RecruitingPhase 2NCT04996875

(Apex) Bezuclastinib in Patients With Advanced Systemic Mastocytosis

A Phase 2 Open-Label, Multicenter Clinical Study of the Safety, Efficacy, Pharmacokinetic, and Pharmacodynamic Profiles of CGT9486 as a Single Agent in Patients With Advanced Systemic Mastocytosis


Sponsor

Cogent Biosciences, Inc.

Enrollment

140 participants

Start Date

Nov 9, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

This is an open-label, two-part Phase 2 study investigating CGT9486 for the treatment of patients with Advanced Systemic Mastocytosis (AdvSM), including patients with Aggressive SM (ASM), SM with Associated Hematologic Neoplasm (SM-AHN), and Mast Cell Leukemia (MCL).


Eligibility

Min Age: 18 Years

Inclusion Criteria19

  • Diagnosed with one of the following advanced mastocytosis diagnoses by Eligibility Committee
  • Aggressive Systemic Mastocytosis (ASM)
  • Systemic Mastocytosis with an Associated Hematologic Neoplasm (SM-AHN)
  • Mast Cell Leukemia (MCL)
  • Measurable disease according to modified IWG-MRT-ECNM criteria. (A subset of patients inevaluble per mIWG-MRT-ECNM will be included in the study).
  • ECOG (0 to 3)
  • Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits
  • Rollover Cohort
  • Demonstrate AHN progression requiring immediate AHN-directed therapy while receiving bezuclastinib
  • Demonstrated clinical benefit from bezuclastinib therapy
  • Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits
  • High-Risk Cohort
  • Receiving or indicated for AHN-directed therapy.
  • Diagnosed with one of the following pathologic diagnoses of SM-AHN:
  • Myelodysplastic syndrome (MDS) that is high- or very high-risk
  • Accelerated phase myeloproliferative neoplasm (MPN)
  • MDS with excessive blasts in bone marrow or peripheral blood
  • Chronic myelomonocytic leukemia-2 (CMML-2)
  • Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits.

Exclusion Criteria19

  • Persistent toxicity from previous therapy for AdvSM that has not resolved to ≤ Grade 1
  • Associated hematologic neoplasm requiring immediate antineoplastic therapy
  • Clinically significant cardiac disease
  • Known positivity for the FIP1L1 PDGFRA fusion. Patients with eosinophilia without detectable KIT D816V mutation must demonstrate lack of PDGFRA fusion mutation prior to enrollment
  • Seropositive for human immunodeficiency virus (HIV) 1 or 2, or positive for hepatitis B surface antigen or hepatitis C virus (HCV) antibody
  • History of clinically significant bleeding event within 30 days before the first dose of study drug or need for therapeutic anticoagulation on study
  • Diagnosed with or treated for malignancy other than the disease under study within the prior 3 years before enrollment
  • Received any cytoreductive therapy or any investigational agent less than 14 days, and for cladribine, interferon alpha, pegylated interferon, and any antibody therapy less than 28 days, before screening bone marrow biopsy
  • Received hematopoietic growth factor support within 14 days before the first dose of study drug
  • Received strong CYP3A4 inhibitors or inducers within 14 days or 5 drug half-lives, whichever is longer, before the first dose of study drug
  • Need for treatment with high dose steroids
  • Diagnosis of Philadelphia chromosome-positive malignancy
  • Diagnosis of acute myeloid leukemia (AML)
  • Appropriate for allogenic hematopoietic stem cell transplantation
  • Any contraindication to selected concomitant therapy
  • Rollover Cohort: Have not demonstrated acceptable tolerability of previous bezuclastinib therapy
  • High-Risk Cohort: Previously treated with investigational therapy for AdvSM
  • High-Risk Cohort: Previously treated with cytoreductive therapy and discontinued due to treatment-related toxicity
  • High-Risk Cohort: Received any cytoreductive therapy or any investigational agent less than 14 days, and for cladribine, interferon alpha, pegylated interferon, and any antibody therapy less than 28 days, before screening or archival bone marrow biopsy

Interventions

DRUGbezuclastinib

Bezuclastinib is administered as tablets to be taken orally, continuously in 28-day cycles.


Locations(42)

University of Alabama at Birmingham (UAB) Hospital

Birmingham, Alabama, United States

Mayo Clinic Arizona

Phoenix, Arizona, United States

City of Hope Comprehensive Cancer Center

Duarte, California, United States

UCLA Medical Center

Los Angeles, California, United States

Stanford Cancer Institute

Stanford, California, United States

Galiz Research

Hialeah, Florida, United States

Winship Cancer Institute - Emory University

Atlanta, Georgia, United States

Rush University Medical Center

Chicago, Illinois, United States

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Columbia University Irving Medical Center

New York, New York, United States

Cleveland Clinic Taussig Cancer Center

Cleveland, Ohio, United States

MUSC Health University Medical Center

Charleston, South Carolina, United States

The University of Texas MD Anderson Cancer Center

Houston, Texas, United States

Huntsman Cancer Institute - University of Utah Health

Salt Lake City, Utah, United States

Nepean Hospital

Kingswood, New South Wales, Australia

Gold Coast University Hospital

Southport, Queensland, Australia

Peter MacCallum Cancer Centre

Melbourne N., Victoria, Australia

AKH Wien, Universitatsklinikum

Vienna, Austria

CHU de Liege

Liège, Belgium

University of Alberta Hospital

Edmonton, Alberta, Canada

St. Michael's Hospital - Unity Health Toronto

Toronto, Ontario, Canada

Necker-Enfants Malades Hospital

Paris, France

Centre Hospitalier Universitaire (CHU) de Poitiers

Poitiers, France

Centre Hospitalier Universitaire (CHU) de Toulouse

Toulouse, France

University Hospital Aachen

Aachen, Germany

Universitätsklinikum Freiburg

Freiburg im Breisgau, Germany

UKSH Campus Lubeck

Lübeck, Germany

Universitätsklinikum Mannheim

Mannheim, Germany

IRCCS Azienda Ospedaliero Universitaria di Bologna

Bologna, Italy

Azienda Ospedaliero Universitaria Careggi

Florence, Italy

AOU San Giovanni di Dio e Ruggi dAragonia

Salerno, Italy

Azienda Ospidaleira Universitaria Integrata Verona

Verona, Italy

University Medical Center Groningen

Groningen, Netherlands

Oslo University Hospital

Oslo, Norway

Public University Hospital No. 1 in Lublin

Lublin, Poland

Hospital Universitario Vall d'Hebron

Barcelona, Spain

Institut Català d'Oncologia - Hospital Duran i Reynals

Barcelona, Spain

Hospital Universitario Ramón y Cajal

Madrid, Spain

Universitätsspital Basel

Basel, Switzerland

Guy's Hospital - NHS Foundation Trust

London, London, United Kingdom

Leeds Teaching Hospitals NHS Trust

Leeds, United Kingdom

University College London Hospital - NHS Foundation Trust

London, United Kingdom

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NCT04996875