Safety and Tolerability Study of PCI-32765 in B Cell Lymphoma and Chronic Lymphocytic Leukemia

Sponsor
Pharmacyclics LLC. (Industry)
Overall Status
Completed
CT.gov ID
NCT01109069
Collaborator
Janssen Research & Development, LLC (Industry)
199
16
1
106.8
12.4
0.1

Study Details

Study Description

Brief Summary

The purpose of this study is to determine the long-term safety of a fixed-dose, daily regimen of PCI-32765 PO in subjects with B cell lymphoma or chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL).

Study Design

Study Type:
Interventional
Actual Enrollment :
199 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Long-term Safety Study of Bruton's Tyrosine Kinase (Btk) Inhibitor PCI-32765 in B Cell Lymphoma and Chronic Lymphocytic Leukemia
Study Start Date :
Jun 1, 2010
Actual Primary Completion Date :
Apr 26, 2019
Actual Study Completion Date :
Apr 26, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: PCI-32765

Drug: PCI-32765
Dose based on parent protocol

Outcome Measures

Primary Outcome Measures

  1. Number of Subjects With Adverse Events [30 days after last dose of study drug, continue up to 6 months]

    Subjects were to receive ibrutinib once daily at the dose level the subject was receiving in the parent study until disease progression or unacceptable toxicity. The study included Screening, Treatment (from the first dose until study drug discontinuation), and Follow-up Phases.

Secondary Outcome Measures

  1. Progressive Disease (PD) [30 days after last dose of study drug, continue up to 6 months]

    A progressive disease confirmed by a CT scan.

  2. Death Event [30 days after last dose of study drug]

    All death events are due to AE, progressive disease, and other reasons.

  3. Documented Responses [30 days after last dose of study drug, continue up to 6 months]

    Investigator-assessed responses were summarized descriptively for subjects with CLL/SLL and listed for subjects with other NHLs based on the efficacy population.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Men and women with recurrent surface immunoglobulin positive B cell non-Hodgkin's lymphoma (NHL) according to WHO classification (including, but not limited to, CLL/SLL, Waldenström's macroglobulinemia [WM], mantle cell lymphoma [MCL], and diffuse large B cell lymphoma [DLBCL) who have met requirements for roll over from their parent protocol and want to continue study drug.

  • Female subjects of childbearing potential must have a negative serum or urine pregnancy test within 3 days of the first dose of study drug and agree to use dual methods of contraception during the study and for 1 month following the last dose with study drug. Post menopausal females (>45 years old and without menses for >1 year) and surgically sterilized females are exempt from this criterion.

  • Male subjects must use an effective barrier method of contraception during the study and for 3 months following the last dose if sexually active with a female of childbearing potential.

  • Willing and able to participate in all required evaluations and procedures in this study protocol including swallowing capsules without difficulty

  • Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (in accordance with national and local patient privacy regulations).

Exclusion Criteria:
  • A life-threatening illness, medical condition or organ system dysfunction which, in the investigator's opinion, could compromise the subject's safety, interfere with the absorption or metabolism of PCI-32765 PO, or put the study outcomes at undue risk

  • Known history of Human Immunodeficiency Virus (HIV) or active infection with Hepatitis C Virus (HCV) or Hepatitis B Virus (HBV) or any uncontrolled active systemic infection.

  • Lactating or pregnant

Contacts and Locations

Locations

Site City State Country Postal Code
1 Stanford University Stanford California United States 94305
2 Stanford California United States 94305
3 University of Chicago Chicago Illinois United States 60637
4 Boston Massachusetts United States 02215
5 New Hyde Park New York United States 11042
6 New York New York United States 10065
7 Rochester New York United States 14642-0001
8 Columbus Ohio United States 43210
9 Springfield Oregon United States 97477
10 Nashville Tennessee United States 37203
11 MD Anderson Cancer Center Houston Texas United States 77030
12 Houston Texas United States 77030
13 Tyler Texas United States 75702
14 Fletcher Allen Health Care and University of Vermont Burlington Vermont United States 05405
15 Vancouver Washington United States 98684
16 Yakima Valley Memorial Hospital/North Star Lodge Yakima Washington United States 98902

Sponsors and Collaborators

  • Pharmacyclics LLC.
  • Janssen Research & Development, LLC

Investigators

  • Study Director: James Dean, MD, Medical Monitor

Study Documents (Full-Text)

