Study of XL114 in Subjects With Non-Hodgkin's Lymphoma
Non-Hodgkin's Lymphoma (NHL), Activated B-Cell Type Diffuse Large B-Cell Lymphoma (ABC-DLBCL), Mantle Cell Lymphoma (MCL)
About this trial
This is an interventional treatment trial for Non-Hodgkin's Lymphoma (NHL) focused on measuring Mucosa-associated Lymphoid Tissue Lymphoma Translocation Protein 1 (MALT-1), B-cell Malignancies, Fatty Acid Binding Protein 5 (FABP-5)
Eligibility Criteria
Inclusion Criteria:
- Dose-Escalation Stage (Cohort A) and Cohort-Expansion Stage (B-E): The subject has received standard life-prolonging therapies or are not qualified to receive such therapies.
- Dose-Escalation Stage (Cohort A): Subjects with histologically documented diagnosis of B-cell or T-cell Non-Hodgkin's Lymphoma as defined by the World Health Organization (WHO) classification. Note: Refer to exclusion criteria for lymphoma subtypes which are excluded from study participation.
- Cohort-Expansion Stage Cohort B (ABC-DLBCL subtype): Subjects with histologically documented activated B-cell diffuse large B-cell lymphoma (ABC-DLBCL) subtype. Note: De novo or transformed diffuse large B-cell lymphoma (DLBCL) from previously diagnosed indolent lymphoma (eg, follicular lymphoma) is allowed.
- Cohort-Expansion Stage Cohort C (MCL): Subjects with histologically documented MCL with monoclonal B-cells that show a chromosome translocation t(11;14)(q13;q32) and/or overexpression of cyclin D1.
- Cohort-Expansion Stage Cohort D (CLL/SLL): Subjects with histologically documented CLL/SLL per the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines.
- Cohort-Expansion Stage Cohort E, Biomarker Cohort (ABC-DLBCL, MCL, and SLL): Subjects with ABC-DLBCL, MCL, and SLL that fulfill the subject disease characteristics criteria as described for Cohorts B, C, or D.
- Cohort-Expansion Stage: Subjects with ABC-DLBCL, MCL, and SLL must have measurable disease by revised criteria for response assessment of lymphoma.
- Cohort-Expansion Stages: Must have archival tumor tissue available, which was collected up to 2 years prior to consent for this study. If archival tumor tissue is not available, a fresh tumor biopsy may be obtained (if safe to acquire) up to 60 days prior to first dose.
- Biomarker Cohort: Subjects must provide a fresh tumor biopsy up to 60 days prior to first dose, at week 2, day 1 (W2D1) after initiation of XL114, and at disease progression. Note: The tumor tissue requirement in the Expansion and Biomarker cohorts doesn't apply for subjects with CLL.
- Recovery to baseline or ≤ Grade 1 severity (Common Terminology Criteria for Adverse Events version 5 [CTCAE v5]) from AEs, unless AEs are clinically nonsignificant or stable.
- Left ventricular ejection fraction (LVEF) > 50% as determined by echocardiogram (ECHO) or multigated acquisition (MUGA) scan per local standard.
- Age 18 years or older on the day of consent.
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-1
- Adequate organ and marrow function
- Sexually active fertile subjects and their partners must agree to highly effective methods of contraception.
- Female subjects of childbearing potential must not be pregnant at screening.
Exclusion Criteria:
- Receipt of prior therapies as defined in the protocol
- The following lymphoma types/manifestations are not eligible for this study: Burkitt's lymphoma (BL), Burkitt-like lymphoma (BLL), lymphoblastic lymphoma/leukemia (LBL), post-transplant lymphoproliferative disease (PTLD), primary mediastinal (thymic) large B-cell lymphoma (PMBL), lymphomas involving the central nervous system (CNS) or meninges
- History of autoimmune hemolytic anemia (AIHA) or idiopathic thrombocytopenic purpura (ITP).
- History of solid organ or allogeneic hematopoietic stem cell transplantation.
- Concomitant anticoagulation with the oral anticoagulants apixaban, betrixaban, rivaroxaban, and dabigatran.
- Use of a strong inhibitor or inducer of cytochrome P450 3A4 (CYP3A4) within 5 half-lives or 4 weeks prior to first dose of study treatment, whichever is shorter.
- Uncontrolled, significant intercurrent or recent illness
- Major surgery (eg, GI surgery) within 3 weeks before first dose of study treatment.
- Corrected QT interval calculated by the Fridericia formula (QTcF) > 470 ms per electrocardiogram (ECG).
- Pregnant or lactating females.
- Inability to swallow XL114 tablets.
- Diagnosis of another malignancy within 2 years before first dose of study treatment, except for superficial skin cancers, or localized, low-grade tumors deemed cured and not treated with systemic therapy
Sites / Locations
- Exelixis Clinical Site #3
- Exelixis Clinical Site #1
- Exelixis Clinical #4
- Exelixis Clinical Site #2
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
XL114 Dose-Escalation Cohorts
XL114 Expansion Cohorts
Subjects (Cohort A1-An) will accrue in cohorts of 3-12 subjects in a i3+3 design.
The recommended dose from the Dose-Escalation stage, will be used in subjects with activated B-cell-like diffuse large B-cell lymphoma [ABC-DLBCL] (Cohort B), mantle cell lymphoma [MCL] (Cohort C), chronic lymphocytic leukemia [CLL]/small lymphocytic lymphoma [SLL] (Cohort D). Subjects will also be enrolled in a Biomarker cohort (Cohort E).