An Open-Label, Phase 2 Trial of Nanatinostat in Combination With Valganciclovir in Patients With Epstein-Barr Virus-Positive (EBV+) Relapsed/Refractory Lymphomas (NAVAL-1)
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ClinicalTrials.gov Identifier: NCT05011058 |
Recruitment Status :
Recruiting
First Posted : August 18, 2021
Last Update Posted : May 1, 2024
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Condition or disease | Intervention/treatment | Phase |
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Epstein-Barr Virus Associated Lymphoproliferative Disorder EBV-Related PTLD EBV Related Non-Hodgkin's Lymphoma EBV-Positive DLBCL, NOS EBV Associated Lymphoma EBV Related PTCL, NOS | Drug: Nanatinostat in combination with valganciclovir | Phase 2 |
Patients with EBV-associated lymphomas have inferior outcomes with standard-of-care therapies compared to those with EBV-negative disease. Nanatinostat is a selective class I HDAC inhibitor which induces EBV lytic phase protein generation, activating (val)ganciclovir to its cytotoxic form. This open-label, multicenter, multinational, single-arm, Phase 2 basket study employs a Simon's 2-stage design to allow termination of enrollment into cohorts where treatment appears futile, and will include the following cohorts of patients with EBV+ relapsed/refractory lymphomas:
- EBV+ diffuse large B-cell lymphoma (DLBCL, NOS)
- Peripheral T-cell lymphoma (PTCL), including PTCL-NOS and AITL
- Post-transplant lymphoproliferative disorder (PTLD)
- EBV+ lymphoproliferative disorders other than the above, including Extranodal NK/T-cell lymphoma (ENKTL)
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 140 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Intervention Model Description: | This is an open-label, single-arm study utilizing a basket trial design. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | An Open-Label, Phase 2 Trial of Nanatinostat in Combination With Valganciclovir in Patients With Epstein-Barr Virus-Positive (EBV+) Relapsed/Refractory Lymphomas |
Actual Study Start Date : | May 28, 2021 |
Estimated Primary Completion Date : | July 2025 |
Estimated Study Completion Date : | December 2026 |
Arm | Intervention/treatment |
---|---|
Experimental: Nanatinostat with Valganciclovir
Patients will receive nanatinostat 20 mg orally once daily, days 1-4 per week with valganciclovir 900 mg orally once daily. Up to 10 PTCL patients will receive nanatinostat 20 mg orally once daily, days 1-4 per week. |
Drug: Nanatinostat in combination with valganciclovir
Drug: Nanatinostat, 20 mg orally once daily, 4 days per week in 28 day cycles Other name: VRx-3996 Drug: Valganciclovir, 900 mg orally once daily in 28 day cycles |
- Objective response rate (ORR) [ Time Frame: Approximately 3 years ]Assessed by an Independent Review Committee (IRC) per the 2007 International Working Group Response Criteria (IWGRC)
- Duration of response (DOR) [ Time Frame: Approximately 3 years ]
- Time to next anti-lymphoma treatment (TTNLT) [ Time Frame: Approximately 3 years ]
- Progression-free survival (PFS) [ Time Frame: Approximately 3 years ]
- Time to progression (TTP) [ Time Frame: Approximately 3 years ]
- Overall survival [ Time Frame: Approximately 3 years ]
- Incidence and severity of treatment-emergent adverse events [ Time Frame: Approximately 28 days following the last dose ]
- Pharmacokinetic parameter - time to maximum plasma concentration [tmax], [ Time Frame: Approximately 6 months following the end of Cycle 1 Day 1 (each cycle is 28 days) ]
- Pharmacokinetic parameter - maximum plasma concentration [Cmax] [ Time Frame: Approximately 6 months following the end of Cycle 1 Day 1 (each cycle is 28 days) ]
- Pharmacokinetic parameter - area under the plasma concentration-time curve [AUC] [ Time Frame: Approximately 6 months following the end of Cycle 1 Day 1 (each cycle is 28 days) ]
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Key Inclusion Criteria:
- EBV+ DLBCL, NOS and PTCL, NOS, and AITL: Relapsed/refractory disease following 1 or more prior systemic therapy(ies) with curative intent.
- For EBV+ PTLD patients: Relapsed/refractory disease following 1 prior therapy and must have received at least 1 course of an anti-CD20 immunotherapy. For patients with EBV+ PTLD only, age 12 years and older and weighing greater than 40 kg (Adolescent, Adult, Older Adult) are allowed
- For other EBV+ relapsed/refractory lymphoma: Following at least 1 course of an anit-CD20 immunotherapy and at least 1 course of anthracycline-based chemotherapy (unless contraindicated)
- No available therapies in the opinion of the Investigator
- Not eligible for high-dose chemotherapy with allogeneic/autologous stem cell transplantation or CAR-T therapy
- Measurable disease per Cheson 2007
- ECOG performance status 0, 1, 2
- Adequate bone marrow function
Key Exclusion Criteria:
- Presence or history of CNS involvement by lymphoma
- Systemic anticancer therapy or CAR-T within 21 days
- Antibody (anticancer) agents within 28 days
- Less than 60 days from prior autologous hematopoietic stem cell or solid organ transplant
- Less than 90 days from prior allogeneic transplant.
- Daily corticosteroids (≥20 mg of prednisone or equivalent) within week prior to Cycle 1 Day 1
- Inability to take oral medication, malabsorption syndrome or any other gastrointestinal condition (nausea, diarrhea, vomiting) that may impact the absorption of nanatinostat and valganciclovir.
- Active infection requiring systemic therapy (excluding viral upper respiratory tract infections).
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05011058
Contact: Strait Hicklin | 858-400-8470 | ClinicalTrials@Viracta.com |
Study Director: | Donald (D.K.) Strickland, MD | Viracta Therapeutics |
Responsible Party: | Viracta Therapeutics, Inc. |
ClinicalTrials.gov Identifier: | NCT05011058 |
Other Study ID Numbers: |
VT3996-202 |
First Posted: | August 18, 2021 Key Record Dates |
Last Update Posted: | May 1, 2024 |
Last Verified: | April 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
EBV positive post-transplant lymphoproliferative disorder (PTLD) EBV lymphoma Lymphoproliferative Disorders Epstein-Barr Virus (EBV) |
EBV positive T cell lymphoma EBV positive diffuse large B-cell lymphoma (DLBCL) EBV positive peripheral T-cell lymphoma (PTCL) EBV positive PTLD in Pediatrics |
Epstein-Barr Virus Infections Lymphoma Lymphoproliferative Disorders Neoplasms by Histologic Type Neoplasms Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases |
Virus Diseases Infections Herpesviridae Infections DNA Virus Infections Tumor Virus Infections Valganciclovir Antiviral Agents Anti-Infective Agents |