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A Phase 1 Study of SHR2554 in Subjects With Relapsed or Refractory Mature Lymphoid Neoplasms

Primary Purpose

Relapsed or Refractory Mature Lymphoid Neoplasms

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
SHR2554
Sponsored by
Jiangsu HengRui Medicine Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory Mature Lymphoid Neoplasms focused on measuring SHR2554, EZH2 inhibitor, phase 1, mature lymphoid neoplasm

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 to 70 years old (Adult, Senior)
  2. Part I: Histologically or cytologically confirmed Mature lymphoid neoplasms; Part II: peripheral T cell lymphomas
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
  4. Has a life expectancy of ≥12 weeks;
  5. Resistant to standard therapy or no standard therapy available,have indications for treatment;
  6. Have measurable disease (lymphoma participants,any nodes/nodal masses>1.5 cm in longest diameter (LDi) or extralymphatic sites of disease >1.0 cm in LDi;Multiple myeloma (MM) or Waldenström macroglobulinemia (WM) participants,serum M protein ≥0.5 g/dL or Bence Jones protein≥0.2 g/24 h). (dose expansion study must satisfy)
  7. Has sufficient tumor tissue (slides or blocks) available for testing EZH2 mutation status and expression level. (dose expansion study must satisfy)
  8. Diffuse large B-cell lymphoma (DLBCL) participants have immunohistochemistry test results of cell origin (germinal center B-cell-like (GCB) or non-GCB), as well as myelocytomatosis oncogene (MYC), B cell lymphoma/leukemia 2 (BCL2) and B-cell lymphoma 6 (BCL6), or provide sufficient tumor tissue for testing. (dose expansion study must satisfy)
  9. With adequate bone marrow function;
  10. With adequate renal and liver function;
  11. Coagulation function index:PT ≤1.5×ULN,APTT ≤1.5×ULN;
  12. Women of childbearing potential (WOCBP) should be proven to be negative by human chorionic gonadotropin (hCG) test in 7 days before the first dose of SHR2554. They must be willing and able to employ a highly effective method of birth control/contraception to prevent pregnancy from the day they sign the informed consent form (ICF) to at least 30 days after receiving the last dose of study treatment. Male subjects with WOCBP partner should receive Surgical sterilization or consent to employ a highly effective method of birth control/contraception to prevent pregnancy;
  13. Any prior treatment-related clinically significant toxicities have resolved to ≤ Grade 1 per CTCAE version 4.03 or prior treatment-related toxicities evaluated by physicians are not clinically significant at time of enrollment.
  14. Participant who has provided written consent to participate in the study and ability to comply with all aspects of the protocol.

Exclusion Criteria:

  1. Prior exposure to other inhibitor(s) of EZH2.
  2. FL 3b or (potentially) transformed FL
  3. Participants with a presence of central nerves invasion
  4. Auto-transplantation within 60 days or allo-transplantation within 90 days before the first dose of study drug; >1 grade graft-versus-host disease (GVHD) or using GVHD control medicines that are not allowed by this trial;
  5. Major surgery or serious trauma within 4 weeks before the first dose of study drug.;
  6. anti-tumor agents within 4 weeks before the first dose of study drug(such as chemotherapy, radiotherapy, immunotherapy, target therapy and other clinical research);Use of Chinese Herbal within 2 weeks before the first dose of study drug;use of Glucocorticoids to anti tumor within 7 days before the first dose of study drug(equivalent to prednisone>20 mg/d);
  7. Has known active infection with hepatitis B virus or hepatitis C virus(HBV DNA≥2×10^3 IU/mL,HCV RNA≥10^3 IU/mL)and liver dysfunction,need the intervention of anti-virus therapy;
  8. Immunocompromised (i.e. has congenital immunodeficiency), including subjects known history of infection with human immunodeficiency virus (HIV) or has known active infection with tubercle bacillus;
  9. Has an active infection or has a temperature > 38.5°C with unknown reasons(Investigators will decide the enrollment of participants with a fever that contributed to tumors);
  10. Has cardiovascular impairment,including history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction, or stroke within 1 year prior to the planned first dose of study drug; or ventricular cardiac arrhythmia requiring medical treatment;
  11. abnormal of ECG with clinical significance:such as prolongation of corrected QT interval using Fridericia's formula (QTcF)(male > 450 ms、female> 470 ms);
  12. History of cerebrovascular accident or transient ischemic attack within 6 months;
  13. Has a prior malignancy other than the malignancies under study within 2 years- EXCEPTION: A subject with a history of a completely resected skin basal cell carcinoma, skin squamous-celled carcinoma, in situ cervical cancer or other in situ carcinomas, and has been relapse-free for 5 years;
  14. Has serious acute/chronic disease or psychic disease,such as suicide intention or action in resent 1 year; or there are abnormal conditions that will increase the risk of using or managing study drug or affect the assessment of study results or investigator's judgment;
  15. Staffs of institute sites directly related to the study or their family members, subordinates. Staffs of the sponsor pharmaceuticals company that directly related to the study;
  16. Females who are pregnant or breastfeeding.
  17. Inability to take oral medication, or any uncontrolled gastrointestinal condition (e.g., active gastroenteritis, chronic diarrhea, known diverticulosis, history of gastrectomy or gastric banding) that might impair the bioavailability of study drug. gastroesophageal reflux disease treated with proton pump inhibitors is eligible(should be no drug interaction);
  18. Use of known median or potent CYP3A4 or CYP3A5 inducers/inhibitors or P-gp inhibitors.
  19. Any other major illness that, in the investigator's judgment, will substantially increase the risk associated with the subject's participation in this study.

Sites / Locations

  • Beijing Cancer Hospital, Peking UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SHR2554 treated group

Arm Description

Part I:treated with escalated doses of EZH2 inhibitor SHR2554 respectively; Part II:treated with fixed dose (RP2D) SHR2554 respectively

Outcomes

Primary Outcome Measures

Incidence and severity of treatment-emergent adverse events (AEs) [Safety and Tolerability])(Part I)
The incidence and severity of treatment-emergent AEs will be collected and the safety and tolerability of SHR2554 will be assessed.
Recommended phase 2 dose (RP2D)(Part I)
Recommended phase 2 dose (RP2D) and/or maximum tolerated dose (MTD) will be established according to the incidence of dose-limiting toxicities (DLTs) of escalated doses of SHR2554.
Objective response rate (ORR)(Part II)
assessed by independent radiology review committee (IRC)

Secondary Outcome Measures

Time to peak (Tmax)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Time to peak (Tmax) of plasma concentration
Maximum plasma concentration (Cmax)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Maximum plasma concentration (Cmax)
Halflife (T1/2)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Halflife (T1/2)
Clearance/ bioavailability (CL/F)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Clearance/ bioavailability (CL/F)
apparent volume of distribution/bioavailability (Vd/F)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): apparent volume of distribution/bioavailability (Vd/F)
Area under curve (AUC)
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Area under curve (AUC)
Area under curve, steady state (AUCss)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Area under curve, steady state (AUCss)
Maximum plasma concentration, steady state (Cmax,ss)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Maximum plasma concentration, steady state (Cmax,ss)
Time to peak, steady state (Tmax,ss)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Time to peak, steady state (Tmax,ss)
Halflife (T1/2)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Halflife (T1/2)
Apparent volume of distribution, steady state/bioavailability (Vss/F)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Apparent volume of distribution, steady state/bioavailability (Vss/F)
Clearance/ bioavailability (CL/F)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Clearance/ bioavailability (CL/F)
Accumulation index (Rac)
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Accumulation index (Rac)
Objective response rate (ORR)
Assess the response rate of subjects to the treatment of SHR2554
Progression-free survival (PFS)
Assess the survival condition of the subjects after the treatment of SHR2554
Duration of Response (DoR)
Assess the duration of complete/partial response after the treatment of SHR2554
Time to response(TTR)(Part II only)
Assess the time to initial response of subjects to the treatment of SHR2554
OS(overall survival)(Part II only)
Assess the overall survival of subjects treated by SHR2554

