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Silmitasertib (CX-4945) in combinazione con chemioterapia per tumori solidi refrattari recidivanti

5 ottobre 2026 aggiornato da: Giselle Sholler, Milton S. Hershey Medical Center

Studio di fase I/II su silmitasertib (CX-4945) in combinazione con chemioterapia in bambini e giovani adulti con tumori solidi refrattari recidivanti

The purpose of this study is to evaluate the investigational drug, silmitasertib (a pill taken by mouth), in combination with FDA approved drugs for solid tumors. An investigational drug is one that has not been approved by the U.S. Food & Drug Administration (FDA), or any other regulatory authorities around the world for use alone or in combination with any drug, for the condition or illness it is being used to treat.

The goals of this part of the study are:

  • Establish a recommended dose of silmitasertib in combination with chemotherapy
  • Test the safety and tolerability of silmitasertib in combination with chemotherapy in subjects with cancer
  • To determine the activity of study treatments chosen based on:
  • How each subject responds to the study treatment
  • How long a subject lives without their disease returning/progressing

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

104

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

  • Canada
    • Quebec
      • Montreal, Quebec, Canada, QC H3S 2G4
  • Stati Uniti
    • Alabama
      • Birmingham, Alabama, Stati Uniti, 35233
        • Reclutamento
        • University of Alabama/Children's of Alabama
        • Contatto:
        • Investigatore principale:
          • Elizabeth Alva
    • Arizona
      • Phoenix, Arizona, Stati Uniti, 85016
        • Reclutamento
        • Phoenix Children's Hospital
        • Contatto:
        • Investigatore principale:
          • Francis Eshun
    • California
      • Oakland, California, Stati Uniti, 94609
        • Reclutamento
        • UCSF Benioff Children's Hospital Oakland
        • Investigatore principale:
          • Jennifer Michlitsch
        • Contatto:
      • Sacramento, California, Stati Uniti, 95817
        • Reclutamento
        • UC Davis Comprehensive Cancer Center
        • Contatto:
        • Investigatore principale:
          • Marcio Malogolowkin
      • San Diego, California, Stati Uniti, 92123
        • Reclutamento
        • Rady Children's Hospital
        • Contatto:
        • Investigatore principale:
          • William Roberts
    • Connecticut
      • Hartford, Connecticut, Stati Uniti, 06106
    • Florida
      • Gainesville, Florida, Stati Uniti, 32611
        • Reclutamento
        • University of Florida
        • Investigatore principale:
          • Joanne Lagmay
        • Contatto:
      • Miami, Florida, Stati Uniti, 33155
      • Orlando, Florida, Stati Uniti, 32806
        • Reclutamento
        • Arnold Palmer Hospital for Children
        • Contatto:
        • Investigatore principale:
          • Jaime Libes-Bander
      • St. Petersburg, Florida, Stati Uniti, 33701
        • Reclutamento
        • All Children's Hospital Johns Hopkins Medicine
        • Contatto:
        • Investigatore principale:
          • Jennifer Dean
      • Tampa, Florida, Stati Uniti, 33614
        • Reclutamento
        • St. Joseph's Children's Hospital
        • Investigatore principale:
          • Don Eslin
        • Contatto:
    • Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Reclutamento
        • Kapiolani Medical Center for Women and Children
        • Contatto:
        • Investigatore principale:
          • Kelley Hutchins
    • Kentucky
      • Louisville, Kentucky, Stati Uniti, 40202
        • Reclutamento
        • Norton Children's Research Institute/Affiliated with University of Louisville School of Medicine
        • Investigatore principale:
          • Michael Ferguson
        • Contatto:
    • Michigan
      • Detroit, Michigan, Stati Uniti, 48201
        • Reclutamento
        • Children's Hospital of Michigan/Wayne State University
        • Contatto:
        • Investigatore principale:
          • Alissa Martin
    • Missouri
      • Kansas City, Missouri, Stati Uniti, 64108
        • Reclutamento
        • Children's Mercy Hospitals and Clinics
        • Investigatore principale:
          • Kevin Ginn
        • Contatto:
      • St Louis, Missouri, Stati Uniti, 63104
        • Reclutamento
        • Cardinal Glennon Children's Medical Center
        • Investigatore principale:
          • William Ferguson
        • Contatto:
    • New Jersey
      • Hackensack, New Jersey, Stati Uniti, 07601
        • Reclutamento
        • Hackensack University Medical Center
        • Investigatore principale:
          • Katharine Offer
        • Contatto:
    • Pennsylvania
      • Hershey, Pennsylvania, Stati Uniti, 17033
        • Reclutamento
        • Penn State Milton S. Hershey Medical Center and Children's Hospital
        • Contatto:
        • Investigatore principale:
          • Valerie Brown
    • Rhode Island
      • Providence, Rhode Island, Stati Uniti, 02903
        • Reclutamento
        • Hasbro Children's Hospital
        • Investigatore principale:
          • Bradley DeNardo
        • Contatto:
    • Tennessee
      • Nashville, Tennessee, Stati Uniti, 37232
        • Reclutamento
        • Monroe Carrell Jr. Children's Hospital at Vanderbilt
        • Contatto:
        • Investigatore principale:
          • Daniel Benedetti
    • Texas
      • Dallas, Texas, Stati Uniti, 75235
        • Reclutamento
        • Children's Medical Center
        • Investigatore principale:
          • Tanya Watt
        • Contatto:
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84113
        • Reclutamento
        • Primary Children's Hospital
        • Investigatore principale:
          • Matthew Dietz
        • Contatto:
    • Virginia
      • Richmond, Virginia, Stati Uniti, 23284
        • Reclutamento
        • Virginia Commonwealth University
        • Contatto:
        • Investigatore principale:
          • Madhu Gowda

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Non più vecchio di 30 anni (Bambino, Adulto)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Age: Less than 30 years old at initial diagnosis

  2. Pathology All subjects must have a confirmed diagnosis of tumor type. Phase I: Relapsed/refractory solid tumors: Neuroblastoma, Ewing Sarcoma, Osteosarcoma, Rhabdomyosarcoma, Liposarcoma

    Phase II:

    • Relapsed/refractory Neuroblastoma
    • Relapsed/refractory Ewing sarcoma

  3. Tumor assessment:

    Disease assessment is required for eligibility and must be done after last dose of previous therapy and prior to first dose of study drug.

  4. Disease Status:

    Relapsed/Refractory Neuroblastoma Relapsed disease defined as neuroblastoma that was previously in remission after standard therapy (at least 4 cycles of aggressive multi-drug induction chemotherapy, with or without radiation and surgery, followed by immunotherapy, or according to a standard high-risk treatment/neuroblastoma protocol) and has now relapsed and is in any number of relapses.

    Refractory disease defined as High-risk neuroblastoma (as defined by INRG) that failed to achieve CR after at least 4 cycles of aggressive multi-drug induction chemotherapy, progression during upfront therapy or with disease remaining after standard immunotherapy.

    International Neuroblastoma Risk Group Staging System (INRG) High Risk NB defined as one of the following:

    1. Any age with International Neuroblastoma Risk Group (INRG) Stage L2, MS, or M with MYCN amplification
    2. Age ≥ 547 days and INRG Stage M regardless of biologic features
    3. Any age initially diagnosed with INRG Stage L1 MYCN amplified NBL who have progressed to Stage M without systemic chemotherapy
    4. Age ≥ 547 days of age initially diagnosed with INRG Stage L1, L2, or MS who have progressed to Stage M without systemic chemotherapy

    Relapsed/refractory Sarcoma Subjects that have relapsed following standard of care therapy or having progressed during standard of care therapy. Standard of care therapy for sarcoma includes multi-agent chemotherapy with local control consisting of either surgery or radiation therapy.

  5. Measurable or evaluable disease, including at least one of the following:

    • Measurable tumor by CT or MRI
    • MIBG or PET that is positive for disease
    • Bone Marrow biopsy/aspirate that is positive for disease

  6. Timing from prior therapy:

    Subjects must have fully recovered from the acute toxic effects of all prior anti- cancer therapy and be within the following timelines:

    1. Myelosuppressive chemotherapy: Must not have received within 2 weeks of enrollment onto this study.

    2. Small Molecule Inhibitors (anti-neoplastic agent): At least 2 weeks from the completion of therapy with a small molecule inhibitor.

    3. Immunotherapy: At least 4 weeks since the completion of any type of immunotherapy, e.g. tumor vaccines, CAR-T cells, anti-GD2 Monoclonal antibodies (ex. naxitamab, dinutuximab, etc.).

    4. Radiotherapy: At least 30 days since the last treatment except for radiation delivered with palliative intent to a non-target site.

    5. Stem Cell Transplant:

      • Allogeneic: No evidence of active graft vs. host disease
      • Allogeneic/Autologous: ≥ 2 months must have elapsed since transplant.

    6. MIBG Therapy: At least 6 weeks since treatment with MIBG therapy.

  7. Subjects must have a Lansky or Karnofsky Performance Scale score of >/= 50.

  8. Subjects must have adequate organ function at the time of enrollment:

    • Cardiac: Subjects must have a QTcF ≤ 480 msc.
    • Hematological: Hematological recovery as defined by ANC ≥750/μL
    • Liver: Adequate liver function as defined by AST and ALT <5x upper limit of normal
    • Renal: Subjects must have adequate renal function defined as:
    • estimated Glomerular Filtration rate (eGFR) as calculated from the Bedside Schwartz equation (for subjects < 17 years old) (in units of mL/min/1.73 m2) or via radioisotope GFR of ≥ 70 mL/min/1.73 m2. The Bedside Schwartz equation is: [(0.413) X (Height in cm)] / SCr
    • estimated Glomerular Filtration rate (eGFR) as calculated from the Cockcroft and Gault formula (for subjects ≥17 years old (in units of mL/min/1.73 m2) or via radioisotope GFR of ≥ 70 mL/min/1.73 m2. The Cockcroft and Gault formula is: [(140-age) x (Wt in kg) x (0.85 if female)] / (72 x SCr)
    • OR a 24 hour urine Creatinine clearance ≥ 70 mL/min/1.73 m2

  9. Subjects of childbearing potential must have a negative serum pregnancy test. Subjects of childbearing potential must agree to use effective measures to avoid pregnancy.

  10. Written informed consent in accordance with institutional and FDA guidelines must be obtained from all subjects (or subjects' legal representative).

Exclusion Criteria:

  1. Investigational Drugs: Subjects who are currently receiving another investigational drug are excluded from participation.

  2. Anti-cancer Agents: Subjects who are currently receiving other anticancer agents are not eligible. Subjects must have fully recovered from the hematological and bone marrow suppression effects of prior therapy.

  3. Subjects who are currently receiving Vitamin K antagonists (warfarin).

  4. Subjects who are currently receiving the class of lipid-lowering medications HMG-CoA reductase inhibitors (statins).

  5. Infection: Subjects who have an uncontrolled infection are not eligible until the infection is judged to be well controlled in the opinion of the investigator.

  6. Subjects who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study, or in whom compliance is likely to be suboptimal, should be excluded.

  7. Subjects with any clinically significant unrelated systemic illness (serious infections or significant cardiac, pulmonary, hepatic or other organ dysfunction), that in the opinion of the investigator would compromise the subject's ability to tolerate protocol therapy, put them at additional risk for toxicity or would interfere with the study procedures or results.

  8. Subjects with any of the following gastrointestinal disorders:

    1. Active malabsorption (e.g. short gut) syndrome.
    2. Uncontrolled diarrhea (excess of 4 stools/day)
    3. Gastritis, ulcerative colitis, Chron's disease or hemorrhagic coloproctitis
    4. History of gastric or small bowel surgery involving any extent of gastric or small bowel resection

  9. Lactating subjects are not eligible unless they have agreed to not breastfeed their infants. There is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the nursing subject with silmitasertib. (NOTE: breast milk cannot be stored for future use while the nursing subject is being treated on study.)

