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MesotheliomaPhase 2NCT02860286

Study of the EZH2 Inhibitor Tazemetostat in Malignant Mesothelioma

A Phase 2 study testing Tazemetostat in people with Mesothelioma and BAP1 Loss of Function, run by Epizyme, Inc. at 16 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a Phase 2, multicenter, open-label, 2-part, single-arm, 2-stage study of tazemetostat 800 mg two times a day (BID) administered orally. Screening of subjects to determine eligibility for the study will be performed within 21 days of the first planned dose of tazemetostat. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Mesothelioma, BAP1 Loss of Function
What is being tested?
Tazemetostat
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
16 sitesin 3 countries
Study dates
Jul 2016to May 2019
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age (at the time of consent) ≥18 years of age
  • Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Has a life expectancy of >3 months
  • Has mesothelioma (pleural, peritoneal, pericardial, tunica vaginalis) of any histology that is relapsed or refractory after treatment with at least one pemetrexed-containing regimen
  • Has a documented local diagnostic pathology of original biopsy confirmed by a Clinical Laboratory Improvement Amendments (CLIA)/College of American Pathologists (CAP) or equivalent laboratory certification
  • Part 2: Molecular evidence of BAP1 loss of function mutation present on local pathology, e.g., lack of nuclear BAP1 staining by immunohistochemistry (IHC) or evidence of loss of function by gene sequencing
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  • Has sufficient archival tumor tissue (a minimum of 10 slides or tumor block) available for central retrospective testing of BAP1 status
  • Has all prior treatment (i.e., chemotherapy, immunotherapy, radiotherapy) related clinically significant toxicities resolve to ≤ Grade 1 per CTCAE, version 4.03 or are clinically stable and not clinically significant, at time of enrollment
  • Prior therapy(ies), if applicable, must be completed according to the criteria below prior to first dose of tazemetostat:
  • Cytotoxic chemotherapy; at least 21 days since last dose
  • Non-cytotoxic chemotherapy (e.g., small molecule inhibitor); at least 14 days since last dose
  • Monoclonal antibody; at least three half-lives since the last dose
  • Non-antibody immunotherapy (e.g., tumor vaccine); at least 42 days since last dose
  • Radiotherapy, at least 14 days from last local site radiotherapy
  • Hematopoietic growth factor; at least 14 days from last dose
  • Investigational drug; 30 days or five half-lives, whichever is longer, from last dose
  • Has measurable disease based on either modified RECIST [Nowak 2005] for thoracic disease or RECIST 1.1 elsewhere
  • Has adequate hematologic (bone marrow and coagulation factors), renal, and hepatic function as defined by criteria below:
  • Hemoglobin ≥9 mg/dL
  • Platelets ≥100,000/mm3 (≥100 × 109/L) without platelet transfusion for 7 days
  • ANC ≥1000/mm3 (≥1.0 × 109/L) without growth factor support for 14 days
  • Coagulation: Prothrombin time (PT) <1.5 × ULN and partial thromboplastin time (PTT) <1.5 × ULN
  • Creatinine < 2.0 × ULN
  • Hepatic function: Conjugated bilirubin <1.5 × ULN and ALT and AST <3 × ULN
  • Has a QT interval corrected by Fridericia's formula (QTcF) ≤480 msec
  • Willing to provide tissue for translational research
  • Female subjects of childbearing potential must have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study drug; if the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required and subject also should agree to use an adequate method of contraception starting with screening through 30 days after the last dose of study therapy (if sexually active).
  • Male subjects should agree to use condoms starting with the first dose of study therapy through 30 days after the last dose of study therapy if sexually active with a female of childbearing potential

Who cannot join

  • Has had prior exposure to tazemetostat or other inhibitor(s) of enhancer of zeste homologue-2 (EZH2)
  • Has a history of known central nervous system metastasis
  • Has had a prior malignancy other than the malignancies under study Exception: A subject who has been disease-free for 5 years, or a subject with a history of a completely resected non-melanoma skin cancer or successfully treated in situ carcinoma is eligible.
  • Has had major surgery within 3 weeks prior to enrollment (a percutaneous biopsy, pleural catheter insertion, placement of central venous catheter or other minor procedure are permitted)
  • Is unwilling to exclude grapefruit juice, Seville oranges and grapefruit from the diet and all foods that contain those fruits from time of enrollment throughout their time on study
  • Has cardiovascular impairment, history of congestive heart failure greater than NYHA Class II, uncontrolled arterial hypertension, unstable angina, myocardial infarction, or stroke within 6 months prior to the planned first dose of tazemetostat; or ventricular cardiac arrhythmia requiring medical treatment
Show all 13Show fewer
  • Is currently taking any prohibited medication(s)
  • Has an active infection requiring systemic treatment
  • Has a congenital or acquired immunodeficiency, including subjects with known history of infection with human immunodeficiency virus (HIV) NOTE: HIV-positive subjects who are taking antiretroviral therapy are ineligible due to potential PK interactions with tazemetostat.
  • Has known history of chronic infection with hepatitis B virus (hepatitis B surface antigen positive) or hepatitis C virus (detectable anti-hepatitis C circulating viral RNA)
  • Has had a deep venous thrombosis (DVT) or pulmonary embolism within the 3 months prior to study enrollment.
  • NOTE: Subjects with a history of a DVT or pulmonary embolism >3 months prior to study enrollment who are on anticoagulation therapy with low molecular weight heparin are eligible for this study.
  • Is pregnant or breastfeeding.

Trial locations and contacts

16 sites in 3 countries.

16 sites in 3 countries

United States7 sites
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02215

  • University of California, Los Angeles

    Los Angeles, California, 90025

  • City of Hope National Medical Center

    Los Angeles, California, 90301

  • Memorial Sloan Kettering Cancer Center

    New York, New York, 10065

  • Mayo Clinic - Rochester

    Rochester, Minnesota, 55905

  • University of California San Francisco

    San Francisco, California, 94143

Other trials in United States

United Kingdom6 sites
  • University of Leicester & Leicester University Hospitals

    Leicester, LE1 9HN

  • St. Bartholomew's Hospital

    London, EC1M 6BQ

  • University College Hospital

    London, NW1 2PG

  • Royal Marsden Hospital - Chelsea

    London, SW3 6JJ

  • University Hospital of South Manchester

    Manchester, M23 9LT

  • Royal Marsden Hospital - Surrey

    Sutton, SM2 5PT

Other trials in United Kingdom

France3 sites
  • Institut Bergonie

    Bordeaux, 33076

  • CHRU de Lille

    Lille, 59037

  • Institut Gustave Roussy

    Villejuif, 94805

Other trials in France

About this study

Official title: A Multicenter Study of the EZH2 Inhibitor Tazemetostat in Adult Subjects With Relapsed or Refractory Malignant Mesothelioma With BAP1 Loss of Function

This is a Phase 2, multicenter, open-label, 2-part, single-arm, 2-stage study of tazemetostat 800 mg two times a day (BID) administered orally. Screening of subjects to determine eligibility for the study will be performed within 21 days of the first planned dose of tazemetostat.

In Part 1: planned to enroll 12 subjects with relapsed or refractory malignant mesothelioma regardless of BAP1 status will be treated and undergo pharmacokinetics (PK) blood sample collection after a single tazemetostat 800 mg.

Read more

Part 2 plans to include 55 subjects with BAP1-deficient relapsed or refractory malignant mesothelioma.

Treatment with tazemetostat will continue until disease progression, unacceptable toxicity or withdrawal of consent, or termination of the study. Response assessment will be evaluated after 6 weeks of treatment and then every 12 weeks thereafter while on study.

Being tested
Tazemetostat
Medical subject headings
Mesothelioma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TazemetostatDrug

    Also called EPZ-6438, E7438

    Tazemetostat (EPZ-6438) is a selective small molecule inhibitor of the histone-lysine methyltransferase EZH2 gene.

Study groups in NCT02860286
Study groupRoleWhat they receive
Open-Label TazemetostatExperimentalOral Tazemetostat 800mg BID
Receives: Drug: Tazemetostat

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): Cmax

    To assess the pharmacokinetic (PK) and safety profile of single (Cycle 1 day 1) and repeated doses (Cycle 1 day 2 onwards) of 800 mg tazemetostat administered as 400 mg tablets in subjects with relapsed or refractory malignant mesothelioma regardless of BRCA1 associated protein 1 (BAP1) status.

    Measured: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and 12 post-dose

  2. Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): Tmax

    Measured: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and12 post-dose.

  3. Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): AUC(0-t)

    To assess the pharmacokinetic (PK) and safety profile of single (Cycle 1 day 1) and repeated doses (Cycle 1 day 2 onwards) of 800 mg tazemetostat administered as 400 mg tablets in subjects with relapsed or refractory malignant mesothelioma regardless of BRCA1 associated protein 1 (BAP1) status

    Measured: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and12 post-dose.

  4. Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): AUC(0-∞)

    Pharmacokinetics profile of tazemetostat and its metabolite (plasma) assessing AUC(0-∞)

    Measured: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and 12 post-dose

  5. Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): t1/2

    Results from assessing the half-life of Tazemetostat and its metabolite shown below

    Measured: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and 12 post-dose

  6. Part 2: To Assess Disease Control Rate (DCR) Defined as Number of Subjects With Complete Response (CR), Partial Response (PR) and Stable Disease (SD)

    Overall, the disease control rate (DCR) (calculated as subjects with CR + subjects with PR + subjects with SD at 12 weeks in duration), and the DCR at 24 weeks.

    Measured: The patients were assessed for DCR for up to 24 weeks

  7. Incidence of Treatment-emergent Adverse Events as a Measure of Safety and Tolerability

    Measured: From the first dose of study treatment until the earlier of either 30 days after the discontinuation of study treatment or until the initiation of subsequent anticancer therapy.

Secondary outcomes (5)
  1. Part 1 and 2: Objective Response Rate (ORR; Complete Response + Partial Response [CR + PR])

    ORR (confirmed CR+PR) to tazemetostat in subjects with relapsed/refractory malignant mesothelioma using disease-appropriate standardized response criteria (modified RECIST or RECIST 1.1)

    Measured: Assessed every 6 weeks for duration of study participation which is estimated to be 12 months

  2. Progression-free Survival (PFS)

    Progression-Free Survival is defined as the interval of time between the date of the first dose of study drug and the earliest date of disease progression or death due to any cause. PFS was analyzed and listed for the ITT population. PFS was calculated using the Kaplan-Meier method.

    Measured: The patients were assessed for PFS for up to 24 weeks

  3. Part 1 and 2: Overall Survival (OS)

    OS was analyzed and listed for the ITT population. Subjects who have not died were censored at the date of last contact which was identified from a visit date, study assessment (physical examination, vital signs, ECOG performance status, electrocardiogram [ECG], study drug record, radiological evaluation), AE, medication, or disposition information.

    OS was calculated using the Kaplan-Meier method. OS at 12 and 24 weeks along with the associated 2-sided 95% CIs were provided. Median OS, first and third quartiles and associated 95% 2-sided CIs were provided.

    Measured: The patients were assessed for PFS for up to 24 weeks

  4. Part 1 and 2: To Evaluate the Duration of Response (DOR) in Subjects With Confirmed CR or PR

    DOR was calculated for subjects with a confirmed CR or PR. DOR is defined as the time from the date of the initial response (CR/PR) to the date of first documented PD or death due to any cause, whichever occurs first.

    DOR censoring rules followed those of the PFS analysis defined in the SAP. DOR was analyzed using the Kaplan-Meier methods and the median DOR, first quartile, and third quartile was presented. The associated 2- sided 95% CIs was estimated.

    Measured: Every 6 weeks up to disease progression or start of new anti-cancer therapy assessed for up to 12 months

  5. Part 1: To Assess Disease Control Rate (DCR) Defined as Number of Subjects With Complete Response (CR), Partial Response (PR) and Stable Disease (SD)

    Overall, the disease control rate (DCR) (calculated as subjects with CR + subjects with PR + subjects with SD at 12 weeks in duration), and the DCR at 24 weeks.

    Measured: The patients were assessed for DCR for up to 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Aug 2016 (estimated)
  2. Study startJul 2016
  3. Primary completionJun 2018
  4. Study completionMay 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
74 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02860286
Sponsor's protocol ID
EZH-203
Status last verified
Mar 2021
First submitted
27 Jul 2016
Last updated
9 Apr 2021
Data monitoring committee
Yes
Individual data sharing
No: To be determined.

Publications

  • Zauderer MG, Szlosarek PW, Le Moulec S, Popat S, Taylor P, Planchard D, Scherpereel A, Koczywas M, Forster M, Cameron RB, Peikert T, Argon EK, Michaud NR, Szanto A, Yang J, Chen Y, Kansra V, Agarwal S, Fennell DA. EZH2 inhibitor tazemetostat in patients with relapsed or refractory, BAP1-inactivated malignant pleural mesothelioma: a multicentre, open-label, phase 2 study. Lancet Oncol. 2022 Jun;23(6):758-767. doi: 10.1016/S1470-2045(22)00277-7. Epub 2022 May 16.

    PubMed 35588752

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tazemetostat in people with Mesothelioma and BAP1 Loss of Function, run by Epizyme, Inc. at 16 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 28 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in United States, United Kingdom, France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Part 1: Pharmacokinetics Profile of Tazemetostat and Its Metabolite (Plasma): Cmax (time frame: Cycle 1 Day 15: pre-dose, 0.5, 1, 2, 4, 6, 8, 10, and 12 post-dose). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02860286, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2021.

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