A Phase 3, Multicenter, Clinical Study to Evaluate the Efficacy and Safety of Safusidenib Erbumine in Participants With Isocitrate Dehydrogenase 1 (IDH1)-Mutant Glioma
Summary
This is a 3-part study. The purpose of Part 1 of the study is to evaluate the efficacy, safety, and pharmacokinetic (PK) characteristics of safusidenib in participants with recurrent/progressive IDH1-mutant World Health Organization (WHO) Grade 2 or Grade 3 glioma. The purpose of Part 2 will be to evaluate the efficacy of maintenance safusidenib treatment versus placebo in IDH1-mutant Grade 2 or Grade 3 astrocytoma with high-risk features or IDH1-mutant Grade 4 astrocytoma, following standard-of-care radiation or chemoradiation and adjuvant temozolomide. Part 2 will be randomized, double-blind, and placebo-controlled. The purpose of Part 3 will be to evaluate the efficacy of safusidenib in participants with residual or recurrent IDH1-mutant Grade 3 oligodendroglioma who have received surgery as their only treatment. Part 3 will be an open-label single-arm cohort and will enroll participants concurrently with Part 2.
Detailed description
Part 1 of this study will enroll up to 25 patients that will be randomized 1:1:1:1:1 (5 patients per group) to receive one of the daily oral doses of safusidenib at 125 mg twice a day (BID), 250 mg BID, 500 mg once daily (QD), 375 mg BID, or 500 mg BID. The PK characteristics and safety and initial efficacy data will be assessed in Part 1. Part 1 was fully enrolled as of 19 Dec 2023 and participants are currently ongoing. Part 2 will include approximately 300 participants with IDH1-mutant Grade 2 or Grade 3 astrocytoma with high-risk features or IDH1-mutant Grade 4 astrocytoma, following standard-of-care radiation or chemoradiation and adjuvant temozolomide. Participants will be randomized (1:1) after their last dose of adjuvant temozolomide to receive either oral safusidenib 250 mg BID or placebo in 28-day continuous cycles. Patients will continue treatment until progression of disease or until other discontinuation criteria are met. The tumor response evaluation will be conducted on a regular basis until progression of disease per Blinded Independent Central Review (BICR), consent withdrawal, or death, whichever occurs first. Long-term survival follow-up will be conducted as well. Part 3 will include approximately 40 participants with residual or recurrent IDH1-mutant Grade 3 oligodendroglioma with measurable disease who have undergone surgery as their only treatment and are not in need of immediate chemotherapy or radiotherapy. Participants will receive oral safusidenib 250 mg BID in 28-day continuous cycles until disease progression or another reason for discontinuation occurs.
Arms & interventions
- Drugsafusidenib
safusidenib administered continuously as dosed single agent orally on Days 1 to 28 of a 28-day cycle. Subjects may continue treatment with agent safusidenib until disease progression or development of other unacceptable toxicity.
- DrugPlacebo
Placebo administered continuously as dosed single agent orally on Days 1 to 28 of a 28-day cycle. Subjects may continue treatment with placebo until disease progression or another reason for discontinuation occurs.
Outcome measures
Primary
Part 1: Incidence of adverse events (AEs) and serious adverse events (SAEs)
calculate Percentage and numbers of participants with treatment emergent adverse events (TEAEs) and serious adverse events (SAEs) assessed by CTCAE 5.0
Time frame: From participants sign ICF to 30 days after last dose,average 2 years
Part 2: Progression-free survival (PFS) assessed by Blinded Independent Central Review (BICR) per Response Assessment in Neuro-Oncology (RANO) 2.0
PFS is defined as the time from randomization to the date of the first documented disease progression assessed by BICR per RANO 2.0 or death (by any cause in the absence of disease progression).
Time frame: From randomization until the date of first documented disease progression, average 2 years
Part 3 Objective Response Rate (ORR) (Complete Response (CR), Partial Response (PR) and Minor Response (MR)) assessed by Blinded Independent Central Review (BICR) per Response Assessment in Neuro-Oncology (RANO) 2.0
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Secondary
Part 1: Cmax of safusidenib
Time frame: on Cycle 1 Day 1 and Day 8 (every cycle is 28 days)
Part 1: Tmax of safusidenib
Time frame: on Cycle 1 Day 1 and Day 8 (every cycle is 28 days)
Part 1: AUC8h of safusidenib
Time frame: on Cycle 1 Day 1 and Day 8 (every cycle is 28 days)
Part 1 : AUC12h of safusidenib
Time frame: on Cycle 1 Day 1 and Day 8 (every cycle is 28 days)
Part 1: AUC24h [QD only] of safusidenib
Time frame: on Cycle 1 Day 1 and Day 8 (every cycle is 28 days)
Part 1 : Ctrough of safusidenib
Time frame: on Days 2, 3, 4, 6, 8, 9 of Cycle 1 and Day 1 of Cycles 2, 3, 4, 6 and 8 (every cycle is 28 days)
Part 1: Overall Response Rate (ORR) assessed by the investigator
Time frame: from the first dose of study drug until the date of first documented disease progression, average 2 years
Part 1: Duration of Response (DOR) assessed by the Investigator
Time frame: from the first dose of study drug until the date of first documented disease progression, average 2 years
Part 1: Disease control rate (DCR) assessed by the Investigator
Time frame: from the first dose of study drug until the date of first documented disease progression, average 2 years
Part 1: Progression free survival (PFS) assessed by the Investigator
Time frame: from the first dose of study drug until the date of first documented disease progression, average 2 years
Part1: Time to Response (TTR) assessed by the Investigator.
