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RecruitingInterventionalPhase 3

A Phase 3, Multicenter, Clinical Study to Evaluate the Efficacy and Safety of Safusidenib Erbumine in Participants With Isocitrate Dehydrogenase 1 (IDH1)-Mutant Glioma

NCT ID: NCT05303519Sponsor: Nuvation Bio Inc.Last updated: 2026-06-11

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

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Key Inclusion Criteria for Part 1: 1. Patient must be ≥ 18 years of age at the time of signing the informed consent form (ICF). 2. Patient must have histologically confirmed recurrent or progressive WHO Grade 2 glioma or Grade 3 glioma with IDH1 R132H or R132C mutation confirmed by immunohistochemistry or molecular genetic testing. 3. The IDH mutation, and other applicable gene/molecular alterations (see Table 10-2) are determined by a validated assay as performed in Clinical Laboratory Improvement Amendments (CLIA)-certified/College of American Pathologists (CAP)-accredited or locally equivalent clinical laboratories. Prior clinical pathology report fulfilling the diagnosis criteria prior to screening with tumor samples collected is acceptable for patient enrollment in both Part 1 and Part 2. 4. Patient has received no more than 2 prior therapies for disease recurrence/progression. 5. Patient has disease recurrence or progression or cannot tolerate the most recent therapy. 6. Patient must have a measurable lesion(s) as per the RANO-HGG criteria for primarily enhancing lesions or RANO-LGG criteria for primarily non-enhancing lesions. The lesion (s) must be visible on 2 or more axial slices and have perpendicular diameters of at least 10 × 10 mm. The definition of primarily enhancing lesions or primarily non-enhancing lesions is referred to Section 8.3.1. Key Inclusion Criteria for Part 2 and 3: 1. Must be ≥18 years old at the time of signing the ICF. 2. Must agree to submit sufficient tumor tissue for retrospective biomarker and histological analyses. This requirement may be waived in rare circumstances with approval by the Sponsor. 3. Has adequate hematologic and organ function Key Inclusion Criteria for Part 2: 1. Diagnosis of histologically confirmed IDH1-mutant Grade 2, Grade 3 with high risk features or Grade 4 astrocytoma, per WHO 2021 classification and Investigator Assessment. 2. Have an IDH1 mutation (R132H/C/G/S/L) based on IHC (R132H only), polymerase chain reaction (PCR), or next-generation sequencing (NGS). CDKN2A/B status and at least 1 of the following must be confirmed: absence of 1p19q co-deletion by fluorescence in situ hybridization, array comparative genomic hybridization, or NGS; presence of an ATRX loss of function mutation by NGS; or loss of normal ATRX expression by IHC. A validated assay performed in a CLIA-certified/CAP-accredited (or local equivalent) clinical laboratory must be used for all of the aforementioned results. Documentation of biomarker status, including redacted molecular pathology and NGS reports, must be provided during Screening. 3. Must not have experienced tumor recurrence or progression between first day of radiotherapy and randomization by local assessment per RANO 2.0. 4. Participants must have completed radiation therapy with a minimum of 80% of planned treatment completed (with or without concurrent temozolomide) and between 6 and 12 cycles of adjuvant . Randomization must occur at least 28 days and not more than 75 days after the final dose of temozolomide. Key Inclusion Criteria for Part 3: 1. Have had at least 1 prior surgery for glioma (biopsy, sub-total resection, or gross total resection), with the most recent surgery having occurred at least 90 days and no longer than 5 years before the date of enrollment, have not had any other prior anticancer therapy, including chemotherapy and radiotherapy, and are not in need of immediate chemotherapy or radiotherapy in the opinion of the Investigator. 2. Have histologically confirmed Grade 3 IDH-mutant oligodendroglioma according to WHO 2021 criteria per local assessment. 3. Have residual or recurrent measurable disease per RANO 2.0 and confirmed by BICR, at the time of enrollment. 4. Have an IDH1 mutation (R132H/C/G/S/L). The presence of 1p19q co-deletion must also be confirmed. All results must be generated using a validated assay performed in a CLIA-certified/CAP-accredited (or local equivalent) clinical laboratory. Key Exclusion Criteria for Part 1: 1. Prior anti-cancer therapy, within the applicable periods shown below, before the start of the protocol treatment: 2. Systemic drug therapies: within 3 weeks (lomustine within 6 weeks) 3. Surgery: within 3 weeks 4. Radiation therapy: within 12 weeks 5. Investigational agents: within 5 half-lives for other investigational agents 6. Patient did receive the prior therapy targeted to IDH1 mutation.. 7. Known hypersensitivity to safusidenib or to any drug with similar chemical structure or to any other excipient present in the pharmaceutical form of safusidenib. Key Exclusion Criteria for Part 2 and 3: 1. Participants with prior or anticipated treatment with anti-angiogenic agents such as Avastin (bevacizumab), agents known to target IDH1 or IDH2, or investigational agents for glioma are excluded. 2. Have brainstem or spinal cord involvement either as primary location, site of multifocal involvement, or by significant tumor extension. 3. Significant functional or neurocognitive deficits, including uncontrolled seizures, that would preclude participation in protocol-defined study activities, as assessed by Investigator. 4. Evidence of diffuse leptomeningeal disease. 5. History of significant cardiac disease within 12 months prior to randomization (if applicable) or first dose of study drug (if randomization does not apply). 6. If taking corticosteroids, must be on a stable or decreasing dose for the 14 days prior to randomization (if applicable) or first dose of study drug (if randomization does not apply). 7. Participants with other malignancies must have received curative treatment and been disease-free for at least 3 years. Curatively resected skin cancer or curatively treated carcinoma in situ is allowed. 8. Have a condition that would interfere with, or increase the risk of, study participation. Key Exclusion Criteria for Part 2 1. Participants may not have received any anticancer treatments other than surgery, radiation, concurrent/adjuvant temozolomide, and tumor-treating fields. Tumor-treating fields must be discontinued prior to randomization. Key Exclusion Criteria for Part 3: 1\. Participants may not have received any prior anticancer therapy other than surgery (biopsy, sub-total, or gross total resection) for treatment of glioma, including radiotherapy.

