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A Pilot Study of the Safety and Activity of Escalating Doses of ON 01910.Na in Patients With Relapsed Mantle Cell Lymphoma, Multiple Myeloma, Chronic Lymphocytic Leukemia, and Related Lymphoid Malignancies
This study is currently recruiting participants.
Verified by National Institutes of Health Clinical Center (CC), February 2009
First Received: March 12, 2009   Last Updated: April 9, 2009   History of Changes
Sponsored by: National Heart, Lung, and Blood Institute (NHLBI)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00861510
  Purpose

Mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), multiple myeloma (MM) and the related lymphoid malignancies included in this protocol are all incurable lymphoid malignancies that mainly affect persons in their late 60s and early 70s. Conventional chemotherapy can be effective at achieving high rates of clinical response, but relapse following these responses is almost universal. Response rates in the relapsed setting are inferior due to acquired resistance of the tumor cells and new therapies with novel mechanisms of action are needed. Our aim in this study is to specifically address the needs of these patients for whom few effective treatments are available.

Patients with lymphoid malignancies relapse due to acquired resistance of tumor cells to chemotherapy agents and innovative targeted therapies which overcome these mechanisms of resistance are needed. One such investigational drug, ON 01910.Na, is a potent and selective inhibitor of the cell cycle and leads to reduction in cyclin D1 expression. In vitro, ON01910.Na shows activity against CLL and MCL cell lines with resultant cellular death. The overexpression of cyclin D1 in these related lymphoid malignancies provides a rationale for it use in selected patients with these conditions.

We therefore propose this non-randomized, pilot, dose-escalating Phase I study of ON 01910.Na in patients with MCL, CLL, MM and related lymphoid malignancies who have relapsed after or are refractory to standard therapy.

The primary objective is to determine the toxicity profile (including the maximum tolerated dose and recommended phase II dose) of ON 01910.Na when administered the first 2 days of a 2-week cycle in escalating doses (1200mg/m2/day x 2 days, 1500mg/m2/day x 2 days, 1800mg/m2/day x 2 days, and 2100mg/m2/day x 2 days ) in patients with MCL, CLL, MM and related lymphoid malignancies.

Secondary objectives include, the biological effects of ON 01910.Na (for example cyclin D1 expression) on cell-cycle pathways of cells obtained from blood, lymph nodes or bone marrow, the toxicity profile of ON 01910.Na with subsequent dosing after 2 cycles of therapy, early indications of biologic activity after 4 cycles of therapy, evaluation of the pharmacokinetics of ON 01910.Na at the RPTD level, and indications of biologic activity during extended access (after 4 cycles (day 56)).

The primary endpoint will be the toxicity profile at each dose level through day 28 (cycle 2 day 14)

...


Condition Intervention Phase
Lymphoma, Mantle-Cell
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, Hairy Cell
Waldenstrom Macroglobulinemia
Multiple Myeloma
Drug: ON01910 Na
Phase I

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic Lymphoma Multiple Myeloma
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title: A Pilot Study of the Safety and Activity of Escalating Doses of ON 01910.Na in Patients With Relapsed Mantle Cell Lymphoma, Multiple Myeloma, Chronic Lymphocytic Leukemia, and Related Lymphoid Malignancies

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • Safety of escalating doses ON01910.Na at day 28.

Secondary Outcome Measures:
  • The reduction in lymph nodes, quantification of circulating lymphoma cells, assessment of extranodal disease sites, and/or measurement of the malignant monoclonal proteins in the serum or urine after 4 cycles of therapy (day 56).

Estimated Enrollment: 39
Study Start Date: March 2009
Intervention Details:
    Drug: ON01910 Na
    N/A
Detailed Description:

Mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), multiple myeloma (MM) and the related lymphoid malignancies included in this protocol are all incurable lymphoid malignancies that mainly affect persons in their late 60s and early 70s. Conventional chemotherapy can be effective at achieving high rates of clinical response, but relapse following these responses is almost universal. Response rates in the relapsed setting are inferior due to acquired resistance of the tumor cells and new therapies with novel mechanisms of action are needed. Our aim in this study is to specifically address the needs of these patients for whom few effective treatments are available.

