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NCT00807495

Study of Alisertib (MLN8237) in Adults With Aggressive Non-Hodgkin's Lymphoma

Completed Phase 2 Results posted Last updated 27 March 2018
What this trial tests

Phase 2 trial testing Alisertib in Diffuse Large B-cell Lymphoma in 48 participants. Completed in 13 February 2013.

Timeline
10 February 2009
Primary endpoint
4 January 2011
13 February 2013

Quick facts

Lead sponsorMillennium Pharmaceuticals, Inc.
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment48
Start date10 February 2009
Primary completion4 January 2011
Estimated completion13 February 2013
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Millennium Pharmaceuticals, Inc. — full company profile →

Who can join

18 and older, any sex, with Diffuse Large B-cell Lymphoma or Mantle Cell Lymphoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Best Overall Response Rate Based on Investigator's Assessment (Applying the IWG 2007 Response Criteria) Primary · Baseline and every 2 cycles up to Month 12 (approximately 16 cycles), from Cycle 16 every 4 cycles until disease progression, after end of treatment every 12 weeks for up to 12 Months from last dose (Up to 4 years)

Best overall response rate is defined as the percentage of participants with complete response (CR) or partial response (PR) as assessed by the Investigator using International Working Group (IWG) Criteria. CR is defined as the disappearance of all evidence of disease and PR is defined as regression of measurable disease and no new sites (as specified in the Cheson 2007, IWG response criteria).

GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)25
Alisertib 50 mg BID Starting Dose (MCL)23
Alisertib 50 mg BID Starting Dose (TFL)40
Alisertib 50 mg BID Starting Dose (BL)100
Alisertib 50 mg BID Starting Dose (ATL)50
Time to Progression (TTP) Secondary · Baseline and every 2 cycles up to Month 12, from Cycle 16 every 4 cycles until disease progression, after end of treatment every 12 weeks for up to 12 Months (Up to 4 years)

Time to progression (TTP) is defined as the time in days from the date of first study drug administration to the date of first documentation of Progressive Disease (PD) according to IWG criteria (Cheson 2007). PD is defined as any new lesion or increase by \>50% of previously involved sites from nadir.

GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)84.048.0 – 430.0
Alisertib 50 mg BID Starting Dose (MCL)139.048.0 – 809.0
Alisertib 50 mg BID Starting Dose (TFL)NANA – NA
Alisertib 50 mg BID Starting Dose (BL)NANA – NA
Alisertib 50 mg BID Starting Dose (ATL)237.046.0 – 631.0
Progression Free Survival (PFS) Secondary · Baseline and every 2 cycles up to Month 12, from Cycle 16 every 4 cycles until disease progression, after end of treatment every 12 weeks for up to 12 Months (Up to 4 years)

PFS is defined as the time in days from the date of first study drug administration to the date of first documentation of progressive disease (PD) or death.

GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)84.048.0 – 364.0
Alisertib 50 mg BID Starting Dose (MCL)139.048.0 – 809.0
Alisertib 50 mg BID Starting Dose (TFL)NANA – NA
Alisertib 50 mg BID Starting Dose (BL)NANA – NA
Alisertib 50 mg BID Starting Dose (ATL)237.046.0 – 631.0
Duration of Response (DOR) Secondary · Baseline and every 2 cycles up to Month 12, from Cycle 16 every 4 cycles until disease progression, after end of treatment every 12 weeks for up to 12 Months (Up to 4 years)

DOR is defined as the time from the date of first documentation of a CR, or partial response (PR) to the date of first documentation of PD according to IWG criteria. CR definition includes the complete disappearance of all evidence of disease, the definition of PR includes at least a 50% decrease in sum of the product of the diameters (SPD) of up to six of the largest dominant nodes or nodal masses, and PD is defined as any new lesion or increase by \>50% of previously involved sites from nadir, as described in the IWG response criteria (Cheson 2007).

GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)454.0182.0 – 565.0
Alisertib 50 mg BID Starting Dose (MCL)646.0243.0 – 646.0
Alisertib 50 mg BID Starting Dose (TFL)NANA – NA
Alisertib 50 mg BID Starting Dose (BL)NANA – NA
Alisertib 50 mg BID Starting Dose (ATL)596.0202.0 – 596.0
Number of Participants With Treatment-Emergent Adverse Events Secondary · First dose of study drug to 30 days after last dose (Up to 25 months)

An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug and includes all-causality (ie, treatment-related and not treatment-related as assessed by the investigator).

GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)22
Alisertib 50 mg BID Starting Dose (MCL)13
Alisertib 50 mg BID Starting Dose (TFL)5
Alisertib 50 mg BID Starting Dose (BL)1
Alisertib 50 mg BID Starting Dose (ATL)7
Number of Participants With Abnormal Vital Signs Reported as Treatment-Emergent Adverse Events Secondary · First dose of study drug to 30 days after last dose (Up to 25 months)

Vital signs (blood pressure, heart rate, and oral temperature) measurements were obtained throughout the study. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug.

Pyrexia
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)7
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)2
Hypotension
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)6
Alisertib 50 mg BID Starting Dose (MCL)1
Alisertib 50 mg BID Starting Dose (TFL)1
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Weight decreased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)2
Alisertib 50 mg BID Starting Dose (MCL)1
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Tachycardia
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)1
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)2
Hypertension
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)1
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)0
Bradycardia
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)1
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)0
Cardiac flutter
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)1
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)0
Number of Participants With Abnormal Laboratory Values Reported as Treatment-Emergent Adverse Events Secondary · First dose of study drug to 30 days after last dose (Up to 25 months)

Abnormal laboratory values for chemistry or hematology tests that were assessed by the investigator using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE V4). A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug.

Thrombocytopenia
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)11
Alisertib 50 mg BID Starting Dose (MCL)5
Alisertib 50 mg BID Starting Dose (TFL)3
Alisertib 50 mg BID Starting Dose (BL)1
Alisertib 50 mg BID Starting Dose (ATL)5
Alanine aminotransferase increased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)6
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Aspartate aminotransferase increased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)6
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Blood alkaline phosphatase increased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)6
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Hypokalaemia
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)3
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)1
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Blood lactate dehydrogenase increased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)3
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1
Blood creatinine increased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)0
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)2
Blood potassium decreased
GroupValue95% CI
Alisertib 50 mg BID Starting Dose (DLBL)1
Alisertib 50 mg BID Starting Dose (MCL)0
Alisertib 50 mg BID Starting Dose (TFL)0
Alisertib 50 mg BID Starting Dose (BL)0
Alisertib 50 mg BID Starting Dose (ATL)1

Adverse events — posted to ClinicalTrials.gov

Time frame: First dose of study drug to 30 days after last dose (Up to 25 Months). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Alisertib 50 mg BID Starting Dose (DLBL)
Serious: 16/22 (73%)
Deaths:
Alisertib 50 mg BID Starting Dose (MCL)
Serious: 4/13 (31%)
Deaths:
Alisertib 50 mg BID Starting Dose (TFL)
Serious: 5/5 (100%)
Deaths:
Alisertib 50 mg BID Starting Dose (BL)
Serious: 0/1 (0%)
Deaths:
Alisertib 50 mg BID Starting Dose (ATL)
Serious: 4/7 (57%)
Deaths:

Serious adverse events (45 terms)

ReactionSystemAlisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…
Febrile NeutropeniaBlood and lymphatic system disorders
StomatitisGastrointestinal disorders
NeutropeniaBlood and lymphatic system disorders
PneumoniaInfections and infestations
DehydrationMetabolism and nutrition disorders
PancytopeniaBlood and lymphatic system disorders
Urinary tract infectionInfections and infestations
LymphomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Deep vein thrombosisVascular disorders
AnaemiaBlood and lymphatic system disorders
Haemolytic anaemiaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
CellulitisInfections and infestations
OsteomyelitisInfections and infestations
Oropharyngeal candidiasisInfections and infestations
Escherichia bacteraemiaInfections and infestations
SepsisInfections and infestations
Colitis ischaemicGastrointestinal disorders
Abdominal pain upperGastrointestinal disorders
ConstipationGastrointestinal disorders
DysphagiaGastrointestinal disorders
NauseaGastrointestinal disorders
AstheniaGeneral disorders
PyrexiaGeneral disorders
Multi-organ failureGeneral disorders
Other adverse events (160 terms — click to expand)

ReactionSystemAlisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…Alisertib 50 mg BID Starti…
NeutropeniaBlood and lymphatic system disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
LeukopeniaBlood and lymphatic system disorders
FatigueGeneral disorders
ThrombocytopeniaBlood and lymphatic system disorders
AlopeciaSkin and subcutaneous tissue disorders
SomnolenceNervous system disorders
StomatitisGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
NauseaGastrointestinal disorders
ConstipationGastrointestinal disorders
PyrexiaGeneral disorders
Alanine aminotransferase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
Blood alkaline phosphatase increasedInvestigations
HypotensionVascular disorders
VomitingGastrointestinal disorders
Abdominal painGastrointestinal disorders
AstheniaGeneral disorders
Oedema peripheralGeneral disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Haemoglobin decreasedInvestigations
Upper respiratory tract infectionInfections and infestations
InsomniaPsychiatric disorders
DyspepsiaGastrointestinal disorders
Abdominal discomfortGastrointestinal disorders
Catheter site erythemaGeneral disorders
Rash pruriticSkin and subcutaneous tissue disorders
Night sweatsSkin and subcutaneous tissue disorders
DizzinessNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders
Dyspnoea exertionalRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
Neutrophil count decreasedInvestigations
White blood cell count decreasedInvestigations
Blood lactate dehydrogenase increasedInvestigations
DehydrationMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
HypoglycaemiaMetabolism and nutrition disorders

Most-reported serious reactions: Febrile Neutropenia, Stomatitis, Neutropenia, Pneumonia, Dehydration, Pancytopenia, Urinary tract infection, Lymphoma.

Data from ClinicalTrials.gov NCT00807495 adverse events section.

Sponsor's own description

The purpose of this study is to evaluate the anti-tumor activity of alisertib (MLN8237) in participants with relapsed or refractory non-hodgkin's lymphoma.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Cell cycle proteins as promising targets in cancer therapy.
    Otto T, Sicinski P. · · 2017 · cited 1412× · PMID 28127048 · DOI 10.1038/nrc.2016.138
  2. Therapeutic targeting of "undruggable" MYC.
    Llombart V, Mansour MR. · · 2022 · cited 349× · PMID 34942444 · DOI 10.1016/j.ebiom.2021.103756
  3. Mitotic chromosomal instability and cancer: mouse modelling of the human disease.
    Schvartzman JM, Sotillo R, Benezra R. · · 2010 · cited 349× · PMID 20094045 · DOI 10.1038/nrc2781
  4. Phase II study of alisertib, a selective Aurora A kinase inhibitor, in relapsed and refractory aggressive B- and T-cell non-Hodgkin lymphomas.
    Friedberg JW, Mahadevan D, Cebula E, Persky D, et al · · 2014 · cited 166× · PMID 24043741 · DOI 10.1200/jco.2012.46.8793
  5. The two sides of chromosomal instability: drivers and brakes in cancer.
    Hosea R, Hillary S, Naqvi S, Wu S, et al · · 2024 · cited 102× · PMID 38553459 · DOI 10.1038/s41392-024-01767-7
  6. Aurora kinase A in gastrointestinal cancers: time to target.
    Katsha A, Belkhiri A, Goff L, El-Rifai W. · · 2015 · cited 74× · PMID 25987188 · DOI 10.1186/s12943-015-0375-4
  7. Emerging roles of Aurora-A kinase in cancer therapy resistance.
    Zheng D, Li J, Yan H, Zhang G, et al · · 2023 · cited 71× · PMID 37521867 · DOI 10.1016/j.apsb.2023.03.013
  8. The potential role of Aurora kinase inhibitors in haematological malignancies.
    Farag SS. · · 2011 · cited 51× · PMID 21980926 · DOI 10.1111/j.1365-2141.2011.08898.x

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