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AS-1763 in Patients With Previously Treated CLL/SLL or Non-Hodgkin Lymphoma

Primary Purpose

B-cell Malignancy, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AS-1763
AS-1763
Sponsored by
Carna Biosciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Malignancy

Eligibility Criteria

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

Inclusion Criteria: Age ≥18 years Provided written informed consent Histologically confirmed B-cell malignancy, including CLL/SLL, WM, MCL, MZL, or FL. Patients must have failed or are intolerant to ≥2 prior lines of systemic therapy ECOG Performance Status 0 to 2 Absolute neutrophil count ≥0.75 × 10⁹/L Platelet count ≥50 × 10⁹/L Hemoglobin ≥8 g/dL Adequate hepatic function Adequate renal function Ability to swallow tablets and comply with study requirements for the duration of study participation. Male and female patients of reproductive potential: Willing to observe conventional and effective birth control methods Exclusion Criteria: Transformed disease (eg, Richter's transformation) prior to or during Screening Investigational agent or anticancer therapy within 5 half-lives before the planned start of AS-1763, except therapeutic monoclonal antibody treatment which must be discontinued at least 4 weeks before the start of AS-1763. Current treatment with investigational therapy or planned investigational therapy which would be concurrent with this study. Requiring therapeutic anticoagulation with warfarin. Current treatment with certain strong cytochrome P450 3A4 (CYP3A4) inhibitors or inducers Treatment with proton pump inhibitors within 7 days before first dose of AS-1763 Current treatment with strong P-glycoprotein inhibitors or strong breast cancer resistance protein (BCRP) inhibitors. Refractory to transfusion support. Major surgery within 4 weeks before planned start of AS-1763. Radiotherapy with a limited field of radiation for palliation within 7 days of the first dose of study treatment Any unresolved toxicities from prior therapy greater than National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 Grade 2 at the time of starting study treatment except for alopecia. History of allogeneic or autologous stem cell transplant or chimeric antigen receptor T-cell (CAR-T) therapy within the last 30 days. Active second malignancy unless in remission with life expectancy >2 years Known central nervous system (CNS) involvement by systemic lymphoma. Patients with previous treatment for CNS involvement who are neurologically stable and without evidence of disease may be eligible if a compelling clinical rationale is provided by the investigator and with documented Sponsor approval. Active uncontrolled autoimmune cytopenia (eg, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura) where new therapy introduced or concomitant therapy escalated within the 4 weeks before study enrollment is required to maintain adequate blood counts. Clinically significant, uncontrolled cardiac, cardiovascular disease or history of myocardial infarction within 6 months before planned start of AS-1763, or prolongation of the QT interval corrected for heart rate using Fridericia's Formula (QTcF) >470 msec on at least 2 of 3 consecutive ECGs, and mean QTcF >470 msec on all 3 ECGs, during Screening. Active uncontrolled systemic bacterial, viral, fungal, or parasitic infection Positive for human immunodeficiency virus (HIV). For patients with unknown HIV status, HIV testing will be performed at Screening. Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal absorption of AS-1763 Pregnant or lactating. Known hypersensitivity to any component or excipient of AS-1763. Prior treatment with AS-1763 or other noncovalent BTKi such as pirtobrutinib or nemtabrutinib

Sites / Locations

  • University of Maryland Baltimore Greenebaum Comprehensive Cancer CenterRecruiting
  • University of Massachusetts Chan Medical SchoolRecruiting
  • Clinical Research Alliance, Inc.Recruiting
  • The University of Texas MD Anderson Cancer CenterRecruiting
  • The Medical College of WisconsinRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose Escalation

Dose Expansion Cohort 1

Dose Expansion Cohort 2

Arm Description

Dose escalation (3+3 design) and determination of MTD and DLTs CLL/SLL or B-cell NHL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet at multiple dose levels twice daily for 24 cycles (1 cycle = 28 days).

CLL/SLL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet for 24 cycles (1 cycle = 28 days). Dose levels will be determined based on the result of dose escalation part.

B-cell NHL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet for 24 cycles (1 cycle = 28 days). Dose levels will be determined based on the result of dose escalation part.

Outcomes

Primary Outcome Measures

Number of patients with dose limiting toxicities (DLTs) and determination of maximum tolerated dose (MTD)
Dose escalation
Overall response rate (ORR) as assessed by safety monitoring committee (SMC)
Dose expansion

Secondary Outcome Measures

Number of patients with adverse events (AEs) and clinical laboratory abnormalities
Dose escalation, dose expansion
Area under the plasma concentration versus time curve (AUC) of AS-1763
Dose escalation, dose expansion
Peak Plasma Concentration (Cmax) of AS-1763
Dose escalation, dose expansion
Time to maximum plasma concentration (tmax) of AS-1763
Dose escalation, dose expansion
ORR as assessed by investigator
Dose escalation, dose expansion
Best overall response as assessed by investigator and SMC
Dose expansion
Duration of response as assessed by the investigator and SMC
Dose expansion
Progression free survival as assessed by the investigator and SMC
Dose expansion
Overall survival
Dose expansion

Full Information

First Posted
October 24, 2022
Last Updated
August 25, 2023
Sponsor
Carna Biosciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05602363
Brief Title
AS-1763 in Patients With Previously Treated CLL/SLL or Non-Hodgkin Lymphoma
Official Title
A Phase 1b Study of Oral AS-1763 in Patients With Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma or Non-Hodgkin Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2023 (Actual)
Primary Completion Date
September 2027 (Anticipated)
Study Completion Date
September 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Carna Biosciences, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This is an open-label, multi-center Phase 1b clinical study of oral AS-1763 in patients with CLL/SLL or B-cell NHL who have failed or are intolerant to ≥2 lines of systemic therapy.
Detailed Description
This study consists of 2 parts. Dose escalation part will enroll up to 27 patients to evaluate safety profile and tolerance of AS-1763 using 3+3 design. The starting dose of AS-1763 in oral tablet form is 100 mg twice daily (200 mg/day). Dose escalation will continue up to the planned maximum dose level or until the maximum tolerated dose (MTD) has been identified. Dose expansion part will enroll up to 48 CLL/SLL patients (Cohort 1) and up to 35 NHL patients (Cohort 2). The first 30 patients in each cohort will be allocated to three dose levels (n=10 at each dose level) which will be selected based on the data from dose escalation. Preliminary efficacy and safety data from the first 30 patients in one of cohorts will be used to identify the provisional recommended Phase 2 dose (RP2D) level. Thereafter, up to a further 18 patients for Cohort 1 and up to a further 5 patients for Cohort 2 will be enrolled and allocated to the provisional RP2D level. Study assessments will continue for 24 cycles (1 cycle = 28 days) or until disease progression, occurrence of unacceptable toxicity, or discontinuation because of other reasons. Patients will then be followed for survival status for a further 2 years. RP2D will be determined based on all the data generated in the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Malignancy, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, Waldenstrom Macroglobulinemia, Mantle Cell Lymphoma, Marginal Zone Lymphoma, Follicular Lymphoma, Non-Hodgkin Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dose Escalation
Arm Type
Experimental
Arm Description
Dose escalation (3+3 design) and determination of MTD and DLTs CLL/SLL or B-cell NHL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet at multiple dose levels twice daily for 24 cycles (1 cycle = 28 days).
Arm Title
Dose Expansion Cohort 1
Arm Type
Experimental
Arm Description
CLL/SLL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet for 24 cycles (1 cycle = 28 days). Dose levels will be determined based on the result of dose escalation part.
Arm Title
Dose Expansion Cohort 2
Arm Type
Experimental
Arm Description
B-cell NHL patients previously treated with ≥2 lines of systemic therapy will self-administer AS-1763 oral tablet for 24 cycles (1 cycle = 28 days). Dose levels will be determined based on the result of dose escalation part.
Intervention Type
Drug
Intervention Name(s)
AS-1763
Intervention Description
oral tablet, twice daily
Intervention Type
Drug
Intervention Name(s)
AS-1763
Intervention Description
oral tablet, twice daily
Primary Outcome Measure Information:
Title
Number of patients with dose limiting toxicities (DLTs) and determination of maximum tolerated dose (MTD)
Description
Dose escalation
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Overall response rate (ORR) as assessed by safety monitoring committee (SMC)
Description
Dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Secondary Outcome Measure Information:
Title
Number of patients with adverse events (AEs) and clinical laboratory abnormalities
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Area under the plasma concentration versus time curve (AUC) of AS-1763
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Peak Plasma Concentration (Cmax) of AS-1763
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Time to maximum plasma concentration (tmax) of AS-1763
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
ORR as assessed by investigator
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Best overall response as assessed by investigator and SMC
Description
Dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Duration of response as assessed by the investigator and SMC
Description
Dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Progression free survival as assessed by the investigator and SMC
Description
Dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Overall survival
Description
Dose expansion
Time Frame
Up to 4 years
Other Pre-specified Outcome Measures:
Title
Proportion of patients with minimal residual disease (MRD) negative
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)
Title
Proportion of patients with BTK and PLCG2 gene mutation before and after disease progression
Description
Dose escalation, dose expansion
Time Frame
Up to 24 cycles (1 cycle = 28 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years Provided written informed consent Histologically confirmed B-cell malignancy, including CLL/SLL, WM, MCL, MZL, or FL. Patients must have failed or are intolerant to ≥2 prior lines of systemic therapy ECOG Performance Status 0 to 2 Absolute neutrophil count ≥0.75 × 10⁹/L Platelet count ≥50 × 10⁹/L Hemoglobin ≥8 g/dL Adequate hepatic function Adequate renal function Ability to swallow tablets and comply with study requirements for the duration of study participation. Male and female patients of reproductive potential: Willing to observe conventional and effective birth control methods Exclusion Criteria: Transformed disease (eg, Richter's transformation) prior to or during Screening Investigational agent or anticancer therapy within 5 half-lives before the planned start of AS-1763, except therapeutic monoclonal antibody treatment which must be discontinued at least 4 weeks before the start of AS-1763. Current treatment with investigational therapy or planned investigational therapy which would be concurrent with this study. Requiring therapeutic anticoagulation with warfarin. Current treatment with certain strong cytochrome P450 3A4 (CYP3A4) inhibitors or inducers Treatment with proton pump inhibitors within 7 days before first dose of AS-1763 Current treatment with strong P-glycoprotein inhibitors or strong breast cancer resistance protein (BCRP) inhibitors. Refractory to transfusion support. Major surgery within 4 weeks before planned start of AS-1763. Radiotherapy with a limited field of radiation for palliation within 7 days of the first dose of study treatment Any unresolved toxicities from prior therapy greater than National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0 Grade 2 at the time of starting study treatment except for alopecia. History of allogeneic or autologous stem cell transplant or chimeric antigen receptor T-cell (CAR-T) therapy within the last 30 days. Active second malignancy unless in remission with life expectancy >2 years Known central nervous system (CNS) involvement by systemic lymphoma. Patients with previous treatment for CNS involvement who are neurologically stable and without evidence of disease may be eligible if a compelling clinical rationale is provided by the investigator and with documented Sponsor approval. Active uncontrolled autoimmune cytopenia (eg, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura) where new therapy introduced or concomitant therapy escalated within the 4 weeks before study enrollment is required to maintain adequate blood counts. Clinically significant, uncontrolled cardiac, cardiovascular disease or history of myocardial infarction within 6 months before planned start of AS-1763, or prolongation of the QT interval corrected for heart rate using Fridericia's Formula (QTcF) >470 msec on at least 2 of 3 consecutive ECGs, and mean QTcF >470 msec on all 3 ECGs, during Screening. Active uncontrolled systemic bacterial, viral, fungal, or parasitic infection Positive for human immunodeficiency virus (HIV). For patients with unknown HIV status, HIV testing will be performed at Screening. Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal absorption of AS-1763 Pregnant or lactating. Known hypersensitivity to any component or excipient of AS-1763. Prior treatment with AS-1763 or other noncovalent BTKi such as pirtobrutinib or nemtabrutinib
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Akinori Arimura
Phone
+1-650-636-4603
Email
clinical_us@dd.carnabio.com
Facility Information:
Facility Name
University of Maryland Baltimore Greenebaum Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nikki M Glynn-Cunningham, MS
Phone
410-328-7996
Email
nglynn@umm.edu
First Name & Middle Initial & Last Name & Degree
Seung Tae Lee, MD PhD
Facility Name
University of Massachusetts Chan Medical School
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
UMass Cancer Research Office
Phone
508-856-3216
Email
cancer.research@umassmed.edu
First Name & Middle Initial & Last Name & Degree
Andrew J Gillis-Smith, MD
Facility Name
Clinical Research Alliance, Inc.
City
Westbury
State/Province
New York
ZIP/Postal Code
11590
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
James T D'Olimpio, MD
Facility Name
The 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:
First Name & Middle Initial & Last Name & Degree
Nitin Jain, MD
Phone
713-745-6080
Email
njain@mdanderson.org
First Name & Middle Initial & Last Name & Degree
Nitin Jain, MD
Facility Name
The Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53266
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nirav Shah, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

AS-1763 in Patients With Previously Treated CLL/SLL or Non-Hodgkin Lymphoma

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