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Pharmacyclics LLC.
ClinicalTrials.gov Identifier:
NCT01109069
Other Study ID Numbers:
  • PCYC-1103-CA
  • PCI-32765
First Posted:
Apr 22, 2010
Last Update Posted:
May 27, 2020
Last Verified:
Mar 1, 2020

Study Results

Participant Flow

Recruitment Details 27 July 2010 (the first Patient enrolled) to 31 March 2016 (the Last patient enrolled), Study was approved on June 2010.
Pre-assignment Detail This study was open to subjects from prior ibrutinib studies who met eligibility criteria for rollover from their parent study and wanted to continue receiving study drug.
Arm/Group Title A LONG-TERM SAFETY STUDY OF BRUTON'S TYROSINE KINASE (BTK) INH
Arm/Group Description A Long-term Safety Study of Bruton's Tyrosine Kinase (Btk) Inhibitor PCI-32765 in B Cell Lymphoma and Chronic Lymphocytic Leukemia. This is a multicenter(16 sites in the USA), open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. Ibrutinib was supplied as 140 mg or 40 mg capsules for oral administration. Subjects were to receive daily administration of a fixed dose of ibrutinib at the same dose level as in the parent study (up to 840 mg).
Period Title: Overall Study
STARTED 199
COMPLETED 106
NOT COMPLETED 93

Baseline Characteristics

Arm/Group Title A Long-term Safety Study of Bruton's Tyrosine Kinase (Btk) Inh
Arm/Group Description A Long-term Safety Study of Bruton's Tyrosine Kinase (Btk) Inhibitor PCI-32765 in B Cell Lymphoma and Chronic Lymphocytic Leukemia. This is a multicenter(16 sites in the USA), open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. Ibrutinib was supplied as 140 mg or 40 mg capsules for oral administration. Subjects were to receive daily administration of a fixed dose of ibrutinib at the same dose level as in the parent study (up to 840 mg).
Overall Participants 199
Age (Count of Participants)
<=18 years
0
0%
Between 18 and 65 years
83
41.7%
>=65 years
116
58.3%
Age (Years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [Years]
65.6
(8.98)
Sex: Female, Male (Count of Participants)
Female
56
28.1%
Male
143
71.9%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino
6
3%
Not Hispanic or Latino
192
96.5%
Unknown or Not Reported
1
0.5%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
1
0.5%
Asian
2
1%
Native Hawaiian or Other Pacific Islander
0
0%
Black or African American
8
4%
White
185
93%
More than one race
0
0%
Unknown or Not Reported
3
1.5%
Region of Enrollment (participants) [Number]
United States
199
100%
Estimated creatinine clearance rate (mL/min) (ML/min) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [ML/min]
85.55
(34.150)

Outcome Measures

1. Primary Outcome
Title Number of Subjects With Adverse Events
Description Subjects were to receive ibrutinib once daily at the dose level the subject was receiving in the parent study until disease progression or unacceptable toxicity. The study included Screening, Treatment (from the first dose until study drug discontinuation), and Follow-up Phases.
Time Frame 30 days after last dose of study drug, continue up to 6 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title A LONG-TERM SAFETY STUDY OF BRUTON'S TYROSINE KINASE (BTK) INH
Arm/Group Description A Long-term Safety Study of Bruton's Tyrosine Kinase (Btk) Inhibitor PCI-32765 in B Cell Lymphoma and Chronic Lymphocytic Leukemia. This is a multicenter(16 sites in the USA), open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. Ibrutinib was supplied as 140 mg or 40 mg capsules for oral administration. Subjects were to receive daily administration of a fixed dose of ibrutinib at the same dose level as in the parent study (up to 840 mg).
Measure Participants 199
Count of Participants [Participants]
199
100%
2. Secondary Outcome
Title Progressive Disease (PD)
Description A progressive disease confirmed by a CT scan.
Time Frame 30 days after last dose of study drug, continue up to 6 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title IBRUTINIB/PCI-32765
Arm/Group Description This was a multicenter, open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. PCI-32765: Dose based on parent protocol CLL: chronic lymphocytic leukemia/ SLL: small lymphocytic lymphoma.
Measure Participants 199
Count of Participants [Participants]
70
35.2%
3. Secondary Outcome
Title Death Event
Description All death events are due to AE, progressive disease, and other reasons.
Time Frame 30 days after last dose of study drug

