Romidepsin + Parsaclisib for Lymphoma

TO
Overseen ByThe Ohio State University Comprehensive Cancer Center
Age: 18+
Sex: Any
Trial Phase: Phase 1
Sponsor: Ohio State University Comprehensive Cancer Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine the optimal dose of parsaclisib when combined with romidepsin (Istodax) for treating T-cell lymphomas that have recurred or resisted standard treatments. It also evaluates the effectiveness of these drugs in achieving cancer remission and improving survival. Romidepsin stops cancer cells from dividing, while parsaclisib blocks a pathway that promotes cancer cell growth. Individuals with T-cell lymphomas who have not responded to at least one systemic therapy may be suitable candidates for this trial. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this new treatment.

Will I have to stop taking my current medications?

The trial requires that all cancer therapy, including radiation, topical steroids, and chemotherapy, must be stopped at least 1 week or 3 half-lives before starting the study treatment. However, if you have been on corticosteroids for a long time without changes, you may continue using them if the dose hasn't changed for 14 days before the study.

Is there any evidence suggesting that this treatment is likely to be safe for humans?

Research has shown that romidepsin, a drug for certain types of T-cell lymphoma, has been tested in several studies. In these studies, some patients experienced side effects like blood issues and general discomfort. However, the FDA has approved romidepsin for treating cutaneous T-cell lymphoma, indicating its safety for that condition.

Parsaclisib is a newer drug that inhibits enzymes aiding cancer cell growth. As a new drug, less information is available, but ongoing tests aim to determine its safety and effectiveness.

Researchers are investigating the combined use of romidepsin and parsaclisib, as they might work better together than separately. While this combination is still in early testing, the established safety of romidepsin offers some reassurance. However, the full safety of using both drugs together remains under study, and this trial is a crucial step in gaining more insight.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of romidepsin and parsaclisib for lymphoma because it targets the cancer in a novel way. Unlike traditional treatments that focus primarily on chemotherapy, this combo includes parsaclisib, a PI3K inhibitor, which interferes with pathways crucial for cancer cell survival and proliferation. In addition, romidepsin, a histone deacetylase inhibitor, can help make the cancer cells more sensitive to treatment. By using this unique dual approach, there's potential to improve outcomes and offer hope to patients who may not respond well to existing therapies.

What evidence suggests that romidepsin and parsaclisib might be effective for T-cell lymphomas?

Research has shown that romidepsin, when used alone, has been somewhat successful in treating cutaneous T-cell lymphoma. In one study, about 34% of patients experienced a reduction or disappearance of their cancer. Parsaclisib works differently by blocking a pathway called PI3K, which cancer cells need to grow and survive. By blocking this pathway, parsaclisib may help stop cancer cells from multiplying. In this trial, participants will receive a combination of romidepsin and parsaclisib. The goal of combining these two drugs is to enhance their effectiveness. Although solid data on the combination's efficacy is not yet available, the expectation is that they might work better together than each drug alone.678910

Who Is on the Research Team?

WH

Walter Hanel, MD, PhD

Principal Investigator

Ohio State University Comprehensive Cancer Center

Are You a Good Fit for This Trial?

Adults with relapsed or refractory T-cell lymphomas, including various subtypes like Anaplastic Large Cell and Cutaneous T-Cell Lymphoma. Participants must have a life expectancy of at least 90 days, adequate organ function, no recent cancer treatments (with some exceptions for steroids), and not be pregnant. They should agree to use effective contraception.

Inclusion Criteria

Bilirubin =< 2.0 x ULN (<= 4 x ULN allowed for specific conditions)
Negative serum pregnancy test at enrollment for females of childbearing potential
Life expectancy >= 90 days
See 13 more

Exclusion Criteria

I have been treated with a PI3K inhibitor before.
I have not had any other cancer in the last 2 years, with some exceptions.
I have a significant history of liver problems.
See 12 more

Timeline for a Trial Participant

Pre-Phase

Patients receive romidepsin intravenously over 4 hours on days 1, 8, and 15. Treatment repeats every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity.

8 weeks
3 visits per cycle (in-person)

Induction Phase

Patients receive romidepsin IV over 4 hours on days 1, 8, and 15 and parsaclisib orally once daily on days 1-28. Treatment repeats every 28 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity.

8 weeks
3 visits per cycle (in-person)

Maintenance Phase

Patients receive romidepsin IV over 4 hours on days 1, 8, and 15 and parsaclisib orally once daily on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Ongoing
3 visits per cycle (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment completion. Follow-up occurs at 30 days post-treatment and then every 3 months for up to 2 years.

Up to 2 years
1 visit at 30 days, then every 3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Parsaclisib
  • Romidepsin
Trial Overview The trial is testing the combination of Romidepsin and Parsaclisib to find the best dose for treating T-cell lymphomas that haven't responded well to other treatments. It aims to see if this combo can achieve complete remission or significant reduction in cancer size and improve patient survival.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Treatment (romidepsin, parsaclisib)Experimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Ohio State University Comprehensive Cancer Center

Lead Sponsor

Trials
350
Recruited
295,000+

Walter Hanel

Lead Sponsor

Trials
1
Recruited
5+

Citations

Clinical Trial: NCT04774068This phase I trial finds the appropriate parsaclisib dose level in combination with romidepsin for the treatment of T-cell lymphomas that have come back ( ...
Therapeutic challenges in peripheral T-cell lymphoma - PMCThe prognosis of ALK + ALCL is better than that of ALK-ALCL, and the 5-year overall survival rate is 70–90% [34]. Alk-negative ALCL cases have ...
Safety and efficacy of tenalisib in combination with ...Overall, 36.4% of patients had relapsed following the last prior therapy (31.3% in PTCL, 41.2% in CTCL). Twenty-one (63.6%) patients (68.8% in ...
Romidepsin: a new therapy for cutaneous T-cell lymphoma ...Within this patient cohort, four patients achieved a complete response, and an additional 20 patients a partial response, for an overall response rate of 34% ...
Bristol Myers Squibb Statement on Istodax® (romidepsin) ...Istodax (romidepsin) for injection is indicated for treatment of cutaneous T-cell lymphoma (CTCL) in patients who have received at least one prior systemic ...
Romidepsin and Parsaclisib for the Treatment of Relapsed ...Giving romidepsin and parsaclisib in combination may work better in treating relapsed or refractory T-cell lymphomas compared to either drug alone. Detailed ...
ISTODAX (romidepsin) Label - accessdata.fda.govThe safety of ISTODAX was evaluated in 185 patients with CTCL in 2 single arm clinical studies in which patents received a starting dose of 14 mg/m2. The ...
8.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/25891346/
Romidepsin in peripheral and cutaneous T-cell lymphomaSafety data show slightly greater haematological and constitutional toxicity in PTCL. cDNA microarray studies show unique individual gene ...
ISTODAX®(romidepsin) for injection, for intravenous useThe data in the WARNINGS AND PRECAUTIONS reflect exposure to ISTODAX in four clinical trials involving 363 patients with T-cell lymphoma, including 185 patients ...
Istodax (romidepsin) - accessdata.fda.govIstodax® (Romidepsin) is a histone deacetylase (HDAC) inhibitor, indicated for the treatment of cutaneous T-cell lymphoma (CTCL) in patients who ...
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