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Study of Phosphatidylinositol-3-kinase (PI3K) Inhibitor Idelalisib (GS-1101) in Waldenström Macroglobulinemia

Primary Purpose

Waldenstrom's Macroglobulinemia

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
GS-1101
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Waldenstrom's Macroglobulinemia focused on measuring Waldenstrom's Macroglobulinemia

Eligibility Criteria

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

Inclusion Criteria:

  • Participants must meet the following criteria on screening examination to be eligible to participate in the study:
  • Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia and meeting criteria for treatment using consensus panel criteria from the Second International Workshop on Waldenstrom's macroglobulinemia (Owen 2003; Kyle 2003).
  • Measurable disease, defined as presence of serum immunoglobulin M (IgM) with a minimum IgM level of > 2 times the upper limit of normal of each institution is required.
  • Have received at least one prior therapy for WM.
  • Age ≥18 years.
  • ECOG performance status <2 (see Appendix A.).
  • Participants must have normal organ and marrow function as defined below:

    • Absolute neutrophil count > 1,000/mm3
    • Platelets > 50,000/mm3
    • Hemoglobin > 8 g/dL
    • Total bilirubin ≤1.5 mg/dL or < 2 mg/dL if attributable to hepatic infiltration by neoplastic disease
    • AST (SGOT) and ALT (SGPT) < 2.5 X institutional upper limit of normal
    • Creatinine ≤ 2 mg/dL
  • Not on any active therapy for other malignancies with the exception of topical therapies for basal cell or squamous cell cancers of the skin.
  • Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or have or will have complete abstinence from heterosexual intercourse during the following time periods related to this study:

    1) while participating in the study; and 2) for at least 28 days after discontinuation from the study. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. FCBP must be referred to a qualified provider of contraceptive methods if needed.

  • Able to adhere to the study visit schedule and other protocol requirements.
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, uncontrolled intercurrent illness, or psychiatric illness/social condition that would prevent the participant from signing the informed consent form
  • Concurrent use of any other anti-cancer agents or treatments or any other study agents
  • Prior exposure to idelalisib
  • Prior or ongoing clinically significant illness, medical condition, surgical history, physical finding, ECG finding, or laboratory abnormality that, in the investigator's opinion, could affect the safety of the patient; alter the absorption, distribution, metabolism or excretion of Idelalisib; or impair the assessment of study results
  • Grade > 2 toxicity (other than alopecia) continuing from prior anti-cancer therapy
  • Known central nervous system lymphoma
  • Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening
  • New York Heart Association classification III or IV heart failure.
  • Malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel, ulcerative colitis, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
  • Known history of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and/or Hepatitis C Virus (HCV) infection
  • Lactating or pregnant women
  • Inability to swallow capsules
  • History of non-compliance to medical regimens
  • Unwilling or unable to comply with the protocol

Sites / Locations

  • Dana Farber Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GS-1101

Arm Description

After the screening procedures confirms eligibility to participate in the research study. Treatment will be administered on an outpatient basis. -- Idelalisib (GS-11-01) orally, predetermined dose twice daily per cycle for up to 6 cycles. After this initial 6 month period, for Cycles 7 and beyond, Idelalisib will be administered once a day until disease progression.

Outcomes

Primary Outcome Measures

Overall Response Rate (ORR)
ORR measured by decrease in serum IgM level by at least 25% from baseline.

Secondary Outcome Measures

Percentage of Participants With Adverse Events
Assess the safety and tolerability of idelalisib
Rate of Complete Response (CR)
CR measured by decrease in serum IgM levels to normal range, disappearnace of monoclonal protein by immunofixation, no evidence of bone marrow involvement, and resolution of any extramedullary disease by CT scan.
Rate of Very Good Partial Response (VGPR)
VGPR measured by decrease in serum IgM levels of at least 90% from baseline.
Rate of Partial Response (PR)
PR measured by decrease in serum IgM levels of between 25% and 50% from baseline.
Rate of Minimal Response
Minimal response measured by decrease in serum IgM levels of between 25% and 50%.
Rate of Stable Disease
Stable disease measured by serum IgM levels <25% reduced from baseline.
Rate of Progressive Disease
Progressive disease measured by an 25% increase in serum IgM level with an absolute increase of at least 500mg/dL from the lowest attained IgM on therapy.

Full Information

First Posted
April 29, 2015
Last Updated
November 14, 2016
Sponsor
Dana-Farber Cancer Institute
Collaborators
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT02439138
Brief Title
Study of Phosphatidylinositol-3-kinase (PI3K) Inhibitor Idelalisib (GS-1101) in Waldenström Macroglobulinemia
Official Title
Phase II Study of Phosphatidylinositol-3-kinase (PI3K) Inhibitor Idelalisib (GS-1101) in Waldenström Macroglobulinemia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Terminated
Why Stopped
Safety issues from trials in CLL
Study Start Date
October 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
Gilead Sciences

