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TerminatedNCT02420795Updated Apr 4, 2022Results posted

Akt/ERK Inhibitor ONC201 in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

A Phase 1/2 interventional study of Akt/ERK Inhibitor ONC201 and Laboratory Biomarker Analysis in Central Nervous System Lymphoma, Gastric Mantle Cell Lymphoma and Recurrent Mantle Cell Lymphoma, sponsored by M.D. Anderson Cancer Center. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-04-04.

Sponsored by M.D. Anderson Cancer Center · Phase 1/2, Interventional, and Treatment

Why this study was terminated
Per PI Request
Phase
Phase 1/2
Study type
Interventional
Enrollment
16
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase I/II trial studies the side effects and the best dose of v-akt murine thymoma viral oncogene homolog (Akt)/mitogen-activated protein kinase 1(ERK) inhibitor ONC201 and to see how well it works in treating patients with non-Hodgkin's lymphoma that has returned after a period of improvement or does not respond to treatment. Akt/ERK inhibitor ONC201 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

Read the detailed description

PRIMARY OBJECTIVES:

I. To determine recommended phase II dose for oral ONC201 (Akt/ERK inhibitor ONC201) in patients with relapsed/refractory lymphomas. (Phase I) II. To identify toxicities associated with oral ONC201 in patients with relapsed/refractory lymphomas. (Phase I) III. To determine the objective response rate to ONC201 in patients with relapsed/refractory lymphomas. (Phase II)

SECONDARY OBJECTIVES:

I. To determine the pharmacokinetics (PK) of oral ONC201 following administration. (Phase I) II. To observe the anti-tumor effects of oral ONC201, if any occur, in patients with relapsed/refractory lymphomas. (Phase I) III. Confirm tolerability of recommended phase II dose. (Phase II) IV. Assess clinical outcomes associated with ONC201 treatment in patients with relapsed/refractory lymphomas. (Phase II) V. Correlate clinical outcome with tumor and serum biomarkers. (Phase II)

OUTLINE: This is a phase I, dose-escalation study followed by a phase II study.

Patients receive Akt/ERK inhibitor ONC201 orally (PO) on day 1 of every cycle or day 1 of every week. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months.

02

Conditions studied

  • Central Nervous System Lymphoma
  • Gastric Mantle Cell Lymphoma
  • Recurrent Mantle Cell Lymphoma
  • Recurrent Non-Hodgkin Lymphoma
  • Refractory Mantle Cell Lymphoma
  • Refractory Non-Hodgkin Lymphoma
  • Splenic Mantle Cell Lymphoma
03

In context

Lymphoma

5,579 studies on the registry are indexed under Lymphoma; 825 are open to participants now.

This study's enrollment of 16 is below the median of 40 across 4,509 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

M.D. Anderson Cancer Center is the lead sponsor of 2,999 studies on the registry; 581 are open to participants now.

Of its 599 completed or terminated interventional studies of FDA-regulated products, 402 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Phase 1 and Phase 2: confirmed diagnosis of previously treated relapsed and/or refractory lymphoma; patients with central nervous system (CNS) lymphoma are included
  • Patient with leukemia phase (peripheral blood involvement), CNS lymphoma [including cerebrospinal fluid (CSF)-only disease], non-measurable disease, gastrointestinal (GI) mantle cell lymphoma (MCL), or bone marrow (BM) MCL are also eligible; gastrointestinal or bone marrow or spleen only patients are allowable and will be analyzed separately
  • All adverse events related to prior therapies (chemotherapy, radiotherapy, and/or surgery) must be resolved to =\< grade 1, except for alopecia
  • Patients must be willing to receive transfusions of blood products
  • Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less
  • Serum creatinine \< 2.0 mg/dl
  • Serum bilirubin \< 1.5 mg/dl
  • Platelet count > 50,000/mm\^3
  • Absolute neutrophil count (ANC) > 1,000/mm\^3
  • Alanine aminotransferase (ALT), or aspartate aminotransferase (AST) \< 2 x upper limit of normal or \< 5 x upper limit of normal if hepatic metastases are present
  • Willing and able to participate in all study related procedures and therapy including swallowing capsules without difficulty
  • Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test and must be willing to use acceptable methods of birth control during the study and for 90 days after the last dose of study treatment; acceptable methods of birth control include condoms with birth control foam, birth control pills, implantable or injectable birth control, birth control patch, intrauterine device (IUD), or diaphragm with spermicidal gel; male patients must use an effective barrier method of contraception (i.e. , condoms with birth control foam or diaphragm with spermicidal gel) during the study and for 90 days following the last dose of study treatment if sexually active with a female of childbearing potential; contraception must be in place at least 2 weeks prior to initiating study treatment; a female of childbearing potential is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
  • Patient must be English-speaking [MD Anderson Symptom Inventory (MDASI) completion only]

