Platform Research for Innovative Medicines in NF2-SWN (PRIME-NF2) (PRIME-NF2)
This is an adaptive platform-basket trial that aims to evaluate the safety and efficacy of multiple novel agents and combination therapies in patients with NF2-related schwannomatosis (NF2-SWN). The study employs a basket design to assess treatment responses across four tumor types commonly associated with NF2-SWN: vestibular schwannomas, non-vestibular schwannomas, meningiomas, and ependymomas.
A shared natural history observational cohort, receiving routine clinical follow-up without investigational treatment, serves as a common control for all substudies. The adaptive platform enables the dynamic addition or closure of substudies based on interim analyses, thereby optimizing trial efficiency.
Eligible patients who meet the master protocol criteria and satisfy substudy-specific safety requirements will be assigned to receive the corresponding intervention. Currently open substudies include:
- Substudy A: Selumetinib
- Substudy B: Luvometinib plus Serplulimab
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
This is an investigator-initiated, prospective, multicenter, adaptive platform-basket clinical trial designed to evaluate the safety and efficacy of multiple therapies in patients with NF2-related schwannomatosis (NF2-SWN). The study includes four tumor baskets: vestibular schwannoma, meningioma, non-vestibular schwannoma, and ependymoma.
MASTER STUDY All patients with a confirmed diagnosis of NF2-SWN who provide written informed consent will be enrolled in the master study and enter the natural history observational cohort. Patients who meet eligibility criteria for one or more active substudies may be assigned to a corresponding treatment arm. When multiple treatment arms are open, allocation will follow a predefined randomization scheme. When only one treatment arm is available, eligible patients may be enrolled directly into that substudy. Patients not eligible for any active intervention will remain in the master study cohort for standardized follow-up.
Patients who experience progression of the target tumor during substudy treatment may be considered for enrollment into another active treatment arm if eligibility criteria are met. Patients who are not eligible for any active substudy will return to the master study observational cohort. Data collected during follow-up may serve as shared control data across the platform.
Patients in the observational cohort will undergo standardized follow-up assessments every 12 months until study completion or voluntary withdrawal. Patients receiving treatment within a substudy will undergo efficacy and safety assessments approximately every 3 months according to the corresponding substudy protocol. The master study plans to enroll at least 200 patients with NF2-SWN, with enrollment continuing over time as eligible patients are identified across participating centers.
SUBSTUDY 1: Selumetinib
- Selumetinib is a selective MEK1/2 inhibitor approved for the treatment of NF1-associated plexiform neurofibromas. It inhibits tumor growth through blockade of the RAS/RAF/MEK/ERK signaling pathway.
- This substudy plans to enroll 20 patients, prioritizing those with vestibular schwannoma as the target tumor. Detailed eligibility criteria are provided in the substudy protocol.
SUBSTUDY 2: Luvometinib + Serplulimab
- Luvometinib is a selective oral MEK1/2 inhibitor. Serplulimab is a humanized anti-PD-1 monoclonal antibody that blocks PD-1 signaling and restores T-cell-mediated antitumor immune activity by preventing interaction with PD-L1 and PD-L2.
- This substudy plans to enroll approximately 30 adult patients, prioritizing those with vestibular schwannoma or meningioma as the target tumor. Detailed inclusion and exclusion criteria are described in the substudy protocol.
Each substudy protocol will be incorporated into the master protocol as an appendix. Addition of new substudies requires review and approval by the Data and Safety Monitoring Board (DSMB).
Efficacy will be evaluated using tumor-specific endpoints. For vestibular schwannoma, the primary endpoint is Hearing Response Rate (HRR). For meningioma, non-vestibular schwannoma, and ependymoma, the primary endpoint is radiographic Objective Response Rate (ORR). All efficacy endpoints will undergo blinded central review by an Independent Review Committee (IRC).
The platform is expected to remain active for 5-10 years, or until all active substudies are completed and no additional treatment arms are planned.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ2
連絡先と場所
研究場所
-
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Beijing Municipality
-
Beijing、Beijing Municipality、中国、100853
- Chinese PLA General Hospital
-
コンタクト:
- Jun Zhang, PhD
- 電話番号:86+ 10-68182255
- メール:junzhang301@163.com
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Beijing、Beijing Municipality、中国、100070
- Beijing Tiantan Hospital, Capital Medical University
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コンタクト:
- Pinan Liu, PhD
- 電話番号:86+ 10-59976611
- メール:pinanliu@ccmu.edu.cn
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Beijing、Beijing Municipality、中国、100053
- Xuanwu Hospital, Capital Medical University
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コンタクト:
- Hao Wu, PhD
- 電話番号:+86 10-83922345
- メール:wuhaospine@xwh.ccmu.edu.cn
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Jilin
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Changchun、Jilin、中国、130021
- The First Hospital of Jilin University
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コンタクト:
- Yunqian Li, PhD
- 電話番号:86+ 431-88782222
- メール:yunqian@jlu.edu.cn
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Shanghai Municipality
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Shanghai、Shanghai Municipality、中国、200080
- Shanghai General Hospital
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コンタクト:
- Meiqing Lou, PhD
- 電話番号:+86 21-63846590
- メール:loumq68128@hotmail.com
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-
参加基準
適格基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Eligibility Specific For MASTER STUDY
Inclusion Criteria:
Subjects must satisfy all of the following criteria to be enrolled into the main study natural history observation cohort:
(1) Must meet the 2022 International Consensus Criteria for NF2-SWN, defined by having at least one of the following:
- Bilateral vestibular schwannomas (VS)
- An identical NF2 pathogenic variant in at least 2 anatomically distinct NF2-related tumors (schwannoma, meningioma, and/or ependymoma). (Note: if the variant allele fraction (VAF) in unaffected tissues such as blood is clearly <50%, the diagnosis is mosaic NF2-related schwannomatosis)
- Either 2 major or 1 major and 2 minor criteria as described in the following:
Major criteria:
- Unilateral VS
- First-degree relative other than sibling with NF2-related schwannomatosis
- 2 or more meningiomas (Note: single meningioma qualifies as minor criteria).
- NF2 pathogenic variant in an unaffected tissue such as blood (Note: if the VAF is clearly <50%, the diagnosis is mosaic NF2-related schwannomatosis)
Minor criteria:
Can count >1 of a type (eg, 2 distinct schwannomas would count as 2 minor criteria)
- Ependymoma, meningioma (Note: multiple meningiomas qualify as a major criteria), schwannoma (Note: if the major criterion is unilateral VS, at least 1 schwannoma must be dermal in location) Can count only once (eg, bilateral cortical cataracts count as a single minor criterion)
Juvenile subcapsular or cortical cataract, retinal hamartoma, epiretinal membrane in a person aged <40 years, meningioma
(2) Presence of at least one evaluable lesion: Vestibular schwannoma, meningioma, or non-vestibular schwannoma: clearly identifiable lesion on contrast-enhanced T1-weighted MRI; Ependymoma: clearly identifiable lesion on contrast-enhanced T1-weighted or T2/FLAIR sequences; (3) Expected ability to complete at least 12 months of follow-up assessments; (4) Ability to understand and voluntarily sign a written informed consent form, or a legally authorized guardian signs the informed consent form together ; (5) Sub-study-specific criteria (for intervention arms only): If the subject intends to enter an interventional sub-study, in addition to meeting the above main study criteria, the subject must also satisfy the specific inclusion criteria specified in that sub-study protocol (e.g., organ function, prior treatment restrictions, washout periods, etc.), as determined by the drug characteristics.
Exclusion Criteria:
Subjects meeting any of the following criteria will not be permitted to enter the main study:
- Coexisting other genetic syndromes that may cause multiple intracranial tumors (e.g., SMARCB1/LZTR1-related schwannomatosis, Cowden syndrome);
- Expected survival <12 months;
- Presence of severe psychiatric disorders or cognitive impairment that precludes cooperation with imaging or hearing assessments;
- Extreme social or geographic factors that, in the investigator's judgment, may impede follow-up for more than 12 months;
- Sub-study-specific exclusion criteria (for intervention arms only): If the subject intends to enter an interventional sub-study, the subject must also satisfy the specific exclusion criteria specified in that sub-study protocol (e.g., specific organ dysfunction, active infection, pregnancy, etc.).
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Substudy A (Selumetinib)
Subjects will receive selumetinib 25 mg/m² by mouth twice daily (single dose not to exceed 50 mg) for up to 12 cycles (28 days per cycle).
|
Oral twice daily per predetermined dosage per protocol.
他の名前:
|
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実験的:Substudy B (Luvometinib + Serplulimab)
Subjects will receive luvometinib 8 mg by mouth once daily in combination with serplulimab 4.5 mg/kg intravenously every 3 weeks for up to 12 cycles (28 days per cycle).
|
Oral once daily per predetermined dosage per protocol.
他の名前:
Intravenous infusion per predetermined dosage per protocol.
他の名前:
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介入なし:Natural History Cohort
Participants who are not eligible for any active treatment substudy, or who choose not to receive investigational therapy, will remain in the Natural History Observation Arm.
No study intervention will be administered.
Participants will undergo standardized longitudinal clinical, imaging, and outcome assessments according to the master protocol.
Data collected from this arm will be used to characterize the natural history of NF2-related schwannomatosis and will serve as a shared observational comparator for active treatment arms within the platform.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Tumor-Type-Specific Response Rate in NF2-SWN Tumors
時間枠:12 months
|
Vestibular schwannoma: HRR is defined as WRS improvement exceeding the 95% critical difference from baseline; if baseline WRS is <20%, HRR is defined as a PTA decrease of at least 10 dB. Meningioma or non-vestibular schwannoma: ORR is defined as at least a 20% reduction in target tumor volume from baseline. Ependymoma: ORR is defined as at least a 30% reduction in maximum diameter from baseline according to RECIST v1.1. |
12 months
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Incidence of Adverse Events in Interventional Substudies
時間枠:From first dose through 30 days after last dose (or as specified by individual substudy protocols)
|
Percentage of participants receiving active treatment who experience at least one adverse event.
Adverse events will be coded and graded according to NCI CTCAE v5.0.
|
From first dose through 30 days after last dose (or as specified by individual substudy protocols)
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Maximum Severity Grade of Adverse Events in Interventional Substudies
時間枠:12 months
|
Maximum NCI CTCAE v5.0 grade of adverse events experienced by each participant during the reporting period.
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12 months
|
|
Incidence of Serious Adverse Events in Interventional Substudies
時間枠:From first dose through 30 days after last dose.
|
Percentage of participants receiving active treatment who experience at least one serious adverse event.
|
From first dose through 30 days after last dose.
|
|
Incidence of Dose Modifications Due to Adverse Events
時間枠:From first dose through 30 days after last dose.
|
Percentage of participants receiving active treatment who require at least one dose modification due to an adverse event.
|
From first dose through 30 days after last dose.
|
|
Incidence of Treatment Interruptions Due to Adverse Events
時間枠:From first dose through 30 days after last dose.
|
Percentage of participants receiving active treatment who require at least one treatment interruption due to an adverse event.
|
From first dose through 30 days after last dose.
|
|
Incidence of Treatment Discontinuations Due to Adverse Events
時間枠:From first dose through 30 days after last dose.
|
Percentage of participants receiving active treatment who discontinue treatment due to an adverse event.
|
From first dose through 30 days after last dose.
|
その他の成果指標
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change From Baseline in MRI-Based Total Tumor Burden (TTB)
時間枠:12 months
|
TTB will be assessed using serial MRI.
TTB is calculated as the sum of the volumes of all prespecified measurable NF2-SWN-related tumors included in the tumor-burden assessment.
The outcome is the relative percentage change in TTB from baseline to 12 months, based on blinded central radiology review.
|
12 months
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
- 神経系疾患
- 部位別新生物
- 新生物
- 遺伝性疾患、先天性疾患
- 組織型別の新生物
- 神経変性疾患
- 新生物、腺および上皮
- 耳鼻咽喉科疾患
- 神経膠腫
- 新生物、神経上皮
- 神経外胚葉性腫瘍
- 新生物、生殖細胞および胚
- 新生物、神経組織
- 神経系腫瘍
- 遺伝性変性疾患、神経系
- 神経鞘腫瘍
- 腫瘍性症候群、遺伝性
- 神経皮膚症候群
- 末梢神経系腫瘍
- 神経内分泌腫瘍
- 耳の病気
- 耳鼻咽喉科の新生物
- 新生物、血管組織
- 髄膜腫瘍
- 中枢神経系腫瘍
- 脳神経疾患
- 神経腫
- 脳神経腫瘍
- 前庭内耳神経疾患
- 蝸牛後疾患
- 神経線維腫
- 神経鞘腫
- 先天性、遺伝性、および新生児の疾患と異常
- 神経線維腫症
- 髄膜腫
- 上衣腫
- 神経腫、音響
- 神経線維腫症 2
- AZD 6244
その他の研究ID番号
その他の研究ID番号
- HX-A-2026016
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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