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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2018-01094 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| 2017-0073 | Other Identifier | M D Anderson Cancer Center |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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This phase I trial studies the side effects and best dose of olaparib when given together with high-dose chemotherapy in treating patients with lymphomas that have come back or does not treatment and are undergoing stem cell transplant. Drugs used in chemotherapy, such as olaparib, vorinostat, gemcitabine, busulfan, and melphalan, 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. Immunotherapy with monoclonal antibodies, such as rituximab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving olaparib and high-dose chemotherapy together may work better in treating patients with relapsed/refractory lymphomas undergoing stem cell transplant than with chemotherapy alone.
PRIMARY OBJECTIVE:
I. Establish the maximum tolerated dose (MTD) of olaparib combined with vorinostat/gemcitabine/busulfan/melphalan with autologous stem-cell transplant [ASCT]).
SECONDARY OBJECTIVES:
I. Determine the 2-year event-free survival (EFS). II. 2-year overall survival (OS). III. Complete remission (CR) rate. IV. Overall remission rate (ORR). V. Describe the toxicity profile. VI. Describe changes of deoxyribonucleic acid (DNA) damage response and repair, poly(ADP-ribose) polymerase (PARP) inhibition and downstream cellular effects in peripheral blood mononuclear cells and, when available, malignant lymphocytes obtained by fine needle aspiration (FNA) of peripheral lymph nodes.
OUTLINE: This is a dose-escalation study of olaparib.
Patients receive olaparib orally (PO) twice daily (BID) on days -11 to -3, vorinostat PO on days -10 to -3, gemcitabine intravenously (IV) over 4.5 hours on days -9 and -4, busulfan IV over 3 hours on day -9 to -6, melphalan IV over 30 minutes on days -4 and -3, and undergo peripheral blood stem cell transplant IV over 30-60 minutes on day 0. Patients with CD20+ tumors also receive rituximab IV over 3-6 hours on day -10.
After completion of study treatment, patients are followed up every 1-2 days for 30 days and then every 2 weeks for up to 100 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (olaparib, high-dose chemotherapy, transplant) | Experimental | Patients receive olaparib PO BID on days -11 to -3, vorinostat PO on days -10 to -3, gemcitabine IV over 4.5 hours on days -9 and -4, busulfan IV over 3 hours on day -9 to -6, melphalan IV over 30 minutes on days -4 and -3, and undergo peripheral blood stem cell transplant IV over 30-60 minutes on day 0. Patients with CD20+ tumors also receive rituximab IV over 3-6 hours on day -10. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Busulfan | Drug | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| Dose limiting toxicities (DLT) | All adverse events will be tabulated by dose, and a Bayesian DLT curve will be fit. | Up to 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival (OS) | OS will be estimated by the method of Kaplan and Meier. Participants without an event at the analysis time point (2 years) will be censored. | At 2 years |
| Event-free survival (EFS) |
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Inclusion Criteria:
Age 18-65
Patients with:
2.1 Diffuse large B-cell lymphoma (DLBCL) with one of the following: 2.1.1 Primary refractory (no CR to 1st line) 2.1.2 High-risk relapse, defined as any of the following: CR1 <6 mo, secondary IPI >1, or LDH > 225 U/L. 2.1.3 Refractory relapse: No response to >/= 1 salvage line and not eligible to receive other novel salvage therapies, such as CAR-T in a timely fashion or have already failed these.
2.2 Hodgkin's with one of the following: 2.2.1 Primary refractory (no CR or PD within 3 months) 2.2.2 High-risk relapse, defined as any of the following: CR1 <1 year, extranodal relapse, or B symptoms.
2.2.3 Refractory relapse: No response to >/= 1 salvage line 2.3 T-non Hodgkin's lymphoma (T-NHL) with one of the following: 2.3.1 Primary refractory (no CR to 1st line) 2.3.2 High-risk relapse (within 6 months) 2.3.3 Refractory relapse to >/= 1 line of salvage 2.3.4 Any other lymphoma that is refractory or relapsed and that does not qualify for autologous transplant protocols of higher priority.
Adequate renal function (creatinine clearance estimated using the Cockcroft-Gault equation of >/= 51 mL/min: Estimated creatinine clearance = (140-age [years]) x weight (kg) (xF)a / serum creatinine (mg/dL) x 72 [a where F=0.85 for females and F=1 for males.]
Adequate hepatic function (Aspartate aminotransferase (AST) (Serum Glutamic Oxaloacetic Transaminase (SGOT)) / Alanine aminotransferase (ALT) (Serum Glutamic Pyruvate Transaminase (SGPT)) </= 3.5 x institutional upper limit of normal unless liver metastases or a systemic inflammatory picture secondary to the lymphoma are present in which case they must be </= 6x ULN; total bilirubin </= 2.5 x ULN or </= 3.5 x ULN if Gilbert's disease)
Prothrombin time (PT) </=1.5 x institutional upper limit of normal
Adequate pulmonary function (FEV1, FVC and DLCOc >/= 50% of predicted)
Adequate cardiac function (LVEF >/= 40%, no uncontrolled arrhythmias or symptomatic cardiac disease
ECOG performance status <2
Provision of informed consent prior to any study specific procedures
Patients must have a life expectancy >/= 16 weeks
Postmenopausal or evidence of non-childbearing status for women of childbearing potential: negative urine or serum pregnancy test within 28 days and within 72 hours of study treatment and confirmed prior to receiving treatment on this study. Patients with positive results will be removed from the study. Postmenopausal is defined as one of the following:
11.1 Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments.
11.2 Luteinizing hormone (LH) and Follicle stimulating hormone (FSH) levels in the postmenopausal range for women under 50.
11.3 Radiation-induced oophorectomy with last menses >1 year ago. 11.4 Chemotherapy-induced menopause with >1 year interval since last menses. 11.5 Surgical sterilization (bilateral oophorectomy or hysterectomy). 11.6 Female patients must agree to use a highly effective birth control method while on study and for at least 6 months after the last dose of study drug(s).
Male patients and their partners, who are sexually active and of childbearing potential, must agree to the use of two highly effective forms of contraception in combination, throughout the period of taking study treatment and for 6 months after last dose of study drug(s) to prevent pregnancy in a partner.
Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations.
Prior apheresis of >/= 3 million CD34+ cells/Kg.
Eligibility for ASCT is determined by the above inclusion criteria 3-7.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yago L Nieto | M.D. Anderson Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| M D Anderson Cancer Center | Houston | Texas | 77030 | United States |
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| Label | URL |
|---|---|
| MD Anderson Cancer Center | View source |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Nov 2, 2022 | Nov 7, 2025 |
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| Gemcitabine | Drug | Given IV |
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| Melphalan | Drug | Given IV |
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| Olaparib | Drug | Given PO |
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| Peripheral Blood Stem Cell Transplantation | Procedure | Undergo peripheral blood stem cell transplant |
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| Pharmacokinetic Study | Other | Correlative studies |
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| Rituximab | Biological | Given IV |
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| Vorinostat | Drug | Given PO |
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EFS will be estimated by the method of Kaplan and Meier. Patients without an event at the analysis time point (2 years) will be censored. EFS is the time to relapse, secondary hematological malignancy, death, whichever occurred first, or last follow-up.
| At 2 years |
| Objective response (OR) | OR will be tabulated by dose, and a Bayesian DLT curve will be fit. | Up to 100 days |
| Complete response (CR) | CR will be tabulated by dose, and a Bayesian DLT curve will be fit. | At 100 days |
| Incidence of adverse events | All adverse events will be tabulated by dose, and a Bayesian DLT curve will be fit. | At 2 years |
| ICF_000.pdf |
| ID | Term |
|---|---|
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D016399 | Lymphoma, T-Cell |
| D006689 | Hodgkin Disease |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D002066 | Busulfan |
| D000093542 | Gemcitabine |
| D008558 | Melphalan |
| C531550 | olaparib |
| D036102 | Peripheral Blood Stem Cell Transplantation |
| D000071184 | Pharmacogenomic Variants |
| D000069283 | Rituximab |
| C000626854 | CT-P10 |
| D000077337 | Vorinostat |
| ID | Term |
|---|---|
| D002072 | Butylene Glycols |
| D006018 | Glycols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D008698 | Mesylates |
| D000476 | Alkanesulfonates |
| D017738 | Alkanesulfonic Acids |
| D000473 | Alkanes |
| D006839 | Hydrocarbons, Acyclic |
| D006838 | Hydrocarbons |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D010649 | Phenylalanine |
| D024322 | Amino Acids, Aromatic |
| D000598 | Amino Acids, Cyclic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D018380 | Hematopoietic Stem Cell Transplantation |
| D033581 | Stem Cell Transplantation |
| D017690 | Cell Transplantation |
| D064987 | Cell- and Tissue-Based Therapy |
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |
| D011110 | Polymorphism, Genetic |
| D014644 | Genetic Variation |
| D055614 | Genetic Phenomena |
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D000813 | Anilides |
| D000577 | Amides |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
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