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Study of XNW5004 Tablet in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors Who Failed Standard Treatments (KEYNOTE F19)

Primary Purpose

Carcinoma, Squamous Cell Carcinoma of Head and Neck, Urothelial Carcinoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
XNW5004
Pembrolizumab 25 mg/mL Solution for Injection
Sponsored by
Evopoint Biosciences Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma focused on measuring XNW5004, EZH2 inhibitor, pembrolizumab, immune checkpoint inhibitors

Eligibility Criteria

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

Inclusion Criteria: Sign informed consent form prior to the commencement of any research activity/procedure. Age ≥ 18. Cohort 3 (mCRPC cohort) is male-only, and no gender restrictions for other cohorts. Subjects with advanced solid tumors who meet one of the following requirements can be enrolled in the study. No cohorts planned for the Phase Ib study, whereas the Phase II study is divided into 6 cohorts: Cohort: 1 Histologically or cytologically confirmed recurrent or metastatic head and neck squamous cell carcinoma (including nasopharyngeal carcinoma),has progressed after treatment with a standard regimen containing PD-1/PD-L1 inhibitors. Cohort 2: Histologically confirmed advanced urothelial carcinoma (including urothelial carcinoma of bladder, renal pelvis, ureter, and urethral origin) that is not suitable for surgical treatment and has progressed after treatment with a standard regimen containing PD-1/PD-L1 inhibitors. Cohort 3: Metastatic castration-resistant prostate adenocarcinoma with histological or cytological evidence of disease progression except neuroendocrine or small cell carcinoma; Imaging examination (CT/MRI/ bone scan) confirmed metastatic lesions. Failed previous standard treatments, and at least received one second-generation anti-androgen drug treatment (including but not limited to abiraterone acetate, enzalutamide or apalutamide). Disease progression at screening. Continuous luteinizing hormone-releasing agonist (LHRHa) or antagonist therapy (drug castration) or prior bilateral orchiectomy (surgical castration). Testosterone at screening was at castration level. Cohort 4: Subjects with histologically or cytologically confirmed extensive-stage small cell lung cancer with disease progression after first-line standard therapy. Cohort 5: Subjects with histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer. Cohort 5a: Previous use of and resistant to EGFR inhibitors and failed standard treatment. Cohort 5b: No driver gene mutations identified and failed standard therapy containing PD-1/PD-L1 inhibitors. Cohort 6: Subjects with advanced solid tumors other than those described in the above cohorts, and failed standard therapy. For recurrent or metastatic cervical cancer, it should be histologically or cytologically confirmed as squamous cell carcinoma, progressed after systematic standard treatment, and is not suitable for radical therapy . For patients who have progressed on treatment with PD-1/PD-L1 inhibitors administered either as monotherapy, or in combination with other checkpoint inhibitors or other therapies, PD-1/PD-L1 inhibitor treatment progression is defined by meeting all of the following criteria: Has received at least 2 doses of approved PD-1/PD-L1 inhibitors. Documented objective radiographic progression following initiation of treatment with a PD-1/PD-L1 inhibitor. Subjects should not be enrolled if they are suspected of permanent withdrawal due to pseudo-progression after previous PD-1/PD-L1 inhibitor treatment. To the extent possible, provide formalin-fixed, paraffin-embedded (FFPE) tumor tissue section (previously archived or fresh) samples and blood samples that meet the detection requirements for exploratory studies. Life expectancy ≥ 3 months. At least one measurable lesion according to RECIST 1.1 criteria. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1. Have adequate organ function. Females of child-bearing potential and males who use adequate birth control through 6 months post last dose. Exclusion Criteria: Cohort-specific exclusion criteria: Cohort 1 (head and neck squamous cell carcinoma cohort) Neuroendocrine carcinoma and small cell carcinoma. Salivary adenocarcinoma or other non squamous cell carcinoma (such as adenocarcinoma, sarcoma or mixed carcinoma) confirmed by histology or cytology, and metastatic squamous cell carcinoma with unknown primary origin. This exclusion criterion is not applicable to nasopharyngeal cancer. Cohort 3 (mCRPC) Severe bone injury caused by tumor bone metastasis, including severe, uncontrolled bone pain as judged by the investigator, bone fractures or spinal cord compression at critical parts of the body that occurred in the last 6 months or are expected to occur in a near future. Any previous treatment targeting T-cell co-stimulation or checkpoint pathways. Cohort 5 (non-small cell lung cancer) Any previous treatment targeting T-cell co-stimulation or checkpoint pathways other than PD-1 / PD-L1 inhibitors. Combined with other targetable driver mutations either alone or in addition to EGFR, including but not limited to: ALK gene rearrangement, ROS1 mutations, BRAFV600E mutation, etc. (For cohort 5a only.) Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137), and was discontinued from that treatment due to a Grade 3 or higher irAE. Prior exposure to EZH2 inhibitor(s) or EZH1/2 inhibitor(s) (including but not limited to tazemetostat). Subjects known to be allergic to the study drug or its active ingredients or excipients, or subjects with prior severe hypersensitivity to other monoclonal antibody therapy in the past. Subjects who received anti-tumor therapies including chemotherapy, immunotherapy, radical radiotherapy, major surgery, targeting therapy and other anti-tumor therapies within 4 weeks or 5 half-lives of the drug (whichever is shorter) before the first dose; or received palliative radiotherapy within 2 weeks before the first dose. Subjects who participated in any other clinical trial of anti-tumor therapy within 28 days before the first dosing, and the last dose of other anti-tumor trial drug is within 28 days prior to the first administration of study drug in this trial. Subjects who underwent major surgery within 4 weeks prior to the start of the study treatment, or who are scheduled to undergo a major surgery during the study period (procedures such as puncture or lymph node biopsy is allowed). Subjects who have an allogenic bone marrow transplantation or solid organ transplantation. Subjects who have diseases requiring systemic therapy with corticosteroids (> 10 mg of prednisone or equivalent dose of other glucocorticoids) or other immunosuppressive medications within 14 days prior to the study drug administration. In the absence of active autoimmune disease, inhaled or topical steroids and adrenal replacement therapy is allowed with a dose of ≤ 10 mg of prednisone or equivalent doses of other glucocorticoids. Subjects who took moderate to strong CYP3A4 inhibitor/inducer medications within 14 days prior to the first dose of study drug. Subjects who have received live vaccines (including attenuated live vaccines) within 28 days prior to the administration of study drug. Inactivated vaccines are permitted. Subjects who experienced toxicity events during previous anti-tumor treatment and the toxicity has not resolved (toxicity has not resolved means the severity of the toxicity events has not been graded as ≤ level 1 according to National Cancer Institute- Common Terminology Criteria for Adverse Events [NCI-CTCAE] 5.0). Other toxicities that the investigator does not think it will affect the safety assessment of the subject (such as hair loss, etc.) will be allowed. Subjects who have a history of other malignancies within 3 years prior to enrollment and do not meet the criteria for clinical cure. This exclusion criterion does not apply to skin basal cell carcinoma or squamous cell carcinoma with local treatment methods available and has been cured, superficial bladder cancer, primary cervical carcinoma in situ, intraductal breast carcinoma in situ, and papillary thyroid carcinoma. Subjects who have symptoms of active central nervous system metastases. However, subjects with stable brain parenchymal metastases can be enrolled. Subjects who have active autoimmune disease that has received systemic treatment in the past 2 years (i.e., taking disease control medications, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered to be systemic treatments. Has a history of (non-infectious) pneumonitis / interstitial lung disease that required steroids or has current pneumonitis / interstitial lung disease. Has had a history of radiation pneumonitis. Subjects who have serious psychiatric illness and are unable to cooperate in completing the clinical study. Has an active infection requiring systemic therapy. Has tuberculosis that is being treated. Subjects who have known history of human immunodeficiency virus (HIV) or Anti- Treponema Pallidum test (anti-TP) positive. Subjects who are Hepatitis B Surface Antigen (HBsAg) positive; or HBsAg negative, but Hepatitis B core Antigen (HBcAb) positive and Hepatitis B virus (HBV)-DNA copy number abnormally high; Hepatitis C virus (HCV) antibody positive and HCV-RNA copy number abnormally high. Subjects who have history of T-cell lymphoblastic lymphoma (T-LBL) or T-cell lymphoblastic leukemia (T-ALL). Subjects who have history of any myeloid malignancies including myelodysplastic syndrome (MDS), or subjects who have abnormal test results related to MDS or myeloproliferative neoplasm (MPN). Women during pregnancy or lactation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Dose escalation and Safety of XNW5004 in combination with pembrolizumab(Phase Ib)

    HNSCC:XNW5004 in combination with pembrolizumab(Phase II - cohorts 1)

    Urothelial carcinoma:XNW5004 in combination with pembrolizumab(Phase II - cohorts 2)

    mCRPC:XNW5004 in combination with pembrolizumab(Phase II - cohorts 3)

    Small cell lung cancer:XNW5004 in combination with pembrolizumab(Phase II - cohorts 4)

    non-small cell lung cancer:XNW5004 in combination with pembrolizumab(Phase II - cohorts 5)

    :XNW5004 in combination with pembrolizumab(Phase II - cohorts 6)

    Arm Description

    Dose escalation and safety with repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with advanced solid tumors.

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with head and neck squamous cell carcinoma (including nasopharyngeal carcinoma), urothelial carcinoma, metastatic castration-resistant prostate adenocarcinoma, small cell lung cancer, non-small cell lung cancer, other solid tumor (including cervical cancer)

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with urothelial carcinoma

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with metastatic castration-resistant prostate adenocarcinoma

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with small cell lung cancer

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with non-small cell lung cancer

    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with other solid tumor (including cervical cancer)

    Outcomes

    Primary Outcome Measures

    Recommended Phase 2 Dose (RP2D) of XNW5004 in Combination With Pembrolizumab (Phase 1b Only)
    Recommended Phase 2 dose (RP2D) of XNW5004 as administered orally twice daily (BID), continuously in 21-day cycles, in combination with pembrolizumab in subjects with advanced solid tumors by safety data, pharmacokinetic data, pharmacodynamic data and efficacy data
    Objective Response Rate (ORR) (Phase 2)
    ORR is defined as the proportion of subjects who have a confirmed complete response (CR) or a partial response (PR) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1)

    Secondary Outcome Measures

    ORR(Phase 1b)
    ORR is defined as the proportion of subjects who have a confirmed CR or a PR per RECIST 1.1.
    Duration of response (DOR)(Phase 1b and Phase 2)
    DOR is defined defined as the length of time from the date of first confirmed CR or PR per RECIST 1.1(whichever status is recorded first) to the date of first evaluation of progressive disease, or death due to any reasons.
    Progression free survival (PFS) (Phase 1b and Phase 2)
    PFS is defined as the the length of time from the date of first administration of the study drug until the date of disease progression or death.
    Percentage of Participants With Adverse Events(AE) (Phase 2)
    An AE is any untoward medical occurrence in a clinical investigation subject administered a study drug and an AE can therefore be any symptom, disease or an abnormal laboratory finding, whether or not related to the investigational product. Severity of AEs is assessed according to Common Terminology Criteria for Adverse Events Version (CTCAE 5.0).
    Maximum Concentration (Cmax) of XNW5004 in Solid Tumor Participants (Phase 1 and Phase 2)
    Blood samples were collected at specified intervals for the determination of Cmax.
    the area under the plasma concentration-time curve at steady state (AUCss) in Solid Tumor Participants (Phase 1 and Phase 2)
    Blood samples were collected at specified intervals for the determination of AUCss.

    Full Information

    First Posted
    August 17, 2023
    Last Updated
    September 20, 2023
    Sponsor
    Evopoint Biosciences Inc.
    Collaborators
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06022757
    Brief Title
    Study of XNW5004 Tablet in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors Who Failed Standard Treatments (KEYNOTE F19)
    Official Title
    A Phase Ib/II Study of XNW5004 Tablet in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors Who Failed Standard Treatments (KEYNOTE F19)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 2023 (Anticipated)
    Primary Completion Date
    August 2028 (Anticipated)
    Study Completion Date
    August 2028 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Evopoint Biosciences Inc.
    Collaborators
    Merck Sharp & Dohme LLC

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    In this study, participants with multiple types of advanced solid tumors who failed standard treatments will be treated with XNW5004 in combination with Pembrolizumab (MK-3475).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Carcinoma, Squamous Cell Carcinoma of Head and Neck, Urothelial Carcinoma, Prostate Cancer, Small-cell Lung Cancer, Non-small Cell Lung Cancer, Cervical Cancer, Other Solid Tumors
    Keywords
    XNW5004, EZH2 inhibitor, pembrolizumab, immune checkpoint inhibitors

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    204 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Dose escalation and Safety of XNW5004 in combination with pembrolizumab(Phase Ib)
    Arm Type
    Experimental
    Arm Description
    Dose escalation and safety with repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with advanced solid tumors.
    Arm Title
    HNSCC:XNW5004 in combination with pembrolizumab(Phase II - cohorts 1)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with head and neck squamous cell carcinoma (including nasopharyngeal carcinoma), urothelial carcinoma, metastatic castration-resistant prostate adenocarcinoma, small cell lung cancer, non-small cell lung cancer, other solid tumor (including cervical cancer)
    Arm Title
    Urothelial carcinoma:XNW5004 in combination with pembrolizumab(Phase II - cohorts 2)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with urothelial carcinoma
    Arm Title
    mCRPC:XNW5004 in combination with pembrolizumab(Phase II - cohorts 3)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with metastatic castration-resistant prostate adenocarcinoma
    Arm Title
    Small cell lung cancer:XNW5004 in combination with pembrolizumab(Phase II - cohorts 4)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with small cell lung cancer
    Arm Title
    non-small cell lung cancer:XNW5004 in combination with pembrolizumab(Phase II - cohorts 5)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with non-small cell lung cancer
    Arm Title
    :XNW5004 in combination with pembrolizumab(Phase II - cohorts 6)
    Arm Type
    Experimental
    Arm Description
    Repeated administrations of XNW5004 in combination with infusions of pembrolizumab in patients with other solid tumor (including cervical cancer)
    Intervention Type
    Drug
    Intervention Name(s)
    XNW5004
    Intervention Description
    XNW5004 an EZH2 inhibitor, BID, administered in continuous
    Intervention Type
    Drug
    Intervention Name(s)
    Pembrolizumab 25 mg/mL Solution for Injection
    Intervention Description
    Pembrolizumab a programmed death receptor (PD-1) blocking antibody administered at 200mg by intravenous (IV) infusions every 3 weeks.
    Primary Outcome Measure Information:
    Title
    Recommended Phase 2 Dose (RP2D) of XNW5004 in Combination With Pembrolizumab (Phase 1b Only)
    Description
    Recommended Phase 2 dose (RP2D) of XNW5004 as administered orally twice daily (BID), continuously in 21-day cycles, in combination with pembrolizumab in subjects with advanced solid tumors by safety data, pharmacokinetic data, pharmacodynamic data and efficacy data
    Time Frame
    The first 21-day cycle of therapy
    Title
    Objective Response Rate (ORR) (Phase 2)
    Description
    ORR is defined as the proportion of subjects who have a confirmed complete response (CR) or a partial response (PR) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1)
    Time Frame
    Radiologic tumor assessments performed at baseline(within 28 days before start of study treatment)and every 9 weeks in the first 54 weeks (including the 54th week) after the first drug administration then every 12 weeks thereafter until confirmed disease
    Secondary Outcome Measure Information:
    Title
    ORR(Phase 1b)
    Description
    ORR is defined as the proportion of subjects who have a confirmed CR or a PR per RECIST 1.1.
    Time Frame
    Radiologic tumor assessments performed at baseline(within 28 days before start of study treatment)and every 9 weeks in the first 54 weeks (including the 54th week) after the first drug administration then every 12 weeks thereafter until confirmed disease
    Title
    Duration of response (DOR)(Phase 1b and Phase 2)
    Description
    DOR is defined defined as the length of time from the date of first confirmed CR or PR per RECIST 1.1(whichever status is recorded first) to the date of first evaluation of progressive disease, or death due to any reasons.
    Time Frame
    Radiologic tumor assessments performed at baseline(within 28 days before start of study treatment)and every 9 weeks in the first 54 weeks (including the 54th week) after the first drug administration then every 12 weeks thereafter until confirmed disease
    Title
    Progression free survival (PFS) (Phase 1b and Phase 2)
    Description
    PFS is defined as the the length of time from the date of first administration of the study drug until the date of disease progression or death.
    Time Frame
    Radiologic tumor assessments performed at baseline(within 28 days before start of study treatment)and every 9 weeks in the first 54 weeks (including the 54th week) after the first drug administration then every 12 weeks thereafter until confirmed disease
    Title
    Percentage of Participants With Adverse Events(AE) (Phase 2)
    Description
    An AE is any untoward medical occurrence in a clinical investigation subject administered a study drug and an AE can therefore be any symptom, disease or an abnormal laboratory finding, whether or not related to the investigational product. Severity of AEs is assessed according to Common Terminology Criteria for Adverse Events Version (CTCAE 5.0).
    Time Frame
    Up to 2.5 years
    Title
    Maximum Concentration (Cmax) of XNW5004 in Solid Tumor Participants (Phase 1 and Phase 2)
    Description
    Blood samples were collected at specified intervals for the determination of Cmax.
    Time Frame
    Cycle 1 (each cycle is 21 days)
    Title
    the area under the plasma concentration-time curve at steady state (AUCss) in Solid Tumor Participants (Phase 1 and Phase 2)
    Description
    Blood samples were collected at specified intervals for the determination of AUCss.
    Time Frame
    Cycle 1 (each cycle is 21 days)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Sign informed consent form prior to the commencement of any research activity/procedure. Age ≥ 18. Cohort 3 (mCRPC cohort) is male-only, and no gender restrictions for other cohorts. Subjects with advanced solid tumors who meet one of the following requirements can be enrolled in the study. No cohorts planned for the Phase Ib study, whereas the Phase II study is divided into 6 cohorts: Cohort: 1 Histologically or cytologically confirmed recurrent or metastatic head and neck squamous cell carcinoma (including nasopharyngeal carcinoma),has progressed after treatment with a standard regimen containing PD-1/PD-L1 inhibitors. Cohort 2: Histologically confirmed advanced urothelial carcinoma (including urothelial carcinoma of bladder, renal pelvis, ureter, and urethral origin) that is not suitable for surgical treatment and has progressed after treatment with a standard regimen containing PD-1/PD-L1 inhibitors. Cohort 3: Metastatic castration-resistant prostate adenocarcinoma with histological or cytological evidence of disease progression except neuroendocrine or small cell carcinoma; Imaging examination (CT/MRI/ bone scan) confirmed metastatic lesions. Failed previous standard treatments, and at least received one second-generation anti-androgen drug treatment (including but not limited to abiraterone acetate, enzalutamide or apalutamide). Disease progression at screening. Continuous luteinizing hormone-releasing agonist (LHRHa) or antagonist therapy (drug castration) or prior bilateral orchiectomy (surgical castration). Testosterone at screening was at castration level. Cohort 4: Subjects with histologically or cytologically confirmed extensive-stage small cell lung cancer with disease progression after first-line standard therapy. Cohort 5: Subjects with histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer. Cohort 5a: Previous use of and resistant to EGFR inhibitors and failed standard treatment. Cohort 5b: No driver gene mutations identified and failed standard therapy containing PD-1/PD-L1 inhibitors. Cohort 6: Subjects with advanced solid tumors other than those described in the above cohorts, and failed standard therapy. For recurrent or metastatic cervical cancer, it should be histologically or cytologically confirmed as squamous cell carcinoma, progressed after systematic standard treatment, and is not suitable for radical therapy . For patients who have progressed on treatment with PD-1/PD-L1 inhibitors administered either as monotherapy, or in combination with other checkpoint inhibitors or other therapies, PD-1/PD-L1 inhibitor treatment progression is defined by meeting all of the following criteria: Has received at least 2 doses of approved PD-1/PD-L1 inhibitors. Documented objective radiographic progression following initiation of treatment with a PD-1/PD-L1 inhibitor. Subjects should not be enrolled if they are suspected of permanent withdrawal due to pseudo-progression after previous PD-1/PD-L1 inhibitor treatment. To the extent possible, provide formalin-fixed, paraffin-embedded (FFPE) tumor tissue section (previously archived or fresh) samples and blood samples that meet the detection requirements for exploratory studies. Life expectancy ≥ 3 months. At least one measurable lesion according to RECIST 1.1 criteria. Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1. Have adequate organ function. Females of child-bearing potential and males who use adequate birth control through 6 months post last dose. Exclusion Criteria: Cohort-specific exclusion criteria: Cohort 1 (head and neck squamous cell carcinoma cohort) Neuroendocrine carcinoma and small cell carcinoma. Salivary adenocarcinoma or other non squamous cell carcinoma (such as adenocarcinoma, sarcoma or mixed carcinoma) confirmed by histology or cytology, and metastatic squamous cell carcinoma with unknown primary origin. This exclusion criterion is not applicable to nasopharyngeal cancer. Cohort 3 (mCRPC) Severe bone injury caused by tumor bone metastasis, including severe, uncontrolled bone pain as judged by the investigator, bone fractures or spinal cord compression at critical parts of the body that occurred in the last 6 months or are expected to occur in a near future. Any previous treatment targeting T-cell co-stimulation or checkpoint pathways. Cohort 5 (non-small cell lung cancer) Any previous treatment targeting T-cell co-stimulation or checkpoint pathways other than PD-1 / PD-L1 inhibitors. Combined with other targetable driver mutations either alone or in addition to EGFR, including but not limited to: ALK gene rearrangement, ROS1 mutations, BRAFV600E mutation, etc. (For cohort 5a only.) Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX 40, CD137), and was discontinued from that treatment due to a Grade 3 or higher irAE. Prior exposure to EZH2 inhibitor(s) or EZH1/2 inhibitor(s) (including but not limited to tazemetostat). Subjects known to be allergic to the study drug or its active ingredients or excipients, or subjects with prior severe hypersensitivity to other monoclonal antibody therapy in the past. Subjects who received anti-tumor therapies including chemotherapy, immunotherapy, radical radiotherapy, major surgery, targeting therapy and other anti-tumor therapies within 4 weeks or 5 half-lives of the drug (whichever is shorter) before the first dose; or received palliative radiotherapy within 2 weeks before the first dose. Subjects who participated in any other clinical trial of anti-tumor therapy within 28 days before the first dosing, and the last dose of other anti-tumor trial drug is within 28 days prior to the first administration of study drug in this trial. Subjects who underwent major surgery within 4 weeks prior to the start of the study treatment, or who are scheduled to undergo a major surgery during the study period (procedures such as puncture or lymph node biopsy is allowed). Subjects who have an allogenic bone marrow transplantation or solid organ transplantation. Subjects who have diseases requiring systemic therapy with corticosteroids (> 10 mg of prednisone or equivalent dose of other glucocorticoids) or other immunosuppressive medications within 14 days prior to the study drug administration. In the absence of active autoimmune disease, inhaled or topical steroids and adrenal replacement therapy is allowed with a dose of ≤ 10 mg of prednisone or equivalent doses of other glucocorticoids. Subjects who took moderate to strong CYP3A4 inhibitor/inducer medications within 14 days prior to the first dose of study drug. Subjects who have received live vaccines (including attenuated live vaccines) within 28 days prior to the administration of study drug. Inactivated vaccines are permitted. Subjects who experienced toxicity events during previous anti-tumor treatment and the toxicity has not resolved (toxicity has not resolved means the severity of the toxicity events has not been graded as ≤ level 1 according to National Cancer Institute- Common Terminology Criteria for Adverse Events [NCI-CTCAE] 5.0). Other toxicities that the investigator does not think it will affect the safety assessment of the subject (such as hair loss, etc.) will be allowed. Subjects who have a history of other malignancies within 3 years prior to enrollment and do not meet the criteria for clinical cure. This exclusion criterion does not apply to skin basal cell carcinoma or squamous cell carcinoma with local treatment methods available and has been cured, superficial bladder cancer, primary cervical carcinoma in situ, intraductal breast carcinoma in situ, and papillary thyroid carcinoma. Subjects who have symptoms of active central nervous system metastases. However, subjects with stable brain parenchymal metastases can be enrolled. Subjects who have active autoimmune disease that has received systemic treatment in the past 2 years (i.e., taking disease control medications, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered to be systemic treatments. Has a history of (non-infectious) pneumonitis / interstitial lung disease that required steroids or has current pneumonitis / interstitial lung disease. Has had a history of radiation pneumonitis. Subjects who have serious psychiatric illness and are unable to cooperate in completing the clinical study. Has an active infection requiring systemic therapy. Has tuberculosis that is being treated. Subjects who have known history of human immunodeficiency virus (HIV) or Anti- Treponema Pallidum test (anti-TP) positive. Subjects who are Hepatitis B Surface Antigen (HBsAg) positive; or HBsAg negative, but Hepatitis B core Antigen (HBcAb) positive and Hepatitis B virus (HBV)-DNA copy number abnormally high; Hepatitis C virus (HCV) antibody positive and HCV-RNA copy number abnormally high. Subjects who have history of T-cell lymphoblastic lymphoma (T-LBL) or T-cell lymphoblastic leukemia (T-ALL). Subjects who have history of any myeloid malignancies including myelodysplastic syndrome (MDS), or subjects who have abnormal test results related to MDS or myeloproliferative neoplasm (MPN). Women during pregnancy or lactation.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Li Zhang, M.D.
    Phone
    13902282893
    Ext
    0
    Email
    zhangli@sysucc.org.cn
    First Name & Middle Initial & Last Name or Official Title & Degree
    Hongyun Zhao, M.D.
    Phone
    020-87342482
    Ext
    0
    Email
    zhaohy@sysucc.org.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Li Zhang
    Organizational Affiliation
    botanic physician
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Study of XNW5004 Tablet in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors Who Failed Standard Treatments (KEYNOTE F19)

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