- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05131022
A Study of NX-5948 in Adults With Relapsed/Refractory B-cell Malignancies
A Phase 1, Dose Escalation, and Cohort Expansion Study Evaluating NX-5948, a Bruton's Tyrosine Kinase (BTK) Degrader, in Adults With Relapsed/Refractory B-cell Malignancies
Study Overview
Status
Conditions
- Chronic Lymphocytic Leukemia (CLL)
- Small Lymphocytic Lymphoma (SLL)
- Mantle Cell Lymphoma (MCL)
- Follicular Lymphoma (FL)
- Primary Central Nervous System Lymphoma (PCNSL)
- Marginal Zone Lymphoma (MZL)
- Waldenstrom Macroglobulinemia (WM)
- Diffuse Large B Cell Lymphoma (DLBCL)
- Secondary Central Nervous System Lymphoma (SCNSL)
Intervention / Treatment
Detailed Description
Phase 1a is a dose escalation to evaluate the safety and tolerability of NX-5948 in adult patients with relapsed/refractory (R/R) B cell malignancies who have received at least 2 prior lines of therapy, or at least 1 prior line of therapy for Primary Central Nervous System Lymphoma (PCNSL), and for whom no other therapies are known to provide clinical benefit. Indications include: Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL), Diffuse Large B-cell Lymphoma (DLBCL), Mantle Cell Lymphoma (MCL), Waldenstrom Macroglobulinemia (WM), Marginal Zone Lymphoma (MZL), Follicular Lymphoma (FL), Primary Central Nervous System Lymphoma (PCNSL) or any of the above indications with disease in the central nervous system or Secondary Central Nervous System Lymphoma (SCNSL).
Phase 1b Part 1, called safety expansion, investigates the safety and anti-tumor activity of NX-5948 at the dose(s) selected in Phase 1a in up to 17 expansion cohorts of patients with histologically confirmed B-cell malignancy indications who have received specified prior therapies based on indication:
- CLL or SLL (patients may be randomized to one of two dose levels investigated for CLL/SLL until an optimal dose is selected)
- MCL
- MZL
- WM
- DLBCL
- FL
- PCNSL/SCNSL
Phase 1b Part 2, called cohort expansion, will further investigate the anti-tumor activity of NX-5948 at the dose(s) selected in Phase 1b par 1 in one additional expansion arm of CLL/SLL patients.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Additional Site Contact Information
- Phone Number: +1 (415) 417-3418
- Email: clinicaltrials@nurixtx.com
Study Locations
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Angers, France, 49933
- Recruiting
- CHU Angers
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Bobigny, France, 93009
- Recruiting
- Hôpital Avicenne
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Nantes, France, 44093
- Recruiting
- CHU de Nantes
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Pessac, France, 33604
- Recruiting
- CHU Bordeaux
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Poitiers, France, 86021
- Recruiting
- CHU De Poitiers
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Saint-Cloud, France, 92210
- Recruiting
- Institut Curie-Site Saint-Cloud
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Vandœuvre-lès-Nancy, France, 54500
- Recruiting
- CHRU de NANCY
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Bologna, Italy, 40138
- Withdrawn
- IRCCS - AOU di Bologna
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Brescia, Italy, 25123
- Withdrawn
- ASST Spedali Civili Brescia
-
Milan, Italy, 20132
- Recruiting
- IRCCS Ospedale San Raffaele
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Milan, Italy, 20132
- Recruiting
- IRCCS Ospedale San Raffaele - Università Vita-Salute San Raffaele di Milano
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Rome, Italy, 00168
- Recruiting
- Fondazione Policlinico Universitario A. Gemelli IRCCS
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Groningen, Netherlands, 9713 GZ
- Withdrawn
- University Medical Center Groningen
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Nijmegen, Netherlands, 6525 GA
- Recruiting
- Radboud University Medical Center
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Rotterdam, Netherlands, 3015 GD
- Recruiting
- Erasmus MC
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Utrecht, Netherlands, 3584 CX
- Recruiting
- University Medical Center Utrecht
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Lublin, Poland, 20-090
- Recruiting
- Medical University of Lublin
-
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Greater Poland Voivodeship
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Skórzewo, Greater Poland Voivodeship, Poland, 60-185
- Recruiting
- AidPort sp. Zo.o
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Lesser Poland Voivodeship
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Krakow, Lesser Poland Voivodeship, Poland, 30-272
- Recruiting
- Pratia MCM
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Lower Silesian Voivodeship
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Wroclaw, Lower Silesian Voivodeship, Poland, 50-367
- Recruiting
