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RecruitingInterventionalPhase 1

A Phase 1b, Multicenter, Open-Label Study of Valemetostat Tosylate in Combination With DXd ADCs in Subjects With Solid Tumors

NCT ID: NCT06244485Sponsor: Daiichi SankyoLast updated: 2026-02-04

Summary

This study will evaluate the safety, tolerability, and efficacy of valemetostat tosylate in combination with DXd ADC in patients with advanced solid tumors.

Detailed description

This is a 2-part study of valemetostat in combination with DXd ADCs in patients with HER2-positive gastric cancer, non-squamous NSCLC, or unresectable or metastatic HER2 low breast cancer. The study will begin with a Part 1 Dose-escalation Phase and will continue until the recommended dose for expansion "RDE" of valemetostat is determined and will then be followed by a Part 2 Dose-expansion Phase to further evaluate the safety and tolerability of the combination.

Arms & interventions

  • DrugValemetostat tosylate

    Administered orally once daily

  • DrugT-DXd

    One IV infusion Q3W on Day 1 of each 21-day cycle

  • DrugDato-DXd

    One IV infusion Q3W on Day 1 of each 21-day cycle.

Outcome measures

Primary

  • Number of Participants Reporting Dose-limiting Toxicities (Part 1 Dose Escalation)

    Time frame: Cycle 1 Day 1 up to Day 21 (each cycle is 21 days)

  • Number of Participants Reporting Treatment-emergent Adverse Events (Part 1 Dose Escalation)

    Time frame: Screening up to 40 days after last dose

  • Objective Response Rate Based on Investigator Assessment (Part 2 Dose Expansion)

    Objective response rate (ORR) is defined as the proportion of participants with a best overall response of confirmed complete response (CR) or confirmed partial response (PR) according to RECIST v 1.1 criteria. CR is defined as a disappearance of all target lesions and PR is defined as at least a 30% decrease in the sum of diameters of target lesions.

    Time frame: Baseline (Screening), at every 6 weeks from Cycle 1 Day 1 in the first year, and every 12 weeks thereafter until disease progression or until the start of a new anticancer treatment, up to approximately 5 years

Secondary

  • Overall Survival

    Time frame: Date of enrollment up to date of death due to any cause, up to approximately 5 years

  • Progression-free Survival

    Time frame: Date of enrollment up to date of radiographic disease progression or death due to any cause (whichever occurs first), up to approximately 5 years

  • Duration of Response (DoR)

    Time frame: Date of first documentation of objective tumor response (CR or PR) that is subsequently confirmed to the first documentation of objective tumor progression or to death due to any cause (whichever occurs first), up to approximately 5 years

  • Objective Response Rate Based on Investigator Assessment (Part 1 Dose Escalation)

    Time frame: Baseline (Screening), at every 6 weeks from Cycle 1 Day 1 in the first year, and every 12 weeks thereafter until disease progression or until the start of a new anticancer treatment, up to approximately 5 years

  • Number of Participants Reporting Treatment-emergent Adverse Events (Part 2 Dose Expansion)

    Time frame: Screening up to 40 days after last dose

  • Total and Unbound Plasma Concentration of Valemetostat

    Time frame: Cycle 1, Day 1: Predose, 1 hour (hr), 2 hr, 4 hr, and 5 hr postdose; Cycle 1, Day 8 and Day 15: Predose; Cycles 2, 3, 4, Day 1: Predose (each cycle is 21 days)

  • Plasma Concentration of DXd Antibody-Drug Conjugates

    Time frame: Cycle 1, Day 1: Predose, 1 hour (hr), 2 hr, 4 hr, and 5 hr postdose; Cycle 1, Day 8 and Day 15: Predose; Cycles 2, 3, 4, Day 1: Predose (each cycle is 21 days)

