Efficacy and Safety of Nemtabrutinib (MK-1026) in Participants With Hematologic Malignancies (MK-1026-003)

Launched by MERCK SHARP & DOHME LLC · Jan 25, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a new medication called nemtabrutinib (MK-1026) to see how safe and effective it is for people with certain blood cancers, including chronic lymphocytic leukemia (CLL), Waldenström's macroglobulinemia (WM), and non-Hodgkin's lymphoma. The researchers want to find out if this medication can help patients who have already tried other treatments but their cancer has not improved or has come back. The trial is currently looking for participants aged between 65 and 74 who meet specific health criteria, such as having a life expectancy of at least three months and the ability to take oral medications.

If you or a loved one are eligible and decide to participate, you'll undergo regular check-ups to monitor your health and how well the treatment is working. Participants will also be asked to provide samples for tests to help the researchers understand how the medication affects different types of blood cancer. It’s important to know that there are certain health conditions and past treatments that could prevent someone from joining the trial, so discussing eligibility with a healthcare provider is a crucial step. This trial aims to offer new hope for patients with challenging blood cancers by exploring a potentially effective treatment option.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 within 7 days prior to allocation
• • Has a life expectancy of at least 3 months, based on the investigator assessment
• • Has the ability to swallow and retain oral medication
• • Participants who are Hepatitis B surface antigen (HBsAg)-positive are eligible if they have received Hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to randomization
• • Participants with history of Hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening
• • Has adequate organ function
• • Male participants agree to refrain from donating sperm and agree to either remain abstinent from penile-vaginal intercourse as their preferred and usual lifestyle OR agree to use contraception, during the intervention period and for at least the time required to eliminate the study intervention after last dose of study intervention
• • Female participants assigned female sex at birth who are not pregnant or breastfeeding are eligible to participate if not a participant of childbearing potential (POCBP), or if a POCBP they either use a contraceptive method that is highly effective OR remain abstinent from penile-vaginal intercourse as their preferred and usual lifestyle during the intervention period and for at least to eliminate study intervention after the last dose of study intervention
• • Participants with HIV are eligible if they meet all of the following: the CD4 count is \>350 cells/uL at screening, the HIV viral load is below the detectable level, are on a stable ART regimen for at least 4 weeks prior to study entry, and are compliant with their ART
• • Part 1 and Part 2 (Cohorts A to C and J)
• • Has a confirmed diagnosis of CLL/SLL with
• • At least 2 lines of prior therapy (Part 1 only)
• • Part 2 Cohort A: CLL/SLL participants who are relapsed or refractory to prior therapy with a covalent, irreversible Bruton's tyrosine kinase inhibitor (BTKi), and a B-cell lymphoma 2 inhibitor (BCL2i). CLL participants must have received and failed, been intolerant to, or determined by their treating physician to be a poor phosphoinositide 3-kinase inhibitor (PI3Ki) candidate or ineligible for a PI3Ki per local guidelines
• • Part 2 Cohort B: CLL/SLL participants who are relapsed or refractory following at least 1 line of prior therapy and are BTKi treatment naive
• • Part 2 Cohort C: CLL/SLL participants with 17p deletion or tumor protein p53 (TP53) mutation who are relapsed or refractory following at least 1 line of prior therapy
• • Part 2 Cohort J: CLL/SLL participants whose disease relapsed or was refractory to prior therapy with a covalent/irreversible BTKi and BCL2i
• • Has active disease for CLL/SLL clearly documented to initiate therapy
• • Has evaluable core or excisional lymph node biopsy for biomarker analysis from an archival or newly obtained biopsy or bone marrow aspirate at Screening (optional for participants enrolling in Part 1)
• • Part 2 (Cohorts D to G)
• * Has a confirmed diagnosis of and meets the following prior therapy requirements:
• • Participants with Richter's transformation who are relapsed or refractory following at least 1 line of prior therapy (Cohort D)
• • Participants with pathologically confirmed MCL, documented by either overexpression of cyclin D1 or t(11;14), who are relapsed or are refractory to chemoimmunotherapy and a covalent irreversible BTKi (Cohort E)
• • Participants with MZL (including splenic, nodal, and extra nodal MZL) who are relapsed or refractory to chemoimmunotherapy and a covalent irreversible BTKi (Cohort F)
• • Participants with FL who are relapsed or refractory to chemoimmunotherapy, immunomodulatory agents (i.e. lenalidomide plus rituximab) (Cohort G)
• • Have measurable disease defined as at least 1 lesion that can be accurately measured in at least 2 dimensions with spiral CT scan
• • Has a lymph node biopsy for biomarker analysis from an archival or newly obtained biopsy or bone marrow aspirate (Cohort D) at Screening
• • Part 2 (Cohort H): confirmed diagnosis of WM; participants who are relapsed or refractory to standard therapies for WM including chemoimmunotherapy and a covalent irreversible BTKi
• • Has active disease defined as 1 of the following: systemic symptoms, physical findings, laboratory abnormalities, coexisting disease
• • Has measurable disease, satisfying any of the following: at least 1 lesion that can be accurately measured in at least 2 dimensions with spiral CT scan (minimum measurement must be \>15 mm in the longest diameter or \>10 mm in the short axis); IgM ≥450 mg/dL; or bone marrow infiltration of 10%
• • Has fresh bone marrow aspirate or a lymph node biopsy for biomarker analysis at Screening or a lymph node biopsy from an archival
• Exclusion Criteria:
• • Has active HBV/HCV infection (Part 1 and Part 2)
• • Has a history of malignancy ≤3 years before providing documented informed consent. Participants with basal cell carcinoma of skin, squamous cell carcinoma of skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potential curative therapy are not excluded. Participants with low-risk, early-stage prostate cancer (T1-T2a, Gleason score ≤6, and prostate-specific antigen \<10 ng/mL) either treated with definitive intent or untreated in active surveillance with SD are not excluded
• • Has active central nervous system (CNS) disease
• • Has an active infection requiring systemic therapy
• • Has received prior systemic anti-cancer therapy within 4 weeks prior to allocation
• • Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study intervention
• • Has any clinically significant gastrointestinal abnormalities that might alter absorption
• • History of severe bleeding disorders