Hematologic Malignancies Clinical Trial
Official title:
A Phase II Study of the ALK Inhibitor, Ceritinib (LDK378), in Relapsed/Refractory ALK+ Hematologic Malignancies
This is a phase II, single arm, unblinded study of ceritinib in patients with rel/ref hematologic malignancies. Up to 24 evaluable subjects will be enrolled with an interim analysis for efficacy after the first 9 subjects are enrolled. Any subject who takes at least one dose of study drug will be evaluable for safety. Only subjects who complete at least 1 cycle of study drug and have clear progression on physical exam or have had at least one restaging study will be considered evaluable for response. Each subject will receive the same dose of 750mg po daily at the study entry. Subjects with stable disease or better will be allowed to continue study drug until disease progression or until intolerable adverse events or patient or physician decision. Intrapatient dose reductions will be allowed for adverse events. This is a multicenter study with Duke as the lead site. Blood and tissue samples, will be collected and used for exploratory analysis.
This is a phase II, single arm, unblinded study of ceritinib in patients with rel/ref
hematologic malignancies. Up to 24 evaluable subjects will be enrolled with an interim
analysis for efficacy after the first 9 subjects are enrolled. Any subject who takes at
least on dose of study drug will be evaluable for safety. Only subjects who complete at
least 1 cycle of study drug and have clear progression on physical exam or have had at least
one restaging study will be considered evaluable for response. Each subject will receive the
same dose of 750mg po daily at the study entry. Subjects with stable disease or better will
be allowed to continue study drug until disease progression or until intolerable adverse
events or patient or physician decision. Intrapatient dose reductions will be allowed for
adverse events. Blood and tissue samples, will be collected and used for exploratory
analysis.
Dose Level 0 (starting dose) 750mg/day Dose level -1 600mg/day Dose level -2 450mg/day
Baseline evaluations are to be conducted within 30 days prior to start of protocol therapy
unless otherwise noted in the time to events table. Scans and x-rays must be performed
within six weeks prior to the start of therapy. Bone marrow biopsy must be performed within
twelve weeks prior to starting therapy. In the event that the patient's condition is
deteriorating, laboratory evaluations should be repeated within 48 hours prior to initiation
of the next cycle of therapy. All the labs have to be within the study eligibility range
prior to the start of study treatment.
All visits should occur within 3 days before or after the scheduled day of the visit. An
early or late visit will not shorten or extend the duration of that cycle - all cycles will
be 28 days.
If study drug is held for any reason then the missed days should still be counted as a day
in the cycle. However, if the study drug is on hold when a 28 day cycle ends, then day 1 of
the next cycle and the necessary evaluations should not be started until drug is restarted.
Therefore, the cycle during which a drug is held could potentially have more than 28 days.
Patients will be followed for up to 2 years after completion of therapy or until progression
of disease or death, whichever comes first. In follow up, patients will be seen every 3
months for physical exam, lab draws for the first two years after completing all study drugs
or until alternative therapy is begun or until progression of disease or death-whichever
comes first. Radiographic imaging will be performed every 6 months for the first two years
after study drug is completed.
Patients removed from study for unacceptable adverse events will be followed until
resolution or stabilization of the adverse event and will continue to be followed until
progression of disease or death. Unacceptable adverse events are those that lead to stopping
of a study drug and for which there is no resolution of drug related toxicity after a 6 week
washout period so that the subject is removed from study as defined in section 6.
Patients removed from the study due to progressive disease will be followed until resolution
or stabilization of any adverse events due to the agents, after which their follow up will
be completed.
At a minimum, all patients who discontinue ceritinib treatment, including those who refuse
to return for a final visit, will be contacted for safety evaluations during the 30 days
following the last dose of treatment
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