Study locations (40)

University of Alabama

Birmingham, Alabama, 35294

Recruiting
Shirley Gibbs · Contact
Luis Nabors, MD · Principal Investigator

Mayo Clinic - Arizona

Phoenix, Arizona, 85013

Recruiting
MCC Prep Team · Contact
Shannon Fortin Ensign, MD · Principal Investigator

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, 85013

Recruiting
Yoshie Umemura, MD · Principal Investigator

University of California San Diego

La Jolla, California, 92093

Not Yet Recruiting
Sheila Medina-Torne · Contact
David Piccioni, MD · Principal Investigator

University of California, Los Angeles

Los Angeles, California, 90095

Recruiting
· Contact
Robert Chong, MD · Principal Investigator

Hoag Memorial Hospital Presbyterian

Newport Beach, California, 92663

Recruiting
Jason Ledesma · Contact
Simon Khagi, MD · Principal Investigator

Stanford University

Palo Alto, California, 94304

Recruiting
Sahara Rout · Contact
Seema Nagpal, MD · Principal Investigator

University of California

San Francisco, California, 94143

Recruiting
Neuro Onc New Patient Coordinator · Contact
John De Groot, MD · Principal Investigator

University of Colorado Health Cancer Care

Aurora, Colorado, 80045

Recruiting
Denise Damek, MD · Principal Investigator

Yale University

New Haven, Connecticut, 06510

Recruiting
Amy Rodrigues · Contact
Nicholas Blondin, MD · Principal Investigator

University of Florida Health

Gainesville, Florida, 32608

Recruiting
Ashley Ghiaseddin, MD · Principal Investigator

Mayo Clinic - Florida

Jacksonville, Florida, 32224

Recruiting
Mayo Clinic Mailbox · Contact
Wendy Sherman, MD · Principal Investigator

University of Miami Health

Miami, Florida, 33136

Recruiting
Irene Marino · Contact
Macarena de la Fuente, MD · Principal Investigator

