Phase 2 Study With PQR309 in Relapsed or Refractory Lymphoma Patients

Lymphoma Clinical Trial

Official title:

Open-Label, Non-Randomized Phase 2 Study With Safety Run-in Evaluating Efficacy and Safety of PQR309 in Patients With Relapsed or Refractory Lymphoma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03127020
• Other study ID #: PQR309-002A
• Status: Completed
• Phase: Phase 2
• Start date: June 2016

Study information

• Verified date: June 2019
• Source: PIQUR Therapeutics AG
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The main goal of this study is to determine the Maximum Tolerated Dose (MTD) and the Recommended Phase II Dose (RP2D) as well as preliminary antitumor activity of PQR309 administered orally, as once daily capsules continuously and on intermittent schedule, in patients with relapsed or refractory lymphomas.

Description:

Open-label, non-randomized, multicentre phase 2 study with a safety run-in evaluating efficacy and safety of PQR309 in patients with relapsed or refractory lymphoma.

The maximum tolerated dose (MTD) of PQR309 in patients with advanced solid tumours was defined as 80 mg once daily given continuously (q.d. schedule) in a previous phase 1 study [8]. The safety run-in of this study will follow a modified 3 + 3 design to evaluate the safety of 60 and 80 mg PQR309 in patients with relapsed or refractory lymphoma administered p.o. once daily during a DLT (dose-limiting toxicity) period of 28 days.

In the safety run-in, three patients will be treated at 60 mg PQR309 for 28 days. Enrollment and treatment of all three patients may occur simultaneously as 80 mg PQR309 p.o. qd was established as the MTD maximum tolerated dose in solid tumours. Unless a DLT (dose-limiting toxicity) is observed in any of the three patients during the first 28 days of treatment, the investigators and the sponsor will decide to escalate the dose to 80 mg.Intermittent dosing schedules may be evaluated if, based on the overall evaluation of all the clinical and PK (pharmacokinetic) data from this and other studies with PQR309, data emerge during the step 1 of the phase 2 expansion in this PQR309 002A study, indicating that daily dosing of PQR309 is not adequately tolerated or inefficacious.

Intermittent dosing schedules may be evaluated if, based on the overall evaluation of all the clinical and PK (pharmacokinetic) data from this and other studies with PQR309, data emerge during the step 1 of the phase 2 expansion in this PQR309 002A study, indicating that daily dosing of PQR309 is not adequately tolerated or inefficacious.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 9
• Est. primary completion date: March 21, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria

1. Histologically confirmed diagnosis* of relapsed or refractory lymphoma, received at least two prior lines of therapy regardless of transformation status. Patients with relapsed chronic lymphoid leukemia (CLL) are eligible if they have received one or more prior lines of any approved standard therapy * archival biopsies may be used if obtained up to a year prior to enrollment; re-biopsy is strongly recommended if last biopsy was obtained more than a year ago.

2. Only for patients in the Phase 2 part: At least one measurable nodal or extra-nodal lesion defined as follows: Clearly measurable (i.e. well-defined boundaries) in at least two perpendicular dimensions on imaging scan with > 1.5 cm in longest transverse diameter.

3. Age = 18 years

4. Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 (See Appendix 2).

5. Adequate organ system functions defined as:

1. Absolute neutrophil count (ANC) =1.0x109/l

2. Platelets = 75x109/l

3. Haemoglobin = 85g/L

4. Adequate hepatic function, defined as total bilirubin = 1.5 times the upper limit of normal (ULN) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 2.5 times ULN

5. Adequate renal function, defined as serum creatinine = 1.5 times ULN

6. Fasting glucose < 7.0 mmol/L

6. Ability and willingness to swallow and retain oral medication.

7. Willingness and ability to comply with the trial procedures

8. Female and male patients with reproductive potential must agree to use effective contraception from screening until 90 days after discontinuation of PQR309

9. Signed informed consent1.5 cm in longest transverse diameter.

3. Age >18 years 4. Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-1 5. Adequate organ system functions defined as:

1. Absolute neutrophil count (ANC) >1.0x109/l

2. Platelets > 75x109/l

Exclusion Criteria:

Any of the following conditions precludes enrollment of a patient:

1. Immunosuppression due to:

• Allogeneic hematopoietic stem cell transplant (HSCT)

• Any immune-suppressive therapy within 4 weeks prior to trial treatment start

2. Autologous stem cell transplant within 3 months prior to trial treatment start.

3. Concomitant anticancer therapy (e.g. chemotherapy, radiotherapy, hormonal therapy, immunotherapy, biological response modifier, signal transduction inhibitors and steroids (steroids as maintenance for adrenal insufficiency are allowed)).

