This is an open-label non-randomized two-center phase 2 study evaluating the safety and efficacy of concurrent therapy with ibrutinib and venetoclax in subjects with relapsed or refractory CLL/SLL.
The primary objective of this study is to evaluate the efficacy of concurrent therapy with ibrutinib and venetoclax in patients with relapsed and refractory chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL). The secondary objectives of this study are to define the safety, tolerability, and dose-limiting toxicity (DLT) within 28 days of completion of dose-escalation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
22
Administered at 420 mg/day, as oral capsules (3 x 140 mg), starting Day 1, Week 1.
Administered as tablets, starting Day 1, Week 9, with dose increasing every 7 days through 5 dose levels (20 mg; 50 mg; 100 mg; 200 mg; 400 mg).
City of Hope
Duarte, California, United States
Stanford University, School of Medicine
Stanford, California, United States
Complete Response (CR)
Complete Response (CR) will be assessed as the number of participants who, based on investigator assessment based on the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria, achieve a complete remission. IWCLL complete remission is defined as follows. * Lymphadenopathy: none \> 1.5 cm * Blood lymphocytes: \< 4,000/µL * Hepatomegaly: none * Splenomegaly: none * Bone marrow: normocellular with \< 30 lymphocytes, no B lymphoid nodules. The outcome is reported as the number of participants who achieve CR, a number without dispersion.
Time frame: 62 weeks
Duration of Response (DoR)
Duration of response (DoR) refers to a participant maintaining clinical response after achieving either complete response (CR) or partial response (PR). The outcome is reported as the number of subjects who have maintained clinical response through 117 weeks. Response defined as the following. CR. * Lymphadenopathy: none \> 1.5 cm * Blood lymphocytes: \< 4,000/µL * Hepatomegaly: none * Splenomegaly: none * Bone marrow: normocellular with \< 30 lymphocytes, no B lymphoid nodules. PR. * Lymphadenopathy: decrease ≥ 50% * Blood lymphocytes: decrease ≥ 50% * Hepatomegaly: decrease ≥ 50% * Splenomegaly: decrease ≥ 50% * Bone marrow: not considered.
Time frame: 117 weeks
Minimal Residual Disease (MRD)
Minimal residual disease (MRD) refers to the small numbers of leukemic cells that can remain in the participant after treatment, and may not be associated with any symptoms (remission). Although the participant may feel "healthy," the MRD is a major cause of eventual leukemic relapse. "MRD-negative" is the ideal treatment outcome. MRD negativity was defined as less than one leukemic cell per 10,000 leukocytes as assessed by bone marrow-based flow cytometry. The outcome is reported as the number of participants who were positive for MRD, or negative.
Time frame: 117 weeks
Overall Response (OR)
Overall response (OR) is the overall number of subjects that begin treatment and achieve a complete response (CR); partial response (PR); or Stable Disease (SD) 62 weeks after the beginning of treatment, according to the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria. IWCLL CR is defined as follows. The outcome is reported as the number of participants who achieve CR, PR, or SD, and number without dispersion. CR: * Lymphadenopathy: none \> 1.5 cm * Blood lymphocytes: \< 4,000/µL * Hepatomegaly: none * Splenomegaly: none * Bone marrow: normocellular with \< 30 lymphocytes, no B lymphoid nodules. PR: * Lymphadenopathy: decrease ≥ 50% * Blood lymphocytes: decrease ≥ 50% * Hepatomegaly: decrease ≥ 50% * Splenomegaly: decrease ≥ 50% * Bone marrow: not considered. SD: * Lymphadenopathy: change of ± 49% * Blood lymphocytes: change of ± 49% * Hepatomegaly: change of ± 49% * Splenomegaly: change of ± 49% * Bone marrow: not considered.
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Time frame: 62 weeks
Overall Survival (OS)
Overall survival (OS) represents the amount of time the participants remain alive after treatment. The outcome is reported as the number of participants remaining alive at 117 weeks (about 2 years and 3 months) after the start of treatment, a number without dispersion.
Time frame: Through 117 weeks
Progression-free Survival (PFS)
Progression-free survival (PFS) is a term that means to remain alive with progressive disease (PD). PD is defined as * Lymphadenopathy: Increase ≥ 50% * Blood lymphocytes: Increase ≥ 50% * Hepatomegaly: Increase ≥ 50% * Splenomegaly: Increase ≥ 50% * Bone marrow: not considered. The outcome is reported as the number of participants who remained alive without PD 117 weeks after the beginning of treatment.
Time frame: 117 weeks
Time-to-progression (TTP)
Time-to-progression (TTP) is a measure of the length of time from the beginning of treatment until progressive disease (PD). PD is defined as * Lymphadenopathy: Increase ≥ 50% * Blood lymphocytes: Increase ≥ 50% * Hepatomegaly: Increase ≥ 50% * Splenomegaly: Increase ≥ 50% * Bone marrow: not considered. The outcome will be reported as the median TTP as determined by Kaplan-Meier methodology, with 95% confidence interval (95% CI).
Time frame: Through 117 weeks