Safety Study of the Proteasome Inhibitor PR-171 (Carfilzomib for Injection) in Patients With Hematological Malignancies

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Amgen

Status and phase

Completed
Phase 1

Conditions

Multiple Myeloma
Non-Hodgkin's Lymphoma
Hodgkin's Disease
Waldenstrom's Macroglobulinemia

Treatments

Drug: Carfilzomib
Drug: Dexamethasone

Study type

Interventional

Funder types

Industry

Identifiers

NCT00150462
PX-171-002

Details and patient eligibility

About

The purpose of this study is to test the safety and tolerability of carfilzomib at different dose levels on hematological cancers such as multiple myeloma, non-Hodgkin's lymphoma, Hodgkin's disease, or Waldenstrom's macroglobulinemia. Carfilzomib is a proteasome inhibitor, an enzyme responsible for degrading a wide variety of cellular proteins.

Enrollment

48 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Written informed consent in accordance with federal, local, and institutional guidelines
  • Males and females ≥18 years of age

Histologically confirmed diagnosis of one of the hematologic malignancies below:

  • Multiple myeloma (MM)
  • Non-Hodgkin's lymphoma (NHL)
  • Waldenström's Macroglobulinemia (WM)
  • Hodgkin's disease (HD)
  • Subjects who are refractory or relapsed following at least two prior therapies
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
  • Adequate cardiovascular function without symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention, or myocardial infarction in the previous six months
  • Adequate hepatic function, with bilirubin < 2.0 times the upper limit of normal, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) of < 3.0 times the upper limit of normal

Total white blood cell (WBC) count ≥ 2,000/mm³, absolute neutrophil count (ANC) ≥ 1000/mm³, hemoglobin ≥ 8.0 g/dL, and platelet count ≥ 50,000/mm³

  • Screening ANC should be independent of granulocyte colony stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) support for ≥ 1 week and of pegylated G-CSF for ≥ 2 weeks)
  • Subjects receiving supportive care including erythropoietin, darbepoetin and/or bisphosphonates can continue to do so, but must be transfusion independent; subjects receiving erythropoietic support must remain on the same dose for the first 28 days of study participation
  • An estimated creatinine clearance of ≥ 30 mL/min, calculated using the formula of Cockroft and Gault
  • Serum creatinine ≤ 2.0 mg/dL
  • Uric acid, if elevated, must be corrected to within laboratory normal range prior to dosing
  • Female subjects of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test. Male subjects must use an effective barrier method of contraception throughout the study and for three months following the last dose if sexually active with a female of child-bearing potential.

Exclusion criteria

  • Female subjects who are pregnant or lactating
  • Subjects who are transfusion dependent
  • Subjects with NHL or HL who have received steroid therapy in the previous seven days
  • Subjects with MM or Waldenström's Macroglobulinemia who have received steroid therapy in the previous three weeks, except for MM subjects in the Carfilzomib + DEX Expansion Cohort, where previous treatment with dexamethasone will be allowed. The dose and schedule of administration of dexamethasone will be adjusted to that used in the protocol
  • Radiation, chemotherapy, or immunotherapy in the previous four weeks, or subjects who, in the judgment of the Investigator, have not recovered from the effects of previous therapy
  • For the Dose Escalation period, subjects who have received prior radioimmunotherapy with anti-cluster of differentiation (CD)20 monoclonal antibodies such as Bexxar® or Zevalin®; subjects treated with these products will be allowed in the Dose Expansion period
  • Subjects who have received allogeneic stem cell transplant therapy
  • Subjects with NHL or HL who have received autologous stem cell transplant therapy and have relapsed within 100 days of therapy
  • Rituxan therapy within three months before Day 1 unless there is evidence of disease progression
  • Major surgery within three weeks before Day 1
  • Congestive heart failure (CHF) (New York Heart Association class III to IV)
  • Acute active infection requiring systemic antibiotics, antivirals, or antifungals within two weeks prior to first dose
  • Subjects who are known or suspected of having human immunodeficiency virus (HIV) infection or who are HIV seropositive
  • Active hepatitis A, B, or C infection; or positive for Hepatitis C ribonucleic acid (RNA) or hepatitis B antigen
  • Non-hematologic malignancy within the past three years except a) adequately treated basal cell or squamous cell skin cancer, b) carcinoma in situ of the cervix, or c) prostate cancer with stable prostate specific antigen (PSA) levels for three years
  • Subjects with treatment-related myelodysplastic disorder
  • Subjects with known brain metastasis (active central nervous system [CNS] disease only)
  • Serious psychiatric or medical conditions that could interfere with treatment
  • Participation in an investigational therapeutic study within one month prior to Day 1
  • Significant neurotoxicity (Grade 2 or higher with pain) at the time of study initiation
  • Concurrent therapy with approved or investigative anticancer therapeutics
  • Subjects with previous hypersensitivity to bortezomib injection
  • Subjects with contraindications to receiving allopurinol
  • Subjects in whom the required program of oral and intravenous fluid hydration is contraindicated, e.g., due to pre-existing pulmonary, cardiac, or renal impairment
  • Subjects with known or suspected amyloidosis
  • Subjects with pleural effusions requiring thoracentesis or ascites requiring paracentesis

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

48 participants in 11 patient groups

CFZ 1.2 mg/m²
Experimental group
Description:
Participants received carfilzomib (CFZ) 1.2 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 2.4 mg/m²
Experimental group
Description:
Participants received carfilzomib 2.4 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 4.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 4.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 6.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 6.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 8.4 mg/m²
Experimental group
Description:
Participants received carfilzomib 8.4 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 11.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 11.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 15.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 115.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 20.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 20.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 27.0 mg/m²
Experimental group
Description:
Participants received carfilzomib 27.0 mg/m² administered by intravenous bolus on Days 1, 2, 8, 9, 15 and 16 in 28-day treatment cycles for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 20/27 mg/m²
Experimental group
Description:
Participants received carfilzomib 20 mg/m² administered by intravenous bolus on Cycle 1 Days 1, 2, 8, 9, 15 and 16, then 27 mg/m² in all subsequent cycles, for up to 12 cycles.
Treatment:
Drug: Carfilzomib
CFZ 20/27 mg/m² + DEX
Experimental group
Description:
Participants received carfilzomib 20 mg/m² administered by intravenous bolus on Cycle 1 Days 1, 2, 8, 9, 15 and 16, then 27 mg/m² in all subsequent cycles, for up to 12 cycles. Participants also received 20 mg dexamethasone (DEX) administered before each dose of carfilzomib (i.e. 40 mg weekly).
Treatment:
Drug: Dexamethasone
Drug: Carfilzomib

Trial contacts and locations

5

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Data sourced from clinicaltrials.gov

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