A Phase 1/2 Study of STP938 for Adult Subjects With Relapsed/Refractory B-Cell and T-Cell Lymphomas

Lymphoma, B-Cell Clinical Trial

Official title:

An Open-Label, First in Human, Phase 1/2 to Evaluate Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of the CTPS1 Inhibitor STP938 In Adult Subjects With Relapsed/Refractory B-Cell and T-Cell Lymphomas

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05463263
• Other study ID #: STP938-101
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: August 3, 2022
• Est. completion date: December 2025

Study information

• Verified date: September 2023
• Source: Step Pharma, SAS
• Contact: Maureen Higgins
• Phone: +33 1 86 26 43 56
• Email: STP938-101[@]step-ph.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The Phase 1 part of the study is a dose escalation of STP938 as monotherapy.

The Phase 2 part of the study is cohort expansion of STP938 as a monotherapy in 5 different B and T cell lymphomas.

Description:

The drug STP938 is an inhibitor of an enzyme called cytidine triphosphate synthase 1 (CTPS1). CTPS1, and a very similar enzyme cytidine triphosphate synthase 2 (CTPS2), control the final step in the production of the cytidine triphosphate (CTP). CTP is an essential building block of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). Studies of people with inherited mutations of the CTPS1 gene indicate that certain types of blood cells required CTPS1 in order to divide rapidly, whereas other cells in the body use the CTPS2 enzyme. Based on these observations, it is expected that blocking CTPS1, using the drug STP938, may be an effective treatment for certain types of cancer that arise from blood cells.

The purpose of this study is to see if STP938 is effective at treating different types of lymphoma. STP938 will be given as a tablet. Blood samples will be taken during the study in order to understand the effects of STP938 on the lymphoma and on the rest of the body. The main outcome of the first part of the study is to see if STP938 can be given safely to patients with lymphoma, and to work out the best dose of STP938. The main outcome of the second part of the study is to see if ST938 is effective in treating different types of lymphoma.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 180
• Est. completion date: December 2025
• Est. primary completion date: December 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Main Inclusion Criteria:

• Signed and dated informed consent, and able to comply with the study procedures and any locally required authorization.

• Male or female aged = 18 years.

• Relapsed/refractory patients with histologically confirmed diagnosis of B cell or T cell lymphoma

• Must have received at least 2 prior systemic therapies and have no treatment options known to provide clinical benefit

• Must have measurable disease per Lugano lymphoma classification except for cutaneous T-cell lymphoma (CTCL) which is measured via International Society for Cutaneous Lymphomas (ISCL)/ European Organization of Research and Treatment of Cancer (EORTC).

• Eastern Cooperative Oncology Group (ECOG) performance status =2.

• Life expectancy > 3 months as assessed by the Investigator.

• Adequate organ function (bone marrow, hepatic, renal function and coagulation).

• All toxicities (except alopecia) from prior cancer treatments or procedures must have resolved to =Grade 1 or returned to baseline levels prior to enrollment.

Main Exclusion Criteria:

• Pregnant or breastfeeding females and women of child bearing potential or males unwilling to comply with contraception requirements.

• Known carcinomatous meningitis or central nervous system (CNS) involvement with lymphoma.

• Active malignancy within 2 years of study enrollment

• Prior radiation or surgical resection of their lymphoma without additional sites of measurable disease outside of the radiation field or subjects who have received prior radiation or surgical resection of their lymphoma =2 weeks prior to the first dose of study drug.

• Systemic cancer treatments, monoclonal antibody-directed therapies, other investigational agents within 4 weeks before enrollment, or <5 half-lives since completion of previous investigational therapy, whichever is shorter.

• Uncontrolled intercurrent illness.

• Immunocompromised subjects with increased risk of opportunistic infections or history of opportunistic infection in the last 12 months.

• Known active or chronic hepatitis B or active hepatitis C virus (HCV) infection.

• Subjects who have received a live vaccine within 30 days prior to study enrollment or whilst participating in the study.