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Key Inclusion Criteria All participants must meet all of the following criteria, as well as all criteria from the relevant sub-protocol to be eligible for enrollment: * At least 18 years or the minimum legal adult age (whichever is greater) at the time the ICF is signed. * Has at least 1 measurable lesion based on investigator imaging assessment (computed tomography or magnetic resonance imaging) using RECIST v 1.1 at Screening. * Is willing to provide an adequate tumor sample. * Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 at Screening. Additional Key Inclusion for Sub-Protocol A: * Diagnosed with pathologically documented breast cancer that: 1. Is unresectable or metastatic. 2. Has progressed on and would no longer benefit from endocrine therapy in hormone receptor-positive subjects in the opinion of the investigator. 3. Has been treated with at least 1 and at most 2 prior lines of chemotherapy in the recurrent or metastatic setting. 4. Has a history of low HER2 expression, defined as IHC 2+ /ISH-negative or IHC 1+ (ISH-negative or untested). ), as classified by the American Society of Clinical Oncology/College of American Pathologists 2018 HER2 testing guidelines. 5. Was never previously HER2-positive (IHC 3+ or IHC 2+/ISH+) on prior pathology testing (per American Society of Clinical Oncology/College of American Pathologists guidelines Additional Key Inclusion for Sub-Protocol B: • Gastric or GEJ adenocarcinoma that is (a) unresectable or metastatic or (b) has progressed on trastuzumab or approved trastuzumab biosimilar-containing regimen. Additional Key Inclusion for Sub-Protocol C: * Pathologically documented Stage IIIB, IIIC, or IV non-squamous NSCLC with or without AGA at the time of enrollment. * Must meet prior therapy requirements: * Participants without AGA: (a) received platinum-based chemotherapy in combination with α-PD-1/α -PD-L1 mAb as a prior line of therapy or (b) received platinum-based chemotherapy and α -PD-1/ α -PD-L1 mAb (in either order) sequentially as 2 prior lines of therapy. * Participants with AGA: (a) has been treated with at least 1 or 2 prior lines of applicable targeted therapy that is locally approved for participant's genomic alteration at the time of Screening, (b) participants who have received platinum-based chemotherapy as a prior line of cytotoxic therapy, (c) may have received α -PD-1/α -PD-L1 mAb alone or in combination with a cytotoxic agent Key Exclusion Criteria * Has previously been treated with any enhancer of zeste homolog inhibitors. * Uncontrolled or significant cardiovascular disease. * Has spinal cord compression or clinically active central nervous system metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. * Has leptomeningeal carcinomatosis or metastasis. * Clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses. * Current use of moderate or strong cytochrome P450 (CYP)3A inducers. * Systemic treatment with corticosteroids (\>10 mg daily prednisone equivalents). * History of severe hypersensitivity reactions to other monoclonal antibodies (mAbs). * Evidence of ongoing uncontrolled systemic bacterial, fungal, or viral infection requiring treatment with intravenous (IV) antibiotics, antivirals, or antifungals. * Female who is pregnant or breastfeeding or intends to become pregnant during the study. * Psychological, social, familial, or geographical factors that would prevent regular follow-up. Additional Key Exclusion for Sub-Protocol A: * Has previously received any anti-HER2 therapy in the metastatic setting. * Has received prior treatment with an antibody-drug conjugate that consists of an exatecan derivative that is a topoisomerase I inhibitor, including either as part of prior treatment history or within prior participation in a clinical study. Additional Key Exclusion for Sub-Protocol B: \* Participants who have received an antibody-drug conjugate consisting of an exatecan derivative that is a topoisomerase I inhibitor. Additional Key Exclusion for Sub-Protocol C: \* Has received any agent, including an ADC, containing a chemotherapeutic agent targeting topoisomerase I or TROP2-targeted therapy including Dato-DXD

Study locations (20)

City of Hope At Orange County Lennar Foundation Cancer Center

Irvine, California, 92618

Recruiting

Valkyrie Clinical Trials

Los Angeles, California, 90067

Withdrawn

Sharp Memorial Hospital

San Diego, California, 92123

Recruiting

Brcr Medical Center, Inc Dba Boca Raton Clinical Research

Plantation, Florida, 33322

Recruiting

H. Lee Moffitt Cancer Center and Research Institute, Inc

Tampa, Florida, 33612

Withdrawn

University of Hawaii At Manoa

Honolulu, Hawaii, 96813

Recruiting

University of Chicago Medical Center

Chicago, Illinois, 60637

Recruiting

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Recruiting

Memorial Sloan-Kettering Cancer Center (Mskcc) - New York

New York, New York, 10065

Recruiting

Clinical Research Alliance

Westbury, New York, 11590

Recruiting

Unc Hospitals

Chapel Hill, North Carolina, 27514

Recruiting

The Cleveland Clinic Foundation

Cleveland, Ohio, 44195

Active Not Recruiting

Providence Portland Medical Center

Portland, Oregon, 97213

Recruiting

Mary Crowley Cancer Research Centers

Dallas, Texas, 75230

Recruiting

Ut Southwestern Medical Center

Dallas, Texas, 75390

Recruiting

University of Texas M. D. Anderson Cancer Center

Houston, Texas, 77030

Recruiting

Inova Schar Cancer Institute

Fairfax, Virginia, 22031

Withdrawn

Next Virginia

Fairfax, Virginia, 22031

Recruiting

Fred Hutchinson Cancer Center

Seattle, Washington, 98109

Recruiting

Medical College of Wisconsin

Milwaukee, Wisconsin, 53226

Recruiting