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Tazemetostat in Malignant Peripheral Nerve Sheath Tumors

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04917042
Recruitment Status : Recruiting
First Posted : June 8, 2021
Last Update Posted : November 16, 2021
Sponsor:
Collaborator:
Epizyme, Inc.
Information provided by (Responsible Party):
University of Florida

Brief Summary:
This phase 2, open label, single arm study will investigate the use of tazemetostat in patients with recurrent/refractory and/or metastatic malignant peripheral nerve sheath tumors.

Condition or disease Intervention/treatment Phase
Peripheral Nerve Sheath Tumor Drug: Tazemetostat Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 24 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase 2 Study Using Tazemetostat in Patients With Recurrent/Refractory and/or Metastatic Malignant Peripheral Nerve Sheath Tumors (MPNST)
Actual Study Start Date : August 24, 2021
Estimated Primary Completion Date : September 2024
Estimated Study Completion Date : September 2024


Arm Intervention/treatment
Experimental: tazemetostat Drug: Tazemetostat
Subjects will receive 520 mg/m2/dose (subjects 12-17 years old) or 800 mg of tazemetostat orally twice daily in 28 day cycles. Subjects will receive treatment with tazemetostat up to 2 years or until disease progression or unacceptable toxicity occurs.
Other Name: TAZVERIK




Primary Outcome Measures :
  1. Objective response rate [ Time Frame: 2 years ]
    Assess the objective response rate, defined as the proportion of subjects who achieve either a complete response or partial response based on radiographic evaluation of treatment response via RECIST1.1


Secondary Outcome Measures :
  1. Progression free survival [ Time Frame: 3 years ]
    Determine the progression free survival, defined as the length of time from the start of treatment to time of progression or death, whichever occurs first.

  2. Time to progression [ Time Frame: 2 years ]
    Determine the time to progression, defined as the length of time from the start of treatment until disease progression by RECIST 1.1 criteria.

  3. Clinical benefit [ Time Frame: 2 years ]
    Determine the clinical benefit using the Numbered Pain Rating Scale. A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means "no pain," and 5 or 10 means "the worst possible pain." These pain intensity levels may be assessed upon initial treatment, or periodically after treatment.

  4. Clinical benefit rate [ Time Frame: 2 years ]
    Assess the clinical benefit rate, defined as the proportion of subjects with complete or partial response or stable disease (by RECIST 1.1 criteria) lasting at least 4 months.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   12 Years to 99 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • A histologic confirmation of recurrent/refractory and/or metastatic malignant peripheral nerve sheath tumor with Response Evaluation Criteria in Solid Tumors (RECIST) measurable disease
  • Patients ≥ 12 years of age at the time of enrollment
  • Performance status: 12-15 years old: Lansky > 50; 16-17 years old: Karnofsky > 50; ≥ 18 years old: Eastern Cooperative Group (ECOG) score 0-2
  • Subjects must have adequately recovered from the acute toxic effects of all prior anti-cancer therapy per enrolling physician and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment.

    • Anti-cancer agents not known to be myelosuppressive: > 7 days after the last dose of agent.
    • Antibodies: > 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to Grade < 1.
    • Systemic Corticosteroids: if related to prior therapy > 14 days must have elapsed, or on stable dose for treatment of CNS disease.
    • Hematopoietic growth factors: > 14 days after the last dose of a long-acting growth factor.
    • Interleukins, Interferons, and Cytokines (other than hematopoietic growth factors): > 21 days after the completion of interleukins, interferon or cytokines (other than hematopoietic growth factors).
    • Radiation therapy (XRT)/External Beam Irradiation including Protons: > 14 days after local XRT; > 150 days after traumatic brain injury, craniospinal XRT or if radiation to > 50% of the pelvis; > 42 days if other substantial bone marow radiation.
    • Radiopharmaceutical therapy: > 42 days after systemically administered radiopharmaceutical therapy.
    • Major surgery > 14 days prior, with evidence of wound healing and no active surgical complications
  • Subjects must not have had prior exposure to Tazemetostat or other inhibitor(s) of EZH2
  • Adequate laboratory values of organ function, defined as:

    • Peripheral absolute neutrophil count (ANC) > 1000/mm3.
    • Platelet count > 100,000/mm2 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment).
    • Hemoglobin > 8.0 g/dL at baseline (may receive RBC transfusions).
    • Creatinine clearance or radioisotope GFR > 70 ml/min/1.73 m2, or serum creatinine based on age/gender
    • Total bilirubin < 1.5 ULN or direct bilirubin < 1 x ULN.
    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.5 x ULN; if liver metastases present, then AST and ALT must be < 5 x ULN.
    • Serum albumin > 2 g/dL.
    • Coagulation INR < 1.5, while on anti-coagulation INR < 2.5.
  • Nervous system disorders (CTCAE v5.0) resulting from prior therapy must be < Grade 2, with the exception of decreased tendon reflex (DTR). Any grade of DTR is eligible.
  • Subjects must not have more than one active malignancy at the time of enrollment
  • Written informed consent obtained from the subject and the subject agrees to comply with all the study-related procedures. All subjects and/or their parents or legally authorized representatives must sign a written informed consent. Assent, when appropriate, will be obtained according to institutional standard practice.
  • Use of contraception:

    • Women of childbearing potential (WOCBP) who are heterosexually active must be using two highly effective methods of contraception to avoid pregnancy throughout the study and for at least 6 months after the last dose of study drug to minimize the risk of pregnancy as Tazemetostat might counteract the effects of hormonal contraceptives. Birth control methods that can be used while in this study include: established use of oral, injected or implanted hormonal birth control or placement of an intrauterine device [IUD] or intrauterine system [IUS]. They or their partner must also use a second method, (e.g., condom with spermicidal foam/gel/film/cream/suppository or occlusive cap [diaphragm or cervical/vault caps] with spermicidal foam/gel/film/cream/suppository. If their male partner is vasectomized, they do not need to use any of the birth control methods listed above. The type of birth control they use must be discussed with the study doctor before beginning the study. The study doctor must approve the method you use before they can enter the study. Prior to study enrollment, women of childbearing potential must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy.
    • Males with female partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms,vasectomy) throughout the study and should avoid donating sperm, for 90 days following the last dose of study drug.

Exclusion Criteria:

  • Subjects who are currently taking the following concomitant medications:

    • Anti-cancer Agents: Subjects who are currently receiving other anti-cancer agents are not eligible.
    • CYP3A4 Agents: Subjects who are currently receiving drugs that are strong inducers or strong inhibitors of CYP3A4 are not eligible. Strong inducers or inhibitors of CYP3A4 are prohibited from 14 days prior to the first dose of Tazemetostat to the end of the study. Note: Dexamethasone for CNS tumors or metastases, on a stable dose, is allowed.
  • Subjects who are acutely ill with an uncontrolled active infection on systemic anti-infective agents are not eligible.
  • Subjects with a prior history of T-cell lymphoblastic lymphoma/T-cell acute lymphoblastic leukemia or myelodysplastic syndrome (MDS).
  • Subjects who have any of the following underlying major cardiac issues or conditions:

    • Known QTc prolongation or documentation on screening ECG (QTcF interval on screening ECG ≥ 480 milliseconds).
    • Documented New York Heart Association (NYHA) Class III or IV congestive heart failure.
    • Myocardial infarction within 6 months prior to registration.
    • Unstable angina within 6 months prior to registration.
    • Symptomatic arrhythmia.
  • Subjects who in the opinion of the investigator may be high risk for treatment complications or unable to comply with the safety monitoring requirements of the study
  • Heterosexually active males or females of reproductive potential may not participate unless they have agreed to use two highly effective contraceptive methods for the duration of study treatment as Tazemetostat might counteract the effects of hormonal contraceptives. Female subjects of childbearing potential should agree to remain abstinent or use adequate contraceptive methods for 6 months after the last dose of Tazemetostat. Male subjects should agree to remain abstinent or use adequate contraceptive methods, and agree to refrain from donating sperm, and for 90 days after the last dose of Tazemetostat.
  • Females who are pregnant or breastfeeding will not be entered on this study because there is currently no available information regarding human fetal or teratogenic toxicities. Pregnancy tests must be obtained in girls who are post-menarchal.
  • Administration of a vaccine containing live virus within 30 days prior to the first dose of trial treatment. Note: Most flu vaccines are killed viruses, with the exception of the intra-nasal vainer (Flu-Mist) which is an attenuated live virus and therefore prohibited for 30 days prior to first dose. Non-live versions of the COVID-19 vaccine are allowed.
  • Prisoners or subjects who are involuntarily incarcerated, or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.

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): NCT04917042


Contacts
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Contact: Abigail Masterson (352) 294-8322 PMO@cancer.ufl.edu

Locations
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United States, Florida
University of Florida Recruiting
Gainesville, Florida, United States, 32608
Contact: Ashley Bayne    352-294-8745    abayne@ufl.edu   
Principal Investigator: Joanne Lagmay, MD         
Sponsors and Collaborators
University of Florida
Epizyme, Inc.
Investigators
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Principal Investigator: Joanne Lagmay, MD University of Florida
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Responsible Party: University of Florida
ClinicalTrials.gov Identifier: NCT04917042    
Other Study ID Numbers: UF-SC-001
IRB202100865 ( Other Identifier: UF IRB-01 )
OCR40197 ( Other Identifier: University of Florida )
First Posted: June 8, 2021    Key Record Dates
Last Update Posted: November 16, 2021
Last Verified: November 2021

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by University of Florida:
metastatic malignant peripheral nerve sheath tumors
Enhancer of zeste homolog 2 (EZH2) inhibition
sarcoma
pediatric
tazemetostat
Additional relevant MeSH terms:
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Nerve Sheath Neoplasms
Neurofibrosarcoma
Neoplasms
Neoplasms, Nerve Tissue
Neoplasms by Histologic Type
Peripheral Nervous System Neoplasms
Nervous System Neoplasms
Nervous System Diseases
Peripheral Nervous System Diseases
Neuromuscular Diseases
Fibrosarcoma
Neoplasms, Fibrous Tissue
Neoplasms, Connective Tissue
Neoplasms, Connective and Soft Tissue
Sarcoma
Neurofibroma