Veliparib, Bendamustine Hydrochloride, and Rituximab in Treating Patients With Advanced Lymphoma, Multiple Myeloma, or Solid Tumors

This study is currently recruiting participants.
Verified February 2013 by National Cancer Institute (NCI)
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01326702
First received: March 30, 2011
Last updated: February 6, 2013
Last verified: February 2013
  Purpose

This phase I/II trial is studying the side effects and the best dose of veliparib when given together with bendamustine hydrochloride and rituximab and to see how well it works in treating patients with advanced lymphoma, multiple myeloma, or solid tumors. Veliparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as bendamustine hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Giving veliparib together with bendamustine hydrochloride and rituximab may kill more cancer cells


Condition Intervention Phase
AIDS-related Diffuse Large Cell Lymphoma
AIDS-related Diffuse Mixed Cell Lymphoma
AIDS-related Diffuse Small Cleaved Cell Lymphoma
AIDS-related Immunoblastic Large Cell Lymphoma
AIDS-related Lymphoblastic Lymphoma
AIDS-related Peripheral/Systemic Lymphoma
AIDS-related Small Noncleaved Cell Lymphoma
Anaplastic Large Cell Lymphoma
Angioimmunoblastic T-cell Lymphoma
Cutaneous B-cell Non-Hodgkin Lymphoma
Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue
Hepatosplenic T-cell Lymphoma
HIV-associated Hodgkin Lymphoma
Nodal Marginal Zone B-cell Lymphoma
Noncutaneous Extranodal Lymphoma
Peripheral T-cell Lymphoma
Recurrent Adult Burkitt Lymphoma
Recurrent Adult Diffuse Large Cell Lymphoma
Recurrent Adult Diffuse Mixed Cell Lymphoma
Recurrent Adult Diffuse Small Cleaved Cell Lymphoma
Recurrent Adult Grade III Lymphomatoid Granulomatosis
Recurrent Adult Hodgkin Lymphoma
Recurrent Adult Immunoblastic Large Cell Lymphoma
Recurrent Adult Lymphoblastic Lymphoma
Recurrent Adult T-cell Leukemia/Lymphoma
Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma
Recurrent Grade 1 Follicular Lymphoma
Recurrent Grade 2 Follicular Lymphoma
Recurrent Grade 3 Follicular Lymphoma
Recurrent Grade I Lymphomatoid Granulomatosis
Recurrent Grade II Lymphomatoid Granulomatosis
Recurrent Mantle Cell Lymphoma
Recurrent Marginal Zone Lymphoma
Recurrent Small Lymphocytic Lymphoma
Refractory Multiple Myeloma
Small Intestine Lymphoma
Splenic Marginal Zone Lymphoma
Unspecified Adult Solid Tumor, Protocol Specific
Drug: bendamustine hydrochloride
Drug: veliparib
Other: diagnostic laboratory biomarker analysis
Other: pharmacological study
Biological: rituximab
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 1b/2a Study of ABT-888 in Combination With Bendamustine +/- Rituximab in Lymphoma, Multiple Myeloma and Solid Tumors

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • MTD of veliparib in combination with bendamustine (phase I) [ Time Frame: Up to 6 courses ] [ Designated as safety issue: Yes ]
    Toxicities will be graded and reported according to criteria listed in CTCAE ver. 4.0.

  • Adverse event profile as assessed by NCI CTCAE v. 4.0 (phase I) [ Time Frame: Up to 30 days post-treatment ] [ Designated as safety issue: Yes ]
  • Response rate (best response at any point on therapy) in patients with non-Hodgkin lymphoma treated with veliparib, bendamustine hydrochloride and rituximab. [ Time Frame: Up to 30 days post-treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Pharmacodynamic parameters of veliparib [ Time Frame: Baseline and week 1 ] [ Designated as safety issue: No ]
  • Pharmacokinetic parameters of veliparib [ Time Frame: Baseline and week 1 ] [ Designated as safety issue: No ]
  • Complete response to study treatment (phase II) [ Time Frame: Up to 30 days post-treatment ] [ Designated as safety issue: No ]
  • Progression-free survival (phase II) [ Time Frame: Up to 30 days post-treatment ] [ Designated as safety issue: No ]
    Kaplan-Meier estimates will be calculated and log-rank tests will be employed when certain comparisons are needed.

