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Completed

NCT Number: NCT03397706

Dose Escalation & Expansion Study of Oral VRx-3996 & Valganciclovir in Subjects With EBV+ Lymphoid Malignancies

A two part, Phase 1b/2 study to define a recommended Phase 2 dose of VRx-3996 in combination with valganciclovir (Phase 1b) designed to evaluate the efficacy of this combination in relapsed/refractory Epstein-Barr Virus Associated Lymphoma (EBV+ lymphomas).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

Centro de Hematologia e Oncologia da Bahia (CEHON), Salvador, Estado de Bahia, Brazil

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About this study

The purpose of this study is to determine whether VRx-3996 in combination with valganciclovir is safe, determine the side effect profile, and to determine whether this therapy may help patients with EBV-related lymphomas. The study has two phases. Goals of the first phase include determining a safe and tolerable dose that can be administered in phase 2. Goals of the second phase include further evaluating the safety and tolerability of VRx-3996 in combination with valganciclovir, evaluating how the drugs are metabolized in the body, evaluating response rates and other exploratory objectives that will help the researchers evaluate how these drugs work in the body. Participants will receive daily oral doses of the two study drugs and will have multiple study visits where they will have blood collected, physical examinations, and other medical monitoring. Following completion of the Ph2, the study will enroll additional patients into a Tablet Pharmacokinetic (PK) cohort to investigate the PK parameters of the tablet formulation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Relapsed/refractory, pathologically confirmed Epstein-Barr Virus positive (EBV+) lymphoid malignancy or lymphoproliferative disease
  • Absence of available therapy with reasonable likelihood of cure or significant clinical benefit
  • Adequate hematologic, hepatic and renal function as defined by laboratory assessment

Key Exclusion Criteria:

  • Known primary central nervous system (CNS) lymphoma
  • Known CNS metastases or leptomeningeal disease unless appropriately treated and neurologically stable for at least 4 weeks
  • Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy
  • Refractory graft versus host disease (GvHD) not responding to treatment
  • Known active hepatitis B virus infection
  • Circulating hepatitis C virus on quantitative polymerase chain reaction (qPCR)
  • Known history of human herpes virus (HHV)-6 chromosomal integration
  • Known history of HIV infection

Treatment and study plan

VRx-3996 and valganciclovir

Combination Product

second-generation histone deacetylase (HDAC) inhibitor, nanatinostat (previously referred to as either VRx-3996 or CHR-3396)

Other names: nanatinostat, ganciclovir, Chroma (CHR)-3996

Primary outcomes

  1. Number (Proportion) of Participants With Adverse Events (AEs)

    Time frame: Up to approximately 2 years

    Number (percentage) of patients experiencing at least one treatment-emergent adverse event, defined as those untoward medical events with onset after the first dose of study drug or existing events that worsened after the first dose during the study

  2. Number (Proportion) of Participants With Dose-Limiting Toxicities (DLTs) in Phase 1b

    Time frame: Cycle 1 (28 days)

    Number (percentage) of patients experiencing a DLT during the first cycle (28 days) of study treatment in Phase 1b, defined as an adverse event (AE) or clinically significant abnormal laboratory value that was at least possibly related to study drugs and was not primarily related to disease, disease progression, concomitant medication(s), or intercurrent illness. In addition, to be considered a DLT, the AE had to meet at least one of the following criteria:

    • Grade 4 anemia unexplained by underlying disease
    • Grade 4 febrile neutropenia
    • Grade 4 neutropenia lasting >5 days
    • Any other Grade 4 hematologic toxicity (thrombocytopenia, neutropenia, febrile neutropenia, anemia) of any duration
    • Grade 4 or higher tumor lysis syndrome
    • Grade 3 or higher thrombocytopenia (with or without bleeding)
    • Any requirement for platelet transfusion
    • Grade 3 or higher non-hematologic toxicity despite adequate supportive care
    • Results in a dose hold of >7 consecutive days
  3. Overall Response Rate

