RECRUITING

A Study to Assess the Efficacy, Safety, Pharmacodynamics, and Pharmacokinetics of Tazemetostat in Combination With Lenalidomide Plus Rituximab Versus Placebo in Combination With Lenalidomide Plus Rituximab in Adult Patients at Least 18 Years of Age With Relapsed/Refractory Follicular Lymphoma.

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The participants of this study would have relapsed/refractory follicular lymphoma. Follicular lymphoma is a type of blood cancer. It is referred to as 'relapsed' when the disease has come back after a period of improvement after that follows a treatment regimen and 'refractory' when treatment no longer works. Stage 1 of this trial will study the safety and the level that adverse effects of each of the study drug combinations can be tolerated (known as tolerability). It is also designed to establish a recommended study drug dosage for stage 2 and 3. Stage 1 of the study is completed. Stages 2 and 3 will evaluate and compare how long participants live without their disease getting worse when receiving the study drug in combination with other drug treatment versus the placebo (dummy drug) in combination with other drug treatment.

Official Title

Symphony-1: A Phase 1b/3 Double-Blind, Randomized, Active-Controlled, 3-Stage, Biomarker Adaptive Study Of Tazemetostat Or Placebo In Combination With Lenalidomide Plus Rituximab In Subjects With Relapsed/Refractory Follicular Lymphoma

Quick Facts

Study Start:2020-06-11
Study Completion:2029-03-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04224493

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Have voluntarily agreed to provide written informed consent and demonstrated willingness and ability to comply with all aspects of the protocol.
  2. 2. Males or females are ≥18 years of age at the time of providing voluntary written informed consent.
  3. 3. Life expectancy ≥3 months before enrollment.
  4. 4. Meet requirement for hepatitis and human immunodeficiency virus (HIV) infection as follows
  5. * Negative serologic or polymerase chain reaction (PCR) test results for acute or chronic hepatitis B virus (HBV) infection Note: Participants whose HBV infection status could not be determined by serologic test results have to be negative for HBV-DNA by PCR to be eligible for study participation. Participants seropositive for HBV with undetectable HBV DNA by PCR are permitted with appropriate antiviral prophylaxis.
  6. * Negative test results for hepatitis C virus (HCV) Note: Participants who are positive for HCV antibody must be negative for HCV RNA by PCR to be eligible for study participation
  7. * If HIV positive, HIV infection is controlled
  8. 5. Have histologically confirmed FL, Grades 1 to 3A.
  9. 6. Must have been previously treated with at least 1 prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy:
  10. 7. Must have documented relapsed, refractory, or PD after treatment with systemic therapy (refractory defined as less than PR or disease progression \<6 months after last dose).
  11. 8. Have measurable disease as defined by the Lugano Classification (Cheson, 2014; Appendix 5).
  12. 9. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
  13. 10. Within 7 days prior to randomization, all clinically significant toxicity related to a prior anticancer treatment (ie, chemotherapy, immunotherapy, and/or radiotherapy must have either resolved to Grade 1 per NCI CTCAE Version 5.0 OR are clinically stable and no longer clinically significant.
  14. 11. Have provided sufficient tumor tissue block or unstained slides for EZH2 mutation testing in all subjects to allow for stratification
  15. 12. Time between prior anticancer therapy and first dose of tazemetostat as follows:
  16. 1. Cytotoxic chemotherapy - At least 21 days.
  17. 2. Noncytotoxic chemotherapy (eg, small molecule inhibitor) - At least 14 days.
  18. 3. Nitrosoureas - At least 6 weeks.
  19. 4. Monoclonal and/or bispecific antibodies or CAR T - At least 28 days.
  20. 5. Radiotherapy - At least 6 weeks from prior radioisotope therapy; at least 12 weeks from 50% pelvic or total body irradiation.
  21. 13. Adequate renal function defined as calculated creatinine clearance ≥30 mL/minute per the Cockcroft and Gault formula.
  22. 14. Adequate bone marrow function:
  23. * Without growth factor support (filgrastim or pegfilgrastim) for at least 14 days.
  24. * Evaluated at least 7 days after last platelet transfusion.
  25. * May receive transfusion
  26. 15. Adequate liver function:
  27. 1. Total bilirubin ≤1.5 × the upper limit of normal (ULN) except for unconjugated hyperbilirubinemia of Gilbert's syndrome.
  28. 2. Alkaline phosphatase (ALP) (in the absence of bone disease), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) ≤3 × ULN (≤5 × ULN if subject has liver infilration).
  29. 16. International normalized ratio (INR) ≤1.5 × ULN and activated partial thromboplastin time (aPTT) ≤1.5 × ULN (unless on warfarin, then INR ≤3.0). In subjects with thromboembolism risk, prophylactic anticoagulation, or antiplatelet therapy at investigator discretion is recommended.
  30. 17. Females of childbearing potential (FCBP) must have a negative urine or serum pregnancy tests (beta-human chorionic gonadotropin \[β-hCG\] tests with a minimum sensitivity of 25 mIU/mL or equivalent units of β-hCG) at screening within 10 to 14 days prior to first dose of study drug. The subject may not receive study drug until the study doctor has verified that the results of pregnancy tests are negative. All females will be considered to be of childbearing potential unless they are naturally postmenopausal (at least 24 months consecutively amenorrhoeic \[amenorrhea following cancer therapy does not rule out childbearing potential\] and without other known or suspected cause) or have been sterilized surgically (ie, total hysterectomy and/or bilateral oophorectomy, with surgery completed at least 1 month before dosing).
  31. 18. Females of childbearing potential (FCBP) enrolled must either practice complete abstinence or agree to use two reliable methods of contraception simultaneously. This includes ONE highly effective method of contraception and ONE additional effective contraceptive method. Contraception must begin at least 28 days prior to first dose of study drug, continue during study treatment (including during dose interruptions), and for 12 months after study drug discontinuation. Female subjects must also refrain from breastfeeding for 12 months following last dose of study drug. If the below contraception methods are not appropriate for the FCBP, she must be referred to a qualified contraception provider to determine the medically effective contraception method appropriate for the subject. The following are examples of highly effective and additional effective methods of contraception:
  32. * Intrauterine device (IUD)
  33. * Hormonal (ovulation inhibitory combined \[estrogen and progesterone\] birth control pills or intravaginal/transdermal system, injections, implants, levonorgestrel-releasing intrauterine system \[IUS\], medroxyprogesterone acetate depot injections, ovulation inhibitory progesterone-only pills \[e.g. desogestrel\]) NOTE: There is a potential for tazemetostat interference with hormonal contraception methods due to enzymatic induction.
  34. * Bilateral tubal ligation
  35. * Partner's vasectomy (if medically confirmed \[azoospermia\] and sole sexual partner).
  36. * Male latex or synthetic condom,
  37. * Diaphragm,
  38. * Cervical Cap
  39. 19. All study participants enrolled must be registered into the applicable pregnancy prevention program (e.g. REVLIMID REMS in the US, Pregnancy Prevention Programme \[PPP\] in Europe, RevAid in Canada) for lenalidomide to be administered and be willing and able to comply with the requirements of the applicable program as appropriate for the country in which the drug is being used.
  40. 20. Male subjects must either practice complete abstinence or agree to use a latex or synthetic condom, even with a successful vasectomy (medically confirmed azoospermia), during sexual contact with a pregnant female or FCBP from first dose of study drug, during study treatment (including during dose interruptions), and for 3 months after study drug discontinuation.
  1. 1. Prior exposure to tazemetostat or other inhibitor(s) of EZH2.
  2. 2. Prior exposure to lenalidomide or drugs of the same class.
  3. 3. Grade 3b, mixed histology, or FL that has histologically transformed to diffuse large B-cell lymphoma (DLBCL) (subjects transformed from DLBCL to FL may be enrolled).
  4. 4. Has thrombocytopenia, neutropenia, or anemia of Grade ≥3 (per CTCAE Version 5.0 criteria) or any prior history of myeloid malignancies, including myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or myeloproliferative neoplasm (MPN).
  5. 5. Has a prior history of T-cell lymphoblastic lymphoma (T-LBL)/T-cell acute lymphoblastic leukemia (T-ALL) or B-cell acute lymphoblastic leukemia (B-ALL).
  6. 6. Subjects with uncontrolled leptomeningeal metastases or brain metastases or history of previously treated brain metastases.
  7. 7. Subjects taking medications that are known strong CYP3A inhibitors and strong or moderate CYP3A inducers (including St. John's wort).
  8. 8. Are unwilling to exclude grapefruit juice, Seville oranges, and grapefruits from the diet and/or consumed within 1 week of the first dose of study drug and for the duration of the study.
  9. 9. Major surgery within 4 weeks before the first dose of study drug.
  10. 10. Are unable to take oral medication OR have malabsorption syndrome or any other uncontrolled gastrointestinal condition (eg, nausea, diarrhea, vomiting) that might impair the bioavailability of tazemetostat.
  11. 11. Significant cardiovascular impairment: history of congestive heart failure greater than New York Heart Association (NYHA) Class II, uncontrolled arterial hypertension, unstable angina, myocardial infarction, or stroke within 6 months of the first dose of study drug; or cardiac ventricular arrhythmia.
  12. 12. Prolongation of corrected QT interval using Fridericia's formula (QTcF) to ≥480 msec at screening or history of long QT syndrome.
  13. 13. Venous thrombosis or pulmonary embolism within the last 3 months before starting tazemetostat.
  14. 14. Have an active infection requiring systemic therapy.
  15. 15. Known hypersensitivity to any component of tazemetostat or lenalidomide; known severe hypersensitivity to any component of rituximab requiring hospitalization or resuscitation.
  16. 16. Active viral infection with or seropositive for HBV: HBV surface antigen (HBsAg) positive OR HBsAg negative, anti-HBs positive and/or anti-HBc positive with detectable HBV DNA.
  17. 17. Active viral infection with hepatitis C virus (as measured by positive HCV antibody and detectable viral RNA, HIV), or known active infection with human T-cell lymphotropic virus.
  18. 18. Any other medical or social condition that, in the Investigator's judgment, will interfere with a participant's ability to provide informed consent, to receive study drugs, or meet study demands, or that substantially increases the risk associated with the subject's participation in the study, or that may interfere with interpretation of results.
  19. 19. Female subjects who are pregnant or lactating/breastfeeding.
  20. 20. Subjects who have undergone a solid organ transplant.
  21. 21. Subjects with malignancies other than FL. a. Exception: Subjects with another malignancy who have been disease-free for 3 years, or subjects with a history of a completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible.

Contacts and Locations

Study Contact

Ipsen Clinical Study Enquiries
CONTACT
See e mail
clinical.trials@ipsen.com

Principal Investigator

Ipsen Medical Director
STUDY_DIRECTOR
Ipsen

Study Locations (Sites)

Southern Cancer Center
Mobile, Alabama, 36608
United States
Arizona Oncology Associates - Tuscon-Rusadill Road
Tucson, Arizona, 85704
United States
TOI - Clinical Research
Cerritos, California, 90703
United States
UCSF Fresno
Clovis, California, 93611
United States
UC San Diego Health Sciences
La Jolla, California, 92093
United States
UCLA Clinical Research Unit Hematology/Oncology
Santa Monica, California, 90404
United States
Rocky Mountain Cancer Centers (RMCC) - Boulder
Boulder, Colorado, 80303
United States
St. Mary's Hospital and Regional Medical Center - St. Mary's
Grand Junction, Colorado, 81501
United States
SCL Health Lutheran Medical Center
Greeley, Colorado, 80033
United States
Cancer Specialists of North Florida
Fleming Island, Florida, 32003
United States
Florida Cancer Specialists & Research Institute (FCS) - Fort Myers Cancer Center
Fort Myers, Florida, 33908
United States
Mayo Clinic - Cancer Clinical Research Office
Jacksonville, Florida, 32224
United States
Mayo Clinic
Jacksonville, Florida, 32224
United States
Miami Cancer Institute
Miami, Florida, 33176
United States
Florida Cancer Affiliates/Ocala Oncology - Clinic
Ocala, Florida, 34474
United States
BRCR Medical Center, INC
Plantation, Florida, 33322
United States
Florida Cancer Specialists
Saint Petersburg, Florida, 33705
United States
Florida Cancer Specialists - Panhandle
Tallahassee, Florida, 32308
United States
H Lee Moffitt Cancer Center and Research Institute I
Tampa, Florida, 33612
United States
Florida Cancer Specialists & Research Institute (FCS) - Atlantis
West Palm Beach, Florida, 33401
United States
Kaiser Permanente Hawaii Moanalua Medical Center
Honolulu, Hawaii, 96819
United States
University of Chicago
Chicago, Illinois, 60637
United States
Illinois Cancer Specialists
Niles, Illinois, 60714
United States
June E. Nylen Cancer Center
Sioux City, Iowa, 51101
United States
The University of Kansas Cancer Center
Overland Park, Kansas, 66210
United States
University of Maryland
Baltimore, Maryland, 21201
United States
The office of Frederick P. Smith, MD, P.C.
Chevy Chase, Maryland, 20815-6908
United States
Mass General Cancer Center at Newton-Wellesley
Newton, Massachusetts, 02462
United States
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109
United States
St. Joseph Mercy Hospital
Ypsilanti, Michigan, 48197
United States
Mayo Clinic - Rochester
Rochester, Minnesota, 55901
United States
Saint Louis University Cancer Center
Saint Louis, Missouri, 63110
United States
University Of Nebraska Medical Center
Omaha, Nebraska, 68198
United States
Astera Cancer Care
East Brunswick, New Jersey, 08816
United States
Astera Cancer Center
East Brunswick, New Jersey, 08816
United States
Regional Cancer Care Associates-Freehold
Freehold, New Jersey, 07728
United States
Hackensack University Medical John Theurer Cancer Center
Hackensack, New Jersey, 07601
United States
Regional Cancer Care Associates LLC - Howell
Howell, New Jersey, 07731
United States
Regional Cancer Care Associates LLC - Little Silver
Little Silver, New Jersey, 07739
United States
New Mexico Cancer Care Alliance
Albuquerque, New Mexico, 87131-0001
United States
New York Oncology Hematology, P.C.
Albany, New York, 12206
United States
Northwell Health/Monter Cancer Center
Lake Success, New York, 11042
United States
Weill Cornell Medicine-New York Presbyterian Hospital
New York, New York, 10021
United States
Columbia U - Herbert Irving Comprehensive Cancer Center
New York, New York, 10032
United States
Memorial Sloan-Kettering Cancer Center
New York, New York, 10065
United States
Hematology Oncology Associates of Rockland, P.C.
Nyack, New York, 10960
United States
Messino Cancer Center
Asheville, North Carolina, 28806
United States
Levine Cancer Institute - Concord
Concord, North Carolina, 28205
United States
FirstHealth of the Carolinas
Pinehurst, North Carolina, 28374
United States
Gabrail Cancer Center Research
Canton, Ohio, 44718
United States
Oncology Hematology Care (OHC), Inc. - Kenwood Office
Cincinnati, Ohio, 45236
United States
Willamette Valley Cancer Institute and Research Center - Oncology
Eugene, Oregon, 97401
United States
University of Pittsburgh Medical Center - Oncology
Pittsburgh, Pennsylvania, 15232
United States
Western Pennsylvania Hospital Hematology & Cellular Therapy
Pittsburgh, Pennsylvania, 15524
United States
Tennessee Oncology, PLLC
Chattanooga, Tennessee, 37404
United States
University of Tennessee Medical Center - Cancer Institute
Knoxville, Tennessee, 37920
United States
Sarah Cannon Research Institute
Nashville, Tennessee, 37203
United States
Texas Oncology - Amarillo
Amarillo, Texas, 79124
United States
Texas Oncology-Austin Midtown
Austin, Texas, 78705
United States
Texas Oncology - Medical City Dallas Pediatric Hematology
Dallas, Texas, 75230
United States
Texas Oncology-Baylor Charles A. Sammons Cancer Center
Dallas, Texas, 75246
United States
The University of Texas MD Anderson Cancer Center
Houston, Texas, 77030
United States
Millennium Physicians - Oncology
Houston, Texas, 77090
United States
Texas Oncology
Plano, Texas, 75075
United States
Mays Cancer Center
San Antonio, Texas, 78229
United States
UT Health East Texas HOPE Cancer Center - Tyler
Tyler, Texas, 75701
United States
USO Texas Oncology - Tyler
Tyler, Texas, 75702
United States
Texas Oncology- Weslaco
Weslaco, Texas, 78596
United States
Utah Cancer Specialists/ IHO Corp
Salt Lake City, Utah, 84106
United States
Huntsman Cancer Institute; The University of Utah
Salt Lake City, Utah, 84112
United States
Peninsula Cancer Institute
Chesapeake, Virginia, 23320
United States
Virginia Cancer Specialists
Gainesville, Virginia, 22155
United States
Oncology and Hematology Associates of Southwest Virginia Inc.
Roanoke, Virginia, 24014
United States
MC Rockwood Cancer Bl Specialty Ctr - North
Spokane, Washington, 99218
United States
Yakima Valley Memorial Hospital - North Star Lodge Cancer Center
Yakima, Washington, 98902
United States

Collaborators and Investigators

Sponsor: Epizyme, Inc.

  • Ipsen Medical Director, STUDY_DIRECTOR, Ipsen

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2020-06-11
Study Completion Date2029-03-01

Study Record Updates

Study Start Date2020-06-11
Study Completion Date2029-03-01

Terms related to this study

Keywords Provided by Researchers

  • Epizyme
  • Tazverik
  • Tazemetostat (EPZ-6438)
  • Lenalidomide
  • Revlimid
  • Rituximab
  • Rituxan
  • Follicular lymphoma
  • EZH2

Additional Relevant MeSH Terms

  • Relapsed/Refractory Follicular Lymphoma
  • Follicular Lymphoma
  • Refractory Follicular Lymphoma