Een studie van CA-4948 bij patiënten met recidiverende of refractaire hematologische maligniteiten
TakeAim-lymfoom: een open-label onderzoek naar dosisescalatie en dosisuitbreiding ter evaluatie van de veiligheid, farmacokinetiek, farmacodynamiek en klinische activiteit van oraal toegediend CA-4948 bij patiënten met recidiverende of refractaire hematologische maligniteiten
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.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 2
- Fase 1
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Ahmed Hamdy, MD
- Telefoonnummer: 617-503-6500
- E-mail: clinicaltrials@curis.com
Studie Locaties
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Bordeaux, Frankrijk
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- Institut Bergonie
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Marseille, Frankrijk
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- Hopital de la Timone
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Paris, Frankrijk
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- Hospital Pitie Salpetriere
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Paris, Frankrijk
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- Institut Curie Hospital
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Beersheba, Israël
- Werving
- Hematology Department Soroka UMC / Heanatology Department
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Haifa, Israël
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- Rambam Medical Center
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Jerusalem, Israël
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- Hadassah Medical Center / Ein-Carem
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Cuneo, Italië
- Werving
- Università di Torino Croce e Carle
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Florence, Italië
- Werving
- SODc Ematologia Azienda Ospedaliera Universitaria Careggi
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Meldola, Italië
- Werving
- IRST - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
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Milan, Italië
- Werving
- IRCCS San Raffaele Scientific Institute
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Gdansk, Polen
- Werving
- Uniwersyteckie Centrum Kliniczne Osrodek Badan Klinicznych Wczesnych Faz
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Krakow, Polen
- Ingetrokken
- Oddzial Kliniczny Hematologii
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Warsaw, Polen
- Werving
- NarodowyInstytutu Onkologii im. Marii Sklodowskiej-Curie-Panstwowy Instytutu Badawczy
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Barcelona, Spanje
- Werving
- University Hospital Vall d'Hebron
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Madrid, Spanje
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- MD Anderson Cancer Center Madrid
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Seville, Spanje
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- Hospital Universitario Virgen del Rocio
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Prague, Tsjechië
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- Všeobecná fakultní nemocnice v Praze
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Arizona
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Phoenix, Arizona, Verenigde Staten, 85013
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- St. Joseph's Hospital and Medical Center
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Phoenix, Arizona, Verenigde Staten, 85054
- Voltooid
- Mayo Clinic
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California
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Duarte, California, Verenigde Staten, 91010
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- City of Hope
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Santa Monica, California, Verenigde Staten, 90404
- Werving
- Providence St. John's Health Center
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Santa Monica, California, Verenigde Staten, 90404
- Ingetrokken
- UCLA Department of Medicine - Hematology/Oncology
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Connecticut
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New Haven, Connecticut, Verenigde Staten, 06510
- Voltooid
- Smilow Cancer Hospital at Yale-New Haven
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Florida
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Jacksonville, Florida, Verenigde Staten, 32224
- Werving
- Mayo Clinic
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Illinois
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Chicago, Illinois, Verenigde Staten, 60611
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- Northwestern Memorial Hospital
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02215
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- Dana Farber Cancer Institute
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Minnesota
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Rochester, Minnesota, Verenigde Staten, 55905
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- Mayo Clinic
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68198
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- Fred and Pamela Buffett Cancer Center
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New Jersey
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Hackensack, New Jersey, Verenigde Staten, 07601
- Voltooid
- Hackensack University Medical Center
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New York
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Buffalo, New York, Verenigde Staten, 14263
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- Roswell Park Comprehensive Cancer Center
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New York, New York, Verenigde Staten, 10065
- Werving
- Memorial Sloan Kettering Cancer Center
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New York, New York, Verenigde Staten, 10032
- Ingetrokken
- Columbia University Irving Medical Center
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New York, New York, Verenigde Staten, 10029
- Werving
- Mt Sinai
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North Carolina
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Durham, North Carolina, Verenigde Staten, 27710
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- Duke University Medical Center, Duke Cancer Center
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Ohio
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Cleveland, Ohio, Verenigde Staten, 44195
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- Cleveland Clinic
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Oregon
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Portland, Oregon, Verenigde Staten, 97225
- Werving
- Providence Neurological Specialties West
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Pennsylvania
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Philadelphia, Pennsylvania, Verenigde Staten, 19104
- Voltooid
- Hospital of the University of Pennsylvania
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Pittsburgh, Pennsylvania, Verenigde Staten, 15232
- Werving
- UPMC Hilman Cancer Center
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Tennessee
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Knoxville, Tennessee, Verenigde Staten, 37920
- Voltooid
- University of Tennessee Medical Center
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Texas
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Dallas, Texas, Verenigde Staten, 75235
- Actief, niet wervend
- UT Southwestern Medical Center
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Houston, Texas, Verenigde Staten, 77030
- Werving
- The University of Texas MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Verenigde Staten, 84112
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- Huntsman Cancer Institute, University of Utah
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Washington
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Seattle, Washington, Verenigde Staten, 98195
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- University of Washington Medical Center
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Seattle, Washington, Verenigde Staten, 98104
- Voltooid
- Swedish Cancer Institute
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Sequentiële toewijzing
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
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Experimenteel: 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.
Andere namen:
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Experimenteel: 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.
Andere namen:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
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Experimenteel: 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.
Andere namen:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
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Experimenteel: 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.
Andere namen:
Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Deel B: Algemeen responspercentage (ORR) bij deelnemers met R/R PCNSL
Tijdsspanne: 18 maanden
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18 maanden
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Deel C: ORR bij deelnemers met R/R PCNSL
Tijdsspanne: 18 maanden
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18 maanden
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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)
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by AUC
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 24- 66 months
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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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 24 - 66 months
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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
Tijdsspanne: 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
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
- Ziekten van het immuunsysteem
- Neoplasmata
- Lymfoom
- NHL
- Lymfoom, non-Hodgkin
- Ibrutinib
- Lymfoproliferatieve aandoeningen
- Immunoproliferatieve aandoeningen
- Lymfatische ziekten
- PCNSL
- Primair CZS-lymfoom
- IRAK4
- MYD88
- Recidiverend/refractair lymfoom van het centraal zenuwstelsel (CZS).
- Systemisch lymfoom met gelijktijdig CZS-lymfoom
- Systemisch lymfoom met een geschiedenis van behandeld CZS-lymfoom
- Bruton tyrosinekinaseremmer (BTKI)
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Neoplasmata per site
- Ziekte attributen
- Neoplasmata per histologisch type
- Hematologische ziekten
- Pathologische aandoeningen, tekenen en symptomen
- Hemische en lymfatische ziekten
- Neoplasmata
- Herhaling
- Hematologische neoplasmata
- Lymfoom
- Lymfoom, non-Hodgkin
- Lymfoproliferatieve aandoeningen
- Ziekten van het immuunsysteem
- Lymfatische ziekten
- Immunoproliferatieve aandoeningen
- Ibrutinib
- CA-4948
Andere studie-ID-nummers
Andere studie-ID-nummers
- CA-4948-101
- 2024-513312-95-00 (Ctis)
- 2022-000891-20 (EudraCT-nummer)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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