Clinical Trial 18-443: Patients with Burkitt Lymphoma/Leukemia or High-Grade B-cell Lymphoma
Trial ID: 18-443 | NCT03793140
A Phase II Clinical Trial of CPI-613 in Patients with Relapsed or Refractory Burkitt Lymphoma/Leukemia or high-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6
- Age Range
Key Eligibility Criteria
- Must be ≥ 18 years of age.
- Histologic diagnosis of Burkitt Lymphoma/Leukemia or high-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6 confirmed at enrolling institution
- Failure of at least one previous line of therapy.
- Failure after prior bone marrow transplant, or ineligible for or opted not to participate in bone marrow transplantation for Burkitt Lymphoma/Leukemia, or DHL/THL.
- ECOG Performance Status of ≤ 3.
- Measurable disease as defined RECIL criteria (2017) or isolated bone marrow involvement.
- Patients must have fully recovered from the acute, non-hematological, non-infectious toxicities of any prior treatment with anti-cancer drugs, radiotherapy or other anti-cancer modalities. Patients with persistent, non-hematologic, non-infectious toxicities from prior treatment must have documented resolution to ≤ Grade 2.
- Central venous access available (e.g., portacath, PICC line or equivalent).
- Laboratory values obtained ≤ 2 weeks prior to enrollment must demonstrate adequate hepatic function, renal function, and coagulation as defined below:
Aspartate aminotransferase (AST/SGOT) ≤ 5x upper normal limit (ULN)
Alanine aminotransferase (ALT/SGPT) ≤ 5x ULN
Total bilirubin ≤1.5x ULN (unless related to hemolysis or Gilbert‘s syndrome)
Creatinine clearance >=40cc min either by 24-hour creatinine clearance or calculated from the modified Cockcroft-Gault equation (with the use of ideal body mass [IBM] instead of mass): CRCL =(140−Age) × IBM (kg) × [0.85 if female]/[(72 • serum creatinine (mg/dL)]
International Normalized Ratio (INR) must be <1.5. Due to the occurrence of thrombocytopenia, patients should not enter with coagulopathy. Patients on anticoagulants should be on short-acting therapy (e.g. low molecular weight heparin) rather than oral anticoagulants.
Albumin ≥2.0 g/dL (or ≥20 g/L)
- Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must use accepted contraceptive methods (abstinence, intrauterine device [IUD], oral contraceptive or double barrier device) during the study and must have a negative serum or urine pregnancy test within 2 weeks prior to treatment initiation.
- Females must agree to abstain from breastfeeding during study participation
- Fertile men must practice effective contraceptive methods during the study unless documentation of infertility exists.
- Patients must have, or be willing and eligible to undergo placement of, a working central venous access device.
- Patients that have received a chemotherapy regimen with stem cell support in the previous 3 months.
- Any medical condition that is clinically unstable despite present therapy (i.e. uncontrolled infection).
- Platelets < 50,000/mm3 unless attributable to marrow based (either Burkitt lymphoma or DHL/THL.) Note: Patients with leukemia/lymphoma in the marrow 25,000-50,000 will be assessed for grade 4 thrombocytopenia unless they have platelet recovery above grade 3. Patients entering with platelets <25,000 will only be assessed for thrombocytopenia related to drug if they recover to grade 3 or higher.
- Serious medical illness, such as significant cardiac disease (e.g. symptomatic congestive heart failure, unstable angina pectoris, coronary artery disease, myocardial infarction within the past 3 months, uncontrolled cardiac arrhythmia, pericardial disease or New York Heart Association Class III or IV), or severe debilitating pulmonary disease, that would potentially increase patient‘s risk for toxicity.
- Patients with active central nervous system (CNS) parenchymal disease. Patients with leptomeningeal disease are allowed as long as the CSF has cleared for more than 4 weeks and the patient is receiving maintenance intrathecal/intra Ommaya therapy.
- Any active uncontrolled bleeding or bleeding diathesis (e.g., active peptic ulcer disease).
- Any condition or abnormality which may, in the opinion of the investigator, compromise his or her safety.
- Life expectancy less than 2 months.
- Requirement for immediate palliative treatment of any kind including surgery.
- HIV patients with any of the following: a) uncontrolled HIV infection defined as an HIV viral load > 100K copies/mL, b) a documented opportunistic infection within the last 90 days, c) concurrent HIV therapy with zidovudine or any strong CYP3A4 inhibitor (e.g. ritonavir or cobicistat) within 7 days of study drug due to potential drug-drug interaction.
- Patients who have received radiotherapy, surgery, treatment with cytotoxic agents, treatment with biologic agents, immunotherapy, or any other anti-cancer therapy for any kind for cancer, or any other investigational agent for any indication, within the past 2 weeks prior to initiation of CPI-613 treatment.
- Psychiatric illness or social situation that would limit the patient’s ability to tolerate and/or comply with study requirements.
- Prior allogeneic stem cell transplant within 2 months of study start
- Patients with active graft-versus-host-disease are not eligible
- Patients receiving immunosuppressive therapy for prevention of graft-versus-host disease are not eligible