A Phase I/II Study of AKR1C3-Activated Prodrug OBI-3424 (OBI-3424) In Patients With Relapsed/Refractory T-Cell Acute Lymphoblastic Leukemia (T-ALL)/T-Cell Lymphoblastic Lymphoma (T-LBL)
Summary
This phase I/II trial studies the safety, side effects and best dose of OBI-3424 and how well it works in treating patients with T-cell acute lymphoblastic leukemia or T-cell lymphoblastic lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Chemotherapy drugs, such as OBI-3424, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. OBI-3424 may reduce the amount of leukemia in the body.
Detailed description
PRIMARY OBJECTIVES: I. To assess the safety of AKR1C3-activated prodrug OBI-3424 (OBI-3424) and to determine the maximum tolerated dose (MTD) of OBI-3424 in this regimen for patients with relapsed/refractory T-cell acute lymphoblastic leukemia (T-ALL)/T-cell lymphoblastic lymphoma (T-LBL). (Phase I) II. To assess the response rate (complete remission \[CR\] or CR with incomplete count recovery \[CRi\]) of patients treated with OBI-3424 at the maximum tolerated dose (MTD) determined in the Phase I portion of the trial in this patient population. (Phase II) SECONDARY OBJECTIVES: I. To estimate the frequency and severity of toxicities of OBI-3424 in this patient population. II. To estimate event-free survival (EFS), relapse-free survival (RFS) and overall survival (OS) in this patient population. TRANSLATIONAL MEDICINE OBJECTIVES: I. To estimate minimal/measurable residual disease (MRD) negativity (among patients who achieve CR or CRi). II. To assess AKR1C3 expression levels in this patient population. III. To evaluate associations between AKR1C3 expression and response to OBI-3424, achievement of MRD-negative remission, and relapse from remission. IV. To bank specimens for future research. OUTLINE: This is a phase I, dose-escalation study followed by a phase II study. Patients receive AKR1C3-activated prodrug OBI-3424 intravenously (IV) over 30 minutes on days 1 and 8. Treatment repeats every 21 days for up to 17 cycles in the absence of disease progression or unacceptable toxicity. Patients who have not achieved a partial remission (PR) by the 4th cycle of treatment are removed from the study (unless clinically benefiting in the opinion of the treating investigator). Patients undergo blood sample collection during screening and cerebrospinal fluid (CSF) sample collection on study. Patients also undergo bone marrow aspirate or core biopsy and may undergo computed tomography (CT) scan throughout the study. After completion of study treatment, patients are followed up every month for 1 year, every 2 months for 1 year, every 3 months for 1 year, and then every 6 months for up to 5 years from registration.
Arms & interventions
- DrugAKR1C3-activated Prodrug AST-3424
Given IV
- ProcedureBiopsy Procedure
Undergo biopsy
- ProcedureBiospecimen Collection
Undergo blood and CSF sample collection
- ProcedureBone Marrow Aspiration
Undergo bone marrow aspirate
- ProcedureComputed Tomography
Undergo CT scan
Outcome measures
Primary
Maximum tolerated dose (MTD) (Phase I)
The regimen will be considered safe and the MTD determined if the dose-limiting toxicity rate is \< 33%.
Time frame: Up to 21 days
Response rate (complete remission [CR] or CR with incomplete count recovery [CRi]) (Phase II)
Time frame: Up to 5 years
Secondary
Incidence of adverse events
Time frame: Up to the time of relapse, assessed up to 5 years
Overall survival
Time frame: From the day of registration on study until death from any cause with observations censored on the day of last contact for patients not known to have died, assessed up to 5 years
Event-free survival
Time frame: From the date of initial registration on study until the first of the following events: death from any cause, relapse from remission (CR or CRi) or completion of protocol therapy without documentation of CR or CRi, assessed up to 5 years
Relapse-free survival
Time frame: From the date the patient first achieves CR or CRi until relapse from CR/CRi or death from any cause, assessed up to 5 years
Eligibility criteria
Study locations (163)
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
Kingman Regional Medical Center
Kingman, Arizona, 86401
Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
PCR Oncology
Arroyo Grande, California, 93420
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Loma Linda University Medical Center
Loma Linda, California, 92354
Children's Hospital of Orange County
Orange, California, 92868
Children's Hospital Colorado
Aurora, Colorado, 80045
Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, 33701
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
Augusta University Medical Center
Augusta, Georgia, 30912
Loyola Center for Health at Burr Ridge
Burr Ridge, Illinois, 60527
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
Northwestern University
Chicago, Illinois, 60611
University of Illinois
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Loyola Medicine Homer Glen
Homer Glen, Illinois, 60491
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
Loyola University Medical Center
Maywood, Illinois, 60153
Marjorie Weinberg Cancer Center at Loyola-Gottlieb
Melrose Park, Illinois, 60160
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois, 60451
University of Chicago Medicine-Orland Park
Orland Park, Illinois, 60462
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
Mary Greeley Medical Center
Ames, Iowa, 50010
McFarland Clinic - Ames
Ames, Iowa, 50010
McFarland Clinic - Boone
Boone, Iowa, 50036
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
Norton Children's Hospital
Louisville, Kentucky, 40202
LSU Health Baton Rouge-North Clinic
Baton Rouge, Louisiana, 70805
Our Lady of the Lake Physician Group
Baton Rouge, Louisiana, 70808
