Phase 1
N=58
Study of MLN8237 in Participants With Advanced Hematological Malignancies
B-cell Follicular Lymphoma · B-cell Marginal Zone Lymphoma · Diffuse Large B-cell Lymphoma · B-cell Mantle Cell Lymphoma · B-cell Small Lymphocytic Lymphoma
Bottom Line
View on ClinicalTrials.gov: NCT00697346 ↗Enrolled (actual)
58
Serious AEs
50.0%
Results posted
May 2019
Primary outcome: Primary: Number of Participants With Dose-Limiting Toxicity (DLT) — 1; 2; 0; 1 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- Alisertib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Millennium Pharmaceuticals, Inc.
- Primary completion
- Oct 2016
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Dose-Limiting Toxicity (DLT) |
1; 2; 0; 1; 2; 2 | — |
| PRIMARY Maximum Tolerated Dose (MTD) of Alisertib |
50 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 1 |
833.2; 1078.3 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
1337.6; 1451.9 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 1 |
2.0; 2.0 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
2.0; 2.0 | — |
| PRIMARY AUCt: Area Under the Concentration Time Curve From Time 0 to Time t for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
14846; 16528 | — |
| PRIMARY Terminal Half-Life (t1/2) for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
20.5; 19.5 | — |
| PRIMARY Accumulation Ratio (Rac) for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
1.9; 1.5 | — |
| PRIMARY Peak/Trough Ratio for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
6.0; 4.3 | — |
| PRIMARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Pill in Capsule (PIC) With Once Daily for 21 Days (QD21D) Dosing at Day 21 |
3.2; 4.1 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 1 |
726.5; 1637.0; 1773.4; 2497.4 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
2193.5; 1634.4; 2300.2 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 1 |
2.0; 3.0; 2.0; 2.9 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
3.4; 2.0; 2.0 | — |
| PRIMARY AUCt: Area Under the Concentration Time Curve From Time 0 to Time t for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
23444; 19671; 28864 | — |
| PRIMARY Accumulation Ratio (Rac) for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
2.4; 1.5; 1.9 | — |
| PRIMARY Peak/Trough Ratio for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
4.1; 5.4; 4.4 | — |
| PRIMARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Pill in Capsule (PIC) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
2.9; 4.3; 4.3 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 1 |
1227 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
1608 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 1 |
3.9 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
5.0 | — |
| PRIMARY AUCt: Area Under the Concentration Time Curve From Time 0 to Time t for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
14306 | — |
| PRIMARY Terminal Half Life for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
11.7 | — |
| PRIMARY Peak/Trough Ratio for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
2.1 | — |
| PRIMARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Enteric Coated Tablet (ECT) With Once Daily for 14 Days (QD14D) Dosing at Day 14 |
2.5 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 1 |
886; 1114; 1531 | — |
| PRIMARY Cmax: Maximum Observed Concentration for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
2025; 2586; 2058 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 1 |
2.0; 2.2; 2.0 | — |
| PRIMARY Tmax: Time of First Occurrence of Cmax for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
2.0; 2.2; 2.0 | — |
| PRIMARY AUCt: Area Under the Concentration Time Curve From Time 0 to Time t for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 1 |
5518; 7095; 9732 | — |
| PRIMARY AUCt: Area Under the Concentration Time Curve From Time 0 to Time t for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
16024; 18624; 17914 | — |
| PRIMARY Terminal Half-Life (t1/2) for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
13.3; 19.9; 18.4 | — |
| PRIMARY Accumulation Ratio (Rac) for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
2.9; 2.8; 2.3 | — |
| PRIMARY Peak/Trough Ratio for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
2.5; 2.4; 2.5 | — |
| PRIMARY CLss/F: Apparent Oral Clearance at Steady State for Alisertib as Enteric Coated Tablet (ECT) With Twice Daily for 7 Days (BID7D) Dosing at Day 7 |
3.7; 4.4; 6.7 | — |
| SECONDARY Best Overall Response Rate Based on Investigator's Assessment |
13; 9; 100 | — |
| SECONDARY Duration of Response (DOR) |
0.03; 2.07; 0.03 | — |
| SECONDARY Number of Participants With Polymorphisms in Gene Encoding Enzyme UGT1A1 |
23; 23; 8; 1; 2; 1 | — |
| SECONDARY Number of Participants With Polymorphisms in Aurora A Kinase |
— | — |
Summary
This is an open-label, multicenter, phase 1 study of MLN8237 in participants with advanced hematological malignancies for whom there are limited standard treatment options.
Eligibility Criteria
Inclusion Criteria
- Relapsed or refractory disease and a histologically or cytologically confirmed hematological malignancy of the following type for which standard curative treatment does not exist or is no longer effective:
- B-cell Follicular lymphoma
- B-cell Marginal zone lymphoma
- Diffuse large B-cell lymphoma
- B-cell Mantle cell lymphoma
- B-cell Small lymphocytic lymphoma (SLL)
- B-Cell Chronic lymphocytic leukemia (B-CLL)
- Multiple myeloma
- Waldenstrom's macroglobulinemia
- Noncutaneous peripheral T-cell lymphoma not otherwise specified (PTCL-NOS)
- Angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma, enteropathy associated T-cell lymphoma (EATCL), NK lymphoma (NKL)
- Participants with diffuse large B-cell lymphoma must have failed, be ineligible for, or have refused an autologous stem cell transplant. There is no restriction regarding the maximum number of prior regimens.
- Aged 18 years or older
- Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2
- Radiographically or clinically evaluable disease for Part 1 of this study and measurable disease for Part 2 of this study
- Suitable venous access for the conduct of blood sampling for MLN8237 pharmacokinetics (PK)
- Recovered from the reversible effects of prior antineoplastic treatment (with the exception of alopecia and Grade 1 neuropathy)
Exclusion Criteria
- Pregnant or lactating
- Treatment with clinically significant enzyme inducers within 14 days prior to the first dose of MLN8237 as specified in the protocol
- Prior allogeneic bone marrow (or other organ) transplantation
- Newly diagnosed or uncontrolled cancer-related central nervous system (CNS) disease
- Systemic antineoplastic treatment within 21 days preceding the first dose of study treatment. Exceptions requiring a 42-day recovery period from last treatment include: Nitrosoureas, mitomycin C or Rituximab, alemtuzumab (Campath®), or other unconjugated therapeutic antibody (21 days if clear evidence of progressive disease)
- Treatment with radioimmunoconjugates or toxin immunoconjugates such as ibritumomab tiuxetan (Zevalin™), or tositumomab (Bexxar®) within 56 days preceding the first dose of study treatment
- Antineoplastic treatment with glucocorticoids within 21 days preceding the first dose of study treatment
- Radiotherapy involving <25% of the hematopoietically active bone marrow within 21 days preceding first dose of study treatment
- Radiotherapy involving ≥25% of the hematopoietically active bone marrow within 42 days preceding first dose of study treatment
- Inability to swallow capsules or known gastrointestinal (GI) disease or GI procedures that could interfere with the oral absorption or tolerance of MLN8237. Examples include, but are not limited to, partial gastrectomy, history of small intestine surgery, and celiac disease.
- History of uncontrolled sleep apnea syndrome and other conditions that could result in excessive daytime sleepiness such as severe chronic obstructive pulmonary disease
- Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface antigen-positive status, or known or suspected active hepatitis C infection. Testing is not required in the absence of clinical findings or suspicion.
- Participants who fail to meet laboratory values as specified in the protocol during the screening period
Data sourced from ClinicalTrials.gov (NCT00697346). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.