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Phase 2 N=36 Treatment

Ofatumumab and Dinaciclib in Treating Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, or B-Cell Prolymphocytic Leukemia

Chronic Lymphocytic Leukemia · Prolymphocytic Leukemia · Recurrent Small Lymphocytic Lymphoma · Refractory Chronic Lymphocytic Leukemia

Enrolled (actual)
36
Serious AEs
97.2%
Results posted
Mar 2018
Primary outcome: Primary: Maximum-tolerated Dose of Dinaciclib When Given in Combination With Ofatumumab, Defined as a Dose Level Where at Most One of 6 Evaluable Patients Has a Dose Limiting Toxicity (Phase Ia) — 7; 10; 14 mg/m2

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Dinaciclib (Drug); Laboratory Biomarker Analysis (Other); Ofatumumab (Biological); Pharmacological Study (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
National Cancer Institute (NCI)
Primary completion
Mar 2015

Outcome Measures

OutcomeResultp-value
PRIMARY
Maximum-tolerated Dose of Dinaciclib When Given in Combination With Ofatumumab, Defined as a Dose Level Where at Most One of 6 Evaluable Patients Has a Dose Limiting Toxicity (Phase Ia)
7; 10; 14
PRIMARY
Number of Patients With Dose-limiting Toxicity Incidents Graded According to the NCI CTCAE v4.0 (Phase I)
0; 0
PRIMARY
Percentage of Patients Who Achieve an Overall Response, Defined as Achieving a Complete Response, an Unconfirmed Complete Response (SLL Only), or a Partial Response (Phase II)
39
SECONDARY
Complete Response Rate
SECONDARY
Overall Survival
990
SECONDARY
Progression Free Survival
322
SECONDARY
Time to Treatment Failure
248

Summary

This phase I/II trial studies the side effects and the best dose of ofatumumab and dinaciclib and to see how well they work in treating patients with relapsed or refractory chronic lymphocytic leukemia, small lymphocytic lymphoma, or B-cell prolymphocytic leukemia. Monoclonal antibodies, such as ofatumumab, can find cancer cells and help kill them. Dinaciclib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving ofatumumab together with dinaciclib may kill more cancer cells.

Eligibility Criteria

Inclusion Criteria

  • Patients must have histologically confirmed B-cell chronic lymphocytic leukemia (B-CLL)/small lymphocytic lymphoma (SLL) or a B-cell prolymphocytic leukemia (B-PLL) according to 2008 World Health Organization (WHO) diagnostic criteria
  • Patients must meet one or more of the following modified indications for treatment as described in the 2008 International Workshop on chronic lymphocytic leukemia (CLL) (IWCLL) guidelines for the diagnosis and treatment of CLL:
  • Progressive disease or marked splenomegaly and/or lymphadenopathy or disease requiring de-bulking for future allogeneic transplantation
  • Anemia (hemoglobin 100.5 º F or night sweats for greater than 2 weeks without evidence of infection
  • Progressive lymphocytosis, with an increase exceeding 50% over a 2-month period or a doubling time of less than 6 months
  • Need for cytoreduction prior to allogeneic stem cell transplant
  • Patients must have received at least one prior therapy that includes either fludarabine or equivalent nucleoside analogue, or an alternative regimen if there was a contraindication (i.e. autoimmune hemolytic anemia) or patient elected not to receive fludarabine
  • Eastern Cooperative Oncology Group (ECOG) performance status = = 60%)
  • Life expectancy >= 12 weeks
  • Absolute neutrophil count >= 1, 000/μL in absence of bone marrow involvement
  • Platelets >= 30, 000/μL in absence of bone marrow involvement
  • Total bilirubin = = 50 mL/min/1.73 m^2 for patients(Cockcroft-Gault estimated)
  • Patients with a history of current/previous infection with hepatitis B virus will be eligible if receiving appropriate antiviral prophylaxis
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

  • Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier; corticosteroids alone will not be considered prior therapy, but must be discontinued at least 24 hours prior to the first day of therapy unless continued for indications other than the primary malignancy
  • Patients who are receiving any other investigational agents
  • Patients who have received prior treatment with dinaciclib will not be eligible; patients previously treated with ofatumumab will be eligible as long as their disease responded to previous treatment (defined as achieving at least stable disease by consensus criteria) and did not subsequently progress < 3 months from completing treatment
  • Patients with known brain metastases should be excluded from this clinical trial
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition as dinaciclib
  • History of anaphylactic reaction to rituximab or other anti-cluster of differentiation (CD)20 monoclonal antibody
  • Because dinaciclib is metabolized by the cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) liver enzyme, the eligibility of patients taking medications that are potent inducers or inhibitors of that enzyme will be determined following a review of their case by the principal investigator; every effort should be made to switch patients taking such agents or substances to other medications; any identified agent needs to be stopped at least 2 weeks prior to study registration; use of aprepitant will be permitted, however, based on drug-drug interaction study performed by the manufacturer showing no effect on dinaciclib pharmacokinetics (PK)
  • Patients with glucose-6-phosphate dehyd
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01515176). 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.

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