NCT02532192

Brief Summary

The goal of this clinical research study is to find the highest tolerable dose of belinostat that can be combined with standard chemotherapy drugs (rituximab, cisplatin, cytarabine, and dexamethasone) in patients with relapsed or refractory DLBCL who are eligible for an autologous stem cell transplant (a transplant of the patient's own stem cells). The safety of the study drug will also be studied.

Trial Health

10
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Status
withdrawn

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Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 21, 2015

Completed
4 days until next milestone

First Posted

Study publicly available on registry

August 25, 2015

Completed
3 months until next milestone

Study Start

First participant enrolled

December 1, 2015

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2019

Completed
Last Updated

January 6, 2016

Status Verified

January 1, 2016

Enrollment Period

4 years

First QC Date

August 21, 2015

Last Update Submit

January 5, 2016

Conditions

Keywords

LymphomaDiffuse large B-cell lymphomaDLBCLRelapsedRefractoryBelinostatRituximabRituxanCisplatinPlatinol-AQPlatinolCDDPCytarabineAra-CCytosarDepoCytCytosine arabinosine hydrochlorideDexamethasoneDecadronCiprofloxacinCiprofloxacin hydrochlorideCiproFluconazoleDiflucan

Outcome Measures

Primary Outcomes (1)

  • Maximum Tolerated Dose (MTD) of Belinostat with RDHAP Chemotherapy in Participants with Relapsed or Refractory Diffuse Large B-cell Lymphoma (DLBCL)

    MTD defined as the highest dose level in which 6 patients have been treated with less than 2 instances of dose limiting toxicity (DLT). DLT defined as an adverse event at least possibly related to study treatment: 1. Any grade 3 or higher non-hematological toxicity possibly related to study medications per National Cancer Institute Common Terminology Criteria for Adverse Events v4.0, with exclusion of grade 3 diarrhea lasting less than 48 hours, grade 3 nausea and/or vomiting lasting less than 48 hours, grade 3 electrolyte abnormalities lasting less than 48 hours, grade 3 creatinine elevation lasting less than 48 hours 2. Any non-hematological toxicity requiring a delay of next cycle of therapy for greater than 14 days; 3. Grade 4 neutropenia which persists for 14 or greater days despite growth factor support. 4. Neutropenic fever incidence closely monitored, but will not be considered a DLT due to known high rate of neutropenic fever with dose adjusted RDHAP (20 - 30%).

    21 days

Secondary Outcomes (1)

  • Overall response Rate (ORR)

    1 year

Study Arms (1)

Belinostat + RDHAP Chemotherapy

EXPERIMENTAL

Belinostat administered by vein on Days 1 - 2 of a 21-day cycle. Rituximab administered by vein on Day 2. Cisplatinum administered by vein on Day 2. Cytarabine administered by vein on Day 3 during the initial cohorts, and on Day 2 in the cohort of modified DHAP scheduling. Ciprofloxacin 500 mg twice daily for 10 days and Fluconazole 100 mg daily for 10 days may be utilized at the discretion of the treating physician.

Drug: BelinostatDrug: RituximabDrug: CisplatinDrug: CytarabineDrug: DexamethasoneDrug: CiprofloxacinDrug: Fluconazole

Interventions

Dose Escalation Phase Starting Dose: 200 mg/m2/d by vein on Days 1 and 2 of a 21 day cycle. Dose Expansion Starting Dose: Maximum tolerated dose from Dose Escalation Phase.

Belinostat + RDHAP Chemotherapy

Dose Escalation and Dose Expansion Phases: 375 mg/m2 by vein on Day 2 of a 21 day cycle.

Also known as: Rituxan
Belinostat + RDHAP Chemotherapy

Dose Escalation and Dose Expansion Phases: 100 mg/m2 by vein on Day 2 of a 21 day cycle

Also known as: Platinol-AQ, Platinol, CDDP
Belinostat + RDHAP Chemotherapy

Dose Escalation Phase: 2 g/m2 by vein on Day 3 of a 21 day cycle. Two doses given every 12 hours. Dose Expansion Phase: 2g/m2 by vein on Day 2 of a 21 day cycle. Two doses given every 12 hours.

Also known as: Ara-C, Cytosar, DepoCyt, Cytosine Arabinosine Hydrochloride
Belinostat + RDHAP Chemotherapy

Dose Escalation and Dose Expansion Phases: 40 mg by mouth on Days 2 - 5 of a 21 day cycle.

Also known as: Decadron
Belinostat + RDHAP Chemotherapy

500 mg by mouth twice daily for 10 days.

Also known as: Ciprofloxacin hydrochloride, Cipro
Belinostat + RDHAP Chemotherapy

100 mg by mouth daily for 10 days.

Also known as: Diflucan
Belinostat + RDHAP Chemotherapy

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Aggressive B-cell lymphoma, including DLBCL and FL or other indolent or low grade malignancy transforming to DLBCL, Grade III FL, Burkitt lymphoma, and unclassifiable B-cell lymphoma with features of Burkitt and DLBCL according to the World Health Organization, with biopsy confirmation of disease which has relapsed after or refractory to a standard cytotoxic chemotherapy combination including rituximab and doxorubicin, for whom an autologous stem cell transplant is planned.
  • Have received between 1 - 2 prior cytotoxic treatments, not to include belinostat, RDHAP, or autologous or allogeneic stem cell transplant. Radiation which was pre-planned to occur at the conclusion of systemic cytotoxic therapy will not be considered a separate prior therapy. Radiation administered for potential recurrent or relapsed disease will be considered a separate prior therapy.
  • Patient or durable power of attorney (DPA) for healthcare must be able to understand and voluntarily sign an IRB-approved informed consent form.
  • Age 18-80 years at the time of signing the informed consent.
  • Patients must have bi-dimensional measurable disease.
  • Patients with performance status of \</=3 (Eastern Cooperative Oncology Group Performance Status Scale, 3 only allowed if decline in status is deemed related to lymphoma and felt potentially reversible by the treating physician).
  • Within 4 weeks of therapy start, serum bilirubin \<1.5x ULN (maximum level based on MD Anderson laboratory ranges is 1.95 mg/dL); AST (SGOT) and ALT (SGPT) \</=3x ULN or \< 5x ULN if hepatic metastases are present; ANC \>1000/mm\^3 and platelets \>100,000/mm\^3 unless deemed likely related to lymphoma involvement in the bone marrow where the minimum ANC allowable will be 500/mm\^3 and minimum allowable platelet count will be 50,000/mm\^3.
  • Within 4 weeks of therapy start, renal function assessed by calculated creatinine clearance \>/= 50ml/min by Cockcroft-Gault formula using actual body weight.
  • Patients must be willing to receive transfusions of blood products.
  • Within 4 weeks of therapy start, women of childbearing potential must have a negative serum (Beta-human chorionic gonadotropin \[Beta-hCG\]) or urine pregnancy test at screening and must adhere to the scheduled pregnancy testing.
  • Women of childbearing potential and men who are sexually active with a woman of childbearing potential must be practicing a highly effective method of birth control during and after the study (12 months for women and 3 months for men), consistent with local regulations regarding the use of birth control methods for subjects participating in this clinical study.

You may not qualify if:

  • Any serious medical condition including but not limited to uncontrolled hypertension, uncontrolled diabetes mellitus, active/symptomatic coronary artery disease, COPD, left ventricular ejection fraction of less than 40, active infection, active hemorrhage, or psychiatric illness that, in the investigators opinion places the patient at unacceptable risk and would prevent the subject from signing the informed consent form. Patients with history of cardiac arrhythmias should have cardiac evaluation and clearance.
  • Pregnant or lactating females.
  • Known hypersensitivity to any component of RDHAP.
  • Patients with Gilbert's syndrome unless homozygosity for the UFT1A1\*28 mutation has been excluded.
  • HIV infection, active hepatitis B infection, active hepatitis C infection.
  • Known homozygous for UGT1A1\*28 mutation from prior testing or family history.
  • Requirement of therapy with a UGT1A1 Inhibitor, as detailed in Section 8.4, or use within 7 days of enrollment on this protocol.
  • All patients with active central nervous system involvement with lymphoma.
  • Diagnosis of prior malignancy within the past 2 years with the exception of successfully treated basal cell carcinoma, squamous cell carcinoma of the skin, carcinoma "in situ" of the cervix or breast. History of other malignancies are allowed if in remission (including prostate cancer patients in remission from radiation therapy, surgery or brachytherapy), not actively being treated, with a life expectancy \> 3 years.
  • Significant neuropathy (Grades 3 - 4, or Grade 2 with pain) within 14 days prior to enrollment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Links

MeSH Terms

Conditions

LymphomaLymphoma, Large B-Cell, DiffuseRecurrence

Interventions

belinostatRituximabCisplatinCytarabineDexamethasoneCalcium DobesilateCiprofloxacinFluconazole

Condition Hierarchy (Ancestors)

Neoplasms by Histologic TypeNeoplasmsLymphoproliferative DisordersLymphatic DiseasesHemic and Lymphatic DiseasesImmunoproliferative DisordersImmune System DiseasesLymphoma, B-CellLymphoma, Non-HodgkinDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Murine-DerivedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulinsChlorine CompoundsInorganic ChemicalsNitrogen CompoundsPlatinum CompoundsCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsArabinonucleosidesNucleosidesNucleic Acids, Nucleotides, and NucleosidesPregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsSteroids, FluorinatedBenzenesulfonatesBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsArylsulfonatesArylsulfonic AcidsSulfonic AcidsSulfur AcidsSulfur CompoundsFluoroquinolones4-QuinolonesQuinolonesQuinolinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingTriazolesAzoles

Study Officials

  • Jason R. Westin, MD

    M.D. Anderson Cancer Center

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 21, 2015

First Posted

August 25, 2015

Study Start

December 1, 2015

Primary Completion

December 1, 2019

Last Updated

January 6, 2016

Record last verified: 2016-01