Patients with lymphoid malignancies relapse due to acquired resistance of tumor cells to chemotherapy agents and innovative targeted therapies which overcome these mechanisms of resistance are needed. One such investigational drug, ON 01910.Na, is a potent and selective inhibitor of the cell cycle and leads to reduction in cyclin D1 expression. In vitro, ON01910.Na shows activity against CLL and MCL cell lines with resultant cellular death. The overexpression of cyclin D1 in these related lymphoid malignancies provides a rationale for it use in selected patients with these conditions.

We therefore propose this non-randomized, pilot, dose-escalating Phase I study of ON 01910.Na in patients with MCL, CLL, MM and related lymphoid malignancies who have relapsed after or are refractory to standard therapy.

The primary objective is to determine the toxicity profile (including the maximum tolerated dose and recommended phase II dose) of ON 01910.Na when administered the first 2 days of a 2-week cycle in escalating doses (1200mg/m2/day x 2 days, 1500mg/m2/day x 2 days, 1800mg/m2/day x 2 days, and 2100mg/m2/day x 2 days ) in patients with MCL, CLL, MM and related lymphoid malignancies.

Secondary objectives include, the biological effects of ON 01910.Na (for example cyclin D1 expression) on cell-cycle pathways of cells obtained from blood, lymph nodes or bone marrow, the toxicity profile of ON 01910.Na with subsequent dosing after 2 cycles of therapy, early indications of biologic activity after 4 cycles of therapy, evaluation of the pharmacokinetics of ON 01910.Na at the RPTD level, and indications of biologic activity during extended access (after 4 cycles (day 56)).

The primary endpoint will be the toxicity profile at each dose level through day 28 (cycle 2 day 14)

Secondary endpoints include the reduction in lymph nodes, quantification of circulating lymphoma cells, assessment of extranodal disease sites, and/or measurement of the malignant monoclonal proteins in the serum or urine after 4 cycles of therapy (day 56)

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA:

    1. Histologically documented or cytologically confirmed diagnosis of Mantle Cell Lymphoma (MCL) and Refractory to, or relapsed after, greater than or equal to 1 prior lines of antineoplastic therapy (including an anthracycline or mitoxantrone and rituximab, each in one or more lines).

      OR

      Histologically documented or cytologically confirmed diagnosis of Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL), or Prolymphocytic Lymphoma (PLL) and refractory to, or relapsed after, greater than or equal to 2 prior lines of antineoplastic therapy (including at least one nucleoside analogue and one alkylating agent or a combination thereof as well as rituximab, each in greater than or equal to 1 line). Must have relapsed after, failed or opted not to receive alemtuzumab. Not a candidate for or opted not to participate in bone marrow transplantation.

      OR

      Histologically documented or cytologically confirmed diagnosis of Multiple Myeloma (MM) and Refractory to, or relapsed after greater than or equal to 2 prior lines of antineoplastic therapy including both bortezomib and an immunomodulatory (IMiD) agent such as lenalidomide or thalidomide.

      OR

      Histologically documented or cytologically confirmed diagnosis of Waldenstrom's macroglobulinemia (WM) or Hairy Cell Leukemia (HCL) and Refractory to, or relapsed after greater than or equal to 1 line of antineoplastic therapy.

    2. Measurable disease (defined as two dimensional disease on imaging or quantifiable leukemic disease or monoclonal paraproteins).
    3. Failed to respond to, relapsed following, not eligible for, or opted not to participate in other standard of care treatment options.
    4. Age greater than or equal to 18 and less than or equal to 99.

EXCLUSION CRITERIA:

  1. Less than 4 weeks since having received any other treatments directed toward their malignancy (standard or investigational). Steroids permissible up to 2 weeks prior to enrollment.
  2. Malignant disease other than MCL, CLL/SLL, PLL, WM, HCL or MM requiring treatment with cytotoxic therapy.
  3. Active infection not adequately responding to appropriate therapy.
  4. HIV positive patients and taking anti-retroviral therapy.
  5. Moribund status or concurrent hepatic, renal, cardiac, neurologic, pulmonary, infectious, or metabolic disease of such severity that it would preclude the patient's ability to tolerate protocol therapy.
  6. Symptomatic congestive heart failure, unstable angina pectoris, history of life threatening cardiac arrhythmia, myocardial infarction within 6 months or new conduction abnormalities by EKG. Patients with symptoms of coronary artery disease or EKG abnormalities must be evaluated and cleared by cardiology prior to enrollment.
  7. Uncontrolled hypertension (defined as systolic pressure greater than or equal to 160 and/or diastolic pressure greater than or equal to 110).
  8. New onset seizures (within 3 months prior to the first dose of ON 01910.Na) or poorly controlled seizures.
  9. ECOG performance status 3 or 4.
  10. Life expectancy less than 3 months.
  11. Absolute neutrophil count (ANC) less than 500.
  12. Platelet count less than 25,000.
  13. Total bilirubin greater than or equal to 1.5 mg/dL not related to hemolysis or Gilbert's disease, ALT or AST greater than or equal to 2 times ULN.
  14. Serum creatinine greater than 1.5 mg/dL, or a calculated creatinine clearance of less than 40 mL/min/1.73 m(2).
  15. Ascites requiring active medical management including paracentesis, or hyponatremia (defined as serum sodium value of less than 134 meq/L).
  16. Current pregnancy, unwilling to take oral contraceptives or refrain from pregnancy if of childbearing potential or currently breastfeeding.
  17. Male patients with female sexual partners who are unwilling to follow the strict contraception requirements described in this protocol.
  18. Major surgery within 3 weeks of ON 01910.Na treatment initiation
  19. Psychiatric illness/social situations that would limit the patient's ability to tolerate and/or comply with study requirements.
  20. Unable to understand the investigational nature of the study or give informed consent.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00861510

Contacts
Contact: Patient Recruitment and Public Liaison Office (800) 411-1222 prpl@mail.cc.nih.gov
Contact: TTY 1-866-411-1010

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

Additional Information:
Publications:
Study ID Numbers: 090094, 09-H-0094
Study First Received: March 12, 2009
Last Updated: April 9, 2009
ClinicalTrials.gov Identifier: NCT00861510     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Small Lymphocytic Lymphoma (SLL)
Prolymphocytic Lymphoma (PLL)
Hairy Cell Leukemia (HCL)

Study placed in the following topic categories:
Leukemia, Lymphoid
Blood Protein Disorders
Lymphoma, Mantle-Cell
Paraproteinemias
Mantle Cell Lymphoma
Hemostatic Disorders
Leukemia
Hemorrhagic Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-cell, Chronic
Lymphoma
Immunoproliferative Disorders
Hematologic Diseases
Blood Coagulation Disorders
Hairy Cell Leukemia
Vascular Diseases
Multiple Myeloma
Lymphatic Diseases
Leukemia, Hairy Cell
Waldenstrom Macroglobulinemia
Chronic Lymphocytic Leukemia
Lymphoproliferative Disorders
Leukemia, B-Cell
Lymphoma, Non-Hodgkin
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Leukemia, Lymphoid
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Hematologic Diseases
Blood Protein Disorders
Lymphoma, Mantle-Cell
Vascular Diseases
Paraproteinemias
Hemostatic Disorders
Multiple Myeloma
Lymphatic Diseases
Leukemia
Leukemia, Hairy Cell
Waldenstrom Macroglobulinemia
Neoplasms
Hemorrhagic Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Cardiovascular Diseases
Lymphoma, Non-Hodgkin
Leukemia, B-Cell
Lymphoproliferative Disorders
Lymphoma
Neoplasms, Plasma Cell

ClinicalTrials.gov processed this record on May 07, 2009