AINV18P1 is a Phase 1 study where palbociclib will be administrated in combination with a standard re-induction platform in pediatric relapsed Acute Lymphoblastic Leukemia (ALL) and lymphoblastic lymphoma (LL). LL patients are included because the patient population is rare and these patients are most commonly treated with ALL regimens. The proposed palbociclib starting dose for this study will be 50 mg/m\^2/day for 21 days.
PRIMARY OBJECTIVES: I. To estimate the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of palbociclib administered in combination with re-induction chemotherapy in pediatric patients with relapsed B- or T-lineage ALL/LL. II. To define and describe the toxicities of palbociclib administered on this schedule. III. To characterize the pharmacokinetics of palbociclib in pediatric patients with relapsed B- or T-lineage ALL/LL. SECONDARY OBJECTIVES: I. To preliminarily define the antitumor activity of palbociclib in combination with chemotherapy for children with relapsed ALL/LL within the confines of a Phase 1 study. II. To assess the biologic activity of palbociclib in this patient population. OUTLINE: Patients receive Palbociclib PO (or via NG-tube) once daily on Days 1-21; Intrathecal cytarabine (IT ARAC) on Day 1, Doxorubicin IV push or infusion over 1-15 min on Day 4; Prednisone or prednisolone PO on days 4-31; Vincristine IV push or mini-bag per institutional policy on Days 4, 11, 18, and 25; and Pegaspargase IV over 1-2 hours on Days 5, and 18. If CNS3 leukemia is present, patients receive Intrathecal Triple Therapy (ITT) on days 4, 11,18, and 25. If CNS1 or 2 disease status, patients receive Methotrexate (IT MTX) on Days 18 and 32. Patients known to be CNS3 at study entry may receive ITT on Day 1 rather than IT ARAC. Treatment will be given for one cycle, 32 days, in the absence of disease progression or unacceptable toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Given PO (or via NG- tube)
Given intrathecally (IT)
Given intrathecally (IT)
Given IT
Given intravenously (IV)
Either prednisone or prednisolone is given PO
Given IV
Given IV
Given intrathecally (IT)
Either prednisone or prednisolone is given PO
Children's Hospital of Alabama
Birmingham, Alabama, United States
Loma Linda University Medical Center
Loma Linda, California, United States
Children's Hospital of Orange County
Orange, California, United States
Lucile Packard Children's Hospital Stanford University
Palo Alto, California, United States
Children's Hospital Colorado
Aurora, Colorado, United States
Children's National Medical Center
Washington D.C., District of Columbia, United States
Children's Healthcare of Atlanta - Egleston
Atlanta, Georgia, United States
Riley Hospital for Children
Indianapolis, Indiana, United States
C S Mott Children's Hospital
Ann Arbor, Michigan, United States
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, United States
...and 9 more locations
Frequency of Dose Limiting Toxicities of Palbociclib
The frequency (%) of patients experiencing a cycle 1 dose limiting toxicity at least possibly attributable to Palbociclib by study part and dose level.
Time frame: Up to 32 days
Frequency of Adverse Events of Palbociclib
The frequency (%) of patients experiencing adverse events at least possibly attributable to Palbociclib by study part and dose level.
Time frame: Up to 26 months
Area Under the Drug Concentration Curve of Palbociclib
The median (min, max) of the area under the drug concentration curve for Palbociclib determined by measures at 0, 1, 2, 4, 8, and 24 hours post-dose on day 11 by study part and dose level.
Time frame: Up to 11 days
Half-life of Palbociclib
The median (min, max) of the half-life of Palbociclib determined by measures at 0, 1, 2, 4, 8, and 24 hours post-dose on day 11 by study part and dose level.
Time frame: Up to 11 days
Maximum Serum Concentration of Palbociclib
Median (min, max) of the maximum serum concentration of Palbociclib determined by measures at 0, 1, 2, 4, 8, and 24 hours post-dose on day 11 by study part and dose level
Time frame: Up to 11 days
Time to Reach Maximum Serum Concentration of Palbociclib
Median (min, max) of the maximum time to reach serum concentration of Palbociclib determined by measures at 0, 1, 2, 4, 8, and 24 hours post-dose on day 11 by study part and dose level
Time frame: Up to 11 days
Clearance of Palbociclib
Median (min, max) of the clearance of Palbociclib determined by measures at 0, 1, 2, 4, 8, and 24 hours post-dose on day 11 by study part and dose level
Time frame: Up to 11 days
Number of Participants With at Least Partial Response to Palbociclib
Frequency (%) of patients with at least partial response to Palbociclib per leukemia/lymphoma specific response criteria: Complete Response (CR), M1 marrow (\<5% blasts) and absolute neutrophil count (ANC) at least 500/uL and platelet count at least 50000/uL without transfusion for 7 days; Complete response with incomplete recovery (CRi), M1 marrow (\<5% blasts), ANC\<500uL, platelet count \<50,000uL; Partial Response (PR), Complete disappearance of circulating blasts and achievement of M2 marrow status if M3 originally, without new sites of extramedullary disease, and with ANC ≥ 500/µL. Complete response in the marrow without resolution of extramedullary sites. Overall Response (OR) = CR+CRi+PR
Time frame: up to 26 months
Absolute Peripheral Blast Count of Palbociclib
Median (min, max) of absolute peripheral blast count of palbociclib by study part and dose level
Time frame: Up to 3 days
Radiographic Response of Palbociclib in Patients With LL Patients
Number of LL patients with radiographic response by study part and dose level. Complete Response (CR): Disappearance of all disease; Partial Response (PR): 50% decrease in SPD (the sum of the products of the largest diameter and the perpendicular diameter for a tumor mass). Total responders = CR+PR
Time frame: Day 32
RB1 Expression of Palbociclib
Median (min,max) of RB1 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
Phospho-RB1 Expression of Palbociclib
Median (min,max) of Phospho-RB1 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
Cyclin D3 Expression of Palbociclib
Median (min,max) of Cyclin D3 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
CDK4 Expression of Palbociclib
Median (min,max) of CDK4 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
CDK6 Expression of Palbociclib
Median (min,max) of CDK6 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
p27Kip1 Expression of Palbociclib
Median (min,max) of p27Kip1 expression of palbociclib by study part and dose level
Time frame: Up to 4 days
Ki67 Biological Activity of Palbociclib
Median (min,max) of CD1a biological activity of palbociclib
Time frame: Up to 32 days
DAPI Biological Activity of Palbociclib
Median (min,max) of DAPI biological activity of palbociclib by study part and dose level
Time frame: up to 26 months