Evaluating Emavusertib for Relapsed or Refractory Primary Central Nervous System Lymphoma
An Open-Label, Dose Escalation and Dose Expansion Trial Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Clinical Activity of Orally Administered CA-4948 in Patients With Relapsed or Refractory Primary Central Nervous System Lymphoma
PHASE1; PHASE2 · Curis, Inc. · NCT03328078
This study is testing a new drug called emavusertib, alone and with another medication, to see if it can help adults with tough-to-treat primary central nervous system lymphoma feel better.
Quick facts
| Phase | PHASE1; PHASE2 |
|---|---|
| Study type | Interventional |
| Enrollment | 152 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Curis, Inc. (industry) |
| Drugs / interventions | ibrutinib, chemotherapy, radiation |
| Locations | 45 sites (Phoenix, Arizona and 44 other locations) |
| Trial ID | NCT03328078 on ClinicalTrials.gov |
What this trial studies
This clinical trial is designed to assess the safety, pharmacokinetics, and anti-cancer activity of emavusertib, both as a standalone treatment and in combination with ibrutinib, for adults with relapsed or refractory primary central nervous system lymphoma. The study is divided into four parts, with initial phases focusing on dose escalation and safety evaluation, followed by an assessment of efficacy in patients who have progressed on prior treatments. Participants will receive oral emavusertib at varying doses, depending on their treatment cohort. The trial aims to provide insights into the potential benefits of this combination therapy for a challenging patient population.
Who should consider this trial
Good fit: Ideal candidates include adults aged 18 and older with a confirmed diagnosis of relapsed or refractory primary central nervous system lymphoma.
Not a fit: Patients who are not diagnosed with primary central nervous system lymphoma or those with a life expectancy of less than three months may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could offer a new therapeutic option for patients with difficult-to-treat primary central nervous system lymphoma.
How similar studies have performed: Other studies have shown promise with similar approaches targeting hematologic malignancies, suggesting potential for success in this trial.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Males and females greater than or equal to 18 years of age 2. Life expectancy of at least 3 months 3. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1 or 2 4. Histopathologically confirmed diagnosis of PCNSL (medical record is acceptable). Cerebral biopsies are not required if imaging reveals typical images of PCNSL. 1. Participants with parenchymal lesions must have unequivocal evidence of disease progression (e.g., presence of at least 1 measurable target lesion \[≥ 10 millimeters (mm) and ≤ 40 mm in the longest diameter on brain magnetic resonance imaging \[MRI\] or head computed tomography \[CT\] 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 central nervous system (CNS) location, disabling the participant and/or causing symptoms, this participant may be eligible following a discussion with the Sponsor Medical Monitor. 2. For participants limited to leptomeningeal involvement, cerebrospinal fluid (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 for Part B and Part C 1. Participants 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 2. 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). 3. 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 participant has been free of the disease for ≥ 3 years. 4. Active malignancy other than PCNSL requiring systemic therapy 5. Previous BTKi treatment (Part C only). 6. History of Grade ≥ 3 rhabdomyolysis without complete recovery 7. Requirement for urgent therapy due to uncontrolled tumor mass/edema effects. 8. Received external beam radiation therapy to the CNS within 28 days prior to Cycle 1 Day 1. 9. 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 10. Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 14 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) 11. Prior history of hypersensitivity or anaphylaxis to emavusertib, ibrutinib or any of their excipients.
Where this trial is running
Phoenix, Arizona and 44 other locations
- St. Joseph's Hospital and Medical Center — Phoenix, Arizona, United States (RECRUITING)
- Mayo Clinic — Phoenix, Arizona, United States (COMPLETED)
- City of Hope — Duarte, California, United States (RECRUITING)
- Providence St. John's Health Center — Santa Monica, California, United States (RECRUITING)
- UCLA Department of Medicine - Hematology/Oncology — Santa Monica, California, United States (WITHDRAWN)
- Smilow Cancer Hospital at Yale-New Haven — New Haven, Connecticut, United States (COMPLETED)
- Mayo Clinic — Jacksonville, Florida, United States (RECRUITING)
- Northwestern Memorial Hospital — Chicago, Illinois, United States (RECRUITING)
- Dana Farber Cancer Institute — Boston, Massachusetts, United States (RECRUITING)
- Mayo Clinic — Rochester, Minnesota, United States (RECRUITING)
- Fred and Pamela Buffett Cancer Center — Omaha, Nebraska, United States (RECRUITING)
- Hackensack University Medical Center — Hackensack, New Jersey, United States (COMPLETED)
- Roswell Park Comprehensive Cancer Center — Buffalo, New York, United States (RECRUITING)
- Mt Sinai — New York, New York, United States (RECRUITING)
- Columbia University Irving Medical Center — New York, New York, United States (WITHDRAWN)
- Memorial Sloan Kettering Cancer Center — New York, New York, United States (RECRUITING)
- Duke University Medical Center, Duke Cancer Center — Durham, North Carolina, United States (RECRUITING)
- Cleveland Clinic — Cleveland, Ohio, United States (RECRUITING)
- Providence Neurological Specialties West — Portland, Oregon, United States (RECRUITING)
- Hospital of the University of Pennsylvania — Philadelphia, Pennsylvania, United States (COMPLETED)
- UPMC Hilman Cancer Center — Pittsburgh, Pennsylvania, United States (RECRUITING)
- University of Tennessee Medical Center — Knoxville, Tennessee, United States (COMPLETED)
- UT Southwestern Medical Center — Dallas, Texas, United States (ACTIVE_NOT_RECRUITING)
- The University of Texas MD Anderson Cancer Center — Houston, Texas, United States (RECRUITING)
- Huntsman Cancer Institute, University of Utah — Salt Lake City, Utah, United States (RECRUITING)
- Swedish Cancer Institute — Seattle, Washington, United States (COMPLETED)
- University of Washington Medical Center — Seattle, Washington, United States (RECRUITING)
- Všeobecná fakultní nemocnice v Praze — Prague, Czechia (RECRUITING)
- Institut Bergonie — Bordeaux, France (RECRUITING)
- Hopital de la Timone — Marseille, France (RECRUITING)
- Hospital Pitie Salpetriere — Paris, France (RECRUITING)
- Institut Curie Hospital — Paris, France (RECRUITING)
- Hematology Department Soroka UMC / Heanatology Department — Beersheba, Israel (RECRUITING)
- Rambam Medical Center — Haifa, Israel (RECRUITING)
- Hadassah Medical Center / Ein-Carem — Jerusalem, Israel (RECRUITING)
- Università di Torino Croce e Carle — Cuneo, Italy (RECRUITING)
- SODc Ematologia Azienda Ospedaliera Universitaria Careggi — Florence, Italy (RECRUITING)
- IRST - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori — Meldola, Italy (RECRUITING)
- IRCCS San Raffaele Scientific Institute — Milan, Italy (RECRUITING)
- Uniwersyteckie Centrum Kliniczne Osrodek Badan Klinicznych Wczesnych Faz — Gdansk, Poland (RECRUITING)
- Oddzial Kliniczny Hematologii — Krakow, Poland (WITHDRAWN)
- NarodowyInstytutu Onkologii im. Marii Sklodowskiej-Curie-Panstwowy Instytutu Badawczy — Warsaw, Poland (RECRUITING)
- University Hospital Vall d'Hebron — Barcelona, Spain (RECRUITING)
- MD Anderson Cancer Center Madrid — Madrid, Spain (RECRUITING)
- Hospital Universitario Virgen del Rocio — Seville, Spain (RECRUITING)
Study contacts
- Study coordinator: Ahmed Hamdy, MD
- Email: clinicaltrials@curis.com
- Phone: 617-503-6500
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Relapsed Hematologic Malignancy, Refractory Hematologic Malignancy, Relapsed Primary Central Nervous System Lymphoma, Refractory Primary Central Nervous System Lymphoma, MYD88, IRAK4, NHL, PCNSL