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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2018-01039 | Registry Identifier | CTRP (Clinical Trial Reporting Program) |
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This phase I/II trial studies the side effects and best dose of venetoclax when given together with carmustine, etoposide, cytarabine, and melphalan before stem cell transplant in treating participants with non-Hodgkin lymphoma that has come back or does not respond to treatment. Drugs used in chemotherapy, such as venetoclax, carmustine, etoposide, cytarabine, 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. Giving chemotherapy before a stem cell transplant helps kill any cancer cells that are in the body and helps make room in the patient?s bone marrow for new blood-forming cells (stem cells) to grow.
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose (MTD) of venetoclax that can be safely combined with carmustine, etoposide, cytarabine, and melphalan (BEAM) prior to autologous stem cell transplant which will the recommended phase II dose (RP2D).
II. Determine the safety and efficacy of venetoclax as measured by overall response rate (ORR) at day 100, 12-month survival and freedom from relapse (FFR-12).
SECONDARY OBJECTIVES:
I. Long term effects (progression-free survival [PFS] and overall survival [OS]) of addition of venetoclax to BEAM.
II. Correlation of response and survival with expression of BCL-2, BCL-XL, and MCL-1 as measured by immunohistochemistry (IHC).
OUTLINE: This is a dose-escalation study of venetoclax.
Participants receive venetoclax orally (PO) once daily (QD) on days -10 to -1, carmustine intravenously (IV) on day -6, etoposide IV twice daily (BID) on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic stem cell transplantation on day 0.
After completion of study treatment, participants are followed up for 2 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (venetoclax, BEAM) | Experimental | Participants receive venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Carmustine | Drug | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose of Venetoclax Defined to be the Dose Cohort Below Which 3 Out of 6 Patients Experience Dose Limiting Toxicities or the Highest Dose Cohort of 1200 mg, if 2 Dose Limiting Toxicities Are Not Observed at Any Dose Cohort | Up to 2 years | |
| Overall Response Rate | Will be estimated as the proportions of patients who achieve a complete response or partial response divided by the number of evaluable patients. Each will be reported with their associated 95% confidence interval. | At day 100 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Progression of Disease | Estimated using Kaplan-Meier method. | Up to 2 years |
| Number of Participants Free From Relapse | Estimated using Kaplan-Meier method. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kami Maddocks, MD | Ohio State University Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ohio State University Comprehensive Cancer Center | Columbus | Ohio | 43210 | United States |
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| Label | URL |
|---|---|
| The Jamesline | View source |
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For this study, dose level 3 was determined to be the maximum tolerated dose (MTD). Therefore, 10 patients who were accrued for the expansion phase were treated at the MTD. Combining with 3 patients treated at dose level 3 in the escalation phase, all 13 patients were treated at the same dose level. Therefore, they were grouped together for the results reporting.
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| ID | Title | Description |
|---|---|---|
| FG000 | Cohort A (Venetoclax 400 mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Dec 9, 2020 |
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| Cytarabine | Drug | Given IV |
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| Etoposide | Drug | Given IV |
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| Hematopoietic Cell Transplantation | Procedure | Undergo hematopoietic cell transplantation |
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| Melphalan | Drug | Given IV |
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| Venetoclax | Drug | Given PO |
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| Up to 2 years |
| Overall Survival | Estimated using Kaplan-Meier method. | Up to 2 years |
| FG001 | Cohort B (Venetoclax 800mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation) | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| FG002 | Cohort C (Venetoclax 1200mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation) | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| COMPLETED |
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| NOT COMPLETED |
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For this study, dose level 3 was determined to be the maximum tolerated dose (MTD). Therefore, 10 patients who were accrued for the expansion phase were treated at the MTD. Combining with 3 patients treated at dose level 3 in the escalation phase, all 13 patients were treated at the same dose level. Therefore, they were grouped together for the results reporting.
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| ID | Title | Description |
|---|---|---|
| BG000 | Cohort A (Venetoclax 400mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation) | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| BG001 | Cohort B (Venetoclax 800mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation) | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| BG002 | Cohort C (Venetoclax 1200mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation) | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Maximum Tolerated Dose of Venetoclax Defined to be the Dose Cohort Below Which 3 Out of 6 Patients Experience Dose Limiting Toxicities or the Highest Dose Cohort of 1200 mg, if 2 Dose Limiting Toxicities Are Not Observed at Any Dose Cohort | Posted | Number | mg | Up to 2 years |
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| ||||||||||||||||||||||||||||
| Primary | Overall Response Rate | Will be estimated as the proportions of patients who achieve a complete response or partial response divided by the number of evaluable patients. Each will be reported with their associated 95% confidence interval. | Posted | Number | percentage of participants | At day 100 |
| |||||||||||||||||||||||||||||
| Secondary | Number of Participants With Progression of Disease | Estimated using Kaplan-Meier method. | Posted | Count of Participants | Participants | Up to 2 years |
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| Secondary | Number of Participants Free From Relapse | Estimated using Kaplan-Meier method. | Posted | Count of Participants | Participants | Up to 2 years |
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| Secondary | Overall Survival | Estimated using Kaplan-Meier method. | Posted | Median | 95% Confidence Interval | Months | Up to 2 years |
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The National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for AE reporting for up to 2 years
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cohort A (Venetoclax 400mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO | 0 | 3 | 1 | 3 | 3 | 3 |
| EG001 | Cohort B (Venetoclax 800mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO | 0 | 3 | 1 | 3 | 3 | 3 |
| EG002 | Cohort C (Venetoclax 1200mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation | Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO | 0 | 13 | 4 | 13 | 13 | 13 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | CTCAE v4.0 | Systematic Assessment |
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| Hypophosphatemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Neutrophil count decreased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Platelet count decreased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Respiratory failure | Respiratory, thoracic and mediastinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Activated Partial Thromboplastin Time Prolonged | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Alkaline phosphatase increased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | CTCAE v4.0 | Systematic Assessment |
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| Atrial fibrillation | Cardiac disorders | CTCAE v4.0 | Systematic Assessment |
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| Blood bilirubin increased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | CTCAE v4.0 | Systematic Assessment |
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| Fatigue | General disorders | CTCAE v4.0 | Systematic Assessment |
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| Gastrointestinal disorder, GI | Gastrointestinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Hyperkalemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Hypernatremia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Hypoalbuminemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Hypocalcemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| Hypomagnesemia | Metabolism and nutrition disorders | CTCAE v4.0 | Systematic Assessment |
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| INR increased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Infection | Infections and infestations | CTCAE v4.0 | Systematic Assessment |
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| Insomnia | Psychiatric disorders | CTCAE v4.0 | Systematic Assessment |
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| Lung infection | Infections and infestations | CTCAE v4.0 | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Oral pain | Gastrointestinal disorders | CTCAE v4.0 | Systematic Assessment |
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| Pain (at line site) | Skin and subcutaneous tissue disorders | CTCAE v4.0 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | CTCAE v4.0 | Systematic Assessment |
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| Platelet count decreased | Investigations | CTCAE v4.0 | Systematic Assessment |
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| Sinus tachycardia | Cardiac disorders | CTCAE v4.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Kami Maddocks | The Ohio State University Comprehensive Cancer Center | 614-293-9165 | Kami.Maddocks@osumc.edu |
| May 10, 2022 |
| Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D008224 | Lymphoma, Follicular |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D008228 | Lymphoma, Non-Hodgkin |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| 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 |
|---|---|
| D002330 | Carmustine |
| C574855 | carmustine, poliferprosan 20 drug combination |
| D003561 | Cytarabine |
| D005047 | Etoposide |
| D033581 | Stem Cell Transplantation |
| D018380 | Hematopoietic Stem Cell Transplantation |
| D008558 | Melphalan |
| C579720 | venetoclax |
| ID | Term |
|---|---|
| D009607 | Nitrosourea Compounds |
| D014508 | Urea |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D009603 | Nitroso Compounds |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001087 | Arabinonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D017690 | Cell Transplantation |
| D064987 | Cell- and Tissue-Based Therapy |
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |
| 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 |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Cohort C (Venetoclax 1200 mg and BEAM Conditioning Followed by Autologous Stem Cell Transplantation |
Participants receive venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
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Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
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Participants receive venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
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Participants receive Venetoclax PO QD on days -10 to -1, carmustine IV on day -6, etoposide IV BID on days -5 to -2, cytarabine IV BID on days -5 to -2, and melphalan IV on day -1. Participants then undergo hematopoietic cell transplantation on day 0. Carmustine: Given IV Cytarabine: Given IV Etoposide: Given IV Hematopoietic Cell Transplantation: Undergo hematopoietic cell transplantation Melphalan: Given IV Venetoclax: Given PO |
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