Nivolumab and Dasatinib in Treating Patients With Relapsed or Refractory Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia

Recurrent Adult Acute Lymphoblastic Leukemia Clinical Trial

Official title: Phase Ib Study of Nivolumab and Dasatinib in Patients With Relapsed/Refractory Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)

Status Terminated

Clinical Trial Summary

The purpose of this research study is to determine the acceptable upper limit dose of nivolumab in combination with dasatinib that may be given to patients with relapsed/refractory philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Nivolumab is currently Food and Drug Administration (FDA) approved for other cancers, but has not yet been investigated in Ph+ ALL. Dasatinib is currently FDA approved for the treatment of Ph+ ALL, but has not yet been investigated in combination with nivolumab for this disease. There is evidence that dasatinib not only blocks the Philadelphia chromosome or breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 (BCR-ABL) mutation, but also increases the activity of cells in your immune system. Nivolumab increases T cells in your immune system, which allows your immune system to attack the cancer. We think the combination of these drugs will be more effective against your leukemia than either drug used alone.

Clinical Trial Description

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose (MTD) of nivolumab when given in combination with dasatinib in patients with relapsed/refractory Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL).

SECONDARY OBJECTIVES:

I. To evaluate the toxicities and safety profile of nivolumab and dasatinib in patients with relapsed/refractory Ph+ ALL.

II. To determine the rate of complete hematologic remission (CR) after three cycles of nivolumab and dasatinib.

III. To determine the rate of molecular remission after three cycles of nivolumab and dasatinib.

IV. To study the pharmacokinetics of nivolumab and dasatinib. V. To evaluate programmed cell death 1 (PD1) expression levels and saturation in the peripheral blood and bone marrow.

VI. To measure peripheral T-cell levels and activation in response to treatment.

TERTIARY OBJECTIVES:

I. To evaluate the 30 day mortality rate, overall survival (OS), progression free survival (PFS), and duration of remission (DOR) one year after treatment with nivolumab when given in combination with dasatinib in patients with relapsed/refractory Ph+ ALL.

II. To compare the OS between patients who receive a hematopoietic stem cell transplant and those who receive no further therapy following remission.

III. To evaluate for resistance mutations at the time of disease progression.

OUTLINE:

Patients receive dasatinib orally (PO) once daily (QD ) on days 1-28 and nivolumab intravenously (IV) over 30 minutes on days 8 and 22 of course 1 and on days 1 and 15 of subsequent courses. Courses repeat every 28 days in the absence of disease progression, unacceptable toxicity, or withdrawal from the study for other reasons.

After completion of study treatment, patients are followed up at 30 days and then monthly for up to 1 year. ;

Related Conditions & MeSH terms

• B Acute Lymphoblastic Leukemia With t(9;22)(q34;q11.2); BCR-ABL1
• Leukemia
• Leukemia, Lymphoid
• Philadelphia Chromosome
• Precursor Cell Lymphoblastic Leukemia-Lymphoma
• Recurrent Adult Acute Lymphoblastic Leukemia
• Recurrent Childhood Acute Lymphoblastic Leukemia
• Refractory Adult Acute Lymphoblastic Leukemia
• Refractory Childhood Acute Lymphoblastic Leukemia

• NCT number: NCT02819804
• Study type: Interventional
• Source: Northwestern University
• Status: Terminated
• Phase: Phase 1
• Start date: August 17, 2017
• Completion date: August 30, 2018