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A Study of INCB050465 in Relapsed or Refractory Mantle Cell Lymphoma Previously Treated With or Without a Bruton's Tyrosine Kinase (BTK) Inhibitor

A Phase 2, Open-Label, 2-Cohort, Multicenter Study of INCB050465, a PI3Kδ Inhibitor, in Relapsed or Refractory Mantle Cell Lymphoma Previously Treated With or Without a BTK Inhibitor (CITADEL-205)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03235544
Acronym
(CITADEL-205)
Enrollment
162
Registered
2017-08-01
Start date
2017-11-20
Completion date
2024-04-30
Last updated
2025-03-18

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

Conditions

Lymphoma

Keywords

Mantle cell lymphoma, non-Hodgkin lymphoma, Bruton's tyrosine kinase (BTK), phosphatidylinositol 3-kinase (PI3K)

Brief summary

This is a Phase 2, open-label, 2-cohort study designed to evaluate the efficacy and safety of 2 parsaclisib treatment regimens in participants with relapsed or refractory mantle cell lymphoma (MCL) previously treated either with or without a Bruton's tyrosine kinase (BTK) inhibitor.

Interventions

DRUGParsaclisib

Parsaclisib tablets administered orally with water and without regard to food.

Sponsors

Incyte Corporation
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Men and women, aged 18 years or older. * Documented failure to achieve at least partial response (PR) with, or documented disease progression after, the most recent treatment regimen. * Radiographically measurable lymphadenopathy or extranodal lymphoid malignancy. * Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2.

Exclusion criteria

* History of central nervous system lymphoma (either primary or metastatic). * Prior treatment with idelalisib, other selective phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitors, or a pan PI3K inhibitor. * Allogeneic stem cell transplant within the last 6 months, or autologous stem cell transplant within the last 3 months before the date of first dose of study treatment. * Active graft-versus-host disease. * Liver disease: Participants positive for hepatitis B surface antigen or hepatitis B core antibody will be eligible if they are negative for hepatitis B virus-deoxyribonucleic acid (HBV-DNA). Participants positive for anti-hepatitis C virus (HCV) antibody will be eligible if they are negative for HCV-ribonucleic acid (RNA).

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR)Up to 1016 daysORR=percentage of participants with complete response(CR) or partial response(PR) per revised response criteria for lymphomas,determined by independent review committee(IRC).Criteria for CR:1.Target nodes/nodal masses of lymph nodes,extralymphatic sites regressed to≤1.5cm in longest dimension transverse diameter of lesion(LDi);2.Absence of non-measured lesion;3.Organ enlargement regressed to normal;4.No new lesions;5.Normal bone marrow morphology;if indeterminate,immunohistochemistry negative.Criteria for PR:1.Lymph nodes,extralymphatic sites- ≥50%decrease in sum of product of perpendicular diameters for multiple lesions(SPD)of up to 6 target measurable nodes,extranodal sites;if lesion is too small to measure on computed tomography(CT),assign5mm×5mm as default;if no longer visible,0×0mm.Node\>5mm×5mm but smaller than normal,use actual measurement.2.Absent/regressed non-measured lesions,no increase.3.Organ enlargement-Spleen regressed by\>50%in length beyond normal.4.No new lesions.

