Clinical trial NCT05242146: GB5121 in Adult Patients With Relapsed/Refractory CNS Lymphoma
Official title: A Phase 1b/2, Open-label Dose Escalation With Expansion Study of GB5121 in Adult Patients With Relapsed/Refractory Primary or Secondary Central Nervous System Lymphoma or Primary Vitreoretinal Lymphoma, With a Phase 2 Open-label Single Dose Level Study of GB5121 in Adult Patients With Relapsed/ Refractory Primary Central Nervous System Lymphoma
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
Conditions: CNS Lymphoma
Keywords: R/R PCNSL
SCNSL
PVRL
Lead sponsor: Gossamer Bio Inc.
Sponsor class: INDUSTRY
First posted: 2022-02-16
Enrollment: 12
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The STAR CNS trial is a 3-part study, comprising a phase 1b dose escalation, dose expansion, and a phase 2, to assess the safety, tolerability, dose-limiting toxicity(ies), maximum tolerated dose, and/or optimal biological dose, determine the recommended phase 2 dose, preliminary anti-tumor activity and efficacy of the recommended phase 2 dose of GB5121.

Detailed description: Note: The Phase 1b dose expansion and Phase 2 parts of the study were not initiated.

Eligibility criteria: Inclusion Criteria:

1. Patients must have histologically/cytologically confirmed primary central nervous system lymphoma (PCNSL), primary vitreoretinal lymphoma (PVRL), or CNS-only involvement of a systemic B-cell lymphoma.
2. All patients must have relapsed/refractory disease and must have received all possible standard-of-care CNS-directed therapy treatment regimens or patients for which further standard-of-care treatment options are contraindicated or declined.
3. Patients must be able to tolerate gadolinium-enhanced magnetic resonance imaging (MRI) scans, or contrast-enhanced computed tomography (CT).
4. Patients with parenchymal lesions must have baseline imaging (gadolinium-enhanced MRI or if contraindicated, contrast-enhanced CT, of the brain) within 28 days prior to first study drug dose. For patients with leptomeningeal disease only, cerebrospinal fluid (CSF) cytology must document lymphoma cells and/or imaging findings consistent with leptomeningeal disease after informed consent and prior to first study dose (at the discretion of the Investigator).
5. Patients with parenchymal lesions must have measurable disease (disease that has at least one lesion on imaging ≥ 10 mm in the longest diameter) on imaging (gadolinium-enhanced MRI or if contraindicated, contrast-enhanced CT, of the brain) prior to first study dose.
6. Patients must be able to tolerate and consent for a lumbar puncture and/or have pre-existing placement of an Ommaya reservoir, unless clinically contraindicated.
7. Patients must have a performance status of 0, 1, or 2 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale.
8. Demonstrate adequate bone marrow and organ function.

Exclusion Criteria:

1. Patients are concurrently using other approved or investigational antineoplastic agents.
2. Patients have an active concurrent malignancy requiring active therapy.
3. Patients are allergic to components of the study drug.
4. Patients have a known bleeding diathesis (eg, von Willebrand's disease) or hemophilia.
5. Patients who require therapeutic anticoagulation, including dual antiplatelet agents. Patients who have received therapeutic anticoagulation, including dual antiplatelet agents, within 5 half-lives of the anticoagulant or 14 days, whichever is longer, prior to starting the study drug. Patients who require the use of antiplatelet agents should be discussed with the Sponsor's Medical Monitor.
6. Patients have significant abnormalities on screening electrocardiogram (ECG) and active and significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, uncontrolled hypertension, valvular disease, pericarditis, or myocardial infarction within 6 months of screening.
7. Patients with any of the following will be excluded:

   1. A marked baseline prolongation of QT/QTc interval (eg, repeated demonstration of a QTc interval \> 480 ms \[CTCAE grade 2\]) using Frederica's QT correction formula.
   2. A history of additional risk factors for Torsades de Pointes (eg, heart failure, hypokalemia, family history of long QT syndrome).
   3. The use of concomitant medications that prolong the QT/QTc interval.
8. Patients are known to have a history of active or chronic infection with hepatitis C virus (HCV), hepatitis B virus (HBV), as determined by serologic tests.
9. Known history of infection with human immunodeficiency virus (HIV).
10. Patients are known to have an uncontrolled active infection.
11. Patients have a history of stroke or intracranial hemorrhage within 6 months prior to enrollment.
12. Patients have a life-threatening illness, medical condition, or organ system dysfunction that, in the opinion of the Investigator, could compromise the subject's safety or put the study outcomes at undue risk.
13. Women who are pregnant or nursing (lactating).

Primary outcomes:
measure: Phase 1b Dose Escalation - Incidence of Adverse Events
timeFrame: From first dose until 28 days after the last dose of GB5121
measure: Phase 1b Dose Escalation - Dose Limiting Toxicity(ies)
timeFrame: From Cycle 1, Day 1 through Cycle 1, Day 28 inclusive, Each Cycle=28 days
measure: Phase 1b Dose Escalation - Serious Adverse Events
timeFrame: From consent until 28 days after the last dose of GB5121
measure: Phase 1b Dose Escalation - Optimal Biologic Dose and/or Maximum Tolerated Dose and Recommended Phase 2 Dose
timeFrame: From first dose up to approximately 36 months
measure: Phase 1b Dose Expansion - Incidence of Adverse Events
timeFrame: From first dose until 28 days after the last dose of GB5121
measure: Phase 1b Dose Expansion - Serious Adverse Events
timeFrame: From consent until 28 days after the last dose of GB5121
measure: Phase 2 - Objective Response Rate According to International Primary CNS Lymphoma Collaborative Group (IPCG) Criteria by Blinded Independent Central Review Committee (BICR)
timeFrame: From Study Day 1 until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
Secondary outcomes:
measure: Phase 1b Dose Expansion - Objective Response Rate According to IPCG Criteria by Investigator Assessment
timeFrame: From Study Day 1 until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Duration of Response by BICR Committee
timeFrame: From first observation of complete response, unconfirmed complete response or partial response until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Confirmed Complete Response by BICR Committee
timeFrame: From Study Day 1 until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Objective Response Rate According to the IPCG Criteria by Investigator Assessment
timeFrame: From Study Day 1 until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Median Progression-Free Survival
timeFrame: From Study Day 1 until disease progression assessed by the Investigator per IPCG criteria, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Progression-Free Survival at Week 24
timeFrame: From Study Day 1 until Week 24
measure: Phase 2 - Median Overall Survival
timeFrame: From Study Day 1 until death, unacceptable toxicity, or discontinuation, up to approximately 36 months
measure: Phase 2 - Incidence of Adverse Events
timeFrame: From first dose until 28 days after the last dose of GB5121
measure: Phase 2 - Incidence of Serious Adverse Events
timeFrame: From consent until 28 days after the last dose of GB5121
Other outcomes:
Locations:
city: Phoenix
country: United States
facility: Mayo Clinic
state: Arizona
city: Jacksonville
country: United States
facility: Mayo Clinic
state: Florida
city: Rochester
country: United States
facility: Mayo Clinic
state: Minnesota
city: New York
country: United States
facility: Memorial Sloan Kettering Cancer Center Main Campus
state: New York
city: Melbourne
country: Australia
facility: Peter MacCallum Cancer Center
state: Victoria
city: Nedlands
country: Australia
facility: Linear Clinical Research
state: Western Australia
city: Ottawa
country: Canada
facility: The Ottawa Hospital
state: Ontario
city: Saint-Cloud
country: France
facility: Institut Curie Site Saint-Cloud
state: Ile-de-France
city: Pierre-Bénite
country: France
facility: South Lyon Hospital Center
state: Lyon
city: Bordeaux
country: France
facility: Bergonie Institute
state: Nouvelle-Aquitaine
city: Marseille
country: France
facility: CHU APHM la Timone / Aix Marseille University
state: Provence-Alpes-Cote d'Azure
city: Paris
country: France
facility: La Pitie-Salpetriere University Hospital
state: Île-de-France
city: Haifa
country: Israel
facility: Rambam Health Care Campus
city: Jerusalem
country: Israel
facility: Hadassah Medical Center
city: Ramat Gan
country: Israel
facility: Chaim Sheba Medical Center
city: Papatoetoe
country: New Zealand
facility: Middlemore Hospital
state: Auckland
Study officials:
References: