This is a multicentre, open-label, single-arm, phase I/II clinical study to evaluate the safety, efficacy and pharmacokinetics of liposomal mitoxantrone hydrochloride in combination with pegaspargase in patients with extranodal natural killer/T-cell lymphoma, nasal type (NKTCL).
This is a multicentre, open-label, single-arm, phase I/II clinical study with a dose-escalation stage (part 1) and a dose-expansion stage (part 2). In part 1, patients with treatment-naïve, relapsed/refractory extranodal natural killer/T-cell lymphoma (nasal type) will be assigned to receive sequentially higher doses of liposomal mitoxantrone hydrochloride plus a standard dose of pegaspargase every 21 days (a cycle). The dose escalation initially will follow an accelerated titration design for the first two dosing groups, then follow a classic 3+3 design. All dose-escalation decisions will be based on the safety data generated from the currently highest dose group. The maximum tolerated dose (MTD) and the recommended Phase 2 dose (RP2D) of liposomal mitoxantrone hydrochloride will be determined in part 1. In part 2, additional patients will be recruited into two groups,the treatment-naïve group and the relapsed or refractory group, to receive liposomal mitoxantrone hydrochloride at the RP2D combined with a standard dose of pegaspargase. All patients will receive the treatment until disease progression, or observation of unacceptable grade 3 drug-related adverse events (a maximum of 6 cycles).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
41
Drug: Liposomal mitoxantrone hydrochloride (12mg/m2, 16mg/m2, 20mg/m2, 24mg/m2) is administered by an intravenous infusion (IV) on day 1 of each 21-day cycle. Drug: Pegaspargase (2000IU/m2) is administered by an intramuscular injection (IM) on day 1 of each 21-day cycle.
Drug: Liposomal mitoxantrone hydrochloride (RP2D defined in Part 1) is administered by an intravenous infusion (IV) on day 1 of each 21-day cycle. Drug: Pegaspargase (2000IU/m2) is administered by an intramuscular injection (IM) on day 1 of each 21-day cycle.
the Affiliated Cancer Hospital of Guizhou Medical University
Guiyang, Guizhou, China
Part 1:dose limiting toxicities (DLTs)
The incidence and severity of adverse events (AEs), abnormalities in clinical laboratory assessments, ECGs, vital sign assessments, and physical exams
Time frame: Cycle 1 (a cycle = 21 days)
Part 2 (treatment-naïve patients):The percentage of patients who achieve complete response (CR)
CR rates at the end of chemotherapy
Time frame: up to 18 weeks
Part 2 (relapsed or refractory patients):The percentage of patients who achieve complete response (CR)
CR rates at the end of treatment(including chemotherapy and radiation)
Time frame: up to 26 weeks
Part 2 (relapsed or refractory patients):The percentage of patients who achieve partial response (PR)
PR rates at the end of treatment(including chemotherapy and radiation)
Time frame: up to 26 weeks
Part 1 the preliminary antitumor efficacy: complete response rate (CR)
the percentage of patients who achieve complete response (CR)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks
Part 1 the preliminary antitumor efficacy:overall response rate (ORR)
the percentage of patients who achieve complete response (CR)and partial response (PR)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks
Part 1 the preliminary antitumor efficacy:disease control rate (DCR)
the percentage of patients who achieve complete response (CR)、partial response (PR) and stable disease(SD)(including at the end of chemotherapy and at the end of treatment)
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Drug: Liposomal mitoxantrone hydrochloride (RP2D defined in Part 1) is administered by an intravenous infusion (IV) on day 1 of each 21-day cycle. Drug: Pegaspargase (2000IU/m2) is administered by an intramuscular injection (IM) on day 1 of each 21-day cycle.
Time frame: up to 26 weeks
Part 1: The pharmacokinetic parameters Cmax
maximum concentration(Cmax)
Time frame: At the end of Cycle 1 and Cycle 3 (each cycle is 21 days)
Part 1: The pharmacokinetic parameters AUC0-t
area under the curve from zero to the time point(AUC0-t)
Time frame: At the end of Cycle 1 and Cycle 3 (each cycle is 21 days)
Part 2 (treatment-naïve patients):The preliminary antitumor efficacy complete response rate (CR)
the percentage of patients who achieve complete response (CR)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks
Part 2 (treatment-naïve patients):The preliminary antitumor efficacy overall response rate (ORR)
the percentage of patients who achieve complete response (CR)and partial response (PR)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks
Part 2 (treatment-naïve patients):The preliminary antitumor efficacy disease control rate (DCR)
the percentage of patients who achieve complete response (CR)、partial response (PR) and stable disease(SD)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks
Part 2 (treatment-naïve patients):The preliminary safety index
The incidence and severity of adverse events (AEs), abnormalities in clinical laboratory assessments, ECGs, vital sign assessments, and physical exams
Time frame: through study completion, an average of 1 year
Part 2 (relapsed or refractory patients): The preliminary antitumor efficacy
disease control rate (DCR):the percentage of patients who achieve complete response (CR)、partial response (PR) and stable disease(SD)(including at the end of chemotherapy and at the end of treatment)
Time frame: up to 26 weeks