Description:
Objectives of this clinical trial are to evaluate the safety, tolerability, pharmacokinetics
and potential efficacy of the investigational drug, cobomarsen (MRG-106), in patients
diagnosed with certain lymphomas and leukemias, including cutaneous T-cell lymphoma (CTCL)
[mycosis fungoides (MF) subtype], chronic lymphocytic leukemia (CLL), diffuse large B-cell
lymphoma (DLBCL) [activated B-cell (ABC) subtype], and adult T-cell leukemia/lymphoma (ATLL).
Cobomarsen is an inhibitor of a molecule called miR-155 that is found at high levels in these
types of cancers and may be important in promoting the growth and survival of the cancer
cells. Participants in the clinical trial will receive weekly doses of cobomarsen
administered by injection under the skin or into a vein, or by injection directly into
cancerous lesions in the skin (for CTCL only). Blood samples will be collected to measure how
cobomarsen is processed by the body, and other measurements will be performed to study how
normal and cancerous cells of the immune system respond when exposed to cobomarsen.
Title
- Brief Title: Safety, Tolerability and Pharmacokinetics of MRG-106 in Patients With Mycosis Fungoides (MF), CLL, DLBCL or ATLL
- Official Title: A Phase 1 Dose-ranging Study to Investigate the Safety, Tolerability, and Pharmacokinetics of MRG-106 Following Local Intratumoral, Subcutaneous, and Intravenous Administration in Subjects With Various Lymphomas and Leukemias
Clinical Trial IDs
- ORG STUDY ID:
MRG106-11-101
- NCT ID:
NCT02580552
Conditions
- Cutaneous T-cell Lymphoma (CTCL)
- Mycosis Fungoides (MF)
- Chronic Lymphocytic Leukemia (CLL)
- Diffuse Large B-Cell Lymphoma (DLBCL), ABC Subtype
- Adult T-Cell Leukemia/Lymphoma (ATLL)
Interventions
Drug | Synonyms | Arms |
---|
Cobomarsen | MRG-106 | Part A, MF |
Purpose
Objectives of this clinical trial are to evaluate the safety, tolerability, pharmacokinetics
and potential efficacy of the investigational drug, cobomarsen (MRG-106), in patients
diagnosed with certain lymphomas and leukemias, including cutaneous T-cell lymphoma (CTCL)
[mycosis fungoides (MF) subtype], chronic lymphocytic leukemia (CLL), diffuse large B-cell
lymphoma (DLBCL) [activated B-cell (ABC) subtype], and adult T-cell leukemia/lymphoma (ATLL).
Cobomarsen is an inhibitor of a molecule called miR-155 that is found at high levels in these
types of cancers and may be important in promoting the growth and survival of the cancer
cells. Participants in the clinical trial will receive weekly doses of cobomarsen
administered by injection under the skin or into a vein, or by injection directly into
cancerous lesions in the skin (for CTCL only). Blood samples will be collected to measure how
cobomarsen is processed by the body, and other measurements will be performed to study how
normal and cancerous cells of the immune system respond when exposed to cobomarsen.
Detailed Description
Study Design:
- Part A: Cohorts of 3-6 patients diagnosed with MF will receive up to five intratumoral
injections of cobomarsen over a period of up to 15 days with follow-up for an additional
20 days, beginning with the maximum deliverable intratumoral dose. Doses may be
decreased in subsequent cohorts to determine the minimum pharmacodynamically active
dose.
- Parts B-F: Patients in these parts of the study will be diagnosed with MF (Parts B and
C), CLL (Part D), DLBCL (Part E), or ATLL (Part F). All patients will receive
subcutaneous or intravenous cobomarsen (or a combination of systemic and intratumoral
administration for MF patients only) on Days 1, 3 and 5, and will continue dosing on a
weekly schedule until the patient becomes intolerant, develops clinically significant
side effects, progresses, or the trial is terminated. Doses administered will not exceed
a dose level predicted to be safe based on all prior treatment experience with the drug.
Patients in Part B may continue on a stable background therapy for their disease during
their treatment with cobomarsen, while patients in Parts C-F will be treated with
cobomarsen alone.
Trial Arms
Name | Type | Description | Interventions |
---|
Part A, MF | Experimental | Intratumoral Injection of cobomarsen | |
Part B, MF | Experimental | Subcutaneous, intravenous or a combination of systemic and intratumoral administration of cobomarsen with or without stable background therapy | |
Part C, MF | Experimental | Subcutaneous or intravenous administration of cobomarsen as monotherapy | |
Part D, CLL | Experimental | Subcutaneous or intravenous administration of cobomarsen as monotherapy | |
Part E, DLBCL, activated B-cell (ABC) subtype | Experimental | Subcutaneous or intravenous administration of cobomarsen as monotherapy | |
Part F, ATLL | Experimental | Subcutaneous or intravenous administration of cobomarsen as monotherapy | |
Eligibility Criteria
Inclusion Criteria:
- Parts A-C only: Patients must have biopsy proven MF, clinical stage I, II, or III
(excluding visceral or nodal involvement), and must be refractory to or intolerant of
established therapies for their condition
- Part D only: Patients diagnosed with CLL who are intolerant to, or have disease that
is relapsed/refractory after, at least two prior therapies
- Part E only: Patients with biopsy-proven DLBCL who are intolerant to, or have disease
that is relapsed/refractory after, at least two prior therapies, including any
anti-CD20 monoclonal antibody and chemotherapy with curative intent
- Part F only: Patients with documented HTLV-1 infection and histologically or
cytologically proven ATLL of any stage, and who are intolerant to, or have disease
that is relapsed/refractory after, at least one prior therapy
- Females must not be pregnant or lactating. Women of child-bearing potential must use a
highly effective method of contraception throughout their study participation and for
at least 6 months following the last dose of study drug.
