Tazemetostat in Combination With Doxorubicin as Frontline Therapy for Advanced Epithelioid Sarcoma
Advanced Soft-tissue Sarcoma, Advanced Epithelioid Sarcoma
About this trial
This is an interventional treatment trial for Advanced Soft-tissue Sarcoma
Eligibility Criteria
Inclusion Criteria
Subjects must meet ALL the following inclusion criteria to be eligible to enroll in this study:
- Have voluntarily agreed to provide written informed consent and demonstrated willingness and ability to comply with all aspects of the protocol. Study related activities will not start until written consent is obtained.
- Life expectancy ≥ 3 months before enrollment
- Phase 1b: 18-65 years old histologically confirmed Soft Tissue Sarcoma
- Phase 3: ≥18 years old with unresectable locally advanced or metastatic Epithelioid Sarcoma and tumor tissue available
- Have measurable disease
- ECOG performance status of 0, 1, or 2
- Have adequate hematologic (bone marrow [BM] and coagulation factors), renal and hepatic function as required per protocol
- Females must not be lactating or pregnant at Screening or Baseline
- Females must not be pregnant or breast feeding and agree to use highly effective contraception during the clinical trial and for 6 months following the final dose of study
- Male subjects of child-bearing potential must have had either a successful vasectomy or practice highly effective contraception
- Subjects diagnosed with human immunodeficiency virus (HIV) are eligible to participate in the study if their infection is well controlled on anti-retroviral therapy.
Exclusion Criteria
Subjects meeting ANY of the following exclusion criteria are NOT eligible to enroll in this study:
- Prior exposure to tazemetostat or other inhibitor(s) of enhancer of zeste homologue-2 (EZH2).
- Prior systemic anticancer therapy.
- Contraindications noted in the doxorubicin label
- Have any prior history of myeloid malignancies, including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
- Have prior history of T-cell lymphoblastic lymphoma/T-cell acute lymphoblastic leukemia (T- LBL/T-ALL).
- Have participated in another interventional clinical study and received investigational drug within 30 days or 5 half-lives, whichever is longer, prior to the planned first dose of study treatment.
- Have known active central nervous system (CNS) or any leptomeningeal metastasis of primary extracranial tumor.
- Subjects taking medications that are known potent cytochrome P450 (CYP)3A4 inducers/inhibitors (including St. John's Wort)
- Are unwilling to exclude Seville oranges, grapefruit juice, AND grapefruit from the diet and all foods that contain those fruits from time of enrollment to through the duration of study participation.
- Major surgery within 4 weeks before the first dose of study treatment. Subjects must have recovered from surgery prior to enrollment to this study.
- Are unable to take oral medication OR have malabsorption syndrome or any other uncontrolled gastrointestinal condition (eg, nausea, diarrhea, vomiting) that might impair the bioavailability of study treatment.
- Have an active infection requiring systemic therapy.
- Are immunocompromised (ie, has a congenital immunodeficiency).
- Have known hypersensitivity to any component of tazemetostat or doxorubicin.
- Cardiovascular impairment as stated in the protocol
- Have a known active infection with hepatitis B virus (HBV, as measured by positive hepatitis B surface antigen), hepatitis C virus (HCV, as measured by positive hepatitis C antibody).
- Any other major illness that, in the Investigator's judgment, will substantially increase the risk associated with the subject's participation in this study OR interfere with their ability to receive study treatment or complete the study.
- Female subjects who are pregnant or breastfeeding.
- Subjects who have undergone a solid organ transplant.
- Subjects with malignancies other than STS (phase 1b) or ES (Phase 3 only).
- Subjects housed in an institution by order of the authorities or courts.
Sites / Locations
- City of Hope Comprehensive Cancer Center
- Sarcoma Oncology Research CenterRecruiting
- University of Colorado Hospital - Anschutz Cancer Pavilion
- Sarah Cannon Research Institute at HealthONE
- Mayo Clinic-Jacksonville
- Massachusetts General Hospital
- Dana Farber Cancer Insititute
- Dana Farber Cancer Institute
- University of Michigan Medical Center
- Washington University
- Columbia University Irving Medical Center
- Duke University Medical Center
- The Ohio State University Comprehensive Cancer CenterRecruiting
- Oregon Health and Science University
- Thomas Jefferson University Hospital
- University of Pittsburgh Medical Center - Hillman Cancer Center
- Sarah Cannon and HCA Research Institute
- Fred Hutchinson Research Center
- McGill University Faculty of Medicine - Royal Victoria Hospital
- National Taiwan University Hospital
- Royal Marsden Foundation Trust
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Phase 1b: Open-label Tazemetostat and Phase 3: Tazemetostat + Doxorubicin Arm
Phase 3: Placebo + Doxorubicin Arm
Phase 1b: On cycle 1 day -1, participants will receive a single morning dose of tazemetostat at the assigned dose level. Participants will receive doxorubicin 75 mg/m2 intravenously (IV) on day 1 of each cycle for up to 6 cycles. Tazemetostat will be escalated from a starting dose of 400 mg twice daily PO to 600 mg twice daily PO to 800 mg twice daily. Phase 3: Tazemetostat (800 mg) administered orally twice daily in continuous 21-day cycles during cycles 1-6 and in continuous 28-day cycles during cycle 7 and beyond. Doxorubicin 75 mg/m2 IV on day 1 of cycles 1-6.
Placebo administered orally twice daily in continuous 21-day cycles during cycles 1-6 and in continuous 28-day cycles during cycles 7 and beyond. Doxorubicin 75 mg/m2 IV on day 1 of cycles 1-6.