Clinical trial NCT02049515: A Phase 3 Extension Study of Duvelisib and Ofatumumab in Participants With CLL/SLL Previously Enrolled in Study IPI-145-07
Official title: A Study of IPI-145 and Ofatumumab in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Previously Enrolled in Study IPI-145-07 Duvelisib (IPI-145)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Chronic Lymphocytic Leukemia
Small Lymphocytic Lymphoma
Keywords: Phase 3
CLL/SLL
PI3K
Lead sponsor: SecuraBio
Sponsor class: INDUSTRY
First posted: 2014-01-30
Enrollment: 99
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: A Phase 3 (extension) clinical trial to examine the efficacy of IPI-145 (duvelisib) monotherapy or ofatumumab monotherapy in participants with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who experienced disease progression after treatment with IPI-145 or ofatumumab in study IPI-145-07 (NCT02004522).

Detailed description: The study was designed as an open-label, two-arm extension evaluation to enable participants who experienced radiologically confirmed disease progression in study IPI-145-07 to receive the alternative treatment (either IPI-145 or ofatumumab) other than what was received during study IPI-145-07.

Participants who previously had received ofatumumab in study IPI-145-07 received a starting dose of 25 milligrams (mg) IPI-145 twice daily continuously in a 21-day cycle for Cycle 1, followed by 28-day treatment cycles thereafter for up to 11 cycles or until disease progression, discontinuation from study participation, or start of subsequent therapy, whichever occurred first. After completing approximately 11 cycles of treatment with duvelisib, participants who, in the judgment of the investigator, may have derived benefit from continued treatment may have continued to receive additional cycles of duvelisib until disease progression or unacceptable toxicity. However, to receive additional cycles of duvelisib beyond 11 cycles, participants must have had evidence of response and CLL/SLL requiring treatment according to the International Workshop on Chronic Lymphocytic Leukemia (IWCLL)/International Working Group by Cycle 12 Day 1.

Participants who previously received IPI-145 in study IPI-145-07 received treatment consistent approved product labeling which consisted of a starting dose of 300 mg ofatumumab on Day 1, followed by seven weekly doses of 2000 mg. Thereafter, participants received 2000 mg ofatumumab once every month for four months unless disease progression or unacceptable toxicity occurred. Administration of ofatumumab was not to exceed the 12 doses (within 7 cycles).

Eligibility criteria: Inclusion Criteria:

* Received either IPI-145 or ofatumumab while participating in study IPI-145-07 and experienced radiologically confirmed disease progression
* Diagnosis of active CLL or SLL that met at least one of the IWCLL 2008 criteria for requiring treatment
* Measurable disease with a lymph node or tumor mass \>1.5 centimeters in at least one dimension as assessed by computed tomography (CT)
* Eastern Cooperative Oncology Group performance status of 0-2
* Must have met the following laboratory parameters:

  1. Serum aspartate transaminase (AST/SGOT) or alanine transaminase (ALT/SGPT) ≤3 x upper limit of normal (ULN)
  2. Total bilirubin ≤1.5 x ULN
  3. Serum creatinine ≤2.0 x ULN
  4. Hemoglobin ≥8.0 grams/deciliter (g/dL) with or without transfusion support
  5. Platelet count ≥10,000 microliters (μL) with or without transfusion support
* For women of childbearing potential (WCBP): negative serum β-human chorionic gonadotropin pregnancy test within one week before first dose (WCBP defined as a sexually mature woman who had not undergone surgical sterilization or who had not been naturally post-menopausal for at least 24 consecutive months \[women ≤55 years\] or 12 consecutive months \[women \>55 years\])
* Willingness of male and female participants who were not surgically sterile or postmenopausal to use medically acceptable methods of birth control from the first dose of study drug to 30 days after the last dose of duvelisib and for 12 months after last dose of ofatumumab. Sexually active men, and women using oral contraceptive pills, should also have used barrier contraception
* Ability to voluntarily sign consent for and adhere to the entire study visit schedule and all protocol requirements
* Signed and dated institutional review board/independent ethics committee-approved informed consent form before any study-specific screening procedures are performed

Exclusion Criteria:

* Discontinued study participation in Verastem-sponsored IPI-145-07 study
* Greater than 3 months from confirmed progressive disease on Study IPI-145-07
* History of Richter's transformation or prolymphocytic leukemia
* Autoimmune hemolytic anemia or idiopathic thrombocytopenia purpura that was uncontrolled or requires \>20 mg daily of prednisone (or equivalent) to maintain hemoglobin \>8.0 g/dL or platelets \>10,000 μL without transfusion support
* Known central nervous system (CNS) lymphoma or leukemia; participants with symptoms of CNS disease must have had a negative CT scan or negative diagnostic lumbar puncture prior to first dose
* Use of any anticancer medication from documented progressive disease on Study IPI-145-07 to enrollment (Note: corticosteroids to manage CLL/SLL-related symptoms were allowed)
* Ongoing systemic bacterial, fungal, or viral infections at the time of initiation of study treatment (defined as requiring IV antimicrobial, antifungal or antiviral agents) (Participants on antimicrobial, antifungal or antiviral prophylaxis are not specifically excluded if all other inclusion/exclusion criteria are met and there is no evidence of active infection at Screening and/or Cycle 1 Day 1 \[predose\])
* Human immunodeficiency virus infection
* Prior, current, or chronic hepatitis B or hepatitis C infection
* History of alcohol abuse or chronic liver disease (other than metastatic disease to the liver)
* Unable to receive prophylactic treatment for pneumocystis and herpes simplex virus
* Baseline QT interval corrected with Fridericia's method \>480 milliseconds Note: this criterion did not apply to participants with a right or left bundle branch block
* Concurrent active malignancy other than nonmelanoma skin cancer or carcinoma in situ of the cervix, bladder, or prostate not requiring treatment. Participants with previous malignancies were eligible provided that they had been disease-free for ≥2 years
* History of stroke, unstable angina, myocardial infarction, or ventricular arrhythmia requiring medication or mechanical control within the last 6 months
* Unstable or severe uncontrolled medical condition (for example, unstable cardiac function, unstable pulmonary condition), or any important medical illness or abnormal laboratory finding that would, in the investigator's judgment, have increased the participant's risk while participating in this study
* Prior surgery or gastrointestinal dysfunction that may have affected drug absorption (for example, gastric bypass surgery, gastrectomy)
* Participants to receive duvelisib: Administration of medications or foods that were strong inhibitors or inducers of cytochrome P450 3A within 2 weeks of starting duvelisib
* Major surgery or invasive intervention within 4 weeks prior to first dose
* Pregnant or breastfeeding women
* Participants to receive ofatumumab: hypersensitivity to ofatumumab or its excipients.

Primary outcomes:
measure: Overall Response Rate (ORR)
timeFrame: Until progressive disease (PD), death, or other anticancer therapy is initiated (up to 4.5 years)
Secondary outcomes:
measure: Duration of Response (DOR)
timeFrame: From the first documentation of response to the first documentation of PD or death due to any cause (up to 4.5 years)
measure: Progression-free Survival (PFS)
timeFrame: From the first dose of study treatment to the first documentation of PD or death from any cause (up to 4.5 years)
Other outcomes:
Locations:
city: La Jolla
country: United States
state: California
city: Denver
country: United States
state: Colorado
city: Fort Myers
country: United States
state: Florida
city: Saint Petersburg
country: United States
state: Florida
city: Boston
country: United States
state: Massachusetts
city: Boston
country: United States
state: Massachusetts
city: Saint Louis
country: United States
state: Missouri
city: Hackensack
country: United States
state: New Jersey
city: New Brunswick
country: United States
state: New Jersey
city: New York
country: United States
state: New York
city: New York
country: United States
state: New York
city: Cincinnati
country: United States
state: Ohio
city: Nashville
country: United States
state: Tennessee
city: Charlottesville
country: United States
state: Virginia
city: Bedford Park
country: Australia
city: East Melbourne
country: Australia
city: Melbourne
country: Australia
city: Linz
country: Austria
city: Vienna
country: Austria
city: Wels
country: Austria
city: Wien
country: Austria
city: Bruxelles
country: Belgium
city: Bruxelles
country: Belgium
city: Gent
country: Belgium
city: Leuven
country: Belgium
city: Sint-Niklaas
country: Belgium
city: Argenteuil Cedex
country: France
city: Bobigny
country: France
city: Bordeaux
country: France
city: Caen
country: France
city: Clermont Ferrand
country: France
city: La Roche Sur Yon
country: France
city: Limoges Cedex
country: France
city: Nantes
country: France
city: Rennes
country: France
city: Vandœuvre-lès-Nancy
country: France
city: Berlin
country: Germany
city: Leer
country: Germany
city: Ulm
country: Germany
city: Budapest
country: Hungary
city: Budapest
country: Hungary
city: Debrecen
country: Hungary
city: Gyor
country: Hungary
city: Kaposvár
country: Hungary
city: Pecs
country: Hungary
city: Szeged
country: Hungary
city: Catania
country: Italy
city: Lecce
country: Italy
city: Meldola
country: Italy
city: Milano
country: Italy
city: Milano
country: Italy
city: Padova
country: Italy
city: Ravenna
country: Italy
city: Rimini
country: Italy
city: Roma
country: Italy
city: Auckland
country: New Zealand
city: Palmerston North
country: New Zealand
city: Barcelona
country: Spain
city: Barcelona
country: Spain
city: Barcelona
country: Spain
city: Madrid
country: Spain
city: Madrid
country: Spain
city: Pamplona
country: Spain
city: Bournemouth
country: United Kingdom
city: Leeds
country: United Kingdom
city: Manchester
country: United Kingdom
city: Nottingham
country: United Kingdom
city: Oxford
country: United Kingdom
city: Sutton
country: United Kingdom
Study officials:
affiliation: Verastem, Inc.
name: Hagop Youssoufian, MD
role: STUDY_CHAIR
References: