Clinical Trials /

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

NCT02670044

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.

Related Conditions:
  • Acute Myeloid Leukemia
Recruiting Status:

Completed

Phase:

Phase 1

Trial Eligibility

Document

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

  • Leukemia, Myeloid, Acute

Interventions

DrugSynonymsArms
CobimetinibDose-Escalation, Arm A (Venetoclax + Cobimetinib)
IdasanutlinDose-Escalation, Arm B (Venetoclax + Idasanutlin)
VenetoclaxDose-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

NameTypeDescriptionInterventions
Dose-Escalation, Arm A (Venetoclax + Cobimetinib)ExperimentalParticipants 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.
  • Cobimetinib
  • Venetoclax
Dose-Escalation, Arm B (Venetoclax + Idasanutlin)ExperimentalParticipants 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.
  • Idasanutlin
  • Venetoclax
Dosing Schedule Optimization, Arm B (Venetoclax+Idasanutlin)ExperimentalParticipants 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.
  • Idasanutlin
  • Venetoclax

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