Nanatinostat + Valganciclovir/Pembrolizumab for Nasopharyngeal Cancer

No longer recruiting at 25 trial locations
AK
Overseen ByAfton Katkov, MSc
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new treatment for EBV-positive nasopharyngeal carcinoma, a cancer affecting the area behind the nose and above the back of the throat. Researchers combine two drugs, nanatinostat (a potential new drug) and valganciclovir, to evaluate their effectiveness and safety. They also add a third drug, pembrolizumab, to assess whether it improves outcomes. Suitable candidates for this trial have recurrent or metastatic EBV-positive nasopharyngeal carcinoma and have previously tried at least one chemotherapy regimen without success. As a Phase 1 trial, this research aims to understand how the treatment works in people, offering participants the opportunity to be among the first to receive this potential new drug.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop your current medications, but you cannot have had anti-tumor treatments like chemotherapy or immunotherapy within 4 weeks before starting the trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that patients generally tolerate the combination of nanatinostat and valganciclovir well. In various studies, patients received higher doses than those used for conditions like lymphoma and tolerated them effectively. Some patients even demonstrated signs of tumor reduction, which is promising.

When researchers added pembrolizumab, the treatment remained safe, and some patients experienced partial improvements. This is encouraging, as it suggests the treatment could be effective without additional safety concerns.

As this is a Phase 1 trial, the primary goal is to assess the treatment's safety and manageability. Early results are positive, but monitoring for side effects remains crucial as more data is collected.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of Nanatinostat, Valganciclovir, and Pembrolizumab for nasopharyngeal cancer because it offers a multi-faceted approach to treatment. Unlike traditional options that often focus on chemotherapy or radiation, Nanatinostat works by inhibiting specific enzymes that control cancer cell growth, potentially making it more targeted. Valganciclovir adds an antiviral angle, which is unique because certain viral infections are linked to nasopharyngeal cancer. Finally, Pembrolizumab, an immunotherapy drug, empowers the immune system to recognize and attack cancer cells, offering a promising new angle to enhance treatment effectiveness. This combination could improve outcomes by addressing the cancer from multiple biological pathways.

What evidence suggests that this trial's treatments could be effective for nasopharyngeal cancer?

Research has shown that combining nanatinostat and valganciclovir, one of the treatment arms in this trial, may effectively treat cancers linked to the Epstein-Barr virus (EBV). In studies, this combination reduced or eliminated cancer in up to 58% of patients, with about one-third having no detectable cancer afterward. Another treatment arm in this trial adds pembrolizumab, which boosts the immune system, to the nanatinostat and valganciclovir combination. Early results suggest that this triple treatment could be a stronger option for patients with hard-to-treat cancers like nasopharyngeal carcinoma.13456

Who Is on the Research Team?

DP

Darrel P Cohen, MD, PhD

Principal Investigator

Viracta Therapeutics

Are You a Good Fit for This Trial?

This trial is for adults with advanced EBV+ solid tumors, including nasopharyngeal carcinoma, who've tried at least one platinum-based chemotherapy but no more than three treatments. They must have measurable disease and be in good physical condition (ECOG 0 or 1), with proper bone marrow and liver function.

Inclusion Criteria

Measurable disease per RECIST v1.1
I have an advanced cancer linked to EBV with no cure.
I am fully active or can carry out light work.
See 2 more

Exclusion Criteria

I cannot take pills or have a condition that affects how my body absorbs medication.
I have an autoimmune disease treated with strong medication.
I have an active brain or spinal cord disease.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase 1b Dose Escalation

Nanatinostat dose escalation starting at 20 mg orally daily, 4 days per week, and valganciclovir starting at 900 mg orally daily to evaluate safety and determine the recommended Phase 2 dose

4 weeks
Weekly visits for dose escalation monitoring

Phase 1b Cohort

Patients with other EBV+ solid tumors receive nanatinostat in combination with valganciclovir at the RP2D

Approximately 28 days
Visits every 2 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Nanatinostat
  • Pembrolizumab
  • Valganciclovir
Trial Overview The study tests nanatinostat combined with valganciclovir for EBV+ solid tumors, and adds pembrolizumab for recurrent/metastatic nasopharyngeal carcinoma. It aims to assess the safety and effectiveness of these combinations.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Nanatinostat in combination with valganciclovir and pembrolizumabExperimental Treatment3 Interventions
Group II: Nanatinostat in combination with valganciclovirExperimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Viracta Therapeutics, Inc.

Lead Sponsor

Trials
4
Recruited
200+

Citations

Nanatinostat Plus Valganciclovir in Advanced EBV+ Solid ...This is an open-label, multicenter Phase 1b/2 study evaluating nanatinostat in combination with valganciclovir alone and in combination with pembrolizumab.
Viracta Therapeutics Announces Positive Topline Nana-val ...In the Nana-val arm, the overall response rate (ORR) was 50% and the complete response rate (CRR) was 20% in the intent-to-treat (ITT) ...
Targeted therapy with nanatinostat and valganciclovir in ...The ORR was 40% in 43 evaluable patients (complete response rate [CRR], 19% [n = 8]) with a median duration of response of 10.4 months. For angioimmunoblastic T ...
NantKwest Announces Updated Clinical Results for ...The combination therapy produced an objective response rate (ORR) of 58%, a complete response rate (CR) of 33% and a disease stabilization rate ...
A phase 1b/2 study of nanatinostat and valganciclovir in ...This phase 1b/2, open-label, multicenter study will evaluate the safety, tolerability, pharmacokinetics, and preliminary activity of Nstat + VGCV in patients ...
354O A phase Ib/II study of nanatinostat (Nstat) plus ...The combination of Nstat and VGCV represents a novel approach for the treatment of R/M EBV+ NPC that is tolerated at doses exceeding the RP2D for lymphoma.
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