Trial record 3 of 36 for:    Copanlisib

Copanlisib and Gemcitabine in Relapsed/Refractory PTCL

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03052933
Recruitment Status : Recruiting
First Posted : February 14, 2017
Last Update Posted : April 11, 2018
Consortium for Improving Survival of Lymphoma
Information provided by (Responsible Party):
Deok-Hwan Yang, Chonnam National University Hospital

Brief Summary:

COPGEM (Copanlisib and Gemcitabine)chemotherapy regimen is proposed as the salvage treatment for relapsed or refractory peripheral T-cell or NK/T-cell lymphomas in this study protocol, which would be expected to be feasible and effective in this group of patients.

Copanlisib (BAY 80-6946), a highly selective and potent class-1 PI3K inhibitor with sub-nanomolar IC50s against PI3Kα and PI3Kδ, has demonstrated activity in relapsed/refractory, aggressive NHLs, suggesting an ORR of 50% for T-cell lymphomas.

Gemcitabine has demonstrated clinical antitumor activity against PTCLs including NK/T-cell lymphomas both as single-agent (ORR 30-50%) and in combination therapy, with limited extramedullary toxicities.

Considering the evidence of activity for both agents against PTCLs, the investigators propose that targeted therapy with copanlisib in combination with gemcitabine will exhibit early elimination of rapidly growing tumor cells and be a rational therapeutic modality for use in relapsed or refractory PTCLs, if the overlapping toxicities can be managed.

Condition or disease Intervention/treatment Phase
Mature T-Cell and NK-Cell Neoplasm Drug: Copanlisib Drug: Gemcitabine Phase 1 Phase 2

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Prospective, Multicenter, Open-labeled, Phase I/II Study of the Efficacy and Safety of Copanlisib (BAY 80-6946) and Gemcitabine Combination in Patients With Relapsed/Refractory Peripheral T-cell or NK/T-cell Lymphoma
Actual Study Start Date : February 1, 2018
Estimated Primary Completion Date : December 2021
Estimated Study Completion Date : December 2021

Arm Intervention/treatment
Experimental: Copanlisib/gemcitabine Drug: Copanlisib

For phase I study, participants will receive copanlisib (in combination with gemcitabine) IV infusion at a dose of 45 mg or 60 mg on Days 1, 8, and 15 of each 28-day treatment cycle. During phase I study, participants will be treated at the level of 45 mg/dose (level1), or 60 mg/dose (level II) of copanlisib. Maximal tolerated dose will be determined by standard 3+3 dose escalation design For phase II study, copanlisib dose level, determined during phase I study, will be administered on Days 1, 8, and 15.

Maximum 6 cycles of gemcitabine and copanlisib combination and subsequent copanlisib monotherapy in participants with ≥ SD to copanlisib and gemcitabine until maximum 12 cycles will be given for this study.

Drug: Gemcitabine
For phase I/II study, participants will receive gemcitabine (in combination with copanlisib) IV infusion at fixed dose of 1,200 mg/m2 on Days 1 and 15 of each 28-day treatment cycle until maximum 6 cycles.

Primary Outcome Measures :
  1. Dose limiting toxicity (DLT), Maximum tolerated dose (MTD) for phase I [ Time Frame: 4 weeks ]
    The recommended dose of the combination of copanlisib and gemcitabine in patients with mature T-cell or NK/T cell neoplasm

  2. Objective response rate for phase II [ Time Frame: 1 year ]
    Primary efficacy data will be maximal change of radiological tumor lesion measurement using CT scan at baseline and every two cycles, with the evaluation of overall response rate, defined as the percentage of patients with a complete response (CR) or a partial response (PR).

Secondary Outcome Measures :
  1. adverse events [ Time Frame: 2 year ]
    Toxicity will be graded according to the NCI-CTCAC version 4.0, from the first day of the first cycle of COPGEM chemotherapy to 30 days after the last dose of study drug.

  2. Progression-free survival (PFS) [ Time Frame: 2 year ]
    PFS will be calculated from the start of study drug treatment to the date of disease progression, death, or last follow-up, as appropriate.

  3. Overall survival (OS) [ Time Frame: 2 year ]
    OS will be calculated from the start of study drug treatment to the date of disease death or last follow-up, as appropriate.

