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A Single-Arm Phase II Clinical Trial With the Novel MEK Inhibitor AZD-6244 for the Treatment of MCT-1 Related Relapsed or Refractory Diffuse Large B-Cell Lymphoma


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Recurrent Adult Diffuse Large Cell Lymphoma

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Trial Information

A Single-Arm Phase II Clinical Trial With the Novel MEK Inhibitor AZD-6244 for the Treatment of MCT-1 Related Relapsed or Refractory Diffuse Large B-Cell Lymphoma


PRIMARY OBJECTIVES:

I. To evaluate the overall response rate (combined complete remission [CR] and partial
remission [PR]) of AZD6244 hyd-sulfate anti-MEK (selumetinib) therapy for patients with
relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

SECONDARY OBJECTIVES:

I. To evaluate the safety and tolerability of MEK inhibitor therapy. II. To determine the
progression-free survival, time to treatment failure, duration of response, and overall
survival with AZD6244 hyd-sulfate therapy.

III. To examine biomarkers through down-regulation of pERK and several relevant target
substrates (e.g., MCT-1, MNK, ELK, c-MYC, and HIF-1alpha) in peripheral blood studies.

OUTLINE: This is a multicenter study.

Patients receive selumetinib orally (PO) twice daily on days 1-28. Treatment repeats every
28 days for 8 courses in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample and tumor tissue collection at baseline and at day 15 of
course 1 for biomarker studies.

After completion of study therapy, patients are followed up every 3 months for up to 3
years.


Inclusion Criteria:



- Diagnosis of relapsed or refractory diffuse large B-cell lymphoma (transformed large
cell lymphoma allowed)

- Must have received ≥ 1 and ≤ 6 prior therapeutic regimens

- No patients who are eligible for potentially curative treatment with bone marrow
transplantation, unless patient refuses transplant option

- No active CNS involvement by lymphoma

- ECOG performance status of 0-2

- Life expectancy > 3 months

- ANC ≥ 1,500/mm³

- Platelet count ≥ 100,000/mm³

- Hemoglobin ≥ 8.0 g/dL

- Serum bilirubin < 1.5 times upper limit of normal (ULN)

- AST or ALT < 2.5 times ULN

- Fertile patients must agree to use adequate contraception (hormonal, barrier method
of birth control, or abstinence) prior to study entry, for the duration of study
participation, and for 4 weeks (female) and 16 weeks (male) after completion of
selumetinib

- Negative pregnancy test

- Not pregnant or nursing

- HIV-positive patients allowed provided CD4 count > 400 and have no AIDS-defining
illnesses (other than non-Hodgkin lymphoma)

- No other active infection

- No cardiac conditions, including any of the following:

- Uncontrolled hypertension (blood pressure ≥ 150/95 mm Hg despite optimal
therapy)

- NYHA class II-IV heart failure

- Prior or concurrent cardiomyopathy

- Baseline LVEF ≤ 50%

- Atrial fibrillation with heart rate > 100 bpm

- Unstable ischemic heart disease (myocardial infarction within 6 months prior to
starting treatment, or angina requiring > once weekly nitrates)

- QTc interval > 450 msecs or other factors that increase the risk of QT
prolongation or arrhythmic events (e.g., heart failure, hypokalemia, family
history of long QT interval syndrome)

- No history of a serious medical or psychiatric illness likely to interfere with
participation in this clinical study

- No recent history of refractory nausea and vomiting, chronic gastrointestinal
diseases (e.g., inflammatory bowel disease), or significant bowel resection that
would preclude adequate absorption

- No concurrent vitamin E supplements or multivitamin supplements that provide a total
daily dose in excess of 100% of the recommended daily allowance for vitamin E

- More than 21 days since prior chemotherapy, radiotherapy, immunotherapy, or systemic
biologic anticancer therapy

- Prior autologous stem cell transplantation allowed, but no prior allogeneic stem cell
transplant

- No prior MEK, Ras, or Raf inhibitors

- At least 1 month wash-out interval since another investigational product, systemic
treatment, or radiotherapy

- No concurrent combination antiretroviral therapy for HIV-positive patients

- No concurrent drugs that alter CYP450 3A4 (or cannot be changed to drugs that do not
alter CYP450 3A4)

- No concurrent drugs that may significantly prolong the QTc

Type of Study:

Interventional

Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall response rate (complete response and partial response) in patients treated with selumetinib

Outcome Description:

Estimates of the response rate based on best response [complete response (CR), and partial response (PR)] and the tumor control rate [CR, PR, and stable disease (SD)] will be provided together with the exact two-sided 95% confidence intervals.

Outcome Time Frame:

Up to 3 years

Safety Issue:

No

Principal Investigator

Leo Gordon

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of Chicago Comprehensive Cancer Center

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-02558

NCT ID:

NCT01278615

Start Date:

December 2010

Completion Date:

Related Keywords:

  • Recurrent Adult Diffuse Large Cell Lymphoma
  • Lymphoma
  • Lymphoma, Large B-Cell, Diffuse
  • Lymphoma, Non-Hodgkin
  • Lymphoma, B-Cell

Name

Location

Ingalls Memorial Hospital Harvey, Illinois  60426
Weill Medical College of Cornell University New York, New York  10021
Northwestern University Chicago, Illinois  60611
University of Massachusetts Medical School Worcester, Massachusetts  01605
Indiana University Medical Center Indianapolis, Indiana  46202
Decatur Memorial Hospital Decatur, Illinois  62526
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
Evanston CCOP-NorthShore University HealthSystem Evanston, Illinois  60201
Illinois CancerCare-Peoria Peoria, Illinois  61615
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard Fort Wayne, Indiana  46845
Saint John's Mercy Medical Center Saint Louis, Missouri  63141
University of Maryland Greenebaum Cancer Center Baltimore, Maryland  21201
University of Michigan University Hospital Ann Arbor, Michigan  48109
Saint Joseph Medical Center Towson, Maryland  21204
Southern Illinois University Springfield, Illinois  62702