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Chronic Lymphocytic LeukemiaPhase 1/2NCT03037645

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

A Phase 1/2 study testing SNS-062 in people with Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, run by Sunesis Pharmaceuticals at 11 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

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

Who is it for?
Ages 18 years and older
What is being tested?
SNS-062
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
39 participants
Where
11 sitesUnited States
Study dates
28 Apr 2017to 31 Aug 2020
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

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

Who cannot join

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

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, 21231

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Willamette Valley Cancer Institute and Research Center

    Eugene, Oregon, 97401

  • MD Anderson Cancer Center

    Houston, Texas, 77030

  • Weill Cornell Medicine

    New York, New York, 10065

  • University of California Irvine Medical Center

    Orange, California, 92868-3201

  • UC San Diego Moores Cancer Center

    San Diego, California, 92093

  • Swedish Cancer Institute

    Seattle, Washington, 98104

  • Fred Hutchinson Cancer Research Center

    Seattle, Washington, 98109

  • Moffitt Cancer Center and Research Institute

    Tampa, Florida, 33612

  • Texas Oncology - Tyler

    Tyler, Texas, 75702

Other trials in United States

About this study

Official title: A Phase 1b/2 Dose-Escalation and Cohort-Expansion Study of the Noncovalent, Reversible Bruton's Tyrosine Kinase Inhibitor, SNS-062, in Patients With B-Lymphoid Malignancies

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

Read the detailed description

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

Being tested
SNS-062
Keywords
CLL, hematological diseases, relapsed, cancer, malignancy, SNS-062, B-lymphoid, chronic lymphocytic leukemia, small lymphocytic lymphoma, lymphoplasmacytoid lymphoma, Waldenström's macrogloulinemia, mantle cell lymphoma, SLL, LPL, WM, MCL, refractory, DLBCL-ABC, DLBCL, follicular lymphoma
Medical subject headings
Leukemia, Lymphocytic, Chronic, B-Cell, Waldenstrom Macroglobulinemia, Lymphoma, Mantle-Cell, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Follicular, Lymphoma, B-Cell, Marginal Zone, Hematologic Diseases, Recurrence

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SNS-062Drug

    SNS-062 will be orally administered twice daily and available in capsules containing either 25 mg or 100 mg of active ingredient.

Study groups in NCT03037645
Study groupRoleWhat they receive
Dose escalating cohorts of SNS-062ExperimentalSequential groups, 25, 50, 100, 200, 300, 400 and 500 mg twice daily to determine maximum tolerated dose and recommended dose (RD) in the treatment of various hematological cancers followed by expansion of the recommended dose cohort in Phase 2 of the study treating hematological cancers.
Receives: Drug: SNS-062

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum tolerated dose and/or Recommended dose of SNS-062 (Phase 1b)

    To determine the Maximum Tolerated Dose (MTD) and/or Recommended Dose (RD)within the tested SNS-062 dose range. The MTD is the highest tested dose level at which ≥6 subjects have been treated and which is associated with a Cycle 1 dose limiting toxicity (DLT) in <33% of the subjects. The RD may be the MTD or may be a lower dose.

    Measured: Up to approximately 21 months

  2. Objective Response Rate (ORR) (Phase 2)

    Phase 2 portion of study measuring ORR and corresponding 90% confidence intervals by cohort. ORR will be defined by disease subtype as the proportion of subjects who achieve CLL/SLL: a CR, CRi, or PR.

    Measured: Up to approximately 36 months

Secondary outcomes (11)
  1. Safety as assessed through reported AEs, SAEs, DLTs and abnormal lab findings (Phase 1b and Phase 2)

    Type, severity, timing of onset, duration, and relationship to study drug of any TEAEs or abnormalities of laboratory tests, SAEs, DLTs, or AEs leading to study discontinuation.

    Measured: Up to approximately 36 months

  2. Characterization of Pharmacokinetics (AUC) (Phase 1b and Phase 2)

    Area Under the Curve (AUC)

    Measured: Up to approximately 36 months

  3. Characterization of Pharmacokinetics (Cmin,ss) (Phase 1b and Phase 2)

    Minimum Plasma Concentration During Dosing Interval at Steady-State (Cmin,ss)

    Measured: Up to approximately 36 months

  4. Characterization of Pharmacokinetics (Cmax) (Phase 1b and Phase 2)

    Maximum Plasma Concentration (Cmax)

    Measured: Up to approximately 36 months

  5. Characterization of Pharmacokinetics (Tmax) (Phase 1b and Phase 2)

    Time of Maximum Plasma Concentration (Tmax)

    Measured: Up to approximately 36 months

  6. Preliminary evidence of anti-tumor activity, in terms of Time to Response (TTR) as assessed by the Investigator. (Phase 2)

    Measure of Time to Response (TTR) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

  7. Preliminary evidence of anti-tumor activity, in terms of Duration of Response (DOR) as assessed by the Investigator. (Phase 2)

    Measure of Duration of Response (DOR) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

  8. Preliminary evidence of anti-tumor activity, in terms of Response Rate (RR) as assessed by the Investigator. (Phase 2)

    Measure of Response Rate (RR) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

  9. Preliminary evidence of anti-tumor activity, in terms of Disease Control Rate (DCR) as assessed by the Investigator. (Phase 2)

    Measure of Disease Control Rate (DCR) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

  10. Preliminary evidence of anti-tumor activity, in terms of Progression-Free Survival (PFS) as assessed by the Investigator. (Phase 2)

    Measure of Progression-Free Survival (PFS) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

  11. Preliminary evidence of anti-tumor activity, in terms of Overall Survival (OS) as assessed by the Investigator. (Phase 2)

    Measure of Overall Survival (OS) as evaluated by standard response and progression criteria for CLL/SLL.

    Measured: Up to approximately 36 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jan 2017 (estimated)
  2. Study start28 Apr 2017
  3. Primary completion31 Aug 2020
  4. Study completion31 Aug 2020

Why it stopped: Phase 1b portion completed. Sponsor decided not to proceed with P2 portion of study. Vecabrutinib was very well tolerated, there was insufficient evidence of activity at the doses tested in the Phase 1b to advance to Phase 2.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential
Masking
None (open label)
Enrolment
39 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03037645
Sponsor's protocol ID
062-HEM-102
Status last verified
Oct 2020
First submitted
25 Jan 2017
Last updated
19 Oct 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kipps TJ. Mining the Microenvironment for Therapeutic Targets in Chronic Lymphocytic Leukemia. Cancer J. 2021 Jul-Aug 01;27(4):306-313. doi: 10.1097/PPO.0000000000000536.

    PubMed 34398557

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing SNS-062 in people with Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, run by Sunesis Pharmaceuticals at 11 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 19 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Phase 1b portion completed. Sponsor decided not to proceed with P2 portion of study. Vecabrutinib was very well tolerated, there was insufficient evidence of activity at the doses tested in the Phase 1b to advance to Phase 2.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum tolerated dose and/or Recommended dose of SNS-062 (Phase 1b) (time frame: Up to approximately 21 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03037645, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2020.

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