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This is a Phase 1, open-label study of HMPL-689 administered orally to patients with lymphoma for whom failed of standard care or have no standard of care.This study consists of a dose escalation stage (Stage I) and a dose expansion stage (Stage II).
Both Stage I and Stage II include the following periods: screening period, treatment period, safety follow-up period, and extended progression free survival (PFS) follow-up period, as defined in Dose Escalation Stage (Stage I).
Dose escalation will be performed according to a modified toxicity probability interval scheme-2 (mTPI-2).To further characterize safety and efficacy of HMPL-689 at RP2D, expansion stage of the study enrolled 144 patients with B cell lymphoma, including CLL/ SLL, FL, MZL, DLBCL, MCL and PTCL. Patients were treated with RP2D as starting dose.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Six arm including in dose expansion stage by following: | Experimental |
|
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HMPL-689 | Drug | Two strengths of HMPL-689 capsules (2.5 mg and 10 mg) will be used for clinical studies. The drug products are capsules. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dose limited toxicities evaluated with NCI CTCAE v4.03 | Incidence of dose limited toxicities and associated dose of HMPL-689 | within 28 days after the first dose |
| Objective response rate (ORR) | Overall response rate (ORR) is defined as the proportion of patients who have a CR or PR | Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum plasma concentration calculated with Blood samples | Blood samples will be taken to measure the levels of study drug | within 29 days after the first dose |
| Time to reach maximum concentration calculated with Blood samples |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events evaluated by NCI CTCAE v4.03 | Incidence of adverse events and associated dose of HMPL-689 | from the first dose to within 30 days after the last dose |
| Complete response rate (CR rate) | Complete response rate (CR rate) is defined as the proportion of patients who have a CR Other lymphomas: Lugano Response Criteria for Hodgkin and Non-Hodgkin's Lymphoma [the Revised Response Criteria for Malignant Lymphoma (Cheson 2014)](streamdown:incomplete-link) |
Inclusion Criteria:
Exclusion Criteria:
Patients with CNS(Central nervous system) involvement
Any of the following laboratory abnormalities:
Absolute neutrophil count < 1.5×109/L Hemoglobin <90 g/L Platelets< 100 ×109/L
Inadequate organ function, defined by the following:
Total bilirubin >1.5 x the upper limit of normal (ULN) with the following exception:
AST or ALT >2.5 x the ULN with the following exception:
Serum creatinine >1.5 x the ULN or estimated creatinine clearance (Ccr) (i.e., estimated Glomerular Filtration Rate, [eGFR[ according to the method of Cockcroft-Gault )< 60 mL/min
International normalized ratio (INR) >1.5 x the ULN or activated partial thromboplastin time (aPTT) >1.5 x the ULN or Prothrombin Time (PT) >1.5 x the ULN
Serum amylase or lipase >ULN at screening
Patients with presence of second primary malignant tumors within the last 5 years, with the exception of the following non-invasive malignancies after curative treatment:
Basal cell carcinoma of the skin Squamous cell carcinoma of the skin Carcinoma in situ of the cervix Carcinoma in situ of the breast Asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy or requiring only hormonal therapy and with normal prostate-specific antigen for≥ 1 year prior to randomization
Clinically significant history of liver disease, including cirrhosis, current alcohol abuse, or current known active infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV)
Prior treatment with any PI3K inhibitors and discontinued due to disease progression
Any anti-cancer therapy, including chemotherapy, radiotherapy within 3 weeks prior to initiation of study treatment
G-CSF/blood transfusion is prohibited 7 days before the screening hematology test
Any steroid therapy or approved targeted small molecule agents for anti-neoplastic intent within 7 days or approximately 5 half-lives, whichever is the longer, prior to initiation of study treatment
Any monoclonal antibody for anti-neoplastic intent within 6 weeks or 2 half-lives, whichever is the longer, prior to initiation of study treatment
Prior use of any anti-cancer vaccine
Prior administration of radioimmunotherapy within 3 months prior to initiation of study treatment
Prior use of any drug that is a strong inducer of CYP3A4, strong inhibitor of CYP3A4 within 2 weeks prior to initiation of study treatment (refer to Appendix 13)
Prior autologous transplant within 6 months prior to initiation of study treatment
Prior allogeneic stem cell transplant within 6 months prior to initiation of study treatment or with any evidence of active graft versus host disease or requirement for immunosuppressants within 21 days prior to initiation of study treatment
Clinically significant active infection (e.g., pneumonia)
Major surgical procedure within 4 weeks prior to initiation of study treatment
Treatment within a clinical study of an investigational agent or using an investigational device within 30 days prior to initiation of study treatment
Adverse events from prior anti-cancer therapy that have not resolved to Grade 1, except for alopecia
Pregnant (positive pregnancy test) or lactating women
New York Heart Association (NYHA) Class II or greater congestive heart failure
Congenital long QT syndrome or QTc > 450 msec
Currently use medication known to cause QT prolongation or torsades de pointes
History of myocardial infarction or unstable angina within 6 months prior to initiation of study treatment
History of stroke or transient ischemic attack within 6 months prior to initiation of study treatment
Inability to take oral medication, prior surgical procedures affecting absorption, or active peptic ulcer disease
History of inflammatory bowel disease (e.g., Crohn disease or ulcerative colitis)
History of drug-induced pneumonitis
Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding that, in the investigator's opinion, gives reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or renders the patient at high risk from treatment complications](streamdown:incomplete-link)
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| Name | Affiliation | Role |
|---|---|---|
| Junning Cao, MD | Fudan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| TongJi Medical College Huazhong University of Science& Technology | Wuhan | Hubei | 430030 | China | ||
| Sun Yat-sen University cancer center |
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| ID | Term |
|---|---|
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
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This study consists of a dose escalation stage (Stage I) and a dose expansion stage (Stage II). Dose escalation will be performed according to a modified toxicity probability interval scheme-2 (mTPI-2). Expansion stage of the study enrolled 143 patients with B cell lymphoma, including CLL/SLL, FL, MZL, DLBCL, MCL and PTCL, Patients were treated with RP2D as starting dose.
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Blood samples will be taken to measure the levels of study drug
| within 29 days after the first dose |
| Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Time to response (TTR) | Time to response (TTR) is defined as the date from the first dose of study drug to the date of first CR or PR | Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Duration of response (DoR) | Duration of response (DoR): defined as the time from when the first CR or PR was achieved until the earlier of the first documentation of definitive disease progression or death from any cause Other lymphomas: Lugano Response Criteria for Hodgkin and Non-Hodgkin's Lymphoma [the Revised Response Criteria for Malignant Lymphoma (Cheson 2014)](streamdown:incomplete-link) | Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Clinical benefit rate (CBR): | Clinical benefit rate (CBR): defined as the proportion of patients who have a CR/CRi, PR/PR-L or SD | Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Progression-free survival (PFS) | Progression-free survival (PFS) is defined as the time from the first dose to the first occurrence of progression or death from any cause, whichever occurs first | Through study completion, 1 year after the last patient has enrolled in the study or all patients have discontinued the study, whichever comes sooner |
| Guangzhou |
| 510060 |
| China |
| Fudan University Shanghai Cancer Center | Shanghai | 200032 | China |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |