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Testing the Combination of an Anti-cancer Drug, Iadademstat, With Other Anti-cancer Drugs (Atezolizumab or Durvalumab) at Improving Outcomes for Small Cell Lung Cancer

Phase 1
Not yet recruiting
Conditions
Extensive Stage Lung Small Cell Carcinoma
Stage IV Lung Cancer AJCC v8
Registration Number
NCT06287775
Lead Sponsor
National Cancer Institute (NCI)
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Not yet recruiting
Sex
All
Target Recruitment
45
Inclusion Criteria

Inclusion Criteria:<br><br> - Patients must have histologically or cytologically confirmed small cell lung cancer<br> (SCLC)<br><br> - Patients must have measurable disease, defined as at least one lesion that can be<br> accurately measured in at least one dimension (longest diameter to be recorded for<br> non-nodal lesions) as = 20 mm (= 2 cm) by chest x-ray or as = 10 mm (= 1 cm) with CT<br> scan, MRI, or calipers by clinical exam or the shortest axis for nodal lesions as =<br> 15 mm (= 1.5 cm) with CT scan<br><br> - Patients who have been treated with platinum etoposide chemotherapy plus either<br> atezolizumab or durvalumab immunotherapy for 4 cycles with either a radiographic<br> response or stable disease<br><br> - Age = 18 years. Because no dosing or adverse event data are currently available on<br> the use of iadademstat in combination with atezolizumab and durvalumab in patients<br> <18 years of age, children are excluded from this study<br><br> - Body weight = 50 kg<br><br> - Patient is able to swallow oral medications<br><br> - Eastern Cooperative Oncology Group (ECOG) performance status = 2 (Karnofsky = 60%).<br> This assessment for eligibility will take place after patients have received 4<br> cycles of standard of care (SOC) chemotherapy-ICI<br><br> - Leukocytes = 2,000/mcL<br><br> - Lymphocyte count = 500/mcL<br><br> - Absolute neutrophil count = 1,500/mcL<br><br> - Hemoglobin = 9 g/dL<br><br> - Platelets = 100,000/mcL<br><br> - Albumin = 3 g/dL<br><br> - Total bilirubin = 1.5 institutional upper limit of normal (ULN)<br><br> - Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT])/<br> alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) = 3 ×<br> institutional ULN unless liver metastases are present, in which case it must be = 5<br> × ULN<br><br> - Glomerular filtration rate (GFR) = 60 mL/min/1.73 m^2 using Chronic Kidney Disease<br> Epidemiology Collaboration (CKD-epi) equation<br><br> - Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral<br> therapy with undetectable viral load within 6 months are eligible for this trial<br><br> - For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV<br> viral load must be undetectable on suppressive therapy, if indicated<br><br> - Patients with a history of hepatitis C virus (HCV) infection must have been treated<br> and cured. For patients with HCV infection who are currently on treatment, they are<br> eligible if they have an undetectable HCV viral load<br><br> - Patients with treated brain metastases are eligible if follow-up brain imaging after<br> central nervous system (CNS)-directed therapy shows no evidence of progression<br><br> - Patients with a prior or concurrent malignancy whose natural history or treatment<br> does not have the potential to interfere with the safety or efficacy assessment of<br> the investigational regimen are eligible for this trial<br><br> - Evidence of post-menopausal status or negative urinary or serum pregnancy test for<br> female pre-menopausal patients. Pregnant women are excluded from this study because<br> atezolizumab and durvalumab are monoclonal antibody agents with the potential for<br> teratogenic or abortifacient effects. Women will be considered post-menopausal if<br> they have been amenorrheic for 12 months without an alternative medical cause. The<br> following age-specific requirements apply:<br><br> - Women < 50 years of age would be considered post-menopausal if they have been<br> amenorrheic for 12 months or more following cessation of exogenous hormonal<br> treatments and if they have luteinizing hormone and follicle-stimulating<br> hormone levels in the post-menopausal range for the institution or underwent<br> surgical sterilization (bilateral oophorectomy or hysterectomy).<br><br> - Women = 50 years of age would be considered post-menopausal if they have been<br> amenorrheic for 12 months or more following cessation of all exogenous hormonal<br> treatments, had radiation-induced menopause with last menses >1 year ago, had<br> chemotherapy-induced menopause with last menses > 1 year ago, or underwent<br> surgical sterilization (bilateral oophorectomy, bilateral salpingectomy or<br> hysterectomy)<br><br> - The effects of iadademstat, atezolizumab, and durvalumab on the developing human<br> fetus are unknown. For this reason and because monoclonal antibody agents are known<br> to be teratogenic, women of child-bearing potential and males with females of<br> child-bearing potential must agree to use adequate contraception (hormonal or<br> barrier method of birth control; abstinence) prior to study entry, for the duration<br> of study participation, and for 150 days after the last dose of study medication.<br> Should a woman become pregnant or suspect she is pregnant while she or her partner<br> is participating in this study, she should inform her treating physician<br> immediately.<br><br> - Females of childbearing potential must agree to:<br><br> - Use effective contraception during the trial and 150 days after the end of<br> treatment.<br><br> - Practice true abstinence during the trial and 150 days after the end of<br> treatment.<br><br> - Have a negative urine pregnancy test at screening.<br><br> - Not to donate or freeze egg(s) during the course of this study or within<br> 150 days after receiving their last dose of study drug.<br><br> - Male patients even if surgically sterilized (i.e., status post-vasectomy) must<br> agree to:<br><br> - Use effective contraception during the entire study treatment period and<br> through 150 days after the last dose of study drug.<br><br> - Not to donate or freeze sperm during the course of this study or within<br> 150 days after receiving their last dose of study drug.<br><br> - Because there is an unknown but potential risk for adverse events in nursing infants<br> secondary to treatment of the mother with atezolizumab and durvalumab, female<br> participants who are breastfeeding must agree to discontinue breastfeeding. These<br> potential risks may also apply to iadademstat<br><br> - Ability to understand and the willingness to sign a written informed consent<br> document. Legally authorized representatives may sign and give informed consent on<br> behalf of study participants<br><br>Exclusion Criteria:<br><br> - Patients medicated with anti-depressants reported to have KDM1A/LSD1 inhibitory<br> activity: Tranylcypromine or phenelzine<br><br> - Patients who have not recovered from grade =2 adverse events (AEs) due to prior<br> anti-cancer therapy with the exception of alopecia, vitiligo, and the laboratory<br> values defined in the inclusion criteria.<br><br> - Patients with grade = 2 neuropathy will be evaluated on a case-by-case basis<br> after consultation with the study physician<br><br> - Patients who are receiving any other investigational agents or any other agent<br> administered for the treatment of the patient's cancer within four half-lives or 4<br> weeks prior to cycle 1, day 1, whichever is shorter<br><br> - Treatment with systemic immunostimulatory agents (including, but not limited to,<br> interferon [IFN]-a or interleukin [IL]-2) within 4 weeks or five half-lives of the<br> drug (whichever is longer) prior to cycle 1, day 1<b

Exclusion Criteria

Not provided

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Progression free survival
Secondary Outcome Measures
NameTimeMethod
Objective response rate;Overall survival;Incidence of adverse events
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