Safety Study of ON 013105 in Lymphoma and Acute Lymphoid Leukemia

Overview

This is an open-label, dose-escalation Phase 1 study of the investigational agent, ON 013105. In laboratory animal studies, ON 013105 has demonstrated anti-cancer activity. The purpose of this study is to determine the highest dose of ON 013105 that can be given safely in patients with relapsed/refractory Lymphoma or B-cell Acute Lymphocytic Leukemia (Philadelphia chromosome negative). Patients will receive weekly 2-hour IV infusions of ON 013105 at higher and higher doses until intolerable side effects are observed. It is important to know the highest safe dose so additional studies can be done.

This is an open-label, dose-escalation Phase I study of ON 013105 in patients with relapsed/refractory Lymphoma or B-cell Acute Lymphocytic Leukemia (Philadelphia chromosome negative) who have satisfied all inclusion/exclusion criteria. Patients will receive weekly 2-hour IV infusions of ON 013105, until evidence of disease progression, intolerable adverse events, or withdrawal of patient consent. Up to 12 additional patients will be treated at the RPTD level. The starting dose will be 17 mg over a 2-hour weekly infusion. Each cycle will comprise three weeks. Up to 43 patients may be enrolled, of which approximately 7 to 37 patients will be enrolled in the dose escalation portion of the study to determine the RPTD. After the maximally administered dose is attained and at least six patients have received a tentative RPTD, up to 6 additional patients may be enrolled in the dose confirmation phase to confirm the RPTD level. Treatment will be administered in the Clinical Research center for the first dose for all patients at each given dose level. If there is no toxicity, then subsequent doses at that level for that patient may be administered on an outpatient basis, unless hospitalization is required for another reason. According to the Simon accelerated titration design, one-patient cohorts and 100% dose increments will be implemented until non-hematological grade 2 toxicity is observed during the first 3-week cycle. The design will then convert to standard 3/6 patient cohorts starting at the dose level where grade 2 toxicity was observed and following 40% dose increments for the subsequent cohorts. If none of the first three patients experiences a dose-limiting toxicity (DLT) during the first cycle (3 weeks), the next 3 patients will receive the next dose level. If there is a DLT in one of the first three patients, this dose level will be expanded to 6 patients. If 1 patient out of 6 experiences DLT, the next patients will receive the next dose level. If ≥ 2 patients experience DLT at any dose level, this dose level will be declared the Maximally Administered Dose. The Maximally Tolerated Dose (MTD) and RPTD will be the highest dose level below the Maximally Administered Dose with 0 out of 3 patients or one out of 6 patients with DLT. Dosing will be reduced to the immediate lower dose for any patient who experiences a DLT at any time. If Grade 1 non-hematological toxicity occurs, treatment will be continued at the original dose without dose reduction. Patients with stable disease or response can continue treatment up to eight 3-week cycles. Further continuation will be determined by the clinical judgment of the Investigator. Patients who drop out for any reason may not re-enter the trial. Blood samples will be collected during Day 1 of the first cycle for pharmacokinetic assessment. Responses will be assessed according to Cheson, B.D., et al., Revised Response Criteria for Malignant Lymphoma, J Clin Oncol 2007. 25: p. 579-86.