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History of Changes for Study: NCT04224493
Study in Subjects With Relapsed/Refractory Follicular Lymphoma
Latest version (submitted May 6, 2024) on ClinicalTrials.gov
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Study Record Versions
Version A B Submitted Date Changes
1 January 8, 2020 None (earliest Version on record)
2 February 21, 2020 Recruitment Status, Study Status and Contacts/Locations
3 March 3, 2020 Study Status and Contacts/Locations
4 April 23, 2020 Study Status
5 June 12, 2020 Study Status and Contacts/Locations
6 June 16, 2020 Contacts/Locations and Study Status
7 June 24, 2020 Contacts/Locations and Study Status
8 June 30, 2020 Contacts/Locations and Study Status
9 July 20, 2020 Study Status and Contacts/Locations
10 July 24, 2020 Contacts/Locations and Study Status
11 August 14, 2020 Contacts/Locations and Study Status
12 August 19, 2020 Contacts/Locations and Study Status
13 August 24, 2020 Contacts/Locations and Study Status
14 August 31, 2020 Contacts/Locations and Study Status
15 September 1, 2020 Study Status and Contacts/Locations
16 September 16, 2020 Contacts/Locations and Study Status
17 September 29, 2020 Contacts/Locations and Study Status
18 October 1, 2020 Study Status and Contacts/Locations
19 October 20, 2020 Contacts/Locations and Study Status
20 October 23, 2020 Contacts/Locations and Study Status
21 November 18, 2020 Study Status and Contacts/Locations
22 November 19, 2020 Contacts/Locations and Study Status
23 November 20, 2020 Contacts/Locations and Study Status
24 December 16, 2020 Study Status and Contacts/Locations
25 December 23, 2020 Contacts/Locations and Study Status
26 December 30, 2020 Contacts/Locations and Study Status
27 January 4, 2021 Study Status and Contacts/Locations
28 January 5, 2021 Contacts/Locations and Study Status
29 March 9, 2022 Outcome Measures, Contacts/Locations, Arms and Interventions, Study Status and Eligibility
30 June 17, 2022 Contacts/Locations, Outcome Measures, Study Status, Eligibility, Study Design, Conditions, Study Description and Study Identification
31 September 29, 2022 Study Status and Contacts/Locations
32 November 14, 2022 Study Status and Contacts/Locations
33 November 29, 2022 Contacts/Locations and Study Status
34 December 9, 2022 Study Status and Contacts/Locations
35 January 31, 2023 Study Status and Contacts/Locations
36 March 7, 2023 Contacts/Locations and Study Status
37 May 31, 2023 Contacts/Locations, Arms and Interventions, Outcome Measures, Study Identification, Study Status, Eligibility, Study Design, Conditions and Study Description
38 July 17, 2023 Study Status and Study Identification
39 August 8, 2023 Contacts/Locations, Arms and Interventions, Outcome Measures, Study Status, IPDSharing, Eligibility and Study Design
40 August 17, 2023 Study Status
41 September 22, 2023 Contacts/Locations and Study Status
42 September 26, 2023 Study Status
43 October 25, 2023 Study Status and Contacts/Locations
44 November 30, 2023 Study Status and Contacts/Locations
45 December 29, 2023 Study Status
46 January 30, 2024 Study Status
47 February 14, 2024 IPDSharing, Contacts/Locations, Study Status and Study Identification
48 April 18, 2024 Study Status, Contacts/Locations, Eligibility and Study Design
49 May 6, 2024 Outcome Measures, Arms and Interventions, Study Description, Study Status, Eligibility and Study Design
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Study NCT04224493
Submitted Date:  January 8, 2020 (v1)

Open or close this module Study Identification
Unique Protocol ID: EZH-302
Brief Title: Study in Subjects With Relapsed/Refractory Follicular Lymphoma
Official Title: A Phase 1b/3 Double-blind, Randomized, Active-controlled, 3-stage, Biomarker Adaptive Study of Tazemetostat or Placebo in Combination With Lenalidomide Plus Rituximab in Subjects With Relapsed/Refractory Follicular Lymphoma
Secondary IDs:
Open or close this module Study Status
Record Verification: January 2020
Overall Status: Not yet recruiting
Study Start: January 2020
Primary Completion: June 2022 [Anticipated]
Study Completion: December 2024 [Anticipated]
First Submitted: December 12, 2019
First Submitted that
Met QC Criteria:
January 8, 2020
First Posted: January 13, 2020 [Actual]
Last Update Submitted that
Met QC Criteria:
January 8, 2020
Last Update Posted: January 13, 2020 [Actual]
Open or close this module Sponsor/Collaborators
Sponsor: Epizyme, Inc.
Responsible Party: Sponsor
Collaborators:
Open or close this module Oversight
U.S. FDA-regulated Drug: Yes
U.S. FDA-regulated Device: No
Data Monitoring: Yes
Open or close this module Study Description
Brief Summary: This is a multicenter, double-blind, active-controlled, randomized, 3-stage, biomarker enrichment design featuring early futility stopping and sample-size re-estimation with safety run-in designed to evaluate the efficacy and safety of tazemetostat in combination with R2 in subjects with R/R FL, who have completed at least 1 prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy.
Detailed Description: Stage 1 is a safety run-in phase, stage 2 is an efficacy and safety phase for an assessment of the EZH2 Mutant Type population and overall FL population regardless of EZH2 mutation status, and optional stage 3 with efficacy and safety phase for subjects with EZH2 mutation. Stage 3 with Mutant Type population alone will be executed in case the efficacy of the overall population in stage 2 fails whilst the efficacy of EZH2 Mutant Type is sufficiently promising. Stage 2 will include 2 futility interim analyses based on ORR for the first futility and PFS for the second one. In addition, there is a possible sample size re-estimation based on PFS. This is to ensure early detection of the presence/absence of clinical efficacy benefit as well as ensuring adequate powering based on the trial results to demonstrate a meaningful efficacy difference.
Open or close this module Conditions
Conditions: Relapsed/Refractory Follicular Lymphoma
Keywords:
Open or close this module Study Design
Study Type: Interventional
Primary Purpose: Treatment
Study Phase: Phase 3
Interventional Study Model: Sequential Assignment
Number of Arms: 2
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Allocation: Randomized
Enrollment: 518 [Anticipated]
Open or close this module Arms and Interventions
Arms Assigned Interventions
Active Comparator: Tazemetostat + R2 Arm

tazemetostat RP3D administered PO twice daily in continuous 28-day cycles.

  • rituximab 375 mg/m2 IV on days 1, 8, 15, and 22 of cycle 1; then on day 1 of cycles 2 to 5.
  • lenalidomide 20 mg (if creatinine clearance ≥60 mL/minute) or 10 mg (if creatinine clearance <60 mL/minute), administered PO QD on days 1 to 21 for 12 cycles.
Drug: Tazemetostat
Tazemetostat RP3D (tablets) administered PO twice daily in continuous 28-day cycles for 12 cycles.
Other Names:
  • EPZ-6438
Combination Product: Lenalidomide
Lenalidomide 20 mg capsules (if creatinine clearance ≥60 mL/minute) or 10 mg capsules (if creatinine clearance <60 mL/minute), administered PO QD on days 1 to 21 for 12 cycles.
Combination Product: Rituximab
Rituximab 375 mg/m2 IV on days 1, 8, 15, and 22 of cycle 1; then on day 1 of cycles 2 to 5.
Placebo Comparator: Placebo + R2 Arm

placebo administered PO twice daily in continuous 28-day cycles.

  • rituximab 375 mg/m2 IV on days 1, 8, 15, and 22 of cycle 1; then on day 1 of cycles 2 to 5.
  • lenalidomide 20 mg (if creatinine clearance ≥60 mL/minute) or 10 mg (if creatinine clearance <60 mL/minute), administered PO QD on days 1 to 21 for 12 cycles.
Drug: Placebo oral tablet
Placebo tablets administered PO twice daily in continuous 28-day cycles for 12 cycles.
Combination Product: Lenalidomide
Lenalidomide 20 mg capsules (if creatinine clearance ≥60 mL/minute) or 10 mg capsules (if creatinine clearance <60 mL/minute), administered PO QD on days 1 to 21 for 12 cycles.
Combination Product: Rituximab
Rituximab 375 mg/m2 IV on days 1, 8, 15, and 22 of cycle 1; then on day 1 of cycles 2 to 5.
Open or close this module Outcome Measures
Primary Outcome Measures:
1. Stage 1: RP3D of tazemetostat in combination with R2
[ Time Frame: Each cohort minimum 3 subjects. Evaluated for DLTs during the first 28 day cycle. 2-3 subjects 1 of the 6 subjects in the cohort experiences a DLT, the next dose level/cohort will be assessed. The RP3D for Phase 3 will be selected at in cohort experience ]

The safety and tolerability of tazemetostat in combination with R2 in subjects with R/R FL will be evaluated. RP3D of tazemetostat for further evaluation in phase 3 will be selected as assessed by the occurrence of treatment-emergent dose-limiting toxicities (DLTs) and adverse events (AEs).
2. Stage 2: Progression-free Survival (PFS)
[ Time Frame: Time from the date of randomization to the time of confirmed disease progression per the 2014 Lugano Classification (Cheson, 2014) or death, whichever occurs first, assessed up to 72 months. ]

Evaluate and compare progression-free survival (PFS), as assessed by Investigators, of tazemetostat + R2 versus placebo + R2 in subjects with R/R FL who have completed at least 1 prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy
Secondary Outcome Measures:
1. Pharmacokinetics of tazemetostat Maximum Plasma Concentration Cmax.
[ Time Frame: Stage 1: Cycles 1 & 2 , days 1 & 15. (Each cycles is 28 days) ]

Assess the pharmacokinetics of tazemetostat when administered concomitantly with R2 in subjects with R/R FL.
2. PFS
[ Time Frame: R2 arm (n = 178) versus investigator assessment of 14.3 months and 14.1 months by IRC in the placebo plus rituximab arm (n = 180) with a hazard ratio (HR) of 0.51 and 0.46, respectiv ]

Stage 2: Evaluate and compare PFS by blinded independent review committee (IRC)
3. Objective Response Rate
[ Time Frame: up to 72 months ]

Stage 2: Evaluate and compare objective response rate (ORR)
4. Stage 2: Duration of response
[ Time Frame: Through study of completion, up to 72 months ]

Evaluate and compare the duration of response (DOR)
5. Stage 2: Duration of complete response
[ Time Frame: Through study of completion, up to 72 hours ]

Evaluate and compare the duration of complete response (DOCR)
6. Disease control rate
[ Time Frame: Through study of completion, up to 72 hours ]

Stage 2: Evaluate and compare the disease control rate (DCR)
7. Overall Survival
[ Time Frame: From day of randomization until death due to any cause or study completion, up to 72 months. o 72 hours ]

Stage 2: Evaluate and compare the overall survival (OS)
8. EuroQOL
[ Time Frame: Measured at Screening, on Day 1 and Day 15 of Cycles 1 and 2, on Day 1 and optionally on Day 15 of each cycle from Cycle 3 and beyond, and at end of treatment visit, up to 3 years. (Each cycle is 28 days) ]

Stage 2: Evaluate and compare health-related quality of life as measured by the EuroQOL 5-Dimension 5-Level (EQ-5D-5L) instrument
9. Number of participants with treatment-related adverse events
[ Time Frame: From date of consent until 30 days after discontinuation of study treatment, up to 72 months. ]

Stage 2: Evaluate and compare safety and tolerability between tazemetostat + R2 vs Placebo + R2.
Open or close this module Eligibility
Minimum Age: 18 Years
Maximum Age:
Sex: All
Gender Based:
Accepts Healthy Volunteers: No
Criteria:

Inclusion Criteria:

  1. Have voluntarily agreed to provide written informed consent and demonstrated willingness and ability to comply with all aspects of the protocol.
  2. Males or females are ≥18 years of age at the time of providing voluntary written informed consent.
  3. Life expectancy ≥3 months before enrollment.
  4. Subjects with a history of hepatitis B or C are eligible on the condition that subjects have adequate liver function as defined by Inclusion Criterion #15 and are hepatitis B surface antigen negative and/or have undetectable hepatitis C virus (HCV) RNA.
  5. Have histologically confirmed FL, grades 1 to 3A.
  6. Must have been previously treated with at least 1 prior systemic chemotherapy, immunotherapy, or chemoimmunotherapy:
    1. Systemic therapy includes treatments such as:

    i. Rituximab monotherapy ii. Chemotherapy given with or without rituximab iii. Radioimmunoconjugates such as 90Y-ibritumomab tiuxetan and 131I-tositumomab.

    b. Systemic therapy does not include, for example: i. Local involved field radiotherapy for limited-stage disease ii. Helicobacter pylori eradication Prior investigational therapies will be allowed provided the subject has received at least

1 prior systemic therapy as discussed in Inclusion Criteria #6a. 7. Must have documented relapsed, refractory, or PD after treatment with systemic therapy (refractory defined as less than PR or disease progression <6 months after last dose).

8. Have measurable disease as defined by the Lugano Classification (Cheson, 2014).

9.Time between prior anticancer therapy and first dose of tazemetostat as follows:

  1. Cytotoxic chemotherapy - At least 21 days.
  2. Noncytotoxic chemotherapy (eg, small molecule inhibitor) - At least 14 days.
  3. Nitrosoureas - At least 6 weeks.
  4. Monoclonal antibody(ies) - At least 28 days.
  5. Radiotherapy -At least 6 weeks from prior radioisotope therapy; at least 12 weeks from 50% pelvic or total body irradiation. 13. Adequate renal function defined as calculated creatinine clearance ≥40 mL/minute per the Cockcroft and Gault formula or local institutional standard formula.

    10. Adequate renal function defined as calculated creatinine clearance ≥40 mL/minute per the Cockcroft and Gault formula or local institutional standard formula.

    11. Adequate bone marrow function. 12. Females must not be lactating or pregnant at Screening or Baseline (as documented by a negative beta-human chorionic gonadotropin [β-hCG] test with a minimum sensitivity of 25 IU/L or equivalent units of β-hCG). A separate baseline assessment is required if a negative screening pregnancy test was obtained more than 72 hours before the first dose of study treatment. All females will be considered to be of childbearing potential unless they are postmenopausal (at least 12 months consecutively amenorrhoeic, in the appropriate age group, and without other known or suspected cause) or have been sterilized surgically (ie, bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before dosing).

    13. Females of childbearing potential must not have had unprotected sexual intercourse within 30 days prior to study entry and must agree to use a highly effective method of contraception, from the last menstrual period prior to randomization, during treatment cycles, and for 30 days after the final dose of study treatment, and have a male partner who uses a condom. Highly effective contraception includes:

    • Double barrier methods of contraception such as condom plus diaphragm or cervical/vault cap with spermicide.
    • Placement of an intrauterine device.
    • Established hormonal contraceptive methods: oral, injectable, or implant. Females who are using hormonal contraceptives must have been on a stable dose of the same hormonal contraceptive product for at least 4 weeks prior to dosing and must continue to use the same contraceptive during the study and for 30 days after study drug discontinuation.

NOTE: Female subjects exempt from this requirement are subjects who practice total abstinence or have a male partner who is vasectomized. If currently abstinent, the subject must agree to use a highly effective method of contraception as described above if they become sexually active during treatment cycles, and for 30 days after study drug discontinuation. 14. All study participants enrolled must be registered into the mandatory Revlimid REMS™ program and be willing and able to comply with the requirements of the Revlimid REMS™ program as appropriate for the country in which the drug is being used.

a. Female subjects of childbearing potential must adhere to the scheduled pregnancy testing as required in the Revlimid REMS™ program. Female subjects exempt from this requirement are subjects who have been in natural menopause for at least 2 years OR have had both ovaries and/or uterus removed.