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Ages Eligible for Study:   19 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically confirmed relapsed or refractory PTCL or NK/T-cell lymphomas, excluding primary cutaneous T-cell lymphoma, and Sezary syndrome based on WHO classification,
  • Age ≥ 19
  • ECOG performance status ≤ 2
  • at least one bi-dimensional measurable lesion
  • Laboratory values

    • Serum Cr < 1.5 mg/dL or CrCl > 50 mL/min
    • Transaminase (AST/ALT) < 2.5 x ULN (or < 5 x ULN in the presence of lymphoma involvement of the liver)
    • Bilirubin < 1.5 x UNL ( or < 3 x ULN in the presence of lymphoma involvement of the liver or Gilbert syndrome)
    • PT (INR) ≤ 1.5 x ULN and aPTT ≤ 1.5 x ULN
    • Lipase ≤ 1.5 x ULN
    • Hematologic functions: absolute neutrophil count (ANC) ≥ 1,500/µL and platelet count ≥ 75,000/µL, hemoglobin ≥ 8 g/dL
  • Left ventricular ejection fraction (LVEF) ≥ the lower limit of normal for the institution
  • Women of childbearing potential and men must agree to use adequate contraception when sexually active
  • Written informed consent

Exclusion Criteria:

  • B-cell NHL, or primary cutaneous T-cell lymphoma and Sezary syndrome
  • Patients who had previous history of lymphoma involvement of the CNS.
  • History of previous gemcitabine therapy
  • Type I or II diabetes mellitus with HbA1c > 8.5% at screening
  • History of chronic hepatitis B; subjects positive for HBsAg will be excluded from this study. However, subjects with HBcAb will be eligible if they are negative for HBV DNA quantification
  • History of chronic hepatitis C; subjects positive for HCV IgG will be eligible if they are negative for HCV-RNA quantification
  • Known history of human immunodeficiency virus (HIV) infection
  • History or concurrent condition of interstitial lung disease of any severity and/or severely impaired lung function
  • Any other malignancies within the past 3 years except curatively treated basal cell carcinoma of the skin, carcinoma in situ of the uterine cervix, or papillary carcinoma of the thyroid
  • Other serious illness or medical conditions

    • Congestive heart failure > NYHA class 2 (Appendix III)
    • Unstable angina or new-onset angina within the last 3 months; Myocardial infarction within 6 months prior to study entry
    • History of significant neurological or psychiatric disorders including dementia or seizure
    • Uncontrolled hypertension despite optimal medical management (per investigator's opinion)
    • Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 6 months before start of study treatment
    • Non-healing wound, ulcer, or bone fracture
    • Active uncontrolled infection (viral, bacterial, or fungal infection)
    • Patients with evidence or history of bleeding diathesis. Any hemorrhage or bleeding event ≥ grade 3 within 4 weeks of start of study medication
    • Proteinuria estimated by urine protein/creatinine ratio > 3.5 on a random urine sample
    • Concurrent diagnosis of pheochromocytoma
  • Other previous or concurrent treatments

    • Ongoing immunosuppressive therapy
    • Radiotherapy or immune-/chemotherapy less than 4 weeks before start of treatment
    • Radioimmunotherapy or autologous transplant less than 3 months before start of treatment
    • Myeloid growth factors within 14 days prior to treatment start
    • Blood or platelet transfusion within 7 days prior to treatment start
    • Systemic continuous corticosteroid therapy at a daily dose higher than 15 mg prednisone or equivalent
    • History of having received an allogeneic bone marrow or organ transplant
    • Major surgical procedure or significant trauma injury within 28 days before start of study medication, open biopsy within 7 days before start of study treatment
    • Anti-arrhythmic therapy (beta-blockers or digoxin are permitted)
    • Use of CYP3A4 inhibitor or inducer
  • Pregnant or lactating women, women of childbearing potential not employing adequate contraception
  • Concomitant administration of any other experimental drugs under investigation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03052933

Contact: Deok-Hwan Yang +82-61-379-7636
Contact: Ho-Young Yhim +82-63-250-2523

Korea, Republic of
Chonnam National University Hwasun Hospital Recruiting
Hwasun-gun, Jeollanam-do, Korea, Republic of, 519-809
Contact: Deok-Hwan Yang, M.D. and Ph.D.    82-61-379-7636   
Contact: Kun-Hee Choi, Research Nurse    82-61-379-7717   
Sponsors and Collaborators
Chonnam National University Hospital
Consortium for Improving Survival of Lymphoma

Responsible Party: Deok-Hwan Yang, Principal investigator, Chonnam National University Hospital Identifier: NCT03052933     History of Changes
Other Study ID Numbers: COPGEM
First Posted: February 14, 2017    Key Record Dates
Last Update Posted: April 11, 2018
Last Verified: April 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Deok-Hwan Yang, Chonnam National University Hospital:
peripheral T-cell lymphoma
extranodal NK/T-cell lymphoma

Additional relevant MeSH terms:
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs