Here are the studies that match your search criteria. If you are interested in participating, please reach out to the contact listed for the study. If no contact is listed, contact us and we'll help you find the right person.
Testing the Use of the Usual Chemotherapy Before and After Surgery for Removable Pancreatic Cancer
This phase III trial compares perioperative chemotherapy (given before and after surgery)
versus adjuvant chemotherapy (given after surgery) for the treatment of pancreatic cancer
that can be removed by surgery (removable/resectable). Chemotherapy drugs, such as
fluorouracil, irinotecan, leucovorin, and oxaliplatin, work in different ways to stop the
growth of tumor cells, either by killing the cells, by stopping them from dividing, or by
stopping them from spreading. Giving chemotherapy before and after surgery (perioperatively)
may work better in treating patients with pancreatic cancer compared to giving chemotherapy
after surgery (adjuvantly).
PRE-REGISTRATION:
• Pathology: Histologic or cytologic proof of pancreatic adenocarcinoma or adenosquamous
carcinoma
• TNM Stage: Tx-4, N0-1, M0 (M0 disease does not include spread to distant lymph nodes
and organs)
• Resectable Primary Tumor: Local radiographic reading must be consistent with
resectable disease defined as the following on 1) arterial and venous phase
contrast-enhanced abdominal/pelvic CT scan or abdominal/pelvic magnetic resonance
imaging (MRI) scan and 2) chest CT:
• No involvement or abutment of the celiac artery, common hepatic artery, superior
mesenteric artery, or replaced right hepatic artery (if applicable)
• Less than 180 degree interface between tumor and vessel wall of the portal vein
or superior mesenteric vein, and patent portal vein/splenic vein confluence
• No evidence of metastatic disease
• Measurable disease or non-measurable disease o Non-measurable disease is defined as
cytologic or histologic confirmation of adenocarcinoma of adenosquamous carcinoma by
fine needle aspiration or core-biopsy of the pancreas without measurable disease by
radiographic imaging
REGISTRATION:
• Confirmation of resectable disease by real-time central imaging review by the Alliance
Imaging Core Lab at Imaging and Radiation Oncology Core (IROC) Ohio
• Determined to be appropriate candidate for curative-intent pancreatectomy by surgeon
intending to perform the resection
• No prior radiation therapy, chemotherapy, targeted therapy, investigational therapy,
or surgery for pancreatic cancer
• Not pregnant and not nursing, because this study involves an agent that has known
genotoxic, mutagenic, and teratogenic effects.
• Therefore, for women of childbearing potential only, a negative pregnancy test done =<
14 days prior to registration is required
• Eastern Cooperative Oncology Group (ECOG) performance status 0-1
• Total Neuropathy Score < 2
• Absolute neutrophil count (ANC) >= 1,500/uL
• Platelet count >= 100,000/uL
• Total bilirubin =< 1.5 x upper limit of normal (ULN) (If obstructive jaundice is
present, then biliary drainage must be initiated and total bilirubin =< 3.0)
• Creatinine =< 1.5 x ULN OR calculated (Calc.) creatinine clearance >= 30 mL/min
(Calculated using the Cockcroft-Gault equation)
• No known Gilbert's Syndrome or known homozygosity for UGAT1A1*28 polymorphism
• No comorbid conditions that would prohibit curative-intent pancreatectomy
• Chronic concomitant treatment with strong inhibitors of CYP3A4 is not allowed on this
study. Patients on strong CYP3A4 inhibitors must discontinue the drug prior to
registration
• Chronic concomitant treatment with strong inducers of CYP3A4 is not allowed on this
study. Patients on strong CYP3A4 inducers must discontinue the drug prior to
registration
A Study of CC-95266 in Participants With Relapsed and/or Refractory Multiple Myeloma
The purpose of this study is to evaluate the safety and preliminary efficacy of CC-95266 in
participants with relapsed and/or refractory multiple myeloma (R/R MM).
• Age ≥ 18 years
• Participant has a diagnosis of multiple myeloma (MM) with relapsed and/or refractory
disease. Participants must have confirmed progressive disease (as per IMWG criteria)
on or within 12 months of completing treatment with the last anti-myeloma treatment
regimen before study entry or have confirmed progressive disease within 6 months prior
to screening and who are subsequently determined to be refractory or non-responsive to
their most recent anti-myeloma treatment regimen, except for participants with
cellular therapy (e.g., Chimeric antigen receptor (CAR) T-cell therapy) as their last
treatment, who may enroll beyond 12 months.
• Participants in Part A, and Part B Cohort A, and Part B Cohort B must have received at
least 3 prior anti-myeloma treatment regimens (note: induction with or without
hematopoietic stem cell transplant (HSCT) and with or without maintenance therapy is
considered one regimen).Subjects in Part B Cohort C only must have received at least 1
but not greater than 3 prior anti-myeloma treatment regimens, including a proteasome
inhibitor and immunomodulatory agent including:
• Autologous HSCT, unless the subject was ineligible
• A regimen that included an immunomodulatory agent (e.g., thalidomide,
lenalidomide, pomalidomide) and a proteasome inhibitor (e.g., bortezomib,
carfilzomib, ixazomib), either alone or combination
• Anti-CD38 (e.g., daratumumab), either alone or combination. Subjects in Cohort C
do not require prior anti-CD38 antibody therapy.
• Measurable disease
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Adequate organ function
Exclusion Criteria:
• Known active or history of central nervous system (CNS) involvement of MM
• Active or history of plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS
(polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes)
syndrome, or clinically significant amyloidosis
• Active autoimmune disease requiring immunosuppressive therapy
• History or presence of clinically significant CNS pathology such as seizure disorder,
aphasia, stroke, severe brain injuries, dementia, Parkinson's disease, cerebellar
disease, or psychosis
Other protocol-defined inclusion/exclusion criteria apply.
A Study of Belzutifan (MK-6482) in Combination With Lenvatinib Versus Cabozantinib for Treatment of Renal Cell Carcinoma (MK-6482-011)
This study will compare the efficacy and safety of belzutifan + lenvatinib versus
cabozantinib in participants with advanced renal cell carcinoma (RCC) with clear cell
component after prior therapy.
The primary hypothesis is that belzutifan + lenvatinib is superior to cabozantinib in terms
of progression-free survival or overall survival.
• Unresectable, locally advanced or metastatic clear cell renal cell carcinoma (RCC).
• Disease progression on or after an anti-programmed cell death-1/ligand 1 (PD-1/L1)
therapy as either first or second-line treatment for locally advanced/metastatic RCC
or as adjuvant treatment or neoadjuvant/adjuvant with progression on or within 6
months of last dose.
• Measurable disease per RECIST 1.1 criteria as assessed by local study investigator.
• Karnofsky performance status (KPS) score of at least 70% assessed within 10 days
before randomization.
• Received no more than 2 prior systemic regimens including: one anti-PD-1/L1 containing
adjuvant or neoadjuvant/adjuvant regimens with progression on or within 6 months from
the last dose of that regimen OR one or 2 regimens for locoregional/advanced disease
• Received only 1 prior antiPD-1/L1 therapy for adjuvant, neoadjuvant/adjuvant or
locally advanced/metastatic RCC.
• A male participant is eligible to participate if he is abstinent from heterosexual
intercourse or agrees to use contraception during the intervention period and for at
least 7 days after the last dose of belzutifan or lenvatinib in the
belzutifan+lenvatinib arm, whichever occurs last, and 23 days after the last dose of
cabozantinib.
• A female participant is eligible to participate if they are not pregnant, not
breastfeeding, and at least 1 of the following conditions applies: Not a woman of
childbearing potential (WOCBP) or a WOCBP who agrees to follow the contraceptive
guidance during the intervention period and for at least 30 days after the last dose
of study intervention in the belzutifan+ lenvatinib arm, or 120 days after the last
dose of study intervention in the cabozantinib arm.
• Adequately controlled blood pressure.
• Adequate organ function.
Exclusion Criteria:
• A pulse oximeter reading <92% at rest, requires intermittent supplemental oxygen, or
requires chronic supplemental oxygen.
• Known additional malignancy that is progressing or has required active treatment
within the past 3 years except for basal cell carcinoma of the skin, squamous cell
carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in
situ) that have undergone potentially curative therapy.
• Known central nervous system (CNS) metastases and/or carcinomatous meningitis.
• Clinically significant cardiac disease within 6 months of first dose of study
intervention.
• Prolongation of QTc interval to >480 ms.
• Symptomatic pleural effusion (e.g.,cough, dyspnea, pleuritic chest pain) that is not
clinically stable.
• Pre-existing ≥Grade 3 gastrointestinal or nongastrointestinal fistula.
• Moderate to severe hepatic impairment.
• History of significant bleeding within 3 months before randomization.
• History of solid organ transplantation.
• Known psychiatric or substance abuse disorder that would interfere with cooperation
with the requirements of the study.
• Unable to swallow orally administered medication or has a gastrointestinal disorder
affecting absorption (e.g., gastrectomy, partial bowel obstruction, malabsorption).
• Known hypersensitivity or allergy to the active pharmaceutical ingredients or any
component of the study intervention formulations.
• Received colony-stimulating factors [eg, granulocyte colony-stimulating factor
(G-CSF), granulocyte macrophage colony-stimulating factor (GMCSF) or recombinant
erythropoietin (EPO)] within 28 days before randomization.
• Prior treatment with belzutifan or another hypoxia-inducible factor (HIF)-2α
inhibitor.
• Prior treatment with lenvatinib.
• Prior treatment with cabozantinib.
• Currently participating in a study of an investigational agent or using an
investigational device.
• Active infection requiring systemic therapy.
• History of human immunodeficiency virus (HIV) infection.
• History of hepatitis B or known active hepatitis C infection.
Testing the Addition of Darolutamide to Hormonal Therapy (Androgen Deprivation Therapy [ADT]) After Surgery for Men With High-Risk Prostate Cancer, The ERADICATE Study
This phase III trial compares the effect of adding darolutamide to ADT versus ADT alone after
surgery for the treatment of high-risk prostate cancer. ADT reduces testosterone levels in
the blood. Testosterone is a hormone made mainly in the testes and is needed to develop and
maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. It
also plays role in prostate cancer development. Darolutamide blocks the actions of the
androgens (e.g. testosterone) in the tumor cells and in the body. Giving darolutamide with
ADT may work better in eliminating or reducing the size of the cancer and/or prevent it from
returning compared to ADT alone in patients with prostate cancer.
• PRE-REGISTRATION INCLUSION (STEP 0)
• Patient must have undergone a radical prostatectomy (RP) and must be registered to
step 0 of this study at least 6 weeks after but not more than 16 weeks after their
radical prostatectomy
• Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of
0- 2
• Patient with a prior or concurrent malignancy within 5 years of registration, whose
natural history or treatment does not have the potential to interfere with the safety
or efficacy assessment of the investigational regimen are eligible for this trial
• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral
therapy with undetectable viral load within 6 months are eligible for this trial
• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral
load must be undetectable on suppressive therapy, if indicated
• Patients with a history of hepatitis C virus (HCV) infection must have been treated
and cured. For patients with HCV infection who are currently on treatment, they are
eligible if they have an undetectable HCV viral load
• For patients with no previous Decipher score: Tumor tissue specimen from prostatectomy
must be available and ready to be shipped
• INCLUSION CRITERIA FOR RANDOMIZATION (STEP 1)
• For patients who have previously had Decipher score performed by Decipher Biosciences,
they must have score of >= 0.6
• For patients who did not have a Decipher score previously performed by Decipher
Biosciences, they must have had a Decipher score of >= 0.6 assessed from the
prostatectomy specimen submitted
• For patients who did not have a Decipher score previously performed by Decipher
Biosciences, patients must also have a CAPRA-S score >= 3. The CAPRA-S score is
calculated by assigning points for PSA in ng/mL, surgical margin status, seminal
vesicle invasion, and extra-capsular extension. Lymph node involvement will serve as
an exclusion criteria and will not count towards CAPRA-S inclusion score. A CAPRA-S
score is not required for patients who had a Decipher score previously performed by
Decipher Biosciences
• Patient must have an undetectable PSA (< 0.2ng/mL) obtained within 2 weeks prior to
randomization
• Leukocytes >= 3,000/mcL (obtained within 4 weeks prior to registration)
• Absolute neutrophil count >= 1,000/mcL (obtained within 4 weeks prior to registration)
• Platelets >= 75,000/mcL (obtained within 4 weeks prior to registration)
• Total bilirubin =< institutional upper limit of normal (ULN) (obtained within 4 weeks
prior to registration)
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase
[SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT])
=< 2.5 x institutional ULN (obtained within 4 weeks prior to registration)
• Glomerular filtration rate (GFR) >= 30 mL/min/1.73 m^2 (obtained within 4 weeks prior
to registration)
Exclusion Criteria:
• PRE-REGISTRATION EXCLUSION (STEP 0)
• Patient must not have any previous treatment with androgen deprivation therapy (ADT),
chemotherapy, or other physician prescribed systemic therapy for treatment of their
prostate cancer
• Patient must not have pathologic evidence of pelvic lymph node involvement
• Patient must not have an uncontrolled intercurrent illness including, but not limited
to, ongoing or active infection, symptomatic congestive heart failure (New York Heart
Association class III and IV heart failure), unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements
• EXCLUSION CRITERIA FOR RANDOMIZATION (STEP 1)
• Patient must not have pre or post-operative radiographic evidence of cancer recurrence
or metastasis by abdominal and pelvic imaging (computed tomography [CT]
abdomen/pelvis, whole body magnetic resonance imaging [MRI], MRI abdomen/pelvis, or
equivalent, AND bone scan) which must be done before or after prostatectomy prior to
randomization. If pre-operative risk does not indicate a need for bone scan,
post-operative Decipher score of >= 0.6 indicates increased risk of metastatic disease
and may be used to obtain CT abdomen/pelvis and bone scan prior to randomization
Substudy 03A: A Study of Immune and Targeted Combination Therapies in Participants With First Line (1L) Renal Cell Carcinoma (MK-3475-03A)
Substudy 03A is part of a larger research study that is testing experimental treatments for
renal cell carcinoma (RCC). The larger study is the umbrella study (U03).
The goal of substudy 03A is to evaluate the safety and efficacy of experimental combinations
of investigational agents in participants with advanced first line (1L) clear cell renal cell
carcinoma (ccRCC).
This substudy will have two phases: a safety lead-in phase and an efficacy phase. The safety
lead-in phase will be used to demonstrate a tolerable safety profile for the combination of
investigational agents. There will be no hypothesis testing in this study.
• Has a histologically confirmed diagnosis of locally advanced/metastatic ccRCC
• Has received no prior systemic therapy for advanced RCC; prior neoadjuvant/adjuvant
therapy for RCC is acceptable if completed ≥12 months before randomization/allocation
• Is able to swallow oral medication
• Has adequate organ function
• Participants receiving bone resorptive therapy must have therapy initiated at least 2
weeks before randomization/allocation
• Has resolution of toxic effects of the most recent prior therapy to ≤Grade 1
• If participants receive major surgery or radiation therapy, they must have recovered
from complications from the intervention
• Has adequately controlled blood pressure (BP ≤150/90 mm Hg) with no change in
hypertensive medications within 1 week before randomization/allocation
• Male participants are abstinent from heterosexual intercourse or agree to use
contraception during treatment with and for at least 7 days after the last dose of
lenvatinib and /or belzutifan; 7 days after lenvatinib and/or belzutifan is stopped,
if the participant is only receiving pembrolizumab, pembrolizumab/quavonlimab,
favezelimab/pembrolizumab or a combination of the aforementioned drugs, no
contraception is needed
• Female participant is not pregnant or breastfeeding and is not a woman of childbearing
potential (WOCBP) or is a WOCBP abstinent from heterosexual intercourse or using
contraception during the intervention period and for at least 120 days after the last
dose of pembrolizumab, pembrolizumab/quavonlimab, favezelimab/pembrolizumab for 30
days after the last dose of lenvatinib or belzutifan, whichever occurs last
Exclusion Criteria:
• Has urine protein ≥1 g/24 hours and has any of the following: (a) hypoxia defined as a
pulse oximeter reading <92% at rest, or (b) requires intermittent supplemental oxygen,
or (c) requires chronic supplemental oxygen
• Has clinically significant cardiovascular disease within 12 months from the first dose
of study intervention administration
• Has had major surgery within 3 weeks before first dose of study interventions
• Has a history of lung disease
• Has a history of inflammatory bowel disease
• Has preexisting gastrointestinal (GI) or non-GI fistula
• Has malabsorption due to prior GI surgery or disease
• Has received prior radiotherapy within 2 weeks of start of study intervention
• Has received a live or live attenuated vaccine within 30 days before the first dose of
study drug; killed vaccines are allowed
• Has received more than 4 previous systemic anticancer treatment regimens
• Has a diagnosis of immunodeficiency or is receiving any form of immunosuppressive
therapy within 7 days prior to the first dose of study intervention
• Has known additional malignancy that is progressing or has required active treatment
within the past 3 years
• Has known central nervous system (CNS) metastases and/or carcinomatous meningitis
• Has an active autoimmune disease that has required systemic treatment in the past 2
years; replacement therapy is not considered a form of systemic treatment and is
allowed
• Has an active infection requiring systemic therapy
• Has a known history of human immunodeficiency virus (HIV) infection
• Has a known history of Hepatitis B
• Has had an allogenic tissue/solid organ transplant
Comparison of Chemotherapy Before and After Surgery Versus After Surgery Alone for the Treatment of Gallbladder Cancer
This phase II/III trial compares the effect of adding chemotherapy before and after surgery
versus after surgery alone (usual treatment) in treating patients with stage II-III
gallbladder cancer. Chemotherapy drugs, such as gemcitabine and cisplatin, work in different
ways to stop the growth of tumor cells, either by killing the cells, by stopping them from
dividing, or by stopping them from spreading. Giving chemotherapy before surgery may make the
tumor smaller; therefore, may reduce the extent of surgery. Additionally, it may make it
easier for the surgeon to distinguish between normal and cancerous tissue. Giving
chemotherapy after surgery may kill any remaining tumor cells. This study will determine
whether giving chemotherapy before surgery increases the length of time before the cancer may
return and whether it will increase a patient's life span compared to the usual approach.
• Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of
0-1
• Patient must have histologically-confirmed T2 or T3 gallbladder cancer discovered
incidentally at the time of or following routine cholecystectomy for presumed benign
disease
• NOTE: Patients with histologically-confirmed Tis, T1a, T1b, or T4 tumors are not
eligible
• Patient must have undergone initial cholecystectomy within 12 weeks prior to
randomization
• Patient must have the ability to understand and the willingness to sign a written
informed consent document
• Leukocytes >= 3,000/mcL (obtained =< 28 days prior to randomization)
• Absolute neutrophil count >= 1,500/mcL (obtained =< 28 days prior to randomization)
• Platelets >= 100,000/mcL (obtained =< 28 days prior to randomization)
• Total bilirubin =< institutional upper limit of normal (ULN) except in patients with
Gilbert's syndrome. Patients with Gilbert's syndrome are eligible if direct bilirubin
< 1.5 x ULN of the direct bilirubin (obtained =< 28 days prior to randomization)
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and
alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x
institutional ULN (obtained =< 28 days prior to randomization)
• Serum creatinine =< institutional ULN OR creatinine clearance >= 50 mL/min/1.73 m^2
(Based on Cockcroft Gault estimation) (obtained =< 28 days prior to randomization)
• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral
therapy with undetectable viral load within 6 months of randomization are eligible for
this trial
• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral
load must be undetectable on suppressive therapy, if indicated
• Patients with a history of hepatitis C virus (HCV) infection must have been treated
and cured. For patients with HCV infection who are currently on treatment, they are
eligible if they have an undetectable HCV viral load
• Patients with a prior or concurrent malignancy whose natural history or treatment does
not have the potential to interfere with the safety or efficacy assessment of the
investigational regimen are eligible for this trial
• Patients with known history or current symptoms of cardiac disease, or history of
treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac
function using the New York Heart Association functional classification. To be
eligible for this trial, patients should be class 2B or better
Exclusion Criteria:
• Patient must not have any evidence of metastatic disease or inoperable loco-regional
disease based on high-quality, preoperative, cross-sectional imaging (computed
tomography [CT] or magnetic resonance imaging [MRI]) of the chest, abdomen, and pelvis
(C/A/P) obtained within 6 weeks prior to randomization, defined as
• No radiographic evidence of distant disease (M1 disease)
• No radiographic evidence of tumor invasion into multiple extrahepatic organs (T4
disease)
• No radiographic evidence of distant lymph node involvement (celiac, para-aortic,
para-caval lymph nodes)
• No evidence of new-onset ascites
• Soft tissue thickening within or in direct communication with the gallbladder
fossa, peri-portal lymph node involvement, involvement of one extrahepatic organ,
and other disease within the confines of what constitutes 'localized resectable'
disease are allowable
• Women must not be pregnant or breast feeding due to the potential harm to unborn fetus
and possible risk for adverse events in nursing infants with the treatment regimens
being used. All females of child bearing potential must have a serum or urine
pregnancy test to rule out pregnancy within 14 days prior to randomization. A female
of childbearing potential is defined as any woman, regardless of sexual orientation or
whether they have undergone tubal ligation, who meets the following criteria: 1) has
achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral
oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer
therapy does not rule out childbearing potential) for at least 24 consecutive months
(i.e., has had menses at any time in the preceding 24 consecutive months)
• Women of childbearing potential and sexually active males must not expect to conceive
or father children by being strongly advised to use accepted and effective method(s)
of contraception or to abstain from sexual intercourse for the duration of their
participation in the study
Stage III Gallbladder Cancer AJCC v8, Stage IIIA Gallbladder Cancer AJCC v8, Stage IIIB Gallbladder Cancer AJCC v8, Liver, Stage II Gallbladder Cancer AJCC v8, Stage IIA Gallbladder Cancer AJCC v8, Stage IIB Gallbladder Cancer AJCC v8
UT Southwestern; Parkland Health & Hospital System
Safety & Efficacy Study of Epcoritamab in Subjects With R/R Chronic Lymphocytic Leukemia and Richter's Syndrome (EPCORE CLL-1)
The trial is an open-label, multi-center safety and efficacy trial of epcoritamab in
relapsed/refractory chronic lymphocytic leukemia (R/R CLL) and Ritcher's Syndrome (RS). The
trial consists of two parts, a dose escalation phase (phase Ib) and an expansion phase (phase
II).
Key Inclusion Criteria
1. Subject must sign an ICF and be at least 18 years of age
2. ECOG performance status score of 0, 1 or 2
3. Screening evidence of CD20 positivity
4. Has laboratory parameters •HBG-≥9.0 g/dL; ANC-≥1.0 x 109/L; Platelets-≥30 x 109/L
5. Received a cumulative dose of corticosteroids less than the equivalent of 250 mg of
prednisone within the 2-week period before the first dose
6. Availability of fresh bone marrow material
7. A woman must not be of childbearing potential and practicing a highly effective method
of birth control, with a negative serum beta-hCG and urine pregnancy test at
screening.
8. A man who is sexually active with a woman of childbearing potential and has not had a
vasectomy must agree to use a barrier method of birth control.
9. For R/R CLL Cohort •Must have active CLL disease requiring treatment per iwCLL2018
10. For R/R CLL Cohort •received at least 2 prior lines of systemic anti-neoplastic
therapy anti-neoplastic therapy including a BTK inhibitor
11. For R/R CLL Cohort •Measurable Disease ≥5 × 109/L (5,000/μL) B lymphocytes in
peripheral blood or Presence of measurable lymphadenopathy and/or organomegaly
12. For RS Cohort •Documented clinical history transformation to diffuse large B cell
lymphoma (DLBCL)
13. For RS Cohort •Not eligible for chemoimmunotherapy
14. For RS Cohort •must have detectable disease by PET scan and measurable by CT scan or
MRI
Key Exclusion Criteria
1. Received prior treatment with a CD3 × CD20 bispecific antibody.
2. Received any prior allogeneic HSCT or solid organ transplantation.
3. Received treatment with an anti-cancer biologic including anti-CD20 therapy,
radio-conjugated or toxin-conjugated antibody or CAR T-cell therapy or investigational
drug within 2 weeks.
4. Received chemotherapy or radiation therapy within 2 weeks of the first dose of
epcoritamab.
5. Concomitant disease requiring permanent or high-dose immunosuppressive therapy.
6. Received vaccination with live vaccines within 28 days prior to the first dose of
epcoritamab.
7. Clinically significant cardiac disease
8. Major surgery within 4 weeks
9. Hepatitis B or C seropositivity (unless clearly due to vaccination)
10. History of human immunodeficiency virus (HIV)
11. Unable or unwilling to comply with contraceptive requirements during treatment and for
12 months after last dose of of epcoritamab.
12. For R/R CLL Cohort •Any history of RS or evidence indicating a potential Richter's
transformation.
13. For RS Cohort •Transformation of CLL to Hodgkin variant of RS
14. For RS Cohort •Diagnosis of Richter's syndrome not of the DLBCL subtype such as
Hodgkin's lymphoma, prolymphocytic leukemia.
15. For RS Cohort •Subject received autologous HSCT within 3 months prior to the first
dose of epcoritamab.
16. For RS Cohort •Subject received more than 1 prior line of therapy for RS.
NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.
Post-Surgical Stereotactic Radiotherapy (SRT) Versus GammaTile-ROADS (Radiation One and Done Study)
This trial will be a randomized controlled study comparing the efficacy and safety of
intraoperative radiation therapy using GammaTilesTM (GT) versus SRS 3-4 weeks following
metastatic tumor resection which is the current standard of care.
1. Patients aged 18 years old and above. Eligibility is restricted to this age group
given that the battery of neurocognitive tests utilized in this protocol are not
developed or validated for use in a younger population.
2. One to four newly diagnosed brain metastases, identified on the screening MRI, from an
extracranial primary tumor.
3. One lesion, designated the index lesion, is planned for surgical resection and is to
be between 2.5 cm and 5.0 cm on the screening MRI. Index lesions > 2.0 cm but <2.5 cm
are also eligible if surgery is deemed clinically necessary and appropriate for an
attempted gross total resection by the neurosurgeon.
4. Non-index lesions must measure < 4.0 cm in maximal extent on the screening MRI brain
scan. The unresected lesions will be treated with SRT as outlined in the treatment
section of the concept.
5. All metastases must be located > 5 mm from the optic chiasm and outside the brainstem.
Dural based metastasis are eligible.
6. Previous and/or concurrent treatment with systemic therapies (e.g., chemotherapy,
targeted therapeutics, immunotherapy) is permitted and must follow protocol guidelines
as follows: Systemic therapy is allowed a minimum of one week from last systemic
therapy cycle to surgical resection, and one week after surgical resection to allow a
minimum of one week before starting/resuming systemic therapy, depending on the
specific systemic agent(s), as recommended by medical/neuro-oncology. Systemic therapy
is not allowed 1 day before SRT, the same day as the SRT, or 1 day after the
completion of the SRT or longer, depending on the specific systemic agent(s), as
recommended by medical/neuro-oncology. Agents that are delivered by implant or depot
injections (such as hormonal therapies) are excluded from these restrictions.
7. KPS score of ≥70.
8. Stable systemic disease or reasonable systemic treatment options predicting a life
expectancy of ≥6 months.
9. Ability to complete an MRI of the head with contrast
10. Adequate renal and hepatic function to undergo surgery, in investigators opinion.
11. For women of childbearing potential only, a negative urine or serum pregnancy test
done < 7 days prior to randomization is required. Women must be willing to notify
investigator immediately if they become pregnant at any time during the trial period.
12. Men and women of childbearing potential must be willing to employ adequate
contraception throughout the study and for men for up to 3 months after completing
treatment.
13. Subjects must be fluent in English language to allow for completion of neurocognitive
tests and completion of QOL questionnaires. Non-English speaking subjects are not
permitted to participate given that participation in the real time integrated
neurocognitive function tests is mandatory for all patients. The psychometric
properties for translated tests are either not known or not as robust.
14. Willingness and ability to provide written informed consent and HIPAA authorization
prior to performance of any study-related procedures.
Exclusion Criteria
1. Age <18 years.
2. KPS<70
3. Past radiation or surgical therapy to the index lesion or the newly diagnosed
non-index lesion(s) is exclusionary. However, up to a total of 2 prior courses of SRT
treatment to previously diagnosed lesions are allowed as long as any treated lesions
are were >15mm from the index lesion.
4. Patients with >4 newly diagnosed metastases on screening MRI
5. Pregnant patients.
6. Primary germ cell tumor, small cell carcinoma, or lymphoma.
7. Leptomeningeal metastasis (LMD). Note: For the purposes of exclusion, LMD is a
clinical diagnosis, defined as radiologic or clinical evidence of leptomeningeal
involvement with or without positive cerebrospinal fluid (CSF) cytology.
8. Prior WBRT for brain metastases.
9. Concomitant therapy that, in the investigator's opinion, would interfere with the
evaluation of the safety or efficacy of the study device.
10. Comorbid psychiatric or neurologic disease or injury impacting cognition, in the
opinion of the treating physician, that might impair patient's ability to understand
or comply with the requirements of the study or to provide consent
11. Subjects who, in the investigator's opinion, are unable to understand the protocol or
to give informed consent, have a history of poor cooperation, noncompliance with
medical treatment, or difficulty in returning for follow up care.
Testing the Use of Targeted Treatment (AMG 510) for KRAS G12C Mutated Advanced Non-squamous Non-small Cell Lung Cancer (A Lung-MAP Treatment Trial)
This phase II Lung-MAP treatment trial studies the effect of AMG 510 in treating non-squamous
non-small cell lung cancer that is stage IV or has come back (recurrent) and has a specific
mutation in the KRAS gene, known as KRAS G12C. Mutations in this gene may cause the cancer to
grow. AMG 510, a targeted treatment against the KRAS G12C mutation, may help stop the growth
of tumor cells.
