Clinical Trials /

Phase I Study of MLN 9708 in Addition to Chemotherapy for the Treatment of Acute Lymphoblastic Leukemia in Older Adults

NCT02228772

Description:

This research study is evaluating a combination of drugs considered standard treatment for children and young adults with acute lymphoblastic leukemia (ALL), in combination with a new drug called MLN 9708. Additionally, the study is also evaluating if bone marrow or stem cell transplantation, which will be given to some participants, helps to prevent ALL from returning.

Related Conditions:
  • Acute Lymphoblastic Leukemia
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Phase I Study of MLN 9708 in Addition to Chemotherapy for the Treatment of Acute Lymphoblastic Leukemia in Older Adults
  • Official Title: Phase I Study of MLN 9708 in Addition to Chemotherapy for the Treatment of Acute Lymphoblastic Leukemia in Older Adults

Clinical Trial IDs

  • ORG STUDY ID: 14-200
  • NCT ID: NCT02228772

Conditions

  • Acute Lymphoblastic Leukemia
  • Lymphoblastic Lymphoma
  • B-cell Adult Acute Lymphoblastic Leukemia
  • T-cell Adult Acute Lymphoblastic Leukemia

Interventions

DrugSynonymsArms
MLN 9708IxazomibMLN 9708
VincristineOncovin, Vincasar PFS, Vincrex, Vincristine sulfate, VCRMLN 9708
CytarabineAra-C, Cytosar-U, Cytosine arabinosideMLN 9708
DoxorubicinAdriamycin, RubexMLN 9708
Mercaptopurine6-MP, Purinethol, PurixanMLN 9708
CyclophosphamideCytoxan, Neosar, CTXMLN 9708
MethotrexateFolex, Mexate, MTX, Methotrex (formerly Amethopterin)MLN 9708

Purpose

This research study is evaluating a combination of drugs considered standard treatment for children and young adults with acute lymphoblastic leukemia (ALL), in combination with a new drug called MLN 9708. Additionally, the study is also evaluating if bone marrow or stem cell transplantation, which will be given to some participants, helps to prevent ALL from returning.

Detailed Description

      In this research study, the investigators are studying the optimal dose of the drug MLN 9708
      when given with a standard multi-drug regimen. In the first part of the study, up to 18
      participants will be enrolled at different doses of MLN 9708. Once the maximally tolerated
      (highest, safest dose) is established, an additional 10 participants will be enrolled.

      Additionally, bone marrow (tissue found in the inside of bones) or stem cell transplantation
      will be given to some participants to study whether it helps to prevent ALL from returning.

      The study treatment consists of several different stages

        -  Induction

        -  Consolidation 1

        -  Or Stem Cell or Bone Marrow Transplant (if you are eligible based on your medical
           condition and the availability of a matched stem cell donor)

        -  Or If you do not have a transplant:

             -  CNS Therapy

             -  Consolidation 2

             -  Continuation Therapy
    

Trial Arms

NameTypeDescriptionInterventions
MLN 9708ExperimentalDose escalation will occur using a standard 3+3 dose escalation approach, beginning in dose level I with dose cohorts and rules for escalation and de-escalation. MLN 9708 will be given with standard multi-drug regimen for ALL . MLN 9708 will be administered on determined days during Induction therapy cycle and Consolidation cycle. If remission occurs and if eligible, the next stage with be either Stem Cell or Bone Marrow Transplant. If not eligible to receive a transplant, the participant will continue on this study for the next 3 stages. CNS Therapy Consolidation 2 Continuation Therapy No further MLN9708, the investigational drug, will be given after Consolidation 1 Standard chemotherapy -Vincristine, Cytarabine, Doxorubicin, Mercaptopurine, Cyclophosphamide, Methotrexate
  • MLN 9708
  • Vincristine
  • Cytarabine
  • Doxorubicin
  • Mercaptopurine
  • Cyclophosphamide
  • Methotrexate

Eligibility Criteria

        Inclusion Criteria:

          -  Acute lymphoblastic leukemia, excluding known mature B-cell ALL by the presence of any
             of the following: surface immunoglobulin, L3 morphology, t(8;14)(q24;q32), t(8;22), or
             t(2;8).

          -  Patients with mature B-cell ALL will be removed from the protocol as soon as that
             diagnosis is made and should be treated on a B-cell leukemia (Burkitt's) protocol.
             NOTE: Patients with T-cell surface markers and a t(8;14)(q24;q11) remain eligible.

          -  Patients with lymphoblastic lymphoma are also eligible

          -  No prior anti-leukemic therapy except the following are allowed: <1 week of
             corticosteroids, or hydroxyurea or emergent leukopheresis. Longer steroid use for
             diseases other than leukemia is permitted.

          -  Age 51- 75 years

          -  Voluntary written consent must be given before performance of any study-related
             procedures not part of standard medical care, with the understanding that consent may
             be withdrawn by the patient at any time without prejudice to future medical care.

          -  If patient is known to be HIV positive, they will not be eligible for the protocol.
             HIV testing is not mandatory prior to protocol enrollment.

          -  Patients whose comorbid medical condition, in the investigator's opinion, would make
             participation in this trial and adherence to the protocol guidelines difficult should
             be excluded.

