A Study of the Safety and Drug/Body Interactions of BGB-3111 for Patients with B-Cell Lymphoid Malignancies

Overview

About this study

The purpose of this study is to evaluate the safety, tolerability, drug/body interactions, and treatment effects of a new drug known as BGB-3111 in patients who have B-cell lymphoid malignancies.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Aged ≥ 18 years old.
  • Voluntarily consented to the study.
  • WHO classification defined B-lymphoid malignancy with the exception of Burkitt lymphoma/leukemia, plasma cell myeloma, acute lymphoblastic leukemia, lymphoblastic lymphoma, and plasmablastic lymphoma.
  • Requirement for treatment in the opinion of the investigator.
  • Disease which has relapsed, or is refractory, following at least one line of therapy, with no therapy of higher priority available.
  • ECOG performance status of 0-2.
  • Adequate hematologic function, as defined by neutrophils ≥ 1.0 x 10^9/L and platelets ≥ 50 x 10^9/L; patients with neutrophils < 1.0 x 10^9/L due to marrow infiltration are allowed to receive growth factors to bring pre-treatment neutrophils to ≥ 1.0 x 10^9/L.
  • Adequate renal function, as defined by creatinine clearance of ≥ 50 ml/min (as estimated by the Cockcroft-Gault equation or as measured by nuclear medicine scan or 24 hour urine collection).
  • Adequate liver function, as defined by AST and ALT ≤ 3 x ULN, and bilirubin ≤ 1.5 x ULN (unless documented Gilbert's syndrome).
  • INR and APTT ≤ 1.5 x ULN.
  • Female subjects of childbearing potential and non-sterile males must practice at least one of the following methods of birth control with partner(s) throughout the study and for 90 days after discontinuing study drug: t
    • Total abstinence from sexual intercourse;
    • Double-barrier contraception;
    • IUD;
    • Hormonal contraceptive initiated at least 3 months prior to first dose of study drug.
  • Male subjects must not donate sperm from initial study drug administration, until 90 days after drug discontinuation.

Exclusion Criteria:

  • Current CNS involvement by disease.
  • Current histologically transformed disease.
  • Prior BTK inhibitor treatment.
  • Allogeneic stem cell transplantation within 6 months, or has active GVHD requiring ongoing immunosuppression.
  • Receipt of the following treatment prior to first dose of BGB-3111:
    • Corticosteroids given with anti-neoplastic intent within 7 days;
    • Chemotherapy or radiotherapy within 2 weeks;
    • Monoclonal antibody within 4 weeks.
  • Not recovered from toxicity of any prior chemotherapy to grade ≤ 1.
  • History of other active malignancies within 2 years of study entry with the exception of:
    • Adequately treated in-situ carcinoma of cervix;
    • Localized basal cell or squamous cell carcinoma of skin'
    • Previous malignancy confined and treated locally (surgery or other modality) with curative intent.
  • Uncontrolled systemic infection requiring parenteral anti-microbial therapy.
  • Major surgery in the past 4 weeks.
  • Known HIV, or active hep B or hep C infection (detected positive by PCR).
  • Cardiovascular disease resulting in New York Heart Association function status of ≥ 3.
  • Significant active renal, neurologic, psychiatric, hepatic or endocrinologic disease that in the investigator's opinion would adversely impact on his/her participating in the study.
  • Inability to comply with study procedures.
  • On medications which are CYP3A inhibitors.

 

  • Current CNS involvement by disease.
  • Current histologically transformed disease.
  • Prior BTK inhibitor treatment.
  • Allogeneic stem cell transplantation within 6 months, or has active GVHD requiring ongoing immunosuppression.
  • Receipt of the following treatment prior to first dose of BGB-3111:
    • Corticosteroids given with anti-neoplastic intent within 7 days;
    • Chemotherapy or radiotherapy within 2 weeks;
    • Monoclonal antibody within 4 weeks.
  • Not recovered from toxicity of any prior chemotherapy to grade ≤ 1.
  • History of other active malignancies within 2 years of study entry, with the exception of:
    • Adequately treated in-situ carcinoma of the cervix;
    • Localized basal cell or squamous cell carcinoma of skin;
    • Previous malignancy confined and treated locally (surgery or other modality) with curative intent.
  • Uncontrolled systemic infection requiring parenteral anti-microbial therapy.
  • Major surgery in the past 4 weeks.
  • Known HIV, or active hep B or hep C infection (detected positive by PCR).
  • Cardiovascular disease resulting in New York Heart Association function status of ≥ 3.
  • Significant active renal, neurologic, psychiatric, hepatic or endocrinologic disease that in the investigator's opinion would adversely impact on his/her participating in the study.
  • Inability to comply with study procedures.
  • On medications which are CYP3A inhibitors.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Patrick Johnston, M.D., Ph.D.

