TulmiSTAR-02: A Phase I/II Open-label Study of Tulmimetostat in Combination With Darolutamide vs. Darolutamide, and Tulmimetostat With Abiraterone in Patients With Metastatic Hormone-sensitive Prostate Cancer (mHSPC)
Start Date
1/13/2026
Completion Date
8/2/2032
Summary
The purpose of this study is to evaluate the safety, tolerability, and efficacy of two different treatment combinations of tulmimetostat in participants with de novo or recurrent metastatic hormone-sensitive prostate cancer (mHSPC). Phase I aims to determine the recommended dose(s) for expansion (RDE) of tulmimetostat in combination with darolutamide or abiraterone. Phase II is designed to further evaluate the efficacy and safety of tulmimetostat in combination with darolutamide compared with darolutamide alone in participants with mHSPC.
Detailed Description
This is a Phase I/II, open-label, global, multicenter study evaluating tulmimetostat in combination with androgen receptor pathway inhibitors in participants with de novo or recurrent metastatic hormone-sensitive prostate cancer (mHSPC). The study consists of two phases: Phase I (Dose Escalation) Phase I includes two treatment groups: 1. Group A (Part 1): tulmimetostat in combination with darolutamide. 2. Group B (Part 2): tulmimetostat in combination with abiraterone. The primary objective of Phase I is to determine the recommended dose(s) for expansion (RDE) of tulmimetostat in each combination regimen through a parallel dose-escalation design guided by a Bayesian Logistic Regression Model (BLRM). Enrollment will follow a staggered approach between the two groups. Participants may have received prior taxane-based chemotherapy and/or prior androgen receptor pathway inhibitor (ARPI) therapy and must not have received prior radioligand therapy. Participants will continue androgen deprivation therapy (ADT) to maintain castrate testosterone levels (\<50 ng/dL or \<1.7 nmol/L) according to investigator choice and local prescribing information. In Group B, abiraterone will be administered with prednisone or prednisolone according to local prescribing information. Phase II (Dose Expansion) Phase II is a randomized, open-label, multicenter dose-expansion study designed to further characterize the recommended dose(s) of tulmimetostat in combination with darolutamide and to provide proof-of-concept for the efficacy and safety of tulmimetostat plus darolutamide compared with darolutamide alone. Eligible participants are adult men with de novo or recurrent mHSPC who have not received prior radioligand therapy and may have received prior taxane-based chemotherapy and/or prior ARPI therapy (excluding darolutamide), with a maximum prior ARPI exposure of 4 months in the mHSPC setting. Participants will continue ADT throughout the study according to investigator choice and local prescribing information. Based on Phase I results, one or two tulmimetostat dose levels in combination with darolutamide may be evaluated. Study Duration and Follow-up For each participant, the study consists of a screening period, a treatment period, and post-treatment follow-up. Post-treatment follow-up includes: 1. A 30-day safety follow-up visit after permanent discontinuation of study treatment. 2. An efficacy follow-up period for participants who discontinue study treatment without documented disease progression or initiation of new anti-neoplastic therapy, including scheduled imaging assessments. 3. Long-term follow-up to collect survival status, new anti-neoplastic therapies, suspected treatment-related serious adverse events, and second primary malignancies. Participants will be contacted approximately every 12 weeks during the first 3 years and every 24 weeks thereafter until death, loss to follow-up, or withdrawal of consent. The study is designed to evaluate whether inhibition of EZH1/2 with tulmimetostat in combination with androgen receptor pathway inhibition may improve clinical outcomes in men with metastatic hormone-sensitive prostate cancer.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
Tulmimetostat
Darolutamide
Abiraterone
Prednisone/Prednisolone
Androgen Deprivation Therapy (ADT)
Conditions
Locations
Univ of Alabama at Birmingham
Birmingham, Alabama 35294-3300
United States
Uni Of Iowa Hospitals And Clinics
Iowa City, Iowa 52242
United States
University of Kansas Cancer Center
Westwood, Kansas 66205
United States
Wichita Urology Group PA
Wichita, Kansas 67226
United States
Duke University Medical Center
Durham, North Carolina 27710
United States
Medical University of South Carolina MUSC
Charleston, South Carolina 29425
United States
Carolina Urologic Research Center
Myrtle Beach, South Carolina 29572
United States
Huntsman Cancer Institute
Salt Lake City, Utah 84112
United States
Novartis Investigative Site
Camperdown, New South Wales 2050
Australia
Novartis Investigative Site
Wollongong, New South Wales 2500
Australia
Novartis Investigative Site
Porto Alegre, Rio Grande do Sul 90610-001
Brazil
Novartis Investigative Site
Montreal, Quebec H2X 1R9
Canada
Novartis Investigative Site
Guangzhou, 510060
China
Novartis Investigative Site
Créteil, 94010
France
Novartis Investigative Site
Lille, 59020
France
Novartis Investigative Site
Nantes, 44093
France
Novartis Investigative Site
Jena, Thuringia 07740
Germany
Novartis Investigative Site
Essen, 45147
Germany
Novartis Investigative Site
Hong Kong, 999077
Hong Kong
Novartis Investigative Site
Budapest, 1083
Hungary
Novartis Investigative Site
Budapest, 1122
Hungary
Novartis Investigative Site
Szeged, 6725
Hungary
Novartis Investigative Site
Rozzano, MI 20089
Italy
Novartis Investigative Site
Verona, VR 37134
Italy
Novartis Investigative Site
Seoul, 05505
South Korea
Novartis Investigative Site
Seoul, 06591
South Korea
Novartis Investigative Site
Madrid, 28034
Spain
Novartis Investigative Site
Madrid, 28040
Spain
Novartis Investigative Site
Madrid, 28222
Spain
Novartis Investigative Site
Ankara, Sihhiye Altindag 06230
Turkey (Türkiye)
Novartis Investigative Site
London, W1G 6AD
United Kingdom