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This research study is evaluating a drug called idelalisib (formerly known as GS-1101 or CAL-101) as a possible treatment for Waldenstrom's Macroglobulinemia (WM).
Detailed Description
This research study is a Phase II clinical trial. Phase II clinical trials test the effectiveness of an investigational drug, idelalisib, to learn whether idelalisib works in treating a specific cancer. "Investigational" means that idelalisib is still being studied and that research doctors are trying to find out more about it-such as the safest dose to use, the side effects it may cause, and if idelalisib is effective for treating different types of cancer. Idelalisib has already been approved in the US by the FDA to treat patients with relapsed chronic lymphocytic leukemia, follicular lymphoma and small lymphocytic lymphoma. Idelalisib is a newly discovered drug that is being developed as an anti-cancer agent. This drug has been used in laboratory experiments and other research studies in B-cell malignancies and information from those other research studies suggests that idelalisib may help to target the tumor cells in B-cell malignancies, including WM. B cells are a type of white blood cell responsible for making antibodies. In this research study, the investigators are testing the safety and efficacy of idelalisib as a treatment option for relapsed or refractory Waldenstrom's Macroglobulinemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Waldenstrom's Macroglobulinemia
Keywords
Waldenstrom's Macroglobulinemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
GS-1101
Arm Type
Experimental
Arm Description
After the screening procedures confirms eligibility to participate in the research study. Treatment will be administered on an outpatient basis. -- Idelalisib (GS-11-01) orally, predetermined dose twice daily per cycle for up to 6 cycles. After this initial 6 month period, for Cycles 7 and beyond, Idelalisib will be administered once a day until disease progression.
Intervention Type
Drug
Intervention Name(s)
GS-1101
Other Intervention Name(s)
Idealisib, Zydelig, CAL-101
Intervention Description
Oral twice daily for 6 months followed by once daily until disease progression or unacceptable toxicity.
Primary Outcome Measure Information:
Title
Overall Response Rate (ORR)
Description
ORR measured by decrease in serum IgM level by at least 25% from baseline.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Secondary Outcome Measure Information:
Title
Percentage of Participants With Adverse Events
Description
Assess the safety and tolerability of idelalisib
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Complete Response (CR)
Description
CR measured by decrease in serum IgM levels to normal range, disappearnace of monoclonal protein by immunofixation, no evidence of bone marrow involvement, and resolution of any extramedullary disease by CT scan.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Very Good Partial Response (VGPR)
Description
VGPR measured by decrease in serum IgM levels of at least 90% from baseline.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Partial Response (PR)
Description
PR measured by decrease in serum IgM levels of between 25% and 50% from baseline.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Minimal Response
Description
Minimal response measured by decrease in serum IgM levels of between 25% and 50%.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Stable Disease
Description
Stable disease measured by serum IgM levels <25% reduced from baseline.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.
Title
Rate of Progressive Disease
Description
Progressive disease measured by an 25% increase in serum IgM level with an absolute increase of at least 500mg/dL from the lowest attained IgM on therapy.
Time Frame
Participants were followed for the duration of therapy, a median of one cycle, for up to 3 cycles.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must meet the following criteria on screening examination to be eligible to participate in the study: Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia and meeting criteria for treatment using consensus panel criteria from the Second International Workshop on Waldenstrom's macroglobulinemia (Owen 2003; Kyle 2003). Measurable disease, defined as presence of serum immunoglobulin M (IgM) with a minimum IgM level of > 2 times the upper limit of normal of each institution is required. Have received at least one prior therapy for WM. Age ≥18 years. ECOG performance status <2 (see Appendix A.). Participants must have normal organ and marrow function as defined below: Absolute neutrophil count > 1,000/mm3 Platelets > 50,000/mm3 Hemoglobin > 8 g/dL Total bilirubin ≤1.5 mg/dL or < 2 mg/dL if attributable to hepatic infiltration by neoplastic disease AST (SGOT) and ALT (SGPT) < 2.5 X institutional upper limit of normal Creatinine ≤ 2 mg/dL Not on any active therapy for other malignancies with the exception of topical therapies for basal cell or squamous cell cancers of the skin. Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or have or will have complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) while participating in the study; and 2) for at least 28 days after discontinuation from the study. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. FCBP must be referred to a qualified provider of contraceptive methods if needed. Able to adhere to the study visit schedule and other protocol requirements. Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Any serious medical condition, laboratory abnormality, uncontrolled intercurrent illness, or psychiatric illness/social condition that would prevent the participant from signing the informed consent form Concurrent use of any other anti-cancer agents or treatments or any other study agents Prior exposure to idelalisib Prior or ongoing clinically significant illness, medical condition, surgical history, physical finding, ECG finding, or laboratory abnormality that, in the investigator's opinion, could affect the safety of the patient; alter the absorption, distribution, metabolism or excretion of Idelalisib; or impair the assessment of study results Grade > 2 toxicity (other than alopecia) continuing from prior anti-cancer therapy Known central nervous system lymphoma Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening New York Heart Association classification III or IV heart failure. Malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel, ulcerative colitis, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction. Known history of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and/or Hepatitis C Virus (HCV) infection Lactating or pregnant women Inability to swallow capsules History of non-compliance to medical regimens Unwilling or unable to comply with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jorge J. Castillo, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of Phosphatidylinositol-3-kinase (PI3K) Inhibitor Idelalisib (GS-1101) in Waldenström Macroglobulinemia

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