Exclusion criteria

Exclusion Criteria:

  • Any serious medical condition including but not limited to, uncontrolled hypertension, uncontrolled diabetes mellitus, uncontrolled infection, active/symptomatic coronary artery disease, chronic obstructive pulmonary disease (COPD), renal failure, active hemorrhage, or psychiatric illness that, in the investigators opinion places the patient at unacceptable risk or would prevent the subject from signing the informed consent form
  • Pregnant or breast feeding females
  • Use of any standard/experimental anti-lymphoma drug therapy, including steroids (dexamethasone dose >= 4 mg/day or prednisone >= 20 mg/day), within 3 weeks of initiation of the study or use of any experimental non-drug therapy (e.g., donor leukocyte/mononuclear cell infusions) within 56 days of initiation of the study drug treatment; hydroxyurea is permitted up to 24 hours before the first dose of study drug in patients with rapidly-proliferating disease
  • Prior allogeneic stem cell transplant (SCT) within 16 weeks or autologous SCT within 8 weeks of initiation of therapy (patients that require immunosuppressive therapy are not eligible within 60 days of therapy)
  • History of human immunodeficiency virus (HIV) infection; patients with active hepatitis B infection (not including patients with prior hepatitis B vaccination; or positive serum hepatitis B antibody); hepatitis C infection is allowed as long as there is no active disease and is cleared by GI consultation; HIV screening is not required for this study
  • Significant neuropathy (grades 3-4, or grade 2 with pain) within 14 days prior to enrollment
  • Malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or ulcerative colitis, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction, or any other gastrointestinal condition that could interfere with the absorption and metabolism of ONC201
  • Major surgery within 4 weeks of initiation of therapy
  • The patient has a prior or concurrent malignancy that in the opinion of the investigator, presents a greater risk to the patient's health and survival, than of the MCL, within the subsequent 6 months at the time of consent; investigator discretion is allowed
  • Patients with New York Heart Association (NYHA) class III and IV heart failure, myocardial infarction in the preceding 6 months, and significant conduction abnormalities, including but not limited to second (2nd) degree atrioventricular (AV) block type II, third (3rd) degree block, QT prolongation (corrected QT [QTc] > 500 msec), sick sinus syndrome, ventricular tachycardia, symptomatic bradycardia (heart rate \< 50 beats per minute [bpm]), hypotension, light headedness and syncope; patients with active atrial fibrillation will be excluded; the protocol excludes patients who have within the past year had a stent and by recommendation of their cardiologist need to stay on anticoagulants such as warfarin equivalent vitamin K antagonist
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ONC201 or its excipients
  • Acute infection requiring treatment (systemic antibiotics, antivirals, or antifungals) within 14 days prior to initiation of study
  • Active alcoholism or use of recreational drug (evaluated by history taking)
05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
16 participants (actual)

Study arms

  • Experimental
    Treatment (Akt/ERK inhibitor ONC201)

    Patients receive Akt/ERK inhibitor ONC201 PO on day 1 of every cycle or day 1 of every week. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.

    Drug: Akt/ERK Inhibitor ONC201 · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study

Interventions

  • DrugAkt/ERK Inhibitor ONC201

    Given PO

    Also known as: ONC201, TIC10

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • OtherPharmacological Study

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Recommended Phase 2 Dose (RP2D) (Phase I)

    Time frame: 21 days

  2. Number of Participants With Overall Response Rate (Phase 1 and 2)

    Defined as either progressive disease or stable disease observed assessed by the Revised International Workshop Standardization Response Criteria for non-Hodgkin lymphoma.

    Time frame: Up to 63 days (first 3 courses)

Secondary outcomes

  1. Overall Survival (OS)

    Overall survival is the time in months from start of study treatment to date of death due to any cause.

    Time frame: every 3 months for 1 year, then every 6 months, up to 3 years

  2. Progression-free Survival (PFS)- (Phase 2)

    Progression free survival is defined as time in weeks from start of study treatment to first documentation of objective tumor progression or up to death due to any cause, whichever occurs first.

    Time frame: every 3 months for 1 year, then every 6 months, up to 6 years

07

Results

Posted Apr 4, 2022

Participant flow

Patients recruited at MD Anderson Lymphoma clinic from November 2015 through April 2018

Participant flow — Overall Study
MilestoneONC201 125 mgONC201 250 mgONC201 625 mg
Started425
Completed000
Not completed425
Withdrew: Withdrawal by subject100
Withdrew: Adverse event100
Withdrew: Progressive disease224
Withdrew: Death001

Outcome measures

PrimaryRecommended Phase 2 Dose (RP2D) (Phase I)
Time frame:
21 days
Reported as:
Number · mg
Recommended Phase 2 Dose (RP2D) (Phase I)
mgONC201 125 mg
Recommended Phase 2 Dose (RP2D) (Phase I)125
PrimaryNumber of Participants With Overall Response Rate (Phase 1 and 2)

Defined as either progressive disease or stable disease observed assessed by the Revised International Workshop Standardization Response Criteria for non-Hodgkin lymphoma.

