728
  • Robert Debre Hopital, FR /ID# 161464
  • CHU Toulouse - Hôpital des enfants /ID# 163727
  • Universitaetsklinikum Freiburg /ID# 164206
  • Universitaetsklinikum Schleswig-Holstein Campus Kiel /ID# 161729
  • Charite Universitaetsklinikum Berlin - Campus Virchow /ID# 161730
  • Universitaetsklinikum Essen /ID# 164207
  • Erasmus MC - Sophia /ID# 161579
  • Prinses Maxima Centrum /ID# 162670
  • Kinderspital Zurich - Eleonorenstiftung /ID# 163037
  • Great Ormond Street Hospital for Children /ID# 169238
  • The Newcastle Upon Tyne Hospitals NHS Foundation Trust /ID# 162938

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Venetoclax with or without chemotherapy

Arm Description

Venetoclax administered orally once daily (QD) with various doses and dosing regimens with or without chemotherapy at the discretion of the investigator. Allowed chemotherapy regimens as outlined in the study protocol.

Outcomes

Primary Outcome Measures

Number of Participants Experiencing Adverse Events
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study.
Number of Participants With Dose Limiting Toxicities (DLT) of Venetoclax Monotherapy
A DLT is any Grade 3 or higher non-hematologic adverse event (AE) with exceptions outlined in the protocol.
Recommended Phase 2 dose (RPTD) of Venetoclax
Venetoclax RPTD is the dose determined based on adverse event reporting and dose-limiting toxicity information from all participants.
Cmax of Venetoclax
Maximum plasma concentration (Cmax) of venetoclax.
Tmax of venetoclax
Time to maximum plasma concentration (Tmax) of venetoclax.
AUC0-24 Post-Dose of Venetoclax
Area under the plasma concentration-time curve from 0 to 24 hours (AUC24) post-dose of venetoclax.

Secondary Outcome Measures

Objective Response Rate (ORR)
ORR is defined as the proportion of participants who achieved a response according to established criteria described in detail in the study protocol.
Partial Response (PR) Rate
PR is defined according to established criteria for each tumor type and is described in detail within the study protocol.
Complete Response (CR) Rate
CR is defined according to established criteria for each tumor type and is described in detail within the study protocol.

Full Information

First Posted
July 31, 2017
Last Updated
May 19, 2023
Sponsor
AbbVie
Collaborators
Roche-Genentech
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1. Study Identification

Unique Protocol Identification Number
NCT03236857
Brief Title
A Study of the Safety and Pharmacokinetics of Venetoclax in Pediatric and Young Adult Patients With Relapsed or Refractory Malignancies
Official Title
A Phase 1 Study of the Safety and Pharmacokinetics of Venetoclax in Pediatric and Young Adult Patients With Relapsed or Refractory Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
November 8, 2017 (Actual)
Primary Completion Date
April 19, 2023 (Actual)
Study Completion Date
April 19, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AbbVie
Collaborators
Roche-Genentech

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
Yes

5. Study Description

Brief Summary
An open-label, global, multi-center study to evaluate the safety and pharmacokinetics of venetoclax monotherapy, to determine the dose limiting toxicity (DLT) and the recommended Phase 2 dose (RPTD), and to assess the preliminary efficacy of venetoclax in pediatric and young adult participants with relapsed or refractory malignancies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignancies, Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Non-Hodgkin's Lymphoma, Neuroblastoma
Keywords
Cancer, Venetoclax, pediatric, relapsed or refractory, Venclexta

