NCT03884972

Brief Summary

This phase I/Ib trial studies the best dose and side effects of trabectedin and venetoclax in treating patients with chronic lymphocytic leukemia or small lymphocytic lymphoma that is resistant or intolerant to a BTK inhibitor. Drugs used in chemotherapy, such as trabectedin and venetoclax, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Trial Health

30
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Timeline
Completed

Started Jun 2019

Geographic Reach
1 country

1 active site

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 19, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 21, 2019

Completed
3 months until next milestone

Study Start

First participant enrolled

June 18, 2019

Completed
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 4, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 4, 2020

Completed
Last Updated

September 25, 2023

Status Verified

September 1, 2023

Enrollment Period

9 months

First QC Date

March 19, 2019

Last Update Submit

September 21, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • Dose and schedule of trabectedin in combination with venetoclax

    Up to 6 months post-treatment

Secondary Outcomes (4)

  • Best response

    Up to 6 months post-treatment

  • Progression free survival

    From treatment initiation to disease progression or death, assessed up to 6 months post-treatment

  • Overall survival

    From treatment initiation to death due to any cause, assessed up to 6 months post-treatment

  • Frequency of myeloid cells and of other immune cells

    Baseline up to 6 months post-treatment

Study Arms (2)

Cohort I (BTK-refractory)

EXPERIMENTAL

Patients receive venetoclax PO QD beginning on day 1 for 5 weeks (cycle 1). Beginning in cycle 2, patients receive venetoclax PO QD and trabectedin IV over 3 hours on day 1. Cycles 2+ repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

Drug: TrabectedinDrug: Venetoclax

Cohort II (BTK-intolerant)

EXPERIMENTAL

Patients receive trabectedin IV over 3 hours on day 1 of a 3-week cycle (cycle 1), then receive venetoclax PO QD beginning on day 1 of a 5-week cycle (cycle 2). Beginning in cycle 3, patients receive trabectedin IV over 3 hours on day 1 and venetoclax PO QD every 3 weeks in the absence of disease progression or unacceptable toxicity.

Drug: TrabectedinDrug: Venetoclax

Interventions

Given IV

Also known as: Ecteinascidin, ecteinascidin 743, ET-743, Yondelis
Cohort I (BTK-refractory)Cohort II (BTK-intolerant)

Given PO

Also known as: ABT-0199, ABT-199, ABT199, GDC-0199, RG7601, Venclexta
Cohort I (BTK-refractory)Cohort II (BTK-intolerant)

Eligibility Criteria

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

You may qualify if:

  • Patients with a diagnosis of CLL/SLL who are progressing (based on 2018 International Workshop on Chronic Lymphocytic Leukemia \[iwCLL\] criteria) on or intolerant to a BTK inhibitor (BTK-inhibitor-intolerant is defined as unable to maintain on a stable and continuous dose of at least ibrutinib 140 mg/day \[or acalabrutinib 100 mg/day\] for at least 2 weeks due to recurrent treatment-related grade 2 or higher non-hematologic toxicity by Common Terminology Criteria for Adverse Events \[CTCAE\] grading)
  • Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
  • Total bilirubin =\< 1.0 x upper limit of normal (ULN) or =\< 3 x ULN for patients with Gilbert's disease
  • Creatinine clearance \> 50 mL/min (calculated according to institutional standards or using Cockcroft-Gault formula)
  • Alanine aminotransferase (ALT), aspartate aminotransferase (AST) =\< 2.5 x ULN
  • Alkaline phosphatase (ALP) =\< 2.5 x ULN
  • Platelet (PLT) count \>= 50,000/l, with no platelet transfusion in 2 weeks prior to registration, unless cytopenia is due to bone marrow involvement with CLL, in which case PLT count \> 30,000/l, with no PLT transfusion in 2 weeks prior to registration
  • Absolute neutrophil count (ANC) \>= 1000/l, unless cytopenia is due to bone marrow involvement with CLL, in which case ANC \> 500/l
  • Creatine phosphokinase (CPK) \< 2.5 x ULN
  • Left ventricular ejection fraction (LVEF) assessed by multi-gated acquisition scan (MUGA) or echocardiogram within limits of normal range
  • Women of childbearing potential must agree to use an effective contraception method during the study and for 60 days following the last dose of study drug. Women of non- childbearing potential are those who are postmenopausal greater than 1 year or who have had a bilateral tubal ligation or hysterectomy. Men who have partners of childbearing potential must agree to use an effective contraceptive method during the study and for 60 days following the last dose of study drug
  • Free of prior malignancies for 2 years with exception of patients diagnosed with basal cell or squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast, who are eligible even if they are currently treated or have been treated and/or diagnosed in the past 2 years prior to study enrollment. If patients have another malignancy that was treated within the last 2 years, such patients may be enrolled, if the likelihood of requiring systemic therapy for this other malignancy within 2 years is less than 20%
  • Patients or their legally authorized representative must provide written informed consent

You may not qualify if:

  • Radiotherapy or chemotherapy within 2 weeks prior to the first dose of the study drugs. Given the quick progression associated with resistance to BTK inhibitors, no limits will be placed to the use of BTK inhibitors for enrollment or initiation of treatment on this trial
  • Uncontrolled active systemic infection (viral, bacterial, and fungal)
  • Active, uncontrolled autoimmune phenomenon (autoimmune hemolytic anemia or immune thrombocytopenia) requiring steroid therapy with \> 20 mg daily of prednisone or equivalent
  • Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 2 months of screening, or any class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification
  • Patient is pregnant or breast-feeding
  • Venetoclax-refractory CLL or prior treatment with trabectedin
  • Malabsorption syndrome or other condition that precludes oral/enteral route of administration
  • Patients who received the following within 7 days prior to first dose of venetoclax: moderate and strong CYP3A inhibitors and inducers, P-glycoprotein inhibitors, or narrow therapeutic index P-glycoprotein substrates AND patients who received the following within 3 days prior to first dose of venetoclax: grapefruit or grapefruit products, Seville oranges and star fruit

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

M D Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

MeSH Terms

Conditions

Leukemia, Lymphocytic, Chronic, B-Cell

Interventions

Trabectedinvenetoclax

Condition Hierarchy (Ancestors)

Leukemia, B-CellLeukemia, LymphoidLeukemiaNeoplasms by Histologic TypeNeoplasmsHematologic DiseasesHemic and Lymphatic DiseasesLymphoproliferative DisordersLymphatic DiseasesImmunoproliferative DisordersImmune System DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

DioxolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsTetrahydroisoquinolinesIsoquinolinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-Ring

Study Officials

  • William G Wierda

    M.D. Anderson Cancer Center

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 19, 2019

First Posted

March 21, 2019

Study Start

June 18, 2019

Primary Completion

March 4, 2020

Study Completion

March 4, 2020

Last Updated

September 25, 2023

Record last verified: 2023-09

Locations