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Valemetostat Tosylate (DS-3201b), an Enhancer of Zeste Homolog (EZH) 1/2 Dual Inhibitor, for Relapsed/Refractory Peripheral T-Cell Lymphoma (VALENTINE-PTCL01)

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ClinicalTrials.gov Identifier: NCT04703192
Recruitment Status : Recruiting
First Posted : January 11, 2021
Last Update Posted : December 3, 2021
Sponsor:
Information provided by (Responsible Party):
Daiichi Sankyo, Inc.

Brief Summary:
This study will characterize the safety and clinical benefit of valemetostat tosylate in participants with relapsed/refractory peripheral T-cell lymphoma, including relapsed/refractory adult T-cell leukemia/lymphoma.

Condition or disease Intervention/treatment Phase
Relapsed/Refractory Peripheral T-Cell Lymphoma Adult T Cell Leukemia/Lymphoma Drug: Valemetostat Tosylate Phase 2

Detailed Description:
This study was designed to evaluate the efficacy and safety of valemetostat tosylate monotherapy. The primary objective will evaluate objective response rate of valemetostat tosylate monotherapy as measured by blinded independent central review (BICR) in relapsed/refractory peripheral T-cell lymphoma, including relapsed/refractory adult T-cell leukemia/lymphoma participants.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 176 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Single-arm, Phase 2 Study of Valemetostat Tosylate Monotherapy in Subjects With Relapsed/Refractory Peripheral T-Cell Lymphoma (VALENTINE-PTCL01)
Actual Study Start Date : June 3, 2021
Estimated Primary Completion Date : December 3, 2023
Estimated Study Completion Date : March 31, 2026


Arm Intervention/treatment
Experimental: Cohort 1: Relapsed/Refractory Peripheral T-Cell Lymphoma
Participants who will receive 200 mg/day valemetostat tosylate and had an eligible peripheral T-cell lymphoma subtype that was confirmed by independent hematopathology central review.
Drug: Valemetostat Tosylate
Oral administration of valemetostat tosylate at a dose of 200 mg once daily starting at Cycle 1, Day 1 (continuous for 28-day cycles), until disease progression or unacceptable toxicity
Other Name: DS-3201b

Experimental: Cohort 2: Relapsed/Refractory Adult T-cell Leukemia/Lymphoma
Participants who will receive 200 mg/day valemetostat tosylate and had an eligible adult T-cell leukemia/lymphoma subtype that was confirmed by the local pathologist/investigators and by documented positive anti-human T-cell leukemia virus type 1 (HTLV-1) antibody.
Drug: Valemetostat Tosylate
Oral administration of valemetostat tosylate at a dose of 200 mg once daily starting at Cycle 1, Day 1 (continuous for 28-day cycles), until disease progression or unacceptable toxicity
Other Name: DS-3201b




Primary Outcome Measures :
  1. Percentage of Participants With Objective Response As Assessed by Blinded Independent Central Review After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: From baseline until disease progression or death (whichever occurs first), up to approximately 56 months ]
    For the relapsed/refractory peripheral T-cell lymphoma (PTCL) cohort, objective response rate (ORR) is defined as the proportion of participants with a best overall response (BOR) of complete response (CR) or partial response (PR), assessed by blinded independent central review (BICR), among participants with centrally confirmed PTCL eligible histology. For the adult T-cell leukemia/lymphoma cohort, ORR is defined as the proportion of participants with a BOR of CR, uncertified CR (CRu), or PR, assessed by BICR, among participants with centrally confirmed histology/peripheral blood assessment.


Secondary Outcome Measures :
  1. Duration of Response After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: Time from the date of first documented response (CR, CRu [ATL only], or PR) until documented disease progression (progressive or relapsed disease) based on BICR assessments or death from any cause (whichever occurs first), up to approximately 56 months ]
    Duration of response (DoR) is defined as the time from the date of the first documentation of objective response (CR, CRu [ATL only], or PR) to the date of the first documentation of disease progression (progressive or relapsed disease) based on BICR assessments or to death due to any cause, whichever occurs first.

  2. Percentage of Participants With Complete Response After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: From baseline to date of first documented objective response of CR (CRu [ATL only]), up to approximately 56 months ]
    Complete response rate is the percentage of participants achieving CR (and CRu [ATL only]) as the BOR based on BICR assessments.

  3. Duration of Complete Response After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: Time from the date of first documented CR (also CRu [ATL only]) until documented disease progression (progressive or relapsed disease) based on BICR assessments or death from any cause (whichever occurs first), up to approximately 56 months ]
    Duration of complete response is defined as the time from the date of the first documentation of CR (also CRu [ATL only]) to the date of the first documentation of disease progression (progressive or relapsed disease) based on BICR assessments or to death due to any cause, whichever occurs first.

  4. Percentage of Participants With Partial Response After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: From baseline to date of first documented objective response of PR, up to approximately 56 months ]
    Partial response rate is the percentage of participants achieving PR as the BOR based on BICR assessment.

  5. Number of Participants With Treatment-emergent Adverse Events After Administration of Valemetostat Tosylate Monotherapy [ Time Frame: From the time the informed consent form is signed up to 30 days after last dose ]
    Treatment-emergent adverse events (TEAEs), treatment-emergent serious adverse events (TESAEs), severe events (Grades 3 and 4), fatal events, TEAEs associated with treatment discontinuation, interruption, or reduction, and adverse events of special interest (AESIs) will be assessed.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written informed consent
  • Participants ≥18 years of age or the minimum legal adult age (whichever is greater) at the time the informed consent form is signed.
  • Eastern Cooperative Oncology Group performance status of 0, 1, or 2
  • Cohort 1 relapsed/refractory peripheral T-cell lymphoma (PTCL):

    • Should be pathologically confirmed by the local pathologist/investigators; local histological diagnosis will be used for eligibility determination. Participants with the following subtypes of PTCL are eligible according to 2016 WHO classification prior to the initiation of study drug. Any T-cell lymphoid malignancies not listed are excluded. Eligible subtypes include:

      • Enteropathy-associated T-cell lymphoma
      • Monomorphic epitheliotropic intestinal T-cell lymphoma
      • Hepatosplenic T-cell lymphoma
      • Primary cutaneous γδ T-cell lymphoma
      • Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma
      • PTCL, not otherwise specified
      • Angioimmunoblastic T-cell lymphoma
      • Follicular T-cell lymphoma
      • Nodal PTCL with T-follicular helper (TFH) phenotype
      • Anaplastic large cell lymphoma, ALK positive
      • Anaplastic large cell lymphoma, ALK negative
  • Cohort 2 relapsed/refractory adult T-cell leukemia/lymphoma (ATL) acute, lymphoma, or unfavorable chronic type. Relapsed/refractory ATL should be pathologically or hematocytologically confirmed by the local pathologist/investigators; local histological/hematocytological diagnosis will be used for eligibility determination. The positivity of anti-human T-cell leukemia virus type 1 (HTLV-1) antibody will be locally determined for eligibility.
  • Must have at least one lesion which is measurable in 2 perpendicular dimensions on computed tomography (or magnetic resonance imaging) based on local radiological read
  • Documented refractory, relapsed, or progressive disease after at least 1 prior line of systemic therapy.

    • Refractory is defined as:

      • Failure to achieve CR (or CRu for ATL) after first-line therapy
      • Failure to reach at least PR after second-line therapy or beyond
  • Must have at least 1 prior line of systemic therapy for PTCL or ATL.

    • Participants must be considered hematopoietic cell transplantation (HCT) ineligible during screening due to disease status (active disease), comorbidities, or other factors; the reason for HCT ineligibility must be clearly documented.
    • In the PTCL cohort, participants with anaplastic large cell lymphoma (ALCL) must have prior brentuximab vedotin treatment.

Exclusion Criteria:

Participants meeting any exclusion criteria for this study will be excluded from this study. Below is a list of the key exclusion criteria:

  • Diagnosis of mycosis fungoides, Sézary syndrome and primary cutaneous ALCL, and systemic dissemination of primary cutaneous ALCL
  • Diagnosis of precursor T-cell lymphoblastic leukemia and lymphoma (T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma), T-cell prolymphocytic leukemia, or T-cell large granular lymphocytic leukemia
  • Prior malignancy active within the previous 2 years except for locally curable cancer that is currently considered as cured, such as cutaneous basal or squamous cell carcinoma, superficial bladder cancer, or cervical carcinoma in situ, or an incidental histological finding of prostate cancer.
  • Presence of active central nervous system involvement of lymphoma
  • History of autologous HCT within 60 days prior to the first dose of study drug
  • History of allogeneic HCT within 90 days prior to the first dose of study drug
  • Clinically significant graft-versus-host disease (GVHD) or GVHD requiring systemic immunosuppressive prophylaxis or treatment
  • Inadequate washout period from prior lymphoma-directed therapy before enrollment, defined as follows:

    • Prior systemic therapy (eg, chemotherapy, immunomodulatory therapy, or monoclonal antibody therapy) within 3 weeks prior to the first dose of study drug
    • Had curative radiation therapy or major surgery within 4 weeks or palliative radiation therapy within 2 weeks prior to the first dose of study drug
  • Uncontrolled or significant cardiovascular disease, including:

    • Evidence of prolongation of QT/QTc interval (eg, repeated episodes of QT corrected for heart rate using Fridericia's method >450 ms) (average of triplicate determinations)
    • Diagnosed or suspected long QT syndrome or known family history of long QT syndrome
    • History of clinically relevant ventricular arrhythmias, such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes
    • Uncontrolled arrhythmia (subjects with asymptomatic, controllable atrial fibrillation may be enrolled) or asymptomatic persistent ventricular tachycardia
    • Participant has clinically relevant bradycardia of <50 bpm, unless the participant has a pacemaker
    • History of second- or third-degree heart block. Candidates with a history of heart block may be eligible if they currently have pacemakers and have no history of fainting or clinically relevant arrhythmia with pacemakers within 6 months prior to Screening
    • Myocardial infarction within 6 months prior to Screening
    • Angioplasty or stent craft implantation within 6 months prior to Screening
    • Uncontrolled angina pectoris within 6 months prior to Screening
    • New York Heart Association Class 3 or 4 congestive heart failure
    • Coronary/peripheral artery bypass graft within 6 months prior to Screening
    • Uncontrolled hypertension (resting systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg)
    • Complete left or right bundle branch block
  • History of treatment with other EZH inhibitors
  • Current use of moderate or strong cytochrome P450 (CYP)3A inducers
  • Systemic treatment with corticosteroids (>10 mg daily prednisone equivalents). Note: Short-course systemic corticosteroids (eg, prevention/treatment for transfusion reaction) or use for a non-cancer indication (eg, adrenal replacement) is permissible.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04703192


Contacts
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Contact: (US sites) Daiichi Sankyo Contact for Clinical Trial Information 908-992-6400 CTRinfo@dsi.com
Contact: (Asia sites) Daiichi Sankyo Contact for Clinical Trial Information +81-3-6225-1111(M-F 9-5 JST) dsclinicaltrial@daiichisankyo.co.jp

Locations
Show Show 28 study locations
Sponsors and Collaborators
Daiichi Sankyo, Inc.
Investigators
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Study Director: Global Clinical Leader Daiichi Sankyo, Inc.
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Responsible Party: Daiichi Sankyo, Inc.
ClinicalTrials.gov Identifier: NCT04703192    
Other Study ID Numbers: DS3201-A-U202
2020-004954-31 ( EudraCT Number )
jRCT2071200095 ( Other Identifier: JAPIC )
First Posted: January 11, 2021    Key Record Dates
Last Update Posted: December 3, 2021
Last Verified: December 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: De-identified individual participant data (IPD) and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Clinical Study Report (CSR)
Time Frame: Studies for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
Access Criteria: Formal request from qualified scientific and medical researchers on IPD and clinical study documents from clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
URL: https://vivli.org/ourmember/daiichi-sankyo/

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Daiichi Sankyo, Inc.:
Relapsed/Refractory Peripheral T-Cell Lymphoma
Adult T-Cell Leukemia/Lymphoma
Valemetostat Tosylate
DS-3201b
Additional relevant MeSH terms:
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Lymphoma
Lymphoma, T-Cell
Leukemia, T-Cell
Leukemia-Lymphoma, Adult T-Cell
Lymphoma, T-Cell, Peripheral
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Leukemia
Lymphoma, Non-Hodgkin
Leukemia, Lymphoid