Phase 1
N=30
Pevonedistat, Irinotecan, and Temozolomide in Treating Patients With Recurrent or Refractory Solid Tumors or Lymphoma
Recurrent Lymphoma · Recurrent Malignant Solid Neoplasm · Recurrent Primary Central Nervous System Neoplasm · Refractory Lymphoma · Refractory Malignant Solid Neoplasm
Bottom Line
View on ClinicalTrials.gov: NCT03323034 ↗Enrolled (actual)
30
Serious AEs
70.0%
Results posted
Sep 2022
Primary outcome: Primary: MTD/RP2D of Pevonedistat in Combination With Irinotecan and Temozolomide — 35 mg/m^2
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- Irinotecan (Drug); Pevonedistat (Drug); Temozolomide (Drug)
- Age
- Pediatric, Adult · 0+ yrs
- Sex
- All
- Sponsor
- Children's Oncology Group
- Primary completion
- Sep 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY MTD/RP2D of Pevonedistat in Combination With Irinotecan and Temozolomide |
35 | — |
| PRIMARY Number of Participants With Grade 3 or Greater Toxicities Associated With Pevonedistat in Combination With Irinotecan and Temozolomide |
5; 4; 6; 2; 4 | — |
| PRIMARY Half-life of Pevonedistat in Combination With Irinotecan and Temozolomide |
5.3; 5; 5.2; 4.7; 6.1 | — |
| PRIMARY T Max of Pevonedistat in Combination With Irinotecan and Temozolomide |
1.; 1; 1; 1.1; 1.1 | — |
| PRIMARY C Max of Pevonedistat in Combination With Irinotecan and Temozolomide |
156; 218.5; 303.5; 419; 363.8 | — |
| PRIMARY AUC of Pevonedistat in Combination With Irinotecan and Temozolomide |
803; 973.5; 1340; 2018.5; 1957 | — |
| PRIMARY Clearance of Pevonedistat in Combination With Irinotecan and Temozolomide |
18.8; 20.8; 18.9; 17.5; 17.9 | — |
| SECONDARY Anti-tumor Activity of Pevonedistat in Combination With Irinotecan and Temozolomide |
1; 1; 0; 0; 0 | — |
Summary
This phase I trial studies the side effects and best dose of pevonedistat when given together with irinotecan hydrochloride and temozolomide in treating patients with solid tumors, central nervous system (CNS) tumors, or lymphoma that have come back after a period of improvement (recurrent) or that do not respond to treatment (refractory). Pevonedistat and irinotecan may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as temozolomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving pevonedistat, irinotecan hydrochloride, and temozolomide may work better in treating patients with solid tumors, central nervous system (CNS) tumors, or lymphoma compared to irinotecan and temozolomide alone.
Eligibility Criteria
Inclusion Criteria
- Part A1: Patients must be >= 12 months and = = 6 months and = 50% for patients > 16 years of age and Lansky >= 50 for patients = = 7 days after the last dose of agent; the duration of this interval must be discussed with the study chair and the study-assigned research coordinator prior to enrollment
- Antibodies: >= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade = = 14 days must have elapsed since last dose of corticosteroid
- Hematopoietic growth factors: >= 14 days after the last dose of a long-acting growth factor (e.g. pegfilgrastim) or 7 days for short-acting growth factor; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair and the study-assigned research coordinator
- Interleukins, interferons and cytokines (other than hematopoietic growth factors): >= 21 days after the completion of interleukins, interferon or cytokines (other than hematopoietic growth factors)
- Stem cell Infusions (with or without total body irradiation [TBI]):
- Allogeneic (non-autologous) bone marrow or stem cell transplant, or any stem cell infusion including donor lymphocyte infusion (DLI) or boost infusion: >= 84 days after infusion and no evidence of graft versus host disease (GVHD)
- Autologous stem cell infusion including boost infusion: >= 42 days
- Cellular therapy: >= 42 days after the completion of any type of cellular therapy (e.g. modified T cells, natural killer [NK] cells, dendritic cells, etc.)
- Radiation therapy (XRT)/external beam irradiation including protons: >= 14 days after local XRT; >= 150 days after TBI, craniospinal XRT or if radiation to >= 50% of the pelvis; >= 42 days if other substantial brain metastases (BM) radiation
- Radiopharmaceutical therapy (e.g., radiolabeled antibody, 131I-metaiodobenzylguanidine [MIBG]): >= 42 days after systemically administered radiopharmaceutical therapy
- Patients must not have received prior exposure to pevonedistat; patients with prior exposure to irinotecan or temozolomide are eligible
- For patients with solid tumors without known bone marrow involvement:
- Peripheral absolute neutrophil count (ANC) >= 1000/mm^3
- Platelet count >= 100, 000/mm^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)
- Hemoglobin >= 8 g/dL
- Patients with known bone marrow metastatic disease will be eligible for study provided they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity; at least 5 of every cohort of 6 patients on Part A1 must be evaluable for hematologic toxicity for the dose-escalation part of the study; if dose-limiting hematologic toxicity is observed, all subsequent patients enrolled must be evaluable for hematologic toxicity
- Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 mL/min/1.73 m^2 or a serum creatinine based on age/gender as follows:
- Age: 6 months to = 16 years maximum serum creatinine: (mg/dL) male: 1.7; female: 1.4
- Bilirubin (sum of conjugated + unconjugated) = = 2.7 g/dL
- Shortening fraction of >= 27% by echocardiogram, or
- Ejection fraction of >= 50% by gated radionuclide study
- No supraventricular arrhythmia on electrocardiogram (EKG)
- Prolonged rate corrected QT (QTc) interval 94% on room air if there is clinical indication for determination (e.g. dyspnea at rest)
- Patients with seizure disorder may be enrolled if on non-enzyme inducing anti-convulsants and well controlled
- Nervous system disorders (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) resulting from prior therapy must be = 99th percentile) ar
Data sourced from ClinicalTrials.gov (NCT03323034). 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.