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A Study of Tazemetostat in Combination With Various Treatments in Participants With Blood Cancer. (ARIA)

Primary Purpose

Relapsed Hematologic Malignancy, Refractory Hematologic Malignancy

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Tazemetostat
Tafasitamab
Lenalidomide
Acalabrutinib
Daratumumab (Intravenously)
Mosunetuzumab
Daratumumab (Subcutaneously)
Hyaluronidase-Fihj
Pomalidomide
Dexamethasone 20mg
Sponsored by
Epizyme, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed Hematologic Malignancy

Eligibility Criteria

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

Inclusion Criteria:

  1. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1 for Phase 1b and status 0 to 2 for Phase 2
  2. Must have documented relapsed, refractory, or progressive disease after 2 lines of treatment with systemic therapy
  3. Measurable disease
  4. Demonstrate adequate organ function
  5. Negative test results for acute or chronic hepatitis B virus (HBV) infection, hepatitis C virus (HCV) and human immunodeficiency virus
  6. No ongoing clinically significant reactions to prior anticancer treatments
  7. Willingness to follow pregnancy precautions and register into the mandatory REMS program in lenalidomide and pomalizdomide arms

Exclusion Criteria:

  1. Presence or history of central nervous system involvement by lymphoma
  2. Less than minimum washout period of prior anticancer therapy as specified by the protocol
  3. Prior allogeneic haematopoietic stem cell transplantation
  4. History of solid organ transplant
  5. Major surgery within 4 weeks of the start of study drug.
  6. Significant cardiac or cardiovascular impairment as specified by protocol
  7. Venous thrombosis or pulmonary embolism within the last 3 months before starting tazemetostat
  8. History of any bleeding disorder, peptic ulcer disease, or significant bleeding within the last 1 month prior to enrollment
  9. Are unable to take oral medication OR have malabsorption syndrome or any other uncontrolled gastrointestinal condition
  10. Patients with known active infection, or reactivation of a latent infection, as specified by the protocol
  11. Known sensitivity or allergy to the study medications
  12. Unwilling to refrain from eating or drinking grapefruit juice, Seville oranges, and grapefruits while on study
  13. Prior exposure to tazemetostat
  14. Any condition that places the subject at unacceptable risk if he/she were to participate in the study or that confounds the ability to interpret data from the study.
  15. Prior history of myeloid malignancies or T-cell lymphoblastic lymphoma (T-LBL)/T-cell acute lymphoblastic leukemia (T-ALL)
  16. For patients with DLBCL in Arm 1 (tazemetostat plus tafasitamab plus lenalidomide) or Arm 2 (tazemetostat plus lenalidomide):

    - Prior exposure to lenalidomide

  17. For patients with MCL in Arm 3 (tazemetostat plus acalabrutinib):

    • Prior exposure to a BTKi
    • Medical condition that would make treatment with a BTKi not reasonable (e.g. allergy to BTKi or mutations known not to respond to BTKi treatment or subjects unable to be transitioned off of proton pump inhibitors)
  18. For patients with MM in Arm 4:

    • Prior exposure to pomalidomide
    • Untreated or impending spinal cord compression in subjects
  19. For patients with FL in Arm 5:

    • Grade 3b, mixed histology, or FL that has histologically transformed to DLBCL.
    • History of significant neurological disorders, hemophagocytic lymphohistiocytosis (HLH), chronic active Epstein-Barr virus (EBV) infection, progressive multifocal leukoencephalopathy (PML), lung disease (ILD), drug-induced pneumonitis, autoimmune pneumonitis, and/or history of severe autoimmune disease

Sites / Locations

  • California Cancer Associates For Research And Excellence, cCARE
  • Central Care Cancer Center
  • Astera Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Arm 1-Tazemetostat plus tafasitamab-cxix (CD19 Ab)/lenalidomide

Arm 2-Tazemetostat plus lenalidomide

Arm 3- Tazemetostat plus BTKi (acalabrutinib)

Arm 4-Tazemetostat plus CD38 mAbPD (daratumumab/pomalidomide/dexamethasone)

Arm 5- Tazemetostat plus CD20/CD3 BsAb (mosunetuzumab)

Arm Description

Participants with R/R, diffuse large B-cell lymphoma (DLBCL) will receive tazemetostat, tafasitamab, and lenalidomide for approximately 1 year. After approximately 1 year, participants will receive tazemetostat and tafasitamab.

Participants with R/R DLBCL will receive tazemetostat and lenalidomide for approximately 1 year. After approximately 1 year, participants will receive tazemetostat alone.

Participants with R/R mantle cell lymphomawill (MCL) will receive tazemetostat and acalabrutinib for the entire study.

Participants with R/R multiple myelomawill (MM) will receive tazemetostat, daratumumab, pomalidomide, and dexamethasone for the entire study. Daratumumab may be given intravenously or subcutaneously during this study.

Participants with R/R follicular lymphoma will receive tazemetostat and mosunetuzumab for approximately 1 year. After approximately 1 year, participants will receive tazemetostat alone.

Outcomes

Primary Outcome Measures

Phase 1b: Recommended Phase 2 Dose (RP2D) of tazemetostat in combination with each partner drug
The safety and tolerability of tazemetostat in combination with each partner drug in participants with R/R malignancies will be evaluated. RP2D of tazemetostat for further evaluation in phase 2 will be selected as assessed by the occurrence of treatment-emergent dose-limiting toxicities (DLTs) and adverse events (AEs).
Phase 2: Objective Response Rate (ORR)
Overall response rate is defined as proportion of participants with a best response of at least partial remission (including partial remission and complete remission for participants with non-Hodgkin lymphoma in Arms 1, 2, 3, or 5 or partial remission, complete remission, stringent complete response, or very good partial response).

Secondary Outcome Measures

Phase 2: Progression Free Survival (PFS)
Progression free survival is defined as the time from randomization into the study to the first observation of documented disease progression or death due to any cause.
Time to response (TTR)
Defined as the time from the first dose of study drug to the earliest date of CR or PR per Lugano Classification (Arms 1, 2, 3, and 5) or sCR, CR, VGPR, or PR per IMWG 2016 criteria (Arm 4) as assessed by Investigator review.
Phase 2: Duration of Response (DOR)
Duration of response is defined as the time from the initial response (at least partial remission) to documented disease progression.
Phase 2: Disease control rate (DCR)
Defined as the percentage of participants who achieve complete response (CR), partial response (PR), or stable disease per Lugano Classification (Arms 1, 2, 3, or 5) or stringent complete response (sCR), CR, very good partial response (VGPR), PR, or stable disease per IMWG 2016 criteria (Arm 4) at 6 months on study treatment, as assessed by Investigator review.
Phase 2: Overall Survival (OS)
Overall survival is defined as the time from the first dose of study drug to date of death due to any cause.
Time to next treatment (TTNT)
Defined as the time from the first dose of study drug to the start of subsequent anticancer therapy
Percentage of participants with Treatment Emergent Adverse Event (TEAEs)
An Adverse Event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Percentage of participants with clinically significant changes in laboratory parameters
Percentage of participants with clinically significant changes in laboratory parameters including, hematology, serum chemistry, coagulation and urinalysis will be reported. The clinical significance will be evaluated by the investigator.

Full Information

First Posted
December 29, 2021
Last Updated
August 11, 2023
Sponsor
Epizyme, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05205252
Brief Title
A Study of Tazemetostat in Combination With Various Treatments in Participants With Blood Cancer.
Acronym
ARIA
Official Title
ARIA: A Phase 1b/2, Open-label, Multi Cohort Trial of Tazemetostat in Combination With Various Treatments in Subjects With Relapsed or Refractory Hematologic Malignancies
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Epizyme Inc. has revised the Tazemetostat development strategy and made the decision to terminate the hematological malignancies basket trial.
Study Start Date
December 22, 2021 (Actual)
Primary Completion Date
July 5, 2023 (Actual)
Study Completion Date
July 5, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Epizyme, 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 trial will study how safely the tazemetostat works with other therapies in various hematological malignancies. Hematologic malignancies are cancers that most often begin in the bone marrow or lymph nodes where blood precursors are produced. They are often called blood cancers and fall into three categories: leukemia, lymphoma and myeloma. Tazemetostat has been found to be a safe and effective drug that works in patients with follicular lymphoma where the disease has come back after treatment (known as relapsed) and when other treatment no longer works (known as refractory). Combining tazemetostat with other treatments may work better in treating patients with hematological malignancies and may improve disease response and durability of response.
Detailed Description
This phase 1b/2 trial studies how safely the EZH2 inhibitor tazemetostat works with other therapies in various hematological malignancies. Tazemetostat has been found to be a safe and effective drug that works in patients with relapsed refractory (R/R) follicular lymphoma. Giving tazemetostat in combination with other treatments may work better in treating patients with hematological malignancies and may improve disease response and durability of response.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed Hematologic Malignancy, Refractory Hematologic Malignancy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1-Tazemetostat plus tafasitamab-cxix (CD19 Ab)/lenalidomide
Arm Type
Active Comparator
Arm Description
Participants with R/R, diffuse large B-cell lymphoma (DLBCL) will receive tazemetostat, tafasitamab, and lenalidomide for approximately 1 year. After approximately 1 year, participants will receive tazemetostat and tafasitamab.
Arm Title
Arm 2-Tazemetostat plus lenalidomide
Arm Type
Active Comparator
Arm Description
Participants with R/R DLBCL will receive tazemetostat and lenalidomide for approximately 1 year. After approximately 1 year, participants will receive tazemetostat alone.
Arm Title
Arm 3- Tazemetostat plus BTKi (acalabrutinib)
Arm Type
Active Comparator
Arm Description
Participants with R/R mantle cell lymphomawill (MCL) will receive tazemetostat and acalabrutinib for the entire study.
Arm Title
Arm 4-Tazemetostat plus CD38 mAbPD (daratumumab/pomalidomide/dexamethasone)
Arm Type
Active Comparator
Arm Description
Participants with R/R multiple myelomawill (MM) will receive tazemetostat, daratumumab, pomalidomide, and dexamethasone for the entire study. Daratumumab may be given intravenously or subcutaneously during this study.
Arm Title
Arm 5- Tazemetostat plus CD20/CD3 BsAb (mosunetuzumab)
Arm Type
Active Comparator
Arm Description
Participants with R/R follicular lymphoma will receive tazemetostat and mosunetuzumab for approximately 1 year. After approximately 1 year, participants will receive tazemetostat alone.
Intervention Type
Drug
Intervention Name(s)
Tazemetostat
Other Intervention Name(s)
IPN60200
Intervention Description
Orally, twice daily in continuous 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Tafasitamab
Intervention Description
Intravenously, 12 mg/kg, once daily on Cycle 1: Days 1, 4, 8, 15 and 22 of the 28-day cycle. Cycles 2 and 3: Days 1, 8, 15 and 22 of each 28-day cycle. Cycle 4 and beyond: Days 1 and 15 of each 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Intervention Description
Orally, 10 mg or 20 mg based on kidney function, once daily from Days 1 to 21 of continuous 28-day cycles for up to 12 cycles.
Intervention Type
Drug
Intervention Name(s)
Acalabrutinib
Other Intervention Name(s)
Bruton tyrosine kinase inhibitor
Intervention Description
Orally, 100 mg, twice daily.
Intervention Type
Drug
Intervention Name(s)
Daratumumab (Intravenously)
Intervention Description
Intravenously, 16 mg/kg actual body weight, once daily on Cycles 1 and 2: Days 1, 8, 15 and 22 of the 28-day cycle. Cycles 3 through 6: Days 1 and 15 each 28-day cycle. Cycle 7 and beyond: Day 1 of each 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Mosunetuzumab
Intervention Description
Subcutaneously, step-up doses on Cycle 1 Days 1 (5 mg), 8 (45 mg) and 15 (45 mg) and then 45 mg from Cycle 2 through 12 on Day 1 of the 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Daratumumab (Subcutaneously)
Intervention Description
Subcutaneously, 1800 mg, once daily on Cycles 1 and 2: Days 1, 8, 15 and 22 of the 28-day cycle. Cycles 3 through 6: Days 1 and 15 each 28-day cycle. Cycle 7 and beyond: Day 1 of each 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Hyaluronidase-Fihj
Intervention Description
Subcutaneously, 30,000 units, once daily on Cycles 1 and 2: Days 1, 8, 15 and 22 of the 28-day cycle. Cycles 3 through 6: Days 1 and 15 each 28-day cycle. Cycle 7 and beyond: Day 1 of each 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Pomalidomide
Intervention Description
Orally, 4 mg, once daily on Days 1 to 21 of continuous 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Dexamethasone 20mg
Intervention Description
Orally, 20 mg or 40 mg, once daily on Days 1, 8, 15, and 22 of continuous 28-day cycles.
Primary Outcome Measure Information:
Title
Phase 1b: Recommended Phase 2 Dose (RP2D) of tazemetostat in combination with each partner drug
Description
The safety and tolerability of tazemetostat in combination with each partner drug in participants with R/R malignancies will be evaluated. RP2D of tazemetostat for further evaluation in phase 2 will be selected as assessed by the occurrence of treatment-emergent dose-limiting toxicities (DLTs) and adverse events (AEs).
Time Frame
Evaluated for DLTs during the first 28-day cycle. The RP2D for Phase 2 for each arm will be selected at the end of that arm's experience in Phase 1b
Title
Phase 2: Objective Response Rate (ORR)
Description
Overall response rate is defined as proportion of participants with a best response of at least partial remission (including partial remission and complete remission for participants with non-Hodgkin lymphoma in Arms 1, 2, 3, or 5 or partial remission, complete remission, stringent complete response, or very good partial response).
Time Frame
Time from the date of first dose of study drug to the time of response, assessed up to 24 months.
Secondary Outcome Measure Information:
Title
Phase 2: Progression Free Survival (PFS)
Description
Progression free survival is defined as the time from randomization into the study to the first observation of documented disease progression or death due to any cause.
Time Frame
Up to 24 months.
Title
Time to response (TTR)
Description
Defined as the time from the first dose of study drug to the earliest date of CR or PR per Lugano Classification (Arms 1, 2, 3, and 5) or sCR, CR, VGPR, or PR per IMWG 2016 criteria (Arm 4) as assessed by Investigator review.
Time Frame
Up to 24 months
Title
Phase 2: Duration of Response (DOR)
Description
Duration of response is defined as the time from the initial response (at least partial remission) to documented disease progression.
Time Frame
Up to 24 months
Title
Phase 2: Disease control rate (DCR)
Description
Defined as the percentage of participants who achieve complete response (CR), partial response (PR), or stable disease per Lugano Classification (Arms 1, 2, 3, or 5) or stringent complete response (sCR), CR, very good partial response (VGPR), PR, or stable disease per IMWG 2016 criteria (Arm 4) at 6 months on study treatment, as assessed by Investigator review.
Time Frame
Up to 24 months
Title
Phase 2: Overall Survival (OS)
Description
Overall survival is defined as the time from the first dose of study drug to date of death due to any cause.
Time Frame
Up to 24 months
Title
Time to next treatment (TTNT)
Description
Defined as the time from the first dose of study drug to the start of subsequent anticancer therapy
Time Frame
Up to 24 months
Title
Percentage of participants with Treatment Emergent Adverse Event (TEAEs)
Description
An Adverse Event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Time Frame
Up to 24 months
Title
Percentage of participants with clinically significant changes in laboratory parameters
Description
Percentage of participants with clinically significant changes in laboratory parameters including, hematology, serum chemistry, coagulation and urinalysis will be reported. The clinical significance will be evaluated by the investigator.
Time Frame
Up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1 for Phase 1b and status 0 to 2 for Phase 2 Must have documented relapsed, refractory, or progressive disease after 2 lines of treatment with systemic therapy Measurable disease Demonstrate adequate organ function Negative test results for acute or chronic hepatitis B virus (HBV) infection, hepatitis C virus (HCV) and human immunodeficiency virus No ongoing clinically significant reactions to prior anticancer treatments Willingness to follow pregnancy precautions and register into the mandatory REMS program in lenalidomide and pomalizdomide arms Exclusion Criteria: Presence or history of central nervous system involvement by lymphoma Less than minimum washout period of prior anticancer therapy as specified by the protocol Prior allogeneic haematopoietic stem cell transplantation History of solid organ transplant Major surgery within 4 weeks of the start of study drug. Significant cardiac or cardiovascular impairment as specified by protocol Venous thrombosis or pulmonary embolism within the last 3 months before starting tazemetostat History of any bleeding disorder, peptic ulcer disease, or significant bleeding within the last 1 month prior to enrollment Are unable to take oral medication OR have malabsorption syndrome or any other uncontrolled gastrointestinal condition Patients with known active infection, or reactivation of a latent infection, as specified by the protocol Known sensitivity or allergy to the study medications Unwilling to refrain from eating or drinking grapefruit juice, Seville oranges, and grapefruits while on study Prior exposure to tazemetostat Any condition that places the subject at unacceptable risk if he/she were to participate in the study or that confounds the ability to interpret data from the study. Prior history of myeloid malignancies or T-cell lymphoblastic lymphoma (T-LBL)/T-cell acute lymphoblastic leukemia (T-ALL) For patients with DLBCL in Arm 1 (tazemetostat plus tafasitamab plus lenalidomide) or Arm 2 (tazemetostat plus lenalidomide): - Prior exposure to lenalidomide For patients with MCL in Arm 3 (tazemetostat plus acalabrutinib): Prior exposure to a BTKi Medical condition that would make treatment with a BTKi not reasonable (e.g. allergy to BTKi or mutations known not to respond to BTKi treatment or subjects unable to be transitioned off of proton pump inhibitors) For patients with MM in Arm 4: Prior exposure to pomalidomide Untreated or impending spinal cord compression in subjects For patients with FL in Arm 5: Grade 3b, mixed histology, or FL that has histologically transformed to DLBCL. History of significant neurological disorders, hemophagocytic lymphohistiocytosis (HLH), chronic active Epstein-Barr virus (EBV) infection, progressive multifocal leukoencephalopathy (PML), lung disease (ILD), drug-induced pneumonitis, autoimmune pneumonitis, and/or history of severe autoimmune disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ipsen Medical Director
Organizational Affiliation
Ipsen
Official's Role
Study Director
Facility Information:
Facility Name
California Cancer Associates For Research And Excellence, cCARE
City
Santa Fe
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
Central Care Cancer Center
City
Bolivar
State/Province
Missouri
ZIP/Postal Code
65613
Country
United States
Facility Name
Astera Cancer Center
City
East Brunswick
State/Province
New Jersey
ZIP/Postal Code
08816
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study of Tazemetostat in Combination With Various Treatments in Participants With Blood Cancer.

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