• Participants must be assigned to S1900E. Assignment to S1900E is determined by the
LUNGMAP protocol genomic profiling using the FoundationOne assay. Biomarker
eligibility for S1900E is based on the identification of a KRAS^G12C mutation
• Participants must have confirmed stage IV or recurrent non-squamous non-small cell
lung cancer (NSCLC). Mixed histology NSCLC with less than 50% squamous component is
allowed
• Participants must have measurable disease documented by computed tomography (CT) or
magnetic resonance imaging (MRI). The CT from a combined positron emission tomography
(PET)/CT may be used to document only non-measurable disease unless it is of
diagnostic quality. Measurable disease must be assessed within 28 days prior to
sub-study registration. Pleural effusions, ascites and laboratory parameters are not
acceptable as the only evidence of disease. Non-measurable disease must be assessed
within 42 days prior to sub-study registration. Participants whose only measurable
disease is within a previous radiation therapy port must demonstrate clearly
progressive disease (in the opinion of the treating investigator) prior to
registration
• Participants must have a CT or MRI scan of the brain to evaluate for central nervous
system (CNS) disease within 42 days prior to sub-study registration
• Participants with known human immunodeficiency virus (HIV) infection must be receiving
anti-retroviral therapy and have an undetectable viral load at their most recent viral
load test within 6 months prior to sub-study registration
• Participants with EGFR sensitizing mutations, EGFR T790M mutation, ALK gene fusion,
ROS1 gene rearrangement, or BRAF V600E mutation must have progressed following all
standard of care targeted therapy
• Participants with spinal cord compression or brain metastases must have received local
treatment to these metastases and remained clinically controlled and asymptomatic for
at least 7 days following stereotactic radiation and/or 14 days following whole brain
radiation, and prior to sub-study registration
• Participants must have received at least one line of systemic treatment for stage IV
or recurrent NSCLC
• Participants must have progressed (in the opinion of the treating physician) following
the most recent line of systemic therapy for NSCLC
• Participants must have recovered (=< grade 1) from side effects of prior therapy. The
exception is if a side effect from a prior treatment is known to be permanent without
expected further recovery or resolution (i.e., endocrinopathy from immunotherapy or
cisplatin neurotoxicity)
• Participants must be able to swallow tablets whole
• Pre-study history and physical exam must be obtained within 28 days prior to sub-study
registration
• Absolute neutrophil count (ANC) >= 1,500/uL obtained within 28 days prior to sub-study
registration
• Platelet count >= 75,000/uL obtained within 28 days prior to sub-study registration
• Hemoglobin >= 9 g/dL obtained within 28 days prior to sub-study registration
• Serum bilirubin =< institutional upper limit of normal (IULN) within 28 days prior to
sub-study registration
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2 x IULN within
28 days prior to sub-study registration. For participants with liver metastases, and
ALT and AST must be =< 5 x IULN
• Participants must have a serum creatinine =< 1.5 x IULN or calculated creatinine
clearance >= 50 mL/min using the following Cockcroft-Gault Formula. This specimen must
have been drawn and processed within 28 days prior to sub-study registration
• Participants must have Zubrod performance status 0-1 documented within 28 days prior
to sub-study registration
• Participants of reproductive potential must have a negative serum pregnancy test
within 28 days prior to sub-study registration
• Participants must agree to have blood specimens submitted for circulating tumor DNA
(ctDNA)
• Participants must be offered the opportunity to participate in specimen banking and in
correlative studies for collection and future use of specimens. With participant
consent, specimens must be collected and submitted via the Southwest Oncology Group
(SWOG) Specimen Tracking System
• Participants must be informed of the investigational nature of this study and must
sign and give informed consent in accordance with institutional and federal guidelines
• NOTE: As a part of the Oncology Patient Enrollment Network (OPEN) registration
process the treating institution's identity is provided in order to ensure that
the current (within 365 days) date of institutional review board approval for
this study has been entered in the system
• As a part of the Oncology Patient Enrollment Network (OPEN) registration process the
treating institution's identity is provided in order to ensure that the current
(within 365 days) date of institutional review board approval for this study has been
entered in the system
• Participants with impaired decision-making capacity are eligible as long as their
neurological or psychological condition does not preclude their safe participation in
the study (e.g., tracking pill consumption and reporting adverse events to the
investigator). For participants with impaired decision-making capabilities, legally
authorized representatives may sign and give informed consent on behalf of study
participants in accordance with applicable federal, local, and Central Institutional
Review Board (CIRB) regulations
Exclusion Criteria:
• Participants with spinal cord compression or brain metastases must not have residual
neurological dysfunction, unless no further recovery is expected, and the participant
has been stable on weaning doses of corticosteroids prior to sub-study registration
• Participants must not have leptomeningeal disease unless: (1) asymptomatic and (2)
only detected on radiographic imaging (i.e., not present in cytology from cerebral
spinal fluid [CSF] if CSF sampled)
• Participants must not have received any prior systemic therapy (systemic chemotherapy,
immunotherapy or investigational drug) within 21 days prior to sub-study registration
• Participants must not have received any radiation therapy within 14 days prior to
sub-study registration, with the exception of stereotactic radiation to CNS metastases
which must have been completed at least 7 days prior to sub-study registration
• Participants must not have received prior AMG 510 or other KRAS^G12C specific
inhibitor
• Participants must not be planning to receive any concurrent chemotherapy,
immunotherapy, biologic or hormonal therapy for cancer treatment while receiving
treatment on this study
• Participants must not have had a major surgery within 14 days prior to sub-study
registration. Participant must have fully recovered from the effects of prior surgery
in the opinion of the treating investigator
• Participants must not have any grade III/IV cardiac disease as defined by the New York
Heart Association criteria (i.e., participants with cardiac disease resulting in
marked limitation of physical activity or resulting in inability to carry on any
physical activity without discomfort), unstable angina pectoris, and myocardial
infarction within 6 months, or serious uncontrolled cardiac arrhythmia
• Participants must not have a prior or concurrent malignancy whose natural history or
treatment has the potential to interfere with the safety or efficacy assessment of the
investigational regimen
• Participants must not have gastrointestinal disorders that may impact drug absorption
• Participants must not have received strong inducers of CYP3A4 (including herbal
supplements such as St. John's wort) within 14 days prior to sub-study registration
and must not be planning to use strong inducers of CYP3A4 throughout protocol
treatment
• Participants must not have received CYP3A4 sensitive substrates (with a narrow
therapeutic window) within 14 days prior to sub-study registration and must not be
planning to use CYP3A4 sensitive substrates (with a narrow therapeutic window)
throughout protocol treatment
• Participants must not be pregnant or nursing. Participants with uteri must have agreed
to use an effective contraceptive method for at least one month after the last dose of
AMG 510. Participants with sperm must have agreed to use an effective contraceptive
method for at least 3 months after the last dose of AMG 510. Participants are
considered to be of "reproductive potential" if they have had menses at any time in
the preceding 12 consecutive months and no prior oophorectomy and/or hysterectomy. In
addition to routine contraceptive methods, "effective contraception" for participants
with uteri also includes heterosexual celibacy and surgery intended to prevent
pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy,
bilateral oophorectomy or bilateral tubal ligation. Acceptable methods of birth
control for participants with sperm include sexual abstinence (refraining from
heterosexual intercourse); vasectomy with testing showing there is no sperm in the
semen; bilateral tubal ligation or occlusion in the partner; or a condom (the female
partner should also consider a form of birth control). However, if at any point a
previously celibate participant chooses to become heterosexually active during the
time period for use of contraceptive measures outlined in the protocol, he/she is
responsible for beginning contraceptive measures
Drug: Sotorasib
Lung Adenocarcinoma, Recurrent Lung Non-Squamous Non-Small Cell Carcinoma, Stage IVA Lung Cancer AJCC v8, Stage IV Lung Cancer AJCC v8, Stage IVB Lung Cancer AJCC v8, Lung Non-Small Cell Carcinoma, Lung/Thoracic
UT Southwestern; Parkland Health & Hospital System
A Study of Relatlimab Plus Nivolumab in Combination With Chemotherapy vs. Nivolumab in Combination With Chemotherapy as First Line Treatment for Participants With Stage IV or Recurrent Non-small Cell Lung Cancer (NSCLC)
The purpose of this study is to assess the safety profile of relatlimab plus nivolumab in
combination with platinum doublet chemotherapy (PDCT) and to determine if nivolumab plus
relatlimab in combination with PDCT improves overall response rate (ORR) when compared to
nivolumab plus PDCT in participants with previously untreated Stage IV or recurrent non-small
cell lung cancer (NSCLC).
• Histologically confirmed metastatic non-small cell lung cancer (NSCLC) of squamous
(SQ) or non-squamous (NSQ) histology with Stage IV A/B (as defined by the 8th
International Association for the Study of Lung Cancer Classification) or recurrent
disease following multi-modal therapy for locally advanced disease
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) of less than or
equal to 1 at screening and confirmed prior to randomization
• Measurable disease by computed tomography (CT) or magnetic resonance resources (MRI)
per response evaluation criteria in solid tumor version 1.1 (RECIST 1.1) criteria
• No prior systemic anti-cancer treatment (including epidermal growth factor receptor
(EGFR) and anaplastic lymphoma kinase (ALK) inhibitors) given as primary therapy for
advanced or metastatic disease
Exclusion Criteria:
• Participants with EGFR, ALK, ROS-1, or known B-rapidly accelerated fibrosarcoma
proto-oncogene (BRAF V600E) mutations that are sensitive to available targeted therapy
• Untreated CNS metastases
• Leptomeningeal metastases (carcinomatous meningitis)
• Concurrent malignancy requiring treatment or history of prior malignancy active within
2 years prior to randomization (ie, participants with a history of prior malignancy
are eligible if treatment was completed at least 2 years before randomization and the
participant has no evidence of disease)
• Prior treatment with an anti-programmed cell death protein 1 (PD-1), anti-programmed
death-ligand 1 (PD-L1), anti-programmed death-ligand 2 (PD-L2), or anti-cytotoxic
T-lymphocyte-associated protein 4 (CTLA-4) antibody, or any other antibody or drug
specifically targeting T-cell co-stimulation or checkpoint pathways
Other protocol-defined inclusion/exclusion criteria apply
Monitoring Neoadjuvant Chemotherapy of Breast Cancer Using 3D Subharmonic Aided Pressure Estimation
This phase II/III trial studies if contrast-enhanced ultrasound (CEUS) using a contrast
agent, perflutren lipid microspheres (Definity), can predict the early response of breast
cancer to neoadjuvant chemotherapy by estimating the pressure gradient between the breast
cancer and surrounding tissues. To estimate the pressures noninvasively, subharmonic (half of
fundamental frequency) aided pressure estimation (SHAPE) using CEUS will be utilized. The
study hypothesis is that the subharmonic signal difference in the tumor relative to the
normal tissue can predict breast cancer NAC response after 10% of therapy regimen.
• Provide signed and dated informed consent form
• Willing to comply with all study procedures and be available for the duration of the
study
• At least 21 years old
• Be diagnosed with breast cancer (T1 or greater LABC, any N and M0)
• Be scheduled for neoadjuvant chemotherapy
• Be medically stable
• Be conscious and able to comply with study procedures
• If a female of child-bearing potential, must have a negative urine pregnancy test
Exclusion Criteria:
• Females who are pregnant or nursing
• Patients with other primary cancers requiring systemic treatment
• Patients with any distal metastatic disease
• Patients undergoing neoadjuvant endocrine therapy
• Patients who are medically unstable, patients who are seriously or terminally ill, and
patients whose clinical course is unpredictable. For example:
• Patients on life support or in a critical care unit;
• Patients with unstable occlusive disease (e.g., crescendo angina);
• Patients with clinically unstable cardiac arrhythmias, such as recurrent
ventricular tachycardia;
• Patients with uncontrolled congestive heart failure (New York Heart Association
[NYHA] Class IV);
• Patients with recent cerebral hemorrhage;
• Patients who have undergone surgery within 24 hours prior to the study
sonographic examination
• Patients with known hypersensitivity or allergy to any component of Definity
• Patients with unstable cardiopulmonary conditions or respiratory distress syndrome
• Patients with uncontrollable emphysema, pulmonary vasculitis, pulmonary hypertension
or a history of pulmonary emboli
Locally Advanced Breast Carcinoma, Anatomic Stage IIIA Breast Cancer AJCC v8, Prognostic Stage IIIA Breast Cancer AJCC v8, Breast - Female, Anatomic Stage III Breast Cancer AJCC v8, Anatomic Stage IIIB Breast Cancer AJCC v8, Anatomic Stage IIIC Breast Cancer AJCC v8, Prognostic Stage III Breast Cancer AJCC v8, Prognostic Stage IIIB Breast Cancer AJCC v8, Prognostic Stage IIIC Breast Cancer AJCC v8
UT Southwestern; Parkland Health & Hospital System
Study of Ravulizumab in Pediatric Participants With HSCT-TMA
This study will evaluate the safety, efficacy, pharmacokinetics, and pharmacodynamics of
ravulizumab administered by intravenous infusion to pediatric participants, from 1 month to <
18 years of age, with HSCT-TMA. The treatment period is 26 weeks, followed by a 26-week
off-treatment follow-up period.
1. 1 month of age up to < 18 years of age at the time of signing the informed consent.
2. Received HSCT within the past 6 months.
3. Diagnosis of TMA that persists despite initial management of any triggering condition.
4. Body weight ≥ 5 kilograms.
5. Female participants of childbearing potential and male participants with female
partners of childbearing potential must use highly effective contraception starting at
Screening and continuing until at least 8 months after the last dose of ravulizumab.
6. Participants must be vaccinated against meningococcal infections if clinically
feasible, according to institutional guidelines for immune reconstitution after HSCT.
Participants must be re-vaccinated against Haemophilus influenzae type b and
Streptococcus pneumoniae if clinically feasible, according to institutional guidelines
for immune reconstitution after HSCT. All participants should be administered coverage
with prophylactic antibiotics according to institutional post-transplant infection
prophylaxis guidances, including coverage against Neisseria meningitidis for at least
2 weeks after meningococcal vaccination. Participants who cannot receive meningococcal
vaccine should receive antibiotic prophylaxis coverage against Neisseria meningitidis
the entire Treatment Period and for 8 months following the final dose of ravulizumab.
Exclusion Criteria:
1. Known familial or acquired 'a disintegrin and metalloproteinase with a thrombospondin
type 1 motif, member 13' deficiency (activity < 5%).
2. Known Shiga toxin-related hemolytic uremic syndrome.
3. Positive direct Coombs test.
4. Diagnosis or suspicion of disseminated intravascular coagulation.
5. Known bone marrow/graft failure.
6. Diagnosis of veno-occlusive disease.
7. Human immunodeficiency virus (HIV) infection (evidenced by HIV-1 or HIV-2 antibody
titer).
8. Unresolved meningococcal disease.
9. Presence or suspicion of sepsis (treated or untreated) within 7 days prior to
Screening.
10. Pregnancy or breastfeeding.
11. Hypersensitivity to murine proteins or to 1 of the excipients of ravulizumab.
12. Previously or currently treated with a complement inhibitor.
Drug: Ravulizumab, Other: Best Supportive Care
Brain and Nervous System, Kidney, Leukemia, Other, Hodgkins Lymphoma, Leukemia, Not Otherwise Specified, Lymphoid Leukemia, Myeloid and Monocytic Leukemia, Non-Hodgkins Lymphoma, Other Hematopoietic, Thrombotic Microangiopathy
Safety and Efficacy of Retifanlimab (INCMGA00012) Alone or in Combination With Other Therapies in Participants With Advanced or Metastatic Endometrial Cancer Who Have Progressed on or After Platinum-based Chemotherapy. (POD1UM-204)
This is a multicenter, open-label, nonrandomized, Phase 2 umbrella study of retifanlimab in
participants who have advanced or metastatic endometrial cancer that has progressed on or
after platinum-based chemotherapy. retifanlimab will be administered as monotherapy or in
combination with other immunotherapy or targeted agents.
• Ability to comprehend and willingness to sign a written ICF for the study. Women 18
years of age or older (or as applicable per local country requirements).
• Histologically confirmed diagnosis of advanced or metastatic endometrial cancer with
disease progression on or after treatment with at least 1 platinum-containing regimen
for advanced or metastatic disease.
• Groups A and B: Have not been previously treated with a PD-(L)1 inhibitor.
• Group A only: Tumor tissue tested as MSI-High
• Group B only: Tumor tissue tested as deficient MMR or an ultra-mutated POLE tumor.
• Group D only: Tumor tissue tested as having an FGFR 1,2,3 mutation or alteration
characterized as per protocol.
• Must have at least 1 measurable tumor lesion per RECIST v1.1.
• Willing to provide tumor tissue sample (fresh or archived).
• ECOG performance status 0 to 1.
• Willingness to avoid pregnancy.
Exclusion Criteria:
• Group A only: Histologically confirmed diagnosis of carcinosarcoma of the uterus.
• Histologically confirmed diagnosis of sarcoma of the uterus.
• Has disease eligible for potentially curative treatment.
• Receipt of anticancer therapy within 28 days of the first administration of study
treatment, with the exception of localized radiotherapy.
• Toxicity of prior therapy that has not recovered to ≤ Grade 1 or baseline unless
approved by the medical monitor.
• Groups C and D (combinations): limiting immune-related toxicity during prior
checkpoint inhibitor therapy.
• Has an active autoimmune disease requiring systemic immunosuppression with
corticosteroids (> 10 mg/day of prednisone or equivalent) or immunosuppressive drugs
within 14 days before the first dose of study treatment.
• Receiving chronic systemic steroids (> 10 mg/day of prednisone or equivalent):
• Known active CNS metastases and/or carcinomatous meningitis.
• Has known active hepatitis B or C.
• Has received a live vaccine within 28 days of the planned start of study treatment.
• Evidence of interstitial lung disease or active, noninfectious pneumonitis.
• Participants who are known to be HIV-positive with some protocol exceptions.
DuRvalumab With chEmotherapy as First Line treAtment in Advanced Pleural Mesothelioma (DREAM3R)
Patients with pleural mesothelioma (PM) that cannot be surgically removed will receive
standard chemotherapy (cisplatin or carboplatin and pemetrexed) given with durvalumab, a type
of immunotherapy, or a treatment chosen by the study doctor, which is either standard
chemotherapy or immunotherapy combination (ipilimumab and nivolumab).
Durvalumab is an antibody (a type of human protein) that works by blocking a body substance
called Programmed Death-Ligand 1 (PD-L1). Blocking PD-L1 helps the body's immune system
attack cancer cells. Research has shown that durvalumab can slow tumor growth and shrink
tumors in some people with cancer. Previous studies of combining durvalumab and chemotherapy
showed that this combination is active in advanced mesothelioma.
The purpose of this study is to see whether adding durvalumab to standard chemotherapy will
improve overall survival (OS) in patients with PM.
• Adults (18 years or over) with a histological diagnosis of epithelioid pleural
mesothelioma that is not amenable to curative surgical resection. Histological
diagnosis requires tumour tissue from an open biopsy, or a core biopsy with a needle
of 19 gauge or wider.
• Measurable disease as per modified RECIST 1.1 (mRECIST 1.1) criteria for assessment of
response in pleural mesothelioma, without prior radiotherapy to these sites.
• Body weight >30 kg,
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Tumour tissue (Formalin-Fixed Paraffin-Embedded [FFPE]) available from standard of
care diagnostic biopsy for PD-L1 testing and other correlative biomarker testing at a
central laboratory.
• Life expectancy of at least 12 weeks.
• Adequate blood tests (done within 14 days prior to randomisation) and with values
within the ranges specified below. Blood transfusions are permissible if completed at
least 7 days prior to treatment start.
• Haemoglobin ≥ 9.0 g/L
• Absolute neutrophil count ≥ 1.5 x 10^9/L
• Platelets ≥ 100 x 10^9/L
• Total bilirubin ≤ 1.5 x upper limit of normal (ULN) (except participants with
Gilbert's Syndrome, who are eligible with bilirubin ≤ 2.5 ULN)
• Alanine transaminase ≤ 2.5 x upper limit of normal (ULN), unless liver metastases
or invasion are present, in which case it must be ≤ 5 x ULN
• Aspartate aminotransferase ≤ 2.5 x ULN, unless liver metastases or invasion are
present, in which case it must be ≤ 5 x ULN
• Creatinine clearance (CrCl) ≥ 45 mL/min (Cockcroft-Gault formula). NOTE:
Carboplatin AUC 5 must be the initial platinum agent of choice in patients with
creatinine Cl <60 mL/min but ≥ 45 mL/min, or those with clinically reported
hearing loss.