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Venetoclax with or without chemotherapy
Arm Type
Experimental
Arm Description
Venetoclax administered orally once daily (QD) with various doses and dosing regimens with or without chemotherapy at the discretion of the investigator. Allowed chemotherapy regimens as outlined in the study protocol.
Intervention Type
Drug
Intervention Name(s)
chemotherapy
Intervention Description
Dexamethasone and/or vincristine and/or pegasparaginase OR cytarabine and/or etoposide and/or pegasparaginase; tyrosine kinase inhibitor; cytarabine OR azacitidine OR decitabine; rituximab and/or dexamethasone and/or vincristine; cyclophosphamide and/or topotecan
Intervention Type
Drug
Intervention Name(s)
venetoclax
Other Intervention Name(s)
ABT-199, GDC-0199, Venclexta
Intervention Description
Oral tablet for participants; Tablet for oral suspension (participants who cannot swallow a tablet)
Primary Outcome Measure Information:
Title
Number of Participants Experiencing Adverse Events
Description
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study.
Time Frame
Up to 9 months
Title
Number of Participants With Dose Limiting Toxicities (DLT) of Venetoclax Monotherapy
Description
A DLT is any Grade 3 or higher non-hematologic adverse event (AE) with exceptions outlined in the protocol.
Time Frame
First 21 days venetoclax monotherapy
Title
Recommended Phase 2 dose (RPTD) of Venetoclax
Description
Venetoclax RPTD is the dose determined based on adverse event reporting and dose-limiting toxicity information from all participants.
Time Frame
First 21 days venetoclax monotherapy
Title
Cmax of Venetoclax
Description
Maximum plasma concentration (Cmax) of venetoclax.
Time Frame
Up to approximately 2 weeks
Title
Tmax of venetoclax
Description
Time to maximum plasma concentration (Tmax) of venetoclax.
Time Frame
Up to approximately 2 weeks
Title
AUC0-24 Post-Dose of Venetoclax
Description
Area under the plasma concentration-time curve from 0 to 24 hours (AUC24) post-dose of venetoclax.
Time Frame
Up to approximately 2 weeks
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
ORR is defined as the proportion of participants who achieved a response according to established criteria described in detail in the study protocol.
Time Frame
Up to 9 months
Title
Partial Response (PR) Rate
Description
PR is defined according to established criteria for each tumor type and is described in detail within the study protocol.
Time Frame
Up to 9 months
Title
Complete Response (CR) Rate
Description
CR is defined according to established criteria for each tumor type and is described in detail within the study protocol.
Time Frame
Up to 9 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
0 Years
Maximum Age & Unit of Time
25 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must have relapsed or refractory cancer. Participants must have adequate hepatic and kidney function. Participants less than or equal to 16 years of age must have performance status of Lansky greater than or equal to 50% and participants greater than 16 years of age must have performance status of Karnofsky greater than or equal to 50%. Participants with solid tumors (with the exception of neuroblastoma) must have adequate bone marrow function in Part 1. For the fifth cohort during Part 2 Cohort Expansion, participants with solid tumors must have evidence of BCL-2 expression (except participants with TCF3-HLF ALL). Exclusion Criteria: Participants with primary brain tumors or disease metastatic to the brain. Participants who have central nervous system (CNS) disease with cranial involvement that requires radiation. Participants who have received any of the following within the listed time frame, prior to the first dose of study drug Inotuzumab ozogamicin or gemtuzumab ozogamicin within 30 days Biologic agent (i.e., antibodies) for anti-neoplastic intent within 30 days or 5 half-lives whichever is shorter. CAR-T infusion or other cellular therapy within 30 days Anticancer therapy including chemotherapy, radiation therapy, targeted small molecule agents, investigational agents within 14 days or 5 half-lives, whichever is shorter (Exceptions: Ph+ALL participants on Tyrosine Kinase Inhibitor (TKI) at Screening may enroll and remain on TKI therapy to control disease and TCF3-HLF ALL participants are allowed to have received chemotherapy within 14 days or 5 half-lives, whichever is shorter). Steroid therapy for anti-neoplastic intent within 5 days (with the exception of TCF3-HLF ALL participants). Requires ongoing hydroxyurea (hydroxyurea permitted up to first dose) Participants who are less than 100 days post-transplant, or greater than or equal to 100 days post-transplant with active graft versus host disease (GVHD), or are receiving immunosuppressant therapy within 7 days prior to first dose of study drug. Participants who are less than 6 weeks post-131 I-metaiodobenzylguanidine (mIBG) therapy. Participants who have received the following within 7 days prior to the first dose of study drug: Strong and moderate Cytochrome P450 3A (CYP3A) inhibitors (Part 1 Dose Determination); Strong and moderate CYP3A inducers (Part 1 Dose Determination and Part 2 Cohort Expansion). Participants who have not recovered from clinically significant adverse effect(s)/toxicity(s) of the previous therapy (Exception: Chemotherapy induced side effects that are expected to return to baseline in TCF3-HLF ALL participants). Participants who have active, uncontrolled infections. Participants with malabsorption syndrome or any other condition that precludes enteral administration. Participants with recent positive test for SARS-CoV-2 (COVID-19) and no follow up test with negative result cannot be enrolled. Participants with contact to persons with COVID-19 and participants with signs and symptoms for COVID-19 infection must be tested before enrolling.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