- University Clinical Hostpital in Wroclaw
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Masovian Voivodeship
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Warsaw, Masovian Voivodeship, Poland, 02-172
- Recruiting
- Pratia MTZ
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Warsaw, Masovian Voivodeship, Poland, 02-781
- Recruiting
- National Institute of Oncology Warszawa
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Silesian Voivodeship
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Katowice, Silesian Voivodeship, Poland, 40-519
- Recruiting
- Pratia Onkologia Katowice
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Barcelona, Spain, 08035
- Recruiting
- Hospital Universitari Vall d'Hebron
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Barcelona, Spain, 08036
- Recruiting
- Hospital Clinic de Barcelona
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Gijón, Spain, 33203
- Recruiting
- Hospital Universitario de Cabueñes
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Madrid, Spain, 28034
- Recruiting
- Hospital Ramon y Cajal
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Madrid, Spain, 28040
- Recruiting
- Hospital Fundación Jimenez Díaz - START Madrid
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Basel, Switzerland, 4031
- Recruiting
- Universitatsspital Basel
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Bellinzona, Switzerland
- Recruiting
- Istituto Oncologico della Svizzera Italiana
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Bern, Switzerland, 3010
- Recruiting
- Inselspital - Universitatsklinik Bern
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Geneva, Switzerland, 1205
- Recruiting
- Hôpitaux Universitaires de Genève
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Sankt Gallen, Switzerland, 9007
- Recruiting
- Kantonsspital St.Gallen
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Zurich, Switzerland, 8091
- Recruiting
- University Hospital Zurich
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Leeds, United Kingdom, LS9 7TF
- Recruiting
- St. James Hospital
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Liverpool, United Kingdom, L7 8YA
- Recruiting
- Clatterbridge Cancer Center NHS Foundation Trust
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London, United Kingdom, W1G 6AD
- Recruiting
- Sarah Cannon Research Institute UK
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London, United Kingdom, EC1A 7BE
- Recruiting
- St. Bartholomew's Hospital, Barts NHS Trust
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Manchester, United Kingdom, M20 4BX
- Recruiting
- The Christie Nhs Foundation Trust
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Oxford, United Kingdom, OX3 7LE
- Recruiting
- Oxford University Hospitals NHS Foundation Trust
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Plymouth, United Kingdom, PL6 8DH
- Recruiting
- University Hospitals Plymouth NHS Trust
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Southampton, United Kingdom, SO16 6YD
- Recruiting
- University Hospital Southampton NHS Foundation Trust
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Sutton, United Kingdom, SM2 5PT
- Recruiting
- Royal Marsden NHS Foundation Trust
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Scotland
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Glasgow, Scotland, United Kingdom, G12 0YN
- Recruiting
- The Beatson WOS Cancer Center
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Contact:
- Pam McKay
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California
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Duarte, California, United States, 91010
- Recruiting
- City of Hope
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San Francisco, California, United States, 94143
- Recruiting
- University of California, San Francisco
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Contact:
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Colorado
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Denver, Colorado, United States, 80218
- Recruiting
- Colorado Blood Cancer Institute
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Connecticut
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New Haven, Connecticut, United States, 06510
- Recruiting
- Yale Cancer Center
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Florida
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Miami, Florida, United States, 33136
- Recruiting
- University of Miami
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Sarasota, Florida, United States, 34232
- Recruiting
- Florida Cancer Specialists
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Georgia
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Atlanta, Georgia, United States, 30322
- Recruiting
- Winship Cancer Institute of Emory University
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Illinois
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Chicago, Illinois, United States, 60611
- Recruiting
- Northwestern University
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Maryland
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Bethesda, Maryland, United States, 20814
- Recruiting
- National Institute of Health
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New York
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Ithaca, New York, United States, 14850
- Withdrawn
- Cayuga Medical Center
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New York, New York, United States, 10065
- Active, not recruiting
- Memorial Sloan Kettering Cancer Center
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North Carolina
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Durham, North Carolina, United States, 27705
- Recruiting
- Duke University Medical Center
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Ohio
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Cincinnati, Ohio, United States, 45219
- Recruiting
- University of Cincinnati Medical Center
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Cleveland, Ohio, United States, 44195
- Recruiting
- Cleveland Clinic
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania, Abramson Cancer Center
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Texas
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Houston, Texas, United States, 77030
- Recruiting
- MD Anderson Cancer Center
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Contact:
- Ana Ayala
- Phone Number: 713-792-4254
- Email: abayala@mdanderson.org
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Utah
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Salt Lake City, Utah, United States, 84112
- Withdrawn
- Huntsman Cancer Institute
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
- Recruiting
- Medical College of Wisconsin
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Key Inclusion Criteria:
- Age ≥18 years
- Patients in Phase 1a (Dose Escalation) must have histologically confirmed R/R CLL, SLL, DLBCL (subgroups include Richter-transformed DLBCL, germinal center B-cell type, activated B-cell type, high-grade B-cell lymphoma with MYC and BCL-2 and/or BCL-6 rearrangements, high-grade B-cell lymphomas NOS), FL, MCL, MZL (subtypes include EMZL, MALT, NMZL, SMZL), WM, or PCNSL.
Patients in Phase 1a must meet the following:
o For non-PCNSL indications, received at least 2 prior lines of therapy and have no other available therapies known to provide clinical benefit. For PCNSL, received at least 1 prior line of therapy
- Patients in Phase 1b (Safety and Cohort Expansion) must have 1 of the following histologically documented B-cell malignancies, must meet criteria for systemic treatment, and must have received prior therapies and/or molecular features based on details described for each cohort: CLL or SLL, DLBCL, MCL, FL, MZL, WM, or PCNSL/SCNSL.
- Measurable disease per response criteria specific to the malignancy.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (0-2 for patients with PCNSL and secondary CNS involvement).
- Adequate organ and bone marrow function
Key Exclusion Criteria:
- Known or suspected active prolymphocytic leukemia or Richter's transformation to Hodgkin's lymphoma prior to study enrollment
Prior treatment for the indication under study for anti-cancer intent that includes:
- Radiotherapy within 2 weeks of planned start of study drug (excluding limited palliative radiation).
- Prior systemic chemotherapy within 2 weeks of planned start of study drug.
- Prior monoclonal antibody therapy within 4 weeks of planned start of study drug, except for patients enrolling in Cohort 16 (CLL with secondary wAIHA) where a 16-week washout period is required.
- Prior small molecule therapy within 2 weeks or 5 half-lives (whichever is shorter) of planned start of study drug.
- Autologous or allogeneic stem cell transplant within 100 days prior to planned start of study drug.
- Chimeric antigen receptor (CAR) T-cell therapy within 100 days prior to start of study drug (within 60 days prior to start of study drug for Phase 1b).
- Use of systemic corticosteroids outside of dosing limits described below and within 7 days prior to initiation of study treatment excepting those used as prophylaxis for radio diagnostic contrast. Patients with PCNSL/SCNSL: no greater than 40 mg/day prednisone, or equivalent. Patients with PCNSL/SCNSL using greater than 20 mg/day prednisone, or equivalent, must be clinically stable at that dose for 7 days. All other diagnoses: no greater than 20 mg/day prednisone or equivalent.
- Use of systemic immunosuppressive drugs other than systemic corticosteroids for any medical condition within 60 days prior to first dose of study drug
- Previously treated with a BTK degrader
- Active, uncontrolled autoimmune hemolytic anemia (except for patients enrolling in Cohort 16) or active, uncontrolled autoimmune thrombocytopenia.
Patient has any of the following within 6 months of planned start of study drug:
- Myocardial infarction, unstable angina, unstable symptomatic ischemic heart disease, or placement of a coronary arterial stent
- Uncontrolled atrial fibrillation or other clinically significant arrhythmias, conduction abnormalities, or New York Heart Association (NYHA) class III or IV heart failure
- Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, or symptomatic cerebrovascular events), stroke, or intracranial hemorrhage
- Any other significant cardiac condition (e.g., pericardial effusion, restrictive cardiomyopathy, severe untreated valvular stenosis, severe congenital heart disease, or persistent uncontrolled hypertension defined as systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg despite optimal medical management)
- Bleeding diathesis, or other known risk for acute blood loss.
- History of Grade ≥ 2 hemorrhage within 28 days of planned start of study drug.
- Active known concurrent malignancy or malignancy other than the one under study within the past 3 years. (Exceptions include, but are not limited to, patients with more recent history of basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix or breast may enroll if they have undergone curative therapy and have no evidence of disease).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Phase 1a Dose Escalation
Multiple dose levels of NX-5948 to be evaluated; determination of Maximum Tolerated Dose/Phase 1b recommended dose(s)
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 1 in CLL or SLL with prior BTKi and BCL2i
CLL or SLL with prior exposure to both a Bruton's tyrosine kinase inhibitor (BTKi) and BCL-2 inhibitor, unless previously deemed ineligible for a BCL-2i.
Patients enrolled in CLL/SLL arm will be randomized to one of two dose levels.
|
Oral NX-5948
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|
Experimental: Phase 1b Part 1 Cohort 2 in CLL/SLL with non-C481S BTK mutations
Prior exposure to both BTKi and BCL-2i (unless deemed ineligible for BCL-2i by Investigator at the time of study enrollment) and documented BTK mutation other than C481S within 6 months prior to study entry
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 6 in MCL
Non-blastoid MCL with prior exposure to a BTKi and an anti-CD20 monoclonal antibody (mAb)-based chemoimmunotherapy regimen
|
Oral NX-5948
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Experimental: Phase 1b Part 1 Cohort 7 in MZL
MZL (EMZL, MALT, NMZL, SMZL) with prior exposure to an anti-CD20 mAb-based chemo-immunotherapy regimen and an additional line of therapy
|
Oral NX-5948
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Experimental: Phase 1b Part 1 Cohort 8 in WM (3L+)
WM with prior exposure to a BTKi and at least an additional line of therapy
|
Oral NX-5948
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Experimental: Phase 1b Part 1 Cohort 9 in WM (2L)
WM following upfront therapy with a BTKi
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Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 10 in DLBCL
DLBCL which transformed from indolent lymphoma or Richters transformation with prior exposure to an anthracycline (unless previously deemed ineligible to receive), an anti-CD20 mAb-based chemoimmunotherapy regimen, and an additional line of therapy
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 11 in FL
FL (grade 1-3a) with prior exposure to an anti-CD20 mAb-based chemoimmunotherapy regimen and an additional line of therapy
|
Oral NX-5948
|
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Experimental: Phase 1b Part 1 Cohort 13 in PCNSL
PCNSL following upfront therapy and with no prior exposure to a BTKi (2L).
|
Oral NX-5948
|
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Experimental: Phase 1b Part 2 in CLL or SLL with prior BTKi and BCL-2i
CLL or SLL with prior exposure to both a Bruton's tyrosine kinase inhibitor (BTKi) and BCL-2 inhibitor
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 3 in CLL/SLL with prior non-covalent BTKi
CLL/SLL with prior exposure to ncBTKi and are BCL-2i naïve.
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 4 in CLL/SLL with TP53 or 17p deletion, 2L, prior BTKi
Patients with documented TP53 mutation or 17p deletion and 1 prior line of therapy that included a BTKi and are BCL-2i naïve.
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 5 in CLL/SLL with 2L+, prior BTKi
Patients with at least 1 prior line of therapy that included a BTKi and are BCL-2i naïve.
