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NCT05131022PHASE1Recruiting

A Study of NX-5948 in Adults With Relapsed/Refractory B-cell Malignancies

Nurix Therapeutics, Inc.

Start Date

4/13/2022

Completion Date

1/1/2028

Summary

This is a first-in-human Phase 1a/1b multicenter, open-label study designed to evaluate the safety and anti-cancer activity of NX-5948 in patients with advanced B-cell malignancies.

Detailed Description

Phase 1a is a dose escalation to evaluate the safety and tolerability of NX-5948 in adult patients with relapsed/refractory (R/R) B cell malignancies who have received at least 2 prior lines of therapy, or at least 1 prior line of therapy for Primary Central Nervous System Lymphoma (PCNSL), and for whom no other therapies are known to provide clinical benefit. Indications include: Chronic Lymphocytic Leukemia (CLL), Small Lymphocytic Lymphoma (SLL), Diffuse Large B-cell Lymphoma (DLBCL), Mantle Cell Lymphoma (MCL), Waldenstrom Macroglobulinemia (WM), Marginal Zone Lymphoma (MZL), Follicular Lymphoma (FL), Primary Central Nervous System Lymphoma (PCNSL) or any of the above indications with disease in the central nervous system or Secondary Central Nervous System Lymphoma (SCNSL). Phase 1b Part 1, called safety expansion, investigates the safety and anti-tumor activity of NX-5948 at the dose(s) selected in Phase 1a in up to 17 expansion cohorts of patients with histologically confirmed B-cell malignancy indications who have received specified prior therapies based on indication: * CLL or SLL (patients may be randomized to one of two dose levels investigated for CLL/SLL until an optimal dose is selected) * MCL * MZL * WM * DLBCL * FL * PCNSL/SCNSL Phase 1b Part 2, called cohort expansion, will further investigate the anti-tumor activity of NX-5948 at the dose(s) selected in Phase 1b par 1 in one additional expansion arm of CLL/SLL patients.

Eligibility Criteria

Age Range: 18 years to No maximum

Key Inclusion Criteria: * Age ≥18 years * Patients in Phase 1a (Dose Escalation) must have histologically confirmed R/R CLL, SLL, DLBCL (subgroups include Richter-transformed DLBCL, germinal center B-cell type, activated B-cell type, high-grade B-cell lymphoma with MYC and BCL-2 and/or BCL-6 rearrangements, high-grade B-cell lymphomas NOS), FL, MCL, MZL (subtypes include EMZL, MALT, NMZL, SMZL), WM, or PCNSL. * Patients in Phase 1a must meet the following: o For non-PCNSL indications, received at least 2 prior lines of therapy and have no other available therapies known to provide clinical benefit. For PCNSL, received at least 1 prior line of therapy * Patients in Phase 1b (Safety and Cohort Expansion) must have 1 of the following histologically documented B-cell malignancies, must meet criteria for systemic treatment, and must have received prior therapies and/or molecular features based on details described for each cohort: CLL or SLL, DLBCL, MCL, FL, MZL, WM, or PCNSL/SCNSL. * Measurable disease per response criteria specific to the malignancy. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (0-2 for patients with PCNSL and secondary CNS involvement). * Adequate organ and bone marrow function Key Exclusion Criteria: * Known or suspected active prolymphocytic leukemia or Richter's transformation to Hodgkin's lymphoma prior to study enrollment * Prior treatment for the indication under study for anti-cancer intent that includes: 1. Radiotherapy within 2 weeks of planned start of study drug (excluding limited palliative radiation). 2. Prior systemic chemotherapy within 2 weeks of planned start of study drug. 3. Prior monoclonal antibody therapy within 4 weeks of planned start of study drug, except for patients enrolling in Cohort 16 (CLL with secondary wAIHA) where a 16-week washout period is required. 4. Prior small molecule therapy within 2 weeks or 5 half-lives (whichever is shorter) of planned start of study drug. 5. Autologous or allogeneic stem cell transplant within 100 days prior to planned start of study drug. 6. Chimeric antigen receptor (CAR) T-cell therapy within 100 days prior to start of study drug (within 60 days prior to start of study drug for Phase 1b). 7. Use of systemic corticosteroids outside of dosing limits described below and within 7 days prior to initiation of study treatment excepting those used as prophylaxis for radio diagnostic contrast. Patients with PCNSL/SCNSL: no greater than 40 mg/day prednisone, or equivalent. Patients with PCNSL/SCNSL using greater than 20 mg/day prednisone, or equivalent, must be clinically stable at that dose for 7 days. All other diagnoses: no greater than 20 mg/day prednisone or equivalent. 8. Use of systemic immunosuppressive drugs other than systemic corticosteroids for any medical condition within 60 days prior to first dose of study drug 9. Previously treated with a BTK degrader * Active, uncontrolled autoimmune hemolytic anemia (except for patients enrolling in Cohort 16) or active, uncontrolled autoimmune thrombocytopenia. * Patient has any of the following within 6 months of planned start of study drug: 1. Myocardial infarction, unstable angina, unstable symptomatic ischemic heart disease, or placement of a coronary arterial stent 2. Uncontrolled atrial fibrillation or other clinically significant arrhythmias, conduction abnormalities, or New York Heart Association (NYHA) class III or IV heart failure 3. Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, or symptomatic cerebrovascular events), stroke, or intracranial hemorrhage 4. Any other significant cardiac condition (e.g., pericardial effusion, restrictive cardiomyopathy, severe untreated valvular stenosis, severe congenital heart disease, or persistent uncontrolled hypertension defined as systolic blood pressure \> 160 mmHg or diastolic blood pressure \> 100 mmHg despite optimal medical management) * Bleeding diathesis, or other known risk for acute blood loss. * History of Grade ≥ 2 hemorrhage within 28 days of planned start of study drug. * Active known concurrent malignancy or malignancy other than the one under study within the past 3 years. (Exceptions include, but are not limited to, patients with more recent history of basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix or breast may enroll if they have undergone curative therapy and have no evidence of disease).

