Informations générales (source: ClinicalTrials.gov)
A Phase 1/2, Open-Label, Dose-Escalation, Dose-Expansion Study of Enzomenib (DSP-5336) in Patients With Acute Leukemia and Other Selected Hematologic Malignancies, With and Without Mixed Lineage Leukemia (MLL) Rearrangement or Nucleophosmin 1 (NPM1) Mutation (Horizen-1)
Interventional
Phase 1/Phase 2
Sumitomo Pharma America, Inc. (Voir sur ClinicalTrials)
février 2022
décembre 2027
02 avril 2026
A phase 1/2 dose escalation / dose expansion study of Enzomenib (DSP-5336) in patients
with acute leukemia.
Etablissements
| Les établissements d'Île-de-France ayant mis à jour leurs données Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| CLCC INSTITUT GUSTAVE ROUSSY | St�phane DE BOTTON | 04/05/2026 12:00:07 | Contacter | ||
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
| Centre Hospitalier Le Mans - Le Mans - France | SMPA Investigative Site | Contact (sur clinicalTrials) | |||
| Centre Hospitalier Universitaire d'Angers - Angers - France | Corentin Orvain, MD | Contact (sur clinicalTrials) | |||
| Centre Hospitalier Universitaire de Limoges - Limoges - France | SMPA Investigative Site | Contact (sur clinicalTrials) | |||
| CHU de Nice - Hôpital l'Archet 1 - Nice - France | Thomas Cluzeau, MD | Contact (sur clinicalTrials) | |||
| Hopital Saint-Louis - Paris - France | Emmanuel Raffoux, MD | Contact (sur clinicalTrials) | |||
| Hospices Civils de Lyon - Lyon - France | SMPA Investigative Site | Contact (sur clinicalTrials) | |||
| Institut Paoli-Calmettes - Marseille - France | Sylvain Garciaz, MD | Contact (sur clinicalTrials) | |||
Critères
Tous
For patients in Phase I:
1. Have a diagnosis of relapsed or refractory AML, ALL or acute leukemia of ambiguous
lineage according to World Health Organization (WHO) 2022 classification, or, in
selected sites and regions, a diagnosis of MDS or MM as determined by pathology
review at the treating institution, and whose disease has progressed after available
standard therapies known to be active for their AML, ALL, or acute leukemia of
ambiguous lineage or, in selected sites and regions, for MM or MDS. If acute
leukemia patients are transformation from MDS or other hematologic malignancies,
patients need to receive available standard therapies as acute leukemia after AML
transformation and before enrolling this trial. In regions or countries where
required by regulatory authorities, participants must have a documented KMT2A (MLL)
fusion or NPM1 mutation, including those with coexisting FLT3 genomic alterations
and/or IDH1/2 mutation. Participants who are candidates for stem cell
transplantation must have been offered this therapeutic option.
For patients with MDS (selected sites and regions):
1. Patients with MDS must have bone marrow blasts ≥ 5%
2. Patients with MDS must have relapsed or refractory disease and have exhausted
available standard therapies including at least 2 cycles of treatment with HMA
For patients with MM (selected sites and regions):
3. Have a confirmed diagnosis of multiple myeloma according to International
Myeloma Working Group (IMWG) 2016 classification (Kumar, 2016) and whose
disease has progressed after treatment with a minimum of 3 prior anti-myeloma
regimens including a proteasome inhibitor (PI), an immunomodulatory drug
(IMiD), and an anti-CD38 monoclonal antibody (mAb); patients must not be
candidates for available therapies with established clinical benefit
4. Have measurable disease as defined in the protocol
5. Meet the laboratory parameters set in the protocol
For patients with relapsed/refractory AML in the venetoclax and azacitidine
combination cohort (in countries and sites where permitted):
6. Have MLLr or NPM1m.
For patients with relapsed/refractory AML in the gilteritinib combination
cohort (in countries and sites where permitted):
7. Have MLLr or NPM1m AND any of the following FLT3 mutations: FLT3-ITD,
FLT3-TKD/D835 or FLT3-TKD/I836.
For patients with relapsed/refractory AML with NPM1 enrolled in the RP2D
confirmation cohort:
8. Must have ≥5% blasts in bone marrow by morphologic assessment
9. Must not have received prior treatment with a menin inhibitor
For patients with newly diagnosed AML:
10. Must have AML as defined by WHO 2022 criteria with a documented MLLr or NPM1m
(patients with AML characterized by MLL partial tandem duplications, MLL
deletions, or trisomy 11 are not eligible)
11. Must not have received treatment for AML with the exception of hydroxyurea for
control of white blood cell counts.
For patients in Phase 2:
2. Have a confirmed diagnosis of relapsed AML or ALL according to WHO 2022
classification, as determined by pathology review at the treating institution, and
who have ≥5% blasts by morphologic assessment in the bone marrow. Patients with
extramedullary disease or peripheral blasts as the only manifestation of relapse are
not eligible. Patients must have received clinically applicable standard therapies
with confirmed survival benefit. Patients must not have had prior exposure to a
menin inhibitor.
3. Have a documented KMT2A (MLL)-fusion assessed at relapse or immediately prior to the
determination of refractory status. KMT2A genetic alterations other than fusions
(eg, KMT2A-PTD, amplification, point mutation) are not permitted.
For all patients:
4. Be > 18 years of age. For countries and sites where approved, for DSP-5336
monotherapy, acute leukemia patients ≥12 years of age who weigh ≥40 kg may be
enrolled.
5. Have an Eastern Cooperative Oncology Group (ECOG) performance status ≤2.
6. For monotherapy, WBC below 30,000/μ at enrollment. For the combination arms, WBC
count must be below 25,000/uL at enrollment and prior to starting treatment.
(Hydroxyurea and steroids for cytoreduction purposes are allowed prior to enrollment
and during study treatment)
7. Clearance of creatinine level ≥ 50 ml/min, assessed by the CPK-EPI formula (2021
version and Cystatin C not required)
8. Total bilirubin ≤1.5 the upper limit of normal (ULN) (or ≤2.0 ULN for patients with
known Gilbert's syndrome)
9. Aspartate aminotransferase (AST) ≤3.0 times ULN
10. Alanine aminotransferase (ALT) ≤3.0 times ULN
11. Any prior treatment-related toxicities resolved to Grade ≤1 prior to enrollment,
with the exception of Grade ≤2 alopecia or neuropathy
12. Be willing to attend study visits as required by the protocol
13. Have an estimated life expectancy ≥3 months, based on the investigator's assessment
14. Females of childbearing potential must have a negative serum pregnancy test. Females
of childbearing potential are defined as women who have (1) experienced menarche and
have not undergone sterilization procedures (hysterectomy, or bilateral
oophorectomy), or have (2) not experienced menopause as defined in the protocol.
15. All men and all women of childbearing potential and male patients' partners who are
women of childbearing potential are required to use a highly effective method of
contraception during the study and for 6 months (for females and males alike) after
the last dose of study drug. Further guidelines noted in protocol.
16. Have AML/ALL/MDS/MM bone marrow material suitable for genomic analysis of AML,ALL,
MDS, or MM genetic alterations. Note: If a bone marrow material is insufficient, an
alternative suitable tissue (ex: peripheral blood) must be provided.
Exclusion Criteria:
1. Has a left ventricular ejection fraction (LVEF) <50%, as determined by ECHO
2. Histological diagnosis of acute promyelocytic leukemia
3. Received systemic calcineurin inhibitors within 2 weeks prior to the first dose of
DSP 5336
4. Have abnormal ECGs at screening that are clinically significant, such as (QTc >480
msec, with QTc corrected according to Fridericia's formula (QTcF). For clinical
sites in the UK, have abnormal ECGs at screening that are clinically significant,
such as QTc ≥470 msec and ≥450 msec with QTc corrected according to Fridericia's
formula (QTcF), for females and males, respectively. In addition, patients with a
history of prolonged QT syndrome or who are required to take therapies associated
with QT-interval prolongation are excluded.
Note: In case of bundle branch block, QT interval correction can be performed.
5. Has an active and uncontrolled, bacterial, viral, or fungal infection requiring
parenteral therapy. Note: Patients must be afebrile with negative blood cultures at
least 72 hours prior to Cycle 1 Day 1.
6. Receives concurrent sensitive substrates with a narrow safety window or strong
inhibitors or inducers of CYP3A4/5, including specifically: ketoconazole,
isavuconazole and itraconazole. Other antifungals that are used as standard of care
to prevent or treat infections are permitted. If a patient is on one of the excluded
azole class antifungals, he/she can be taken off or switched to a permitted azole 7
or more days prior to first dose, then the patient could be allowed on study (Arm B)
with approval of the medical monitor.
