CA-4948-101: Open-Label, Dose Escalation and Expansion Trial of Emavusertib (CA-4948) in R/R PCNSL

2024-513312-95-00 Protocol CA-4948-101 Phase I and Phase II (Integrated) - First administration to humans Ongoing, recruiting

Start 30 May 2023 · Status Ongoing, recruiting · 5 EU/EEA countries · 14 sites · Protocol CA-4948-101

Overview

Sponsor-declared trial summary

Phase Phase I and Phase II (Integrated) - First administration to humans
Status Ongoing, recruiting
Participants planned 152
Countries 5
Sites 14

Part B+C. Primary central nervous system lymphoma (PCNSL)

- Part A1+ A2 (Dose Escalation Phase) (Enrollment is Closed) To determine the safety and tolerability, dose-limiting toxicities (DLTs), maximum tolerated dose (MTD), and recommended Phase 2 dose (RP2D) of oral emavusertib as monotherapy and in combination with ibrutinib - Part B (PCNSL Expansion Phase) (Currently Enro…

Key facts

Sponsor
Curis Inc.
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
30 May 2023 → ongoing
Decision date (initial)
2024-07-03
Transition trial
Yes
Low-intervention
No
Rare-disease indication
Yes
Vulnerable population
Yes
Funding sources
Curis, Inc.

External identifiers

EU CT number
2024-513312-95-00
EudraCT number
2022-000891-20
ClinicalTrials.gov
NCT03328078

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Dose response, Therapy, Pharmacokinetic, Pharmacogenetic, Others, Pharmacogenomic, Pharmacodynamic, Safety, Efficacy

- Part A1+ A2 (Dose Escalation Phase) (Enrollment is Closed)
To determine the safety and tolerability, dose-limiting toxicities (DLTs), maximum tolerated dose (MTD), and recommended Phase 2 dose (RP2D) of oral emavusertib as monotherapy and in combination with ibrutinib

- Part B (PCNSL Expansion Phase) (Currently Enrolling)
To assess the anti-cancer activity of emavusertib in combination with ibrutinib in patients with R/R PCNSL

- Part C – PCNSL Contribution of Components (to Inform Contribution of Effect in a BTKi-Naïve Population; Currently Enrolling)
To assess the anti-cancer activity of emavusertib as monotherapy, ibrutinib as monotherapy, and emavusertib in combination with ibrutinib in patients with R/R PCNSL

Secondary objectives 12

  1. Part A2: To assess the pharmacokinetic (PK) profile of emavusertib and ibrutinib
  2. Part A2: To assess overall response rate (ORR) following treatment with emavusertib as monotherapy and in combination with ibrutinib
  3. Part A2: To assess duration of response (DOR) following treatment with emavusertib as monotherapy and in combination with ibrutinib
  4. Part A2: To assess disease control rate (DCR) following treatment with emavusertib as monotherapy and in combination with ibrutinib
  5. Part A2: To assess progression-free survival (PFS) following treatment with emavusertib as monotherapy and in combination with ibrutinib
  6. Part A2: To assess overall survival (OS) following treatment with emavusertib as monotherapy and in combination with ibrutinib
  7. Part B: To further assess the anti-cancer activity of emavusertib in combination with ibrutinib in patients with R/R PCNSL
  8. Part B: To demonstrate the safety and tolerability of emavusertib in combination with ibrutinib in patients with R/R PCNSL
  9. Part B: To assess the exposure profile of emavusertib in combination with ibrutinib in patients with R/R PCNSL
  10. Part C: To further assess the anti-cancer activity of emavusertib as monotherapy, ibrutinib as monotherapy, and emavusertib in combination with ibrutinib in patients with R/R PCNSL
  11. Part C: To demonstrate the safety and tolerability of emavusertib as monotherapy, ibrutinib as monotherapy, and emavusertib in combination with ibrutinib in patients with R/R PCNSL
  12. Part C: To assess the exposure profile of emavusertib as monotherapy, ibrutinib as monotherapy, and emavusertib in combination with ibrutinib in patients with R/R PCNSL

Conditions and MedDRA coding

Part B+C. Primary central nervous system lymphoma (PCNSL)

VersionLevelCodeTermSystem organ class
21.0 LLT 10036685 Primary central nervous system lymphoma 10029104
21.1 LLT 10066481 Hematological malignancy 10029104

Study design 3 periods

#TitleAllocationBlindingRoles blindedArms
1 Part A2
Part A2: Dose escalation of emavusertib (CA-4948) in combination with ibrutinib in patients with relapsed or refractory (RR) hematologic malignancies (enrollment is closed)
2 None Part A2: Emavusertib (CA-4948)+ Ibrutinib
2 Part B
Part B - PCNSL Expansion Cohorts: E mavusertib (CA-4948) in combination with ibrutinib in patients with primary central nervous system lymphoma (PCNSL) who previously failed treatment with BTKi treatment (currently enrolling)
2 None Part B: Emavusertib (CA-4948)+ Ibrutinib
3 Part C
Part C - PCNSL Contribution of Components. (Currently enrolling). Eligible second-line patients with R/R PCNSL who are naïve to BTKi treatment will be randomized 1:1:1 to 1 of 3 treatment arms: (1) emavusertib (CA-4948) , (2) ibrutinib or (3) emavusertib + ibrutinib. Patients enrolled in Treatment Arm 1 (emavusertib monotherapy) or Treatment Arm 2 (ibrutinib monotherapy) may crossover to emavusertib plus ibrutinib combination treatment after documented disease progression as determined by the Investigator based on IPCG Response Criteria guidelines for PCNSL and Investigator review of radiographic image to confirm disease progression after discussion with the Sponsor Medical Monitor.
Randomised Controlled None Part C: Emavusertib (CA-4948) alone OR Ibrutinib alone OR Emavusertib (CA-4948)+ Ibrutinib

Regulatory references

Plan to share IPD
Yes
EU CT numberTitleSponsor
2023-509691-41-00 A Single-Center, Open-Label, Two-Way Crossover Study to Assess the Effect of Food on the Pharmacokinetics of Emavusertib (CA-4948) in Healthy Male Subjects Curis Inc.
2023-505828-58-00 A Phase 1 Single-Arm, Open-Label Study of CA-4948 in Combination with Azacitidine and Venetoclax in Acute Myeloid Leukemia Patients in Complete Response with Measurable Residual Disease Curis Inc.
2024-513313-13-00 A Phase 1/2A, Open Label Dose Escalation and Cohort Expansion Study of Orally Administered CA-4948 (IRAK4i) as a Monotherapy in Patients With Acute Myelogenous Leukemia or Myelodysplastic Syndrome Curis Inc.

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 26

  1. Part A2+B+C. 01. Males and females >= 18 years of age
  2. Part A2. 13. CPK Grade < 2
  3. Part A2. 14. Patients on a cholesterol lowering statin must be on a stable dose with no changes within 3 weeks prior to study start
  4. Part B+C. 08. Acceptable organ function at Screening within 28 days prior to Cycle 1 Day 1 as described below: a. ANC ≥ 1000/µL. b. Platelet count ≥ 75,000/µL without transfusion or ≥ 50,000/µL after prior CAR T-cell treatment. c. Estimated creatinine clearance of ≥ 35 mL/min (Appendix M). d. Hemoglobin ≥ 9.0 g/dL and without red blood cell (RBC) transfusion. e. International normalized ratio (INR) ≤ 1.5 and activated partial thromboplastin time (aPTT) ≤ 1.5× ULN. f. AST and ALT ≤ 2 × ULN. g. Total bilirubin ≤ 1.5 × ULN or ≤ 3 × ULN in patients with documented Gilbert syndrome.
  5. Part B+C. 03. ECOG Performance Status of 0, 1, or 2.
  6. Part B. 05. Relapsed or refractory to a systemic frontline chemotherapy (e.g., high-dose methotrexate-based therapies) AND no more than a total of 3 lines of prior anti-PCNSL therapies (patients with 4 prior lines of therapy may be allowed after consultation with the Sponsor Medical Monitor) AND the following: a. For Cohort 1 as of protocol v11.0, must have direct progression on a BTKi (administered as monotherapy or in combination). b. For Cohort 2, must have direct progression on a BTKi (administered as monotherapy or in combination).
  7. Part B+C. 06. Patients must be able to tolerate gadolinium-enhanced MRI or contrast-enhanced CT if MRI is not possible following a discussion with the Sponsor Medical Monitor.
  8. Part B+C. 11. For patients on corticosteroids, a stable dose of ≤ 8 mg dexamethasone (or equivalent) per day is acceptable.
  9. Part B+C. 15. Ability to understand and willingness to sign a written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants.
  10. Part B+C. 09. CPK < 2.5× ULN
  11. Part A2+B+C. 02. Life expectancy of ≥ 3 months
  12. Part A2. 07. Must have recovered from toxicity after any prior autologous stem cell transplants or CAR-T cell therapy, and must have disease progression prior to initiation of study treatment
  13. Part B+C. 10. For patients on a cholesterol-lowering agent that has been associated with CPK elevations, such as statins or fibrates, the agent should be discontinued or reduced to the lowest dose possible.
  14. Part A2. 03. ECOG Performance Status of ≤ 1
  15. Part A2. 04. Diagnosis of histopathologically confirmed B-cell NHL, as per the WHO 2016 classification (Swerdlow et al. 2016). Eligible NHL subtypes include follicular lymphoma, MZL, MCL, DLBCL (including extranodal lymphomas of leg-, testicular-, or NOS [not otherwise specified]-type), and primary or secondary central nervous system (CNS) lymphoma. NOTE: Once a dose has been shown not to exceed the MTD in NHL patients, other hematological malignancies can be considered for enrollment in specific malignancies that have been approved by the CSC and Sponsor. Patients with MCL or MZL should meet clinical criteria for requiring treatment of their disease.
  16. Part A2. 05. Relapsed or refractory disease (as defined below) for which patients are ineligible for or have exhausted standard therapeutic options that would be considered standard of care. a. Relapsed NHL is per Revised Response Criteria for Malignant Lymphoma and as documented by excisional/incisional biopsy (preferred) or FNA or CNB as PD after a CR, PR, or stable disease. NOTE: For confirmation of documented relapse during prior treatment, biopsy/FNA of the lymphoma at Screening is recommended but not mandatory. b. Refractory NHL is defined for all eligible NHL by PD (per Revised Response Criteria for Malignant Lymphoma) during prior treatment or failure to achieve an objective response on prior treatment. NOTE: Biopsy (preferred) or FNA at Screening is recommended but not mandatory.
  17. Part A2. 06. Measurable disease: Defined as CT scan showing at least 1 clearly demarcated lymph node(s) with a long axis > 1.5 cm and short axis > 1.0 cm or 1 clearly demarcated extranodal lesion(s) with a long axis > 1.0 cm and short axis > 1.0 cm. All lesions must have a maximum diameter of < 10 cm.
  18. Part C 05. Patients must have failed a total of 1 systemic line of prior anti-PCNSL therapy, which must have contained methotrexate.
  19. Part A2. 08. Acceptable marrow and organ function at Screening as described below: a.ANC ≥ 1,000/µL* b.Platelet count ≥ 50,000/µL without transfusion within 1 week prior to start of study treatment* c. SCr ≤ 1.5× ULN or a calculated creatinine clearance ≥ 30 mL/min according to Cockcroft Gault formula (using actual body weight) or by 24-hour urine collection d. AST or ALT ≤ 2× ULN e. Total bilirubin ≤ 1.5× ULN or ≤ 3 × ULN in patients with documented Gilbert’s syndrome *NOTE: For patients with bone marrow involvement of their disease, eligibility will be determined following discussion between Investigator and Sponsor Medical Monitor
  20. Part A2 (10)+ Part B (13)+ Part C (13). Negative serum pregnancy test in WOCP
  21. Part A2 (09) + Part B (12) + Part C (12) . Ability to swallow and retain oral medications
  22. Part B+C. 07 Patients must be able to tolerate lumbar punctures or Ommaya taps.
  23. Part B+C. 16. Any toxicity caused by prior anti-cancer therapies must have recovered to Grade ≤1 with the exception of neurotoxicity and post-transplant cytopenias following a discussion with the Sponsor Medical Monitor.
  24. Part A2 (11)+ Part B (14)+ Part C (14). WOCP and men who partner with a WOCP must agree to use highly effective contraceptive methods for the duration of the study and for 3 months after the last dose of study treatment.
  25. Part A2. 12. Willing and able to provide written informed consent and comply with the requirements of the trial
  26. Part B+C. 04. Histopathologically confirmed diagnosis of PCNSL (medical record is acceptable). Cerebral biopsies are not required if imaging reveals typical images of PCNSL. a. Patients with parenchymal lesions must have unequivocal evidence of disease progression (e.g., presence of at least 1 measurable target lesion [≥ 10 mm and ≤ 40 mm in the longest diameter on brain MRI or head 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 CNS location, disabling the patient and/or causing symptoms, this patient may be eligible following a discussion with the Sponsor Medical Monitor. b. For patients limited to leptomeningeal involvement, 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 39

  1. Part A2. 01. Patients with active CNS involvement other than PCNSL at study entry are ineligible. Patients with prior CNS disease (leptomeningeal disease or brain metastasis) that has been adequately treated (eg, radiation or intravenous or intrathecal chemotherapy) are permitted, but must have completed such treatment and have no evidence of active CNS disease for at least 4 weeks prior to the first dose of study treatment. Intrathecal chemoprophylaxis to prevent the emergence or recurrence of lymphoma in the CNS is permitted on study during dose expansion only and may be administered per institutional guidelines.
  2. Part B+C. 09. 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.
  3. Part B+C. 11. Receiving the following medications within 7 days or 5 half-lives, whichever is shorter, prior to Cycle 1 Day 1: a. Medications which, in the opinion of the Investigator, have a high risk of causing prolonged QTc and/or Torsades de Pointes (Appendix L). b. Peg-filgrastim or equivalent. c. St John’s Wort.
  4. Part A2. 19. Any other severe, acute, or chronic medical, psychiatric, or social condition, or laboratory abnormality that may increase the risk of trial participation or study treatment administration, may interfere with the informed consent process and/or with compliance with the requirements of the trial, or may interfere with the interpretation of the trial results and, in the Investigator’s opinion, would make the patient inappropriate for entry into this trial.
  5. Part B+C. 12. History of stroke or intracranial hemorrhage within 6 months prior to Cycle 1 Day 1. Patients with post-biopsy hemorrhagic sequela defined as a small hyperdense lesion < 3 mm on T2 sequence will not be excluded.
  6. Part B+C. 13. Patients who require anticoagulation with warfarin or equivalent vitamin K antagonists, including dual antiplatelet agents, within 5 half-lives of the anti-coagulant or 7 days, whichever is longer, prior to Cycle 1 Day 1. Low molecular weight heparin is allowed. Patients who require the use of antiplatelet agents should be discussed with the Sponsor Medical Monitor (e.g., use of factor Xa inhibitors).
  7. Part B+C. 14. Vaccinated with live-attenuated vaccines within 4 weeks prior to Cycle 1 Day 1
  8. Part A2. 12. In patients with a history of HBV, hepatitis B core antibody testing is required and if positive, then hepatitis B DNA testing will be performed and if positive the patient will be excluded.
  9. Part B+C. 20. Concomitant illness that would preclude safe participation in the study, including: a. Uncontrolled or severe cardiovascular disease, including myocardial infarction or unstable angina within 6 months prior to Cycle 1 Day 1, New York Heart Association Class II or greater congestive heart failure or left ventricular ejection fraction ≤ 50% by echocardiogram (ECHO) or multigated acquisition (MUGA) scan, serious arrhythmias uncontrolled on treatment, clinically significant pericardial disease, cardiac amyloidosis, or QTcF that is unmeasurable or > 450 msec on Screening ECG. Note: For QTcF > 450 msec on the Screening ECG, the ECG may be repeated twice ≥ 24 hours apart; the mean QTcF from the 3 Screening ECGs must be ≤ 450 msec to meet eligibility for study participation. Patients with bundle branch block and/or ventricular paced rhythms should be reviewed by the Sponsor Medical Monitor for potential inclusion. b. Gastrointestinal disease or disorder that could interfere with swallowing, oral absorption, or tolerance of study treatment. This includes major abdominal surgery and/or significant bowel resection and/or gastrointestinal diseases that could alter the assessment of PK or safety. c. Known bleeding diathesis (e.g., von Willebrand disease) or hemophilia. d. Uncontrolled hypertension or electrolytic imbalance. e. Any other severe, acute, or chronic medical, psychiatric or social condition, or laboratory abnormality that may increase the risk of study participation or study treatment administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of the study results and, in the Investigator's opinion, would make the patient inappropriate for entry into this study.
  10. Part B+C. 15. Prior history of hypersensitivity or anaphylaxis to emavusertib, ibrutinib, or any of their excipients.
  11. Part B+C. 16. Prior history of Stevens Johnson syndrome or toxic epidermal necrolysis
  12. Part A2. 09. Major surgery, other than diagnostic surgery, < 28 days from the start of study treatment; minor surgery < 14 days from the start of study treatment NOTE: Insertion of a vascular access device is not considered minor surgery.
  13. Part B+C. 17. Patient who is intolerant of contrast-enhanced MRI due to allergic reactions to contrast agents
  14. Part B+C. 18. Major surgery < 28 days prior to Cycle 1 Day 1; minor surgery < 7 days prior to Cycle 1 Day 1. Note: Insertion of a vascular access device is not considered surgery
  15. Part B+C. 19. Viral Infections. a. Known to be HIV positive or have an acquired immunodeficiency syndrome (AIDS) related illness. If HIV is undetectable or maintained on treatment, enrollment may be allowed after discussion with the Sponsor Medical Monitor. b. HBV DNA positive or HCV infection < 6 months prior to Cycle 1 Day 1, unless viral load is undetectable, or HCV with cirrhosis. Note: Testing required only in patients with history of HCV < 6 months or history of HBV prior to Cycle 1 Day 1. c. Active systemic infection, including HIV, cytomegalovirus infection, or SARS CoV-2 infection, or has had, within 28 days prior to Cycle 1 Day 1, an infection (other than nail trichophytosis) that requires hospitalization or an intravenous antibiotic.
  16. Part A2. 20. B-cell NHL of the following subtypes: a. Burkitt lymphoma b. Lymphoblastic lymphoma or leukemia c. Post-transplantation lymphoproliferative disorder d. Known primary mediastinal, ocular, or epidural DLBCL
  17. Part B+C. 22. Patients with history of hemophagocytic lymphohistiocytosis (HLH)
  18. Part A2. 13. Uncontrolled or severe cardiovascular disease, including myocardial infarction, unstable angina, or atrial fibrillation within 6 months prior to the start of study treatment; New York Heart Association Class II or greater congestive heart failure; serious arrhythmias requiring medication for treatment; clinically significant pericardial disease; cardiac amyloidosis; or QT interval corrected (QTc) with Fridericia’s correction (QTcF) that is unmeasurable or ≥ 480 msec on Screening ECG. NOTE: For QTcF ≥ 480 msec on the Screening ECG, the ECG may be repeated twice at least 24 hours apart; the mean QTcF from the 3 Screening ECGs must be < 480 msec in order to meet eligibility for trial participation.
  19. Part A2. 14. Gastrointestinal disease or disorder that could interfere with the swallowing, oral absorption, or tolerance of study treatment. This includes uncontrolled diarrhea (> 1 watery stool/day), major abdominal surgery, significant bowel obstruction, and/or gastrointestinal diseases that could alter the assessment of PK or safety, including but not limited to irritable bowel syndrome, ulcerative colitis, Crohn’s disease, and hemorrhagic coloproctitis.
  20. Part A2. 15. History of other invasive malignancy, unless adequately treated with curative intent and with no known active disease present within 2 years prior to the start of study treatment, provided it is deemed to be at low risk for recurrence by the treating physician NOTE: These latter conditions include but are not limited to non-melanoma skin cancer, carcinoma in situ [including superficial bladder cancer and cervical intraepithelial neoplasia], and organ-confined prostate cancer.
  21. Part A2. 16. Concomitant use of drugs with a known risk of causing prolonged QTc and/or Torsades de Pointes or a history of risk factors for Torsades de Pointes (eg, familial long QT syndrome, heart failure, left ventricular hypertrophy). See crediblemeds.org for a list of drugs that may prolong QT by risk category.
  22. Part A2. 10. Known to be human immunodeficiency virus (HIV) positive or have an acquired immunodeficiency syndrome-related illness
  23. Part A2 (17) + Part B and C (21) . Pregnant or lactating
  24. Part A2. 18. Systemic fungal, bacterial, viral, or other infection that is not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment).
  25. Part B+C. 02. 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).
  26. Part C. 05. Previous BTKi treatment (Part C only).
  27. Part A2. 02. Radiotherapy delivered to non-target lesions involving > 25% of bone marrow within 1 week prior to starting study treatment or delivered to target lesions that will be followed on the study NOTE: Prior sites of radiation will be recorded.
  28. Part A2 + Part B +C : - Part A2 (04) Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 14 days prior to the start of study treatment (with the exception of ibrutinib for Parts A2 , which may be continued as part of this study without interruption). - Part B and C (10). Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 21 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).
  29. Part A2. 05. Current or planned glucocorticoid therapy, with the following exceptions: a. Doses ≤ 10 mg/day prednisolone or equivalent is allowed, provided that the steroid dose has been stable or tapering for at least 14 days prior to the first dose of study treatment. b.Inhaled, intranasal, intra-articular, and topical steroids are permitted.
  30. Part A2. 06. Use of any investigational agent within 21 days or 5 half-lives, whichever is shorter, prior to start of study treatment
  31. Part A2. 07. Presence of an acute or chronic toxicity resulting from prior anti-cancer therapy, with the exception of alopecia, that has not resolved to Grade ≤ 1, as determined by NCI CTCAE v4.03, within 7 days prior to the start of study treatment unless approved by the Medical Monitor
  32. Part A2. 08. Known allergy or hypersensitivity to any component of the formulation of emavusertib (or ibrutinib for entry into Parts A2) used in this study
  33. Part A2. 11. Hepatitis B virus (HBV) DNA positive or hepatitis C virus (HCV) infection < 6 months prior to start of study treatment unless viral load is undetectable, or HCV with cirrhosis (NOTE: testing required only in patients with history of HBV or history of HCV < 6 months prior to start of study treatment)
  34. Part B+C. 08. Received external beam radiation therapy to the CNS within 28 days prior to Cycle 1 Day 1.
  35. Part B+C. 01. Patients 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.
  36. Part B+C. 03. 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 patient has been free of the disease for ≥ 3 years.
  37. Part B+C. 04. Active malignancy other than PCNSL requiring systemic therapy
  38. Part B+C. 06. History of Grade ≥ 3 rhabdomyolysis without complete recovery
  39. Part B+C. 07. Requirement for urgent therapy due to uncontrolled tumor mass/edema effects.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 3

  1. Part A1 and Part A2: •Incidence of DLTs •Incidence of adverse events (AEs) •Clinically significant changes in vital signs and laboratory parameters • Clinically significant changes from baseline in electrocardiograms (ECGs)
  2. Part B: ORR: the percentage of patients achieving CR, unconfirmed complete response (CRu), or PR (as determined by an independent review committee [IRC] assessment for Cohort 2 only) using the International Primary CNS Lymphoma Collaborative Group (IPCG) Response Criteria guidelines for PCNSL (Abrey et al, 2005)
  3. Part C: ORR: the percentage of patients achieving CR, CRu, or PR using the IPCG Response Criteria guidelines for PCNSL (Abrey et al, 2005)

Secondary endpoints 9

  1. Part A1 and Part A2: • Maximum observed plasma concentration (Cmax) • Minimum observed plasma concentration (Cmin) • Time after dosing that a drug is present at the maximum concentration in serum (Tmax) • Area under the concentration-time curve (AUC) • Terminal elimination half-life (T1/2)
  2. Part A1 and Part A2: • ORR: complete response (CR) + partial response (PR) • Waldenström macroglobulinemia/ lymphoplasmacytic lymphoma (WM/LPL) ORR: CR + PR + very good partial response (VGPR)
  3. Part A1 and Part A2: • DOR: time from CR or PR to first documentation of relapse, disease progression, or death from any cause • WM/LPL DOR: time from CR, PR, or VGPR to first documentation of relapse, disease progression, or death from any cause
  4. Part A1 and Part A2: • DCR: PR + CR + stable disease • WM/LPL DCR: CR + PR + VGPR + stable disease
  5. Part A1 and Part A2: • PFS: time from date of first dose of study treatment until first documentation of relapse, disease progression, or death from any cause
  6. Part A1 and Part A2: OS: time from date of first dose of study treatment until death from any cause
  7. Part B+C: DOR:the time from the date CR, CRu, or PR is achieved to the date of first documented disease progression (as determined by an IRC assessment for Cohort 2 only) or death due to any cause, whichever occurs first/PFS:the time from the date of the first dose of study treatment to the date of the first documented disease progression (as determined by an IRC assessment for Cohort 2 only) or death due to any cause, whichever occurs first/OS:the time from date of 1st dose until death
  8. Part B+C: Incidence of treatment-emergent adverse events (TEAEs) and treatment-related AEs, physical examinations, vital signs, ECGs, and laboratory values
  9. Part B+C: PK parameters including but not limited to AUC, Cmax, Tmax, and T1/2 for emavusertib and ibrutinib

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 2

Ibrutinib

SUB120863 · Substance

Active substance
Ibrutinib
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Study specif labeling

CA-4948

PRD7988755 · Product

Active substance
Emavusertib
Pharmaceutical form
COATED TABLET
Route of administration
ORAL USE
Authorisation status
Not Authorised
MA holder
CURIS INC
Paediatric formulation
No
Orphan designation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Curis Inc.

Sponsor organisation
Curis Inc.
Address
128 Spring Street Suite 500 Building C
City
Lexington
Postcode
02421-7800
Country
United States

Scientific contact point

Organisation
Curis Inc.
Contact name
Jonathan Zung

Public contact point

Organisation
Curis Inc.
Contact name
Jonathan Zung

Third parties 10

OrganisationCity, countryDuties
Worldwide Clinical Trials d.o.o.
ORG-100030991
Zagreb, Croatia Code 12
Icon Clinical Research Limited
ORG-100008322
Dublin 18, Ireland Other
Northeast Bioanalytical Laboratories LLC
ORG-100047699
Hamden, United States Other, Laboratory analysis
Suvoda LLC
ORG-100043523
Conshohocken, United States Interactive response technologies (IRT)
Fortrea Inc.
ORG-100012602
Durham, United States Data management, E-data capture
Tempus Labs Inc.
ORG-100044006
Chicago, United States Other, Laboratory analysis
Catalyst Clinical Research LLC
ORG-100043484
Wilmington, United States On site monitoring, Code 13, Other
Fortrea Development Limited
ORG-100009463
Maidenhead, United Kingdom Code 8
Labcorp Central Laboratory Services SARL
ORG-100011524
Meyrin, Switzerland Other, Laboratory analysis
TrialPEX
ORL-000002071
Aussonne, France Other

Locations

5 EU/EEA countries · 14 investigational sites

By country

CountryMS statusPlanned subjectsSites
Czechia Ongoing, recruiting 12 1
France Ongoing, recruiting 12 4
Italy Ongoing, recruiting 12 4
Poland Ongoing, recruiting 15 2
Spain Ongoing, recruiting 18 3
Rest of world
Israel, United States
83

Investigational sites

Czechia

1 site · Ongoing, recruiting
Vseobecna Fakultni Nemocnice V Praze
Hematology, U Nemocnice 499/2, Nove Mesto, Prague

France

4 sites · Ongoing, recruiting
Centre Hospitalier Regional De Marseille
Neuro-oncology, 264 Rue Saint Pierre, 13005, Marseille
Institut Curie
Hematology, 35 Rue Dailly, 92210, Saint-Cloud
Assistance Publique Hopitaux De Paris
Neuro-oncology, Num Voie 47 A 83, 47 Boulevard De L Hopital, Paris
Institut Bergonie
Hematology, 180 R De Saint Genes, 229 Cours De L Argonne, Bordeaux

Italy

4 sites · Ongoing, recruiting
Ospedale San Raffaele S.r.l.
Lymphoma Unit, Hematology and Bone Marrow Transplantation, Via Olgettina 60, 20132, Milan
Careggi University Hospital
SOD Ematologia, Largo Giovanni Alessandro Brambilla 3, 50134, Florence
Azienda Ospedaliera Santa Croce E Carle
Hematology Department, Via Michele Coppino 26, 12100, Cuneo
Istituto Romagnolo Per Lo Studio Dei Tumori Dino Amadori IRST S.r.l.
Dipartimento Oncologia ed Ematologia Clinica e Sperimentale, Via Piero Maroncelli 40, 47014, Meldola

Poland

2 sites · Ongoing, recruiting
Narodowy Instytut Onkologii Im. Marii Sklodowskiej-Curie Panstwowy Instytut Badawczy
NA, Ul. Wilhelma Konrada Roentgena 5, 02-781, Warsaw
Uniwersyteckie Centrum Kliniczne
NA, Ul. Mariana Smoluchowskiego 17, 80-214, Gdansk

Spain

3 sites · Ongoing, recruiting
University Hospital Virgen Del Rocio S.L.
Hematology, Avenida De Manuel Siurot S/n, 41013, Sevilla
MD Anderson Cancer Center
Hematology, Calle De Arturo Soria Nº 270, 28033, Madrid
Hospital Universitari Vall D Hebron
Hematology, Passeig De La Vall D'Hebron 119-129, 08035, Barcelona

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Czechia 2024-02-21 2025-11-06
France 2024-03-01 2024-08-12
Italy 2023-11-20 2024-04-19
Poland 2023-06-20 2023-08-31
Spain 2023-05-30 2023-09-29

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 48 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_ Protocol 2024-513312-95-00_eng_Redacted 2.0
Recruitment arrangements (for publication) K1_ Recruitment arrangements_CZE_Public 1.1
Recruitment arrangements (for publication) K1_ Recruitment arrangements_ESP_public 1.1
Recruitment arrangements (for publication) K1_ Recruitment arrangements_ITA_Public 1.0
Recruitment arrangements (for publication) K1_Recruitment arrangements_FRA_Public 1.1
Recruitment arrangements (for publication) K1_Recruitment arrangements_POL_Public 1.0
Recruitment arrangements (for publication) K2_Information for Healthcare Professionals_Redacted 2.0
Recruitment arrangements (for publication) K2_Patient Flyer in Italian_Public 2.0
Recruitment arrangements (for publication) K2_Patient Flyer in Polish_Public 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Healthcare Professionals_FRA_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Healthcare Professionals_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Healthcare Professionals_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Patient_Flyer_FRA_Public 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Patient_Flyer_Public 2.0
Recruitment arrangements (for publication) K2_TakeAim_Lymphoma_Patient_Flyer_Public 2.0
Recruitment arrangements (for publication) K3_TakeAim_Lymphoma_ Information for Healthcare Professionals_Redacted 2.0
Subject information and informed consent form (for publication) L1_ Future Research ICF_CZE_Public 3.1
Subject information and informed consent form (for publication) L1_ GDPR_ICF_CZE_Public 4.1
Subject information and informed consent form (for publication) L1_ ICF Part A2 B C in English_ESP_Redacted 13.1
Subject information and informed consent form (for publication) L1_ ICF Part A2 B C_ESP_Redacted 13.1
Subject information and informed consent form (for publication) L1_ Main Subject ICF_CZE_Redacted 13.1
Subject information and informed consent form (for publication) L1_ Main Subject ICF_FR_Redacted 13.1
Subject information and informed consent form (for publication) L1_ Pregnant Partner ICF_CZE_Redacted 3.1
Subject information and informed consent form (for publication) L1_Legal Representative ICF_CZE_Redacted 2.1
Subject information and informed consent form (for publication) L1_Main ICF Part B_C_Redacted 13.1
Subject information and informed consent form (for publication) L1_Pregnancy and Birth ICF_clean_Public 3.1
Subject information and informed consent form (for publication) L1_Pregnancy ICF_FR_public 3.1
Subject information and informed consent form (for publication) L1_Pregnant Partner ICF_ESP_Public 3.1
Subject information and informed consent form (for publication) L1_Privacy for Main Subject ICF Part B_C_clean_Public 3.1
Subject information and informed consent form (for publication) L1_SIS and ICF_Main_POL_Redacted 13.1
Subject information and informed consent form (for publication) L1_SIS_and_IC_ Future Research_POL_Public 3.2
Subject information and informed consent form (for publication) L1_SIS_and_ICF_Pregnant Partner_POL_Redacted 3.2
Subject information and informed consent form (for publication) L2_Patient_Card_Public 3.0
Subject information and informed consent form (for publication) L3_Dosing_diary_redacted 6.0
Subject information and informed consent form (for publication) L4_List of documents in Part II_CZE n/a
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Imbruvica N/A
Synopsis of the protocol (for publication) D1 Protocol synopsis_CZE 2024-513312-95_Redacted 1.0
Synopsis of the protocol (for publication) D1 Protocol synopsis_FRA_2024-513312-95-00_Redacted 12.0
Synopsis of the protocol (for publication) D1_ Protocol synopsis_ENG_ 2024-513312-95-00_Redacted 12.0
Synopsis of the protocol (for publication) D1_CA-4948-101_Protocol_LaySummary_CZE_Redacted n/a
Synopsis of the protocol (for publication) D1_LaySummary_ITA_2024-513312-95-00_Redacted N/A
Synopsis of the protocol (for publication) D1_Protocol Lay Summary POL_2024-513312-95-00_Redacted N/A
Synopsis of the protocol (for publication) D1_Protocol Lay Summary_2024-513312-95-00_ENG_Redacted N/A
Synopsis of the protocol (for publication) D1_Protocol Lay Summary_ESP_Redacted N/A
Synopsis of the protocol (for publication) D1_Protocol Lay summary_FRA_2024-513312-95-00_Redacted N/A
Synopsis of the protocol (for publication) D1_Protocol synopsis POL_2024-513312-95-00_Redacted 12.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_ITA_2024-513312-95-00_Redacted 12.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_SPA_2024-513312-95-00_Redacted 12.0

Application history

6 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-05-27 Spain Acceptable
2024-07-01
2024-07-01
2 SUBSTANTIAL MODIFICATION SM-1 2024-12-02 Spain Acceptable
2025-02-11
2025-02-12
3 SUBSTANTIAL MODIFICATION SM-2 2025-05-26 Spain Acceptable
2025-07-28
2025-07-29
4 SUBSTANTIAL MODIFICATION SM-3 2025-08-18 Acceptable 2025-09-25
5 SUBSTANTIAL MODIFICATION SM-4 2025-09-03 Spain Acceptable 2025-09-12
6 NON SUBSTANTIAL MODIFICATION NSM-1 2026-02-17 Spain Acceptable 2026-02-17