Full Information

First Posted
July 10, 2018
Last Updated
April 24, 2022
Sponsor
Jiangsu HengRui Medicine Co., Ltd.
Collaborators
Peking University Cancer Hospital & Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03603951
Brief Title
A Phase 1 Study of SHR2554 in Subjects With Relapsed or Refractory Mature Lymphoid Neoplasms
Official Title
A Phase 1 Study to Characterize Safety, Tolerance, Pharmacokinetics and Efficacy of SHR2554 in Subjects With Relapsed or Refractory Mature Lymphoid Neoplasms
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 14, 2018 (Actual)
Primary Completion Date
February 14, 2023 (Anticipated)
Study Completion Date
August 14, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jiangsu HengRui Medicine Co., Ltd.
Collaborators
Peking University Cancer Hospital & Institute

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1 multicenter, single-arm, open-label, dose escalation and dose expansion study of enhancer of zeste homolog 2 (EZH2 ) inhibitor SHR2554. This study will assess the tolerability, safety, pharmacokinetics, and preliminary anti-tumor activity of SHR2554 in participants with relapsed or refractory mature lymphoid neoplasms in part I, and the the efficacy in PTCL patients will be studied in Part II.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory Mature Lymphoid Neoplasms
Keywords
SHR2554, EZH2 inhibitor, phase 1, mature lymphoid neoplasm

