Phase I/II Study of the Combination of Bendamustine, Rituximab and MK-2206 in the Treatment of Relapsed Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
PRIMARY OBJECTIVES:
I. To assess the safety and maximum tolerated dose (MTD) of MK-2206 (Akt inhibitor MK2206)
in combination therapy with bendamustine (bendamustine hydrochloride)-rituximab in relapsed
CLL or SLL patients. (Phase I)
II. To assess the rate of complete response (CR) of MK-2206 in combination with
bendamustine-rituximab in relapsed CLL or SLL patients. (Phase II)
SECONDARY OBJECTIVES:
I. To assess clinical efficacy of MK-2206 in combination with bendamustine-rituximab as
demonstrated by analysis of overall response rate (CR, CRi, CCR, nPR and PR), duration of
response, and treatment free survival.
II. To assess the toxicity profile of MK-2206 in combination with bendamustine-rituximab.
CORRELATIVE RESEARCH:
I. Evaluation of whether the established CLL prognostic factors (CD38, CD49d, IGHV, FISH and
ZAP-70) predict responses to the combination therapy of MK2206, with bendamustine-rituximab.
II. Minimal residual disease will be evaluated after treatment in patients who achieve a
clinical response. MRD status will be explored in relation to both the quality and duration
of response.
III. Evaluation of the effects of the addition of MK-2206 to bendamustine-rituximab on B
cell receptor initiated, PI3K/Akt downstream signal pathways, apoptosis analysis and
leukemic cell activation status, as well as multiple cytokine profiles and key gene
expression analysis with focus on leukemic cells.
IV. Evaluation of MSC-CLL biology including the effects of the addition of MK-2206 to
bendamustine-rituximab on CLL marrow stromal cell (MSC) proliferation, migration and
cytokine production, as well as the adhesion capacity between MSC and leukemic cells.
OUTLINE: This is a multicenter, phase I dose-escalation study of Akt inhibitor MK2206
followed by a phase II study.
Patients receive Akt inhibitor MK2206 orally (PO) on days 1, 8, 15, 22, and 29 of course 1;
bendamustine hydrochloride intravenously (IV) over 30-60 minutes on days 1-2 (days 8-9 of
course 1); and rituximab IV on day 1 (day 8 of course 1). Treatment repeats every 28 days
(35 days for course 1 and 84 days for course 6) for 6 courses in the absence of disease
progression or unacceptable toxicity.
Blood and bone marrow samples are collected at baseline and periodically during study for
correlative studies.
After completion of study treatment, patients are followed up every 3 months for 2 years and
then every 6 or 12 months for 3 years.
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
MTD of Akt Inhibitor MK2206 in combination with bendamustine hydrochloride and rituximab (Phase I)
The descriptions and grading scales found in the revised National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized. The number and severity of all adverse events will be tabulated and summarized in this patient population. The grade 3+ adverse events will also be described and summarized in a similar fashion.
After course 1
Yes
Wei Ding
Principal Investigator
North Central Cancer Treatment Group
United States: Food and Drug Administration
N1087
NCT01369849
September 2011
Name | Location |
---|---|
Mayo Clinic | Rochester, Minnesota 55905 |
Mercy Medical Center - Sioux City | Sioux City, Iowa 51104 |
Fairview Ridges Hospital | Burnsville, Minnesota 55337 |
Fairview Southdale Hospital | Edina, Minnesota 55435 |
Hutchinson Area Health Care | Hutchinson, Minnesota 55350 |
Hennepin County Medical Center - Minneapolis | Minneapolis, Minnesota 55415 |
United Hospital | St. Paul, Minnesota 55102 |
Ridgeview Medical Center | Waconia, Minnesota 55387 |
Rapid City Regional Hospital | Rapid City, South Dakota 57709 |
Adena Regional Medical Center | Chillicothe, Ohio 54601 |
Doctors Hospital at Ohio Health | Columbus, Ohio 43228 |
Riverside Methodist Hospital Cancer Care | Columbus, Ohio 43214 |
Grady Memorial Hospital | Delaware, Ohio 43015 |
Fairfield Medical Center | Lancaster, Ohio 43130 |
Licking Memorial Cancer Care Program at Licking Memorial Hospital | Newark, Ohio 43055 |
Mercy Hospital | Coon Rapids, Minnesota 55433 |
Abbott-Northwestern Hospital | Minneapolis, Minnesota 55407 |
Regions Hospital | Saint Paul, Minnesota 55101 |
Saint Francis Regional Medical Center | Shakopee, Minnesota 55379 |
Rice Memorial Hospital | Willmar, Minnesota 56201 |
Grant Medical Center Cancer Care | Columbus, Ohio 43215 |
Knox Community Hospital | Mount Vernon, Ohio 43050 |
Mayo Clinic in Arizona | Scottsdale, Arizona 85259-5404 |
Columbus CCOP | Columbus, Ohio 43206 |
Metro-Minnesota CCOP | St. Louis Park, Minnesota |
Lakeview Hospital | Stillwater, Minnesota 55082 |
Saint Luke's Regional Medical Center | Sioux City, Iowa 51104 |
Miller-Dwan Hospital | Duluth, Minnesota 55805 |
Unity Hospital | Fridley, Minnesota 55432 |
Saint John's Hospital - Healtheast | Maplewood, Minnesota 55109 |
Minnesota Oncology Hematology PA-Maplewood | Maplewood, Minnesota 55109 |
North Memorial Medical Health Center | Robbinsdale, Minnesota 55422 |
Park Nicollet Clinic - Saint Louis Park | Saint Louis Park, Minnesota 55416 |
Minnesota Oncology and Hematology PA-Woodbury | Woodbury, Minnesota 55125 |
Mount Carmel Health Center West | Columbus, Ohio 43222 |
Marietta Memorial Hospital | Marietta, Ohio 45750 |
Saint Ann's Hospital | Westerville, Ohio 43081 |
Southern Ohio Medical Center Cancer Center | Portsmouth, Ohio 45662 |
North Central Cancer Treatment Group | Rochester, Minnesota 55905 |
Essentia Health Saint Joseph's Medical Center | Brainerd, Minnesota 56401 |
Essentia Health Duluth Clinic CCOP | Duluth, Minnesota 55805 |
Essentia Health Saint Mary's Medical Center | Duluth, Minnesota 55805 |
Springfield Regional Medical Center | Springfield, Ohio 45505 |
Genesis HealthCare System-Good Samaritan | Zanesville, Ohio 43701 |