Time frame:
Up to 63 days (first 3 courses)
Reported as:
Count of participants · Participants
Number of Participants With Overall Response Rate (Phase 1 and 2)
ParticipantsONC201 125 mgONC201 250 mgONC201 625 mg
Progressive Disease313
Stable Disease111
SecondaryOverall Survival (OS)

Overall survival is the time in months from start of study treatment to date of death due to any cause.

Time frame:
every 3 months for 1 year, then every 6 months, up to 3 years
Reported as:
Median · months
Overall Survival (OS)
monthsONC201 125 mgONC201 250 mgONC201 625 mg
Overall Survival (OS)29 (1 to 30)15 (1 to 30)24 (1 to 48)
SecondaryProgression-free Survival (PFS)- (Phase 2)

Progression free survival is defined as time in weeks from start of study treatment to first documentation of objective tumor progression or up to death due to any cause, whichever occurs first.

Time frame:
every 3 months for 1 year, then every 6 months, up to 6 years
Reported as:
Median · weeks
Progression-free Survival (PFS)- (Phase 2)
weeksONC201 625 mg
Progression-free Survival (PFS)- (Phase 2)5 (1 to 10)

Adverse events

Collected over From the first dose through every 3 months after the last dose of study medication, up to 1 year.. Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
ONC201 125 mg0/4 (0%)0/4 (0%)4/4 (100%)
ONC201 250 mg0/2 (0%)1/2 (50%)2/2 (100%)
ONC201 625 mg1/5 (20%)1/5 (20%)5/5 (100%)
Most frequent serious events
Most frequent serious events
EventONC201 125 mgONC201 250 mgONC201 625 mg
AnemiaBlood and lymphatic system disorders0/41/20/5
DehydrationGeneral disorders0/41/20/5
Blood and lymphatic system disorders- OtherBlood and lymphatic system disorders0/41/20/5
Myocardial InfarctionInfections and infestations0/40/21/5
Edema LimbsGeneral disorders0/40/21/5
Most frequent other events
Showing 10 of 83
Most frequent other events
EventONC201 125 mgONC201 250 mgONC201 625 mg
FatigueGeneral disorders3/42/24/5
Numbness/TinglingNervous system disorders0/42/20/5
DiarrheaGastrointestinal disorders1/40/24/5
AnemiaBlood and lymphatic system disorders3/41/20/5
Edema limbsGeneral disorders1/40/23/5
Abdominal painGastrointestinal disorders0/41/21/5
AST increasedGeneral disorders2/40/20/5
Blood and lymphatic system disorderBlood and lymphatic system disorders0/41/20/5
ConstipationGastrointestinal disorders1/41/21/5
CoughRespiratory, thoracic and mediastinal disorders0/41/20/5

Baseline characteristics

Patients enrolled on Arm A until Arm B approved in 2/9/2016 IRB amendment

Age, Categorical
Age, Categorical(Participants)ONC201 125 mgONC201 250 mgONC201 625 mgTotal
<=18 years0000
Between 18 and 65 years1012
>=65 years3249
Sex: Female, Male
Sex: Female, Male(Participants)ONC201 125 mgONC201 250 mgONC201 625 mgTotal
Female1023
Male3238
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)ONC201 125 mgONC201 250 mgONC201 625 mgTotal
Hispanic or Latino0011
Not Hispanic or Latino3249
Unknown or Not Reported1001
Race (NIH/OMB)
Race (NIH/OMB)(Participants)ONC201 125 mgONC201 250 mgONC201 625 mgTotal
American Indian or Alaska Native0000
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American0000
White42511
More than one race0000
Unknown or Not Reported0000
Region of Enrollment
Region of Enrollment(participants)ONC201 125 mgONC201 250 mgONC201 625 mgTotal
United States42511
08

Study locations

1 site
  • M D Anderson Cancer Center
    Houston, Texas 77030, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Nov 13, 2018

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 4, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02420795
Lead sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Apr 20, 2015
Start date
Nov 3, 2015
Primary completion
Nov 16, 2020
Completion
Nov 16, 2020
Results posted
Apr 4, 2022
Last update
Apr 4, 2022

Study contacts

Luhua (Michael) Wang
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Mar 2022. You cannot join it, but the record below documents what was studied.

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