Phase 3
N=271
Alisertib (MLN8237) or Investigator's Choice in Patients With Relapsed/Refractory Peripheral T-Cell Lymphoma
Relapsed Peripheral T-Cell Lymphoma · Refractory Peripheral T-Cell Lymphoma
Bottom Line
View on ClinicalTrials.gov: NCT01482962 ↗Enrolled (actual)
271
Serious AEs
54.9%
Results posted
Jul 2018
Primary outcome: Primary: Overall Response Rate (ORR) Based on Independent Review Committee (IRC) Assessment — 33; 45 percentage of participants — p=0.038
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Alisertib (Drug); Pralatrexate (Drug); Gemcitabine (Drug); Romidepsin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Millennium Pharmaceuticals, Inc.
- Primary completion
- Jun 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate (ORR) Based on Independent Review Committee (IRC) Assessment |
33; 45 | 0.038 sig |
| PRIMARY Progression-Free Survival (PFS) Based on IRC Assessment |
115; 104 | 0.177 |
| SECONDARY Overall Survival (OS) |
415; 367 | 0.338 |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) |
136; 126; 75; 69 | — |
| SECONDARY Number of Participants With Clinically Important Abnormal Laboratory Values Reported as AEs |
18; 14; 17; 10; 6; 5 | — |
| SECONDARY Number of Participants With Clinically Important Vital Sign Measurements Reported as AEs |
1; 0; 0; 1; 4; 6 | — |
| SECONDARY Complete Response (CR) Rate |
18; 27 | — |
| SECONDARY Time to Disease Progression (TTP) |
162; 116 | 0.362 |
| SECONDARY Duration of Response (DOR) |
225; 172 | — |
| SECONDARY Time to Response |
62; 64 | — |
| SECONDARY Time to Subsequent Antineoplastic Therapy |
336; 233 | — |
| SECONDARY Plasma Concentration-time Data to Contribute to Future Population Pharmacokinetics (PK) Analysis |
— | — |
| SECONDARY Change Form Baseline in Reported Symptoms and Quality of Life (QoL) Assessment Per Functional Assessment of Cancer Therapy-Lymphoma (FACT-LYM) for Functioning and Symptoms |
-2.4; -1.3; -0.3; 0.0; -1.4; -0.8 | — |
Summary
This is a phase 3, randomized, 2-arm, open-label, international trial evaluating alisertib compared with single-agent treatment, as selected by the investigator from the offered options of pralatrexate or gemcitabine or romidepsin, in participants with relapsed or refractory peripheral T-cell lymphoma (PTCL). Note: romidepsin was not used as a single-agent comparator outside the United States of America (USA) as supply was not available.
Eligibility Criteria
Inclusion Criteria
- Male or female participants age 18 or older
- Participants with Peripheral T cell lymphoma (PTCL) (selected subtypes) according to World Health Organization (WHO) criteria and have relapsed or are refractory to at least 1 prior systemic, cytotoxic therapy for PTCL. Participants must have received conventional therapy as a prior therapy. Cutaneous-only disease is not permitted. Participants must have documented evidence of progressive and measurable disease.
- Tumor biopsy available for central hematopathologic review
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- Female participants who are post menopausal for at least 1 year, surgically sterile, or agree to practice 2 effective methods of contraception through 30 days after the last dose of study drug or agree to abstain from heterosexual intercourse.
- Male participants who agree to practice effective barrier contraception through 6 months after the last dose of alisertib or agree to abstain from heterosexual intercourse
- Suitable venous access
- Voluntary written consent
Exclusion Criteria
- Known central nervous system lymphoma
- Systemic antineoplastic therapy, immunotherapy, investigational agent or radiation therapy within 4 weeks of first dose of study treatment or concomitant use during study
- Prior administration of an Aurora A kinase-targeted agent, including alisertib; or all of the 3 comparator drugs (pralatrexate, or romidepsin or gemcitabine; or known hypersensitivity)
- History of uncontrolled sleep apnea syndrome or other conditions that could result in excessive daytime sleepiness
- Cardiac condition as specified in study protocol, including left ventricular ejection fraction (LVEF) <40%
- Concomitant use of other medicines as specified in study protocol
- Participants with abnormal gastric or bowel function who require continuous treatment with H2-receptor antagonists or proton pump inhibitors
- Known active infection with human immunodeficiency virus (HIV), hepatitis B virus, or hepatitis C
- Autologous stem cell transplant less than 3 months prior to enrollment
- Participants who have undergone allogeneic stem cell or organ transplantation any time
- Inadequate blood levels, bone marrow or other organ function as specified in study protocol
- The participant must have recovered to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade ≤ 1 toxicity, to participant's baseline status (except alopecia), or deemed irreversible from the effects of prior cancer therapy
- Major surgery, serious infection, or infection requiring systemic antibiotic therapy within 14 days prior to the first dose of study treatment
- Female participants who are breastfeeding or pregnant
- Coexistent second malignancy or history of prior solid organ malignancy within previous 3 years
- Serious medical or psychiatric illness or laboratory abnormality that could, in the investigator's opinion, potentially interfere with the completion of treatment according to the protocol
Data sourced from ClinicalTrials.gov (NCT01482962). 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.