A Phase 1, Dose Escalation, Safety and Tolerability Study of NX-2127, a Bruton's Tyrosine Kinase (BTK) Degrader, in Adults With Relapsed/Refractory B-cell Malignancies
Summary
This is a first-in-human Phase 1a/1b multicenter, open-label oncology study designed to evaluate the safety and anti-cancer activity of NX-2127 in patients with advanced B-cell malignancies.
Detailed description
Phase 1a (Dose Escalation) will evaluate the safety and tolerability of NX-2127 in adult patients with relapsed/refractory (R/R) B-cell malignancies, who have required and received at least 2 prior systemic therapies (or at least 1 prior therapy for patients with WM or PCNSL) and for which no other therapies are known to provide clinical benefit. Phase 1b (Dose Optimization) will use a 2-stage design to further investigate the safety, tolerability, and preliminary efficacy of NX-2127 in R/R B-cell malignancies based on the dosage(s) selected in Phase 1a. Stage 1 will enroll approximately 10 participants per group based on B-cell lymphoma/leukemia indication at a specific dose selected from the first part of the study. The Sponsor may decide to open Stage 2 for any given group after review of safety and anti-tumor activity data from Stage 1. In Stage 2, an additional 10 participants will be enrolled at the dose from Stage 1 as well as 20 additional participants at a second alternative dose. Participants will be randomly assigned to one of the 2 dose levels in Stage 2.
Arms & interventions
- DrugNX-2127
Oral NX-2127
Outcome measures
Primary
Number of Participants with Protocol Specified Dose-Limiting Toxicities
Phase 1a
Time frame: Up to 24 months
To establish the MTD and/or recommended Phase 1b dosage(s) of NX-2127
Phase 1a
Time frame: Up to 24 months
To evaluate the clinical activity of NX-2127 at the recommended Phase 1b dosage(s) based on overall response rate (ORR) as assessed by the Investigator
Phase 1b
Time frame: Up to 4 years
Number of Participants with Adverse Events and Clinical Laboratory Abnormalities
Phase 1a/1b
Time frame: Up to 5 years
Secondary
Pharmacokinetic (PK) Profile of NX-2127: Maximum Serum Concentration
Time frame: Up to 5 years
Duration of response (DOR) as assessed by the Investigator
Time frame: Up to 5 years
Progression-free survival (PFS) as assessed by the Investigator
Time frame: Up to 5 years
Overall survival (OS) as assessed by the Investigator
Time frame: Up to 4 years
To further evaluate the safety and tolerability of NX-2127 by collecting adverse events, treatment emergent adverse events, and incidence of all deaths
Time frame: Up to 4 years
Complete response (CR) rate / CR with incomplete marrow recovery as assessed by the Investigator
Time frame: Up to 5 years
Eligibility criteria
Study locations (16)
City of Hope
Duarte, California, 91010
University of California Irvine
Orange, California, 92868
University of California San Francisco Medical Center
San Francisco, California, 94143
Sarah Cannon Research Institute at Colorado Blood Cancer Institute
Denver, Colorado, 80218
Mount Sinai Comprehensive Cancer Center
Miami Beach, Florida, 33140
Sarah Cannon Research Institute at Florida Cancer Specialists
Sarasota, Florida, 34203
The University of Chicago Medical Center
Chicago, Illinois, 60637
National Institutes of Health Clinical Center
Bethesda, Maryland, 20814
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
University of Cincinnati Medical Center
Cincinnati, Ohio, 45267
OSU Wexner Medical Center
Columbus, Ohio, 43210
Tennessee Oncology
Nashville, Tennessee, 37203
Baylor University Medical Center
Dallas, Texas, 75246
MD Anderson Cancer Center
Houston, Texas, 77030
Huntsman Cancer Institute, University of Utah
Salt Lake City, Utah, 84112
Swedish Cancer Institute
Seattle, Washington, 98104
References
- Zhang D, Harris HM, Chen J, Judy J, James G, Kelly A, McIntosh J, Tenn-McClellan A, Ambing E, Tan YS, Lu H, Gajewski S, Clifton MC, Yung S, Robbins DW, Pirooznia M, Skanland SS, Gaglione E, Mhibik M, Underbayev C, Ahn IE, Sun C, Herman SEM, Noviski M, Wiestner A. NRX-0492 degrades wild-type and C481 mutant BTK and demonstrates in vivo activity in CLL patient-derived xenografts. Blood. 2023 Mar 30;141(13):1584-1596. doi: 10.1182/blood.2022016934.(PubMed)