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Nanatinostat Plus Valganciclovir in Patients With Advanced EBV+ Solid Tumors, and in Combination With Pembrolizumab in EBV+ RM-NPC

Primary Purpose

Nasopharyngeal Carcinoma, EBV-Related Gastric Carcinoma, EBV-Related Leiomyosarcoma

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Nanatinostat
Pembrolizumab
Valganciclovir
Sponsored by
Viracta Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasopharyngeal Carcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Recurrent or metastatic EBV+ nasopharyngeal carcinoma (RM-NPC) for whom no potentially curative options are available, who have received at least 1 prior line of platinum-based chemotherapy and no more than 3 prior lines of therapy for RM-NPC.
  • Phase 1b exploratory proof-of-concept cohort only: Advanced/metastatic EBV+ non-NPC solid tumors with no available curative therapies.
  • Measurable disease per RECIST v1.1
  • ECOG performance status 0 or 1
  • Adequate bone marrow and liver function

Key Exclusion Criteria:

  • Anti-tumor treatment with cytotoxic drugs, biologic therapy, immunotherapy, or other investigational drugs within 4 weeks or >5 half-lives, whichever is shorter
  • Active CNS disease
  • Inability to take oral medication, malabsorption syndrome or any other gastrointestinal condition (nausea, diarrhea, vomiting) that may impact the absorption of nanatinostat and valganciclovir
  • Active infection requiring systemic therapy
  • Active autoimmune disease that has required systemic therapy with modifying agents, corticosteroids, or immunosuppressive agents
  • Positive hepatitis B or hepatitis C

Sites / Locations

  • The Oncology Institute of Hope and InnovationRecruiting
  • Stanford Cancer CenterRecruiting
  • University of Colorado HospitalRecruiting
  • University of Texas MD Anderson Cancer CenterRecruiting
  • Blacktown HospitalRecruiting
  • Macquarie UniversityRecruiting
  • Princess Margaret Cancer CentreRecruiting
  • Queen Mary HospitalRecruiting
  • Hong Kong United Oncology Centre
  • Prince Of Wales Hospital, The Chinese University Of Hong KongRecruiting
  • Samsung Medical CenterRecruiting
  • The Catholic University of Korea, Seoul St. Mary's HospitalRecruiting
  • Sarawak General HospitalRecruiting
  • University of Malaya Medical CentreRecruiting
  • National Cancer Institute (Institut Kanser Negara)
  • National Cancer Centre SingaporeRecruiting
  • Tan Tock Seng HospitalRecruiting
  • National Taiwan University HospitalRecruiting
  • Taipei Veterans General HospitalRecruiting
  • Mackay Memorial HospitalRecruiting
  • Linkou Chang Gung Memorial HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Nanatinostat in combination with valganciclovir

Nanatinostat in combination with valganciclovir and pembrolizumab

Arm Description

Outcomes

Primary Outcome Measures

Phase 1b: Incidence of dose-limiting toxicities (DLTs)
Phase 2: Overall response rate (ORR)

Secondary Outcome Measures

Incidence and severity of adverse events
Duration of response (DOR)
Disease control rate (DCR)
Progression-free survival (PFS)
Overall survival (OS)
Pharmacokinetic parameter - time to maximum plasma concentration [tmax]
Pharmacokinetic parameter - maximum plasma concentration [Cmax]
Pharmacokinetic parameter - area under the plasma concentration-time curve [AUC]

Full Information

First Posted
December 3, 2021
Last Updated
December 15, 2022
Sponsor
Viracta Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05166577
Brief Title
Nanatinostat Plus Valganciclovir in Patients With Advanced EBV+ Solid Tumors, and in Combination With Pembrolizumab in EBV+ RM-NPC
Official Title
An Open-Label, Multicenter Phase 1b/2 Study of Nanatinostat and Valganciclovir in Patients With Advanced Epstein-Barr Virus-Positive (EBV+) Solid Tumors and in Combination With Pembrolizumab in Patients With Recurrent/Metastatic Nasopharyngeal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 7, 2021 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
March 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Viracta Therapeutics, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the safety efficacy of nanatinostat in combination with valganciclovir in patients with relapsed/refractory EBV-positive solid tumors and in combination with pembrolizumab in patients with recurrent/metastatic nasopharyngeal carcinoma
Detailed Description
This is an open-label, multicenter Phase 1b/2 study evaluating nanatinostat in combination with valganciclovir alone and in combination with pembrolizumab. Nanatinostat is a selective class I HDAC inhibitor which induces EBV early lytic phase protein generation, activating (val)ganciclovir to its cytotoxic form. The Phase 1b dose escalation portion is designed to evaluate safety and to determine the recommended Phase 2 dose (RP2D) in patients with EBV+ RM-NPC. In Phase 2, up to sixty patients with EBV+ RM-NPC will be randomized to receive nanatinostat in combination with valganciclovir at the RP2D with or without pembrolizumab, to evaluate safety, overall response rate, and potential pharmacodynamic markers. Additionally, patients with other EBV+ solid tumors will be enrolled to receive nanatinostat in combination with valganciclovir at the RP2D in a Phase 1b dose expansion cohort.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasopharyngeal Carcinoma, EBV-Related Gastric Carcinoma, EBV-Related Leiomyosarcoma, EBV Related Carcinoma, EBV-Related Sarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
A traditional 3+3 dose escalation design followed by a Phase 2 expansion randomized 1:1 to receive nantinostat and valganciclovir with or without pembrolizumab
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Nanatinostat in combination with valganciclovir
Arm Type
Experimental
Arm Title
Nanatinostat in combination with valganciclovir and pembrolizumab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Nanatinostat
Other Intervention Name(s)
VRx-3996
Intervention Description
Nanatinostat dose escalation starting at 20 mg orally daily, 4 days per week
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
Keytruda
Intervention Description
Pembrolizumab (anti-PD-1) dosed at 200 mg intravenous (IV) every 3 weeks
Intervention Type
Drug
Intervention Name(s)
Valganciclovir
Other Intervention Name(s)
Valcyte
Intervention Description
Valganciclovir starting at 900 mg orally daily
Primary Outcome Measure Information:
Title
Phase 1b: Incidence of dose-limiting toxicities (DLTs)
Time Frame
DLT period of 28 Days
Title
Phase 2: Overall response rate (ORR)
Time Frame
Approximately 3 years
Secondary Outcome Measure Information:
Title
Incidence and severity of adverse events
Time Frame
Approximately 28 days following the last dose
Title
Duration of response (DOR)
Time Frame
Approximately 3 years
Title
Disease control rate (DCR)
Time Frame
Approximately 3 years
Title
Progression-free survival (PFS)
Time Frame
Approximately 3 years
Title
Overall survival (OS)
Time Frame
Approximately 3 years
Title
Pharmacokinetic parameter - time to maximum plasma concentration [tmax]
Time Frame
Approximately at 28 days following enrollment
Title
Pharmacokinetic parameter - maximum plasma concentration [Cmax]
Time Frame
Approximately 28 days following enrollment
Title
Pharmacokinetic parameter - area under the plasma concentration-time curve [AUC]
Time Frame
Approximately 28 days following enrollment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Recurrent or metastatic EBV+ nasopharyngeal carcinoma (RM-NPC) for whom no potentially curative options are available, who have received at least 1 prior line of platinum-based chemotherapy and no more than 3 prior lines of therapy for RM-NPC. Phase 1b exploratory proof-of-concept cohort only: Advanced/metastatic EBV+ non-NPC solid tumors with no available curative therapies. Measurable disease per RECIST v1.1 ECOG performance status 0 or 1 Adequate bone marrow and liver function Key Exclusion Criteria: Anti-tumor treatment with cytotoxic drugs, biologic therapy, immunotherapy, or other investigational drugs within 4 weeks or >5 half-lives, whichever is shorter Active CNS disease Inability to take oral medication, malabsorption syndrome or any other gastrointestinal condition (nausea, diarrhea, vomiting) that may impact the absorption of nanatinostat and valganciclovir Active infection requiring systemic therapy Active autoimmune disease that has required systemic therapy with modifying agents, corticosteroids, or immunosuppressive agents Positive hepatitis B or hepatitis C
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Afton Katkov, MSc
Phone
858-400-8470
Email
ClinicalTrials@Viracta.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lisa Rojkjaer, MD
Organizational Affiliation
Viracta Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
The Oncology Institute of Hope and Innovation
City
Lynwood
State/Province
California
ZIP/Postal Code
90262
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Stanford Cancer Center
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
University of Colorado Hospital
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Blacktown Hospital
City
Blacktown
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Macquarie University
City
Sydney
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Princess Margaret Cancer Centre
City
Toronto
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
Hong Kong
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Hong Kong United Oncology Centre
City
Kowloon
Country
Hong Kong
Individual Site Status
Not yet recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Prince Of Wales Hospital, The Chinese University Of Hong Kong
City
Sha Tin
Country
Hong Kong
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
The Catholic University of Korea, Seoul St. Mary's Hospital
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Sarawak General Hospital
City
Kuching
State/Province
Sarawak
Country
Malaysia
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
University of Malaya Medical Centre
City
Kuala Lumpur
Country
Malaysia
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
National Cancer Institute (Institut Kanser Negara)
City
Putrajaya
Country
Malaysia
Individual Site Status
Not yet recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
National Cancer Centre Singapore
City
Singapore
Country
Singapore
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Tan Tock Seng Hospital
City
Singapore
Country
Singapore
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
National Taiwan University Hospital
City
Taipei City
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Taipei Veterans General Hospital
City
Taipei City
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Mackay Memorial Hospital
City
Taipei
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com
Facility Name
Linkou Chang Gung Memorial Hospital
City
Taoyuan City
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
Email
ClinicalTrials@Viracta.com

12. IPD Sharing Statement

Learn more about this trial

Nanatinostat Plus Valganciclovir in Patients With Advanced EBV+ Solid Tumors, and in Combination With Pembrolizumab in EBV+ RM-NPC

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