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Phase II Trial of the Aurora Kinase A Inhibitor MLN8237, in Relapsed or Refractory Peripheral T-Cell Non-Hodgkin Lymphoma

Phase 2
18 Years
Open (Enrolling)
Adult Nasal Type Extranodal NK/T-cell Lymphoma, Anaplastic Large Cell Lymphoma, Angioimmunoblastic T-cell Lymphoma, Hepatosplenic T-cell Lymphoma, Peripheral T-cell Lymphoma, Recurrent Adult Non-Hodgkin Lymphoma, Recurrent Adult T-cell Leukemia/Lymphoma

Thank you

Trial Information

Phase II Trial of the Aurora Kinase A Inhibitor MLN8237, in Relapsed or Refractory Peripheral T-Cell Non-Hodgkin Lymphoma


I. To estimate the objective response rate (complete responses [CR] + partial responses
[PR]) after 4 courses of treatment with alisertib (MLN8237) in patients with relapsed or
refractory peripheral T-cell non-Hodgkin lymphoma.

II. To assess overall survival (OS) and progression-free survival (PFS) in this patient

III. To evaluate the safety and tolerability of MLN8237 treatment for this patient

IV. To explore the association between pre-treatment aurora kinase A expression in tumor
biopsies as measured by fluorescence in situ hybridization (FISH) and objective response
rate in patients with peripheral T-cell lymphomas (PTCL) treated with MLN8237. (exploratory)
IV. To investigate the copy number, mutational status, expression of aurora kinase (A, B,
and C) and associated signaling pathways in PTCL utilizing tissue microarray analysis (TMA)
before and after treatment with MLN8237.


I. To investigate changes in the serum cytokine profile pre- and post- aurora kinase
Inhibitor treatment.

II. To evaluate serum markers of apoptosis pre- and post- aurora kinase inhibitor treatment
as pharmacodynamic markers of efficacy.


Patients receive alisertib orally (PO) twice daily (BID) on days 1-7. Treatment repeats
every 21 days for 17 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 4 months for 2 years.

Inclusion Criteria:

- Patients must have histologically or cytologically confirmed relapsed/refractory
non-Hodgkin lymphoma (NHL) with any of the following T-cell histologies:

- Peripheral T-cell NHL (PTCL) not otherwise specified (NOS)

- Anaplastic large cell T-cell lymphoma (ALCL) that is anaplastic lymphoma kinase
either positive or negative

- Angioimmunoblastic T-cell NHL

- Subcutaneous panniculitis-like T-cell lymphoma

- Enteropathy-associated T-cell NHL

- Hepatosplenic T-cell lymphomas

- Extranodal NK/T-cell lymphoma, nasal type

- Adult T-cell leukemia/lymphoma

- Unclassifiable PTCL

- Transformed cutaneous T-cell lymphoma (CTCL) to PTCL with systemic involvement
(not local skin transformation)

- No other histologies are eligible; examples of ineligible histologies include:
T-cell prolymphocytic leukemia, T-cell large granular lymphocytic leukemia,
NK-cell leukemia, mycosis fungoides, Sezary syndrome, lymphomatoid papulosis,
and primary CTCL

- Patients must have received at least one course of prior systemic therapy which may
include chemotherapy, antibody therapy, or immunotherapy; for all forms of systemic
therapy, patients must have completed therapy at least 21 days prior to registration;
patients must not be within 84 days of radioimmunotherapy; steroids at a low dose for
control of itching (up to the equivalent of 20 mg of prednisone daily) are allowed

- Adequate sections and a paraffin block from the relapsed/refractory specimen must be
submitted for review by the lymphoma pathology group; an adequate biopsy requires
sufficient tissue to establish the architecture and a Revised European American
Lymphoma (REAL) or World Health Organization (WHO) histologic subtype with certainty;
thus, core biopsies, especially multiple core biopsies MAY be adequate; whereas,
needle aspirations or cytologies are not adequate

- Patients must have bidimensionally measurable disease

- Patients who also have non-measurable disease in addition to measurable disease
must have all non-measurable disease assessed within 42 days prior to

- Patients must have a bilateral or unilateral bone marrow aspirate and biopsy
performed within 42 days prior to registration

- Patients must not have clinical evidence of central nervous system involvement by

- Patients must be able to swallow tablets

- Patients known to be human immunodeficiency virus (HIV)-positive must not have
multi-drug resistant HIV infection, CD4 counts < 150/mcL, or other concurrent
acquired immunodeficiency syndrome (AIDS)-defining conditions

- Absolute granulocyte count >= 1,000 cells/mcL

- Platelet count >= 75,000 cells/mcL (patients with documented marrow involvement may
be transfused to this value)

- Serum bilirubin =< 2 times institutional upper limit of normal

- Patients must have a Zubrod performance status of 0, 1, or 2

- No other prior malignancy is allowed except for the following: adequately treated
basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated
stage I or II cancer from which the patient is currently in complete remission, or
any other cancer from which the patient has been disease free for five years

- Pregnant or nursing women may not participate

- Women or men of reproductive potential may not participate unless they have agreed to
use an effective contraceptive method

- Patients may have received prior radiation in combination with systemic therapy;
patients must not be within 21 days of external-beam radiation therapy

- Patients must not have received a previous allogeneic stem cell transplant or be
within 90 days of an autologous stem cell transplant

Type of Study:


Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Objective response rate (CR and PR)

Outcome Time Frame:

Up to 2 years

Safety Issue:


Principal Investigator

Paul Barr

Investigator Role:

Principal Investigator

Investigator Affiliation:

Southwest Oncology Group


United States: Food and Drug Administration

Study ID:




Start Date:

October 2011

Completion Date:

Related Keywords:

  • Adult Nasal Type Extranodal NK/T-cell Lymphoma
  • Anaplastic Large Cell Lymphoma
  • Angioimmunoblastic T-cell Lymphoma
  • Hepatosplenic T-cell Lymphoma
  • Peripheral T-cell Lymphoma
  • Recurrent Adult Non-Hodgkin Lymphoma
  • Recurrent Adult T-cell Leukemia/Lymphoma
  • Immunoblastic Lymphadenopathy
  • Leukemia
  • Leukemia, T-Cell
  • Leukemia-Lymphoma, Adult T-Cell
  • Lymphoma
  • Lymphoma, Large B-Cell, Diffuse
  • Lymphoma, Non-Hodgkin
  • Lymphoma, T-Cell
  • Lymphoma, T-Cell, Peripheral
  • Lymphoma, Large-Cell, Anaplastic
  • Lymphoma, Extranodal NK-T-Cell



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Saint John's Hospital Springfield, Missouri  65804
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