Window Trial to Evaluate Molecular Response to PI3K Inhibition With Copanlisib in r/r Adult B-cell ALL

  • STATUS
    Recruiting
  • End date
    May 9, 2024
  • participants needed
    10
  • sponsor
    Dorothy Sipkins, MD, PhD
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Updated on 4 October 2022
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Summary

This study will provide an evaluation of biologic markers of leukemia cell response following a single dose of copanlisib prior to any salvage induction therapy in a projected cohort of 10 relapsed/refractory B-ALL patients.

Details
Condition Leukemia, Acute Lymphocytic
Treatment Copanlisib
Clinical Study IdentifierNCT04803123
SponsorDorothy Sipkins, MD, PhD
Last Modified on4 October 2022

Eligibility

 Yes No Not Sure

Inclusion Criteria

Relapsed/refractory, Philadelphia chromosome positive or negative, B-cell, adult (≥ age 18) acute lymphoblastic leukemia (including bone marrow, extramedullary, CNS disease, or all), with or without prior hematopoietic stem cell transplant
Philadelphia chromosome positive patients prior to enrollment must have
documented treatment failure to all FDA-approved for use in R/R ALL tyrosine
kinase inhibitor (TKI) therapy, or have previously been deemed by their
treating physician to not be a candidate for further TKI therapy
ECOG 0-3
CrCl ≥ 30 mL/minute
Bilirubin ≤ 1.5x upper limit of normal (ULN), AST/ALT ≤ 3x ULN
Any patients with known pulmonary disease (including COPD, asthma, ongoing tobacco use, pulmonary hypertension, pulmonary sarcoidosis, or other relevant pulmonary disease which severely limits their pulmonary function), require an assessment of lung capacity with pulmonary function testing prior to acceptance to the study, with a threshold acceptance of DLCO > 40% corrected

Exclusion Criteria

Type 2 diabetes mellitus with HgbA1C ≥10% while on treatment for diabetes
History of or concurrent condition of interstitial lung disease or autoimmune pneumonitis
Active pneumonia requiring treatment, including Pneumocystis jirovecci pneumonia (PJP)
History of type 1 diabetes mellitus
Uncontrolled hypertension despite optimal medical management (per investigator's assessment)
Untreated human immunodeficiency virus (HIV)
Active replication of hepatitis B or active hepatitis C. Those with prior disease who are PCR negative at enrollment and meet liver function eligibility criterion are eligible
Cytomegalovirus (CMV) infection with positive PCR at baseline. CMV PCR test is considered positive if the result can be interpreted as a CMV viremia according to institutional standard
History of hematopoietic stem cell transplant with active GVHD requiring > 10 mg of prednisone daily or equivalent
History of calcineurin inhibitor use in the last 28 days prior to enrollment
Patients requiring immediate cytoreductive therapy. Exceptions for: patients whose peripheral blast counts are being controlled by single agent or combination therapy with steroids and/or hydroxyurea
Pregnancy
Patients with residual toxicities related to prior treatment (including chemotherapy, immunotherapy, clinical trial, surgery, radiotherapy, or hematopoietic stem cell transplant) persistently > Grade 1 despite adequate treatment. Exceptions for: patients with residual toxicity related to prior treatment of ≤Grade 2 which is stable prior to enrollment and for which the natural history would not be expected to change over time; toxicity which cannot be reasonably excluded to be due to disease
Active concurrent malignancy requiring ongoing treatment. Exceptions for: resected breast cancer being treated with hormonal therapy only, prostate cancer treated with hormonal therapy not progressing within the past year, if subject has received definitive local therapy (i.e., surgical excision, external beam radiation, or other local therapy with curative intent), non-melanoma skin cancers, or carcinoma in situ
Active COVID-19 infection
Progressive and/or uncontrolled infections despite active treatment
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