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title IBRUTINIB/PCI-32765
Arm/Group Description This was a multicenter, open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. PCI-32765: Dose based on parent protocol CLL: chronic lymphocytic leukemia/ SLL: small lymphocytic lymphoma.
Measure Participants 199
Count of Participants [Participants]
42
21.1%
4. Secondary Outcome
Title Documented Responses
Description Investigator-assessed responses were summarized descriptively for subjects with CLL/SLL and listed for subjects with other NHLs based on the efficacy population.
Time Frame 30 days after last dose of study drug, continue up to 6 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title IBRUTINIB/PCI-32765
Arm/Group Description This was a multicenter, open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. PCI-32765: Dose based on parent protocol CLL: chronic lymphocytic leukemia/ SLL: small lymphocytic lymphoma.
Measure Participants 199
CLL/SLL
180
90.5%
Other NHL
16
8%
Treatment discontinuation
3
1.5%

Adverse Events

Time Frame 8 Years, 5 months. This is a safety longterm follow-up study, it doesn't have any common milestones.
Adverse Event Reporting Description Adverse event data collection included Grade 3 or 4 AEs and major hemorrhage AEs, and the following: Grade 2 or higher eye-related AEs, and AEs of any grade that were serious, an +other malignancy, or led to dose reduction or treatment discontinuation.
Arm/Group Title IBRUTINIB/PCI-32765
Arm/Group Description This was a multicenter, open-label, monotherapy, long-term extension study designed to evaluate the long-term (> 6 months) safety and tolerability of a fixed daily dosing regimen of ibrutinib. PCI-32765: Dose based on parent protocol CLL: chronic lymphocytic leukemia/ SLL: small lymphocytic lymphoma.
All Cause Mortality
IBRUTINIB/PCI-32765
Affected / at Risk (%) # Events
Total 111/199 (55.8%)
Serious Adverse Events
IBRUTINIB/PCI-32765
Affected / at Risk (%) # Events
Total 111/199 (55.8%)
Blood and lymphatic system disorders
Febrile neutropenia 4/199 (2%) 5
Anaemia 1/199 (0.5%) 1
Neutropenia 1/199 (0.5%) 1
Cardiac disorders
Atrial fibrillation 21/199 (10.6%) 25
Angina pectoris 2/199 (1%) 2
Atrial flutter 2/199 (1%) 2
Sinus bradycardia 2/199 (1%) 2
Arteriosclerosis coronary artery 1/199 (0.5%) 1
Atrioventricular block complete 1/199 (0.5%) 1
Bundle branch block left 1/199 (0.5%) 1
Bundle branch block right 1/199 (0.5%) 1
Cardiac failure congestive 1/199 (0.5%) 1
Cardio-respiratory arrest 1/199 (0.5%) 1
Coronary artery disease 1/199 (0.5%) 1
Ischaemic cardiomyopathy 1/199 (0.5%) 1
Myocardial infarction 1/199 (0.5%) 1
Palpitations 1/199 (0.5%) 1
Pericarditis 1/199 (0.5%) 1
Subendocardial ischaemia 1/199 (0.5%) 1
Ventricular tachycardia 1/199 (0.5%) 2
Ear and labyrinth disorders
Haematotympanum 1/199 (0.5%) 1
Eye disorders
Uveitis 1/199 (0.5%) 1
Gastrointestinal disorders
Diarrhoea 3/199 (1.5%) 3
Abdominal pain upper 2/199 (1%) 2
Gastrointestinal haemorrhage 2/199 (1%) 2
Upper gastrointestinal haemorrhage 2/199 (1%) 2
Dysphagia 1/199 (0.5%) 1
Enteritis 1/199 (0.5%) 1
Nausea 1/199 (0.5%) 1
Oesophageal ulcer 1/199 (0.5%) 1
Pancreatitis necrotising 1/199 (0.5%) 1
Small intestinal obstruction 1/199 (0.5%) 1
Umbilical hernia 1/199 (0.5%) 1
Vomiting 1/199 (0.5%) 1
General disorders
Pyrexia 8/199 (4%) 9
Asthenia 1/199 (0.5%) 1
Chest pain 1/199 (0.5%) 1
Fatigue 1/199 (0.5%) 1
Multiple organ dysfunction syndrome 1/199 (0.5%) 1
Hepatobiliary disorders
Cholecystitis 2/199 (1%) 2
Cholecystitis acute 1/199 (0.5%) 1
Infections and infestations
Pneumonia 32/199 (16.1%) 61
Cellulitis 13/199 (6.5%) 16
Sepsis 11/199 (5.5%) 12
Urinary tract infection 6/199 (3%) 7
Gastroenteritis 3/199 (1.5%) 4
Gastroenteritis viral 3/199 (1.5%) 4
Herpes zoster 3/199 (1.5%) 3
Septic shock 3/199 (1.5%) 3
Bacteraemia 2/199 (1%) 2
Clostridium difficile colitis 2/199 (1%) 2
Diverticulitis 2/199 (1%) 3
Gastroenteritis clostridial 2/199 (1%) 2
Influenza 2/199 (1%) 3
Localised infection 2/199 (1%) 2
Lung infection 2/199 (1%) 3
Urosepsis 2/199 (1%) 2
Viral infection 2/199 (1%) 2
Acute sinusitis 1/199 (0.5%) 1
Appendicitis 1/199 (0.5%) 1
Bronchitis 1/199 (0.5%) 1
Bronchopulmonary aspergillosis 1/199 (0.5%) 1
Cellulitis orbital 1/199 (0.5%) 1
Cellulitis staphylococcal 1/199 (0.5%) 1
Clostridial sepsis 1/199 (0.5%) 1
Clostridium difficile infection 1/199 (0.5%) 1
Dengue fever 1/199 (0.5%) 1
Ear infection 1/199 (0.5%) 1
Fusarium infection 1/199 (0.5%) 3
Gangrene 1/199 (0.5%) 1
Gastrointestinal infection 1/199 (0.5%) 1
Klebsiella infection 1/199 (0.5%) 1
Klebsiella sepsis 1/199 (0.5%) 1
Lymphangitis 1/199 (0.5%) 1
Osteomyelitis 1/199 (0.5%) 1
Parainfluenzae virus infection 1/199 (0.5%) 1
Pelvic abscess 1/199 (0.5%) 1
Pharyngitis 1/199 (0.5%) 1
Pilonidal cyst 1/199 (0.5%) 1
Pneumonia bacterial 1/199 (0.5%) 1
Pneumonia fungal 1/199 (0.5%) 1
Pneumonia legionella 1/199 (0.5%) 1
Pneumonia pseudomonal 1/199 (0.5%) 1
Pneumonia respiratory syncytial viral 1/199 (0.5%) 1
Pseudomonal bacteraemia 1/199 (0.5%) 1
Pseudomonas infection 1/199 (0.5%) 1
Pyelonephritis 1/199 (0.5%) 1
Sinusitis 1/199 (0.5%) 1
Staphylococcal infection 1/199 (0.5%) 1
Vestibular neuronitis 1/199 (0.5%) 1
Wound infection 1/199 (0.5%) 1
Wound infection staphylococcal 1/199 (0.5%) 1
Injury, poisoning and procedural complications
Subdural haematoma 3/199 (1.5%) 4
Fall 2/199 (1%) 2
Femoral neck fracture 1/199 (0.5%) 1
Hip fracture 1/199 (0.5%) 1
Perirenal haematoma 1/199 (0.5%) 1
Splenic rupture 1/199 (0.5%) 1
Subarachnoid haemorrhage 1/199 (0.5%) 1
Thermal burn 1/199 (0.5%) 1
Investigations
Transaminases increased 1/199 (0.5%) 1
Metabolism and nutrition disorders
Hypercalcaemia 2/199 (1%) 2
Decreased appetite 1/199 (0.5%) 1
Dehydration 1/199 (0.5%) 1
Diabetic ketosis 1/199 (0.5%) 1
Failure to thrive 1/199 (0.5%) 1
Musculoskeletal and connective tissue disorders
Osteoarthritis 2/199 (1%) 2
Lumbar spinal stenosis 1/199 (0.5%) 1
Musculoskeletal chest pain 1/199 (0.5%) 1
Pain in extremity 1/199 (0.5%) 1
Spinal column stenosis 1/199 (0.5%) 1
Spondylolisthesis 1/199 (0.5%) 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Chronic lymphocytic leukaemia 3/199 (1.5%) 4
Lung adenocarcinoma 3/199 (1.5%) 3
Richter's syndrome 3/199 (1.5%) 4
Bladder neoplasm 2/199 (1%) 2
Adenocarcinoma 1/199 (0.5%) 1
Appendix cancer 1/199 (0.5%) 1
Basal cell carcinoma 1/199 (0.5%) 1
Bladder transitional cell carcinoma 1/199 (0.5%) 1
Chronic lymphocytic leukaemia transformation 1/199 (0.5%) 1
Colon cancer 1/199 (0.5%) 1
