Uno studio sul CA-4948 in pazienti con neoplasie ematologiche recidivanti o refrattarie
TakeAim Lymphoma: uno studio in aperto, aumento della dose e espansione della dose che valuta la sicurezza, la farmacocinetica, la farmacodinamica e l'attività clinica del CA-4948 somministrato per via orale in pazienti con neoplasie ematologiche recidivanti o refrattarie
This is a multi-center, open-label study to evaluate the safety, pharmacokinetics (PK), and anti-cancer activity of oral administration of emavusertib alone or in combination with ibrutinib in adult participants with relapsed or refractory (R/R) hematologic malignancies.
This trial will be completed in four parts. In Part A1, emavusertib will be evaluated first in a dose escalating monotherapy setting to establish the safety and tolerability (complete). In Part A2, emavusertib will be evaluated in combination with ibrutinib at 560 milligrams (mg) once daily (QD) or 420 mg QD as indicated by disease (Part A2 complete).
Part B will comprise 2 cohorts to assess safety and efficacy of emavusertib in combination with ibrutinib in participants with R/R primary central nervous system lymphoma (PCNSL) who have directly progressed on a bruton tyrosine kinase inhibitor (BTKi). In this part of the study, emavusertib will be dosed at 100 mg or 200 mg twice daily (BID) in combination with ibrutinib in 28-day treatment cycles.
Part C will comprise 3 treatment arms in the second-line setting to assess the efficacy and safety of emavusertib monotherapy, ibrutinib monotherapy, and emavusertib in combination with ibrutinib in participants with R/R PCNSL who are naïve to BTKi treatment. In this part of the study, eligible second-line participants with R/R PCNSL who are naïve to BTKi treatment will be randomized 1:1:1 to 1 of 3 treatment arms: (1) emavusertib 200 mg BID, (2) ibrutinib 560 mg QD, or (3) emavusertib 200 mg BID in combination with ibrutinib 560 mg QD.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
- Fase 1
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Ahmed Hamdy, MD
- Numero di telefono: 617-503-6500
- Email: clinicaltrials@curis.com
Luoghi di studio
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Prague, Cechia
- Reclutamento
- Všeobecná fakultní nemocnice v Praze
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Bordeaux, Francia
- Reclutamento
- Institut Bergonie
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Marseille, Francia
- Reclutamento
- Hopital de la Timone
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Paris, Francia
- Reclutamento
- Hospital Pitie Salpetriere
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Paris, Francia
- Reclutamento
- Institut Curie Hospital
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Beersheba, Israele
- Reclutamento
- Hematology Department Soroka UMC / Heanatology Department
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Haifa, Israele
- Reclutamento
- Rambam Medical Center
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Jerusalem, Israele
- Reclutamento
- Hadassah Medical Center / Ein-Carem
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Cuneo, Italia
- Reclutamento
- Università di Torino Croce e Carle
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Florence, Italia
- Reclutamento
- SODc Ematologia Azienda Ospedaliera Universitaria Careggi
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Meldola, Italia
- Reclutamento
- IRST - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
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Milan, Italia
- Reclutamento
- IRCCS San Raffaele Scientific Institute
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Gdansk, Polonia
- Reclutamento
- Uniwersyteckie Centrum Kliniczne Osrodek Badan Klinicznych Wczesnych Faz
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Krakow, Polonia
- Ritirato
- Oddzial Kliniczny Hematologii
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Warsaw, Polonia
- Reclutamento
- NarodowyInstytutu Onkologii im. Marii Sklodowskiej-Curie-Panstwowy Instytutu Badawczy
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Barcelona, Spagna
- Reclutamento
- University Hospital Vall d'Hebron
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Madrid, Spagna
- Reclutamento
- MD Anderson Cancer Center Madrid
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Seville, Spagna
- Reclutamento
- Hospital Universitario Virgen del Rocio
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Arizona
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Phoenix, Arizona, Stati Uniti, 85013
- Reclutamento
- St. Joseph's Hospital and Medical Center
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Phoenix, Arizona, Stati Uniti, 85054
- Completato
- Mayo Clinic
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California
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Duarte, California, Stati Uniti, 91010
- Reclutamento
- City of Hope
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Santa Monica, California, Stati Uniti, 90404
- Reclutamento
- Providence St. John's Health Center
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Santa Monica, California, Stati Uniti, 90404
- Ritirato
- UCLA Department of Medicine - Hematology/Oncology
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Connecticut