          -  Patients with an active psychiatric or mental illness making informed consent or
             careful clinical follow-up unlikely are excluded.

          -  Ejection fraction ≥ 45%

          -  Creatinine<2.0 times upper limit of normal

          -  Total bilirubin < 1.5 times upper limit of normal except for known conjugation
             diseases such as Gilbert's, ALT and AST <3.0 times upper limit of normal. Direct
             bilirubin is not an inclusion criteria.

          -  ECOG performance status of 0, 1, 2

          -  Non pregnant and non lactating Female patients who:

               -  Are postmenopausal for at least 1 year before the screening visit, OR

               -  Are surgically sterile, OR

               -  If they are of childbearing potential, agree to practice 2 effective methods of
                  contraception, at the same time, from the time of signing the informed consent
                  form through 90 days after the last dose of study drug, AND

               -  Must also adhere to the guidelines of any treatment-specific pregnancy prevention
                  program, if applicable, OR

               -  Agree to practice true abstinence when this is in line with the preferred and
                  usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation,
                  symptothermal, post-ovulation methods] and withdrawal are not acceptable methods
                  of contraception.)

          -  Male patients, even if surgically sterilized (i.e., status post-vasectomy), must agree
             to one of the following:

               -  Agree to practice effective barrier contraception during the entire study
                  treatment period and through 90 days after the last dose of study drug, OR

               -  Must also adhere to the guidelines of any treatment-specific pregnancy prevention
                  program, if applicable, OR

               -  Agree to practice true abstinence when this is in line with the preferred and
                  usual lifestyle of the subject. (Periodic abstinence (eg, calendar, ovulation,
                  symptothermal, post-ovulation methods] and withdrawal are not acceptable methods
                  of contraception.)

        Exclusion Criteria:

          -  Patients meeting any of the following exclusion criteria are not to be enrolled in the
             study.

          -  Female patients who are lactating or have a positive serum pregnancy test during the
             screening period.

          -  Major surgery within 14 days before enrollment. Biopsies and line placement procedures
             are not exclusion criteria.

          -  Radiotherapy within 14 days before enrollment. Radiotherapy is excluded during
             induction and consolidation 1 while receiving MLN 9708.

          -  Evidence of current uncontrolled cardiovascular conditions, including uncontrolled
             hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure,
             unstable angina, or myocardial infarction within the past 6 months.

          -  Active hepatitis B or C virus infection, or known human immunodeficiency virus (HIV)
             positive. Hepatitis and HIV testing are not required prior to the start of treatment.

          -  Any serious medical or psychiatric illness that could, in the investigator's opinion,
             potentially interfere with the completion of treatment according to this protocol.

          -  Known allergy to any of the study medications, their analogues, or excipients in the
             various formulations of any agent.

          -  Patient has ≥ Grade 3 peripheral neuropathy, or Grade 2 with pain on clinical
             examination during the screening period.

          -  Known GI disease or GI procedure that could interfere with the oral absorption or
             tolerance of MLN9708 including difficulty swallowing.

          -  Diagnosed or treated for another malignancy within 2 years before study enrollment or
             previously diagnosed with another malignancy and have any evidence of residual
             disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are
             not excluded if they have undergone complete resection.

          -  Participation in other clinical trials, including those with other investigational
             agents not included in this trial, within 21days of the start of this trial and
             throughout induction and consolidation 1 portions of this trial (while on MLN 9708).
             Patients may enroll in transplant and post transplant studies after consolidation 1
             treatment (See Section 6.5).

          -  Systemic treatment, within 14 days before the first dose of MLN9708, with strong
             inhibitors of CYP1A2 (fluvoxamine, enoxacin), strong inhibitors of CYP3A
             (clarithromycin, telithromycin, itraconazole, voriconazole, ketoconazole, nefazodone,
             posaconazole) or strong CYP3A inducers (rifampin, rifapentine, rifabutin,
             carbamazepine, phenytoin, phenobarbital), or use of Ginkgo biloba or St. John's wort.
             Ciprofloxocin should not be administered for at least 2 days before MLN 9708
             administration. Extended release ciprofloxocin should not be administered for at least
             3 days prior to MLN 9708 administration.
      
Maximum Eligible Age:75 Years
Minimum Eligible Age:51 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Maximum Dose Tolerated of MLN 9708
Time Frame:2 Years
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Percentage of Patient with Complete Remission (CR) rate at the end of induction therapy
Time Frame:30 Days
Safety Issue:
Description:
Measure:Percentage of Participants with Disease Free Survival
Time Frame:2 Years
Safety Issue:
Description:
Measure:Rate of Overall survival (OS)
Time Frame:1 Year, 2 Year, 3 Year
Safety Issue:
Description:
Measure:Complete Remission Rate
Time Frame:2 Years
Safety Issue:
Description:
Measure:Rate of Toxicity
Time Frame:2 Years
Safety Issue:
Description:Assess adverse events, serious adverse events, neurotoxicity grading

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Massachusetts General Hospital

Trial Keywords

  • Acute lymphoblastic Leukemia
  • Lymphoblastic lymphoma
  • B-cell Adult Acute Lymphoblastic Leukemia
  • T-cell Adult Acute Lymphoblastic Leukemia

Last Updated

November 26, 2019