Recruiting
Phase 1/2
An Open-label Dose Escalation and Expansion, Followed by a Phase II Study of Tulmimetostat (DZR123) and JSB462 (Luxdegalutamide) in Patients With Progressive Metastatic Castrate Resistant Prostate Cancer (mCRPC) (TulmiSTAR-01)
Condition(s) studied
Progressive Metastatic Castrate Resistant Prostate Cancer
Investigational drug(s) / intervention(s)
Tulmimetostat DL1 QDTulmimetostat DL2 QDTulmimetostat DL3 QDTulmimetostat Doses 1 or 2 QDTulmimetostat RP2D QDJSB462 Dose 1 QDJSB462 Dose 2 QDJSB462 QDStandard of Care (SoC)
Tulmimetostat DL1 QD: Part 1a (dose escalation):
Doses of tulmimetostat beyond DL1 once a day (QD) will be opened depending on outcome of Dose Escalation Meetings (DEM(s))
Tulmimetostat DL2 QD: Part 1a (dose escalation):
Doses of tulmimetostat beyond DL1 once a day (QD) will be opened depending on outcome of Dose Escalation Meetings (DEM(s))
Tulmimetostat DL3 QD: Part 1a (dose escalation):
Doses of tulmimetostat beyond DL1 once a day (QD) will be opened depending on outcome of Dose Escalation Meetings (DEM(s))
Tulmimetostat Doses 1 or 2 QD: Part 1b (dose expansion and optimization):
tulmimetostat doses 1 or 2 QD
Tulmimetostat RP2D QD: Part 2:
tulmimetostat Recommended Phase 2 Dose (RP2D) QD
JSB462 Dose 1 QD: JSB462 Dose 1 QD
JSB462 Dose 2 QD: JSB462 Dose 2 QD
JSB462 QD: The dose of JSB462 QD will be determined based on the totality of data from Part 1a
Standard of Care (SoC): Androgen Receptor Pathway Inhibitors (ARPI), chemotherapy or Pluvicto (AAA617) at the discretion of the investigator
Study summary
This is a two-part, Phase I/II, open-label, global, multicenter study assessing the safety and efficacy of the combination of tulmimetostat (DZR123) and JSB462 (luxdegalutamide) versus standard of care in participants with progressive metastatic castrate resistant prostate cancer (mCRPC).
Eligibility
Key Inclusion Criteria:
* Participant is an adult man ≥ 18 years of age.
* Participant must have histologically and/or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine or small cell features (current or prior biopsy of the prostate and/or metastatic site).
* Participant must have ≥ 1 metastatic lesion that is present on screening/baseline CT, MRI, or bone scan imaging obtained ≤ 28 days prior to start of treatment (Part 1a dose escalation) or randomization (Part 1b dose expansion and Part 2).
* Participant must have progressive mCRPC.
* Participant must have a castrate level of serum/plasma testosterone (\< 50 ng/dL or \< 1.7 nmol/L).
* Prior ARPI therapy:
* Part 1a and 1b only: must have progressed on at least one prior second generation ARPI (abiraterone, enzalutamide, darolutamide, or apalutamide).
* Part 2 only: must have progressed on one prior second generation ARPI (abiraterone, enzalutamide, darolutamide, or apalutamide).
* Prior chemotherapy:
* Part 1a dose escalation only: may have received ≤ 2 prior lines of chemotherapy in CRPC setting. Note: Prior chemotherapy is permitted in the HSPC setting.
* Part 1b dose expansion/optimization only: may have received up to one prior line of chemotherapy in CRPC setting. Note: Prior chemotherapy is permitted in the HSPC setting.
* Part 2 only: Participants must be taxane-naïve in mCRPC setting; prior chemotherapy permitted in HSPC setting only
Key Exclusion Criteria:
* Previous treatment with any PRC2 inhibitor, including but not limited to EZH2 inhibitors, EZH2/1 inhibitors, or embryonic ectoderm development (EED) inhibitors.
* Previous treatment with a protein degrader compound that targets the AR.
* Known hypersensitivity or contraindication to any of the study treatment components or its excipients or to drugs of similar chemical classes.
* Treatment with any investigational agent within 28 days (or 5 half-lives, whichever is longer) prior to study entry.
* Previous treatment with radioligand therapy in the mCRPC setting, except in Part 1a where participants may have received RLT in mCRPC setting.
* Participants with evidence of mCRPC or biochemical recurrence / PSA only disease or asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy and with normal PSA for ≥ 1 year prior to study entry.
* Participants with a history of CNS metastases must have received therapy (surgery, radiotherapy, gamma knife) and be neurologically stable, asymptomatic, and not receiving corticosteroids for the purpose of maintaining neurologic integrity. Those with leptomeningeal disease are eligible if those areas have been treated, are stable, and no neurological impairment is present. For those with parenchymal CNS metastasis (or a history of CNS metastasis), baseline and subsequent radiological imaging must include evaluation of the brain with MRI (preferred) or CT with contrast.
Other protocol-defined inclusion/exclusion criteria may apply.
Primary outcome measure(s)
- Part 1a: Dose-limiting toxicities (DLTs) — Up to 28 days
A dose-limiting toxicity (DLT) is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness/injury, or concomitant medications that occurs within the first 28 days of treatment with tulmimetostat and JSB462 and meets any of the criteria specified in the protocol. The National Cancer Institute Common Terminology Criteria for Adverse events (NCI CTCAE) version 5.0 will be used for all grading. For the purpose of dose-escalation decisions, DLTs will be considered and included in the Bayesian Logistic Regression Model (BLRM).
- Part 1a and Part 1b: Incidence rate of Adverse Events (AEs) and Serious Adverse Events (SAEs) — From date of randomization till 30 days safety fup, assessed up to approximately 14 months
The analysis of adverse events will include categorization by type, frequency, and severity, as graded by the NCI CTCAE version 5.0.
- Part 1a and Part 1b: Number of Participants with dose adjustments — From date of randomization till 30 days safety fup, assessed up to approximately 14 months
The number of participants with dose adjustments (reductions, interruption, or permanent discontinuation) will be summarized by treatment arm.
- Part 1a and Part 1b: Dose Intensity — From date of randomization till 30 days safety fup, assessed up to approximately 14 months
Dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity) will be summarized by means of descriptive statistics
- Part 1a and Part 1b: Duration of exposure to each study drug — From date of randomization till 30 days safety fup, assessed up to approximately 14 months
The duration of exposure (in months) to Tulmimetostat and JSB462 (Part 1a and Part 1b) will be summarized by means of descriptive statistics
- Part 1b and Part 2: prostate-specific antigen 50 (PSA50) at Month 6 — Month 6
PSA50 is defined as a PSA reduction of at least 50% from baseline at 6 months confirmed by a second PSA measurement ≥ 3 weeks later.
Trial sites (35)
| Facility | City | Region | Status |
| Sarah Cannon Research Institute |
Denver |
Colorado |
Recruiting |
| Sarah Cannon Research Institute |
Jacksonville |
Florida |
Recruiting |
| Emory University |
Atlanta |
Georgia |
Recruiting |
| Wichita Urology Group PA |
Wichita |
Kansas |
Recruiting |
| Mass General Hospital |
Boston |
Massachusetts |
Recruiting |
| Duke University Medical Center |
Durham |
North Carolina |
Recruiting |
| Cleveland Clinic Foundation |
Cleveland |
Ohio |
Recruiting |
| Fred Hutchinson Cancer Research Center |
Seattle |
Washington |
Recruiting |
| Novartis Investigative Site |
St Leonards |
New South Wales |
Recruiting |
| Novartis Investigative Site |
Melbourne |
Victoria |
Recruiting |
| Novartis Investigative Site |
Liverpool |
Australia |
Recruiting |
| Novartis Investigative Site |
Halifax |
Nova Scotia |
Recruiting |
| Novartis Investigative Site |
Beijing |
China |
Recruiting |
| Novartis Investigative Site |
Herlev |
Denmark |
Recruiting |
| Novartis Investigative Site |
Odense C |
Denmark |
Recruiting |
| Novartis Investigative Site |
Vejle |
Denmark |
Recruiting |
| Novartis Investigative Site |
Bordeaux |
France |
Recruiting |
| Novartis Investigative Site |
Paris |
France |
Recruiting |
| Novartis Investigative Site |
Paris |
France |
Recruiting |
| Novartis Investigative Site |
Düsseldorf |
North Rhine-Westphalia |
Recruiting |
| Novartis Investigative Site |
Jena |
Thuringia |
Recruiting |
| Novartis Investigative Site |
Milan |
MI |
Recruiting |
| Novartis Investigative Site |
Padova |
PD |
Recruiting |
| Novartis Investigative Site |
Orbassano |
TO |
Recruiting |
| Novartis Investigative Site |
Kuching |
Sarawak |
Recruiting |
| Novartis Investigative Site |
Tlalpan |
Mexico City |
Recruiting |
| Novartis Investigative Site |
Poznan |
Poland |
Recruiting |
| Novartis Investigative Site |
Singapore |
Singapore |
Recruiting |
| Novartis Investigative Site |
Singapore |
Singapore |
Recruiting |
| Novartis Investigative Site |
Santiago Compostela |
A Coruna |
Recruiting |
| Novartis Investigative Site |
L'Hospitalet de Llobregat |
Barcelona |
Recruiting |
| Novartis Investigative Site |
Madrid |
Spain |
Recruiting |
| Novartis Investigative Site |
Madrid |
Spain |
Recruiting |
| Novartis Investigative Site |
Sutton |
Surrey |
Recruiting |
| Novartis Investigative Site |
London |
United Kingdom |
Recruiting |
More Novartis Pharmaceuticals trials in the UK