• Patient consent must be appropriately obtained in accordance with applicable local and
regulatory requirements. Each patient or legal representative must sign a consent form
prior to enrolment in the trial to document their willingness to participate.
• Willing and able to comply with all study requirements, including treatment, timing
and/or nature of required assessments.
• Women of childbearing potential must use a reliable means of contraception during
treatment and for at least 90 days thereafter. Breastfeeding is not permissible during
or for at least 90 days after the final study treatment. Men must have been surgically
sterilised or use a barrier method of contraception if they are sexually active with a
woman of child bearing potential.
• Evidence of post-menopausal status or negative serum pregnancy test for female
pre-menopausal patients. Women will be considered post-menopausal if they have been
amenorrheic for 12 months without an alternative medical cause.
Exclusion Criteria:
• Non-epithelioid histology (biphasic or sarcomatoid).
• Prior chemotherapy or other systemic anti-cancer or immunotherapy for PM.
• Diagnosis based only on cytology or aspiration biopsy with a needle narrower than 19
gauge.
• Active or prior documented autoimmune or inflammatory disorders (including
inflammatory bowel disease [e.g. colitis or Crohn's disease], diverticulitis [with the
exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or
Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid
arthritis, hypophysitis, uveitis, etc.]). The following are exceptions to this
criterion:
1. Patients with vitiligo or alopecia
2. Patients with hypothyroidism (e.g. following Hashimoto syndrome) stable on
hormone replacement
3. Any chronic skin condition that does not require systemic therapy
4. Patients without active disease in the last 5 years may be included
5. Patients with celiac disease controlled by diet alone
• Any condition requiring systemic treatment with either corticosteroids (>10 mg daily
prednisone or equivalent dose of an alternative corticosteroid) or other
immunosuppressive medications within 28 days of durvalumab or ipilimumab or nivolumab
administration. Intranasal, inhaled or topical steroids or local steroid injections
(e.g. intra-articular injection) are permitted in the absence of active autoimmune
disease. Standard steroid premedication given prior to chemotherapy or as prophylaxis
for imaging contrast allergy should not be counted for this criterion.
• Participants with symptomatic or uncontrolled brain metastases or leptomeningeal
disease are excluded.
• Prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any
other antibody or drug specifically targeting T cell co-stimulation or immune
checkpoint pathways.
• Current treatment or treatment within the last 12 months with any investigational
anti-cancer products.
• Concurrent enrolment in another clinical study testing an anticancer treatment.
• Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) ≥ 470 msec
in screening ECG measured using standard institutional method or history of familial
long QT syndrome.
• Major surgical procedure (as defined by the Investigator) within 28 days prior to the
first dose of study treatment on protocol. Note: Local surgery of isolated lesions for
palliative intent is acceptable. Limited pleural biopsy procedures do not apply.
• No other malignancy that requires active treatment. Participants with a past history
of adequately treated carcinoma in situ, non-melanoma skin cancer or lentigo maligna
without evidence of disease or superficial transitional cell carcinoma of the bladder
are eligible.
• Hearing loss or peripheral neuropathy considered by the investigators to
contraindicate administration of either cisplatin, carboplatin or pemetrexed.
• History of allergy or hypersensitivity to investigational product, cisplatin,
carboplatin, pemetrexed, ipilimumab, nivolumab or any excipient.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive cardiac failure, uncontrolled hypertension, unstable
angina pectoris, cardiac arrhythmia, interstitial lung disease, active peptic ulcer
disease or gastritis, serious chronic gastrointestinal conditions associated with
diarrhoea, active bleeding diatheses.
• Hepatitis B, hepatitis C or human immunodeficiency virus (HIV). Exceptions include
past or resolved Hepatitis B (defined as the presence of hepatitis B core antibody
[anti-HBc] and absence of HBsAg) and patients positive for hepatitis C (HCV) antibody
if polymerase chain reaction is negative for HCV RNA. HIV testing is not required in
absence of clinical suspicion of HIV.
• Known history of primary immunodeficiency, allogeneic organ transplant, pneumonitis or
active tuberculosis.
• Receipt of live attenuated vaccination within 30 days prior to enrolment or within 30
days of receiving durvalumab, ipilimumab, nivolumab.
• Specific comorbidities or conditions or concomitant medications which may interact
with the investigational product(s).
• Any condition that, in the opinion of the investigator, would interfere with
evaluation of study treatment or interpretation of patient safety or study results.
• Serious medical or psychiatric conditions or social situation that might limit
compliance with study requirements, substantially increase risk of incurring adverse
events or compromise the ability of the patient to give written informed consent.
Drug: Durvalumab, Drug: Standard Chemotherapy, Drug: Ipilimumab and Nivolumab
Safety and Efficacy Trial of Epcoritamab Combinations in Subjects With B-cell Non-Hodgkin Lymphoma (B-NHL) (EPCORE™ NHL-2)
A phase 1b/2, open-label, multinational, interventional trial to evaluate the safety,
tolerability, pharmacokinetics (PK), pharmacodynamics/biomarkers, immunogenicity, and
preliminary efficacy of epcoritamab in combination with other standard of care (SOC) agents
in subjects with B-cell Non-Hodgkin Lymphoma (B-NHL).
Key Inclusion Criteria
1. Subject must sign an Informed Consent Form (ICF)
2. At least 18 years of age
3. Measurable disease defined as ≥1 measurable nodal lesion (long axis >1.5 cm and short
axis >1.0 cm) or ≥1 measurable extra-nodal lesion (long axis >1.0 cm) on computed
tomography (CT) or magnetic resonance imaging (MRI)
4. Eastern Cooperative Oncology Group (ECOG) PS score of 0, 1 or 2
5. Acceptable organ function at screening
6. CD20-positive non-Hodgkin lymphoma (NHL) at most recent representative tumor biopsy
7. If of childbearing potential subject must practicing a highly effective method of
birth control
8. A man who is sexually active with a woman of childbearing potential must agree to use
a barrier method of birth control
Arm 1:
• Newly Diagnosed Documented diffuse large B-cell lymphoma (DLBCL)
• DLBCL, NOS
• "double-hit" or "triple-hit" DLBCL
• FL Grade 3B
Arm 2: R/R FL
Arm 3: Newly diagnosed, previously untreated FL grade 1-3A
Arm 4:
• Documented DLBCL and eligible for HDT-ASCT
• DLBCL, NOS
• "double-hit" or "triple-hit" DLBCL
• FL Grade 3B
Arm 5:
• Relapsed or refractory documented DLBCL and ineligible for HDT-ASCT
• DLBCL, NOS
• "double-hit" or "triple-hit" DLBCL
• FL Grade 3B
Arm 6: Newly diagnosed, previously untreated FL grade 1-3A
Arm 7:
• FL Grade 1-3A
• If PR or CR per Lugano criteria following first-line or second-line treatment with SOC
regimen, and last dose of SOC within 6 months prior to enrollment.
Arm 8:
• DLBCL, NOS
• T-cell/histiocyte rich DLBCL
• "double-hit" or "triple-hit" DLBCL
• FL Grade 3B
Key Exclusion Criteria
1. Chemotherapy, radiation therapy, or major surgery within 4 weeks prior to the first
dose of epcoritamab
2. Any prior treatment with a bispecific antibody targeting CD3 and CD20.
3. Treatment with CAR-T therapy within 30 days prior to first dose of epcoritamab
4. Clinically significant cardiovascular disease
5. Evidence of significant, uncontrolled concomitant diseases that could affect
compliance with the protocol or interpretation of results
6. CNS lymphoma or known CNS involvement by lymphoma at screening as confirmed by MRI/CT
scan of the brain and, if clinically indicated, by lumbar puncture
7. Active positive tests for hepatitis B virus or hepatitis C virus indicating acute or
chronic infection
8. Known history of seropositivity of human immunodeficiency virus (HIV)
9. Active tuberculosis or history of completed treatment for active tuberculosis within
the past 12 months
10. Neuropathy > grade 1
11. Receiving immunostimulatory agent
12. Prior allogeneic HSCT
13. Current seizure disorder requiring anti-epileptic therapy
NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.
Drug: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, Drug: rituximab and lenalidomide, Drug: rituximab and bendamustine, Drug: rituximab, cytarabine, dexamethasone, and oxaliplatin/carboplatin, Drug: gemcitabine and oxaliplatin, Biological: Epcoritamab, Biological: Epcoritamab Maintenance, Drug: rituximab, cyclophosphamide, reduced dose of doxorubicin, vincristine, and prednisone
Diffuse Large B-Cell Lymphoma, Follicular Lymphoma, Non-Hodgkins Lymphoma
A Comparison of TULSA Procedure vs. Radical Prostatectomy in Participants With Localized Prostate Cancer (CAPTAIN)
Men with localized, intermediate risk prostate cancer will be randomized to undergo either
radical prostatectomy or the TULSA procedure, with a follow-up of 10 years in this
multi-centered randomized control trial. This study will determine whether the TULSA
procedure is as effective and more safe compared to radical prostatectomy.
• Male
• Age 40 to 80 years, with >10 years life expectancy
• Biopsy-confirmed, NCCN (favorable and unfavourable) intermediate-risk prostate
acquired within last 12 months
• Stage ≤cT2c, N0, M0
• ISUP Grade Group 2 or 3 disease on TRUS-guided biopsy or in-bore biopsy
• PSA ≤20ng/mL within last 3 months
• Treatment-naïve
• Planned ablation volume is < 3 cm axial radius from urethra on mpMRI acquired within
last 6 months
Exclusion Criteria:
• Inability to undergo MRI or general anesthesia
• Suspected tumor is > 30 mm from the prostatic urethra
• Prostate calcifications is > 3 mm in maximum extent obstructing ablation of tumor
• Unresolved urinary tract infection or prostatitis
• History of proctitis, bladder stones, hematuria, history of acute urinary retention,
severe neurogenic bladder
• Artificial urinary sphincter, penile implant, or intraprostatic implant
• Patients who are otherwise not deemed candidates for radical prostatectomy
• Inability or unwillingness to provide informed consent
• History of anal or rectal fibrosis or stenosis, or urethral stenosis, or other
abnormality challenging insertion of devices
A Study of Abemaciclib (LY2835219) With Abiraterone in Men With Prostate Cancer That Has Spread to Other Parts of the Body and is Expected to Respond to Hormonal Treatment (Metastatic Hormone-Sensitive Prostate Cancer) (CYCLONE 3)
The purpose of this study is to learn whether adding abemaciclib to abiraterone plus
prednisone prolongs the time before prostate cancer gets worse. Participation may last
approximately 60 months.
• Adenocarcinoma of the prostate (as the predominant histology)
• High-risk metastatic hormone-sensitive prostate cancer. High risk is defined as:
• Greater than or equal to (≥)4 bone metastases by bone scan and/or
• ≥1 visceral metastases by computed tomography or magnetic resonance imaging
• Must have initiated androgen deprivation therapy (ADT) with luteinizing
hormone-releasing hormone (LHRH) agonist/antagonist or bilateral orchiectomy prior to
randomization. Up to 3 months of ADT prior to randomization is permitted with or
without first-generation anti-androgen.
• Adequate organ function
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Exclusion Criteria:
• Prior treatment with abemaciclib or any other cyclin dependent kinase 4 and 6 (CDK4 &
6) inhibitor
• Development of metastatic prostate cancer in the context of castrate levels of
testosterone
• Received any prior systemic therapy for metastatic prostate cancer (including
investigational agents), except for ADT and first-generation anti-androgen
• Clinically significant cardiovascular disease as evidenced by myocardial infarction,
arterial thrombotic events, or severe/unstable angina in the past 6 months, or New
York Heart Association Class II to IV heart failure
• History of syncope of cardiovascular etiology, ventricular arrhythmia of pathological
origin, or sudden cardiac arrest. Chronic and hemodynamically stable atrial arrhythmia
well-controlled on medical therapy is permitted
• Uncontrolled hypertension
• Clinically active or chronic liver disease, moderate/severe hepatic impairment
• Known untreated central nervous system (CNS) metastasis. Participants with a history
of treated brain metastases are eligible if stable for at least 8 weeks prior to
randomization and off corticosteroid for at least 2 weeks prior to randomization
Drug: Abemaciclib, Drug: Abiraterone, Drug: Prednisone or Prednisolone, Drug: Placebo for Abemaciclib
Neoadjuvant Her2-targeted Therapy and Immunotherapy With Pembrolizumab
A phase 2 open-label, randomized, multi-center trial to evaluate the efficacy and safety of
neoadjuvant trastuzumab, pertuzumab and weekly paclitaxel (THP) as compared to neoadjuvant
trastuzumab, pertuzumab, pembrolizumab and weekly paclitaxel (THP-K), or neoadjuvant
trastuzumab, pembrolizumab and weekly paclitaxel (TH-K) in chemo naive patients with invasive
human epidermal growth factor receptor 2 (HER2) positive breast cancer whose primary tumors
are > 2 cm and/or clinically lymph node positive. Treatment will be followed by standard of
care breast surgery and physician's choice adjuvant therapy per standard of care.
1. Male/female patients with histologically confirmed invasive HER2-positive (by American
Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines)
unilateral breast cancer
2. Have previously untreated non-metastaic (M0), cT2-4N0 or cT1-4N1-3 (biopsies of
clinically suspicious lymph nodes to confirm nodal status is encouraged).
3. Multifocal/centric disease is permitted if all suspicious foci have been biopsied and
are consistent with HER2-positive (by ASCO/CAP guidelines) invasive breast cancer
4. Be a male or female subject 18 years of age on the day of signing informed consent
5. Male Participants: A male participant must agree to use a contraception as detailed in
Appendix C of this protocol during the treatment period and for at least 6 months
after the last dose of study treatment and refrain from donating sperm during this
period.
6. Female Participants: A female participant is eligible to participate if she is not
pregnant (see Appendix C), not breastfeeding, and at least one of the following
conditions applies: a.) Not a woman of childbearing potential (WOCBP) as defined in
Appendix C OR b.) A WOCBP who agrees to follow the contraceptive guidance in Appendix
C during the treatment period and for at least 6 months after the last dose of study
treatment.
7. The participant (or legally acceptable representative if applicable) provides written
informed consent for the trial.
8. Provides adequate archival tumor tissue sample or newly obtained core or excisional
biopsy of a tumor lesion not previously irradiated. Formalin-fixed, paraffin embedded
(FFPE) tissue blocks are preferred to slides. Newly obtained biopsies are preferred to
archived tissue. Note: If submitting unstained cut slides, newly cut slides should be
submitted to the testing laboratory within 14 days from the date slides are cut.
9. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
10. Have adequate organ function as defined by the following parameters. Specimens must be
collected within 7 days prior to the start of study treatment.
• Absolute neutrophil count (ANC) ≥1500/µL
• Platelets ≥100 000/µL
• Hemoglobin ≥9.0 g/dL or ≥5.6 mmol/La
• Renal Creatinine (≤1.5 × ULN OR) OR Measured or calculated(b) creatinine
clearance (≥30 mL/min for participant with creatinine levels) (GFR can also be
used in place of creatinine or CrCl) (>1.5 × institutional ULN)
• Hepatic Total bilirubin ≤1.5 ×ULN OR direct bilirubin ≤ULN for participants with
total bilirubin levels >1.5 × ULN aspartate aminotransferase (AST, SGOT) and
alanine aminotransferase (ALT, SGPT) ≤2.5 × ULN (≤5 × ULN for participants with
liver metastases)
• Coagulation International normalized ratio (INR) OR prothrombin time (PT)
Activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is
receiving anticoagulant therapy as long as PT or aPTT is within therapeutic range
of intended use of anticoagulants
• Cardiac Echocardiogram or MUGA (multigated radionuclide angiography) Baseline
LVEF ≥ 55%
Exclusion Criteria:
1. A WOCBP who has a positive urine pregnancy test within 72 hours prior to
randomization. If the urine test is positive or cannot be confirmed as negative, a
serum pregnancy test will be required. Note: in the event that 72 hours have elapsed
between the screening pregnancy test and the first dose of study treatment, another
pregnancy test (urine or serum) must be performed and must be negative in order for
subject to start receiving study medication.
2. Has received prior therapy with an anti-PD-1 (programmed death protein 1), anti-PD-L1
(Programmed death-ligand 1), or anti PD L2 (Programmed death-ligand 2) agent or with
an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g.,
CTLA-4, OX 40, CD137).
3. Has received prior systemic anti-cancer therapy including investigational agents
within 4 weeks prior to randomization. Note: If participant received major surgery,
they must have recovered adequately from the toxicity and/or complications from the
intervention prior to starting study treatment.
4. Has received prior radiotherapy within 2 weeks of start of study treatment.
Participants must have recovered from all radiation-related toxicities, not require
corticosteroids, and not have had radiation pneumonitis.
5. Has received a live vaccine within 30 days prior to the first dose of study drug.
Examples of live vaccines include, but are not limited to, the following: measles,
mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus
Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection
are generally killed virus vaccines and are allowed; however, intranasal influenza
vaccines (eg, FluMist®) are live attenuated vaccines and are not allowed.
6. Is currently participating in or has participated in a study of an investigational
agent or has used an investigational device within 4 weeks prior to the first dose of
study treatment.
Note: Participants who have entered the follow-up phase of an investigational study
may participate as long as it has been 4 weeks after the last dose of the previous
investigational agent.
7. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
(in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
immunosuppressive therapy within 7 days prior to the first dose of study drug.
8. Has a known additional malignancy that is progressing or has required active systemic
treatment within the past 3 years. Note: Participants with basal cell carcinoma of the
skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast
carcinoma, cervical cancer in situ) that have undergone potentially curative therapy
are not excluded.
9. Has active autoimmune disease that has required systemic treatment in the past 2 years
(i.e. with use of disease modifying agents, corticosteroids or immunosuppressive
drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid
replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a
form of systemic treatment.
10. Has a history of (non-infectious) pneumonitis that required steroids or has current
pneumonitis.
11. Has an active infection requiring systemic therapy.
12. Has a known history of Human Immunodeficiency Virus (HIV).
13. Has a known active Hepatitis B (defined as Hepatitis B surface antigen [HBsAg]
reactive) or Hepatitis C virus (i.d. HCV RNA [qualitative] is detected) infection.
14. Has a known history of active TB (Bacillus Tuberculosis).
15. Has a history or current evidence of any condition, therapy, or laboratory abnormality
that might confound the results of the study, interfere with the subject's
participation for the full duration of the study, or is not in the best interest of
the subject to participate, in the opinion of the treating investigator.
16. Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the trial.
17. Is pregnant or breastfeeding, or expecting to conceive or father children within the
projected duration of the study, starting with the screening visit through 120 days
after the last dose of trial treatment.
18. Has significant cardiovascular disease, such as:
• History of myocardial infarction, acute coronary syndrome or coronary
angioplasty/stenting/bypass grafting within the last 6 months
• Congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV or
history of CHF NYHA class III or IV
• Angina pectoris requiring anti-anginal medication, uncontrolled arrhythmias, or
uncontrolled hypertension (systolic blood pressure > 180mmHg and/or diastolic
blood pressure > 100mmHg).
Study of TT-00420 Tablet as Monotherapy and Combination Therapy in Patients With Advanced Solid Tumors
This is a Phase Ib/II, multicenter, open-label study to evaluate the safety and preliminary
efficacy of TT-00420 tablet, as monotherapy or in combination regimens, in patients with
advanced solid tumors.
1. ≥ 18 years of age
2. Histopathological or cytologically documented locally advanced or metastatic solid
tumors who have no available standard therapeutic treatment options
3. At least one measurable lesion as defined by RECIST V1.1 criteria for solid tumors
4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
5. Adequate organ function confirmed at screening and within 10 days of initiating
treatment, as evidenced by:
• Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L
• Hemoglobin (Hgb) ≥ 8 g/dl
• Platelets (plt) ≥ 75 x 10^9/L
• AST/SGOT and ALT/SGPT ≤ 2.5 x Upper Limit of Normal (ULN) or ≤ 5.0 x ULN if liver
metastases are present
• Total bilirubin ≤ 1.5 x ULN
• Calculated creatinine clearance ≥ 50 mL/min (Cockcroft Gault formula)
6. Negative pregnancy test within 72 hours before starting study treatment in all
premenopausal women and women < 12 months after the onset of menopause
7. Must agree to take sufficient contraceptive methods to avoid pregnancy during the
study and until at least 6 months after ceasing study treatment
8. Able to sign informed consent and comply with the protocol
Exclusion Criteria:
1. Women who are pregnant or lactating
2. Women of child-bearing potential (WOCBP) who do not use adequate birth control
3. Patients with any hematologic malignancy, including leukemia (any form), lymphoma, and
multiple myeloma
4. Patients with a history of primary central nervous system tumors or carcinomatous
meningitis.
5. Patients with the following mood disorders as judged by the Investigator or a
psychiatrist:
• Medically documented history of or active major depressive episode, bipolar
disorder (I or II), obsessive-compulsive disorder, schizophrenia; a history of
suicidal attempt or ideation, or homicidal ideation (immediate risk of doing harm
to others)
• ≥ CTCAE grade 3 anxiety
6. Impaired cardiac function or significant diseases, including but not limited to any of
the following:
• left ventricular ejection fraction (LVEF) < 45% as determined by multigated
acquisition (MUGA) scan or echocardiogram (ECHO)
• Congenital long QT syndrome
• QTcF ≥ 480 msec on screening ECG
• Unstable angina pectoris ≤ 3 months prior to starting study drug
• Acute myocardial infarction ≤ 3 months prior to starting study drug
7. Patients with:
• unresolved diarrhea ≥ CTCAE grade 2, or
• impairment of gastrointestinal (GI) function, or
• GI disease that may significantly alter the absorption of TT-00420
8. Other concurrent severe and/or uncontrolled concomitant medical conditions (e.g.,
uncontrolled hypertension, uncontrolled hypertriglyceridemia, or active or
uncontrolled infection) that could cause unacceptable safety risks or compromise
compliance with the protocol
9. Patients who have received chemotherapy, targeted therapy, or immunotherapy ≤ 4 weeks
(6 weeks for nitrosourea or mitomycin-C) prior to starting study drug or who have not
recovered from side effects of such therapy
10. Patients who have received wide field radiotherapy ≤ 4 weeks or limited field
radiation for palliation ≤ 2 weeks prior to starting study drug or who have not
recovered from side effects of such therapy
11. Patients who have undergone major surgery ≤ 4 weeks prior to starting study drug or
who have not recovered from side effects of such therapy
12. Patients who have been treated with any hematopoietic colony-stimulating growth
factors (e.g., G-CSF, GM-CSF) ≤ 4 weeks prior to starting study drug.
13. Patients who are currently receiving treatment with therapeutic doses of warfarin
sodium or any other coumarin-derivative anticoagulants
14. Patients who have received systemic corticosteroids ≤ 2 weeks prior to starting study
drug or who have not recovered from the side effects of such treatment.
15. Patients who are currently receiving treatment with strong CYP3A inhibitors or
inducers ≤ 2 weeks prior to starting study drug.
16. Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not
mandatory; patients with well controlled HIV might be enrolled)
17. Known history of active infection with Hepatitis B or Hepatitis C
18. Has received a live-virus vaccination within 30 days of planned first dose
19. Inability to swallow or tolerate oral medication
20. Has a history or current evidence of any condition, therapy, or laboratory abnormality
that, in the opinion of the investigator, might confound the results of the trial,
interfere with the patient's safe participation and compliance in the trial.
Prostate Cancer, Sarcoma, Gastric Cancer, Bladder Cancer, Cholangiocarcinoma, Gallbladder Cancer, Thyroid Cancer, Triple Negative Breast Cancer, HER2-negative Breast Cancer, Advanced Solid Tumor, Breast - Female, Breast - Male, Lung/Thoracic, Other Digestive Organ, Other Skin, Other Urinary, Prostate, Stomach, Thyroid, Small Intestine, Small-cell Lung Cancer
A Study of Belzutifan (MK-6482) Plus Pembrolizumab (MK-3475) Versus Placebo Plus Pembrolizumab in Participants With Clear Cell Renal Cell Carcinoma Post Nephrectomy (MK-6482-022)
The purpose of this study is to assess the efficacy and safety of oral belzutifan (MK-6482)
plus intravenous (IV) pembrolizumab (MK-3475) compared to placebo plus pembrolizumab, in the
adjuvant treatment of Clear Cell Renal Cell Carcinoma (ccRCC) post nephrectomy.
The primary study hypothesis is that belzutifan plus pembrolizumab is superior to placebo
plus pembrolizumab with respect to disease-free survival (DFS).
The main inclusion and exclusion criteria include but are not limited to the following:
Inclusion Criteria:
• Has a histologically or cytologically confirmed diagnosis of RCC with clear cell
component per American Joint Committee on Cancer (AJCC) (8th Edition), with or without
sarcomatoid features
• Has intermediate-high risk, high risk, or M1 no evidence of disease (NED) RCC as
defined by the following pathological tumor-node metastasis and tumor grading:
1. Intermediate-high risk RCC: pT2, Grade 4 or sarcomatoid, N0, M0; pT3, any grade,
N0, M0
2. High risk RCC: pT4, any Grade N0, M0; pT any stage, any Grade, N+, M0
3. M1 NED RCC participants who present not only with the primary kidney tumor but
also solid, isolated, soft tissue metastases that can be completely resected at
one of the following: the time of nephrectomy (synchronous) or, ≤2 years from
nephrectomy (metachronous)
• Has undergone complete resection of the primary tumor (partial or radical nephrectomy)
and complete resection of solid, isolated, soft tissue metastatic lesion(s) in M1 NED
participants
• Must have undergone a nephrectomy and/or metastasectomy ≤12 weeks prior to
randomization
• Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 10
days before randomization.
• Male participants must agree to continue contraception at least 7 days after the last
dose of belzutifan/placebo
• Female participants of childbearing potential must be willing to use an adequate
method of contraception, for the course of the study through 120 days after the last
dose of pembrolizumab or at least 30 days after last dose of belzutifan/placebo,
whichever occurs last
• Has adequate organ function
Exclusion Criteria:
• Has had a major surgery, other than nephrectomy plus resection of preexisting
metastases for M1 NED participants, within 4 weeks prior to randomization
• Has a pulse oximeter reading <92% at rest, requires intermittent supplemental oxygen,
or requires chronic supplemental oxygen
• Has clinically significant cardiovascular disease within 6 months from first dose of
study intervention
• Has other clinically significant disorders such as: serious active nonhealing
wound/ulcer/bone fracture; requirement for hemodialysis or peritoneal dialysis
• Has preexisting brain or bone metastatic lesions
• Has received prior systemic therapy for RCC
• Has received prior radiotherapy for RCC
• Has received a live or live-attenuated vaccine within 30 days before the first dose of
study intervention; administration of killed vaccines are allowed
• Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
• Has a known additional malignancy (other than RCC treated with nephrectomy and/or
metastasectomy) that is progressing or has required active treatment within the past 3
years
• Has an active autoimmune disease that has required systemic treatment in past 2 years
(i.e., with use of disease modifying agents, corticosteroids, or immunosuppressive
drugs); replacement therapy is allowed
• Has a history of (noninfectious) pneumonitis/interstitial lung disease that required
steroids or has current pneumonitis/interstitial lung disease
• Has an active infection, requiring systemic therapy
• Has a known history of human immunodeficiency virus (HIV) infection, a known history
of Hepatitis B or known active Hepatitis C virus infection
• Has had an allogenic tissue/solid organ transplant
Chemotherapy for the Treatment of Patients With Newly Diagnosed Very Low-Risk and Low Risk Fusion Negative Rhabdomyosarcoma
Rhabdomyosarcoma is a type of cancer that occurs in the soft tissues in the body. This phase
III trial aims to maintain excellent outcomes in patients with very low risk rhabdomyosarcoma
(VLR-RMS) while decreasing the burden of therapy using treatment with 24 weeks of vincristine
and dactinomycin (VA) and examines the use of centralized molecular risk stratification in
the treatment of rhabdomyosarcoma. Another aim of the study it to find out how well patients
with low risk rhabdomyosarcoma (LR-RMS) respond to standard chemotherapy when patients with
VLR-RMS and patients who have rhabdomyosarcoma with DNA mutations get separate treatment.
Finally, this study examines the effect of therapy intensification in patients who have RMS
cancer with DNA mutations to see if their outcomes can be improved.
• All patients must be enrolled on APEC14B1 (NCT02402244) and consented to the Molecular
Characterization Initiative (Part A) prior to enrollment and treatment on ARST2032
(this trial).
• Patients must be =< 21 years at the time of enrollment.
• Patients must have newly diagnosed embryonal rhabdomyosarcoma (ERMS), spindle
cell/sclerosing RMS, or FOXO1 fusion negative alveolar rhabdomyosarcoma (ARMS)
(institutional FOXO1 fusion results are acceptable). RMS types included under ERMS
include those classified in the 1995 International Classification of Rhabdomyosarcoma
(ICR) as ERMS (classic, spindle cell, and botryoid variants), which are reclassified
in the 2020 World Health Organization (WHO) classification as ERMS (classic, dense and
botryoid variants) and spindle cell/sclerosing RMS (encompassing the historical
spindle cell ERMS variant and the newly recognized sclerosing RMS variant). Enrollment
in APEC14B1 is required for all patients.
• All patients will be evaluated for stage and clinical group. Note that clinical
group designation assigned at the time of enrollment on study remains unchanged
regardless of any second-look operation that may be performed.
• Patients will be eligible for the very low-risk stratum (Regimen VA) if they
have Stage 1, CG I disease.
• Patients will be eligible for the low-risk stratum (Regimen VAC/VA) if they
have Stage 1, CG II disease, Stage 2, CG I or II disease, or Stage 1, CG III
(orbit only) disease.
• Paratesticular Tumors: Staging ipsilateral retroperitoneal lymph node sampling
(SIRLNS) is required for all patients >= 10 years of age with paratesticular
tumors who do not have gross nodal involvement on imaging.
• Extremity Tumors: Regional lymph node sampling is required for histologic
evaluation in patients with extremity tumors.
• Clinically or radiographically enlarged nodes must be sampled for histologic
evaluation.
• Patients must have a Lansky (for patients =< 16 years of age) or Karnofsky (for
patients > 16 years of age) performance status score of >= 50. Patients who are unable
to walk because of paralysis, but who are up in a wheelchair, will be considered
ambulatory for the purpose of assessing performance score.
• Peripheral absolute neutrophil count (ANC) >= 750/uL (within 7 days prior to
enrollment).
• Platelet count >= 75,000/uL (transfusion independent) (within 7 days prior to
enrollment).
• Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70
mL/min/1.73 m^2 or a serum creatinine (within 7 days prior to enrollment) based on
age/gender as follows:
• Age: 1 month to < 6 months; Maximum serum creatinine (mg/dL): 0.4 (male) : 0.4
(female)
• Age: 6 months to < 1 year; Maximum serum creatinine (mg/dL): 0.5 (male) : 0.5
(female)
• Age: 1 to < 2 years; Maximum serum creatinine (mg/dL): 0.6 (male) : 0.6 (female)
• Age: 2 to < 6 years; Maximum serum creatinine (mg/dL): 0.8 (male) : 0.8 (female)
• Age: 6 to < 10 years; Maximum serum creatinine (mg/dL): 1 (male) : 1 (female)
• Age: 10 to < 13 years; Maximum serum creatinine (mg/dL): 1.2 (male) : 1.2
(female)
• Age: 13 to < 16 years; Maximum serum creatinine (mg/dL): 1.5 (male) : 1.4
(female)
• Age >= 16 years; Maximum serum creatinine (mg/dL): 1.7 (male) : 1.4 (female)
• Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to
enrollment), and
• If there is evidence of biliary obstruction by the tumor, then the total
bilirubin must be < 3 x ULN for age.
• Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the
value of 45 U/L.
• Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 135
U/L (within 7 days prior to enrollment).
• All patients and/or their parents or legal guardians must sign a written informed
consent.
• All institutional, Food and Drug Administration (FDA), and National Cancer Institute
(NCI) requirements for human studies must be met.
Exclusion Criteria:
• Patients who have received prior chemotherapy and/or radiation therapy for cancer
prior to enrollment. Surgical resection alone of previous cancer(s) is permitted.
• Patients who have received chemotherapy or radiation for non-malignant conditions
(e.g., autoimmune diseases) are eligible. Patients must discontinue chemotherapy for
non-malignant conditions prior to starting protocol therapy.
• Vincristine is sensitive substrate of the CYP450 3A4 isozyme. Patients must not have
received drugs that are moderate to strong CYP3A4 inhibitors and inducers within 7
days prior to study enrollment.
• Patients unable to undergo radiation therapy, if necessary, as specified in the
protocol.
• Evidence of uncontrolled infection.
• Female patients who are pregnant since fetal toxicities and teratogenic effects have
been noted for several of the study drugs. A pregnancy test is required for female
patients of childbearing potential.
• Lactating females who plan to breastfeed their infants.
• Sexually active patients of reproductive potential who have not agreed to use an
effective contraceptive method for the duration of their study participation.
Evaluation of Co-formulated Pembrolizumab/Quavonlimab (MK-1308A) Versus Other Treatments in Participants With Microsatellite Instability-High (MSI-H) or Mismatch Repair Deficient (dMMR) Stage IV Colorectal Cancer (CRC) (MK-1308A-008)
The purpose of this study is to assess the efficacy and safety of co-formulated
pembrolizumab/quavonlimab versus other treatments in participants with MSI-H or dMMR
Metastatic Stage IV Colorectal Cancer.