  • Duration of remission (phase II) [ Time Frame: Up to 30 day post-treatment ] [ Designated as safety issue: No ]
  • Overall survival (phase II) [ Time Frame: Up to 30 days post-treatment ] [ Designated as safety issue: No ]
    Kaplan-Meier estimates will be calculated and log-rank tests will be employed when certain comparisons are needed.


Estimated Enrollment: 93
Study Start Date: July 2011
Estimated Primary Completion Date: July 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Treatment (bendamustine hydrochloride, veliparib, rituximab)

Patients receive veliparib orally twice daily on days 1-7 and bendamustine hydrochloride IV over 30-60 minutes on days 1-2. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Once the maximum-tolerated dose is determined, a cohort of patients receives veliparib and bendamustine hydrochloride as above and rituximab IV on day 1. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Blood samples are collected at baseline and periodically during study for pharmacokinetic and pharmacodynamic studies. Bone marrow biopsies and/or core tumor biopsies samples may also be collected.

Drug: bendamustine hydrochloride
Given IV
Other Names:
  • bendamustin hydrochloride
  • bendamustine
  • cytostasan hydrochloride
  • Treanda
Drug: veliparib
Given orally
Other Name: ABT-888
Other: diagnostic laboratory biomarker analysis
Correlative studies
Other: pharmacological study
Correlative studies
Other Name: pharmacological studies
Biological: rituximab
Given IV
Other Names:
  • IDEC-C2B8
  • IDEC-C2B8 monoclonal antibody
  • Mabthera
  • MOAB IDEC-C2B8
  • Rituxan

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine the maximum-tolerated dose (MTD) of veliparib (ABT-888) in combination with bendamustine hydrochloride in patients with solid tumors, lymphoma, or multiple myeloma. (Phase I) II. To establish the safety of ABT-888 in combination with bendamustine hydrochloride and rituximab in an expansion cohort of patients with non-Hodgkin lymphoma (NHL). (Phase I) III. To assess the toxicity profile of this regimen in the above patients. (Phase I) IV. To determine the complete response (CR) rate in patients with indolent NHL or mantle cell lymphoma (MCL) treated with ABT-888, bendamustine, and rituximab. (Phase II)

SECONDARY OBJECTIVES:

I. To assess response rates and survival parameters of patients treated with ABT-888, bendamustine hydrochloride, and with or without rituximab. (Phase I) II. To assess pharmacokinetic parameters of ABT-888 in this regimen. (Phase I) III. To assess pharmacodynamic endpoints, including PAR levels in tumor samples and gamma-H2AX levels in peripheral blood mononuclear cells and tumor samples before and after treatment on protocol. (Phase I and II) IV. To assess progression-free survival, overall survival, and duration of remission of patients with indolent NHL and MCL treated with ABT-888, bendamustine, and rituximab. (Phase II)

OUTLINE: This is a dose-escalation, phase I study of veliparib followed by an expansion cohort and phase II study.

Patients receive veliparib orally twice daily on days 1-7 and bendamustine hydrochloride IV over 30-60 minutes on days 1-2. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Once the maximum-tolerated dose is determined, a cohort of patients receives veliparib and bendamustine hydrochloride as above and rituximab IV on day 1. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Blood samples are collected at baseline and periodically during study for pharmacokinetic and pharmacodynamic studies. Bone marrow biopsies and/or core tumor biopsies samples may also be collected.

After completion of study therapy, patients are followed up for 30 days.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have a histologically confirmed solid malignancy, lymphoma, or multiple myeloma for which standard curative or palliative measures do not exist, are no longer effective, or for which the patient is not eligible or refuses (Phase I)