Interventions

DRUG

NX-5948

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Conditions

Chronic Lymphocytic Leukemia (CLL)Small Lymphocytic Lymphoma (SLL)Diffuse Large B Cell Lymphoma (DLBCL)Follicular Lymphoma (FL)Mantle Cell Lymphoma (MCL)Marginal Zone Lymphoma (MZL)Waldenstrom Macroglobulinemia (WM)Primary Central Nervous System Lymphoma (PCNSL)Secondary Central Nervous System Lymphoma (SCNSL)

Locations

City of Hope

Duarte, California 91010

United States

University of California, San Francisco

San Francisco, California 94143

United States

Colorado Blood Cancer Institute

Denver, Colorado 80218

United States

Yale Cancer Center

New Haven, Connecticut 06510

United States

University of Miami

Miami, Florida 33136

United States

Florida Cancer Specialists

Sarasota, Florida 34232

United States

Winship Cancer Institute of Emory University

Atlanta, Georgia 30322

United States

Northwestern University

Chicago, Illinois 60611

United States

National Institute of Health

Bethesda, Maryland 20814

United States

Cayuga Medical Center

Ithaca, New York 14850

United States

Memorial Sloan Kettering Cancer Center

New York, New York 10065

United States

Duke University Medical Center

Durham, North Carolina 27705

United States

University of Cincinnati Medical Center

Cincinnati, Ohio 45219

United States

Cleveland Clinic

Cleveland, Ohio 44195

United States

University of Pennsylvania, Abramson Cancer Center

Philadelphia, Pennsylvania 19104

United States

MD Anderson Cancer Center

Houston, Texas 77030

United States

Huntsman Cancer Institute

Salt Lake City, Utah 84112

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States

CHU Angers

Angers, 49933

France

Hôpital Avicenne

Bobigny, 93009

France

CHU de Nantes

Nantes, 44093

France

CHU Bordeaux

Pessac, 33604

France

CHU de Poitiers

Poitiers, 86021

France

Institut Curie-Site Saint-Cloud

Saint-Cloud, 92210

France

CHRU de Nancy

Vandœuvre-lès-Nancy, 54500

France

IRCCS - AOU di Bologna

Bologna, 40138

Italy

ASST Spedali Civili Brescia

Brescia, 25123

Italy

IRCCS Ospedale San Raffaele - Università Vita-Salute San Raffaele di Milano

Milan, 20132

Italy

IRCCS Ospedale San Raffaele

Milan, 20132

Italy

Fondazione Policlinico Universitario A. Gemelli IRCCS

Rome, 00168

Italy

University Medical Center Groningen

Groningen, 9713 GZ

Netherlands

Radboud University Medical Center

Nijmegen, 6525 GA

Netherlands

Erasmus MC

Rotterdam, 3015 GD

Netherlands

University Medical Center Utrecht

Utrecht, 3584 CX

Netherlands

AidPort sp. Zo.o

Skórzewo, Greater Poland Voivodeship 60-185

Poland

Pratia MCM

Krakow, Lesser Poland Voivodeship 30-272

Poland

University Clinical Hostpital in Wroclaw

Wroclaw, Lower Silesian Voivodeship 50-367

Poland

Pratia MTZ

Warsaw, Masovian Voivodeship 02-172

Poland

National Institute of Oncology Warszawa

Warsaw, Masovian Voivodeship 02-781

Poland

Pratia Onkologia Katowice

Katowice, Silesian Voivodeship 40-519

Poland

Medical University of Lublin

Lublin, 20-090

Poland

Hospital Universitari Vall d'Hebron

Barcelona, 08035

Spain

Hospital Clínic de Barcelona

Barcelona, 08036

Spain

Hospital Universitario de Cabuenes

Gijón, 33203

Spain

Hospital Ramón y Cajal

Madrid, 28034

Spain

Hospital Fundación Jimenez Díaz - START Madrid

Madrid, 28040

Spain

Universitätsspital Basel

Basel, 4031

Switzerland

Istituto Oncologico della Svizzera Italiana

Bellinzona,

Switzerland

Inselspital - Universitatsklinik Bern

Bern, 3010

Switzerland

Hôpitaux Universitaires de Genève

Geneva, 1205

Switzerland

Kantonsspital St.Gallen

Sankt Gallen, 9007

Switzerland

University Hospital Zurich

Zurich, 8091

Switzerland

The Christie NHS Foundation Trust

Manchester, Manchester M20 4BX

United Kingdom

The Beatson WOS Cancer Center

Glasgow, Scotland G12 0YN

United Kingdom

St. James Hospital

Leeds, LS9 7TF

United Kingdom

Clatterbridge Cancer Center NHS Foundation Trust

Liverpool, L7 8YA

United Kingdom

St. Bartholomew's Hospital, Barts NHS Trust

London, EC1A 7BE

United Kingdom

Sarah Cannon Research Institute UK

London, W1G 6AD

United Kingdom

Oxford University Hospitals NHS Foundation Trust

Oxford, OX3 7LE

United Kingdom

University Hospitals Plymouth NHS Trust

Plymouth, PL6 8DH

United Kingdom

University Hospital Southampton NHS Foundation Trust

Southampton, SO16 6YD

United Kingdom

Royal Marsden NHS Foundation Trust

Sutton, SM2 5PT

United Kingdom