Selumetinib 25mg/m2: Oral twice daily per predetermined dosage per protocol.
Luvometinib: Oral once daily per predetermined dosage per protocol.
Serplulimab: Intravenous infusion per predetermined dosage per protocol.
Study summary
This is an adaptive platform-basket trial that aims to evaluate the safety and efficacy of multiple novel agents and combination therapies in patients with NF2-related schwannomatosis (NF2-SWN). The study employs a basket design to assess treatment responses across four tumor types commonly associated with NF2-SWN: vestibular schwannomas, non-vestibular schwannomas, meningiomas, and ependymomas.
A shared natural history observational cohort, receiving routine clinical follow-up without investigational treatment, serves as a common control for all substudies. The adaptive platform enables the dynamic addition or closure of substudies based on interim analyses, thereby optimizing trial efficiency.
Eligible patients who meet the master protocol criteria and satisfy substudy-specific safety requirements will be assigned to receive the corresponding intervention. Currently open substudies include:
* Substudy A: Selumetinib
* Substudy B: Luvometinib plus Serplulimab
Eligibility
Sex
ALL
Min age
—
Max age
—
Healthy volunteers
No
Eligibility Specific For MASTER STUDY
Inclusion Criteria:
Subjects must satisfy all of the following criteria to be enrolled into the main study natural history observation cohort:
(1) Must meet the 2022 International Consensus Criteria for NF2-SWN, defined by having at least one of the following:
1. Bilateral vestibular schwannomas (VS)
2. An identical NF2 pathogenic variant in at least 2 anatomically distinct NF2-related tumors (schwannoma, meningioma, and/or ependymoma). (Note: if the variant allele fraction (VAF) in unaffected tissues such as blood is clearly \<50%, the diagnosis is mosaic NF2-related schwannomatosis)
3. Either 2 major or 1 major and 2 minor criteria as described in the following:
Major criteria:
* Unilateral VS
* First-degree relative other than sibling with NF2-related schwannomatosis
* 2 or more meningiomas (Note: single meningioma qualifies as minor criteria).
* NF2 pathogenic variant in an unaffected tissue such as blood (Note: if the VAF is clearly \<50%, the diagnosis is mosaic NF2-related schwannomatosis)
Minor criteria:
Can count \>1 of a type (eg, 2 distinct schwannomas would count as 2 minor criteria)
* Ependymoma, meningioma (Note: multiple meningiomas qualify as a major criteria), schwannoma (Note: if the major criterion is unilateral VS, at least 1 schwannoma must be dermal in location) Can count only once (eg, bilateral cortical cataracts count as a single minor criterion)
* Juvenile subcapsular or cortical cataract, retinal hamartoma, epiretinal membrane in a person aged \<40 years, meningioma
(2) Presence of at least one evaluable lesion: Vestibular schwannoma, meningioma, or non-vestibular schwannoma: clearly identifiable lesion on contrast-enhanced T1-weighted MRI; Ependymoma: clearly identifiable lesion on contrast-enhanced T1-weighted or T2/FLAIR sequences; (3) Expected ability to complete at least 12 months of follow-up assessments; (4) Ability to understand and voluntarily sign a written informed consent form, or a legally authorized guardian signs the informed consent form together ; (5) Sub-study-specific criteria (for intervention arms only): If the subject intends to enter an interventional sub-study, in addition to meeting the above main study criteria, the subject must also satisfy the specific inclusion criteria specified in that sub-study protocol (e.g., organ function, prior treatment restrictions, washout periods, etc.), as determined by the drug characteristics.
Exclusion Criteria:
Subjects meeting any of the following criteria will not be permitted to enter the main study:
1. Coexisting other genetic syndromes that may cause multiple intracranial tumors (e.g., SMARCB1/LZTR1-related schwannomatosis, Cowden syndrome);
2. Expected survival \<12 months;
3. Presence of severe psychiatric disorders or cognitive impairment that precludes cooperation with imaging or hearing assessments;
4. Extreme social or geographic factors that, in the investigator's judgment, may impede follow-up for more than 12 months;
5. Sub-study-specific exclusion criteria (for intervention arms only): If the subject intends to enter an interventional sub-study, the subject must also satisfy the specific exclusion criteria specified in that sub-study protocol (e.g., specific organ dysfunction, active infection, pregnancy, etc.).
Primary outcome measure(s)
Tumor-Type-Specific Response Rate in NF2-SWN Tumors — 12 months Vestibular schwannoma: HRR is defined as WRS improvement exceeding the 95% critical difference from baseline; if baseline WRS is \<20%, HRR is defined as a PTA decrease of at least 10 dB.
Meningioma or non-vestibular schwannoma: ORR is defined as at least a 20% reduction in target tumor volume from baseline.
Ependymoma: ORR is defined as at least a 30% reduction in maximum diameter from baseline according to RECIST v1.1.
Trial sites (5)
Facility
City
Region
Status
Xuanwu Hospital, Capital Medical University
Beijing
Beijing Municipality
Beijing Tiantan Hospital, Capital Medical University
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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