Time frame: From the first dose of study drug until the date of first documented objective response, average 2 years
Part 1: Overall Survival (OS)
Time frame: from the first dose of study drug to date of death, average 7 years
Part 2: Overall Survival (OS)
Time frame: from randomization to date of death, average 7 years
Part 2: PFS assessed by the Investigator.
Time frame: from randomization until the date of first documented disease progression, average 2 years
Part2: Time to Next Intervention (TTNI) by Investigator assessment
Time frame: From randomization until the date of next treatment, average 2 years
Part2: DCR assessed by BICR and by the Investigator
Time frame: from randomization until the date of first documented disease progression, average 2 years
Part2: ORR
Time frame: from randomization until the date of first documented disease progression, average 2 years
Part2: DOR, assessed by BICR and the Investigator
Time frame: from randomization until the date of first documented disease progression, average 2 years
Part2: Time to Response (TTR) assessed by BICR and by the Investigator
Time frame: From randomization until the date of first documented objective response, average 2 years
Part2: Health-related quality of life
Time frame: From the first dose of study drug to treatment discontinuation, average 2 years
Part2: Safety and tolerability
Time frame: from the first dose of study drug until 30 days after treatment discontinuation, average 2 years
Part2: Seizure Activity
Time frame: from the first dose of study drug until the date of first documented disease progression, average 2 years
Part2: Safusidenib PK Profile
Time frame: from the first dose of study drug through 20 weeks
Part 3: ORR, assessed by the Investigator
Time frame: From first dose of study drug until the date of first documented disease progression, average 18 months
Part 3: DOR, assessed by BICR and the Investigator
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Part 3: Time to Next Intervention (TTNI)
Time frame: From the first dose of study drug until the date of next treatment, average 18 months
Part 3: PFS assessed by BICR and the Investigator.
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Part 3: DCR assessed by BICR and by the Investigator
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Part 3: Time to Response (TTR) assessed by BICR and by the Investigator
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Part 3: Overall Survival (OS)
Time frame: From the first dose of study drug until the date of death, average 7 years
Part 3: Safety and tolerability
Time frame: From the first dose of study drug until 30 days after treatment discontinuation, average 18 months
Part 3: Safusidenib PK Profile
Time frame: From the first dose of study drug through 20 weeks
Part 3: Health-related quality of life
Time frame: From the first dose of study drug to treatment discontinuation, average 18 months
Part 3: Seizure Activity
Time frame: From the first dose of study drug until the date of first documented disease progression, average 18 months
Eligibility criteria
Study locations (40)
University of Alabama
Birmingham, Alabama, 35294
Mayo Clinic - Arizona
Phoenix, Arizona, 85013
St. Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
University of California San Diego
La Jolla, California, 92093
University of California, Los Angeles
Los Angeles, California, 90095
Hoag Memorial Hospital Presbyterian
Newport Beach, California, 92663
Stanford University
Palo Alto, California, 94304
University of California
San Francisco, California, 94143
University of Colorado Health Cancer Care
Aurora, Colorado, 80045
Yale University
New Haven, Connecticut, 06510
University of Florida Health
Gainesville, Florida, 32608
Mayo Clinic - Florida
Jacksonville, Florida, 32224
University of Miami Health
Miami, Florida, 33136
Orlando Health Cancer Institute
Orlando, Florida, 32806
University of Chicago
Chicago, Illinois, 60637
University of Kansas Medical Center
Kansas City, Kansas, 66160
Massachusetts General Hospital
Boston, Massachusetts, 02214
Dana-Farber Cancer Institute
Boston, Massachusetts, 02215
Henry Ford Hospital
Detroit, Michigan, 48202
Mayo Clinic - Rochester
Rochester, Minnesota, 55905
Washington University
St Louis, Missouri, 63110
Billings Clinic
Billings, Montana, 59101
Rutgers Cancer Institute
New Brunswick, New Jersey, 08901
NYU Langone Health
New York, New York, 10016
Icahn School of Medicine at Mount Sinai
New York, New York, 10029
Columbia University Medical Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
Duke Cancer Institute
Durham, North Carolina, 27710
Cleveland Clinic
Cleveland, Ohio, 44106
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, 37203
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
MD Anderson Cancer Center
Houston, Texas, 77030
Mays Cancer Center
San Antonio, Texas, 78229
Huntsman Cancer Insititute, University of Utah
Salt Lake City, Utah, 84112
UVA Health, Emily Couric Clinical Cancer Cente
Charlottesville, Virginia, 22903
Inova Schar Cancer Institute
Fairfax, Virginia, 22031
Fred Hutch Cancer Center
Seattle, Washington, 98195
University of Wisconsin Health
Madison, Wisconsin, 53792