Description:
This phase II trial studies how well OBI-3424 works in treating patients with T-cell acute
lymphoblastic leukemia that has come back (relapsed) or does not response to treatment
(refractory). Drugs used in chemotherapy, such as OBI-3424, work in different ways to stop
the growth of cancer cells, either by killing the cells, by stopping them from dividing, or
by stopping them from spreading. OBI-3424 may reduce the amount of leukemia in the body.
Title
- Brief Title: Study to Test AKR1C3-Activated Prodrug OBI-3424 (OBI-3424) in Patients With Relapsed/Refractory T-Cell Acute Lymphoblastic Leukemia (T-ALL)
- Official Title: A Phase II Study of AKR1C3-Activated Prodrug OBI-3424 (OBI-3424) in Patients With Relapsed/Refractory T-Cell Acute Lymphoblastic Leukemia (T-ALL)
Clinical Trial IDs
- ORG STUDY ID:
S1905
- SECONDARY ID:
NCI-2020-00768
- SECONDARY ID:
S1905
- SECONDARY ID:
S1905
- SECONDARY ID:
U10CA180888
- NCT ID:
NCT04315324
Conditions
- Recurrent T Acute Lymphoblastic Leukemia
- Refractory T Acute Lymphoblastic Leukemia
Interventions
Drug | Synonyms | Arms |
---|
AKR1C3-activated Prodrug OBI-3424 | AKR1C3-activated Prodrug TH-3424, Aldo-keto Reductase 1c3-activated Prodrug OBI-3424, OBI 3424, OBI-3424, OBI3424, TH 3424, TH-3424, TH3424 | Treatment (AKR1C3-activated prodrug OBI-3424) |
Purpose
This phase II trial studies how well OBI-3424 works in treating patients with T-cell acute
lymphoblastic leukemia that has come back (relapsed) or does not response to treatment
(refractory). Drugs used in chemotherapy, such as OBI-3424, work in different ways to stop
the growth of cancer cells, either by killing the cells, by stopping them from dividing, or
by stopping them from spreading. OBI-3424 may reduce the amount of leukemia in the body.
Detailed Description
PRIMARY OBJECTIVE:
I. To assess the response rate (complete remission [CR] or CR with incomplete count recovery
[CRi]) of AKR1C3-activated prodrug OBI-3424 (OBI-3424) in patients with relapsed/refractory
T-cell acute lymphoblastic leukemia (T-ALL).
SECONDARY OBJECTIVES:
I. To estimate the frequency and severity of toxicities of OBI-3424 in this patient
population.
II. To estimate event-free survival (EFS), relapse-free survival (RFS) and overall survival
(OS) in this patient population.
TRANSLATIONAL MEDICINE OBJECTIVES:
I. To estimate minimal/measurable residual disease (MRD) negativity (among patients who
achieve CR or CRi).
II. To bank specimens for future research.
OUTLINE:
Patients receive AKR1C3-activated prodrug OBI-3424 intravenously (IV) over 30 minutes on days
1 and 8. Treatment repeats every 21 days for up to 17 cycles in the absence of disease
progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every month for 1 year, every 2
months for 1 year, every 3 months for 1 year, and then every 6 months for up to 5 years from
registration.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (AKR1C3-activated prodrug OBI-3424) | Experimental | Patients receive AKR1C3-activated prodrug OBI-3424 IV over 30 minutes on days 1 and 8. Treatment repeats every 21 days for up to 17 cycles in the absence of disease progression or unacceptable toxicity. | - AKR1C3-activated Prodrug OBI-3424
|
Eligibility Criteria
Inclusion Criteria:
- Patients must have a diagnosis of relapsed or refractory T-cell acute lymphoblastic
leukemia (T-ALL) based on World Health Organization (WHO) classification. Note that
patients who were diagnosed initially with lymphoblastic lymphoma but who have
relapsed with T-ALL are eligible
- Patients must have evidence of acute leukemia in their peripheral blood or bone
marrow. Patients must have >= 5% lymphoblasts in the peripheral blood or bone marrow
within 14 days prior to registration. Patients with only extramedullary disease are
not eligible
- Patients must be refractory to or have relapsed following prior standard induction
therapy. A standard induction regimen is defined as any program of treatment that
includes:
- Vincristine and prednisone
- Vincristine and dexamethasone
- Cytarabine and anthracycline, or
- High dose cytarabine
- Patients must have no evidence of central nervous system disease within 28 days prior
to registration. Patients with clinical signs or symptoms consistent with central
nervous system (CNS) involvement must have a lumbar puncture which is negative for CNS
involvement; the lumbar puncture must be completed within 28 days prior to
registration. Note that the patients may receive intrathecal chemotherapy with the
initial lumbar puncture
- Prior nelarabine therapy is not required. In addition, patients who do not receive
nelarabine during initial induction or post-remission treatment are eligible only if
the physician does not feel they would benefit from other, multi-agent chemotherapy
- Patients must be >= 18 years of age
- Patients must have a Zubrod performance status of 0-3
- Patients must have creatinine clearance > 30 mL/min within 14 days prior to
registration according to the Cockcroft Gault equation
- Patients must have direct bilirubin =< 1.5 x institutional upper limit of normal (ULN)
within 14 days prior to registration
- Patients must have aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
=< 3.0 x institutional upper limit of normal (ULN) or =< 5.0 x ULN (if thought to be
related to leukemic involvement) within 14 days prior to registration
- Prothrombin time (PT)/partial thromboplastin time (PTT)/fibrinogen (as clinically
