A Phase 1/2 Study of DZR123 (CPI-0209) in Patients With Advanced Solid Tumors and Lymphomas
Summary
The purpose of this open-label, first-in-human (FIH) trial is to evaluate the safety, tolerability, and preliminary clinical activity of Tulmimetostat as a monotherapy in patients with advanced solid tumors and lymphomas.
Detailed description
The study is divided into Phase 1 and Phase 2. In Phase 1 and the Phase 2 expansion (M1 to M7), patients are non-randomized. In Phase 2 optimization, patients in Cohort M2 and M3 (Stage 2a and 2b) and Cohort M8 (Part 2) are randomized. Phase 1 of the study is composed of a Tulmimetostat Dose Escalation period in patients with advanced tumors and aims to determine maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D) of Tulmimetostat as monotherapy in patients with advanced tumors. Phase 2 of the study is planned to evaluate safety and tolerability and antitumor activity of Tulmimetostat in six disease-specific cohorts (M1 to M6). Patients in Cohorts M1, M2, M3, M5, and M6 will be enrolled at 10 to 29 patients per cohort, using a Simon 2-stage design. Cohort M4 will enroll up to 20 patients with lymphoma in a single-stage. The primary aim of Phase 2 part of the study is to evaluate the antitumor activity of Tulmimetostat, and characterize the safety and tolerability of Tulmimetostat as monotherapy in patients with selected tumors. In Phase 2, two additional doses are planned to be evaluated in cohorts M2 and M3 in 2 stages: Stage 2a and Stage 2b. In Stage 2a approximately 20 patients will be enrolled per cohort and will be randomized 1:1 to receive 2 prespecified dose levels of Tulmimetostat once daily. When protocol criteria for initiating Stage 2b will be fulfilled after completion of Stage 2a, then Stage 2b will be opened for enrolment of additional 10 patients in one or both dose arms in each of the two cohorts. Thus, up to 40 patients per cohort (M2 and M3) could be enrolled. The study will explore the Tulmimetostat in anti-tumor activity and effect of food on pharmacokinetics of Tulmimetostat in in patients with ARID1A WT endometrial carcinoma (Cohort M7) and safety and anti-tumor activity of Tulmimetostat in in combination with enzalutamide in patients with mCRPC (Cohort M8). In Cohort M8 Part 1, the safety and tolerability of Tulmimetostat in and enzalutamide combination will be evaluated in patients with mCRPC. The M8 Part 1 dose escalation incorporates combination of Tulmimetostat in at escalating provisional doses with enzalutamide. In Cohort M8 Part 2, the safety, tolerability and preliminary antitumor activity of Tulmimetostat at a RP2D in combination with enzalutamide will be further evaluated in patients with mCRPC.
Arms & interventions
- DrugTulmimetostat
Tulmimetostat dosed once per day orally in 28 day cycles
- DrugEnzalutamide
Enzalutamide dosed once per day orally in 28 day cycles
Outcome measures
Primary
Tulmimetostat Monotherapy Phase 1: Frequency of Dose-limiting toxicities (DLTs)
The maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) of Tulmimetostat as monotherapy in patients with advanced tumors.
Time frame: DLTs assessed during Cycle 1 (cycle = 28 days)
Tulmimetostat Monotherapy Phase 2: Overall response rate (ORR)
ORR is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR) based on RECIST 1.1 or applicable response criteria
Time frame: Up to 30 months
Cohort M8 Part 1: Frequency of Dose-limiting toxicities (DLTs)
The maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) of Tulmimetostat in combination with enzalutamide in patients with castration-resistant prostate cancer (mCRPC) with measurable soft tissue disease.
Time frame: DLTs assessed during Cycle 1 (cycle = 28 days)
Cohort M8 Part 2: Overall response rate (ORR)
ORR is defined as the proportion of patients with a best overall response of complete response (CR) or partial response (PR) per Investigator assessment based on Prostate Cancer Clinical Trials Working Group 3 (PCWG3)
Time frame: Up to 30 months
Secondary
Tulmimetostat Monotherapy Phase 1: Incidence Rate of AEs
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Maximum observed plasma concentration (Cmax)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Time of maximum observed plasma concentration (Tmax)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Area under the plasma concentration-time curve from time zero to the last quantifiable time point (AUC0-last)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-Inf)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Terminal elimination half-life (T1/2)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Plasma concentrations prior to the next dose-trough (Cmin)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Gene expression in blood cells
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: H3K27me3
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 1: Objective Response Rate (ORR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: ORR per Gynecologic Cancer Intergroup (GCIG)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: ORR per Prostate Cancer Clinical Trials Working Group 3 (PCWG3)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: Progression-free survival (PFS)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: Duration of response (DOR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: Time to response (TTR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 1: Disease Control Rate (DCR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Progression-free survival (PFS)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Time-to-progression (TTP)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Duration of response (DOR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Time to response (TTR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Disease Control Rate (DCR)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: ORR per Gynecologic Cancer Intergroup (GCIG)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Overall survival (OS)
