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Ibrutinib (PCI-32765) in Waldenstrom's Macroglobulinemia

Phase 2 Study of Bruton's Tyrosine Kinase (Btk) Inhibitor, Ibrutinib (PCI-32765), in Waldenstrom's Macroglobulinemia

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01614821
Enrollment
63
Registered
2012-06-08
Start date
2012-05-31
Completion date
2018-09-15
Last updated
2020-01-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Waldenstrom's Macroglobulinemia

Keywords

Relapsed, Refractory

Brief summary

This research study is a Phase II clinical trial. Phase II clinical trials test the effectiveness of an investigational drug, PCI-32765, to learn whether PCI-32765 works in treating a specific cancer. Investigational means that PCI-32765 is still being studied and that research doctors are trying to find out more about it-such as the safest dose to use, the side effects it may cause, and if PCI-32765 is effective for treating different types of cancer. It also means that the FDA has not yet approved PCI-32765 for use in patients, including people with Waldenstrom's Macroglobulinemia. PCI-32765 is a newly discovered drug that is being developed as an anti-cancer agent. PCI-32765 is a Bruton's tyrosine kinase (Btk) inhibitor drug which interrupts B cell receptor (BCR) signaling in lymphomas by selectively and irreversibly binding to the Btk protein, which then results in malignant cell death. This drug has been used in laboratory experiments and other research studies in B-cell malignancies and information from those other research studies suggests that PCI-32765 may be a treatment strategy for B-cell malignancies, including Waldenstrom's Macroglobulinemia. In this research study, the investigators are testing the safety and efficacy of PCI-32765 as a treatment option for relapsed or refractory Waldenstrom's Macroglobulinemia.

Detailed description

Patients in this research study will receive up to 40 cycles of treatment. Each treatment cycle lasts 4 weeks. Patients will take PCI-32765 by mouth, once a day in the morning. During each cycle patients will be asked to visit the clinic for scheduled tests and exams and to receive a supply of PCI-32765 to take at home every day. Patients will visit the clinic on the first day of each of the first 3 cycles, and then just once at the beginning of every three cycles. During study visits, patients will have a physical exam where they will be asked questions about their general health and specific questions about any problems that they might be having and any medications they may be taking. Patients will have blood tests to see how their disease is responding to the study treatment and how they are tolerating the study drug. Patients may also have CT scans of the chest, abdomen and pelvis as well as a bone marrow aspirate and biopsy. If a patient's disease stays the same or is helped, he/she will continue to get study treatment. If disease worsens, he/she will be taken off study treatment at that time. After completion of the treatment and as part of standard of care, follow-up tests will include a physical exam, review of symptoms and medications, blood tests, bone marrow aspirate and biopsy, CT scans of the chest, abdomen and pelvis. The investigators would like to continue to monitor progress by following-up every three months for up to two years after completion of study treatment or until next treatment, whichever comes first.

Interventions

Taken orally, once daily in the morning

Sponsors

Dana-Farber Cancer Institute
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia * Measurable disease * Have received at least one prior therapy for WM therapies * Disease free of prior malignancies * Able to adhere to study visit schedule and other protocol requirement

Exclusion criteria

* Pregnant or breastfeeding * Any other serious medical condition * Concurrent use of other anti-cancer agents or treatments * Prior exposure to PCI-32765 * Known CNS lymphoma * Significant cardiovascular disease * Any disease affecting gastrointestinal function

Design outcomes

Primary

MeasureTime frameDescription
Overall Response Rate4 yearsTo assess the overall response rate (\>25% reduction in serum IgM from baseline).

Secondary

MeasureTime frameDescription
Safety and Tolerability of PCI-327654 yearsTo assess the safety and tolerability of PCI-32765 in symptomatic WM patients with relapsed/refractory disease. Grade \> or = 2 Adverse Events determined to be associated with PCI-32765 and subsequent outcomes will constitute the safety profile of PCI-32765 in WM. Percent of participants who experienced at least 1 grade 2 or higher treatment emergent adverse event.
Determine Progression Free Survival6 yearsTo determine Progression Free Survival (PFS in symptomatic WM patients with relapsed/refractory disease. Participants were treated for 40 cycles and then followed for 2 years or until next therapy or death. 40 participants were censored prior to disease progression.
To Determine Time to Next Therapy (TTNT) of PCI-32765 in Symptomatic WM Patients With Relapsed/Refractory Disease6 yearsTime to Next Therapy is the duration of time from of starting ibrutinib until next therapy. Participants were treated for 40 cycles and then followed for 2 years or until next therapy or death. Participants had the option to continue ibrutinib commercially. 40 participants were censored while still on commercial ibrutinib therapy.
Major Response Rates4 yearsTo assess the major response rate (\>50% reduction in serum IgM from baseline)
Very Good Partial Response Rate4 yearsTo assess the very good partial response rate (\>90% reduction in serum IgM from baseline)

Countries

United States

Participant flow

Participants by arm

ArmCount
Treatment Arm
PCI-32765; ibrutinib PCI-32765: Taken orally, once daily in the morning
63
Total63

Baseline characteristics

CharacteristicTreatment Arm
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
31 Participants
Age, Categorical
Between 18 and 65 years
32 Participants
Age, Continuous63 years
STANDARD_DEVIATION 10.6
Race and Ethnicity Not Collected— Participants
Region of Enrollment
United States
63 participants
Sex: Female, Male
Female
15 Participants
Sex: Female, Male
Male
48 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
1 / 63
other
Total, other adverse events
62 / 63
serious
Total, serious adverse events
30 / 63

Outcome results

Primary

Overall Response Rate

To assess the overall response rate (\>25% reduction in serum IgM from baseline).

Time frame: 4 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Treatment ArmOverall Response Rate57 Participants
Secondary

Determine Progression Free Survival

To determine Progression Free Survival (PFS in symptomatic WM patients with relapsed/refractory disease. Participants were treated for 40 cycles and then followed for 2 years or until next therapy or death. 40 participants were censored prior to disease progression.

Time frame: 6 years

ArmMeasureValue (MEDIAN)
Treatment ArmDetermine Progression Free Survival39 months
Secondary

Major Response Rates

To assess the major response rate (\>50% reduction in serum IgM from baseline)

Time frame: 4 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Treatment ArmMajor Response Rates49 Participants
Secondary

Safety and Tolerability of PCI-32765

To assess the safety and tolerability of PCI-32765 in symptomatic WM patients with relapsed/refractory disease. Grade \> or = 2 Adverse Events determined to be associated with PCI-32765 and subsequent outcomes will constitute the safety profile of PCI-32765 in WM. Percent of participants who experienced at least 1 grade 2 or higher treatment emergent adverse event.

Time frame: 4 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Treatment ArmSafety and Tolerability of PCI-3276562 Participants
Secondary

To Determine Time to Next Therapy (TTNT) of PCI-32765 in Symptomatic WM Patients With Relapsed/Refractory Disease

Time to Next Therapy is the duration of time from of starting ibrutinib until next therapy. Participants were treated for 40 cycles and then followed for 2 years or until next therapy or death. Participants had the option to continue ibrutinib commercially. 40 participants were censored while still on commercial ibrutinib therapy.

Time frame: 6 years

ArmMeasureValue (MEDIAN)
Treatment ArmTo Determine Time to Next Therapy (TTNT) of PCI-32765 in Symptomatic WM Patients With Relapsed/Refractory Disease49 months
Secondary

Very Good Partial Response Rate

To assess the very good partial response rate (\>90% reduction in serum IgM from baseline)

Time frame: 4 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Treatment ArmVery Good Partial Response Rate17 Participants

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026