4. Concomitant treatment with medicinal products that increase the pH (reduce acidity) of the upper gastrointestinal tract, including, but not limited to, proton-pump inhibitors (e.g. omeprazole), H2-antagonists (e.g. ranitidine) and antacids. Patients may be enrolled in the study after a wash-out period sufficient to terminate their effect (section 11.1.3.7).

5. Use of any investigational drug within 21 days prior to trial treatment start.

6. Patients who experienced National Cancer Institute (NCI) Common Terminology Criteria For Adverse Events (CTCAE) grade 4 on PI3K/mTOR inhibitors

7. Any major surgery, chemotherapy or immunotherapy within 21 days prior to trial treatment start.

8. Symptomatic or progressing central nervous system (CNS) involvement. Exception:

Patients with meningeal involvement can be included upon discussion between the sponsor and the investigator.

9. Persisting toxicities NCI CTCAE =2 related to prior anticancer therapy

10. Presence of gastrointestinal disease or any other condition that could interfere significantly with the absorption of the study drug.

11. Severe/unstable angina, myocardial infarction or coronary artery bypass within the last 3 years prior to trial treatment start, symptomatic congestive heart failure New York Heart Association (NYHA) Class 3 or 4, hypertension BP>150/100mmHg

12. A serious active infection (e.g. chronic active hepatitis) at the time of treatment, or another serious underlying medical condition that could impair the ability of the patient to receive treatment.

13. Lack of appropriate contraceptive measures (male and female)

14. Pregnant or lactating women

15. Known HIV infection

16. Significant medical conditions which could jeopardize compliance with the protocol.

17. Uncontrolled diabetes mellitus; patients with controlled diabetes may be enrolled (see fasting glucose levels in inclusion criteria).

Related Conditions & MeSH terms

• Lymphoma
• Lymphoma, Non-Hodgkin
• Non-Hodgkin Lymphoma

Intervention

Drug:
• PQR309
taken continuously on daily basis (60mg, 80mg) or intermittent dosing (120mg, 140mg, 160mg)

Locations

Country	Name	City	State
Germany	Medizinische Klinik und Poliklinik III	Munich	Bavaria

Sponsors (6)

Lead Sponsor	Collaborator
PIQUR Therapeutics AG	Charite University, Berlin, Germany, University Hospital Freiburg, University Hospital Munich, University Hospital, Basel, Switzerland, University of Stuttgart

Country where clinical trial is conducted

Germany, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Change in insulin/ c-Peptide/ glucose	Continuous and intermittent dosing	During treatment on Day 1, 2, 8,15,22 and 50
Primary	Assessment of Change of Tumor Response Criteria in lymphoma patients During Treatment with PQR309 in patients with relapsed or refractory lymphoma according to Cheston Criteria (5)	Radiological lymphoma Evaluation (CT or other indicated according to institutional Standard practice), clinical examination and bone marrow biopsy	28 days prior to first treatment (baseline), during study treatment every 8 weeks during first 6 months and every 6 months afterwards up to 48 months
Secondary	Incidence of serious adverse events (SAEs), incidence and severity of all adverse events (AEs)	Continuous and intermittent dosing	During treatment on Day 1, 2, 8, 15, 22, 36 and 50; at the endof treatment and 30 days after last dose.
Secondary	Change in pulse rate	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in blood pressure	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in body temperature	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in ECOG (Eastern Cooperative Oncology Group) Performance Status	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1,8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in bodyweight/kg	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1,2, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in haematology	Continuous and intermittent dosing	Before treatment on Day 1,2 and after treatment started on Day 1, 8, 15, 22, 36, 50 and subsequently every 4 weeks , at the end of treatment and 30 days after last treatment
Secondary	Change in blood chemistry	Continuous and intermittent dosing	Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Secondary	Change in haemostasis	Continuous and intermittent dosing	Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Secondary	Change in ECG (electrocardiogram)	Continuous and intermittent dosing	Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Secondary	Change in urine analysis	Continuous and intermittent dosing	Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Secondary	Change in HbA1c	Continuous and intermittent dosing	Before treatment on Day 1and after treatment started on Day 1, 22, 50 and subsequently every 4 weeks and at the end of treatment
Secondary	Change in Cmax	Continuous and intermittent dosing	During treatment on Day1, 2,8, 15,22 and 50
Secondary	Change in tmax	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50
Secondary	Change in AUC0-24 •	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50
Secondary	Change in AUClast,	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50
Secondary	Change in AUC0-8,	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50
Secondary	Change in t1/2 •	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50
Secondary	Change in RAC •	Continuous and intermittent dosing	During treatment on Day1, 2, 8, 15,22 and 50