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
231 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SHR2554 treated group
Arm Type
Experimental
Arm Description
Part I:treated with escalated doses of EZH2 inhibitor SHR2554 respectively; Part II:treated with fixed dose (RP2D) SHR2554 respectively
Intervention Type
Drug
Intervention Name(s)
SHR2554
Other Intervention Name(s)
EZH2 Inhibitor
Intervention Description
SHR2554 is a selective small molecule inhibitor of the histone-lysine methyltransferase EZH2.
Primary Outcome Measure Information:
Title
Incidence and severity of treatment-emergent adverse events (AEs) [Safety and Tolerability])(Part I)
Description
The incidence and severity of treatment-emergent AEs will be collected and the safety and tolerability of SHR2554 will be assessed.
Time Frame
through study completion, an average of about 6 months
Title
Recommended phase 2 dose (RP2D)(Part I)
Description
Recommended phase 2 dose (RP2D) and/or maximum tolerated dose (MTD) will be established according to the incidence of dose-limiting toxicities (DLTs) of escalated doses of SHR2554.
Time Frame
30 days since the date of first dose
Title
Objective response rate (ORR)(Part II)
Description
assessed by independent radiology review committee (IRC)
Time Frame
60 days since the date of first dose
Secondary Outcome Measure Information:
Title
Time to peak (Tmax)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Time to peak (Tmax) of plasma concentration
Time Frame
Day 1 and Day 2 of the single dose
Title
Maximum plasma concentration (Cmax)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Maximum plasma concentration (Cmax)
Time Frame
Day 1 and Day 2 of the single dose
Title
Halflife (T1/2)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Halflife (T1/2)
Time Frame
Day 1 and Day 2 of the single dose
Title
Clearance/ bioavailability (CL/F)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Clearance/ bioavailability (CL/F)
Time Frame
Day 1 and Day 2 of the single dose
Title
apparent volume of distribution/bioavailability (Vd/F)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): apparent volume of distribution/bioavailability (Vd/F)
Time Frame
Day 1 and Day 2 of the single dose
Title
Area under curve (AUC)
Description
Pharmacokinetics profile of a single dose SHR2554 and its metabolite (plasma): Area under curve (AUC)
Time Frame
Day 1 and Day 2 of the single dose
Title
Area under curve, steady state (AUCss)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Area under curve, steady state (AUCss)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Maximum plasma concentration, steady state (Cmax,ss)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Maximum plasma concentration, steady state (Cmax,ss)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Time to peak, steady state (Tmax,ss)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Time to peak, steady state (Tmax,ss)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Halflife (T1/2)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Halflife (T1/2)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Apparent volume of distribution, steady state/bioavailability (Vss/F)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Apparent volume of distribution, steady state/bioavailability (Vss/F)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Clearance/ bioavailability (CL/F)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Clearance/ bioavailability (CL/F)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Accumulation index (Rac)
Description
Pharmacokinetics profile of continuous medication of SHR2554 and its metabolite (plasma): Accumulation index (Rac)
Time Frame
Day 1 of cycle 1 to day 1 of cycle 4 (28 days/cycle)
Title
Objective response rate (ORR)
Description
Assess the response rate of subjects to the treatment of SHR2554
Time Frame
every 8 weeks through study completion, an average of about 6 months
Title
Progression-free survival (PFS)
Description
Assess the survival condition of the subjects after the treatment of SHR2554
Time Frame
every 8 weeks through study completion, an average of about 6 months
Title
Duration of Response (DoR)
Description
Assess the duration of complete/partial response after the treatment of SHR2554
Time Frame
every 8 weeks through study completion, an average of about 6 months
Title
Time to response(TTR)(Part II only)
Description
Assess the time to initial response of subjects to the treatment of SHR2554
Time Frame
60 days since the date of first dose
Title
OS(overall survival)(Part II only)
Description
Assess the overall survival of subjects treated by SHR2554
Time Frame
2 years since the date of first dose
Other Pre-specified Outcome Measures:
Title
Effect of escalated doses of SHR2554 on the histone H3 lysine 27 trimethylation (H3K27me3) level(Part I-exploratory endpoints)
Description
Analyze the level of H3K27me3 in the peripheral blood mononuclear cells of the subjects before and after the treatment of escalated doses of SHR2554.
Time Frame
day 1 of the single dose to day 1 of continuous medication cycle 2
Title
EZH2 gene mutation(Part I-exploratory endpoints)
Description
Assess the known mutation of EZH2 gene in tumor cells or tissues, analyze the relationship between efficacy and EZH2 mutation
Time Frame
within 2 weeks after the last dose
Title
EZH2 expression level(Part I-exploratory endpoints)
Description
Assess EZH2 expression level in tumor tissues, analyze the relationship between efficacy and EZH2 expression level
Time Frame