ABBVIE INC.
Organizational Affiliation
AbbVie
Official's Role
Study Director
Facility Information:
Facility Name
Univ California, San Francisco /ID# 163460
City
San Francisco
State/Province
California
ZIP/Postal Code
94143-2204
Country
United States
Facility Name
Children's Hospital Colorado /ID# 161551
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Children's Healthcare of Atlan /ID# 161552
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Dana-Farber Cancer Institute /ID# 163440
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center-Koch Center /ID# 163444
City
New York
State/Province
New York
ZIP/Postal Code
10065-6007
Country
United States
Facility Name
Cincinnati Children's Hospital /ID# 161550
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Children's Hospital of Philadelphia /ID# 163445
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
St Jude Children's Research Hospital /ID# 163447
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Primary Children's /ID# 164399
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84113
Country
United States
Facility Name
Seattle Children's Hospital /ID# 163459
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Medical College of Wisconsin /ID# 163461
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226-3522
Country
United States
Facility Name
Sydney Children's Hospital /ID# 163148
City
Randwick
State/Province
New South Wales
ZIP/Postal Code
2031
Country
Australia
Facility Name
Queensland Children's Hospital /ID# 163146
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Women and Childrens Hospital /ID# 163147
City
North Adelaide
State/Province
South Australia
ZIP/Postal Code
5006
Country
Australia
Facility Name
Royal Children's Hospital /ID# 163104
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3052
Country
Australia
Facility Name
Hospital for Sick Children /ID# 163726
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Facility Name
CHU Sainte-Justine /ID# 163725
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3T 1C5
Country
Canada
Facility Name
AP-HM - Hopital de la Timone /ID# 161465
City
Marseille CEDEX 05
State/Province
Bouches-du-Rhone
ZIP/Postal Code
13385
Country
France
Facility Name
Centre Leon Berard /ID# 163707
City
Lyon CEDEX 08
State/Province
Rhone
ZIP/Postal Code
69373
Country
France
Facility Name
AP-HP - Hopital Armand-Trousseau /ID# 163728
City
Paris
ZIP/Postal Code
75012
Country
France
Facility Name
Robert Debre Hopital, FR /ID# 161464
City
Paris
ZIP/Postal Code
75019
Country
France
Facility Name
CHU Toulouse - Hôpital des enfants /ID# 163727
City
Toulouse CEDEX 9
ZIP/Postal Code
31059
Country
France
Facility Name
Universitaetsklinikum Freiburg /ID# 164206
City
Freiburg
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Universitaetsklinikum Schleswig-Holstein Campus Kiel /ID# 161729
City
Kiel
State/Province
Schleswig-Holstein
ZIP/Postal Code
24105
Country
Germany
Facility Name
Charite Universitaetsklinikum Berlin - Campus Virchow /ID# 161730
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Universitaetsklinikum Essen /ID# 164207
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Erasmus MC - Sophia /ID# 161579
City
Rotterdam
ZIP/Postal Code
3015 GD
Country
Netherlands
Facility Name
Prinses Maxima Centrum /ID# 162670
City
Utrecht
ZIP/Postal Code
3584 CS
Country
Netherlands
Facility Name
Kinderspital Zurich - Eleonorenstiftung /ID# 163037
City
Zurich
State/Province
Zuerich
ZIP/Postal Code
8032
Country
Switzerland
Facility Name
Great Ormond Street Hospital for Children /ID# 169238
City
London
State/Province
London, City Of
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Facility Name
The Newcastle Upon Tyne Hospitals NHS Foundation Trust /ID# 162938
City
Newcastle Upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34088831
Citation
Dalton KM, Krytska K, Lochmann TL, Sano R, Casey C, D'Aulerio A, Khan QA, Crowther GS, Coon C, Cai J, Jacob S, Kurupi R, Hu B, Dozmorov M, Greninger P, Souers AJ, Benes CH, Mosse YP, Faber AC. Venetoclax-based Rational Combinations are Effective in Models of MYCN-amplified Neuroblastoma. Mol Cancer Ther. 2021 Aug;20(8):1400-1411. doi: 10.1158/1535-7163.MCT-20-0710. Epub 2021 Jun 4.
Results Reference
derived
PubMed Identifier
29595064
Citation
Place AE, Goldsmith K, Bourquin JP, Loh ML, Gore L, Morgenstern DA, Sanzgiri Y, Hoffman D, Zhou Y, Ross JA, Prine B, Shebley M, McNamee M, Farazi T, Kim SY, Verdugo M, Lash-Fleming L, Zwaan CM, Vormoor J. Accelerating drug development in pediatric cancer: a novel Phase I study design of venetoclax in relapsed/refractory malignancies. Future Oncol. 2018 Sep;14(21):2115-2129. doi: 10.2217/fon-2018-0121. Epub 2018 Mar 29.
Results Reference
derived

Learn more about this trial

A Study of the Safety and Pharmacokinetics of Venetoclax in Pediatric and Young Adult Patients With Relapsed or Refractory Malignancies

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