    • Patients must have a histologically confirmed CD-20 positive B-cell non-Hodgkin lymphoma for which standard curative or palliative measures do not exist, are no longer effective, or for which the patient is not eligible or refuses (Phase Ib cohort expansion)
  • Patients must have histologically or cytologically confirmed marginal zone B-cell lymphoma, small lymphocytic lymphoma, lymphoplasmacytic lymphoma, or mantle cell lymphoma, and must have at least one measurable site of disease (phase II)
  • For lymphoma and multiple myeloma patients: patients who have relapsed or are refractory to at least one prior chemotherapeutic regimen or biologic agent; patients must either be ineligible for or have refused curative options for treatment, including stem cell transplant, if applicable
  • For solid tumor patients: relapsed or refractory to at least one prior chemotherapeutic regimen or biologic agent; patients must either be ineligible for or have refused curative options for treatment
  • Patients must have had a rest period of at least 2 weeks since prior chemotherapy or radiation therapy, 6 weeks if the last regimen included BCNU or mitomycin C; there must be a rest period of at least 3 months if the last therapy was immunotherapy or radioimmunotherapy (unless the disease has progressed since treatment)
  • ECOG performance status 0-1 (Karnofsky >= 60%)
  • Life expectancy of greater than 3 months
  • ANC ≥ 1,000/mcL
  • Platelet count ≥ 100,000/mcL unsupported by transfusion within the prior 2 weeks
  • Hemoglobin >= 8.0 g/dL unsupported by transfusion within the prior 2 weeks
  • Total bilirubin =< 2x upper normal institutional limits; in patients with Gilbert's disease or documented liver metastases, total bilirubin up to 3x ULN will be allowed
  • AST(SGOT)/ALT(SGPT) ≤ 2.5 X institutional upper limit of normal
  • Creatinine within normal institutional limits OR creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal
  • Prior stem cell transplant allowed provided patient has not relapsed or progressed within 100 days post transplant
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal, barrier method of birth control, or abstinence) prior to study entry and for the duration of study participation
  • Ability to understand and the willingness to sign a written informed consent document
  • Toxicities from prior therapies must have resolved to baseline, or be =< grade 2 and stable for at least one month
  • Patient must be able to swallow pills
  • Patients with CNS metastases must be stable after therapy for > 3 months and off steroid treatment prior to study enrollment

Exclusion Criteria:

  • Patients who have had chemotherapy or radiotherapy within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered to baseline (or are not at stable grade =< 2) from adverse events due to agents administered more than 2 weeks earlier; patients who have received immunotherapy or radioimmunotherapy within 3 months, unless disease has progressed since treatment; patients who have been administered ABT-888 as part of a single or limited dosing study, such as a phase 0 study, will not be excluded from participating in this study solely because of receiving prior ABT-888
  • Patients may not be receiving any other investigational agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ABT-888, bendamustine or mannitol; patients enrolling in the cohort expansion or phase 2 portions of the study who have been intolerant of repeated doses of rituximab in the past will be excluded (patients who have had infusion reactions to their initial dose of rituximab will not be excluded)
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant women are excluded from this study because ABT-888 is a PARP inhibitor with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ABT-888, breastfeeding should be discontinued if the mother is treated with ABT-888; teratogenic and nonteratogenic events have been observed in animal studies following intraperitoneal dosing of bendamustine
  • HIV-positive patients on combination antiretroviral therapy are eligible if their HIV is under adequate control with an antiretroviral regimen that has been stable for >= 4 weeks, as long as the CD4 count is > 300; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated; due to toxicity issues, patients on zidovudine or stavudine would not be eligible
  • Patients with history of seizure are not eligible
  • Patients with uncontrolled CNS metastasis are not eligible
  • Patients with unrelated prior malignancies must have undergone potentially curative therapy for their prior malignancy, have no evidence of that disease for three years, and be deemed at low risk for recurrence of their prior malignancy by her/his treating physician; patients with dermal squamous cell carcinoma, basal cell carcinoma or melanoma in situ that has been completely excised will be eligible following excision
  • Patients with active seizure or a history of seizure
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01326702

Locations
United States, New York
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: John F. Gerecitano         gerecitj@mskcc.org    
Principal Investigator: John F. Gerecitano            
Sponsors and Collaborators
Investigators
Principal Investigator: John Gerecitano Memorial Sloan-Kettering Cancer Center
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01326702     History of Changes
Other Study ID Numbers: NCI-2011-02583, 10-174, U01CA069856
Study First Received: March 30, 2011
Last Updated: February 6, 2013
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome
HIV Infections
Burkitt Lymphoma
Hodgkin Disease
Immunoblastic Lymphadenopathy
Leukemia
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, T-Cell
Leukemia-Lymphoma, Adult T-Cell
Lymphoma
Lymphoma, Follicular
Lymphoma, Non-Hodgkin
Lymphomatoid Granulomatosis
Multiple Myeloma
Neoplasms, Plasma Cell
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Large-Cell, Immunoblastic
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Lymphoma, T-Cell
Lymphoma, T-Cell, Cutaneous
Lymphoma, T-Cell, Peripheral
Lymphoma, Large-Cell, Anaplastic
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Extranodal NK-T-Cell
Neoplasms
Lymphoma, Mantle-Cell
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections

ClinicalTrials.gov processed this record on May 23, 2013