within 2 weeks after the last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 to 70 years old (Adult, Senior) Part I: Histologically or cytologically confirmed Mature lymphoid neoplasms; Part II: peripheral T cell lymphomas Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; Has a life expectancy of ≥12 weeks; Resistant to standard therapy or no standard therapy available,have indications for treatment; Have measurable disease (lymphoma participants,any nodes/nodal masses>1.5 cm in longest diameter (LDi) or extralymphatic sites of disease >1.0 cm in LDi;Multiple myeloma (MM) or Waldenström macroglobulinemia (WM) participants,serum M protein ≥0.5 g/dL or Bence Jones protein≥0.2 g/24 h). (dose expansion study must satisfy) Has sufficient tumor tissue (slides or blocks) available for testing EZH2 mutation status and expression level. (dose expansion study must satisfy) Diffuse large B-cell lymphoma (DLBCL) participants have immunohistochemistry test results of cell origin (germinal center B-cell-like (GCB) or non-GCB), as well as myelocytomatosis oncogene (MYC), B cell lymphoma/leukemia 2 (BCL2) and B-cell lymphoma 6 (BCL6), or provide sufficient tumor tissue for testing. (dose expansion study must satisfy) With adequate bone marrow function; With adequate renal and liver function; Coagulation function index:PT ≤1.5×ULN,APTT ≤1.5×ULN; Women of childbearing potential (WOCBP) should be proven to be negative by human chorionic gonadotropin (hCG) test in 7 days before the first dose of SHR2554. They must be willing and able to employ a highly effective method of birth control/contraception to prevent pregnancy from the day they sign the informed consent form (ICF) to at least 30 days after receiving the last dose of study treatment. Male subjects with WOCBP partner should receive Surgical sterilization or consent to employ a highly effective method of birth control/contraception to prevent pregnancy; Any prior treatment-related clinically significant toxicities have resolved to ≤ Grade 1 per CTCAE version 4.03 or prior treatment-related toxicities evaluated by physicians are not clinically significant at time of enrollment. Participant who has provided written consent to participate in the study and ability to comply with all aspects of the protocol. Exclusion Criteria: Prior exposure to other inhibitor(s) of EZH2. FL 3b or (potentially) transformed FL Participants with a presence of central nerves invasion Auto-transplantation within 60 days or allo-transplantation within 90 days before the first dose of study drug; >1 grade graft-versus-host disease (GVHD) or using GVHD control medicines that are not allowed by this trial; Major surgery or serious trauma within 4 weeks before the first dose of study drug.; anti-tumor agents within 4 weeks before the first dose of study drug(such as chemotherapy, radiotherapy, immunotherapy, target therapy and other clinical research);Use of Chinese Herbal within 2 weeks before the first dose of study drug;use of Glucocorticoids to anti tumor within 7 days before the first dose of study drug(equivalent to prednisone>20 mg/d); Has known active infection with hepatitis B virus or hepatitis C virus(HBV DNA≥2×10^3 IU/mL,HCV RNA≥10^3 IU/mL)and liver dysfunction,need the intervention of anti-virus therapy; Immunocompromised (i.e. has congenital immunodeficiency), including subjects known history of infection with human immunodeficiency virus (HIV) or has known active infection with tubercle bacillus; Has an active infection or has a temperature > 38.5°C with unknown reasons(Investigators will decide the enrollment of participants with a fever that contributed to tumors); Has cardiovascular impairment,including history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction, or stroke within 1 year prior to the planned first dose of study drug; or ventricular cardiac arrhythmia requiring medical treatment; abnormal of ECG with clinical significance:such as prolongation of corrected QT interval using Fridericia's formula (QTcF)(male > 450 ms、female> 470 ms); History of cerebrovascular accident or transient ischemic attack within 6 months; Has a prior malignancy other than the malignancies under study within 2 years- EXCEPTION: A subject with a history of a completely resected skin basal cell carcinoma, skin squamous-celled carcinoma, in situ cervical cancer or other in situ carcinomas, and has been relapse-free for 5 years; Has serious acute/chronic disease or psychic disease,such as suicide intention or action in resent 1 year; or there are abnormal conditions that will increase the risk of using or managing study drug or affect the assessment of study results or investigator's judgment; Staffs of institute sites directly related to the study or their family members, subordinates. Staffs of the sponsor pharmaceuticals company that directly related to the study; Females who are pregnant or breastfeeding. Inability to take oral medication, or any uncontrolled gastrointestinal condition (e.g., active gastroenteritis, chronic diarrhea, known diverticulosis, history of gastrectomy or gastric banding) that might impair the bioavailability of study drug. gastroesophageal reflux disease treated with proton pump inhibitors is eligible(should be no drug interaction); Use of known median or potent CYP3A4 or CYP3A5 inducers/inhibitors or P-gp inhibitors. Any other major illness that, in the investigator's judgment, will substantially increase the risk associated with the subject's participation in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Weiwei Wang, MD
Phone
+86-021-68868570
Email
weiwei.wang@hengrui.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jun Zhu, MD
Facility Information:
Facility Name
Beijing Cancer Hospital, Peking University
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lin Shen, M.D

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
35772429
Citation
Song Y, Liu Y, Li ZM, Li L, Su H, Jin Z, Zuo X, Wu J, Zhou H, Li K, He C, Zhou J, Qi J, Hao S, Cai Z, Li Y, Wang W, Zhang X, Zou J, Zhu J. SHR2554, an EZH2 inhibitor, in relapsed or refractory mature lymphoid neoplasms: a first-in-human, dose-escalation, dose-expansion, and clinical expansion phase 1 trial. Lancet Haematol. 2022 Jul;9(7):e493-e503. doi: 10.1016/S2352-3026(22)00134-X.
Results Reference
derived

Learn more about this trial

A Phase 1 Study of SHR2554 in Subjects With Relapsed or Refractory Mature Lymphoid Neoplasms

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