Secondary

MeasureTime frameDescription
Complete Response Rate (CRR)Up to 1016 daysCRR is defined as the percentage of participants with a CR as defined by response criteria for lymphomas, as determined by an IRC. The criteria for CR included: 1.Target nodes/nodal masses of lymph nodes and extralymphatic sites must regress to ≤ 1.5 cm in LDi; 2. Absence of non-measured lesion; 3.Organ enlargement regressed to normal; 4.No new lesions; 5.Bone marrow must be normal by morphology; if indeterminate, immunohistochemistry negative.
Progression-Free Survival (PFS)Up to 1016 daysPFS is defined as the time from the date of the first dose of study treatment until the earliest date of disease progression as determined by radiographic disease assessment provided by an IRC, or death from any cause.
Duration of Response (DOR)Up to 1016 daysDOR=time from first documented evidence of CR or PR until disease progression or death from any cause among participants who achieve an objective response as determined by IRC. Criteria for CR: 1.Target nodes/nodal masses of lymph nodes and extralymphatic sites must regress to ≤ 1.5 cm in LDi; 2. Absence of non-measured lesion; 3.Organ enlargement regressed to normal; 4.No new lesions; 5.Bone marrow must be normal by morphology; if indeterminate, immunohistochemistry negative. The criteria for PR included: 1.Lymph nodes and extralymphatic sites- a. ≥50% decrease in SPD of up to 6 target measurable nodes and extranodal sites; b. when a lesion is too small to measure on CT, assign 5 mm×5 mm as the default; c.when no longer visible, 0×0 mm. For a node \>5 mm×5 mm but smaller than normal, use actual measurement. 2.Non-measured lesions- Absent/regressed, but no increase. 3. Organ enlargement-Spleen must have regressed by \>50% in length beyond normal. 4.No new lesions.
Best Percent Change From Baseline in Target Lesion SizeUp to 1016 daysTarget lesion size is measured by the sum of the product of diameters of all target lesion sizes and is determined by the IRC. The best percent change from Baseline is defined as the largest decrease, or smallest increase if no decrease available, from Baseline in target lesion sizes on/before new (next-line) anti-lymphoma therapy during the study. Baseline is the last nonmissing measurement obtained before the first administration of study drug. A negative percent change from Baseline indicates improvement.
Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)From first dose of study drug up to 2045 daysAn adverse event (AE) is any untoward medical occurrence associated with use of a drug in humans, whether or not considered drug related, that occurs after a participant provides informed consent. A TEAE is any AE either reported for the first time or worsening of a pre-existing event after first dose of study drug and within 30 days of the last administration of study drug regardless of starting new anti-lymphoma therapy. A SAE is any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, leads to a congenital anomaly/birth defect or is considered to be an important medical event that may not result in death, be immediately life-threatening, or require hospitalization but may be considered serious when, based on appropriate medical judgment, the event may jeopardize the participant or may require medical or surgical intervention.
Overall Survival (OS)Up to 2017 daysOS is defined as the time from the date of the first dose of study treatment until death from any cause.

Countries

Belgium, Czechia, Denmark, France, Germany, Israel, Italy, Poland, Spain, United Kingdom, United States

Participant flow

Recruitment details

Participants took part in the study at 76 investigative sites in France, Spain, the United States, Italy, Poland, Czech Republic, Great Britain, Denmark, Belgium, Germany, and Israel.

Pre-assignment details

A total of 161 participants with relapsed or refractory mantle cell lymphoma who received 1-3 prior systemic therapies were enrolled into 2 Cohorts and treated. An additional participant was enrolled but not treated. Because this participant was not treated, he/she was not assigned to any treatment/cohort and was not included in the Full Analysis Set or Safety Population for analysis. Cohort 1 had previously received ibrutinib and Cohort 2 were Bruton's tyrosine kinase (BTK) inhibitor naive.

Participants by arm

ArmCount
Cohort 1: Treatment A (Exposed to Ibrutinib)
Participants received parsaclisib 20 milligrams (mg), orally, once daily (QD) for 8 weeks followed by 20 mg once weekly (QW) for up to 52 weeks. Participants who were exposed to ibrutinib before enrollment were included in this group.
12
Cohort 1: Treatment B (Exposed to Ibrutinib)
Participants received parsaclisib 20 mg, orally, QD for 8 weeks followed by 2.5 mg QD for up to 116 weeks. Participants who were exposed to ibrutinib before enrollment were included in this group.
41
Cohort 2: Treatment A (BTK Inhibitor Naïve)
Participants received parsaclisib 20 mg, orally, QD for 8 weeks followed by 20 mg QW for up to approximately 145 weeks. Participants who were not exposed to BTK inhibitor before enrollment were included in this group.
31
Cohort 2: Treatment B (BTK Inhibitor Naïve)
Participants received parsaclisib 20 mg, orally, QD for 8 weeks followed by 2.5 mg QD for up to approximately 136 weeks. Participants who were not exposed to BTK inhibitor before enrollment were included in this group.
77
Total161

