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Dose Escalation Study of CAL-101 in Select Relapsed or Refractory Hematologic Malignancies

Primary Purpose

Chronic Lymphocytic Leukemia (CLL), Lymphoma, Non-Hodgkin (NHL), Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CAL-101
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Lymphocytic Leukemia (CLL) focused on measuring CLL, NHL, AML, MM, Phosphatidylinositol 3-kinase

Eligibility Criteria

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

Inclusion Criteria:

  1. Age > or = 18.
  2. Has relapsed or refractory disease as defined by the following:

    • CLL - refractory to or relapsed after at least 2 prior therapies, including fludarabine, alone or in combination. Patients should not be eligible for transplantation (patients who are candidates for transplantation and have declined transplantation are eligible for this study).
    • B-cell NHL - refractory to or relapsed after at least 1 prior chemotherapy regimen and having received rituximab as a single agent or in combination with other therapies.
    • AML - refractory to or relapsed after at least 1 cycle of induction chemotherapy. Patients over the age of 70 who are not appropriate candidates for chemotherapy are eligible for this study.
    • MM - refractory to or relapsed after at least 2 prior chemotherapy regimens, including bortezomib and thalidomide or lenalidomide (except if the drug is contraindicated in a patient then this requirement is waived).
  3. Disease status requirement:

    • For CLL patients, symptomatic disease that mandate treatment.
    • For B-cell NHL patients, has measurable disease by CT scan.
    • For AML patients, has > 10% blasts in the bone marrow for refractory or relapsed disease and > 20% blasts in the bone marrow if no prior chemotherapy.
    • For MM patients, has measurable disease defined by at least 1 of the following 3 measurements: serum M-protein > or = to 1 g/dL, urine M-protein > or = to 200 mg/24 h, or serum free light chain (FLC) assay with involved FLC level > or = to 10 mg/dL provided serum FLC ratio is abnormal.
  4. WHO performance status of ≤ 2.
  5. For men and women of child-bearing potential, willing to use adequate contraception (i.e., latex condom, cervical cap, diaphragm, abstinence, etc.) for the entire duration of the study.
  6. Is able to provide written informed consent.

Exclusion Criteria:

  1. Had radiotherapy, radioimmunotherapy, biological therapy, chemotherapy, or treatment with an investigational product within 4-weeks prior to screening.
  2. For CLL or NHL patients, had treatment with a short course of corticosteroids for symptom relief within 1-week prior to screening.
  3. Had alemtuzumab therapy within 12-weeks prior to screening.
  4. For AML patients, had treatment with hydroxyurea within 1-week prior to screening.
  5. Is pregnant or nursing.
  6. Has significant, ongoing co-morbid conditions which would preclude safe delivery of the study drug.
  7. Has had a transplant with current active graft-versus-host-disease.
  8. Has known active central nervous system involvement of the malignancy.
  9. Has active, serious infection requiring systemic therapy. Patients may receive prophylactic antibiotics and antiviral therapy at the discretion of the treating physician.
  10. Has significant renal or liver dysfunction.
  11. Has severe thrombocytopenia requiring platelet transfusion support, unless the diagnosis is AML.
  12. Has a positive test for human immunodeficiency virus (HIV) antibodies.
  13. Has active hepatitis B or C. Patients with serologic evidence of prior exposure are eligible.
  14. Has poorly controlled diabetes mellitus.
  15. Has taken a medication that is a potent inhibitor or inducer of cytochrome P450 3A4 within 1-week prior to screening.

Sites / Locations

  • Stanford Cancer Center
  • The Sidney Kimmel Comprehensive Cancer Center at John Hopkins
  • Dana-Farber Cancer Institute
  • Washington University School of Medicine
  • Weill Medical College of Cornell
  • The Ohio State University Medical Center
  • Oregon Health and Science University
  • Sarah Cannon Research Institute
  • University of Wisconsin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

one arm

Arm Description

Outcomes

Primary Outcome Measures

To evaluate the safety of CAL-101 and determine the dose limiting toxicity in patients with hematologic malignancies.

Secondary Outcome Measures

To evaluate the pharmacokinetic parameters, pharmacodynamic effects and clinical response rate following CAL-101 treatment in patients with hematologic malignancies.

Full Information

First Posted
July 1, 2008
Last Updated
August 29, 2012
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT00710528
Brief Title
Dose Escalation Study of CAL-101 in Select Relapsed or Refractory Hematologic Malignancies
Official Title
A Phase 1 Sequential Dose Escalation Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics, and Clinical Activity of CAL-101 in Patients With Select, Relapsed or Refractory Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
June 2008 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Gilead Sciences

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the dose that can be safely given to see what effect it may have on your cancer and to determine how the drug is distributed in the body.
Detailed Description
A Phase 1, sequential dose escalation followed by cohort expansion study of CAL-101, an oral inhibitor of PI3K delta, in patients with relapsed or refractory CLL, select B-cell NHL and AML.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia (CLL), Lymphoma, Non-Hodgkin (NHL), Acute Myeloid Leukemia (AML), Multiple Myeloma (MM)
Keywords
CLL, NHL, AML, MM, Phosphatidylinositol 3-kinase

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
one arm
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
CAL-101
Intervention Description
CAL-101 50, 100, 150, 200, 350 mg capsules BID for 28 days CAL-101 150, 300 mg QD for 28 days CAL-101 150 mg BID 3 weeks on 1 week off for 28 days
Primary Outcome Measure Information:
Title
To evaluate the safety of CAL-101 and determine the dose limiting toxicity in patients with hematologic malignancies.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
To evaluate the pharmacokinetic parameters, pharmacodynamic effects and clinical response rate following CAL-101 treatment in patients with hematologic malignancies.
Time Frame
28 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > or = 18. Has relapsed or refractory disease as defined by the following: CLL - refractory to or relapsed after at least 2 prior therapies, including fludarabine, alone or in combination. Patients should not be eligible for transplantation (patients who are candidates for transplantation and have declined transplantation are eligible for this study). B-cell NHL - refractory to or relapsed after at least 1 prior chemotherapy regimen and having received rituximab as a single agent or in combination with other therapies. AML - refractory to or relapsed after at least 1 cycle of induction chemotherapy. Patients over the age of 70 who are not appropriate candidates for chemotherapy are eligible for this study. MM - refractory to or relapsed after at least 2 prior chemotherapy regimens, including bortezomib and thalidomide or lenalidomide (except if the drug is contraindicated in a patient then this requirement is waived). Disease status requirement: For CLL patients, symptomatic disease that mandate treatment. For B-cell NHL patients, has measurable disease by CT scan. For AML patients, has > 10% blasts in the bone marrow for refractory or relapsed disease and > 20% blasts in the bone marrow if no prior chemotherapy. For MM patients, has measurable disease defined by at least 1 of the following 3 measurements: serum M-protein > or = to 1 g/dL, urine M-protein > or = to 200 mg/24 h, or serum free light chain (FLC) assay with involved FLC level > or = to 10 mg/dL provided serum FLC ratio is abnormal. WHO performance status of ≤ 2. For men and women of child-bearing potential, willing to use adequate contraception (i.e., latex condom, cervical cap, diaphragm, abstinence, etc.) for the entire duration of the study. Is able to provide written informed consent. Exclusion Criteria: Had radiotherapy, radioimmunotherapy, biological therapy, chemotherapy, or treatment with an investigational product within 4-weeks prior to screening. For CLL or NHL patients, had treatment with a short course of corticosteroids for symptom relief within 1-week prior to screening. Had alemtuzumab therapy within 12-weeks prior to screening. For AML patients, had treatment with hydroxyurea within 1-week prior to screening. Is pregnant or nursing. Has significant, ongoing co-morbid conditions which would preclude safe delivery of the study drug. Has had a transplant with current active graft-versus-host-disease. Has known active central nervous system involvement of the malignancy. Has active, serious infection requiring systemic therapy. Patients may receive prophylactic antibiotics and antiviral therapy at the discretion of the treating physician. Has significant renal or liver dysfunction. Has severe thrombocytopenia requiring platelet transfusion support, unless the diagnosis is AML. Has a positive test for human immunodeficiency virus (HIV) antibodies. Has active hepatitis B or C. Patients with serologic evidence of prior exposure are eligible. Has poorly controlled diabetes mellitus. Has taken a medication that is a potent inhibitor or inducer of cytochrome P450 3A4 within 1-week prior to screening.
Facility Information:
Facility Name
Stanford Cancer Center
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304-5548
Country
United States
Facility Name
The Sidney Kimmel Comprehensive Cancer Center at John Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Washington University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Weill Medical College of Cornell
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
The Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239-3098
Country
United States
Facility Name
Sarah Cannon Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
University of Wisconsin
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792-5156
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24615778
Citation
Kahl BS, Spurgeon SE, Furman RR, Flinn IW, Coutre SE, Brown JR, Benson DM, Byrd JC, Peterman S, Cho Y, Yu A, Godfrey WR, Wagner-Johnston ND. A phase 1 study of the PI3Kdelta inhibitor idelalisib in patients with relapsed/refractory mantle cell lymphoma (MCL). Blood. 2014 May 29;123(22):3398-405. doi: 10.1182/blood-2013-11-537555. Epub 2014 Mar 10.
Results Reference
derived
PubMed Identifier
24615777
Citation
Brown JR, Byrd JC, Coutre SE, Benson DM, Flinn IW, Wagner-Johnston ND, Spurgeon SE, Kahl BS, Bello C, Webb HK, Johnson DM, Peterman S, Li D, Jahn TM, Lannutti BJ, Ulrich RG, Yu AS, Miller LL, Furman RR. Idelalisib, an inhibitor of phosphatidylinositol 3-kinase p110delta, for relapsed/refractory chronic lymphocytic leukemia. Blood. 2014 May 29;123(22):3390-7. doi: 10.1182/blood-2013-11-535047. Epub 2014 Mar 10.
Results Reference
derived
PubMed Identifier
24615776
Citation
Flinn IW, Kahl BS, Leonard JP, Furman RR, Brown JR, Byrd JC, Wagner-Johnston ND, Coutre SE, Benson DM, Peterman S, Cho Y, Webb HK, Johnson DM, Yu AS, Ulrich RG, Godfrey WR, Miller LL, Spurgeon SE. Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-delta, as therapy for previously treated indolent non-Hodgkin lymphoma. Blood. 2014 May 29;123(22):3406-13. doi: 10.1182/blood-2013-11-538546. Epub 2014 Mar 10.
Results Reference
derived
PubMed Identifier
21816833
Citation
Stevenson FK, Krysov S, Davies AJ, Steele AJ, Packham G. B-cell receptor signaling in chronic lymphocytic leukemia. Blood. 2011 Oct 20;118(16):4313-20. doi: 10.1182/blood-2011-06-338855. Epub 2011 Aug 3.
Results Reference
derived

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Dose Escalation Study of CAL-101 in Select Relapsed or Refractory Hematologic Malignancies

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