A Dose Escalation Study of Ibrutinib With Lenalidomide for Relapsed and Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
PRIMARY OBJECTIVES:
I. To define the safety, tolerability and maximum tolerated dose (MTD) of lenalidomide when
used in combination with ibrutinib in adults with relapsed and refractory chronic
lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL).
SECONDARY OBJECTIVES:
I. To determine the response rate and response duration in relapsed and refractory CLL/SLL
patients with ibrutinib and lenalidomide.
II. To characterize the plasma pharmacokinetic (PK) interaction between ibrutinib and
lenalidomide.
III. To explore whether pharmacogenetic studies can predict response, resistance or toxicity
to ibrutinib and lenalidomide.
IV. To explore the ability of ibrutinib to occupy its targets (Bruton's tyrosine kinase
[BTK] in B-cells and interleukin-2 inducible kinase [ITK] in T-cells), and whether
co-administration with lenalidomide influences this binding.
V. To explore the early and late immunologic consequences of combining ibrutinib with
lenalidomide in relapsed and refractory CLL.
VI. To explore the impact of ibrutinib and lenalidomide on ras homolog family member H
(RhoH) expression and whether baseline RhoH expression predicts outcomes with this regimen.
VII. To explore mechanisms of resistance to ibrutinib and lenalidomide. VIII. To explore the
influence of traditional and new CLL/SLL clinical and laboratory prognostic factors on
response to ibrutinib and lenalidomide.
OUTLINE: This is a dose-escalation study of lenalidomide.
Patients receive a run-up course of ibrutinib orally (PO) daily on days 1-28. Patients then
receive ibrutinib and lenalidomide orally (PO) daily on days 1-28. Courses repeat every 28
days in the absence of disease progression or unacceptable toxicity. After 12 courses,
patients who have achieved complete remission (CR)/CR with incomplete marrow recovery (CRi),
nodular partial remission (PR), partial remission or who have stable disease will
discontinue lenalidomide and continue ibrutinib.
After completion of study treatment, patients are followed up for 90 days.
Interventional
Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
MTD of lenalidomide when combined with ibrutinib defined as the highest dose in which less than or equal to 1/6 patients have dose limiting toxicity
Assessed using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. All patient safety information collected will be summarized using descriptive statistics (number of non-missing values, mean, median, standard deviation, minimum and maximum) for continuous variables and counts and percentages for categorical variables, where applicable.
28 days
Yes
Daniel Pollyea
Principal Investigator
University of Colorado Cancer Center - Anschutz Cancer Pavilion
United States: Food and Drug Administration
NCI-2013-00888
NCT01886859
April 2013
Name | Location |
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University of Colorado Cancer Center - Anschutz Cancer Pavilion | Aurora, Colorado 80045 |