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyDeath11311934
Overall StudyDiscomfort, Pain, and Radiographic Advancement0001
Overall StudyDisease Progression0102
Overall StudyLost to Follow-up0111
Overall StudyParticipant Transitioned to Rollover Protocol0025
Overall StudyWithdrawal by Subject0315

Baseline characteristics

CharacteristicCohort 1: Treatment B (Exposed to Ibrutinib)Cohort 1: Treatment A (Exposed to Ibrutinib)TotalCohort 2: Treatment B (BTK Inhibitor Naïve)Cohort 2: Treatment A (BTK Inhibitor Naïve)
Age, Continuous69.8 years70.2 years70.9 years71.5 years72.2 years
Race/Ethnicity, Customized
American-Indian/Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
0 Participants0 Participants1 Participants1 Participants0 Participants
Race/Ethnicity, Customized
Black or African American
0 Participants0 Participants2 Participants2 Participants0 Participants
Race/Ethnicity, Customized
Captured as Other in Database
0 Participants1 Participants2 Participants2 Participants0 Participants
Race/Ethnicity, Customized
Hispanic or Latino
2 Participants3 Participants14 Participants5 Participants4 Participants
Race/Ethnicity, Customized
Missing
3 Participants0 Participants6 Participants7 Participants2 Participants
Race/Ethnicity, Customized
Native Hawaiian/Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
28 Participants6 Participants112 Participants57 Participants21 Participants
Race/Ethnicity, Customized
Not Reported
5 Participants1 Participants20 Participants8 Participants6 Participants
Race/Ethnicity, Customized
Unknown
4 Participants2 Participants7 Participants1 Participants0 Participants
Race/Ethnicity, Customized
White
37 Participants11 Participants136 Participants64 Participants24 Participants
Sex: Female, Male
Female
11 Participants1 Participants34 Participants17 Participants5 Participants
Sex: Female, Male
Male
30 Participants11 Participants127 Participants60 Participants26 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
11 / 1231 / 4119 / 3134 / 7795 / 161
other
Total, other adverse events
9 / 1228 / 4127 / 3166 / 77130 / 161
serious
Total, serious adverse events
5 / 1220 / 4112 / 3145 / 7782 / 161

Outcome results

Primary

Objective Response Rate (ORR)

ORR=percentage of participants with complete response(CR) or partial response(PR) per revised response criteria for lymphomas,determined by independent review committee(IRC).Criteria for CR:1.Target nodes/nodal masses of lymph nodes,extralymphatic sites regressed to≤1.5cm in longest dimension transverse diameter of lesion(LDi);2.Absence of non-measured lesion;3.Organ enlargement regressed to normal;4.No new lesions;5.Normal bone marrow morphology;if indeterminate,immunohistochemistry negative.Criteria for PR:1.Lymph nodes,extralymphatic sites- ≥50%decrease in sum of product of perpendicular diameters for multiple lesions(SPD)of up to 6 target measurable nodes,extranodal sites;if lesion is too small to measure on computed tomography(CT),assign5mm×5mm as default;if no longer visible,0×0mm.Node\>5mm×5mm but smaller than normal,use actual measurement.2.Absent/regressed non-measured lesions,no increase.3.Organ enlargement-Spleen regressed by\>50%in length beyond normal.4.No new lesions.

