A Study of AZD0486 Monotherapy or in Combination With Other Anti-Cancer Agents for Mature B-Cell Malignancies

Purpose

The purpose of this study is to assess the safety and efficacy of AZD0486 administered as monotherapy or in combination with other anticancer agents in participants with hematological malignancies.

Conditions

  • Chronic Lymphocytic Leukaemia
  • Small Lymphocytic Lymphoma
  • Mantle-cell Lymphoma
  • Large B-cell Lymphoma
  • B-cell Non-Hodgkin Lymphoma

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

Master Inclusion Criteria applicable to all substudies: - Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. - Contraception use during treatment and at least 90 days after final dose. - Confirmed CD19 expression if prior anti-CD19 therapy. Substudy 1 Specific Inclusion Criteria: - Participants with CLL must require treatment according to the international workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria. - SLL: at least 1 measurable site per Lugano. - Absolute lymphocytes <10,000. - Cohort 1A and 1C: at least 2 prior lines of systemic therapy for CLL/SLL. - Cohort 1B: at least 1 prior line of therapy and is bruton tyrosine kinase inhibitor (BTKi)-sensitive. Substudy 2 Specific Inclusion Criteria: - MCL diagnosis per WHO. - Clinical Stage II, III, or IV by Ann Arbor Classification. - At least 1 measurable site per Lugano. - ALC < 10,000. - Cohort 2A and 2C: Relapse or progressed after 2 or more lines of therapy including BTKi. Substudy 3 Specific Inclusion Criteria: - Large B-cell lymphoma per WHO 2022. - R/R B-NHL after at least 1 prior line of therapy. - International Prognostic Index (IPI) 2-5. - At least 1 measurable site as per Lugano. - Left ventricular ejection fraction (LVEF) >50%. - Contraception at least 90 days after last dose of AZD0486 or 4 months after last dose of vincristine, and 6 months after the last dose of cyclophosphamide, or doxorubicin.

Exclusion Criteria

Master Exclusion Criteria applicable to all substudies: - Central nervous system (CNS) lymphoma. - Surgery within 14 days of study drug. - Clinically significant cardiovascular (CV) disease. - Unresolved Grade >2 AEs from prior anticancer therapy (except alopecia or fatigue). - Any anticancer therapy within 5 half-lives or 21 days (whichever is shorter) prior to treatment. - Radiation therapy within 28 days. - Prior CAR T-cell therapy or autologous-haematopoietic stem cell transplant (HSCT) within 12 weeks or prior T-cell engager (TCE) within 8 weeks. - Prior Grade > 3 cytokine release syndrome (CRS) or immune effector cell-associated neurotoxicity syndrome (ICANS) event. - Prior allogeneic HSCT or solid organ transplantation within 24 weeks of starting Cycle 1 Day 1. Substudy 1 Specific Exclusion Criteria: - CLL transformation to more aggressive lymphoma. - Cohort 1B: bleeding diathesis, CYP3A inhibitor or inducer, history of ICH or stroke within 24 weeks, GI malabsorption, receiving vitamin K antagonist. Substudy 3 Specific Exclusion Criteria: - Mediastinal grey-zone lymphoma, Burkitt, Richter's transformation, primary effusion large B-cell lymphoma (LBCL). - Cumulative dose of anthracycline >150 mg/m2.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Sequential Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Substudy 1 (RR CLL/SLL): Cohort 1A (AZD0486 Monotherapy)
Participants will receive AZD0486 monotherapy as subcutaneous (SC) injection.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
Experimental
Substudy 1 (RR CLL/SLL): Cohort 1B (AZD0486 + Acalabrutinib)
Participants will receive AZD0486 as SC injection. Participants will receive acalabrutinib tablet orally twice daily.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
  • Drug: Acalabrutinib
    Acalabrutinib will be administered orally
Experimental
Substudy 1 (RR CLL/SLL): Cohort 1C (AZD0486 Monotherapy)
Participants will receive AZD0486 monotherapy as intravenous (IV) infusion.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
Experimental
Substudy 2 (RR MCL): Cohort 2A (AZD0486 Monotherapy)
Participants will receive AZD0486 monotherapy as SC injection.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
Experimental
Substudy 2 (RR MCL): Cohort 2C (AZD0486 Monotherapy)
Participants will receive AZD0486 monotherapy as IV infusion.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
Experimental
Substudy 3 (LBCL): AZD0486 + R-CHOP
Participants will receive AZD0486 as IV infusion in combination with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy.
  • Drug: AZD0486
    AZD0486 will be administered as either SC injection or IV infusion.
    Other names:
    • TNB-486
    • Surovatamig
  • Drug: Prednisone (or equivalent)
    Prednisone (or equivalent) will be administered either oral or IV infusion as per standard of care.
  • Drug: Rituximab
    Rituximab will be administered as IV infusion as per standard of care.
  • Drug: Cyclophosphamide
    Cyclophosphamide will be administered as IV infusion as per standard of care.
  • Drug: Vincristine
    Vincristine will be administered as IV infusion as per standard of care.
  • Drug: Doxorubicin
    Doxorubicin will be administered as IV infusion as per standard of care.

Recruiting Locations

Research Site
Boston 4930956, Massachusetts 6254926 02215

Research Site
New Brunswick 5101717, New Jersey 5101760 08901

Research Site
New York 5128581, New York 5128638 10029

Research Site
Charlotte 4460243, North Carolina 4482348 28204

Research Site
Portland 5746545, Oregon 5744337 97239

Research Site
Philadelphia 4560349, Pennsylvania 6254927 19104

Research Site
Providence 5224151, Rhode Island 5224323 02903

More Details

Status
Recruiting
Sponsor
AstraZeneca

Study Contact

AstraZeneca Clinical Study Information Center
1-877-240-9479
information.center@astrazeneca.com

Detailed Description

This is open-label, multi-center study to evaluate the safety and preliminary efficacy of AZD0486 administered as monotherapy and in combination with other anticancer agents in participants with mature B-cell hematologic malignancies. This master study currently includes 3 substudies and each substudy focusing on a defined population: Substudy 1: Relapsed/refractory (R/R) Chronic lymphocytic leukaemia (CLL)/ Small lymphocytic lymphoma (SLL) Substudy 2: R/R Mantle-cell lymphoma (MCL) Substudy 3: Large B-cell lymphoma (LBCL) or R/R B-cell non-Hodgkin lymphoma (B-NHL) (not applicable to US) The study will have the following sequential periods: 1. Screening period of 28 days 2. Treatment period 3. Follow-up period