• Has a histologically confirmed diagnosis of Stage IV CRC adenocarcinoma (as defined by
American Joint Committee on Cancer [AJCC] version 8)
• Has locally confirmed dMMR/MSI-H
• Has a life expectancy of at least 3 months
• Female participants are eligible to participate if not pregnant or breastfeeding, and
not a woman of childbearing potential (WOCBP), or if a WOCBP then uses a contraceptive
method that is highly effective or is abstinent on a long-term and persistent basis,
during the intervention period and for at least 120 days after the last dose of study
intervention
• Has measurable disease per RECIST 1.1 as assessed by the site and verified by BICR
• Submit an archival (within 5 years of Screening) or newly obtained tumor tissue sample
that has not been previously irradiated; formalin-fixed, paraffin embedded (FFPE)
blocks are preferred to slides.
• Has adequate organ function
Cohort A:
•Has been previously treated for their disease and radiographically progressed per RECIST
1.1 on or after or could not tolerate standard treatment, which must include all of the
following agents if approved and locally available in the country where the participant is
randomized:
• Fluoropyrimidine, irinotecan and oxaliplatin (capecitabine is acceptable as equivalent
to fluorouracil in prior therapy)
• With or without an anti-vascular endothelial growth factor (VEGF) monoclonal antibody
(e.g., bevacizumab)
• At least one of the anti-epidermal growth factor receptor (EGFR) monoclonal antibodies
(cetuximab or panitumumab) for rat sarcoma viral oncogene homolog (RAS) wild-type
participants with left-sided tumors. Prior EGFR therapy is optional for patients with
right sided RAS Wild-type (WT) tumors.
Cohort B:
•Has untreated Stage IV dMMR/MSI-H CRC with no prior chemotherapy or immunotherapy for
this disease
Exclusion Criteria:
• Has received prior therapy with an agent directed to another stimulatory or
coinhibitory T-cell receptor
• Has received prior systemic anticancer therapy including investigational agents within
4 weeks before the first dose of study intervention
• Has not recovered adequately from a surgery procedure, and/or has any complications
from a prior surgery before starting study intervention
• Has received prior radiotherapy within 2 weeks of start of study intervention
• Has received a live or live-attenuated vaccine within 30 days before the first dose of
study intervention
• Is currently participating in or has participated in a study of an investigational
agent or has used an investigational device within 4 weeks before the first dose of
study intervention
• Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
(in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
immunosuppressive therapy within 7 days prior to the first dose of study medication
• Has a known additional malignancy that is progressing or has required active treatment
within the past 2 years
• Has known active central nervous system (CNS) metastases and/or carcinomatous
meningitis
• Has severe hypersensitivity (≥Grade 3) to pembrolizumab, quavonlimab, favezelimab,
vibostolimab, MK-4830, and/or any of their excipients
• Has an active autoimmune disease that has required systemic treatment in past 2 years
(i.e., with use of disease modifying agents, corticosteroids or immunosuppressive
drugs)
• Has a history of (noninfectious) pneumonitis that required steroids or has current
pneumonitis
• Has a history of acute or chronic pancreatitis
• Has neuromuscular disorders associated with an elevated creatine kinase
• Has urine protein ≥1 gram/24 hours
• Has an active infection requiring systemic therapy (e.g., tuberculosis, known viral or
bacterial infections, etc.)
• Has a known history of Human Immunodeficiency Virus (HIV) infection
• Concurrent active Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] positive
and/or detectable Hepatitis B Virus [HBV] deoxyribonucleic acid [DNA]) and Hepatitis C
virus (defined as anti-HCV antibody positive and detectable HCV ribonucleic acid [RNA]
infection
• Has clinically significant cardiac disease, including unstable angina, acute
myocardial infarction within 6 months from Day 1 of study intervention administration,
or New York Heart Association Class III or IV congestive heart failure. Medically
controlled arrhythmia stable on medication is permitted.
• Has present or progressive accumulation of pleural, ascitic, or pericardial fluid
requiring drainage or diuretic drugs within 2 weeks before randomization/allocation
• Has a history or current evidence of any condition, therapy, or laboratory abnormality
that might confound the results of the study, interfere with the participant's
participation for the full duration of the study, or is not in the best interest of
the participant to participate, in the opinion of the treating investigator
• Has a known psychiatric or substance abuse disorder that would interfere with the
participant's ability to cooperate with the requirements of the study
• Has had an allogenic tissue/solid organ transplant
Testing the Use of Combination Immunotherapy Treatment (N-803 [ALT-803] Plus Pembrolizumab) Against the Usual Treatment for Advanced Non-small Cell Lung Cancer (A Lung-MAP Treatment Trial)
This phase II/III Lung-MAP trial studies how well immunotherapy treatment with N-803
(ALT-803) and pembrolizumab working in treating patients with non-small cell lung cancer that
has spread to other places in the body (advanced). Natural killer cells, part of our immune
system, are always on alert and ready to defend our bodies from many kinds of infection or
rogue cells, such as those that cause cancer. N-803 (ALT-803) may activate natural killer
cells so that they can stimulate an immune response to help fight cancer. Immunotherapy with
monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the
cancer, and may interfere with the ability of tumor cells to grow and spread. Giving N-803
(ALT-803) and pembrolizumab may help shrink and stabilize lung cancer or prevent it from
returning.
• Participants must have been assigned to S1800D by the Southwest Oncology Group (SWOG)
Statistics and Data Management Center (SDMC). Assignment to S1800D is determined by
the LUNGMAP or S1400 protocol
• Participants must have measurable or non-measurable disease documented by computed
tomography (CT) or magnetic resonance imaging (MRI). Measurable disease must be
assessed within 28 days prior to randomization. Non-measurable disease must be
assessed within 42 days prior to randomization. The CT from a combined positron
emission tomography (PET)/CT may be used only if it is of diagnostic quality. All
known sites of disease must be assessed and documented on the Baseline Tumor
Assessment Form (RECIST 1.1)
• Participants must have a CT or MRI scan of the brain to evaluate for central nervous
system (CNS) disease within 42 days prior to sub-study randomization
• Participants with spinal cord compression or brain metastases must have received local
treatment to these metastases and remained clinically controlled and asymptomatic for
at least 7 days following stereotactic radiation and/or 14 days following whole brain
radiation, and prior to sub-study randomization
• Participants with spinal cord compression or brain metastases must not have residual
neurological dysfunction, unless no further recovery is expected, and the participant
has been stable on weaning doses of corticosteroids (=< 10 mg daily prednisone or
equivalent) prior to sub-study randomization
• Participants must have progressed (in the opinion of the treating investigator)
following the most recent line of therapy for non-small cell lung cancer (NSCLC)
• Participants with a known sensitizing mutation for which an FDA-approved targeted
therapy for NSCLC exists (e.g. EGFR, ALK gene fusions, ROS1, BRAF, RET, NTRK, and MET
sensitizing mutations), must have previously received at least one of the approved
therapy(s)
• Participants must have received exactly one line of anti-PD-1 or anti-PD-L1 therapy
for advanced disease (stage IV or recurrent, or stage III in certain circumstances
outlined below) given alone or in combination with platinum-based chemotherapy.
Participants must have experienced disease progression during or after this regimen
• Continuing the same agent(s) after progression counts as a single line of
therapy. However, a change or addition in agent(s) after progression (e.g. the
addition of chemotherapy to anti-PD-1 monotherapy after progression) counts as a
subsequent line of therapy and would exclude the participant
• For participants who received consolidation anti-PD-1 or anti-PD-L1 therapy
following concurrent chemoradiation for Stage III disease as their only line of
anti-PD-1 or anti-PD-L1 therapy:
• If they experienced disease progression less than (<) 365 days from the
first date of anti-PD-1 or anti-PD-L1 therapy, this counts as the single
line of anti-PD-1 or anti-PD-L1 therapy for advanced disease
• If they experienced disease progression more than or equal to (>=) 365 days
from the first date of anti-PD-1 or anti-PD-L1 therapy, this is not
considered a line of anti-PD-1 or anti-PD-L1 therapy for advanced disease
• Participants must have recovered (=< grade 1) from any side effects of prior therapy,
except for alopecia
• Participants must be able to safely receive at least one of the investigator's choice
of standard of care regimens, per the current FDA-approved package insert
• Note: Pemetrexed is not FDA-approved for squamous cell NSCLC and must not be used
to treat participants with squamous cell NSCLC
• Absolute neutrophil count (ANC) >= 1.5 x 10^3/uL (obtained within 28 days prior to
sub-study randomization)
• Platelet count >= 100 x 10^3/uL(obtained within 28 days prior to sub-study
randomization)
• Hemoglobin >= 9 g/dL (obtained within 28 days prior to sub-study randomization)
• Serum bilirubin =< institutional upper limit of normal (IULN) (within 28 days prior to
sub-study randomization). For participants with liver metastases, bilirubin must be =<
5 x IULN
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2 x IULN
(within 28 days prior to sub-study randomization). For participants with liver
metastases, ALT and AST must be =< 5 x IULN
• Serum creatinine =< the IULN or calculated creatinine clearance >= 50 mL/min using
Cockcroft-Gault formula. This specimen must have been drawn and processed within 28
days prior to sub-study randomization
• Participants' most recent Zubrod performance status must be 0-1 and be documented
within 28 days prior to sub-study randomization
• Participants must have history and physical exam must be obtained within 28 days prior
to sub-study randomization
• Participants with known human immunodeficiency virus (HIV) infection must be receiving
anti-retroviral therapy and have an undetectable viral load at their most recent viral
load test within 6 months prior to sub-study randomization
• Participants must also be offered participation in banking and in the correlative
studies for collection and future use of specimens
• Note: As a part of the OPEN registration process the treating institution's identity
is provided in order to ensure that the current (within 365 days) date of
institutional review board approval for this study has been entered in the system
• Participants must be informed of the investigational nature of this study and
must sign and give written informed consent in accordance with institutional and
federal guidelines
Exclusion Criteria:
• Participants must not have leptomeningeal disease that requires CNS-specific treatment
prior to registration and must not be planning to receive the CNS-specific treatment
through the first cycle of the protocol therapy
• Participants must not have experienced the following:
• Any grade 3 or worse immune-related adverse event (irAE). Exception: asymptomatic
nonbullous/nonexfoliative rash
• Any unresolved grade 2 irAE
• Any toxicity that led to permanent discontinuation of prior anti-PD-1/PD-L1
immunotherapy
• Exception to the above: Toxicities of any grade that requires replacement therapy
and has stabilized on therapy (e.g., thyroxine, insulin, or physiologic
corticosteroid replacement therapy for adrenal or pituitary insufficiency) are
allowed
• Participants must not have any history of organ transplant that requires use of
immunosuppressives
• Participants must not have history of (non-infectious) pneumonitis that required
steroids or current pneumonitis/interstitial lung disease
• Participants must not have any known allergy or reaction to any component of the
investigational formulations. If there is a known allergy or reaction to standard of
care formulations, participants must be able to safely receive at least one of the
standard of care options
• Participants must not have any grade III/IV cardiac disease as defined by the New York
Heart Association Criteria (i.e., participants with cardiac disease resulting in
marked limitation of physical activity or resulting in inability to carry on any
physical activity without discomfort), unstable angina pectoris, and myocardial
infarction within 6 months prior to sub-study randomization, or serious uncontrolled
cardiac arrhythmia
• Participants must not have experienced any arterial thromboembolic events, including
but not limited to myocardial infarction, transient ischemic attack, cerebrovascular
accident, or unstable angina, within 6 months prior to sub-study randomization
• Participants must not have an active or uncontrolled infection in the opinion of the
treating investigator
• Participants must not have a prior or concurrent malignancy whose natural history or
treatment has the potential to interfere with the safety or efficacy assessment of the
investigational regimen
• Participants must not have any of following:
• Cirrhosis at a level of Child-Pugh B (or worse)
• Cirrhosis (any degree) and a history of hepatic encephalopathy
• Or clinically meaningful ascites resulting from cirrhosis. Clinically meaningful
ascites is defined as ascites from cirrhosis requiring diuretics or paracentesis
• Participants must not have received anti-CTLA4 therapy (e.g. ipilimumab,
tremelimumab), or other immune-modulatory therapy (e.g. anti-TIM-3, anti-LAG-3,
anti-GITR, IL-2, IL-15)
• Participants must not have received any prior systemic therapy (systemic chemotherapy,
immunotherapy or investigational drug) within 21 days prior to sub-study randomization
• Participants must not have received any radiation therapy within 14 days prior to
sub-study randomization
• Participants must not have received nitrosoureas or mitomycin-c within 42 days prior
to sub-study randomization
• Participants must not have received systemic treatment with corticosteroids (> 10 mg
daily prednisone or equivalent) or other immunosuppressive medications within 7 days
prior to sub-study randomization. Inhaled or topical steroids, and adrenal replacement
doses =< 10 mg daily prednisone or equivalent are permitted in the absence of active
autoimmune disease
• Participants must not have received a live attenuated vaccination within 28 days prior
to sub-study randomization. All COVID-19 vaccines that have received Food and Drug
Administration (FDA) approval or FDA emergency use authorization are acceptable
• Participants must not be planning to receive any concurrent chemotherapy,
immunotherapy, biologic or hormonal therapy for cancer treatment while receiving
treatment on this study
• Participants must not have had a major surgery within 14 days prior to sub-study
randomization. Participant must have fully recovered from the effects of prior surgery
in the opinion of the treating investigator
• Participants must not have an active autoimmune disease that has required systemic
treatment within two years prior to sub-study randomization (i.e., with use of disease
modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy
(e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for
adrenal or pituitary insufficiency) is not considered a form of systemic treatment and
is allowed
• Participants must not have any history of primary immunodeficiency
• Participants must not be pregnant or nursing. Women/men of reproductive potential must
have agreed to use an effective contraceptive method during the study and 4 months
after completion of study treatment. A woman is considered to be of "reproductive
potential" if she has had menses at any time in the preceding 12 consecutive months.
In addition to routine contraceptive methods, "effective contraception" also includes
heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect
of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or
bilateral tubal ligation. However, if at any point a previously celibate participant
chooses to become heterosexually active during the time period for use of
contraceptive measures outlined in the protocol, he/she is responsible for beginning
contraceptive measures during the study and 4 months after study completion
1. Histologically confirmed GBM (MGMT unmethylated, IDH wild type) at first, second,
third, or fourth recurrence after concurrent chemoradiotherapy. Patients with an
initial diagnosis of a lower-grade glioma are eligible if a subsequent biopsy
determined the progressive tumor to be GBM.
2. Imaging confirmation of first tumor progression or regrowth as defined by the Response
Assessment in Neuro-Oncology (RANO) criteria. A minimum of 12 weeks must have elapsed
from the completion of radiotherapy to study entry to minimize the potential for MRI
changes related to radiation necrosis that might be misdiagnosed as progression of
disease, unless there is a new lesion outside the radiation field or unequivocal
evidence of viable tumor on histopathological sampling.
3. Karnofsky Performance Status (KPS) ≥ 60%.
4. Patients must be willing and able to provide written informed consent and to comply
with the study protocol as judged by the investigator.
5. Age ≥ 18 years.
6. Patients must be able to swallow oral medications.
7. For women who are of child-bearing potential and who are sexually active and who are
not surgically sterile (absence of ovaries and/or uterus): to use an adequate method
of contraception (oral contraceptives, intrauterine contraceptive device, barrier
method of contraception in conjunction with spermicidal jelly) during the treatment
period and for at least 6 months after last dose of study drug. Should a woman become
pregnant or suspect she is pregnant while participating in this study, she should
inform her treating physician immediately. For male patients who are partners of
premenopausal women: agreement to use a barrier method of contraception during the
treatment period and for at least 6 months after the last dose of study drug.
7.1 A female of child-bearing potential is any woman (regardless of sexual
orientation, having undergone a tubal ligation, or remaining celibate by choice) who
meets the following criteria:
• Has not undergone a hysterectomy or bilateral oophorectomy; or
• Has not been naturally postmenopausal for at least 12 consecutive months (i.e.,
has had menses at any time in the preceding 12 consecutive months).
8. Patients who have undergone recent surgery for recurrent or progressive tumor are
eligible provided that:
8.1 Surgery must have confirmed the recurrence.
8.2 A minimum of 28 days must have elapsed from the day of surgery to study entry. For
core or needle biopsy, a minimum of 7 days must have elapsed prior to study entry.
8.3 Craniotomy or intracranial biopsy site must be adequately healed and free of
drainage or cellulitis, and the underlying cranioplasty must appear intact at the time
of randomization.
9. Patients must have recovered (Common Terminology Criteria for Adverse Events CTCAE
version 6] Grade ≤1) from the acute effects of chemotherapy except for residual
alopecia or Grade 2 peripheral neuropathy prior to randomization. Minimum times from
prior therapies include:
9.1 Greater than or equal to 28 days elapsed from the administration of any
investigational agent.
9.2 Greater than or equal to 28 days elapsed from the administration of any prior
cytotoxic agents, except ≥ 42 days from nitrosoureas. NOTE: Prior treatment with
Novo-TTF therapy is allowed at initial diagnosis but must be discontinued prior to
study entry.
10. GBMs of the study patients must have EGFR gene amplification, which will be detected
by next generation sequencing of tumor tissue from resected sample.
11. Prior use of bevacizumab is allowed, however patient must be off of this medication
for 180 days.
12. Patients must have adequate organ and marrow function as defined by the following
criteria:
• ANC ≥1.5 × 10(9)/L
• Platelets ≥100 × 10(9)/L
• Hemoglobin ≥8 g/dL
• Total bilirubin ≤1.5 × ULN Patients with Gilbert's syndrome with a total
bilirubin ≤2.0 times ULN and direct bilirubin within normal limits are permitted.
ALT and AST ≤3 × ULN
Exclusion Criteria:
1. Prior treatment with an EGFR or JAK inhibitor.
2. Subjects may not be receiving any other investigational agents for the treatment of
the cancer under study.
3. Patients unable to undergo brain MRI scans with IV gadolinium contrast.
4. History of allergic reactions attributed to compounds of similar chemical or biologic
composition to Tofacitinib
5. Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that, in the opinion of the
investigator, would limit compliance with study requirements.
6. Subjects must not be pregnant or nursing due to the potential for congenital
abnormalities and the potential of this regimen to harm nursing infants.
7. Prior history of hypertensive crisis, hypertensive encephalopathy, or inadequately
controlled hypertension (defined as systolic blood pressure > 150 mmHg and/or
diastolic blood pressure > 100 mmHg while on antihypertensive medication).
8. Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to
swallow the formulated product, or previous significant gastrointestinal resection
that would preclude adequate absorption of the trial medications.
9. History of another malignancy in the previous 3 years, with a disease-free interval of
< 3 years. Patients with prior history of in situ cancer or basal or squamous cell
skin cancer are eligible.
10. Concurrent use of Bevacizumab.
Osimertinib With or Without Bevacizumab as Initial Treatment for Patients With EGFR-Mutant Lung Cancer
This phase III trial compares the effect of bevacizumab and osimertinib combination vs.
osimertinib alone for the treatment of non-small cell lung cancer that has spread outside of
the lungs (stage IIIB-IV) and has a change (mutation) in a gene called EGFR. The EGFR protein
is involved in cell signaling pathways that control cell division and survival. Sometimes,
mutations in the EGFR gene cause EGFR proteins to be made in higher than normal amounts on
some types of cancer cells. This causes cancer cells to divide more rapidly. Osimertinib may
stop the growth of tumor cells by blocking EGFR that is needed for cell growth in this type
of cancer. Monoclonal antibodies, such as bevacizumab, may interfere with the ability of
tumor cells to grow and spread. Giving osimertinib with bevacizumab may control cancer for
longer and help patients live longer as compared to osimertinib alone.
• Patient must have a pathologically-confirmed diagnosis of non-squamous, non-small cell
lung cancer (NSCLC)
• Patient must have advanced disease, defined as •either stage IV disease, stage IIIB
disease not amenable to definitive multi-modality therapy, or recurrent disease after
a prior diagnosis of stage I-III disease. All staging is via the American Joint
Committee on Cancer (AJCC)/International Association for the Study of Lung Cancer
(IASLC) 8th edition staging criteria
• Patient must have somatic activating sensitizing mutation in EGFR (e.g. but not
limited to Exon 19 deletion, L858R, E709X, G719X, exon 19 insertions, L861Q, S768I).
Patients with non-sensitizing mutations in EGFR (EGFR exon 20 insertions) are not
eligible. Test results originating from a Clinical Laboratory Improvement Act
(CLIA)-certified or similarly accredited laboratory are acceptable; no specific assay
is mandated. Plasma, cytology, or tumor tissue can be utilized for mutation testing
• Patients that have received prior radiation therapy are eligible. Radiation (limited
field stereotactic radiation or conventional radiation) must have been completed at
least one week prior to study drug initiation and more extensive field radiation
(i.e., whole-brain radiotherapy [WBRT]) must have been completed at least two weeks
prior to drug initiation
• Patient must have measurable disease. Baseline measurements of sites of disease must
be obtained within 4 weeks prior to study registration. If a potential target lesion
is previously irradiated without subsequent growth and/or is radiated after the
imaging from which baseline measurements are obtained, they cannot be included as
target lesions, and additional target lesions are required to meet criteria for
measurable disease
• Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0
to 2
• All females of childbearing potential must have a blood test or urine study within 14
days prior to registration to rule out pregnancy
• A female of childbearing potential is defined as any woman, regardless of sexual
orientation or whether they have undergone tubal ligation, who meets the following
criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy
or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea
following cancer therapy does not rule out childbearing potential) for at least 24
consecutive months (i.e., has had menses at any time in the preceding 24 consecutive
months)
• Patient of childbearing potential and sexually active males must not expect to
conceive or father children by using accepted and effective method(s) of contraception
or by abstaining from sexual intercourse for 2 weeks prior to the start of treatment,
while on study treatment, and for
• 6 weeks after the last dose of protocol treatment for female patients on the
osimertinib (AZD9291) alone arm
• 4 months after the last dose of protocol treatment for male patients on
osimertinib (AZD9291) alone arm
• 6 months after the last dose of protocol treatment for all patients on
osimertinib (AZD9291) plus bevacizumab combination arm
• NOTE: Female patients should also not breastfeed while on treatment and for 6
months after the last dose bevacizumab
• Leukocytes >= 3,000/mcL (obtained =< 14 days prior to registration)
• Absolute neutrophil count >= 1,500/mcL (obtained =< 14 days prior to registration)
• Platelets >= 100,000/mcL (obtained =< 14 days prior to registration)
• Hemoglobin >= 9 g/dL (obtained =< 14 days prior to registration)
• Total bilirubin and creatinine =< 1.5 x institutional upper limit of normal (ULN)
(obtained =< 14 days prior to registration)
• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase
[SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT])
=< 2.5 x institutional ULN (obtained =< 14 days prior to registration)
• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral
therapy with undetectable viral load within 6 months are eligible for this trial
• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral
load must be undetectable on suppressive therapy, if indicated
• Patients with a history of hepatitis C virus (HCV) infection must have been treated
and cured. For patients with HCV infection who are currently on treatment, they are
eligible if they have an undetectable HCV viral load
• Patients with treated brain metastases are eligible if neurologically stable without
glucocorticoid therapy after the stated washout period from radiation therapy (RT) or
surgery provided the metastatic lesions are non-hemorrhagic
• Patients with untreated brain metastases or leptomeningeal disease are eligible if the
treating physician determines that immediate CNS specific treatment is not required
provided the metastatic lesions are non-hemorrhagic and are neurologically stable
without glucocorticoid therapy
• Patients with a prior or concurrent malignancy whose natural history or treatment does
not have the potential to interfere with the safety or efficacy assessment of the
investigational regimen are eligible for this trial
• Patients with known history or current symptoms of cardiac disease, should have a
clinical risk assessment of cardiac function using the New York Heart Association
Functional Classification. To be eligible for this trial, patients should be class 2B
or better
• Patient must have the ability to understand and the willingness to sign a written
informed consent document and comply with study requirements
Exclusion Criteria:
• Patient must not have received any prior treatment with an EGFR TKI or with an
anti-VEGF agent
• Patient must not have any risk factors for anti-VEGF administration, specifically,
hemoptysis, active cardiovascular disease, uncontrolled hypertension, significant
proteinuria (screening urinalysis > 300 mg/dl) and tumor invading major blood vessels
• Patient must not have had any prior systemic treatment for metastatic disease
• Patient must not be pregnant or breast-feeding due to the potential harm to an unborn
fetus and possible risk for adverse events in nursing infants with the treatment
regimens being used
• Patient must not have had treatment with any investigational drug within five
half-lives or 3 months (whichever is greater), prior to study initiation
• Patient must not be currently receiving (or unable to stop use prior to receiving the
first dose of study treatment) medications or herbal supplements known to be strong
inducers of CYP3A4. For any patient currently receiving such inducers of CYP3A4, they
must discontinue use prior to first dose of study treatment. All patients must try to
avoid concomitant use of any medications, herbal supplements and/or ingestion of foods
with known inducer effects on CYP3A4
• Patient must not have any unresolved toxicities from prior therapy greater than Common
Terminology Criteria for Adverse Events (CTCAE) grade 1 at the time of registration,
with the exception of alopecia and grade 2 prior platinum-therapy-related neuropathy
• Patient must not have any evidence of severe or uncontrolled systemic diseases,
including uncontrolled hypertension and active bleeding diatheses, which in the
investigator's opinion makes it challenging for the patient to participate in the
study. Screening for chronic conditions is not required
• Patient must not have refractory nausea and vomiting, chronic gastrointestinal
diseases, the inability to swallow the osimertinib tablets or previous significant
bowel resection that would preclude adequate absorption of osimertinib
• Patient must not have a medical history of interstitial lung disease, drug-induced
interstitial lung disease, radiation pneumonitis which required steroid treatment, or
any evidence of clinically active interstitial lung disease
• Patient must not have a history of hypersensitivity to active or inactive excipients
of osimertinib or drugs with a similar chemical structure or class to osimertinib
• Patient must not have mean resting corrected QT interval (QTc) > 470 msec obtained
from 3 electrocardiograms (ECGs), using the screening clinic ECG machine derived QTc
value (using Bezet's correction)
• Patient must not have any clinically important abnormalities in rhythm, conduction or
morphology of resting ECG e.g. complete left bundle branch block, third degree heart
block and second-degree heart block
• Patient must not have any factors that increase the risk of QTc prolongation or risk
of arrhythmic events such as heart failure, electrolyte abnormalities (including:
potassium < lower limit of normal [LLN]; magnesium < LLN; calcium < LLN), congenital
long QT syndrome, family history of long QT syndrome or unexplained sudden death under
40 years of age in first degree relatives or any concomitant medication known to
prolong the QT interval and cause torsades de pointes
Biological: Bevacizumab, Drug: Osimertinib
Metastatic Lung Non-Squamous Non-Small Cell Carcinoma, Recurrent Lung Non-Squamous Non-Small Cell Carcinoma, Stage IIIB Lung Cancer AJCC v8, Stage IVA Lung Cancer AJCC v8, Stage IV Lung Cancer AJCC v8, Stage IVB Lung Cancer AJCC v8, Advanced Lung Non-Squamous Non-Small Cell Carcinoma
UroLift System With SAbR for Prostate Cancer and BPH
Confirming safety of combining UroLift System prior to SAbR for patients with newly diagnosed
prostate cancer and a history of BPH, by measuring the acute complication rate of UroLift
System implant in patients with BPH undergoing SAbR (within 90 days of treatment completion)
• AJCC 8th edition clinical stage T1 (a, b, or c) or T2 (a, b, or c) adenocarcinoma of
the prostate gland, Gleason 3+3 = 6 or 3+4 = 7, with no direct evidence of regional or
distant metastases following appropriate staging studies. See Appendix I for details
on AJCC 8th Edition staging criteria. T-staging may be assessed by multi-parametric
imaging alone if digital rectal examination was deferred
• Histologic confirmation of prostate cancer is required by biopsy performed within 18
months of registration.
• Age > 45 years.
• Eastern Cooperative Oncology Group (ECOG) Performance status 0-1.
• American Society of Anesthesia (ASA) physical status score of 1-3
• Baseline AUA symptom score ≥ 17 regardless of medical therapy
• The serum PSA should be < 20 ng/ml within 120 days of registration
• Study entry PSA must not be obtained during the following time frames: (1) 10-day
period following prostate biopsy; (2) following initiation of ADT or anti-androgen
therapy; (3) within 30 days after discontinuation of finasteride; (4) within 90 days
after discontinuation of dutasteride; (5) within 5 days of a digital rectal
examination
• Ultrasound or MRI based volume estimation of prostate gland < 100 grams, regardless of
cytoreduction with pharmacotherapy
• Ability to undergo general anesthesia for <60 minutes
• Ability to understand and the willingness to sign a written informed consent.
• All men must agree to use adequate contraception (barrier method of birth control;
abstinence) prior to study entry, for the duration of study participation, and for 90
days following completion of therapy.
Exclusion Criteria:
• Contraindications to UroLift System placement including:
• Prostate volume >100 cc based on imaging-based estimation
• Urethral conditions (e.g. urethral strictures and neoplams) that may prevent insertion
of UroLift System delivery system into the bladder
• Urinary incontinence due to incompetent sphincter
• An active urinary tract infection
• Current gross hematuria
• In addition to the contraindications if there is a known allergy to nickel, titanium,
or stainless steel these patients should be excluded
• Prior transurethral resection of the prostate (TURP), median lobe manipulation, simple
prostatectomy, or other ablative procedures for benign prostatic hyperplasia.
• Foley / self-catheterization in the last 12 months.
• Patients with all three intermediate risk factors (PSA >10 and ≤ 20, Gleason 7,
clinical stage T2b-T2c) who ALSO have ≥50% of the number of their template biopsy
cores positive for cancer are ineligible.
• Prior pelvic radiotherapy, chemotherapy, or surgery for prostate cancer.
• Current active androgen deprivation therapy
A Study of LOXO-783 in Patients With Breast Cancer/Other Solid Tumors (PIKASSO-01)
The main purpose of this study is to learn more about the safety, side effects, and
effectiveness of LOXO-783. LOXO-783 may be used to treat breast cancer and other solid tumors
that have a change in a particular gene (known as the PIK3CA gene). Participation could last
up to 36 months (3 years) and possibly longer if the disease does not get worse.
• Have advanced breast cancer or another solid tumor with the presence of a PIK3CA
H1047R mutation (or other Sponsor and SRC-approved, activating PIK3CA mutations other
than H1047R mutation)
• Have adequate archival tumor tissue sample available or be approved by the Sponsor for
enrollment if no tumor sample is available.
• Have stopped all cancer treatment and have recovered from the major side effects
• Have adequate organ function, as measured by blood tests
• Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG)
scale
• Patients must have
• Measurable disease
--- Patients with non-breast tumor types must have at least 1 measurable lesion
• Non-measurable bone disease (at least one bone lesion in breast cancer patients
only)
• For patients with an ER+ breast cancer diagnosis:
• If female, must be postmenopausal
• If male, must agree to use hormone suppression
• Phase 1a:
-- Dose escalation and backfill patients:
• Advanced solid tumor
• Patients may have had up to 5 prior regimens for advanced disease
• Phase 1b:
• Part A:
• ER+/HER2- advanced breast cancer
• Patients may have had up to 2 prior regimens for advanced disease
• Prior cyclin dependent kinase (CDK)4/6 inhibitor therapy required
• Part B:
• ER+/HER2- advanced breast cancer
• Patients may have had up to 2 prior regimens for advanced disease.
• Part C:
• ER+/HER2- advanced breast cancer
• Patients may have had up to 5 prior regimens for advanced disease.
---- Prior CDK4/6 inhibitor therapy required.
• Have a diagnosis of diabetes mellitus Type 2
• Part D:
• Advanced breast cancer
• Patients may have had up to 5 prior regimens for advanced disease.
• Part E:
• Advanced solid tumor
• Patients may have had up to 3 prior regimens for advanced disease
Exclusion Criteria:
• Medical Conditions
• Colorectal cancer
• Endometrial cancers with specific concurrent oncogenic alterations
• A history of known active or suspected
• Diabetes mellitus Type 1 or
• Diabetes mellitus Type 2 requiring antidiabetic medication (Phase 1a and all
parts of Phase 1b except Part C).
• Serious concomitant systemic disorder
• Known or suspected history of untreated or uncontrolled central nervous system (CNS)
involvement.
• Active uncontrolled systemic bacterial, viral, fungal, or parasitic infection, or
other clinically significant active disease process
• Prior exposure to PI3K/AKT/mTOR inhibitor(s), except in certain circumstances
Breast Cancer, Brain and Nervous System, Eye and Orbit, Anus, Bones and Joints, Breast - Female, Breast - Male, Cervix, Colon, Corpus Uteri, Kidney, Larynx, Lip, Oral Cavity and Pharynx, Liver, Lung/Thoracic, Melanoma, skin, Other Digestive Organ, Other Endocrine System, Other Female Genital, Other Male Genital, Other Respiratory and Intrathoracic Organs, Other Skin, Other Urinary, Ovary, Pancreas, Prostate, Rectum, Stomach, Thyroid, Kaposis sarcoma, Small Intestine, Soft Tissue, Unknown Sites
A Trial of Robotic Versus Open Hysterectomy Surgery in Cervix Cancer (ROCC)
This is a randomized controlled trial to compare survival for patients who undergi robotic
assisted laparoscopy versus open radical hysterectomy and lymph node assessment for the
treatment of early stage cervical cancer.
1. Patient must have histologically confirmed adenocarcinoma (usual/classic/NOS),
squamous cell carcinoma, adenosquamous carcinoma (Including glassy cell)
2. Patient must be FIGO Stage IA2, IBI, IB2 (2018 staging) without evidence of definitive
parametrial, vaginal, nodal or distant metastases on exam or imaging.