    Time frame: Up to approximately 2 years

    Number (percentage) of patients with a best overall complete response (CR) or partial response (PR) according to the Lugano 2014 criteria (Cheson, Bruce D. et al. J Clin Oncology 2014;32(27):3059-68), where CR included complete metabolic response (no/minimal fluorodeoxyglucose [FDG] uptake) and radiologic response (target lesions regress to ≤1.5 cm in longest transverse diameter of a lesion) and no new lesions, and PR included partial metabolic response (reduced FDG uptake compared with baseline) or radiologic response (target lesions ≤ 50% decrease in the sum of the product of perpendicular diameters of up to 6 target measurable nodes and extranodal sites)

Secondary outcomes

  1. Duration of Response

    Time frame: Up to approximately 2 years

    Interval of time from date of first observed complete or partial response per Lugano 2014 criteria (Cheson BD et al. J Clin Oncology 2014;32(27):3059-68) to the date of documented disease progression or death due to any cause, where disease progression is defined by Lugano 2014 criteria (Cheson BD et al. J Clin Oncology 2014;32(27):3059-68) as progressive metabolic disease (increase in fluorodeoxyglucose [FDG] uptake from baseline or new FDG-avid foci consistent with lymphoma) or progressive radiologic response (increase in the product of perpendicular diameters of a single node by ≥ 50% or emergence of a new lesion)

  2. Time to Response

    Time frame: Up to approximately 2 years

    Interval of time from the start of study drug treatment to the first documentation of CR or PR per Lugano 2014 criteria (Cheson BD et al. J Clin Oncology 2014;32(27):3059-68)

  3. Progression-Free Survival

    Time frame: Up to approximately 2 years

    Interval of time from the date of first study drug administration to the documented date of disease progression or death, whichever occurred first, where disease progression is defined by Lugano 2014 criteria (Cheson BD et al. J Clin Oncology 2014;32(27):3059-68) as progressive metabolic disease (increase in fluorodeoxyglucose [FDG] uptake from baseline or new FDG-avid foci consistent with lymphoma) or progressive radiologic response (increase in the product of perpendicular diameters of a single node by ≥ 50% or emergence of a new lesion)

  4. Disease Control Rate

    Time frame: Up to approximately 2 years

    Number (percentage) of patients with CR, PR, or stable disease (SD) per Lugano 2014 criteria (Cheson BD et al. J Clin Oncology 2014;32(27):3059-68)

  5. Overall Survival

    Time frame: Up to approximately 2 years

    Interval of time from date of first study drug treatment to date of death, for any reason (patients without documentation of death at the time of analysis were censored at the date the patient was last known to be alive)

  6. Cmax (ng/mL) of VRx-3996

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    Pharmacokinetic (PK) assessment of VRx-3996 pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on cycle 1 day 1 (C1D1) and cycle 2 day 2 (C2D1)

  7. Cmax (ng/mL) of Valganciclovir

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    PK assessment of valganciclovir pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on C1D1 and C2D1

  8. Area Under Curve (AUC) 0-t of VRx-3996

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    PK assessment of VRx-3996 pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on C1D1 and C2D1

  9. AUC 0-t of of Valganciclovir

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    PK assessment of valganciclovir pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on C1D1 and C2D1

  10. Half-life of VRx-3996

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    PK assessment of VRx-3996 pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on C1D1 and C2D1

  11. Half-life of Valganciclovir

    Time frame: Phase 1b: Cycle 1 Day 1 and Phase 2: multiple doses through Cycle 2 Day 1

    PK assessment of valganciclovir pre-dose and at hours 0.5, 1, 2, 4, and 6 post-dose on C1D1 and C2D1

Sponsors and collaborators

Lead sponsor

Viracta Therapeutics, Inc.

Industry

Registry information

Official study title

A Phase 1b/2 Open-Label, Dose Escalation & Expansion Study of Orally Administered Viracta (VRx)-3996 & Valganciclovir in Subjects With Epstein-Barr Virus-Associated Lymphoid Malignancies

Important dates

Study start
2018
Primary completion
2023
Study completion
2023
First posted
Jan 12, 2018
Registry last updated
Mar 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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