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New Haven, Connecticut, Stati Uniti, 06510
- Completato
- Smilow Cancer Hospital at Yale-New Haven
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Florida
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Jacksonville, Florida, Stati Uniti, 32224
- Reclutamento
- Mayo Clinic
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Illinois
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Chicago, Illinois, Stati Uniti, 60611
- Reclutamento
- Northwestern Memorial Hospital
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02215
- Reclutamento
- Dana Farber Cancer Institute
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Minnesota
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Rochester, Minnesota, Stati Uniti, 55905
- Reclutamento
- Mayo Clinic
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Nebraska
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Omaha, Nebraska, Stati Uniti, 68198
- Reclutamento
- Fred and Pamela Buffett Cancer Center
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New Jersey
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Hackensack, New Jersey, Stati Uniti, 07601
- Completato
- Hackensack University Medical Center
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New York
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Buffalo, New York, Stati Uniti, 14263
- Reclutamento
- Roswell Park Comprehensive Cancer Center
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New York, New York, Stati Uniti, 10065
- Reclutamento
- Memorial Sloan Kettering Cancer Center
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New York, New York, Stati Uniti, 10032
- Ritirato
- Columbia University Irving Medical Center
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New York, New York, Stati Uniti, 10029
- Reclutamento
- Mt Sinai
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North Carolina
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Durham, North Carolina, Stati Uniti, 27710
- Reclutamento
- Duke University Medical Center, Duke Cancer Center
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Ohio
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Cleveland, Ohio, Stati Uniti, 44195
- Reclutamento
- Cleveland Clinic
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Oregon
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Portland, Oregon, Stati Uniti, 97225
- Reclutamento
- Providence Neurological Specialties West
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Pennsylvania
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Philadelphia, Pennsylvania, Stati Uniti, 19104
- Completato
- Hospital of the University of Pennsylvania
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Pittsburgh, Pennsylvania, Stati Uniti, 15232
- Reclutamento
- UPMC Hilman Cancer Center
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Tennessee
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Knoxville, Tennessee, Stati Uniti, 37920
- Completato
- University of Tennessee Medical Center
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Texas
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Dallas, Texas, Stati Uniti, 75235
- Attivo, non reclutante
- UT Southwestern Medical Center
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Houston, Texas, Stati Uniti, 77030
- Reclutamento
- The University of Texas MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Stati Uniti, 84112
- Reclutamento
- Huntsman Cancer Institute, University of Utah
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Washington
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Seattle, Washington, Stati Uniti, 98195
- Reclutamento
- University of Washington Medical Center
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Seattle, Washington, Stati Uniti, 98104
- Completato
- Swedish Cancer Institute
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
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Males and females greater than or equal to 18 years of age
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Life expectancy of at least 3 months
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Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1 or 2
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Histopathologically confirmed diagnosis of PCNSL (medical record is acceptable). Cerebral biopsies are not required if imaging reveals typical images of PCNSL.
- Participants with parenchymal lesions must have unequivocal evidence of disease progression (e.g., presence of at least 1 measurable target lesion [≥ 10 millimeters (mm) and ≤ 40 mm in the longest diameter on brain magnetic resonance imaging [MRI] or head computed tomography [CT] on imaging within 28 days prior to Cycle 1 Day 1]). In cases where the tumor size is smaller but still measurable and located at a critical central nervous system (CNS) location, disabling the participant and/or causing symptoms, this participant may be eligible following a discussion with the Sponsor Medical Monitor.
- For participants limited to leptomeningeal involvement, cerebrospinal fluid (CSF) analysis (cytology and/or flow cytometry) with or without additional imaging (MRI) of the spine as clinically indicated is required to document abnormal cells within 28 days prior to Cycle 1 Day 1.
Exclusion Criteria for Part B and Part C
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Participants with only intraocular PCNSL without brain lesion or CSF involvement, T-cell lymphoma, systemic presence of lymphoma, or non-CNS lymphoma metastatic to the CNS
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Evidence of systemic lymphoma. This must be demonstrated by a positron emission tomography (PET) scan (or CT scan with contrast if applicable) of the chest, abdomen, and pelvis at Screening (testicular ultrasound may be considered to exclude a testicular lymphoma disseminated to the brain).
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Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) or prior history of systemic lymphoma, unless the participant has been free of the disease for ≥ 3 years.
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Active malignancy other than PCNSL requiring systemic therapy
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Previous BTKi treatment (Part C only).
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History of Grade ≥ 3 rhabdomyolysis without complete recovery
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Requirement for urgent therapy due to uncontrolled tumor mass/edema effects.
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Received external beam radiation therapy to the CNS within 28 days prior to Cycle 1 Day 1.
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Received prior investigational drugs (including treatment in clinical research, unapproved combination products, and new dosage forms) within 28 days or 5 half-lives, whichever is shorter, prior to Cycle 1 Day 1; allogeneic hematopoietic stem cell transplant (HSCT) within 60 days prior to Cycle 1 Day 1; or had clinically significant graft-versus-host disease (GVHD) requiring ongoing up-titration of immunosuppressive medications prior to Screening (with the exception of a BTKi for Part B only).
Note: The use of a stable or tapering dose of immunosuppressive therapy post-HSCT and/or topical steroids for ongoing skin GVHD is permitted with Sponsor Medical Monitor approval
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Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 14 days or 5 half-lives, whichever is shorter, prior to Cycle 1 Day 1 (with the exception of ibrutinib or other BTKi for Part B only, which may be continued until the day before Cycle 1 Day 1)
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Prior history of hypersensitivity or anaphylaxis to emavusertib, ibrutinib or any of their excipients.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione sequenziale
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: Emavusertib (CA-4948) dose escalation
Part A1: Dose-level cohorts with up to approximately 6 participants each will be used to define the Maximum Tolerated Dose (MTD) for emavusertib. |
Emavusertib will be provided as a tablet dosage form to be taken BID.
Altri nomi:
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Sperimentale: Emavusertib (CA-4948) and ibrutinib dose escalation
Part A2: Evaluate escalating dose levels of oral emavusertib in combination with 560 mg QD or 420 mg QD of oral ibrutinib. The starting dose of emavusertib to be used in combination will be 200 mg BID. It is anticipated that 12 to 20 participants at a potential dose level will be required to establish optimal combination dosing. |
Emavusertib will be provided as a tablet dosage form to be taken BID.
Altri nomi:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
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Sperimentale: Emavusertib (CA-4948) and ibrutinib dose expansion
In two Expansion Cohorts (Part B), emavusertib in combination with ibrutinib will be administered in participants with R/R PCNSL who have progressed on a BTKi. In Cohort 1, emavusertib 100 mg BID will be administered with ibrutinib 560 mg QD consecutively in 28-day treatment cycles. In Cohort 2, emavusertib 200 mg BID will be administered with ibrutinib 560 mg QD consecutively in 28-day treatment cycles. |
Emavusertib will be provided as a tablet dosage form to be taken BID.
Altri nomi:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
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Sperimentale: Emavusertib (CA-4948) and ibrutinib
In this part of the study (Part C), eligible second-line participants with R/R PCNSL who are naïve to BTKi treatment will receive 1 of 3 treatment arms: (1) emavusertib 200 mg BID, (2) ibrutinib 560 mg QD, or (3) emavusertib 200 mg BID in combination with ibrutinib 560 mg QD. Treatments will be administered continuously in 28-day treatment cycles. |
Emavusertib will be provided as a tablet dosage form to be taken BID.
Altri nomi:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Parte B: tasso di risposta globale (ORR) nei partecipanti con PCNSL R/R
Lasso di tempo: 18 mesi
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18 mesi
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Parte C: ORR nei partecipanti con R/R PCNSL
Lasso di tempo: 18 mesi
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18 mesi
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Part A: To determine the safety and tolerability of emavusertib as a monotherapy and in combination with ibrutinib: dose-limiting toxicity (DLT)
Lasso di tempo: 12 months
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The number of participants with a dose-limiting toxicity (DLT) in the first treatment cycle |
12 months
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Part A: Maximum tolerated dose (MTD) of emavusertib as a monotherapy and in combination with ibrutinib measured by dose-limiting toxicities (DLTs)
Lasso di tempo: 12 months
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MTD determined by the highest dose level studied at which fewer than 2 out of 6 subjects (<33%) experience a dose limiting toxicity. |
12 months
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Part A: Recommended Phase 2 Dose (RP2D) of emavusertib as a monotherapy and in combination with ibrutinib based on overall tolerability data
Lasso di tempo: 12 months
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RP2D selected based on overall tolerability data from all participants treated at different dose levels and will not exceed the MTD. |
12 months
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by AUC
Lasso di tempo: 24- 66 months
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Area Under the concentration-time curve (AUC) |
24- 66 months
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Cmax
Lasso di tempo: 24- 66 months
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Maximum plasma concentration (Cmax) |
24- 66 months
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Cmin
Lasso di tempo: 24- 66 months
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Minimum plasma concentration (Cmin) |
24- 66 months
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Tmax
Lasso di tempo: 24- 66 months
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Time to maximum plasma concentration (Tmax) |
24- 66 months
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by plasma terminal half-life
Lasso di tempo: 24- 66 months
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Plasma terminal elimination half-life (T 1/2) |
24- 66 months
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Part A: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib measured by ORR
Lasso di tempo: 24- 36 months
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Assessed by ORR |
24- 36 months
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Parts A, B and C: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib and ibrutinib as monotherapy measured by duration of response (DOR)
Lasso di tempo: 24- 66 months
|
Assessed by DOR |
24- 66 months
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Part A: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib measured by disease control rate (DCR)
Lasso di tempo: 24- 36 months
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Assessed by DCR |
24- 36 months
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Parts A, B and C: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib and ibrutinib as monotherapy measured by progression free survival (PFS)
Lasso di tempo: 24- 66 months
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Assessed by PFS |
24- 66 months
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Parts A, B and C: To assess efficacy of emavusertib as a monotherapy, in combination with ibrutinib and ibrutinib as monotherapy measured by overall survival (OS)
Lasso di tempo: 24 - 66 months
|
Assessed by OS |
24 - 66 months
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Parts B and C: To assess the safety and tolerability of emavusertib as monotherapy, ibrutinib as monotherapy and emavusertib in combination with ibrutinib in participants with R/R PCNSL
Lasso di tempo: up to 66 months
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Measured by the number of participants with treatment-emergent adverse events (TEAEs) and treatment-related adverse events |
up to 66 months
|
Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
- Malattie del sistema immunitario
- Neoplasie
- Linfoma
- NHL
- Linfoma non Hodgkin
- Ibrutinib
- Malattie linfoproliferative
- Disturbi immunoproliferativi
- Malattie linfatiche
- PCNSL
- Linfoma primitivo del SNC
- IRAK4
- MYD88
- Linfoma recidivante/refrattario del sistema nervoso centrale (SNC).
- Linfoma sistemico con concomitante linfoma del sistema nervoso centrale
- Linfoma sistemico con una storia di linfoma del sistema nervoso centrale trattato
- Bruton tirosina chinasi inibitore (BTKI)
Termini MeSH pertinenti aggiuntivi
- Processi patologici
- Neoplasie per sede
- Attributi della malattia
- Neoplasie per tipo istologico
- Malattie ematologiche
- Condizioni patologiche, segni e sintomi
- Malattie emiche e linfatiche
- Neoplasie
- Ricorrenza
- Neoplasie ematologiche
- Linfoma
- Linfoma non Hodgkin
- Malattie linfoproliferative
- Malattie del sistema immunitario
- Malattie linfatiche
- Disturbi immunoproliferativi
- Ibrutinib
- CA-4948
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CA-4948-101
- 2024-513312-95-00 (Ctis)
- 2022-000891-20 (Numero EudraCT)
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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