7. Had major surgery within 28 days prior to the first dose of DSP-5336
8. Has active central nervous system leukemia (prophylactic intrathecal chemotherapy is
allowed).
9. Underwent HSCT or chimeric antigen receptor cell (CAR-T) therapy or other modified
T-cell therapy within 60 days prior to the first dose of DSP-5336. For clinical
sites in the UK, underwent CAR-T therapy or other modified T-cell therapy within 6
months prior to the first dose of DSP-5336.
10. Received a donor lymphocyte infusion within 28 days prior to the first dose of
DSP-5336, or receiving immunosuppressive therapy post-HSCT at the time of screening,
or with clinically active GVHD or GVHD requiring active medical intervention other
than the use of topical steroids for ongoing cutaneous GVHD
11. Received antineoplastic agents (except hormonal therapies as adjuvant maintenance
for breast or prostate cancers if a patient is taking before starting study
treatment, and hydroxyurea given for controlling blast cells) or other
investigational treatment within 7 days or 5 half-lives, whichever is shortest,
prior to the first dose of DSP-5336
12. In the opinion of the treating investigator, have any concurrent conditions that
could pose an undue medical hazard or interfere with interpretation of study
results; these conditions include, but are not limited to: clinically significant
non-healing or healing wounds; concurrent congestive heart failure (New York Heart
Association Functional Classification Class III or IV; see Section 21.2); concurrent
unstable angina; concurrent cardiac arrhythmia requiring treatment (excluding
asymptomatic atrial fibrillation); recent (within the prior 6 months) myocardial
infarction; acute coronary syndrome within the previous 6 months; significant
pulmonary disease (shortness of breath at rest or on mild exertion), eg, due to
concurrent severe obstructive pulmonary disease, concurrent hypertension not
controlled with concomitant medication, or diabetes mellitus with more than 2
episodes of ketoacidosis in the prior 6 months
13. Have a known detectable viral load for human immunodeficiency virus or hepatitis C,
or evidence of hepatitis B surface antigen, all being indicative of active
infection.
For sites in Japan, Taiwan, and Korea only: Hepatitis B core (HBc) antibody or
hepatitis B surface (HBs) antibody test should be performed if HBsAg is negative. If
HBc antibody or HBs antibody test is positive, HBV DNA quantification test should be
performed to confirm that HBV DNA is negative.
14. Have severe dysphagia, short-gut syndrome, gastroparesis, or other conditions that
limit the ingestion or gastrointestinal absorption of drugs administered orally,
including the inability to swallow oral medication
15. Have cognitive, psychological, or psychosocial impediment that would impair the
ability of the patient to receive therapy according to the protocol, or adversely
affect the ability of the patient to comply with the informed consent process,
protocol, or protocol-required visits and procedures
16. Are pregnant or breastfeeding or planning to become pregnant. Note: Patients who are
breastfeeding may be enrolled if they interrupt breastfeeding prior to the first
dose of any study drugs and do not feed the baby with breast milk expressed after
receiving the first dose of any study drugs. Breastfeeding should not be resumed for
at least 6 months after the last dose of study drug
17. Have any history or complication of interstitial lung disease (for sites in Japan in
Phase 1 dose escalation).
For clinical sites in the EU, have a history of Grade ≥ 2 drug-induced interstitial
lung disease or Grade ≥ 2 non-infectious pneumonitis within 6 months of starting
study treatment.
18. Have a history of Torsades de Pointes
19. Received systemic calcineurin inhibitors within 4 weeks prior to the first dose of
DSP-5336
20. Have plasma cell leukemia (>2.0 x 109 /L plasma cells in blood by standard
differential) (for patients with MM)
21. For patients intending to enroll into the combination cohort with gilteritinib:
Patients must be gilteritinib-naïve or sensitive and have not received a FLT3
inhibitor in the relapsed refractory setting (prior FLT3 inhibitor in front line
therapy is allowed)
22. Have a known intolerance of hypersensitivity reaction to components of the
investigational medicinal product
23. For clinical sites in the UK: In Arm E (DSP-5336 + venetoclax/azacitidine), have
received a live vaccine within 30 days prior to the first dose of DSP-5336