Closed for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

More information

Publications

  • The phase I/II AU-003 study in patients with treatment-naïve (TN) or relapsed/refractory (R/R) chronic lymphocytic leukaemia/small lymphocytic lymphoma demonstrated that zanubrutinib therapy results in clinically meaningful and durable responses with acceptable safety and tolerability. We report updated safety and efficacy data for 123 patients with a median follow-up of 47·2 months. Patients received zanubrutinib 160 mg twice daily (81 patients), 320 mg once daily (40), or 160 mg once daily (two). Discontinuations due to adverse events or disease progression were uncommon. The overall response rate (ORR) was 95·9% (TN, 100%; R/R, 95%) with 18·7% achieving complete response (CR). Ongoing response at 3 years was reported in 85·7%. The ORR in patients with del(17p)/tumour protein p53 mutation was 87·5% (CR 16·7%). The 2- and 3-year progression-free survival estimates were 90% (TN, 90%; R/R, 91%) and 83% (TN, 81%; R/R, 83%) respectively. The most reported Grade ≥3 adverse events were neutropenia (15·4%), pneumonia (9·8%), hypertension (8·9%) and anaemia (6·5%). The annual incidence of atrial fibrillation, major haemorrhage, Grade ≥3 neutropenia and Grade ≥3 infection decreased over time. With a median follow-up of ~4 years, responses remain clinically meaningful and durable and long-term tolerability to zanubrutinib therapy continues. Read More on PubMed
  • Inhibitors of Bruton's tyrosine kinase (BTK) have established therapeutic activity in patients with Waldenström macroglobulinemia (WM). Zanubrutinib, a potent and selective BTK inhibitor, was evaluated in a phase 1/2 study in patients with WM who were either treatment-naïve (TN) or had relapsed/refractory (R/R) disease. Patients had disease requiring treatment per International Workshop on Waldenström Macroglobulinemia (IWWM) criteria. Treatment was 160 mg of oral zanubrutinib twice daily (n = 50) or 320 mg once daily (n = 23). Efficacy endpoints included overall response rate (ORR) and very good partial response/complete response (VGPR/CR) rates per IWWM-6 criteria (with modification of VGPR definition published previously). Between September 2014 and March 2018, 77 patients (24 TN and 53 R/R) began treatment. At a median follow-up of 36.0 months for patients with R/R disease and 23.5 months for TN, 72.7% remained on treatment. Reasons for treatment discontinuation included any adverse events in 13.0% of patients (1 treatment related), disease progression (10.4%), and other (3.9%). The ORR was 95.9%, and the VGPR/CR rate was 45.2%, which increased over time: 20.5% at 6 months, 32.9% at 12 months, and 43.8% at 24 months. Estimated 3-year progression-free survival rate was 80.5%, and overall survival rate was 84.8%. Adverse events of interest included contusion (32.5%, all grade 1), neutropenia (18.2%), major hemorrhage (3.9%), atrial fibrillation/flutter (5.2%), and grade 3 diarrhea (2.6%). Long-term treatment with single-agent zanubrutinib resulted in deep and durable responses in some patients with WM. The safety profile of long-term zanubrutinib therapy in these patients was acceptable. This trial was registered at www.clinicaltrials.gov as #NCT02343120. Read More on PubMed
  • Zanubrutinib is a potent and highly selective inhibitor of Bruton tyrosine kinase (BTK). In this first-in-human, open-label, multicenter, phase 1 study, patients in part 1 (3 + 3 dose escalation) had relapsed/refractory B-cell malignancies and received zanubrutinib 40, 80, 160, or 320 mg once daily or 160 mg twice daily. Part 2 (expansion) consisted of disease-specific cohorts, including treatment-naive or relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The primary end points were safety and tolerability, and definition of the maximum tolerated dose (part 1). Additional end points included pharmacokinetics/pharmacodynamics and preliminary efficacy. Reported herein are results from 144 patients enrolled in the dose-finding and CLL/SLL cohorts. No dose-limiting toxicities occurred in dose escalation. Median BTK occupancy in peripheral blood mononuclear cells was >95% at all doses. Sustained complete (>95%) BTK occupancy in lymph node biopsy specimens was more frequent with 160 mg twice daily than 320 mg once daily (89% vs 50%; = .0342). Consequently, 160 mg twice daily was selected for further investigation. With median follow-up of 13.7 months (range, 0.4-30.5 months), 89 CLL/SLL patients (94.7%) remain on study. Most toxicities were grade 1/2; neutropenia was the only grade 3/4 toxicity observed in >2 patients. One patient experienced a grade 3 subcutaneous hemorrhage. Among 78 efficacy-evaluable CLL/SLL patients, the overall response rate was 96.2% (95% confidence interval, 89.2-99.2). Estimated progression-free survival at 12 months was 100%. Zanubrutinib demonstrated encouraging activity in CLL/SLL patients, with a low incidence of major toxicities. This trial was registered at www.clinicaltrials.gov as #NCT02343120. Read More on PubMed

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