Lymphoma, T-Cell Clinical Trial
Official title:
Phase 1B Study of the PI3K Inhibitor Copanlisib in Combination With Romidepsin in the Treatment of Patients With Relapsed or Refractory Mature T-cell Lymphoma
This is an open label, Phase IB dose-escalation study of the PI3K inhibitor copanlisib in
combination with romidepsin in patients with relapsed or refractory (R/R) non-Hodgkin
lymphoma (NHL) or Hodgkin lymphoma (HL).
The primary objective of the phase I study is to determine the maximum tolerated dose (MTD),
recommended phase 2 dose (RP2D), and dose limiting toxicities (DLTs) of the combination of
copanlisib and romidepsin in patients with R/R, NHL or HL.
The non-Hodgkin lymphomas (NHL) represent 4-5% of all new cancer cases, and is the seventh
leading cause of cancer death. In 2015, there were an estimated 71,850 cases in the United
States, and approximately 19,790 deaths. An evaluation of the distribution of NHL sub-types
was performed on 114,548 cases of lymphoid neoplasms diagnosed between 1992-2001 and reported
to the Surveillance Epidemiology and End Results (SEER) registry. Of all NHL, 87,666 were
B-cell lymphoid neoplasms, and 6,228 were considered T/Natural Killer (NK) cell neoplasms.
The peripheral T-cell lymphomas (PTCL) are a heterogeneous group of aggressive lymphoid
neoplasms and account for 10-15% of all newly diagnosed cases of NHL. The current prevalence
of PTCL in the United States is estimated to be approximately 9,500 patients. PTCL-Not
Otherwise Specified (NOS), a nodal subtype, is the most common T-cell lymphoma in the United
States and Europe. PTCL is associated with a significantly worse prognosis compared to its
B-cell counterparts. Treatment options for patients with relapsed/refractory (R/R) PTCL have
been limited. The addition of novel drugs to conventional chemotherapy has largely proven
unsuccessful. Since 2009, new drugs have entered the therapeutic field for patients with R/R
PTCL.
Pralatrexate was the first drug approved for patients with R/R PTCL. Other drugs approved for
patients with R/R PTCL include romidepsin and belinostat. These agents appear to exhibit
lineage-specific activity in PTCL. Over the past few years, the investigators have focused on
exploring rational combinations of these T-cell active agents in an effort to develop novel
treatment platforms. Early clinical studies of these combinations have shown very promising
activity.
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