3. Patient must have uterine size <12 cm AND felt to be appropriate for vaginal delivery
of the specimen per investigator.
4. Patient must be suitable surgical candidate with preoperative assessments such as labs
and EKG performed per institutional standard.
5. Patient must be age 18 years or older.
6. Patient must have ECOG performance status 0-1.
7. Patient must have a negative urine pregnancy test within 30 days of surgery in
pre-menopausal women.
8. Patient must have signed an approved informed consent and authorization permitting the
release of personal health information.
Exclusion Criteria:
1. Patients with any tumor histology other than those listed above, specifically
excluding the following histologies: neuroendocrine, other adenocarcinoma (gastric
type, endometrioid, clear cell, serous, signet ring, minimal deviation)
2. Patients with FIGO stage 1A1, IB3, II-IV (2018 staging).
3. Patient with inability to receive an MRI.
4. Patients with a tumor size ≥4cm or with definite evidence of vaginal/parametrial
involvement on MRI (if MRI findings are not definitive, then clinical examination must
also reveal parametrial or vaginal extension).
5. Patients with evidence of metastatic disease (imaging or histologically positive lymph
nodes).
6. Patients with a history of prior pelvic or abdominal radiotherapy.
7. Patients with a prior malignancy < 5 years from enrollment with the exception of
non-melanoma skin cancer.
8. Patients who are unable to withstand prolonged lithotomy or steep trendelenberg.
9. Patient compliance and geographic proximity that do not allow adequate follow-up.
10. Patients with poorly controlled HIV with CD4 counts <500.
Device: da Vinci, Other: open surgery
Cervical Cancer, Cervix
UT Southwestern; Parkland Health & Hospital System
Tagraxofusp in Pediatric Patients With Relapsed or Refractory CD123 Expressing Hematologic Malignancies
Tagraxofusp is a protein-drug conjugate consisting of a diphtheria toxin redirected to target
CD123 has been approved for treatment in pediatric and adult patients with blastic
plasmacytoid dendritic cell neoplasm (BPDCN). This trial aims to examine the safety of this
novel agent in pediatric patients with relapsed/refractory hematologic malignancies.
The mechanism by which tagraxofusp kills cells is distinct from that of conventional
chemotherapy. Tagraxofusp directly targets CD123 that is present on tumor cells, but is
expressed at lower or levels or absent on normal hematopoietic stem cells. Tagraxofusp also
utilizes a payload that is not cell cycle dependent, making it effective against both highly
proliferative tumor cells and also quiescent tumor cells.
The rationale for clinical development of tagraxofusp for pediatric patients with hematologic
malignancies is based on the ubiquitous and high expression of CD123 on many of these
diseases, as well as the highly potent preclinical activity and robust clinical
responsiveness in adults observed to date.
This trial includes two parts: a monotherapy phase and a combination chemotherapy phase. This
design will provide further monotherapy safety data and confirm the FDA approved pediatric
dose, as well as provide safety data when combined with chemotherapy.
The goal of this study is to improve survival rates in children and young adults with
relapsed hematological malignancies, determine the recommended phase 2 dose (RP2D) of
tagraxofusp given alone and in combination with chemotherapy, as well as to describe the
toxicities, pharmacokinetics, and pharmacodynamic properties of tagraxofusp in pediatric
patients.
About 54 children and young adults will participate in this study. Patients with Down
syndrome will be included in part 1 of the study.
Age
• Patients must be ≥ 1 and ≤21 years of age at the time of study enrollment.
Diagnosis
• Relapsed and/or refractory hematologic malignancy (including, but not limited to,
acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, mixed
phenotype acute leukemia, acute undifferentiated leukemia, blastic plasmacytoid
dendritic cell neoplasm, Hodgkin lymphoma, and non-Hodgkin lymphoma).
• Tumor cells must demonstrate surface expression of CD123 at the time of enrollment by
flow cytometry or immunohistochemistry, as defined by the local institution.
Disease Status:
Monotherapy, Part 1
• Second or greater relapse; or
• Refractory after 2 or more chemotherapy cycles; or
• First relapse after primary chemotherapy-refractory disease; or
• BPDCN in first relapse or refractory after 1 or more chemotherapy cycles
Combination therapy, Part 2
• First or greater relapse; or
• Refractory after 2 or more chemotherapy cycles; or
• BPDCN in first relapse or refractory after 1 or more chemotherapy cycles
For relapsed/refractory leukemia, patients must have:
• >5% blasts in the bone marrow aspirate by morphology or flow cytometry
• Patients with 1% •5% blasts are eligible for Part 2, Cohort C (only), if A single
bone marrow sample with flow cytometry and at least one other test (e.g. karyotype,
FISH, PCR, or NGS) shows ≥ 1% leukemic blasts and/or flow cytometry demonstrates a
stable or rising level of disease on two serial bone marrows.
For relapsed/refractory non-Hodgkin or Hodgkin lymphoma, patients must have:
• Histologic verification of relapse
• Measurable disease documented by radiographic criteria or bone marrow
• Patients in Part 1 may have sites of non-CNS extramedullary disease, but no CNS
disease. Patients in Part 2 may have CNS disease and/or other non-CNS extramedullary
disease. No cranial irradiation is allowed during the protocol therapy.
• Patients with Down syndrome are eligible.
Performance Level
• Karnofsky > 50% for patients > 16 years of age and Lansky > 50% for patients ≤ 16
years of age (See Appendix I for Performance Scales). Patients who are unable to walk
because of paralysis, but who are up in a wheelchair, will be considered ambulatory
for the purpose of assessing the performance score.
Prior Therapy
• Patients must have fully recovered from the acute toxic effects of all prior
chemotherapy, immunotherapy, or radiotherapy, defined as resolution of all such
toxicities to ≤ Grade 2 or lower per the inclusion/exclusion criteria.
Myelosuppressive chemotherapy: Patients must have fully recovered from the acute toxic
effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this
study. At least 14 day must have elapsed since the completion of myelosuppressive therapy.
However, individuals may receive any of the following medications within 14 days without a
"wash-out period":
• Hydroxyurea: Hydroxyurea can be initiated and/or continued for up to 24 hours prior to
the start of protocol therapy.
• "Maintenance-style" therapy: therapy including vincristine (dosed a maximum of
one-time weekly), oral 6-mercaptopurine, oral methotrexate (dosed a maximum of
one-time weekly), intrathecal therapy (dosed a maximum of one-time weekly) and/or
dexamethasone (dosed at ≤3 mg/m2/dose twice daily) or prednisone (dosed at ≤20
mg/m2/dose twice daily) can be continued for up to 24 hours prior to entering the
study.
• Hematopoietic stem cell transplant: Patients who have experienced their relapse after
a HSCT are eligible, provided they have no evidence of acute or chronic
Graft-versus-Host Disease (GVHD) and are at least 100 days post-transplant at the time
of enrollment.
• Hematopoietic growth factors: It must have been at least 7 days since the completion
of therapy with granulocyte colony stimulating factor (GCSF) or other growth factors
at the time of enrollment. It must have been at least 14 days since the completion of
therapy with pegfilgrastim (Neulasta®).
• Biologic (anti-neoplastic agent): At least 7 days after the last dose of a biologic
agent. For agents that have known adverse events occurring beyond 7 days after
administration, this period must be extended beyond the time during which adverse
events are known to occur. The duration of this interval must be discussed with the
study chair.
• Monoclonal antibodies: Maximum of 3 half-lives of the antibody or 21 days (whichever
is shorter) must have elapsed after the last dose of monoclonal antibody.
• Immunotherapy: At least 30 days from last infusion of chimeric antigen receptor T cell
(CART) therapy or tumor vaccine.
• XRT: Craniospinal XRT is prohibited during protocol therapy. No washout period is
necessary for radiation given to any extramedullary site other than CNS chloromas; ≥
90 days must have elapsed if prior TBI or craniospinal XRT.
• Patients that have received other non-tagraxofusp CD123 targeting agents are eligible.
Patients that have previously received tagraxofusp are not eligible.
Organ Function Requirements
Adequate Bone Marrow Function Defined as:
• Patients should not be known to be refractory to red blood cell or platelet
transfusions.
• Blood counts are not required to be normal prior to enrollment on trial. However,
platelet count must be ≥20,000/mm3 to initiate therapy (may receive platelet
transfusions).
Adequate Renal Function Defined as:
• Patient must have a calculated creatinine clearance or radioisotope GFR ≥
70ml/min/1.73m2 OR a normal serum creatinine based on age/gender in the chart below:
Maximum Serum Creatinine (mg/dL):
• 1 to < 2 years old •Male: 0.6, Female: 0.6
• 2 to < 6 years old •Male:0.8, Female: 0.8
• 6 to < 10 years old •Male: 1, Female: 1
• 10 to < 13 years old •Male: 1.2, Female: 1.2
• 13 to < 16 years old •Male: 1.5, Female: 1.4
• ≥ 16 years old •Male: 1.7, Female: 1.4
The threshold creatinine values in this Table were derived from the Schwartz formula for
estimating GFR (Schwartz et al. J. Peds, 106:522, 1985) utilizing child length and stature
data published by the CDC.
Adequate Liver Function Defined as:
• Total bilirubin (sum of conjugated + unconjugated) ≤ 1.5 x institutional upper limit
of normal for age
• SGPT (ALT) and SGOT (AST) must be less than 3x institutional upper limit of normal.
• Serum albumin ≥3.2 g/dL (albumin infusion independent).
Adequate Cardiac Function Defined as:
• Shortening fraction of ≥27% by echocardiogram, or
• Ejection fraction of ≥ 50% by gated radionuclide study/echocardiogram.
Adequate Pulmonary Function Defined as:
• Pulse oximetry > 94% on room air (> 90% if at high altitude)
• No evidence of dyspnea at rest and no exercise intolerance.
Reproductive Function
• Female patients of childbearing potential must have a negative urine or serum
pregnancy test confirmed within 2 weeks prior to enrollment.
• Female patients with infants must agree not to breastfeed their infants while on this
study.
• Male and female patients of child-bearing potential must agree to use an effective
method of contraception approved by the investigator during the study and for 12 weeks
after the last dose of tagraxofusp.
Exclusion Criteria
Disease Status:
• Patients with CNS disease are not eligible for Part 1.
• Patients with isolated CNS disease are not eligible for Part 1 or Part 2.
• Patients with isolated non-CNS disease are eligible for Part 1 and Part 2.
Concomitant Medications
• Corticosteroids •Patients receiving corticosteroids for disease control who have not
been on a stable or decreasing dose of corticosteroid for at least 7 days prior to
enrollment are not eligible.
• Investigational Drugs •Patients who are currently receiving another investigational
drug are not eligible. The definition of "investigational" for use in this protocol
means any drug that is not licensed by the FDA, Health Canada or the Therapeutic Goods
Administration to be sold in the countries they govern. (United States, Canada and
Australia)
• Anti-cancer Agents •Patients who are currently receiving or may receive while on
therapy, other anti-cancer agents, radiation therapy or immunotherapy are not eligible
[except hydroxyurea, which may be continued until 24 hours prior to start of protocol
therapy]. Intrathecal chemotherapy (at the discretion of the primary oncologist) may
be given up to one week prior to the initiation of study treatment (day 1 therapy).
• Anti-GVHD or agents to prevent organ rejection post-transplant •Patients who are
receiving cyclosporine, tacrolimus or other agents to prevent either graft-versus-host
disease post bone marrow transplant or organ rejection post-transplant are not
eligible for this trial. At least 4 weeks must have elapsed after the last dose of
GVHD meds.
Infection Criteria •Patients are excluded if they have:
• Positive blood culture within 48 hours of study enrollment;
• Fever above 38.2 within 48 hours of study enrollment with clinical signs of infection.
Fever that is determined to be due to tumor burden is allowed if patients have
documented negative blood cultures for at least 48 hours prior to enrollment and no
concurrent signs or symptoms of active infection or hemodynamic instability.
• A positive fungal culture within 30 days of study enrollment.
• Active fungal, viral, bacterial, or protozoal infection requiring IV treatment.
Chronic prophylaxis therapy to prevent infections is allowed.
• Patients will be excluded if they have a known allergy to any of the drugs used in the
study.
• Patients will be excluded if they have significant concurrent disease, illness,
psychiatric disorder or social issue that would compromise patient safety or
compliance with the protocol treatment or procedures, interfere with consent, study
participation, follow up, or interpretation of study results.
• Patients with DNA fragility syndromes (such as Fanconi anemia, Bloom syndrome) are
excluded.
Stereotactic Radiosurgery (SRS) Dose-Escalation Study for Brain Metastasis (SRS)
SRS dose escalation for brain metastases in radiation-naïve patients will establish true
tolerable doses, which may exceed the current standard doses. This may lead to an improvement
in local control, patient survival, and/or quality-of life.
Inclusion Criteria
1. Biopsy-proven non-hematopoietic malignancy, except for small cell lung cancer, germ
cell cancer, or unknown primary tumor.
2. Radiographic evidence by MRI (or by CT scan with CT contrast if ineligible or
intolerant of MRI) of brain metastasis. (If patient is unable to tolerate MRI
contrast, an MRI without contrast is acceptable if lesions are visible)
3. All brain metastases must be outside the brain stem (midbrain, pons and medulla).
4. Patient must have 10 or less brain metastases.
5. The maximum diameter of any lesion must be less than or equal to 3.0 cm.
6. Previous treatment with surgery, radiation, chemotherapy, immunotherapy or any
targeted agents are allowed provided that:
• Radiation was not to the brain.
• Surgery to the brain was > 7 days prior to SRS and there remains at least one
additional brain metastasis that can be targeted with SRS
7. Age ≥ 18 years.
8. ECOG Performance Score of 2 or better/Karnofsky Performance Status score of 50-60 or
better.
9. All men, as well as women of child-bearing potential must agree to use adequate
contraception (hormonal or barrier method of birth control; abstinence) prior to study
entry and for the duration of study participation. Should a woman become pregnant or
suspect she is pregnant while participating in this study, she should inform her
treating physician immediately.
A female of child-bearing potential is any woman (regardless of sexual orientation,
marital status, having undergone a tubal ligation, or remaining celibate by choice)
who meets the following criteria:
• Has not undergone a hysterectomy or bilateral oophorectomy; or
• Has not been naturally postmenopausal for at least 12 consecutive months (i.e.,
has had menses at any time in the preceding 12 consecutive months).
Medically acceptable birth control (contraceptives) includes:
• Approved hormonal contraceptives (such as birth control pills, patch, or ring:
Depo-Provera, Implanon), or
• Barrier methods (such as a condom or diaphragm) used with a spermicide (a
substance that kills sperm)
10. Ability to understand and the willingness to sign a written informed consent.
Exclusion Criteria
1. Patients had craniotomy and surgery to the brain within 7 days from the date of SRS.
2. Patients with leptomeningeal metastasis.
NOTE: For the purposes of exclusion, LMD is a clinical diagnosis, defined as positive
CSF cytology and/or equivocal radiologic or clinical evidence of leptomeningeal
involvement. Patients with leptomeningeal symptoms in the setting of leptomeningeal
enhancement by imaging (MRI) would be considered to have LMD even in the absence of
positive CSF cytology, unless a parenchymal lesion can adequately explain the
neurologic symptoms and/or signs. In contrast, an asymptomatic or minimally
symptomatic patient with mild or nonspecific leptomeningeal enhancement (MRI) would
not be considered to have LMD. In that patient, CSF sampling is not required to
formally exclude LMD, but can be performed at the investigator's discretion based on
level of clinical suspicion.
3. Patients with a contraindication to both MRI (with or without contrast) and CT scan
(with contrast)
4. Patients with life expectancy < 3 months.
5. Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that, in the opinion of the
investigator, would limit compliance with study requirements.
6. Subjects must not be pregnant or nursing at the time of SRS treatment due to the
potential for congenital abnormalities and the potential of this regimen to harm
nursing infants.
Radiation: Stereotactic Radiosurgery
Brain Neoplasms, Adult, Malignant, Lymphoma, Sarcoma, Multiple Myeloma, Brain and Nervous System, Other, Eye and Orbit, Anklylosing Spondylitis, Anus, Bones and Joints, Breast - Female, Breast - Male, Cardiovascular, Cervix, Colon, Corpus Uteri, Ear, Esophagus, Gall Bladder, Head and Neck, Kidney, Larynx, Lip, Oral Cavity and Pharynx, Liver, Lung/Thoracic, Melanoma, skin, Nose, Other Digestive Organ, Other Endocrine System, Other Female Genital, Other Male Genital, Other Respiratory and Intrathoracic Organs, Other Skin, Other Urinary, Ovary, Pancreas, Prostate, Rectum, Stomach, Throat, Thyroid, Urinary Bladder, Uterine (Endometrial), Vulva, Hodgkins Lymphoma, Lymphoid Leukemia, Small Intestine, Soft Tissue
UT Southwestern; Parkland Health & Hospital System