Clinical Trials /

Study of Oral Administration of LP-168 in Patients With Relapsed or Refractory B-cell Malignancies.

NCT04775745

Description:

This is a phase I, multi-center, open-label, dose-escalation study to evaluate the safety, tolerability, pharmacokinetics and clinical activity of LP-168 in subjects with relapsed or refractory B-cell malignancies. LP-168 is a small molecule inhibitor.

Related Conditions:
  • Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
  • Diffuse Large B-Cell Lymphoma
  • Follicular Lymphoma
  • Hairy Cell Leukemia
  • Mantle Cell Lymphoma
  • Marginal Zone Lymphoma
  • Waldenstrom Macroglobulinemia
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Study of Oral Administration of LP-168 in Patients With Relapsed or Refractory B-cell Malignancies.
  • Official Title: A Phase I, Multicenter, Open-Label, Dose-escalation Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Clinical Activity of Orally Administered LP-168 in Subjects With Relapsed or Refractory B-cell Malignancies.

Clinical Trial IDs

  • ORG STUDY ID: LP-168-US-I01
  • NCT ID: NCT04775745

Conditions

  • CLL/SLL
  • Waldenstrom Macroglobulinemia
  • Follicular Lymphoma
  • Diffuse Large B Cell Lymphoma
  • Mantle Cell Lymphoma
  • Marginal Zone Lymphoma
  • Hairy Cell Leukemia

Interventions

DrugSynonymsArms
LP-168Dose Escalation Phase
LP-168Dose Expansion Phase

Purpose

This is a phase I, multi-center, open-label, dose-escalation study to evaluate the safety, tolerability, pharmacokinetics and clinical activity of LP-168 in subjects with relapsed or refractory B-cell malignancies. LP-168 is a small molecule inhibitor.

Detailed Description

      The primary objectives for the study are to assess the safety and tolerability profile,
      determine the maximum tolerated dose (MTD), and/or the recommended Phase 2 dose (RP2D) of
      LP-168 administered once or twice daily as a single agent dosed orally in adult subjects with
      relapsed/refractory B-cell Malignancies (CLL/SLL, WM, FL, MCL, MZL, DLBCL, HCL); and to
      characterize the pharmacokinetics (PK) profile of LP-168 in adult subjects with
      relapsed/refractory B-cell Malignancies (CLL/SLL, WM, FL, MCL, MZL, DLBCL, HCL).

      Secondary objectives of the study are to evaluate preliminary efficacy regarding the effect
      of LP-168 on progression-free survival (PFS), objective response rate (ORR), and duration of
      response (DOR) in adult subjects with relapsed/refractory B-cell Malignancies (CLL/SLL, WM,
      FL, MCL, MZL, DLBCL, HCL).

      Once the MTD is declared and the RP2D is established, additional subjects will be enrolled in
      a cohort expansion phase (Phase 1b).
    

Trial Arms

NameTypeDescriptionInterventions
Dose Escalation PhaseExperimentalThree to six subjects per treatment cohort will be assigned to receive sequentially higher oral doses of LP-168 on a once or twice daily schedule for 28 days, starting at a dose of 100 mg/day.
  • LP-168
Dose Expansion PhaseExperimentalAdditional subjects will be recruited to further explore the safety, tolerability, PK, and efficacy in specific subject subgroups.
  • LP-168

Eligibility Criteria

        Inclusion Criteria:

        A subject will be eligible for study participation if he/she meets the following criteria:

          -  Subjects are eligible with B-cell malignancies, WM, FL, MCL, MZL, DLBCL, HCL, CLL,
             SLL, based upon 2016 updated WHO classification. Those subjects with WM, FL, MCL,
             DLBCL, or HCL must have received at least 2 prior systemic therapies.

          -  Low-grade B-cell lymphomas as follicular Grade 1, 2, or 3A, marginal zone or small
             lymphocytic lymphoma.

          -  Subject must have adequate coagulation, renal, and hepatic function, per local
             laboratory reference ranges at Screening as follows:

               -  Activated partial thromboplastin time (APTT) and prothrombin time (PT) not to
                  exceed 1.5 × ULN

               -  Calculated creatinine clearance (CrCl) ≥ 60 mL/min using 24-hour CrCl OR
                  Cockcroft-Gault formula.

               -  Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 1.5 ×ULN;
                  Bilirubin ≤ 1.5 × ULN (except subjects with Gilbert's Syndrome, who may have a
                  bilirubin > 1.5 × ULN, per discussion between the Investigator and the Medical
                  Monitor).

          -  Subjects must have adequate bone marrow independent of growth factor support per local
             laboratory reference range at screening as follows:

               -  Absolute Neutrophil Count (ANC) ≥1000/uL;

               -  An exception is for subjects with an ANC<1000/uL and bone marrow heavily
                  infiltrated with underlying disease (approximately 60% or more) may use growth
                  factor to achieve the ANC eligibility criteria per discussion between the
                  Investigator and the Medical Monitor.