  10. Subjects with a history of any other malignancy.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione sequenziale
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Phase I- Dose level 1

Silmitasertib 600 mg/m2 twice a day plus Neuroblastoma: Regimen A: Irinotecan and Temozolomide Sarcoma: Regimen B: Vincristine, Irinotecan and Temozolomide
Droga: Silmitasertib

Capsules

Altri nomi:
  • CX-4945
Droga: Irinotecan

IV

Droga: Temozolomide

Oral or IV

Droga: Vincristine

IV
Sperimentale: Phase I- Dose level 2

Silmitasertib 800 mg/m2 twice a day plus Neuroblastoma: Regimen A: Irinotecan and Temozolomide Sarcoma: Regimen B: Vincristine, Irinotecan and Temozolomide
Droga: Silmitasertib

Capsules

Altri nomi:
  • CX-4945
Droga: Irinotecan

IV

Droga: Temozolomide

Oral or IV

Droga: Vincristine

IV
Sperimentale: Phase II- Relapsed/refractory Neuroblastoma

Silmitasertib RP2D twice a day plus Irinotecan and Temozolomide
Droga: Silmitasertib

Capsules

Altri nomi:
  • CX-4945
Droga: Irinotecan

IV

Droga: Temozolomide

Oral or IV
Sperimentale: Phase II- Relapsed/refractory Ewing sarcoma

Silmitasertib RP2D twice a day plus Vincristine, irinotecan and temozolomide
Droga: Silmitasertib

Capsules

Altri nomi:
  • CX-4945
Droga: Irinotecan

IV

Droga: Temozolomide

Oral or IV

Droga: Vincristine

IV

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Phase I- Number of Participants with Adverse Events as a Measure of Safety and Tolerability
Lasso di tempo: 2 years plus 30 days

To characterize the safety profile of silmitasertib in combination with chemotherapy
2 years plus 30 days
Phase I- Number of Participants with Dose Limiting Toxicities to determine RP2D
Lasso di tempo: 21 days

To determine the Recommended Phase 2 Dose (RP2D) of silmitasertib in combination with chemotherapy
21 days
Phase II- Determine the Overall Response Rate (ORR) of Participants using INRC
Lasso di tempo: 2 years

To evaluate the efficacy of silmitasertib in combination with chemotherapy in 2 disease cohorts, based upon Overall response rate (ORR)
2 years

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Phase I- Determine the Overall Response Rate (ORR) of Participants using INRC
Lasso di tempo: 2 years

To evaluate the efficacy of silmitasertib in combination with chemotherapy in 2 disease cohorts based upon Overall response rate (ORR)
2 years
Number of participants with progression free survival (PFS) during study
Lasso di tempo: 2 years

To evaluate the efficacy of silmitasertib in combination with chemotherapy in 2 disease cohorts based upon Progression Free Survival (PFS)
2 years
Phase II- Length of time that participants experience Overall Survival (OS)
Lasso di tempo: 7 years

To evaluate the efficacy of silmitasertib in combination with chemotherapy in 2 disease cohorts based upon Overall Survival (OS)
7 years
Phase II- Number of Participants with Adverse Events as a Measure of Safety and Tolerability
Lasso di tempo: 2 years plus 30 days

To characterize the safety profile of silmitasertib in combination with chemotherapy
2 years plus 30 days
Phase II - Determine the Disease Control Rate (DCR) of participants based on response
Lasso di tempo: 2 years plus 30 days

Disease Control Rate (DCR): Defined as CR + PR + MR + SD for Neuroblastoma (INRC) and CR + PR + SD for Ewing Sarcoma (RECIST v1.1).
2 years plus 30 days

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Milton S. Hershey Medical Center

Investigatori

  • Cattedra di studio: Chandrika Behura, MD, Penn State Health Children's Hospital

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

30 ottobre 2024

Completamento primario (Stimato)

1 novembre 2030

Completamento dello studio (Stimato)

1 novembre 2035

Date di iscrizione allo studio

Primo inviato

2 agosto 2024

Primo inviato che soddisfa i criteri di controllo qualità

2 agosto 2024

Primo Inserito (Effettivo)

7 agosto 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

6 ottobre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

5 ottobre 2026

Ultimo verificato

1 ottobre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • BCC021

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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