Phase I Study of Obatoclax Mesylate (GX15-070MS) in Combination With Fludarabine and Rituximab in Previously Treated Patients With B-cell Chronic Lymphocytic Leukemia (B-CLL)
PRIMARY OBJECTIVE:
I. To determine the maximum tolerated dose of obatoclax mesylate in combination with
fludarabine phosphate-rituximab (FR) in patients with relapsed chronic lymphocytic leukemia.
SECONDARY OBJECTIVES:
I. To evaluate toxicity of obatoclax mesylate in combination with FR in this patient
population.
II. To determine objective response rate and progression-free survival of obatoclax mesylate
in combination with FR.
III. To correlate levels of anti-apoptotic Bcl-2 family members with drug response.
IV. To determine whether apoptosis is induced via the mitochondrial pathway in response to
obatoclax mesylate and further enhanced by FR.
OUTLINE: This is a dose-escalation study of obatoclax mesylate.
Patients receive obatoclax mesylate IV over 3 hours on days 1 and 3, fludarabine IV over
20-30 minutes on days 1-5, and rituximab IV over 4 hours on day 1 (days 1 and 3 of course 1
only). Treatment repeats every 28 days for up to 6 courses in the absence of disease
progression or unacceptable toxicity.
Patients undergo peripheral blood collection for correlative studies. Samples are analyzed
for expression of pro- and anti-apoptotic Bcl-2 family members by western blot; apoptosis
induction by measurement of lymphocyte count, Annexin V staining, and Caspase and PARP
cleavage; activated Bax by immunoprecipitation; and Bax promoter polymorphism by PCR
amplification and direct sequencing.
After completion of study therapy, patients are followed every 6 months.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose of obatoclax mesylate
DLT will be defined as any non-hematologic toxicity of grade 3 or greater severity (excluding asymptomatic grade 3 laboratory abnormalities that are not life-threatening and respond to treatment; grade 3 fatigue; grade 3 nausea, vomiting or diarrhea occurring without optimal prophylaxis; or expected grade 3 rituximab infusion reactions). Any grade 4 non-hematological toxicity, as well as any irreversible grade 2 cardiac, renal or neurologic toxicities, will be considered dose-limiting. Grading of non-hematologic toxicities will be according to NCI CTC version 3.0.
28 days
Yes
Jennifer Brown
Principal Investigator
Dana-Farber Cancer Institute
United States: Food and Drug Administration
NCI-2009-00254
NCT00612612
January 2008
Name | Location |
---|---|
Dana-Farber Cancer Institute | Boston, Massachusetts 02115 |