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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04996875
Registration number
NCT04996875
Ethics application status
Date submitted
22/07/2021
Date registered
9/08/2021
Titles & IDs
Public title
(Apex) Bezuclastinib in Patients With Advanced Systemic Mastocytosis
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Scientific title
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
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Secondary ID [1]
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2021-001010-10
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Secondary ID [2]
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CGT9486-20-201
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Advanced Systemic Mastocytosis (AdvSM)
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SM With an Associated Hematologic Neoplasm (SM-AHN)
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Mast Cell Leukemia (MCL)
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Aggressive Systemic Mastocytosis (ASM)
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Skin
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Other skin conditions
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Blood
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Other blood disorders
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Mental Health
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - bezuclastinib
Experimental: bezuclastinib -
Treatment: Drugs: bezuclastinib
Bezuclastinib is administered as tablets to be taken orally, continuously in 28-day cycles.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Part I: Identify clinically active and tolerable exposures of bezuclastinib in patients with AdvSM
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Assessment method [1]
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Timepoint [1]
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18 months
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Primary outcome [2]
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Part II: - Determine efficacy of bezuclastinib as measured by mIWG Objective Response Rate (ORR) - Confirm the exposure-response relationship of bezuclastinib
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Assessment method [2]
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Timepoint [2]
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18 months
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Secondary outcome [1]
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Pure Pathologic Response (PPR)
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Assessment method [1]
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Months
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Timepoint [1]
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18 months
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Secondary outcome [2]
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Safety of CGT9486 as assessed by incidence of Adverse Events (AEs)
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Assessment method [2]
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Incidence of AEs according to CTCAE version 5.0 or higher
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Timepoint [2]
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18 months
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Secondary outcome [3]
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To determine the effects of bezuclastinib on mutation allele burden.
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Assessment method [3]
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Percentage change in KIT D816V
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Timepoint [3]
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18 months
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Secondary outcome [4]
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To determine the effects of bezuclastinib on serum tryptase.
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Assessment method [4]
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Percentage change in Serum Tryptase
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Timepoint [4]
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18 months
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Secondary outcome [5]
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To assess the pharmacokinetics of bezuclastinib in subjects with AdvSM.
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Assessment method [5]
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Percentage change in plasma concentrations of bezuclastinib
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Timepoint [5]
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18 months
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Secondary outcome [6]
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Change from baseline in histopathologic findings in blood and bone marrow
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Assessment method [6]
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Percentage change in mast cell infiltration in the bone marrow and percentage change in eosinophilia and monocytosis in the blood
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Timepoint [6]
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18 months
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Secondary outcome [7]
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Change in spleen and liver volume by imaging
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Assessment method [7]
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Percentage change
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Timepoint [7]
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18 months
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Secondary outcome [8]
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Change in Patient Global Impression of Severity (PGIS) scale
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Assessment method [8]
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0 -10 points (higher values represent worse symptom outcomes)
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Timepoint [8]
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18 months
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Secondary outcome [9]
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Change in Patient Global Impression of Change (PGIC) scale
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Assessment method [9]
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0 - 7 points (higher values represent better symptom outcomes)
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Timepoint [9]
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18 months
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Secondary outcome [10]
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Change in Mastocytosis Quality of Life Questionnaire (MC-QoL)
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Assessment method [10]
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0 - 100 (higher values represent better symptom outcomes)
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Timepoint [10]
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18 months
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Secondary outcome [11]
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Change in Mastocytosis Activity Score (MAS)
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Assessment method [11]
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0 - 252 (higher values represent worse symptom outcomes)
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Timepoint [11]
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18 months
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Secondary outcome [12]
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Duration of Response (DOR)
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Assessment method [12]
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Months
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Timepoint [12]
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18 months
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Secondary outcome [13]
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Time to Response (TTR)
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Assessment method [13]
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Months
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Timepoint [13]
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18 months
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Secondary outcome [14]
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Progression Free Survival (PFS)
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Assessment method [14]
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Months
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Timepoint [14]
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18 Months
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Secondary outcome [15]
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Overall Survival (OS)
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Assessment method [15]
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Months
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Timepoint [15]
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18 months
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Eligibility
Key inclusion criteria
Key Inclusion Criteria for Main Study:
1. Diagnosed with one of the following advanced mastocytosis diagnoses by Eligibility Committee
1. Aggressive Systemic Mastocytosis (ASM)
2. Systemic Mastocytosis with an Associated Hematologic Neoplasm (SM-AHN)
3. Mast Cell Leukemia (MCL)
2. Measurable disease according to modified IWG-MRT-ECNM criteria. (A subset of patients inevaluble per mIWG-MRT-ECNM will be included in the study).
3. ECOG (0 to 3)
4. Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits
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Minimum age
18
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria for Main Study:
1. Persistent toxicity from previous therapy for AdvSM that has not resolved to = Grade 1
2. Associated hematologic neoplasm requiring immediate antineoplastic therapy
3. Clinically significant cardiac disease
4. 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
5. Seropositive for human immunodeficiency virus (HIV) 1 or 2, or positive for hepatitis B surface antigen or hepatitis C virus (HCV) antibody
6. History of clinically significant bleeding event within 30 days before the first dose of study drug or need for therapeutic anticoagulation on study
7. Diagnosed with or treated for malignancy other than the disease under study within the prior 3 years before enrollment
8. 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
9. Received hematopoietic growth factor support within 14 days before the first dose of study drug
10. Received strong CYP3A4 inhibitors or inducers within 14 days or 5 drug half-lives, whichever is longer, before the first dose of study drug
11. Need for treatment with high dose steroids
Key Inclusion Criteria for Substudy Population:
Rollover Cohort
1. Demonstrate AHN progression requiring immediate AHN-directed therapy while receiving bezuclastinib
2. Demonstrated clinical benefit from bezuclastinib therapy
3. Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits
High-Risk Cohort
1. Receiving or indicated for AHN-directed therapy.
2. Diagnosed with one of the following pathologic diagnoses of SM-AHN:
1. Myelodysplastic syndrome (MDS) that is high- or very high-risk
2. Accelerated phase myeloproliferative neoplasm (MPN)
3. MDS with excessive blasts in bone marrow or peripheral blood
4. Chronic myelomonocytic leukemia-2 (CMML-2)
3. Have clinically acceptable local laboratory screening results (clinical chemistry, hematology) within certain limits.
Key Exclusion Criteria for Substudy Population:
1. Diagnosis of Philadelphia chromosome-positive malignancy
2. Diagnosis of acute myeloid leukemia (AML)
3. Appropriate for allogenic hematopoietic stem cell transplantation
4. Any contraindication to selected concomitant therapy
5. Rollover Cohort: Have not demonstrated acceptable tolerability of previous bezuclastinib therapy
6. High-Risk Cohort: Previously treated with investigational therapy for AdvSM
7. High-Risk Cohort: Previously treated with cytoreductive therapy and discontinued due to treatment-related toxicity
8. 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
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
9/11/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/09/2025
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Actual
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Sample size
Target
140
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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Nepean Hospital - Kingswood
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Recruitment hospital [2]
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Gold Coast University Hospital - Southport
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Recruitment hospital [3]
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Peter MacCallum Cancer Centre - Melbourne N.
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Recruitment postcode(s) [1]
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2747 - Kingswood
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Recruitment postcode(s) [2]
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4215 - Southport
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Recruitment postcode(s) [3]
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3051 - Melbourne N.
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Alabama
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Country [2]
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United States of America
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State/province [2]
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Arizona
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United States of America
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California
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United States of America
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Florida
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Country [5]
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United States of America
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Georgia
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Country [6]
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United States of America
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Illinois
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Country [7]
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United States of America
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Massachusetts
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United States of America
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New York
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United States of America
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Ohio
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United States of America
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South Carolina
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United States of America
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Texas
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United States of America
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Utah
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Country [13]
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Austria
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State/province [13]
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Vienna
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Country [14]
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Belgium
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State/province [14]
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Liège
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Canada
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State/province [15]
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Alberta
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Canada
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State/province [16]
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Ontario
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France
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Paris
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France
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Poitiers
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France
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Toulouse
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Germany
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Aachen
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Germany
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Freiburg
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Germany
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Mannheim
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Italy
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Bologna
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Italy
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Florence
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Italy
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Verona
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Netherlands
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Groningen
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Norway
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Oslo
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Spain
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Barcelona
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Spain
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Madrid
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Switzerland
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Basel
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Country [31]
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United Kingdom
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State/province [31]
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Leeds
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United Kingdom
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State/province [32]
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London
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Cogent Biosciences, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief 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).
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Trial website
https://clinicaltrials.gov/study/NCT04996875
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Rachael Easton, MD, Ph.D.
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Address
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Cogent Biosciences, Inc.
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Hina Jolin, PharmD
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Address
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Phone
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+1 (617) 945-5576
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04996875