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 12 in PCNSL/SCNSL
PCNSL following at least 1 prior line of therapy that included a BTKi (2L+) or following 2 or more prior lines of therapy (3L+), or SCNSL patients meeting criteria for a non-CLL/SLL cohort enrolling that disease with secondary CNS involvement of lymphoma
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 14 in first-line WM
Treatment-naïve WM deemed unfit for chemoimmunotherapy
|
Oral NX-5948
|
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Experimental: Phase 1b Part 1 Cohort 15 in BTKi-naive CLL/SLL
First-line (1L) or second-line+ (2L)+ CLL/SLL with no prior exposure to a BTKi
|
Oral NX-5948
|
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Experimental: Phase 1b Part 1 Cohort 16 in CLL/SLL with secondary warm autoimmune hemolytic anemia (wAIHA)
BTKi-exposed R/R CLL or SLL with secondary wAIHA
|
Oral NX-5948
|
|
Experimental: Phase 1b Part 1 Cohort 17 in CLL/SLL with CNS involvement
BTKi-exposed R/R CLL or SLL with CNS involvement
|
Oral NX-5948
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of participants with protocol specified dose-limiting toxicities
Time Frame: Up to 24 months
|
Phase 1a
|
Up to 24 months
|
|
To establish the maximum tolerated dose and/or recommended Phase 1b dose(s)
Time Frame: Up to 24 months
|
Phase 1a
|
Up to 24 months
|
|
To evaluate the anti-tumor activity of NX-5948 in the dose levels selected for Phase 1b safety expansion based on overall response rate (ORR) as assessed by Investigator
Time Frame: Up to 3 years
|
Phase 1b Part 1
|
Up to 3 years
|
|
Number of participants with treatment-emergent adverse events (TEAEs); Grade 3, 4, 5 TEAEs, serious adverse events (SAEs), TEAEs leading to study drug discontinuation, deaths due to TEAEs, and all deaths
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1
|
Up to 6 years
|
|
To further evaluate the anti-tumor activity of NX-5948 in patients with CLL/SLL at the dose identified in Phase 1b Part 1 based on overall response rate (ORR) as assessed by Investigator
Time Frame: Up to 3 years
|
Phase 1b Part 2
|
Up to 3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pharmacokinetic (PK) profile of NX-5948: Maximum Serum Concentration
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2 - Sampling following the first dose, pre- and post-dose at selected cycles and at the end of treatment
|
Up to 6 years
|
|
Pharmacodynamic (PD) profile of NX-5948: Changes from baseline of BTK levels in B-cells
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2 - Sampling at screening, following the first dose, pre and post-dose at selected cycles and at the end of treatment
|
Up to 6 years
|
|
Complete response (CR) rate / CR with incomplete marrow recovery as assessed by the Investigator
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2
|
Up to 6 years
|
|
Duration of response (DOR) as assessed by the Investigator
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2
|
Up to 6 years
|
|
Progression-free survival (PFS) as assessed by the Investigator
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2
|
Up to 6 years
|
|
Time to next therapy
Time Frame: Up to 6 years
|
Phase 1a / Phase 1b Part 1 and Part 2
|
Up to 6 years
|
|
Number of participants with treatment-emergent adverse events (TEAEs); Grade 3, 4, 5 TEAEs, serious adverse events (SAEs), TEAEs leading to study drug discontinuation, deaths due to TEAEs, and all deaths
Time Frame: Up to 3 years
|
Phase 1b Part 2
|
Up to 3 years
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Study Director, Nurix Therapeutics, Inc.
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Neoplasms
- Chronic Disease
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Hematologic Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Leukemia, B-Cell
- Lymphoma, B-Cell
- Neoplasms, Plasma Cell
- Hemostatic Disorders
- Paraproteinemias
- Blood Protein Disorders
- Hemorrhagic Disorders
- Leukemia, Lymphoid
- Leukemia
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Lymphoma
- Lymphoma, Large B-Cell, Diffuse
- Leukemia, Lymphocytic, Chronic, B-Cell
- Lymphoma, Follicular
- Lymphoma, Mantle-Cell
- Waldenstrom Macroglobulinemia
- Lymphoma, B-Cell, Marginal Zone
Other Study ID Numbers
- NX-5948-301
- 2023-510541-25-00 (Ctis)
- 2021-003125-29 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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