The primary objectives of this study are to evaluate safety, tolerability, pharmacokinetics (PK) and preliminary efficacy of idelalisib; and to establish recommended phase 2 doses (RP2D) of idelalisib in combination with rituximab, ifosfamide, carboplatin, etoposide (RICE) in children and adolescents with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) or mediastinal B-cell lymphoma (MBCL)
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Tablet (s) or dispersible tablets for suspension administered orally twice daily
375 mg/m\^2 administered intravenously
3 mg/m\^2 administered intravenously
Centre Hospitalier Régional Universitaire de Lille
Lille, France
Istituto Giannina Gaslini
Genova, Italy
Ospedale Pediatrico Bambino Gesu
Roma, Italy
Infantile Regina Margherita Hospital
Torino, Italy
Incidence Rate of Dose Limiting Toxicities (DLTs)
DLTs refer to toxicities experienced during the first 21 days of study treatment that have been judged to be clinically significant and related to study treatment.
Time frame: Up to Day 21
Proportion of Participants Experiencing Adverse Events (AEs)
Time frame: Up to 12 months
Proportion of Participants Experiencing Serious Adverse Events (SAEs)
Time frame: Up to 12 months
Proportion of Participants Experiencing Adverse Events (AEs) Leading to Idelalisib Interruption, Idelalisib Dose Reduction, Premature Discontinuation of Idelalisib, or Death
Time frame: Up to 12 months
Rate of Grade ≥ 3 Transaminase Elevations Based on Laboratory Findings
Time frame: Up to 12 months
Overall Response Rate (ORR)
Overall response rate (ORR) is defined as the proportion of participants who achieve a best response of Complete Response (CR) or Partial Response (PR) after the first dose of idelalisib (either as a result of monotherapy or in combination with RICE chemoimmunotherapy). The screening imaging study will serve as the reference for ORR.
Time frame: Up to 12 months
Overall Survival (OS)
Overall Survival (OS) is defined as the interval from the first dose date of idelalisib to death from any cause.
Time frame: Up to 5 years
Progression-Free Survival (PFS)
Progression-Free Survival (PFS) is defined as the interval from the start date of RICE to the earlier of the first documentation of disease progression or death from any cause. Computed tomography/ magnetic resonance imaging (CT/MRI) scan at the conclusion of idelalisib monotherapy will serve as the reference for progression.
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635 mg/m\^2 administered intravenously
100 mg/m\^2 administered intravenously
Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu
Wroclaw, Poland
Hospital Vall d´Hebrón
Barcelona, Spain
Hospital Universitario HM Monteprincipe
Madrid, Spain
Time frame: Up to 12 months
Pharmacokinetic Parameter: Cmax of Idelalisib
Cmax is defined as the maximum observed concentration of drug.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Pharmacokinetic Parameter: Cmax of GS-563117
GS-563117 is the metabolite of idelalisib. Cmax is defined as the maximum observed concentration of drug.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Pharmacokinetic Parameter: Ctrough of Idelalisib
Ctrough is defined as the plasma concentration at the end of the dosing interval.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Pharmacokinetic Parameter: Ctrough of GS-563117
Ctrough is defined as the plasma concentration at the end of the dosing interval.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Pharmacokinetic Parameter: Area Under the Concentration-Time Curve (AUC) of Idelalisib
AUC is defined as the plasma concentration at the end of the dosing interval.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Pharmacokinetic Parameter: Area Under the Concentration-Time Curve (AUC) of GS-563117
AUC is defined as the plasma concentration at the end of the dosing interval.
Time frame: Predose and up to 24 hours postdose on Day 1 and Cycle 1, Day 5 of idelalisib + RICE combination therapy
Levels of Optional Exploratory Biomarkers on Bone Marrow Samples (eg pAKT, pS6 ribosomal protein) and plasma cytokines
Time frame: Baseline and Day 21
Acceptability and Palatability of Idelalisib 10-mg Dispersible Tablet
For participants who cannot swallow a whole tablet, the investigator will ask if the tablet administered as a suspension is palatable and will observe if the participant is able to swallow the dosage form. The acceptability and palatability of idelalisib dispersible tablets administered as an oral suspension (for participants unable to swallow the tablet) will be evaluated by a questionnaire administered to the participant and/or the parent/legal guardian.
Time frame: Day 1 of idelalisib monotherapy and at Day 1, Cycle 1 of idelalisib in combination with RICE chemoimmunotherapy