- Males must be surgically sterile, abstinent, or if engaged in sexual relations with a
female of child-bearing potential, must be willing to use a highly effective method of
contraception throughout their study participation and for at least 6 months after the
last dose of study drug.
Exclusion Criteria:
- Evidence of renal or liver dysfunction at screening
- Clinically significant anemia, neutropenia or thrombocytopenia at screening
- History of bleeding diathesis or coagulopathy
- Clinically significant cardiovascular disease, history of myocardial infarction within
the last 6 months, or evidence of QTc interval prolongation at screening
- Serologically positive for HIV; serologically positive for Hepatitis B or Hepatitis C
with evidence of liver dysfunction or documented liver cirrhosis
- Prior malignancies within the past 3 years (with allowance for adequately treated in
situ carcinoma of the cervix uteri, and basal cell or localized squamous cell
carcinoma of the skin treated with curative intent)
- Use of an investigational small molecule drug during the 30 days prior to screening or
use of an investigational oligonucleotide or biologic drug during the prior 90 days
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Safety and tolerability of cobomarsen based on vital signs, physical examination, clinical laboratory tests, ECG, and incidence and severity of adverse events |
Time Frame: | From start of treatment to end of study participation |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Area under the plasma concentration vs. time curve (AUC) of cobomarsen following single and repeat doses administered intratumorally, subcutaneously or intravenously |
Time Frame: | Up to 56 days |
Safety Issue: | |
Description: | |
Measure: | Peak plasma concentration (Cmax) of cobomarsen following single and repeat doses administered intratumorally, subcutaneously or intravenously |
Time Frame: | Up to 56 days |
Safety Issue: | |
Description: | |
Measure: | Trough plasma concentration (Ctrough) of cobomarsen following each 4-week cycle of dosing |
Time Frame: | Monthly from Week 5 up to end of study participation |
Safety Issue: | |
Description: | |
Measure: | Skin disease severity (index lesions) - MF only |
Time Frame: | Every 2 weeks from start of treatment until end of study participation |
Safety Issue: | |
Description: | Changes in MF skin lesion severity before and after treatment based on the Composite Assessment of Index Lesion Severity (CAILS) score |
Measure: | Skin disease severity (whole body) - MF only |
Time Frame: | Every 2 weeks from start of treatment until end of study participation |
Safety Issue: | |
Description: | Changes in MF skin lesion severity before and after treatment based on the modified Severity Weighted Assessment Tool (mSWAT) score |
Measure: | Overall Response Rate in the skin - MF |
Time Frame: | Approximately 1 year |
Safety Issue: | |
Description: | Proportion of subjects who achieve a partial response (PR) or complete response (CR) in the skin, based on SWAT score |
Measure: | Overall Response Rate - CLL |
Time Frame: | Approximately 1 year |
Safety Issue: | |
Description: | Proportion of subjects who achieve a PR or CR as defined by IWCLL criteria (Hallek et al., 2008) based on CT scans, bone marrow biopsies, and flow cytometry |
Measure: | Minimal Residual Disease (MRD) - CLL only |
Time Frame: | Approximately 1 year |
Safety Issue: | |
Description: | Proportion of subjects who achieve a CR with no evidence of MRD by flow cytometry |
Measure: | Overall Response Rate - DLBCL |
Time Frame: | Approximately 1 year |
Safety Issue: | |
Description: | Proportion of subjects who achieve a PR or CR as defined by the Lugano classification (Cheson et al., 2014) based on positron emission tomography-computed tomography (PET-CT) scans and bone marrow biopsy to confirm CR |
Measure: | Overall Response Rate - ATLL |
Time Frame: | Approximately 1 year |
Safety Issue: | |
Description: | Proportion of subjects who achieve a PR or CR as defined by international consensus criteria (Tsukasaki et al., 2009) based on CT scans and flow cytometry, and bone marrow biopsy to confirm CR |
Measure: | Duration of Response |
Time Frame: | Up to approximately 2 years |
Safety Issue: | |
Description: | Number of days from initial date of confirmed PR or CR until loss of response or relapse |
Measure: | Time to Progression |
Time Frame: | Up to approximately 2 years |
Safety Issue: | |
Description: | Number of days from first dose until objective disease progression |
Measure: | Progression Free Survival (PFS) |
Time Frame: | Up to approximately 2 years |
Safety Issue: | |
Description: | Number of days from first dose until objective disease progression or death from any cause |
Measure: | Overall Survival (OS) |
Time Frame: | Up to approximately 2 years |
Safety Issue: | |
Description: | Number of days from first dose until death from any cause |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | miRagen Therapeutics, Inc. |
Trial Keywords
- Cutaneous T-cell Lymphoma
- CTCL
- Mycosis Fungoides
- Chronic lymphocytic leukemia
- CLL
- Diffuse large B-cell lymphoma
- DLBCL
- Adult T-cell leukemia/lymphoma
- ATLL
Last Updated
November 23, 2020