Invasive ductal breast carcinoma 1/199 (0.5%) 1
Lung adenocarcinoma recurrent 1/199 (0.5%) 1
Malignant melanoma 1/199 (0.5%) 1
Mantle cell lymphoma 1/199 (0.5%) 1
Metastases to central nervous system 1/199 (0.5%) 1
Metastases to lung 1/199 (0.5%) 1
Myelodysplastic syndrome 1/199 (0.5%) 1
Nasopharyngeal cancer 1/199 (0.5%) 1
Neuroendocrine carcinoma of the skin 1/199 (0.5%) 1
Ovarian cancer 1/199 (0.5%) 1
Ovarian cancer metastatic 1/199 (0.5%) 1
Prostate cancer 1/199 (0.5%) 1
Renal cell carcinoma 1/199 (0.5%) 1
Nervous system disorders
Syncope 3/199 (1.5%) 3
Headache 2/199 (1%) 2
Transient ischaemic attack 2/199 (1%) 2
Autoimmune neuropathy 1/199 (0.5%) 1
Cauda equina syndrome 1/199 (0.5%) 1
Dizziness 1/199 (0.5%) 1
Embolic stroke 1/199 (0.5%) 1
Encephalopathy 1/199 (0.5%) 1
Hypoaesthesia 1/199 (0.5%) 1
Ischaemic stroke 1/199 (0.5%) 1
Myelitis transverse 1/199 (0.5%) 1
Optic neuritis 1/199 (0.5%) 1
Psychiatric disorders
Mental status changes 3/199 (1.5%) 3
Confusional state 1/199 (0.5%) 1
Renal and urinary disorders
Acute kidney injury 4/199 (2%) 4
Haematuria 1/199 (0.5%) 1
Ureterolithiasis 1/199 (0.5%) 1
Urinary retention 1/199 (0.5%) 1
Reproductive system and breast disorders
Prostatic obstruction 1/199 (0.5%) 1
Prostatitis 1/199 (0.5%) 1
Respiratory, thoracic and mediastinal disorders
Dyspnoea 4/199 (2%) 5
Pleural effusion 4/199 (2%) 5
Acute respiratory failure 1/199 (0.5%) 1
Atelectasis 1/199 (0.5%) 1
Hypoxia 1/199 (0.5%) 1
Pulmonary alveolar haemorrhage 1/199 (0.5%) 1
Respiratory failure 1/199 (0.5%) 2
Tachypnoea 1/199 (0.5%) 1
Tracheal stenosis 1/199 (0.5%) 1
Skin and subcutaneous tissue disorders
Eosinophilic pustular folliculitis 1/199 (0.5%) 1
Vascular disorders
Hypotension 3/199 (1.5%) 4
Aortic aneurysm 1/199 (0.5%) 1
Aortic stenosis 1/199 (0.5%) 1
Deep vein thrombosis 1/199 (0.5%) 1
Hypertension 1/199 (0.5%) 1
Orthostatic hypotension 1/199 (0.5%) 1
Other (Not Including Serious) Adverse Events
IBRUTINIB/PCI-32765
Affected / at Risk (%) # Events
Total 114/199 (57.3%)
Blood and lymphatic system disorders
Neutropenia 21/199 (10.6%) 24
Thrombocytopenia 10/199 (5%) 23
Ear and labyrinth disorders
Cataract 14/199 (7%) 20
Gastrointestinal disorders
Diarrohea 9/199 (4.5%) 10
Infections and infestations
Upper Respiratory Track Infection 9/199 (4.5%) 10
Investigations
Lymphocyte count decreased 24/199 (12.1%) 59
Neutrophil Count decreased 17/199 (8.5%) 32
White Blood cell count decreased 8/199 (4%) 12
Metabolism and nutrition disorders
Hyperglycemia 10/199 (5%) 15
Vascular disorders
Hypertension 67/199 (33.7%) 197

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Institution/Investigator will not publish without Sponsor prior review and approval Institution/Investigator will not publish until the earlier of (i) results of the study are submitted for publication (ii) notification that submission of the multicenter results is no longer planned (iii) 18 months after study termination.

Results Point of Contact

Name/Title James Dean
Organization Pharmacyclics
Phone 669-224-1880
Email jdean@pcyc.com
Responsible Party:
Pharmacyclics LLC.
ClinicalTrials.gov Identifier:
NCT01109069
Other Study ID Numbers:
  • PCYC-1103-CA
  • PCI-32765
First Posted:
Apr 22, 2010
Last Update Posted:
May 27, 2020
Last Verified:
Mar 1, 2020