Pharmacokinetic Study of Venetoclax Tablets Crushed and Dissolved Into a Solution

Children's Hospital Medical Center, Cincinnati30 enrolled

Overview

The use of venetoclax-based therapies for pediatric patients with relapsed or refractory malignancies is increasingly common outside of the clinical trial setting. For patients who cannot swallow tablets, it is common to crush the tablets and dissolve them in liquid to create a solution. However, no PK data exists in adults or children using crushed tablets dissolved in liquid in this manner, and as a result, the venetoclax exposure with this solution is unknown. Primary Objectives • To determine the pharmacokinetics of venetoclax when commercially available tablets are crushed and dissolved into a solution Secondary Objectives * To evaluate the safety of crushed venetoclax tablets administered as an oral solution * To determine the pharmacokinetics of venetoclax solution in patients receiving concomitant strong and moderate CYP3A inhibitors * To determine potential pharmacokinetic differences based on route of venetoclax solution administration (ie. PO vs NG tube vs G-tube) * To determine the concentration of venetoclax in cerebral spinal fluid when administered as an oral solution

Peripheral blood will be drawn at multiple time points to evaluate venetoclax pharmacokinetics in patients who are receiving venetoclax solution made from crushed tablets as part of their oncology treatment.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Hematologic Malignancy Leukemia Lymphoma Acute Lymphocytic Leukemia

Eligibility

Sex: ALLMin age: 0 YearsMax age: 38 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age: Patients must be \<39 years of age at time of study enrollment * Diagnosis: Patients may have a diagnosis of any hematologic malignancy * Central access: Patients must have an existing venous or arterial access line for PK blood draws * Weight requirement: Patients must weigh at least 5.5 kg at the time of enrollment * Venetoclax: Patients must be receiving any dose of venetoclax given as a solution made from crushed tablets by mouth (PO) or via nasogastric (NG), or G-tube as prescribed by their treating oncologist. * Concurrent chemotherapy medications: Patients may receive venetoclax as a single agent or in combination with any other chemotherapeutic agents. Exclusion Criteria: * Pregnant women are excluded from this study because venetoclax has the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with venetoclax, breastfeeding should be discontinued if the mother is treated with venetoclax. * Males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method while on study treatment and for six months following completion.

Outcomes

Primary Outcomes

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: the observed peak plasma concentration (Cmax)

Time frame: Blood will be collected on one PK day between Days 5-12 after completion of the venetoclax dose ramp-up : within 1hr prior to the administration of venetoclax, then 2hrs, 5hrs, 12hrs, 18hrs and 24hrs after the administration of venetoclax.

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: the time to peak (Tmax)

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: the apparent terminal phase elimination rate constant (β)

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: the terminal-phase elimination half-life (T1/2)

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: the areas under plasma concentration curve (AUC) over a 24-hour dose interval (AUC0-24) or for infinite time (AUC0-∞)

Clearance (CL) as measured by PK sampling (Peripheral Blood; Required)

PK parameters of venetoclax will be described in peripheral blood including: oral clearance (CL/F) of venetoclax