A Study of Tolinapant in Combination With Oral Decitabine/Cedazuridine and Oral Decitabine/Cedazuridine Alone in Participants With Relapsed/Refractory Peripheral T-cell Lymphoma (R/R PTCL)

NCT ID: NCT05403450

Last Updated: 2025-06-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-23

Study Completion Date

2026-12-01

Brief Summary

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The primary purpose of the study is to assess safety, and to identify the recommended phase 2 dose (RP2D) of tolinapant in combination with oral decitabine/cedazuridine in Phase 1 and to assess preliminary efficacy as determined by overall response rate (ORR) in Phase 2.

Detailed Description

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Conditions

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Relapsed/Refractory Peripheral T-cell Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phases 1 and 2: Tolinapant + Oral Decitabine/Cedazuridine

Tolinapant, orally, once daily (QD) on Days 1 to 7 and 15 to 21 of each 28-day cycle in combination with oral decitabine/cedazuridine fixed-dose combination (FDC) tablet, QD on days determined by the Lead-in Phase during each 28-day cycle. The starting dose of tolinapant will be escalated stepwise in successive cohorts until the RP2D is determined.

Based on RP2D and results determined from Phase 1 participants would receive tolinapant at the identified RP2D in combination with decitabine/cedazuridine, FDC tablet, orally, QD on days determined by the Lead-in Phase during each 28-day cycle in Phase 2.

Group Type EXPERIMENTAL

Tolinapant

Intervention Type DRUG

Capsule for oral administration

Decitabine + Cedazuridine

Intervention Type DRUG

Tablet for oral administration

Phase 1: Oral Decitabine/Cedazuridine

Decitabine/cedazuridine FDC tablet, orally, QD on days determined by the Lead-in Phase during each 28-day cycle.

Group Type EXPERIMENTAL

Decitabine + Cedazuridine

Intervention Type DRUG

Tablet for oral administration

Interventions

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Tolinapant

Capsule for oral administration

Intervention Type DRUG

Decitabine + Cedazuridine

Tablet for oral administration

Intervention Type DRUG

Other Intervention Names

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ASTX660 ASTX727

Eligibility Criteria

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Inclusion Criteria

1. Participants with expected life expectancy of \>12 weeks.
2. Participants must have histologically confirmed R/R PTCL (local pathology report) as defined by 2016 World Health Organization (WHO) classification. The following subtypes are eligible for the study:

1. Extranodal natural killer (NK)/T-cell lymphoma nasal type.
2. Enteropathy-associated T-cell lymphoma.
3. Monomorphic epitheliotropic intestinal T-cell lymphoma.
4. Hepatosplenic T-cell lymphoma.
5. Subcutaneous panniculitis-like T-cell lymphoma.
6. Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS).
7. Angioimmunoblastic T-cell lymphoma.
8. Follicular peripheral T-cell lymphoma.
9. Nodal peripheral T-cell with T-follicular helper (THF) phenotype.
10. Anaplastic large-cell lymphoma (ALCL).
3. Participants must have evidence of progressive disease and must have received at least two prior systemic therapies.
4. Participants must have measurable disease by contrast-enhanced diagnostic CT (at least 1 nodal lesion \>1.5 centimeters (cm) or extranodal lesions \>1.0 cm).
5. Participants with CD30-positive disease must have received, be ineligible for, or intolerant to brentuximab vedotin.
6. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
7. Acceptable organ function as per protocol.
8. Women of childbearing potential (according to recommendations of the Clinical Trial Facilitation Group \[CTFG\]) must not be pregnant or breastfeeding and must have a negative pregnancy test at screening.

Exclusion Criteria

1. Prior treatment with tolinapant or any hypomethylating agent.
2. Hypersensitivity to tolinapant or oral decitabine/cedazuridine, excipients of the drug product, or other components of the study treatment regimen.
3. Poor medical risk because of systemic diseases (e.g., uncontrolled infections) in addition to the qualifying disease under study.
4. Life-threatening illness, significant organ system dysfunction, or other condition that, in the investigator's opinion, could compromise participant safety or the integrity of the study outcomes, or interfere with the absorption or metabolism of tolinapant.
5. A history of, or at risk for, cardiac disease, as evidenced by 1 or more of the following conditions:

1. Abnormal left ventricular ejection fraction.
2. Congestive cardiac failure of Grade ≥3.
3. Unstable cardiac disease.
4. History or presence of complete left bundle branch block, third-degree heart block, cardiac pacemaker, or clinically significant arrhythmia.
5. History of long QTc syndrome or ventricular arrhythmias including ventricular bigeminy.
6. Screening 12-lead electrocardiogram (ECG) with measurable QTc interval of ≥470 milliseconds (msec) (according to either Fridericia's or Bazett's correction).
7. Any other condition that, in the opinion of the investigator, could put the participant at increased cardiac risk.
6. Known history of human immunodeficiency virus (HIV) infection; or seropositive results consistent with active hepatitis B virus (HBV) or active hepatitis C virus (HCV) infection.
7. Grade 3 or greater neuropathy.
8. Known significant mental illness or other conditions such as active alcohol or other substance abuse that, in the opinion of the investigator, predisposes the participant to high risk of noncompliance with the protocol treatment or assessments.
9. Prior anticancer treatments or therapies within the indicated time window before first dose of study treatment (tolinapant), as follows:

1. Cytotoxic chemotherapy or radiotherapy within 4 weeks prior.
2. Monoclonal antibodies within 4 weeks prior.
3. At least 12 weeks must have elapsed since chimeric antigen receptor T-cell (CAR-T) infusion.
4. Small molecules or biologics (investigational or approved) within the longer of 3 weeks or 5 half-lives before study treatment.
10. Monoclonal antibody treatment for rheumatologic conditions within 4 weeks of study drug initiation.
11. Concurrent second malignancy currently requiring active therapy, except breast or prostate cancer stable on or responding to endocrine therapy or superficial bladder cancer.
12. Any concurrent second malignancy that is metastatic.
13. Known central nervous system (CNS) lymphoma.
14. Participants with a history of allogeneic transplant are excluded from this study.
15. Autotransplant within 100 days of the first dose of the study drug(s).
16. Systemic corticosteroids \>10 mg prednisone equivalent within 7 days of the first dose of study drug(s).
17. Anti-T-cell directed therapy:

1. Lymphotoxic agents (e.g., anti-CD52) in the past 12 months.
2. Inhibitory drugs (e.g., calcineurin inhibitors) within 4 weeks of the first dose of study drug(s).
18. Use of a concomitant medication which is a moderate or strong CYP3A4 inhibitor/inducer within 2 weeks of the start of the study.
19. Use of any vaccine within 10 days of the first dose of the study drug(s).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Taiho Oncology, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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City of Hope Site #151

Duarte, California, United States

Site Status

University of Califonia, Los Angeles

Los Angeles, California, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

University of Colorado Anschutz Medical Campus Site #118

Aurora, Colorado, United States

Site Status

Yale Cancer Center Site #109

New Haven, Connecticut, United States

Site Status

Moffitt Cancer Center Site #157

Tampa, Florida, United States

Site Status

Winship Cancer Institute of Emory University

Atlanta, Georgia, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

University of Michigan Rogel Cancer Center

Ann Arbor, Michigan, United States

Site Status

Barbara Ann Karmanos Cancer Institute Site#159

Detroit, Michigan, United States

Site Status

Rochester Skin Lymphoma Medical Group, PLLC Site #147

Fairport, New York, United States

Site Status

NYU Langone Laura and Isaac Perlmutter Cancer Center Site #153

New York, New York, United States

Site Status

University of Pennsylvania Site# 160

Philadelphia, Pennsylvania, United States

Site Status

The University of Texas MD Anderson Cancer Center Site #101

Houston, Texas, United States

Site Status

University of Virginia Comprehensive Cancer Center

Charlottesville, Virginia, United States

Site Status

Fred Hutchinson Cancer Center

Seattle, Washington, United States

Site Status

Concord Hospital

Concord, New South Wales, Australia

Site Status

Monash Medical Center

Melbourne, Victoria, Australia

Site Status

Linear Clinical Research Site #834

Nedlands, , Australia

Site Status

Hôpital Bretonneau

Tours, Indre-et-Loire, France

Site Status

Centre Henri Becquerel

Rouen, Seine-Maritime, France

Site Status

Institut Bergonié Site#553

Bordeaux, , France

Site Status

Institut Paoli-Calmettes

Marseille, , France

Site Status

CHU Saint-Eloi Site#556

Montpellier, , France

Site Status

Centre Antoine Lacassagne

Nice, , France

Site Status

AP-HP Pitie Saltpetriere Site# 552

Paris, , France

Site Status

Institut Gustave Roussy

Villejuif, , France

Site Status

Ospedale Santa Maria delle Croci di Ravenna

Ravenna, Emilia-Romagna, Italy

Site Status

Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - IRST

Meldola, Forli-Cesena, Italy

Site Status

U.O.C. di Ematologia Pad. 8IRCCS Azienda OspedalieroUniversitaria di Bologna Site#651

Bologna, , Italy

Site Status

Azienda Socio Sanitaria Territoriale (ASST) degli Spedali Civili di Brescia Site#650

Brescia, , Italy

Site Status

Istituto Europeo di Oncologia Site#652

Milan, , Italy

Site Status

Fondazione IRCCS San Gerardo dei Tintori Site #655

Monza, , Italy

Site Status

Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy

Warsaw, Masovia, Poland

Site Status

Ośrodek Badań Klinicznych Wczesnych Faz - Uniwersyteckie Centrum Kliniczne w Gdańsku

Gdansk, Pomeranian Voivodeship, Poland

Site Status

Wojewódzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Łodzi

Lodz, Łódź Voivodeship, Poland

Site Status

Hospital Universitario Virgen del Rocío

Seville, Andalusia, Spain

Site Status

Hospital de la Santa Creu i Sant Pau

Barcelona, Catalonia, Spain

Site Status

Institut Català d'Oncologia - Hospital Duran i Reynals (ICO L'Hospitalet)

Barcelona, Catalonia, Spain

Site Status

Hospital del Mar Site #704

Barcelona, , Spain

Site Status

Hospital Universitario Fundación Jiménez Díaz Site #703

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre Site#710

Madrid, , Spain

Site Status

Hospital Universitario Marqués de Valdecilla Site#711

Santander, , Spain

Site Status

Guy's and Saint Thomas' NHS Foundation Trust

London, England, United Kingdom

Site Status

University College London Hospitals NHS Foundation Trust

London, England, United Kingdom

Site Status

The Christie NHS Foundation Trust

Manchester, England, United Kingdom

Site Status

Countries

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United States Australia France Italy Poland Spain United Kingdom

Other Identifiers

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2021-005338-40

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ASTX660-03

Identifier Type: -

Identifier Source: org_study_id

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