Safety, PK, PD, and Antitumor Activity of Vecabrutinib (SNS-062) in B Lymphoid Cancers

Sunesis Pharmaceuticals

Status and phase: Terminated; Phase 2; Phase 1

Conditions: Waldenstrom Macroglobulinemia; Marginal Zone Lymphoma; Lymphoplasmacytoid Lymphoma; Follicular Lymphoma; Small Lymphocytic Lymphoma; Chronic Lymphocytic Leukemia; Diffuse Large B Cell Lymphoma; Mantle-Cell Lymphoma

Treatments: Drug: SNS-062

Study type: Interventional

Funder types: Industry

Identifiers

NCT03037645

062-HEM-102

Details and patient eligibility

About

This is an open-label Phase 1b/2 study in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)or non hodgkin's lymphoma (NHL) who have failed prior standard of care therapies including a BTK inhibitor where one is approved for the indication.

Full description

This study includes 2 parts: phase 1 (dose escalation) and phase 2 (cohort expansion) in patients with CLL/SLL or NHL who have failed prior standard of care therapies including a BTK inhibitor where one is approved for the indication. NHL indications include lymphoplasmacytoid lymphoma/Waldenström's macroglobulinemia (LPL/WM), mantle cell lymphoma (MCL), marginal zone lymphoma (MZL), diffuse large B-cell lymphoma of the activated B-cell subtype (DLBCL-ABC), and follicular lymphoma (FL). In Phase 1b, cohorts of 3 to 6 patients are studied at each dose level, starting with 25 mg vecabrutnib BID in oral capsule form. Following identification of the MTD and/or recommended dose, in Phase 2 only CLL/SLL patients will be enrolled to expansion cohorts to further characterize the clinical activity, safety, and pharmacology of vecabrutinib. Cycle length is 4 weeks.

Enrollment: 39 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (Key factors listed):

• Eastern Cooperative Oncology Group Performance Status of ≤2.
• Confirmed malignancy with relapsed/refractory disease after ≥2 lines of standard systemic therapy including prior BTK inhibitor therapy having CLL, LPL/WM, MCL or MZL and for DLBCL-ABC and FL, after ≥2 lines of standard systemic therapy (Phase 1b). For Phase 2, CLL/SLL patients with confirmed malignancy with relapsed/refractory disease after ≥1 line of standard systemic therapy including prior BTK inhibitor therapy
• Presence of measurable disease through various assessments depending on specific cancer type.
• Current medical need for therapy of the B-lymphoid malignancy.

Exclusion Criteria (Key factors listed):

• Active central nervous system involvement.
• History of second primary malignancy that has progressed or required systemic treatment in the past 2 years. Exceptions include: local cancers of the skin, cervix or breast cancers, non-invasive bladder cancer, hormone sensitive prostate cancer with stable PSA ≥3 months, and other localized solid tumors in situ/other low risk cancers.
• Significant cardiovascular disease or electrocardiogram (ECG) abnormalities
• Ongoing risk for bleeding due to bleeding diathesis, platelet function disorder, uncontrolled peptic ulcer disease, oral anticoagulation medications.
• Evidence of uncontrolled systemic bacterial, fungal or viral infections at the start of drug therapy.
• Demonstrated intolerance to BTK inhibitor as shown by discontinuation due to adverse effects.
• Use of a moderate or strong inhibitor or inducer of CYP3A4 within 7 days prior to start of study therapy (e.g., some antibiotics, antifungals, anticonvulsants, grapefruit).

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Sequential Assignment

Masking: None (Open label)

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39 participants in 1 patient group

Dose escalating cohorts of SNS-062

Experimental group

Description:

Sequential groups, 25, 50, 100, 200, 300, 400 and 500 mg twice daily to determine maximum tolerated dose and recommended dose (RD) in the treatment of various hematological cancers followed by expansion of the recommended dose cohort in Phase 2 of the study treating hematological cancers.

Treatment:

Drug: SNS-062