Copanlisib Plus Ibrutinib in R/R CLL

Sponsor
Dana-Farber Cancer Institute (Other)
Overall Status
Recruiting
CT.gov ID
NCT04685915
Collaborator
Bayer (Industry)
30
Enrollment
1
Location
1
Arm
84.4
Anticipated Duration (Months)
0.4
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This research study is examining the effect of adding a fixed duration of copanlisib to ibrutinib in select participants who have been on ibrutinib for at least six months for relapsed/refractory chronic lymphocytic leukemia (CLL).

The names of the study drugs involved in this study are:
  • Copanlisib

  • Ibrutinib

Detailed Description

This is an open-label, phase II study, adding copanlisib to ibrutinib in select participants who are receiving ibrutinib for relapsed/refractory CLL.

Copanlisib has not been approved by the U.S. Food and Drug Administration (FDA) for CLL, but it has been approved for use in relapsed/refractory follicular lymphoma. Ibrutinib is approved by the FDA as a treatment option for CLL.

This research study is:
  • Trying to understand what effects, good or bad, treatment with copanlisib in combination with ibrutinib has in select participants who are receiving ibrutinib for relapsed/refractory CLL

  • Determining if this approach is better or worse than the usual approach for this type of cancer

  • Determining whether genomic changes in CLL cells and changes in immune response make treatment with the study drugs more or less effective

The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits.

Participants will receive combination therapy for six months before resuming ibrutinib alone. They will continue therapy for as long as they do not have serious side effects and their disease does not get worse and will be followed for up to 5 years.

It is expected that about 30 people will take part in this research study.

Bayer HealthCare Pharmaceuticals is supporting this research study by providing the study drug, copanlisib. Ibrutinib will be obtained from commercial supply.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
30 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Study of Copanlisib to Deepen Response in CLL Patients on Ibrutinib in the Relapsed/Refractory Setting
Actual Study Start Date :
Feb 18, 2021
Anticipated Primary Completion Date :
Mar 1, 2023
Anticipated Study Completion Date :
Mar 1, 2028

Arms and Interventions

ArmIntervention/Treatment
Experimental: Ibrutinib + Copanlisib

During 28 day study treatment cycle, participants will: Take Ibrutinib daily at predetermined dose for as long as there are no serious side effects and disease progression Receive intravenous infusion of Copanlisib at a predetermined dose days 1, 8 and 15 for cycles 1-6.

Drug: Ibrutinib
Capsule, taken by mouth once daily
Other Names:
  • Imbruvica
  • Drug: Copanlisib
    Intravenous Infusion
    Other Names:
  • Aliqopa
  • Outcome Measures

    Primary Outcome Measures

    1. Complete response (CR) Rate [6 months]

      Rate of complete response (CR) by 2018 IW-CLL criteria following the addition of six months of copanlisib to the therapy of patients with SD or PR or PR-L on ibrutinib in the relapsed/refractory setting.

    Secondary Outcome Measures

    1. Number of Participants with Treatment Related Adverse Events as Assessed by CTCAE ver. 5.0. [6 months]

      Adverse events will be collected and reported as percentages

    2. Duration of Response (DOR) [3 years]

      Legnth of time the patients respond to therapy

    3. Progression-free Survival PFS [3 years]

      The time from registration to progression or death due to any cause. Participants alive without disease progression are censored at date of last disease evaluation.

    4. Overall Survival [3 years]

      The time from registration to death due to any cause or censored at date last known alive.

    5. Genomic Mutation Rates [3 years]

      RNA and DNA Sequencing will be performed and correlated with outcome

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Must have a confirmed diagnosis of chronic lymphocytic leukemia or small lymphocytic ymphoma as per IW-CLL 2018 criteria with evidence of persistent disease, defined as measurable adenopathy or splenomegaly, circulating disease, or marrow disease

    • On ibrutinib which was instituted due to the patient previously meeting IWCLL 2018 criteria for treatment, started at least 6 months prior to study entry

    • Must have received at least one prior line of therapy for CLL prior to ibrutinib

    • Must have achieved either SD, PR or PR-L (with residual lymphadenopathy in addition to lymphocytosis) on ibrutinib by IW-CLL 2018 criteria

    • ECOG performance status < 2

    • Patients must meet the following hematologic criteria at screening, unless they have significant bone marrow involvement of CLL confirmed on biopsy:

    • Absolute neutrophil count ≥500 cells/mm3 (0.5 x 109/L). Growth factor is allowed in order to achieve this

    • Platelet count ≥50,000 cells/mm3 independent of transfusion within 7 days of screening

    • Adequate hepatic function defined as: Serum aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 3.0 x upper limit of normal (ULN), bilirubin ≤2.0 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin including hemolysis)

    • Adequate renal function defined by serum creatinine ≤1.5 x ULN or creatinine clearance by Cockroft-Gauldt ≥ 50 ml/min

    • 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

    • Age greater than or equal to 18 years.

    • Ability to understand and the willingness to sign a written informed consent document

    Exclusion Criteria:
    • Patients receiving cancer therapy (i.e., chemotherapy, radiation therapy, immunotherapy, biologic therapy, hormonal therapy, surgery and/or tumor embolization) other than ibrutinib within 2 weeks of Cycle 1/Day 1 with the following exceptions:

    • Limited palliative radiation is allowed if completed > 1 weeks of C1D1

    • Hormonal therapy given in the adjuvant setting

    • Corticosteroid therapy (prednisone or equivalent <15 mg daily) is allowed as clinically warranted as long as the dose is stabilized at least for 7 days prior to initial dosing. Topical or inhaled corticosteroids are permitted

    • Within six months of allogeneic hematologic stem cell transplant at the time of starting study treatment or active graft vs. host disease requiring systemic treatment or prophylaxis within 6 weeks of starting study treatment

    • Prior treatment with copanlisib

    • Patients in CR, or in partial response with residual lymphocytosis (PR-L) as their only remaining evidence of disease on ibrutinib

    • History of other malignancies, except:

    • Malignancy treated with curative intent and with no known active disease present for ≥2 years before the first dose of study drug and felt to be at low risk for recurrence by treating physician

    • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease

    • Adequately treated carcinoma in situ

    • Low-risk prostate cancer on active surveillance

    • Vaccinated with live, attenuated vaccines <4 weeks before first dose of study drug

    • Active autoimmune disease requiring systemic treatment

    • Recent infection requiring intravenous antibiotics that was completed ≤7 days before the first dose of study drug, or any uncontrolled active systemic infection

    • Known bleeding disorders (eg, von Willebrand's disease) or hemophilia

    • History of stroke or intracranial hemorrhage within 6 months prior to enrollment

    • Human immunodeficiency virus (HIV) or active hepatitis C virus (HCV) or hepatitis B virus (HBV)

    • CMV PCR positive at baseline

    • Major surgery within 4 weeks of first dose of study drug

    • History of or concurrent condition of interstitial lung disease of any severity and/or severely impaired lung function (as judged by the investigator)

    • Concurrent diagnosis of pheochromocytoma

    • Uncontrolled arterial hypertension despite optimal medical management

    • Type 1 or type 2 diabetes mellitus with a HbA1c > 8.5%

    • Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator's opinion, could compromise the subject's safety

    • Currently active, clinically significant cardiovascular disease, such as uncontrolled arrhythmia or Class 3 or 4 congestive heart failure as defined by the New York Heart Association Functional Classification; or a history of myocardial infarction, unstable angina, or acute coronary syndrome within 6 months prior to randomization

    • Unable to swallow capsules or malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel, symptomatic inflammatory bowel disease or ulcerative colitis, or partial or complete bowel obstruction

    • Lactating or pregnant

    • Patients with known CNS involvement

    • Concurrent administration of medications or foods that are strong inhibitors or inducers of CYP3A

    • Known hypersensitivity to copanlisib or ibrutinib

    Contacts and Locations

    Locations

    SiteCityStateCountryPostal Code
    1Dana-Farber Cancer InstituteBostonMassachusettsUnited States02215

    Sponsors and Collaborators

    • Dana-Farber Cancer Institute
    • Bayer

    Investigators

    • Principal Investigator: Jennifer Crombie, MD, Dana-Farber Cancer Institute

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Jennifer Crombie, Principal Investigator, Dana-Farber Cancer Institute
    ClinicalTrials.gov Identifier:
    NCT04685915
    Other Study ID Numbers:
    • 20-281
    First Posted:
    Dec 28, 2020
    Last Update Posted:
    Sep 10, 2021
    Last Verified:
    Sep 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Jennifer Crombie, Principal Investigator, Dana-Farber Cancer Institute
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Sep 10, 2021