Time frame: Up to 30 months
Tulmimetostat Monotherapy Phase 2: Incidence Rate of AEs
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Maximum observed plasma concentration (Cmax)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Time of maximum observed plasma concentration (Tmax)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Area under the plasma concentration-time curve from time zero to the last quantifiable time point (AUC0-last)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-Inf)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Terminal elimination half-life (T1/2)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Plasma concentrations prior to the next dose-trough (Cmin)
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: Gene expression in blood cells
Time frame: Up to 18 months
Tulmimetostat Monotherapy Phase 2: H3K27me3
Time frame: Up to 18 months
Cohort M7: Maximum observed plasma concentration (Cmax)
Time frame: Up to 18 months
Cohort M7: Time of maximum observed plasma concentration (Tmax)
Time frame: Up to 18 months
Cohort M7: Area under the plasma concentration-time curve from time zero to the last quantifiable time point (AUC0-last)
Time frame: Up to 18 months
Cohort M7: Area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-Inf)
Time frame: Up to 18 months
Cohort M7: Terminal elimination half-life (T1/2)
Time frame: Up to 18 months
Cohort M7: Plasma concentrations prior to the next dose-trough (Cmin)
Time frame: Up to 18 months
Cohort M8 Part 1: Incidence Rate of AEs
Time frame: Up to 18 months
Cohort M8 Part 1: Maximum observed plasma concentration (Cmax)
Time frame: Up to 18 months
Cohort M8 Part 1: Time of maximum observed plasma concentration (Tmax)
Time frame: Up to 18 months
Cohort M8 Part 1: Area under the plasma concentration-time curve from time zero to the last quantifiable time point (AUC0-last)
Time frame: Up to 18 months
Cohort M8 Part 1: Area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-Inf)
Time frame: Up to 18 months
Cohort M8 Part 1: Plasma concentrations prior to the next dose-trough (Cmin)
Time frame: Up to 18 months
Cohort M8 Part 1: Gene expression in blood cells
Time frame: Up to 18 months
Cohort M8 Part 1: H3K27me3
Time frame: Up to 18 months
Cohort M8 Part 1: Objective Response Rate (ORR)
Time frame: Up to 30 months
Cohort M8 Part 1: Duration of response (DOR)
Time frame: Up to 30 months
Cohort M8 Part 1: Disease Control Rate (DCR)
Time frame: Up to 30 months
Cohort M8 Part 1: Prostate-Specific Antigen 50 (PSA50) Response
Time frame: Up to 18 months
Cohort M8 Part 1: Number of participants experiencing Dose-limiting toxicities (DLTs)
Time frame: DLTs assessed during Cycle 1 (cycle = 28 days)
Cohort M8 Part 2: Incidence Rate of AEs
Time frame: Up to 18 months
Cohort M8 Part 2: Maximum observed plasma concentration (Cmax)
Time frame: Up to 18 months
Cohort M8 Part 2: Time of maximum observed plasma concentration (Tmax)
Time frame: Up to 18 months
Cohort M8 Part 2: Area under the plasma concentration-time curve from time zero to the last quantifiable time point (AUC0-last)
Time frame: Up to 18 months
Cohort M8 Part 2: Area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-Inf)
Time frame: Up to 18 months
Cohort M8 Part 2: Plasma concentrations prior to the next dose-trough (Cmin)
Time frame: Up to 18 months
Cohort M8 Part 2: Gene expression in blood cells
Time frame: Up to 18 months
Cohort M8 Part 2: H3K27me3
Time frame: Up to 18 months
Cohort M8 Part 2: Duration of response (DOR)
Time frame: Up to 30 months
Cohort M8 Part 2: Progression-free survival (PFS)
Time frame: Up to 30 months
Cohort M8 Part 2: Prostate-Specific Antigen 50 (PSA50) Response
Time frame: Up to 18 months
Cohort M8 Part 2: Time to Prostate-Specific Antigen (PSA) Progression
Time frame: Up to 18 months
Cohort M8 Part 2: Overall survival (OS)
Time frame: Up to 30 months
Eligibility criteria
Study locations (17)
Winship Cancer Institute of Emory University
Atlanta, Georgia, 30322-1013
University of Chicago Medical Center
Chicago, Illinois, 60637
University of Maryland - Marlene and Stewart Greenebaum Cancer Center
Baltimore, Maryland, 21201
Massachusetts General Hospital
Boston, Massachusetts, 02114
Dana Farber Cancer Institute
Boston, Massachusetts, 02215-5450
University of Michigan Hospital
Ann Arbor, Michigan, 48109
South Texas Accelerated Research Therapeutics (Start) - Midwest Location
Grand Rapids, Michigan, 49546
Hackensack University Medical Center
Hackensack, New Jersey, 07601
NYU Langone Medical Center - Laura and Isaac Perlmutter Cancer Center
New York, New York, 10016
Weill Medical College of Cornell University
New York, New York, 10065
Montefiore Einstein Center for Cancer Care
The Bronx, New York, 10467-2490
University of Cincinnati Medical Center
Cincinnati, Ohio, 45219
Abramson Cancer Center of the University of Pennsylvania
Philadelphia, Pennsylvania, 19104
South Texas Accelerated Research Therapeutics
San Antonio, Texas, 78229
University of Virginia Health System
Charlottesville, Virginia, 22908
Swedish Cancer Institute
Seattle, Washington, 98104
Fred Hutchinson Cancer
Seattle, Washington, 98109-1023