Description:
The primary objective for this study is to assess the safety and tolerability as well as
preliminary efficacy of venetoclax in combination with cobimetinib, and venetoclax in
combination with idasanutlin in patients with relapsed or refractory acute myeloid leukemia
(R/R) AML who are not eligible for cytotoxic therapy.
Title
- Brief Title: A Study of Venetoclax in Combination With Cobimetinib and Venetoclax in Combination With Idasanutlin in Patients With Relapsed or Refractory Acute Myeloid Leukemia Who Are Not Eligible for Cytotoxic Therapy
- Official Title: A Phase IB Multi-Arm Study With Venetoclax in Combination With Cobimetinib and Venetoclax in Combination With Idasanutlin in Patients With Relapsed or Refractory Acute Myeloid Leukemia Who Are Not Eligible for Cytotoxic Therapy
Clinical Trial IDs
- ORG STUDY ID:
GH29914
- SECONDARY ID:
2015-003386-28
- NCT ID:
NCT02670044
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Cobimetinib | | Dose-Escalation, Arm A (Venetoclax + Cobimetinib) |
Idasanutlin | | Dose-Escalation, Arm B (Venetoclax + Idasanutlin) |
Venetoclax | | Dose-Escalation, Arm A (Venetoclax + Cobimetinib) |
Purpose
The primary objective for this study is to assess the safety and tolerability as well as
preliminary efficacy of venetoclax in combination with cobimetinib, and venetoclax in
combination with idasanutlin in patients with relapsed or refractory acute myeloid leukemia
(R/R) AML who are not eligible for cytotoxic therapy.
Trial Arms
Name | Type | Description | Interventions |
---|
Dose-Escalation, Arm A (Venetoclax + Cobimetinib) | Experimental | Participants will receive Venetoclax daily on Days 1-28 of each 28 day treatment cycle and Cobimetinib daily on Days 1-21 of each 28-day treatment cycle. | |
Dose-Escalation, Arm B (Venetoclax + Idasanutlin) | Experimental | Participants will receive Venetoclax on Days 1-28 of each 28 day treatment cycle and Idasanutlin daily or twice daily on Days 1-5 of each 28 day treatment cycle. | |
Dosing Schedule Optimization, Arm B (Venetoclax+Idasanutlin) | Experimental | Participants will receive Venetoclax on Days 1-21 or Days 1-14 of each 28-day treatment cycle and Idasanutlin daily on Days 1-5 of each 28 day treatment cycle. | |
Eligibility Criteria
Inclusion Criteria:
- Histological confirmation of relapsed or refractory AML after prior anti-leukemic
therapy by WHO classification
- Ineligible for cytotoxic therapy defined by the following:
a. Age (>/=) 75 years or b. age 18- 74 years with at least one of the following
comorbidities: i. Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 or
3 ii. Cardiac history of congestive heart failure requiring treatment or ejection
fraction (</=) 50% or chronic stable angina iii. Diffusing capacity of the lungs for
carbon monoxide (</=) 65% or forced expiratory volume in the first second of
expiration (</=) 65% iv. Creatinine clearance (>/=) 30 mL/min to< 45 mL/min v. any
other comorbidity that the physician judges to be incompatible with intensive
chemotherapy must be reviewed and approved by the Medical Monitor before screening and
study enrollment.
- Life expectancy of at least 12 weeks
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Adequate liver and renal function
Exclusion Criteria:
- Patients with acute promyelocytic leukemia (French-American-British [FAB] class M3
AML)
- Known active central nervous system (CNS) involvement with AML at study entry
- ECOG Performance Status (>/=) 3 in patients who are (>/=) 75 years old or ECOG
Performance Status of 4, regardless of age
- Prior exposure to Bcl-2 inhibitors, murine double minute 2 (MDM2) antagonists or prior
exposure to experimental treatment targeting Raf, mitogen-activated protein kinase
(MEK), or the mitogen-activated protein kinase (MAPK) RAS/RAF/MEK/ERK MAPK pathway
- Positive for hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg) and known
history of HIV, malignancy, active infection and cardiovascular diseases (CVs)
- Received strong cytochrome (CYP) 3A inhibitors, moderate CYP3A inhibitors, strong
CYP3A inducers and moderate CYP3A inducers within 7 days prior to initiation of study
treatment
- History of symptomatic Clostridium difficile infection within 1 month prior to dosing
Additional arm specific exclusion criteria:
Dose Escalation Arm A (Venetoclax and Cobimetinib):
- History or evidence of retinal pathology on ophthalmologic examination that is
considered a risk factor for neurosensory retinal detachment/central serous
chorioretinopathy (CSCR), retinal vein occlusion (RVO), or neovascular macular
degeneration
- Left ventricular ejection fraction (LVEF) below institutional lower limit of normal
(LLN) or below 50%, whichever is lower
Arm B (Venetoclax and Idasanutlin):
- Received the following within 7 days prior to the initiation of study treatment:
Strong CYP2C8 inhibitors or CYP2C8 substrates, OATP1B1/3 substrates
- Received the following within 14 days prior to the initiation of study treatment:
Strong CYP2C8 inducers
- History of liver cirrhosis by radiologic, clinical or laboratory data, or biopsy
despite normal liver function tests
- Received treatment with oral or parenteral anticoagulants/anti-platelet agents within
7 days prior to initiation of study treatment.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Phase Ib: Number of Participants with Dose Limiting Toxicities (DLTs) |
Time Frame: | From Cycle 1 Day 1 to Cycle 2 Day 1 for a minimum of 28 days |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Overall Response Rate (ORR) (CR + CRi + CRp + Partial Remission/Partial Response [PR]) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Duration of Response (DOR) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Time to Progression (TTP) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Progression-Free Survival (PFS) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Event-Free Survival (EFS) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Leukemia-Free Survival (LFS) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Overall Survival (OS) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Venetoclax Area Under the Concentration-Time Curve from Time Zero to Last Measurable Concentration (AUC0-t) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Venetoclax Maximum Observed Concentration (Cmax) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Cobimetinib Area Under the Concentration-Time Curve from Time Zero to Last Measurable Concentration (AUC0-t) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Cobimetinib Maximum Observed Concentration (Cmax) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Idasanutlin Maximum Observed Concentration (Cmax) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetics of Idasanutlin Area Under the Concentration-Time Curve from Time Zero to Last Measurable Concentration (AUC0-t) |
Time Frame: | Up to 6 months |
Safety Issue: | |
Description: | |
Measure: | Number of Patients Reporting Symptoms in Patient-Reported Outcomes of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) Questionnaire |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Complete remission (CR) + Complete Remission with Incomplete Blood Count Recovery (CRi) + Complete Remission with Incomplete Platelet Count Recovery (CRp) |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | CR + Complete Remission with Partial Hematologic Recovery (CRh) Rate |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Rate of Transfusion Independence |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Duration Of Transfusion Independence, Defined As The Number Of Consecutive Days Of Transfusion Independence, Measured From 1 Day After Last Transfusion To Disease Progression Or Subsequent Transfusion |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Measure: | Minimal Residual Disease (MRD) In The Bone Marrow To Evaluate The Depth Of Response |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Hoffmann-La Roche |
Last Updated
December 22, 2020