Orlando Health Cancer Institute

Orlando, Florida, 32806

Recruiting
Alfredo Voloschin, MD · Principal Investigator

University of Chicago

Chicago, Illinois, 60637

Not Yet Recruiting
Lauren Singer, MD · Principal Investigator

University of Kansas Medical Center

Kansas City, Kansas, 66160

Recruiting
Clinical Trial Nurse Navigator · Contact
Tolga Tuncer, MD · Principal Investigator

Massachusetts General Hospital

Boston, Massachusetts, 02214

Recruiting
Julie Miller, M.D. · Principal Investigator

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Recruiting
David Reardon, MD · Principal Investigator

Henry Ford Hospital

Detroit, Michigan, 48202

Recruiting
Phillip Alther · Contact
Tobias Walbert, MD · Principal Investigator

Mayo Clinic - Rochester

Rochester, Minnesota, 55905

Recruiting
Sonia Velazquez · Contact
Eva Galanis, MD · Principal Investigator

Washington University

St Louis, Missouri, 63110

Recruiting
Leslie Nehring · Contact
Omar Butt, MD · Principal Investigator

Billings Clinic

Billings, Montana, 59101

Not Yet Recruiting
Department of Neurology and Oncology Cancer Research · Contact
Matthew Smith-Cohn, MD · Principal Investigator

Rutgers Cancer Institute

New Brunswick, New Jersey, 08901

Recruiting
Simbiat Ajao · Contact
Morana Vojnic, MD · Principal Investigator

NYU Langone Health

New York, New York, 10016

Recruiting
Jose McFaline-Figueroa, MD · Principal Investigator

Icahn School of Medicine at Mount Sinai

New York, New York, 10029

Not Yet Recruiting
Kim Lydon, MD · Principal Investigator

Columbia University Medical Center

New York, New York, 10032

Recruiting
Research Nurse Navigator · Contact
Fabio Iwamoto, MD · Principal Investigator

Memorial Sloan Kettering Cancer Center

New York, New York, 10065

Recruiting
Nancy Keith · Contact
Madeleine Ruff · Contact
Thomas Kaley, M.D. · Principal Investigator

Duke Cancer Institute

Durham, North Carolina, 27710

Recruiting
Erin Severance · Contact
Katy Peters, M.D. · Principal Investigator

Cleveland Clinic

Cleveland, Ohio, 44106

Recruiting
Marci Ciolfi · Contact
Mina Lobbous, M.D. · Principal Investigator

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107

Recruiting
Community Research Operations & Enrollment (CROE) · Contact
Iyad Alnahhas, MD · Principal Investigator

UPMC Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232

Not Yet Recruiting
Linda Elias · Contact
Michal Nisnboym Ziv, MD · Principal Investigator

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, 37203

Not Yet Recruiting
Vanderbilt-Ingram Cancer Center · Contact
Ryan Merrell, MD · Principal Investigator

University of Texas Southwestern Medical Center

Dallas, Texas, 75390

Recruiting
Michael Youssef, MD · Principal Investigator

MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Vinay Puduvalli, MD · Principal Investigator

Mays Cancer Center

San Antonio, Texas, 78229

Not Yet Recruiting
Leti Velten · Contact
Andrew Brenner, MD · Principal Investigator

Huntsman Cancer Insititute, University of Utah

Salt Lake City, Utah, 84112

Recruiting
Neuro Oncology Coordination · Contact
Howard Colman, MD · Principal Investigator

UVA Health, Emily Couric Clinical Cancer Cente

Charlottesville, Virginia, 22903

Recruiting
CJ Woodburn, 434-243-9900 · Contact
David Schiff, M.D. · Principal Investigator

Inova Schar Cancer Institute

Fairfax, Virginia, 22031

Not Yet Recruiting
Stephanie Van Bebber · Contact
Adam Cohen, MD · Principal Investigator

Fred Hutch Cancer Center

Seattle, Washington, 98195

Recruiting
Madhuri Poduri · Contact
Vyshak Venur, MD · Principal Investigator

University of Wisconsin Health

Madison, Wisconsin, 53792

Recruiting
UW Cancer Connect · Contact
Ankush Bhatia, MD · Principal Investigator