This is a modular, multicentre, open-label, non-randomised, Phase I/II, dose-setting and expansion study including an intra-participants dose ramp up. AZD4573 will be administered intravenously, in novel combinations with anti-cancer agents, to participants with relapsed/refractory (r/r) haematological malignancies.
In Module 1 Part A (dose-setting), this study module will enrol participants with r/r Diffuse large B-cell lymphoma (DLBCL) or r/r Marginal zone lymphoma (MZL) who have failed prior therapy(ies), are not eligible for curative treatment options, for whom there is no standard therapy available, and will initially explore once weekly administration of AZD4573 at up to three target dose levels in combination with oral acalabrutinib 100 mg twice daily. The primary objective of Part A will be to identify the maximum tolerated dose and/or Recommended Phase II dose (RP2D) for further evaluation in Part B. A 5-week DLT-assessment period will incorporate the whole of Cycle 1 in Part A, including the dose ramp up and the first 3 weeks at the target dose. In Module 1 Part B (expansion), separate expansion cohorts for participants with Germinal Centre B-cell (GCB) and non-GCB DLBCL subtypes will be opened at the RP2D. In Module 2, this study module will enroll participants with r/r Mantle Cell Lymphoma (MCL) who have failed at least one line of prior therapy, are not eligible for curative treatment options. Module 2, Part A consist of AZD4573 monotherapy (Period 1) followed by AZD4573 + acalabrutinib combination treatment (Period 2). Period 1: AZD4573 will be administered weekly (12 mg, infusion). Period 2: AZD4573 (RP2D from Module 1) will be administered (weekly) in combination with oral acalabrutinib 100 mg twice daily. Cycle 1 of each dosing period has a duration of 5 weeks; subsequent cycles have a duration of 3 weeks. The AZD4573 monotherapy (Period 1) includes an intra-patient ramp up; participants will receive AZD4573 at Cycle 1 Week 1, Cycle 1 Week 2, and Cycle 1 Week 3 in 3 dose escalation manner (6, 9 and 12 mg respectively). Part A, Period 1 of Module 2 aims to confirm the AZD4573 monotherapy RP2D in MCL participants. In Period 2, the safety and tolerability of the RP2D of AZD4573 + acalabrutinib established in Module 1 will be assessed in participants with MCL. The study design of Part B of Module 2 will be determined from the data emerging from Part A.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
AZD4573 will be administered as an absolute (flat) dose, 2-hour (± 15 minutes) IV infusion once weekly (as monotherapy for Module 2 only) and in combination with orally administered acalabrutinib twice daily continuously. For both Part A and Part B of this study, Cycle 1 consists of 5 weeks, with a dose ramp-up. Subsequent cycles are 21 days (3 weeks) with once weekly dosing of AZD4573 in combination with acalabrutinib twice daily continuously (in Module 1 and Module 2, period 2).
Oral Acalabrutinib capsule will be administered twice daily continuously from Day 1 of Cycle 1 Week 1 in combination with AZD4573.
Research Site
Duarte, California, United States
Research Site
La Jolla, California, United States
Research Site
Houston, Texas, United States
Module 1: Number of Participants With Adverse Events
Safety and tolerability of AZD4573 in combination with acalabrutinib was assessed.
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 2: Number of Participants With Adverse Events
Assessed safety and confirmed the RP2D of AZD4573 monotherapy in MCL participants and assessed the safety and tolerability of AZD4573 in combination with acalabrutinib in participants administered AZD4573 monotherapy.
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Overall Response Rate (ORR) of AZD4573 in Combination With Acalabrutinib
Overall response rate (ORR), defined as the proportion of participants who have a tumour response (complete response \[CR\] and partial response \[PR\]).
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Complete Response (CR) Rate
CR is defined as no detectable evidence of tumor, according to the revised response criteria for malignant lymphoma.
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Duration of Response (DoR)
DoR, defined as the time from the first objective response of CR or PR to the time of documented disease progression or death due to any cause, whichever occurs first.
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Progression Free Survival (PFS)
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Research Site
Salt Lake City, Utah, United States
Research Site
Clayton, Australia
Research Site
Nedlands, Australia
Research Site
Québec, Quebec, Canada
Research Site
Lille, France
Research Site
Dublin, Ireland
Research Site
Galway, Ireland
...and 7 more locations
PFS, defined as the time from first dose date to documented disease progression, or death from any cause, whichever occurs first
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Overall Survival (OS)
OS, defined as the time from first dose until the date of death from any cause.
Time frame: From Screening (Day -30 to Day -1) until disease progression or survival until death (approximately 2.5 years)
Module 1: Cmax of AZD4573
Maximum concentration that a drug achieves in a specified compartment or test area of the body after the drug has been administered (Cmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: Cmax of Acalabrutinib
Maximum concentration that a drug achieves in a specified compartment or test area of the body after the drug has been administered (Cmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: Cmax of ACP-5862
Maximum concentration that a drug achieves in a specified compartment or test area of the body after the drug has been administered (Cmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUClast of AZD4573
Area under the plasma concentration time curve from zero to the time of the last measurable concentration (AUClast).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUClast of Acalabrutinib
Area under the plasma concentration time curve from zero to the time of the last measurable concentration (AUClast).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUClast of ACP-5862
Area under the plasma concentration time curve from zero to the time of the last measurable concentration (AUClast).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUCinf of AZD4573
Area under the plasma concentration time curve from zero extrapolated to infinity (AUCinf).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUCinf of Acalabrutinib
Area under the plasma concentration time curve from zero extrapolated to infinity (AUCinf).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: AUCinf of ACP-5862
Area under the plasma concentration time curve from zero extrapolated to infinity (AUCinf).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: Tmax of AZD4573
Time to reach peak or maximum observed concentration following drug administration (tmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: Tmax of Acalabrutinib
Time to reach peak or maximum observed concentration following drug administration (tmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: Tmax of ACP-5862
Time to reach peak or maximum observed concentration following drug administration (tmax).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: t1/2 of AZD4573
Time taken for half the initial dose of drug administered to be eliminated from the body (t1/2).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: t1/2 of Acalabrutinib
Time taken for half the initial dose of drug administered to be eliminated from the body (t1/2).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1
Module 1: t1/2 of ACP-5862
Time taken for half the initial dose of drug administered to be eliminated from the body (t1/2).
Time frame: Cycle 1 (5 weeks in total) on Day 1 of Week 1, 2 and 3, and Cycle 2 (3 weeks in total) on Day 1 of Week 1