Cancer Clinical Trial
Official title:
A Phase 1, Open-label Study of SNX‑5422 and Ibrutinib in Chronic Lymphocytic Leukemia Subjects With a Mutation in Bruton's Tyrosine Kinase
SNX-5422 is a prodrug of SNX-2112, a potent, highly selective, small molecule inhibitor of the molecular chaperone heat shock protein 90 (HSP90). Hsp90 inhibitors may overcome ibrutinib resistance in Mantle cell lymphomas and this study will investigate whether the addition of SNX-5422 to an established dose of ibrutinib will result in the removal of mutated BTK from blood mononuclear cells and/or prevents or delays disease progression of subjects with CLL
Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in adults and is not
considered curable outside of allogeneic stem cell transplantation.
BTK is a critical kinase in the B cell receptor signaling pathway. This pathway is amplified
in CLL and results in amplification of proliferation and anti-apoptotic signals. By
inhibiting BTK, ibrutinib eliminates the activation of these pro-survival pathways and
microenvironment survival signals. While response to ibrutinib has been high with therapy
well-tolerated overall, some patients have relapsed while others have been taken off therapy
for toxicity or other reasons. Relapse in CLL can be mediated by at least two separate
mechanisms. One is by mutations in BTK, which both decrease ibrutinib's affinity for BTK, and
also changes the binding from irreversible to reversible. This is a proof of concept study to
investigate whether the addition of SNX-5422 to an established dose of ibrutinib will reduce
mutated BTK from CLL cells and/or prevents or delays disease progression of subjects with
CLL.
This is an open-label study of SNX‑5422 combined with ibrutinib. In each 28 day cycle,
SNX‑5422 will be dosed in the morning once every other day for 21 days, followed by a 7‑day
drug‑free period. Subjects will continue to receive daily oral ibrutinib at their established
dose level in the afternoon every day for 28 days. cycle
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