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
Bronson Battle Creek
Battle Creek, Michigan, 49017
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
Weisberg Cancer Treatment Center
Farmington Hills, Michigan, 48334
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Beacon Kalamazoo Cancer Center
Kalamazoo, Michigan, 49009
Beacon Kalamazoo
Kalamazoo, Michigan, 49048
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
Corewell Health Lakeland Hospitals - Niles Hospital
Niles, Michigan, 49120
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
Corewell Health Lakeland Hospitals - Saint Joseph Hospital
Saint Joseph, Michigan, 49085
Munson Medical Center
Traverse City, Michigan, 49684
University of Michigan Health - West
Wyoming, Michigan, 49519
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
Cambridge Medical Center
Cambridge, Minnesota, 55008
Mercy Hospital
Coon Rapids, Minnesota, 55433
Fairview Southdale Hospital
Edina, Minnesota, 55435
Unity Hospital
Fridley, Minnesota, 55432
Fairview Clinics and Surgery Center Maple Grove
Maple Grove, Minnesota, 55369
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Health Partners Inc
Minneapolis, Minnesota, 55454
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
Monticello Cancer Center
Monticello, Minnesota, 55362
New Ulm Medical Center
New Ulm, Minnesota, 56073
Fairview Northland Medical Center
Princeton, Minnesota, 55371
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
Regions Hospital
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
Lakeview Hospital
Stillwater, Minnesota, 55082
Ridgeview Medical Center
Waconia, Minnesota, 55387
Rice Memorial Hospital
Willmar, Minnesota, 56201
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
Fairview Lakes Medical Center
Wyoming, Minnesota, 55092
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Carson Tahoe Regional Medical Center
Carson City, Nevada, 89703
Cancer and Blood Specialists-Henderson
Henderson, Nevada, 89052
Comprehensive Cancer Centers of Nevada - Henderson
Henderson, Nevada, 89052
Comprehensive Cancer Centers of Nevada-Horizon Ridge
Henderson, Nevada, 89052
Las Vegas Cancer Center-Henderson
Henderson, Nevada, 89052
OptumCare Cancer Care at Seven Hills
Henderson, Nevada, 89052
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson, Nevada, 89074
GenesisCare USA - Henderson
Henderson, Nevada, 89074
Las Vegas Urology - Green Valley
Henderson, Nevada, 89074
Las Vegas Urology - Pebble
Henderson, Nevada, 89074
Urology Specialists of Nevada - Green Valley
Henderson, Nevada, 89074
Las Vegas Urology - Pecos
Las Vegas, Nevada, 89074
Desert West Surgery
Las Vegas, Nevada, 89102
OptumCare Cancer Care at Charleston
Las Vegas, Nevada, 89102
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
Hope Cancer Care of Nevada
Las Vegas, Nevada, 89103
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
Urology Specialists of Nevada - Central
Las Vegas, Nevada, 89106
GenesisCare USA - Las Vegas
Las Vegas, Nevada, 89109
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
Las Vegas, Nevada, 89109
Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
HealthCare Partners Medical Group Oncology/Hematology-San Martin
Las Vegas, Nevada, 89113
Las Vegas Prostate Cancer Center
Las Vegas, Nevada, 89113
Las Vegas Urology - Sunset
Las Vegas, Nevada, 89113
Urology Specialists of Nevada - Southwest
Las Vegas, Nevada, 89113
Radiation Oncology Centers of Nevada Southeast
Las Vegas, Nevada, 89119
Ann M Wierman MD LTD
Las Vegas, Nevada, 89128
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas, Nevada, 89128
GenesisCare USA - Vegas Tenaya
Las Vegas, Nevada, 89128
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
Las Vegas, Nevada, 89128
Las Vegas Urology - Cathedral Rock
Las Vegas, Nevada, 89128
Las Vegas Urology - Smoke Ranch
Las Vegas, Nevada, 89128
OptumCare Cancer Care at MountainView
Las Vegas, Nevada, 89128
Urology Specialists of Nevada - Northwest
Las Vegas, Nevada, 89128
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
Comprehensive Cancer Centers of Nevada - Town Center
Las Vegas, Nevada, 89144
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas, Nevada, 89144
Summerlin Hospital Medical Center
Las Vegas, Nevada, 89144
Las Vegas Cancer Center-Medical Center
Las Vegas, Nevada, 89148-2405
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
GenesisCare USA - Fort Apache
Las Vegas, Nevada, 89148
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89148
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
Las Vegas, Nevada, 89149
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas, Nevada, 89169
University Cancer Center
Las Vegas, Nevada, 89169
Hope Cancer Care of Nevada-Pahrump
Pahrump, Nevada, 89048
Renown Regional Medical Center
Reno, Nevada, 89502
Saint Mary's Regional Medical Center
Reno, Nevada, 89503
Radiation Oncology Associates
Reno, Nevada, 89509
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Roswell Park Cancer Institute
Buffalo, New York, 14263
University of Rochester
Rochester, New York, 14642
Duke University Medical Center
Durham, North Carolina, 27710
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, 45069
Oregon Health and Science University
Portland, Oregon, 97239
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
Rhode Island Hospital
Providence, Rhode Island, 02903
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
The Children's Hospital at TriStar Centennial
Nashville, Tennessee, 37203
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
El Paso Children's Hospital
El Paso, Texas, 79905
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
Overlake Medical Center
Bellevue, Washington, 98004
Valley Medical Center
Renton, Washington, 98055
Fred Hutchinson Cancer Center
Seattle, Washington, 98109
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017