Time frame: Up to 1016 days

Population: Full Analysis Set: all participants enrolled in the study who received at least 1 dose of parsaclisib

ArmMeasureValue (NUMBER)
Cohort 1: Treatment A (Exposed to Ibrutinib)Objective Response Rate (ORR)8.3 percentage of participants
Cohort 1: Treatment B (Exposed to Ibrutinib)Objective Response Rate (ORR)39.0 percentage of participants
Cohort 2: Treatment A (BTK Inhibitor Naïve)Objective Response Rate (ORR)64.5 percentage of participants
Cohort 2: Treatment B (BTK Inhibitor Naïve)Objective Response Rate (ORR)71.4 percentage of participants
Secondary

Best Percent Change From Baseline in Target Lesion Size

Target lesion size is measured by the sum of the product of diameters of all target lesion sizes and is determined by the IRC. The best percent change from Baseline is defined as the largest decrease, or smallest increase if no decrease available, from Baseline in target lesion sizes on/before new (next-line) anti-lymphoma therapy during the study. Baseline is the last nonmissing measurement obtained before the first administration of study drug. A negative percent change from Baseline indicates improvement.

Time frame: Up to 1016 days

Population: Full Analysis Set: all participants enrolled in the study who received at least 1 dose of parsaclisib. The overall number of participants analyzed is the number of participants with data available for analysis.

ArmMeasureValue (MEAN)Dispersion
Cohort 1: Treatment A (Exposed to Ibrutinib)Best Percent Change From Baseline in Target Lesion Size-19.82 percent change in lesion sizeStandard Deviation 35.926
Cohort 1: Treatment B (Exposed to Ibrutinib)Best Percent Change From Baseline in Target Lesion Size-9.51 percent change in lesion sizeStandard Deviation 133.438
Cohort 2: Treatment A (BTK Inhibitor Naïve)Best Percent Change From Baseline in Target Lesion Size-64.65 percent change in lesion sizeStandard Deviation 53.36
Cohort 2: Treatment B (BTK Inhibitor Naïve)Best Percent Change From Baseline in Target Lesion Size-67.54 percent change in lesion sizeStandard Deviation 32.918
Secondary

Complete Response Rate (CRR)

CRR is defined as the percentage of participants with a CR as defined by response criteria for lymphomas, as determined by an IRC. The criteria for CR included: 1.Target nodes/nodal masses of lymph nodes and extralymphatic sites must regress to ≤ 1.5 cm in LDi; 2. Absence of non-measured lesion; 3.Organ enlargement regressed to normal; 4.No new lesions; 5.Bone marrow must be normal by morphology; if indeterminate, immunohistochemistry negative.

Time frame: Up to 1016 days

Population: Full Analysis Set: all participants enrolled in the study who received at least 1 dose of parsaclisib

ArmMeasureValue (NUMBER)
Cohort 1: Treatment A (Exposed to Ibrutinib)Complete Response Rate (CRR)0.0 percentage of participants
Cohort 1: Treatment B (Exposed to Ibrutinib)Complete Response Rate (CRR)2.4 percentage of participants
Cohort 2: Treatment A (BTK Inhibitor Naïve)Complete Response Rate (CRR)22.6 percentage of participants
Cohort 2: Treatment B (BTK Inhibitor Naïve)Complete Response Rate (CRR)15.6 percentage of participants
Secondary

Duration of Response (DOR)

DOR=time from first documented evidence of CR or PR until disease progression or death from any cause among participants who achieve an objective response as determined by IRC. Criteria for CR: 1.Target nodes/nodal masses of lymph nodes and extralymphatic sites must regress to ≤ 1.5 cm in LDi; 2. Absence of non-measured lesion; 3.Organ enlargement regressed to normal; 4.No new lesions; 5.Bone marrow must be normal by morphology; if indeterminate, immunohistochemistry negative. The criteria for PR included: 1.Lymph nodes and extralymphatic sites- a. ≥50% decrease in SPD of up to 6 target measurable nodes and extranodal sites; b. when a lesion is too small to measure on CT, assign 5 mm×5 mm as the default; c.when no longer visible, 0×0 mm. For a node \>5 mm×5 mm but smaller than normal, use actual measurement. 2.Non-measured lesions- Absent/regressed, but no increase. 3. Organ enlargement-Spleen must have regressed by \>50% in length beyond normal. 4.No new lesions.