               -  Platelet count ≥ 50,000/µL - OR - Platelet count ≥ 20,000/ µL if thrombocytopenia
                  is clearly due to CLL disease under study (per Investigator discretion)

               -  Hemoglobin ≥8.0g/dL, and can be achieved by transfusion

        Exclusion Criteria:

        A subject will not be eligible for study participation if he/she meets any of the following
        criteria.

          -  Subject has received any of the following therapies within 14 days or 5 half-lives
             (whichever is shorter) prior to the first dose of study drug, or has not recovered to
             ≤ Grade 1 clinically significant adverse effect(s)/toxicity(s) of the previous therapy
             (other than alopecia):

               -  Any anti-cancer therapy including chemotherapy, biologic or immunotherapy,
                  radiotherapy, etc;

               -  Any investigational therapy, including targeted small molecule agents.

               -  For CLL subjects who come off BCR antagonists (BTK inhibitors, PI3K inhibitors,
                  etc.) treatment, allow washout for 2 days as these subjects progress quickly
                  after treatment discontinuation and then remain eligible (steroids may be given
                  during these two days to allow disease control).

          -  Subjects who require immediate cytoreduction. However, subjects may receive up to two
             days of steroids for symptoms of impending organ impairment and remain eligible.

          -  Subject has received the following medications or therapies within 7 days prior to the
             first dose of study drug:

               -  Steroid therapy (at dosages equivalent to prednisone >20 mg/day) for
                  anti-neoplastic intent (except as noted in exclusion criteria #3);

               -  Cytochrome P450, family 3, subfamily A (CYP3A4) strong inhibitors and strong
                  CYP2C8 inducers/inhibitors.

               -  Potent CYP3A4 inducers such as rifampin, carbamazepine, phenytoin, and St. John's
                  wort.

          -  Subjects require treatment with systemic acid-reducing agents including H-2-receptor
             antagonists and proton pump inhibitors with the following exceptions:

               -  Proton pump inhibitors should be discontinued at least 7 days prior and held
                  throughout the study

               -  If concurrent use of an H2 blocking agent is necessary, it must be administered
                  only between 2 and 3 hours after the dose of LP-168. If not taken during this
                  time, the dose of H2 blocking agents should not be taken again until 2-3 hours
                  after the next dose of LP-168.

               -  If concurrent use of a local antacid is necessary, it must be administered 2 or
                  more hours before and/or 2 or more hours after the dose of LP-168.

          -  Subject has significant screening electrocardiogram (ECG) abnormalities including. 2nd
             degree AV block type II 3rd degree block, Grade 2 or higher bradycardia, and corrected
             QT interval (QTc) ≥ 480ms.

          -  Serum amylase > 1.5 × ULN or serum lipase > 1.5 × ULN.

          -  Subject has any history of Richter's transformation for Phase 1a portion of the trial.

          -  Subjects who have undergone autologous/allogeneic hematopoietic stem cell
             transplantation (HSCT) therapy within 90 days of the first dose of LP-168, or patients
             on immunosuppressive therapy post-HSCT at the time of Screening, or currently with
             clinically significant graft-versus-host disease (GVHD) as per treating physician
             (Patients in relapse after allogeneic transplantation must be off treatment with
             systemic immunosuppressive agents for at least 4 weeks. The use of topical steroids
             and/or up to 20 mg/day prednisone or equivalent systemic steroids for ongoing GVHD is
             permitted.

          -  Subject has a history of other active malignancies other than B-cell malignancies
             within the past 3 years prior to study entry, with the exception of:

               -  Adequately treated in situ carcinoma of the cervix uteri;

               -  Basal cell carcinoma of the skin or localized squamous cell carcinoma of the
                  skin;

               -  Previous malignancy confined and surgically resected (or treated with other
                  modalities) with curative intent.

          -  Subject requires anticoagulation with Warfarin.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Maximum Tolerated Dose (MTD)
Time Frame:Up to 24 months, each cycle is 28 days
Safety Issue:
Description:When more than 1 DLT occurs in ≤ 6 subjects in a dosing cohort, dose escalation will be stopped and this dose level will be identified as the non-tolerated dose. Doses between the non-tolerated dose and the preceding lower dose, where ≤ 1 DLT occurred, may be explored to more precisely define the MTD.

Secondary Outcome Measures

Measure:Progression-Free Survival (PFS)
Time Frame:Up to 24 months, each cycle is 28 days
Safety Issue:
Description:PFS is measured from the time of first study drug administration until the first date that recurrent or progressive disease is objectively documented.
Measure:Objective Response Rate (ORR)
Time Frame:Up to 24 months, each cycle is 28 days
Safety Issue:
Description:ORR is defined as the sum of complete response (CR) and partial remission rates.
Measure:Duration of Response (DOR)
Time Frame:Up to 24 months, each cycle is 28 days
Safety Issue:
Description:The duration of overall response is measured from the time measurement criteria are met for CR or PR (which is first recorded) until the first date that recurrent or progressive disease is objectively documented

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Newave Pharmaceutical Inc

Last Updated

August 25, 2021