A Multicenter Phase Ib/II Study to Evaluate the Safety, Efficacy and Pharmacokinetics of NBM-BMX in Patients With Metastatic Uveal Melanoma
This study is being done to find the best dose of an investigational drug called NBM-BMX for people with metastatic uveal melanoma, a type of eye cancer that has spread to other parts of the body. The study will help doctors learn about the side effects of NBM-BMX, how the drug is processed in the body, and whether it may slow down or shrink tumors. Participants will take NBM-BMX as a capsule by mouth twice daily on an empty stomach with at least six ounces (180 mL) of water. No food or drink (other than water) should be consumed for at least two hours after each dose. Participants will visit the clinic about once every week or two for exams and blood tests while taking NBM-BMX. After stopping treatment, a follow-up visit will occur about 30 days later. Treatment may continue as long as the cancer does not get worse and side effects remain manageable.
∙ \- Patients must meet the following criteria to be eligible for study entry:
• Signed, written IRB-approved informed consent.
• Men and women age ≥ 18 years
• ECOG Performance status ≤ 2
• Have measurable disease based on RECIST 1.1
• Histologic or cytologic confirmation of metastatic uveal melanoma
• Previous Therapy
‣ Surgery: Previous surgery is permitted provided that a minimum of 28 days (4 weeks) has elapsed between any major surgery and date of registration, and that wound healing has occurred.
⁃ Cytotoxic Chemotherapy: There is no limit to the number of prior regimens received.
⁃ Other Systemic Therapy: There is no limit to the number of prior therapies received for metastatic uveal melanoma. Prior treatment with tebentafusp is required for HLA-A\*02:01-positive patients unless unavailable or clinically inappropriate, as determined by the investigator. Prior HDAC inhibitor treatment is not permitted.
• Patients must have recovered (to baseline or ≤ grade 1) from all reversible toxicity related to prior chemotherapy or systemic therapy and have adequate washout as follows:
• Longest of one of the following:
⁃ Two weeks,
⁃ 5 half-lives for investigational agents,
‣ o For anti-cancer therapies with half-lives \> 8 days, a washout period of at least 28 days will be acceptable,
⁃ Standard cycle length of standard therapies.
• QTcF \<= 480 msec
• Adequate hematopoietic capacity, as defined by the following:
‣ Hemoglobin ≥ 9.0 g/dL and not transfusion dependent
⁃ Platelets ≥ 100,000/mm3
⁃ Absolute neutrophil count ≥ 1,500 cells/mm3
• Adequate hepatic function, as defined by the following:
‣ AST and ALT ≤ 2.5 times upper limit of normal (ULN) or ≤ 5 times ULN if liver metastases are present
⁃ Total bilirubin ≤ 1.5 x ULN or within 3x the ULN for patients with Gilbert disease
⁃ Albumin ≥ 3.0 g/dL
⁃ Adequate renal function, as defined by the following:
⁃ \- Renal: calculated creatinine clearance \>45 mL/min for patients between 18 and 70 years old with abnormal, increased, creatinine levels (Cockcroft-Gault formula; Appendix F). For patients who are greater than 70 years old, investigator judgment may be used to assess the renal risk of study participation.
⁃ Women/men of childbearing potential must have agreed to use two effective contraceptive methods while on study and for 6 months after the last dose of NBM-BMX.
⁃ Willingness and ability to comply with the study scheduled visits, treatment plans, laboratory tests and other procedures.