Time frame: Up to 1016 days

Population: Full Analysis Set: all participants enrolled in the study who received at least 1 dose of parsaclisib. Only participants with objective response were analyzed.

ArmMeasureValue (MEDIAN)
Cohort 1: Treatment A (Exposed to Ibrutinib)Duration of Response (DOR)NA months
Cohort 1: Treatment B (Exposed to Ibrutinib)Duration of Response (DOR)3.20 months
Cohort 2: Treatment A (BTK Inhibitor Naïve)Duration of Response (DOR)17.45 months
Cohort 2: Treatment B (BTK Inhibitor Naïve)Duration of Response (DOR)13.01 months
Secondary

Overall Survival (OS)

OS is defined as the time from the date of the first dose of study treatment until death from any cause.

Time frame: Up to 2017 days

Population: Full Analysis Set

ArmMeasureValue (MEDIAN)
Cohort 1: Treatment A (Exposed to Ibrutinib)Overall Survival (OS)10.91 months
Cohort 1: Treatment B (Exposed to Ibrutinib)Overall Survival (OS)11.01 months
Cohort 2: Treatment A (BTK Inhibitor Naïve)Overall Survival (OS)33.48 months
Cohort 2: Treatment B (BTK Inhibitor Naïve)Overall Survival (OS)45.86 months
Secondary

Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)

An adverse event (AE) is any untoward medical occurrence associated with use of a drug in humans, whether or not considered drug related, that occurs after a participant provides informed consent. A TEAE is any AE either reported for the first time or worsening of a pre-existing event after first dose of study drug and within 30 days of the last administration of study drug regardless of starting new anti-lymphoma therapy. A SAE is any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, leads to a congenital anomaly/birth defect or is considered to be an important medical event that may not result in death, be immediately life-threatening, or require hospitalization but may be considered serious when, based on appropriate medical judgment, the event may jeopardize the participant or may require medical or surgical intervention.

Time frame: From first dose of study drug up to 2045 days

Population: Safety Population: all enrolled participants who received at least 1 dose of parsaclisib

ArmMeasureGroupValue (NUMBER)
Cohort 1: Treatment A (Exposed to Ibrutinib)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)TEAEs83.3 percentage of participants
Cohort 1: Treatment A (Exposed to Ibrutinib)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)SAEs41.7 percentage of participants
Cohort 1: Treatment B (Exposed to Ibrutinib)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)SAEs48.8 percentage of participants
Cohort 1: Treatment B (Exposed to Ibrutinib)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)TEAEs90.2 percentage of participants
Cohort 2: Treatment A (BTK Inhibitor Naïve)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)TEAEs93.5 percentage of participants
Cohort 2: Treatment A (BTK Inhibitor Naïve)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)SAEs38.7 percentage of participants
Cohort 2: Treatment B (BTK Inhibitor Naïve)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)TEAEs92.2 percentage of participants
Cohort 2: Treatment B (BTK Inhibitor Naïve)Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)SAEs58.4 percentage of participants
Secondary

Progression-Free Survival (PFS)

PFS is defined as the time from the date of the first dose of study treatment until the earliest date of disease progression as determined by radiographic disease assessment provided by an IRC, or death from any cause.

Time frame: Up to 1016 days

Population: Full Analysis Set: all participants enrolled in the study who received at least 1 dose of parsaclisib

ArmMeasureValue (MEDIAN)
Cohort 1: Treatment A (Exposed to Ibrutinib)Progression-Free Survival (PFS)3.94 months
Cohort 1: Treatment B (Exposed to Ibrutinib)Progression-Free Survival (PFS)3.68 months
Cohort 2: Treatment A (BTK Inhibitor Naïve)Progression-Free Survival (PFS)8.11 months
Cohort 2: Treatment B (BTK Inhibitor Naïve)Progression-Free Survival (PFS)13.83 months

Source: ClinicalTrials.gov · Data processed: Feb 27, 2026