Trial Outcomes & Findings for Oral Clofarabine for Relapsed/Refractory Non-Hodgkin Lymphoma (NCT NCT00644189)

NCT ID: NCT00644189

Last Updated: 2023-03-15

Results Overview

Determine the efficacy of oral clofarabine (any of the 4 dose levels: 1mg, 2mg, 4mg, and 3mg) in all phase I-II trial patients with relapsed/refractory non-Hodgkin lymphomas. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

50 participants

Primary outcome timeframe

after at most 6 28-day cycles

Results posted on

2023-03-15

Participant Flow

Participant milestones

Participant milestones
Measure
Clofarabine 1 mg
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Clofarabine 2 mg
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Clofarabine 4 mg
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Clofarabine: 3 mg
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I
STARTED
3
3
6
18
Phase I
COMPLETED
3
3
6
18
Phase I
NOT COMPLETED
0
0
0
0
Phase II
STARTED
0
0
0
50
Phase II
Completed All 6 Cycles of Treatment
0
0
0
19
Phase II
COMPLETED
0
0
0
50
Phase II
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Oral Clofarabine for Relapsed/Refractory Non-Hodgkin Lymphoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Clofarabine Phase I
n=30 Participants
Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles. Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Age, Continuous
62 years
n=5 Participants
Sex: Female, Male
Female
15 Participants
n=5 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
Region of Enrollment
United States
30 participants
n=5 Participants
Number of prior regimens
1 number of prior regimens
n=5 Participants
Histologies
follicular lymphoma (FL)
7 Participants
n=5 Participants
Histologies
small lymphocytic lymphoma (SLL)
6 Participants
n=5 Participants
Histologies
diffuse large B-cell lymphoma (DLBCL)
3 Participants
n=5 Participants
Histologies
marginal zone lymphoma (MZL)
7 Participants
n=5 Participants
Histologies
mantle cell lymphoma (MCL)
6 Participants
n=5 Participants
Histologies
T-cell lymphoma (TCL)
0 Participants
n=5 Participants
Histologies
lymphoplasmacytic lymphoma (LPL)
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: after at most 6 28-day cycles

Population: all participants from phase I-II trial who are treated with any of the 4 dose levels of oral clofarabine

Determine the efficacy of oral clofarabine (any of the 4 dose levels: 1mg, 2mg, 4mg, and 3mg) in all phase I-II trial patients with relapsed/refractory non-Hodgkin lymphomas. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Phase I-II
n=50 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
All Phase I-II Participants: Overall Response Rate (ORR)
28 percentage of participants
Interval 16.0 to 42.0

PRIMARY outcome

Timeframe: after at most 6 28-day cycles

Population: Phase I participants only

Determine the efficacy of oral clofarabine (any of the 4 dose levels: 1mg, 2mg, 4mg, and 3mg) in all phase I trial patients with relapsed/refractory non-Hodgkin lymphomas. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Phase I-II
n=30 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I Participants Only: Overall Response Rate (ORR)
47 percentage of participants
Interval 31.0 to 63.0

SECONDARY outcome

Timeframe: after at most 6 28-day cycles

Population: only participants from phase I-II trial who were treated at the RP2D (3mg)

To determine the efficacy of oral clofarabine (3mg) in patients with relapsed/refractory non-Hodgkin lymphoma. The 3mg dose was declared the recommended phase 2 dose (RP2D) from phase I. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Phase I-II
n=36 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I-II Participants Treated at the RP2D (3mg): Overall Response Rate (ORR)
28 percentage of participants
Interval 14.0 to 45.0

SECONDARY outcome

Timeframe: at 1 and 2 years

Population: all participants from phase I-II trial who are treated with any of the 4 dose levels of oral clofarabine

Determine the progression-free survival rate among all phase I-II trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg). Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Outcome measures

Outcome measures
Measure
Phase I-II
n=50 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
All Phase I-II Participants: Progression-free Survival (PFS)
1-year PFS
32 percentage of patients
Interval 20.0 to 45.0
All Phase I-II Participants: Progression-free Survival (PFS)
2-year PFS
16 percentage of patients
Interval 7.5 to 27.0

SECONDARY outcome

Timeframe: 3 years

Population: all participants from phase I-II trial who are treated with any of the 4 dose levels of oral clofarabine

Determine the overall survival rate among all phase I-II trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg)

Outcome measures

Outcome measures
Measure
Phase I-II
n=50 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
All Phase I-II Participants: Overall Survival (OS)
58 percentage of participants
Interval 43.0 to 71.0

SECONDARY outcome

Timeframe: during 6 28-day cycles and 90 days out

Population: all phase I-II trial participants who are treated with any of the 4 dose levels of oral clofarabine

Grade 3-4 toxicities among all phase I-II trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg)

Outcome measures

Outcome measures
Measure
Phase I-II
n=50 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
All Phase I-II Participants: Safety
Any grade 3-4 toxicity
29 Participants
All Phase I-II Participants: Safety
Leukopenia and neutropenia
24 Participants
All Phase I-II Participants: Safety
Thrombocytopenia
15 Participants
All Phase I-II Participants: Safety
Anemia
7 Participants
All Phase I-II Participants: Safety
Fatigue
3 Participants

SECONDARY outcome

Timeframe: after at most 6 28-day cycles

Population: Phase I participants only who were treated at the RP2D (3mg)

To determine the efficacy of oral clofarabine (3mg) in patients with relapsed/refractory non-Hodgkin lymphoma. The 3mg dose was declared the recommended phase 2 dose (RP2D) from phase I. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Phase I-II
n=16 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I Participants Treated at the RP2D (3mg): Overall Response Rate (ORR)
Complete Response (CR)
5 Participants
Phase I Participants Treated at the RP2D (3mg): Overall Response Rate (ORR)
Partial Response (PR)
4 Participants
Phase I Participants Treated at the RP2D (3mg): Overall Response Rate (ORR)
Stable Disease (SD) or Progressive Disease (PD)
7 Participants

SECONDARY outcome

Timeframe: at 17 months

Population: Phase I participants only

Determine the progression-free survival rate among all phase I trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg). Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Outcome measures

Outcome measures
Measure
Phase I-II
n=30 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I Participants: Progression-free Survival (PFS)
34 percentage of participants
Interval 17.0 to 51.0

SECONDARY outcome

Timeframe: at 17 months

Population: Phase I participants only

Determine the overall survival rate among all phase I trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg)

Outcome measures

Outcome measures
Measure
Phase I-II
n=30 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
All Phase I Participants: Overall Survival (OS)
75 percentage of participants
Interval 62.0 to 89.0

SECONDARY outcome

Timeframe: during 6 28-day cycles and 90 days out

Population: Phase I participants only

Grade 2-4 toxicities and grade 3-4 infections among all phase I trial participants who are treated with any of the 4 dose levels of oral clofarabine (1mg, 2mg, 4mg, or 3mg)

Outcome measures

Outcome measures
Measure
Phase I-II
n=30 Participants
Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Phase I Participants: Safety
Anemia
19 Participants
Phase I Participants: Safety
Neutropenia
18 Participants
Phase I Participants: Safety
Thrombocytopenia
9 Participants
Phase I Participants: Safety
Fatigue
8 Participants
Phase I Participants: Safety
Neutropenic fever
1 Participants
Phase I Participants: Safety
Grade 3-4 infections
3 Participants
Phase I Participants: Safety
Any grade 3-4 toxicity
20 Participants

Adverse Events

Clofarabine

Serious events: 15 serious events
Other events: 50 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Clofarabine
n=50 participants at risk
Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles. Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
Blood and lymphatic system disorders
Anemia
10.0%
5/50 • Number of events 6
Nervous system disorders
CNS Cerebrovascular Ischemia
2.0%
1/50 • Number of events 1
Nervous system disorders
CNS Hemorrhage
2.0%
1/50 • Number of events 1
Gastrointestinal disorders
Constipation
2.0%
1/50 • Number of events 1
Blood and lymphatic system disorders
Death (due to disease Progression)
4.0%
2/50 • Number of events 2
Gastrointestinal disorders
Diarrhea
4.0%
2/50 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Dyspnea
6.0%
3/50 • Number of events 3
General disorders
Fatigue
2.0%
1/50 • Number of events 1
Blood and lymphatic system disorders
Febrile Neutropenia
4.0%
2/50 • Number of events 2
General disorders
Fever
2.0%
1/50 • Number of events 1
Metabolism and nutrition disorders
Hypercalcemia
2.0%
1/50 • Number of events 1
Vascular disorders
Hypotension
2.0%
1/50 • Number of events 1
Infections and infestations
Infection
4.0%
2/50 • Number of events 2
Renal and urinary disorders
Kidney Failure
2.0%
1/50 • Number of events 1
Blood and lymphatic system disorders
Leukopenia
2.0%
1/50 • Number of events 2
Blood and lymphatic system disorders
Neutropenia
6.0%
3/50 • Number of events 5
General disorders
Pain - Left Flank
2.0%
1/50 • Number of events 1
Cardiac disorders
Pericarditis
2.0%
1/50 • Number of events 1
Blood and lymphatic system disorders
Petechia
2.0%
1/50 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pneumonia
2.0%
1/50 • Number of events 1
Gastrointestinal disorders
suspected GI Bleed
2.0%
1/50 • Number of events 1
Infections and infestations
Suspected respiratory tract infection
2.0%
1/50 • Number of events 1
Blood and lymphatic system disorders
Thrombocytopenia
10.0%
5/50 • Number of events 7
Musculoskeletal and connective tissue disorders
Weakness in legs
2.0%
1/50 • Number of events 1

Other adverse events

Other adverse events
Measure
Clofarabine
n=50 participants at risk
Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles. Clofarabine: Taken orally once a day (in the AM) on days 1 through 21 of a 28-day cycle for a maximum of 6 cycles.
General disorders
Chills
100.0%
50/50 • Number of events 255
Gastrointestinal disorders
Ascites
100.0%
50/50 • Number of events 254
Blood and lymphatic system disorders
Platelets
100.0%
50/50 • Number of events 253
Blood and lymphatic system disorders
Febrile neutropenia
100.0%
50/50 • Number of events 253
Blood and lymphatic system disorders
Thrombotic thrombocytopenic purpura
100.0%
50/50 • Number of events 253
Gastrointestinal disorders
Nausea
100.0%
50/50 • Number of events 252
Gastrointestinal disorders
Vomiting
100.0%
50/50 • Number of events 252
Blood and lymphatic system disorders
Leukocytosis
100.0%
50/50 • Number of events 252
General disorders
Head/headache
100.0%
50/50 • Number of events 252
Skin and subcutaneous tissue disorders
Rash/desquamation
100.0%
50/50 • Number of events 244
Respiratory, thoracic and mediastinal disorders
Bronchial obstruction
24.0%
12/50 • Number of events 27
Respiratory, thoracic and mediastinal disorders
Bronchial stricture
22.0%
11/50 • Number of events 24
Nervous system disorders
Brachial plexopathy
22.0%
11/50 • Number of events 16
Gastrointestinal disorders
Constipation
22.0%
11/50 • Number of events 15
Metabolism and nutrition disorders
Hypokalemia
20.0%
10/50 • Number of events 32
Metabolism and nutrition disorders
AST, SGOT
20.0%
10/50 • Number of events 17
Metabolism and nutrition disorders
Dehydration
16.0%
8/50 • Number of events 14
Metabolism and nutrition disorders
Hyperkalemia
16.0%
8/50 • Number of events 14
Nervous system disorders
Movements involuntary
14.0%
7/50 • Number of events 17
General disorders
Back, pain
14.0%
7/50 • Number of events 12
General disorders
Joint, pain
14.0%
7/50 • Number of events 10
General disorders
Abdomen, pain
14.0%
7/50 • Number of events 9
Skin and subcutaneous tissue disorders
Chemoradiation dermatitis
14.0%
7/50 • Number of events 7
Gastrointestinal disorders
Dyspepsia
12.0%
6/50 • Number of events 9
Metabolism and nutrition disorders
Alkaline phosphatase
10.0%
5/50 • Number of events 16
Blood and lymphatic system disorders
Edema limb
10.0%
5/50 • Number of events 14
Metabolism and nutrition disorders
Hypophosphatemia
10.0%
5/50 • Number of events 11
Immune system disorders
Allergic rhinitis
10.0%
5/50 • Number of events 9
Skin and subcutaneous tissue disorders
Pruritus/itching
10.0%
5/50 • Number of events 9
Metabolism and nutrition disorders
Hypernatremia
10.0%
5/50 • Number of events 6
Metabolism and nutrition disorders
Hyponatremia
10.0%
5/50 • Number of events 6
Blood and lymphatic system disorders
Lymphopenia
8.0%
4/50 • Number of events 13
Gastrointestinal disorders
Gastrointestinal disorders - Other, specify
8.0%
4/50 • Number of events 9
General disorders
Insomnia
8.0%
4/50 • Number of events 8
Gastrointestinal disorders
Anorexia
8.0%
4/50 • Number of events 7
Infections and infestations
Infection Gr0-2 neut, upper airway
8.0%
4/50 • Number of events 7
Metabolism and nutrition disorders
Hypoalbuminemia
6.0%
3/50 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Pulmonary/Upper Respiratory-other
8.0%
4/50 • Number of events 6
General disorders
Fatigue
8.0%
4/50 • Number of events 5
Musculoskeletal and connective tissue disorders
Arthritis
6.0%
3/50 • Number of events 7
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other, specify
6.0%
3/50 • Number of events 7
General disorders
Pelvic, pain
6.0%
3/50 • Number of events 6
Infections and infestations
Infection Gr0-2 neut, skin
6.0%
3/50 • Number of events 5
Cardiac disorders
Cardiac-other
6.0%
3/50 • Number of events 4
General disorders
Fever w/o neutropenia
6.0%
3/50 • Number of events 4
General disorders
Weight loss
6.0%
3/50 • Number of events 3
General disorders
Pain-other
6.0%
3/50 • Number of events 3

Additional Information

Jeremy Abramson, MD

Massachusetts General Hospital Cancer Center

Phone: 617-724-4000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place