• Subjects with corrected QT interval >470 msec based on averaged triplicate electrocardiogram (ECG) readings at the Screening Visit using the QT interval corrected for heart rate using Fridericia's method (QTcF).

• Subjects who received a severe acute respiratory syndrome coronavirus 2 vaccine =3 weeks prior to study drug dosing.

Related Conditions & MeSH terms

• Lymphoma
• Lymphoma, B-Cell
• Lymphoma, T-Cell

Intervention

Drug:
• STP938
Small molecule

Locations

Country	Name	City	State
France	The Centre Léon Bérard	Lyon
France	Institut Paoli Calmettes	Marseille
France	CHU de Nantes	Nantes
France	Institut Gustave Roussy	Villejuif
United Kingdom	University Hospitals of Leicester NHS Trust	Leicester
United Kingdom	Imperial College / Clinical Trials Unit, Hammersmith Hospital	London
United Kingdom	The Christie	Manchester
United Kingdom	Nottingham City Hospital	Nottingham
United Kingdom	Churchill Hospital	Oxford
United Kingdom	Derriford Hospital	Plymouth
United Kingdom	The Royal Marsden	Sutton
United States	Colorado Blood Cancer Institute	Denver	Colorado
United States	Florida Cancer Specialists	Sarasota	Florida

Sponsors (1)

Lead Sponsor	Collaborator
Step Pharma, SAS

Countries where clinical trial is conducted

United States,  France,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Safety and Tolerability (Phase 1 / Dose Escalation)	Incidence of dose limiting toxicities (DLTs), serious adverse events (SAEs), treatment-emergent adverse events (TEAEs)	Through study completion, an average of 9 months
Primary	Objective Response Rate (ORR) (Phase 2 / Dose Expansion)	ORR is defined as the proportion of subjects achieving a confirmed response (complete response [CR] or partial response [PR]). Evaluation of ORR will be via standard response criteria	Through study completion, an average of 9 months
Secondary	Maximum plasma concentration (Cmax) of STP938 including effects of food on absorption (Phase 1 / Dose Escalation)	Pharmacokinetic parameter from plasma STP938 levels	16 Days
Secondary	Time to reach maximum concentration (TMax) of STP938 including effects of food on absorption (Phase 1 / Dose Escalation)	Pharmacokinetic parameter from plasma STP938 levels	16 Days
Secondary	Area under the curve (AUC) of STP938 including effects of food on absorption (Phase 1 / Dose Escalation)	Pharmacokinetic parameter from plasma STP938 levels	16 Days
Secondary	Evaluate preliminary clinical activity of STP938 (Phase 1)	Evaluation of ORR using standard response criteria	Through study completion, an average of 9 months
Secondary	Evaluate best overall response of STP938 (Phase 1 / Phase 2)	Evaluation of best overall response (Complete response [CR], Partial response [PR], Stable disease [SD], Progression of disease [PD], Not evaluable, Not applicable) using standard response criteria	Through study completion, an average of 9 months
Secondary	Evaluation Time To Respond (Phase 1 / Phase 2)	Time to response (TTR) defined as the time from first dose of STP938 to the date of first CR or PR response assessment	Through study completion, an average of 9 months
Secondary	Evaluation Duration of Response (Phase 1 / Phase 2)	Duration of response (DoR) is defined as the time, in days, from the date measurement criteria that are first met for CR or PR (whichever is first recorded) to the first date that relapse, progressive disease or death, whichever occurs first	Through study completion, an average of 9 months
Secondary	Evaluation Progression Free Survival (Phase 1 / Phase 2)	Progression-free survival (PFS) is defined as the time from first STP938 dose to the date of disease progression or death, whichever occurs first	Through study completion, an average of 9 months
Secondary	Evaluation of Complete Response Rate (Phase 2)	Complete Response Rate using standard response criteria	Through study completion, an average of 9 months
Secondary	Safety and Tolerability (Phase 2 / Dose Expansion)	Incidence of SAEs and TEAEs	Through study completion, an average of 9 months