A Study of AZD0486 Monotherapy or in Combination With Other Anti-Cancer Agents for Mature B-Cell Malignancies (Soundtrack-E)

AstraZeneca

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: B-cell Non-Hodgkin Lymphoma; Small Lymphocytic Lymphoma; Large B-cell Lymphoma; Mantle-cell Lymphoma; Chronic Lymphocytic Leukaemia

Treatments: Drug: Doxorubicin; Drug: Rituximab; Drug: AZD0486; Drug: Vincristine; Drug: Prednisone (or equivalent); Drug: Cyclophosphamide; Drug: Acalabrutinib

Study type: Interventional

Funder types: Industry

Identifiers

NCT06564038

2024-515034-33-00 (Registry Identifier)

D7407C00001

Details and patient eligibility

About

The purpose of this study is to assess the safety and efficacy of AZD0486 administered as monotherapy or in combination with other anticancer agents in participants with hematological malignancies.

Full description

This is open-label, multi-center study to evaluate the safety and preliminary efficacy of AZD0486 administered as monotherapy and in combination with other anticancer agents in participants with mature B-cell hematologic malignancies.

This master study currently includes 3 substudies and each substudy focusing on a defined population:

Substudy 1: Relapsed/refractory (R/R) Chronic lymphocytic leukaemia (CLL)/ Small lymphocytic lymphoma (SLL) Substudy 2: R/R Mantle-cell lymphoma (MCL) Substudy 3: Large B-cell lymphoma (LBCL) or R/R B-cell non-Hodgkin lymphoma (B-NHL) (not applicable to US)

The study will have the following sequential periods:

1. Screening period of 28 days
2. Treatment period
3. Follow-up period

Enrollment: 276 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Master Inclusion Criteria applicable to all substudies:

• Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
• Contraception use during treatment and at least 90 days after final dose.
• Confirmed CD19 expression if prior anti-CD19 therapy.

Substudy 1 Specific Inclusion Criteria:

• Participants with CLL must require treatment according to the international workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria.
• SLL: at least 1 measurable site per Lugano.
• Absolute lymphocytes <10,000.
• Cohort 1A and 1C: at least 2 prior lines of systemic therapy for CLL/SLL.
• Cohort 1B: at least 1 prior line of therapy and is bruton tyrosine kinase inhibitor (BTKi)-sensitive.

Substudy 2 Specific Inclusion Criteria:

• MCL diagnosis per WHO.
• Clinical Stage II, III, or IV by Ann Arbor Classification.
• At least 1 measurable site per Lugano.
• ALC < 10,000.
• Cohort 2A and 2C: Relapse or progressed after 2 or more lines of therapy including BTKi.

Substudy 3 Specific Inclusion Criteria:

• Large B-cell lymphoma per WHO 2022.
• R/R B-NHL after at least 1 prior line of therapy.
• International Prognostic Index (IPI) 2-5.
• At least 1 measurable site as per Lugano.
• Left ventricular ejection fraction (LVEF) >50%.
• Contraception at least 90 days after last dose of AZD0486 or 4 months after last dose of vincristine, and 6 months after the last dose of cyclophosphamide, or doxorubicin.

Exclusion criteria

Master Exclusion Criteria applicable to all substudies:

• Central nervous system (CNS) lymphoma.
• Surgery within 14 days of study drug.
• Clinically significant cardiovascular (CV) disease.
• Unresolved Grade >2 AEs from prior anticancer therapy (except alopecia or fatigue).
• Any anticancer therapy within 5 half-lives or 21 days (whichever is shorter) prior to treatment.
• Radiation therapy within 28 days.
• Prior CAR T-cell therapy or autologous-haematopoietic stem cell transplant (HSCT) within 12 weeks or prior T-cell engager (TCE) within 8 weeks.
• Prior Grade > 3 cytokine release syndrome (CRS) or immune effector cell-associated neurotoxicity syndrome (ICANS) event.
• Prior allogeneic HSCT or solid organ transplantation within 24 weeks of starting Cycle 1 Day 1.

Substudy 1 Specific Exclusion Criteria:

• CLL transformation to more aggressive lymphoma.
• Cohort 1B: bleeding diathesis, CYP3A inhibitor or inducer, history of ICH or stroke within 24 weeks, GI malabsorption, receiving vitamin K antagonist.

Substudy 3 Specific Exclusion Criteria:

• Mediastinal grey-zone lymphoma, Burkitt, Richter's transformation, primary effusion large B-cell lymphoma (LBCL).
• Cumulative dose of anthracycline >150 mg/m2.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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276 participants in 6 patient groups

Substudy 1 (RR CLL/SLL): Cohort 1A (AZD0486 Monotherapy)

Experimental group

Description:

Participants will receive AZD0486 monotherapy as subcutaneous (SC) injection.

Treatment:

Drug: AZD0486

Substudy 1 (RR CLL/SLL): Cohort 1B (AZD0486 + Acalabrutinib)

Experimental group

Description:

Participants will receive AZD0486 as SC injection. Participants will receive acalabrutinib tablet orally twice daily.

Treatment:

Drug: Acalabrutinib

Drug: AZD0486

Substudy 1 (RR CLL/SLL): Cohort 1C (AZD0486 Monotherapy)

Experimental group

Description:

Participants will receive AZD0486 monotherapy as intravenous (IV) infusion.

Treatment:

Drug: AZD0486

Substudy 2 (RR MCL): Cohort 2A (AZD0486 Monotherapy)

Experimental group

Description:

Participants will receive AZD0486 monotherapy as SC injection.

Treatment:

Drug: AZD0486

Substudy 2 (RR MCL): Cohort 2C (AZD0486 Monotherapy)

Experimental group

Description:

Participants will receive AZD0486 monotherapy as IV infusion.

Treatment:

Drug: AZD0486

Substudy 3 (LBCL): AZD0486 + R-CHOP

Experimental group

Description:

Participants will receive AZD0486 as IV infusion in combination with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy.

Treatment:

Drug: Cyclophosphamide

Drug: Prednisone (or equivalent)

Drug: Vincristine

Drug: AZD0486

Drug: Rituximab

Drug: Doxorubicin