indicated) (within 14 days prior to registration to obtain baseline measurements)
- From comprehensive metabolic panel: sodium, potassium, chloride, carbon dioxide (CO2),
and blood urea nitrogen (BUN) (within 14 days prior to registration to obtain baseline
measurements)
- Patients with known human immunodeficiency virus (HIV)-infection are eligible
providing they are on effective anti-retroviral therapy and have undetectable viral
load at their most recent viral load test within 6 months prior to registration. (HIV
viral load testing is required only for patients with known HIV infection)
- Patients with evidence of chronic hepatitis B virus (HBV) infection may be eligible
provided that they have an undetectable HBV viral load within 28 days prior to
registration. Patients may be currently receiving HBV treatment. (HBV viral load
testing is required only for patients with known HBV infection)
- Patients with known history of hepatitis C virus (HCV) infection may be eligible
provided that they have an undetectable HCV viral load within in 28 days prior to
registration. Patients may be currently receiving treatment. (HCV viral load testing
is required only for patients with known HCV infection)
- Patients must agree to have bone marrow and blood specimens submitted for MRD testing
- Patients must be offered the opportunity to participate in specimen banking. With
patient consent, residuals from specimens submitted will be retained and banked for
future research
- Patients must be informed of the investigational nature of this study and must sign
and give written informed consent in accordance with institutional and federal
guidelines
- As a part of the Oncology Patient Enrollment Network (OPEN) registration process the
treating institution's identity is provided in order to ensure that the current
(within 365 days) date of institutional review board approval for this study has been
entered in the system
Exclusion Criteria:
- Patients must not have had chemotherapy within 14 days prior to registration except
for steroids, oral 6-mercaptopurine, oral methotrexate, vincristine, intrathecal
chemotherapy, or hydroxyurea
- Patients must not have undergone allogeneic hematopoietic transplant within 90 days
prior to registration
- Patients must have no evidence of >= grade 2 acute graft versus host disease (GVHD) or
moderate or severe limited chronic GVHD and must have no history of extensive GVHD of
any severity within 90 days prior to registration. Extensive GVHD is defined as 1)
generalized skin involvement or 2) localized skin involvement and/or hepatic
dysfunction plus liver histology or cirrhosis or involvement of eye or minor salivary
organ or oral mucosa or any other target organ
- Patients must not have systemic fungal, bacterial, viral or other infection that is
not controlled (defined as exhibiting ongoing signs/symptoms related to the infection
and without improvement, despite appropriate antibiotics or other treatment) within 14
days prior to registration
- Patients must not be pregnant or nursing due to the teratogenic potential of the drug
used on this study. Females of reproductive potential must have a negative serum
pregnancy test within 14 days prior to registration. Women/men of reproductive
potential must have agreed to use an effective contraceptive method during and up to 6
months after treatment. A woman is considered to be of "reproductive potential" if she
has had menses at any time in the preceding 12 consecutive months. In addition to
routine contraceptive methods, "effective contraception" also includes heterosexual
celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy
prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal
ligation. However, if at any point a previously celibate patient chooses to become
heterosexually active during the time period for use of contraceptive measures
outlined in the protocol, he/she is responsible for beginning contraceptive measures
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Response rate (complete remission [CR] or CR with incomplete count recovery [CRi]) |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Incidence of adverse events |
Time Frame: | Up to the time of relapse, assessed up to 5 years |
Safety Issue: | |
Description: | Toxicities will be captured and described. The probability of any particular toxicity can be estimated to within at most +/- 17% (95% confidence interval). |
Measure: | Overall survival |
Time Frame: | From the day of registration on study until death from any cause with observations censored on the day of last contact for patients not known to have died, assessed up to 5 years |
Safety Issue: | |
Description: | Will be estimated using the Kaplan-Meier method. |
Measure: | Event-free survival |
Time Frame: | From the date of initial registration on study until the first of the following events: death from any cause, relapse from remission (CR or CRi) or completion of protocol therapy without documentation of CR or CRi, assessed up to 5 years |
Safety Issue: | |
Description: | Will be estimated using the Kaplan-Meier method. |
Measure: | Relapse-free survival |
Time Frame: | From the date the patient first achieves CR or CRi until relapse from CR/CRi or death from any cause, assessed up to 5 years |
Safety Issue: | |
Description: | Will be estimated using the Kaplan-Meier method. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Southwest Oncology Group |
Last Updated
August 10, 2021