15. Male subjects must have had either a successful vasectomy OR they and their female partner must meet the criteria above (ie, not of childbearing potential OR practicing highly effective contraception and use a condom throughout the study period and for 30 days after study drug discontinuation).

Exclusion Criteria:

All Subjects

  1. Prior exposure to tazemetostat or other inhibitor(s) of EZH2.
  2. Prior exposure to lenalidomide for the treatment of FL.
  3. Subjects who have mixed or transformed histology.
  4. Has thrombocytopenia, neutropenia, or anemia of grade ≥3 (per CTCAE Version 5.0 criteria) or any prior history of myeloid malignancies, including myelodysplastic syndrome (MDS).
  5. Has a prior history of T-cell lymphoblastic lymphoma (T-LBL)/T-cell acute lymphoblastic leukemia (T-ALL).
  6. Subjects with uncontrolled leptomeningeal metastases or brain metastases or history of previously treated brain metastases.
  7. Subjects taking medications that are known potent cytochrome P450 (CYP)3A4 inducers/inhibitors (including St. John's wort) (Flockhart, 2007; U. S. Food and Drug Administration, February 2015).
  8. Are unwilling to exclude Seville oranges, grapefruit juice, AND grapefruit from their diet.
  9. Major surgery within 4 weeks before the first dose of study drug.

    a. Note: Minor surgery (eg, minor biopsy of extracranial site, central venous catheter placement, shunt revision) is permitted within 3 weeks prior to enrollment.

  10. Are unable to take oral medication OR have malabsorption syndrome or any other uncontrolled gastrointestinal condition (eg, nausea, diarrhea, vomiting) that might impair the bioavailability of tazemetostat.
  11. Significant cardiovascular impairment: history of congestive heart failure greater than New York Heart Association (NYHA) Class II, uncontrolled arterial hypertension, unstable angina, myocardial infarction, or stroke within 6 months of the first dose of study drug; or cardiac ventricular arrhythmia.
  12. Prolongation of corrected QT interval using Fridericia's formula (QTcF) to >480 msec at screening or history of long QT syndrome.
  13. Venous thrombosis or pulmonary embolism within the last 3 months before starting tazemetostat.

    a. whereas subjects greater than 3 months since deep vein thrombosis/pulmonary embolism are eligible but recommended to receive prophylaxis.

  14. Have an active infection requiring systemic therapy.
  15. Known hypersensitivity to any component of tazemetostat, lenalidomide, or rituximab.
  16. Inability to be treated with a Pneumocystis prophylaxis medication.
  17. Have an active infection with hepatitis B virus (as measured by positive hepatitis B surface antigen), HCV (as measured by positive hepatitis C antibody), human immunodeficiency virus, OR human T-cell lymphotropic virus 1.

    a. Exceptions: Subjects with a history of hepatitis B or C who have normal ALT AND are hepatitis B surface antigen negative and/or have undetectable HCV RNA.

  18. Any other major illness that, in the Investigator's judgment, will substantially increase the risk associated with the subject's participation in this study OR interfere with their ability to receive study treatment or complete the study.
  19. Female subjects who are pregnant or breastfeeding.
  20. Subjects who have undergone a solid organ transplant.
  21. Subjects with malignancies other than FL. a. Exception: Subjects with another malignancy who have been disease-free for 5 years, or subjects with a history of a completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible.
Open or close this module Contacts/Locations
Central Contact Person: Study Director, MD
Telephone: 855-500-1011
Email: clinicaltrials@epizyme.com
Locations: United States, Washington
Multicare Health System
Spokane, Washington, United States, 99218
Contact:Contact: Brett Gourley, MD 509-724-4440 bgourley@multicare.org
Open or close this module IPDSharing
Plan to Share IPD:
Open or close this module References
Citations:
Links:
Available IPD/Information:

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