Testing Entinostat and ZEN003694 for Advanced Solid Tumors

This study is testing a new combination of two anti-cancer drugs, entinostat and ZEN003694, for people with advanced or refractory (meaning it hasn't responded to other treatments) solid tumors, including pancreatic cancer. Researchers want to find the safest and most effective dose of these drugs when given together. Entinostat works by blocking certain enzymes that help cancer cells grow, and ZEN003694 targets proteins that can also promote tumor growth. The study will look at how well the combination shrinks tumors and how safe it is. You may be able to join if you have an advanced or refractory solid tumor, or locally advanced/metastatic pancreatic cancer that hasn't responded to standard treatments.

Study design
This is an interventional study with a planned enrollment of 49 participants. It is a Phase I/II trial, meaning it first looks at safety and dosage, then at how well the treatment works.
What's involved
Participants will receive entinostat and ZEN003694 by mouth. You will also undergo CT scans and core biopsies.
Compensation
Not stated in the trial record.
Follow-up
The study measures how well the treatment works up to 4 weeks after the intervention.

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NCT05053971

Testing A New Anti-cancer Drug Combination, Entinostat and ZEN003694, for Advanced and Refractory Solid Tumors

Recruiting
PHASE1Ages 18+InterventionalTreatment
National Cancer Institute (NCI)
~49 participants
Updated 2026-07-15 on ClinicalTrials.gov
What's tested:BET Bromodomain Inhibitor ZEN-3694Computed TomographyCore BiopsyEntinostat

At a glance

Recruiting sites
3 of 3 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Maximum tolerated dose (MTD) (Phase Ib)
Measured over Up to 28 days
+2 more outcomes measured
Advanced Malignant Solid Neoplasm
Locally Advanced Pancreatic Carcinoma
Metastatic Pancreatic Carcinoma
Refractory Malignant Solid Neoplasm
Refractory Pancreatic Carcinoma
Stage II Pancreatic Cancer AJCC v8
Stage III Pancreatic Cancer AJCC v8
Stage IV Pancreatic Cancer AJCC v8
Unresectable Pancreatic Carcinoma
3 sites across 3 states
Connecticut1
Florida1
Oklahoma1
  • Patricia M LoRusso · PRINCIPAL_INVESTIGATOR · Yale University Cancer Center LAO

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Eligibility criteria

Inclusion

Patients must have a) advanced or refractory solid tumor and must meet standard requirements for treatment
For patients in Phase 2: Patients must have locally advanced, unresectable OR metastatic pancreatic cancer refractory to standard therapy
For patients with solid tumors, they must have measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria
For patients with solid tumors, they must have received at least one standard of care regimen for metastatic disease
Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of ZEN003694, alone or in combination with entinostat, in patients \< 18 years of age, children are excluded from this study
Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
Hemoglobin \>= 9.0 g/dL (measured within 14 days prior to administration of study treatment)
Absolute neutrophil count (ANC) \>= 1,500/mcL (measured within 14 days prior to administration of study treatment)
Platelets \>= 100,000/mcL (measured within 14 days prior to administration of study treatment)
Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN) (measured within 14 days prior to administration of study treatment)
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase \[SGPT\]) =\< 2.5 x institutional ULN (measured within 14 days prior to administration of study treatment)
Glomerular filtration rate (GFR) \>= 60 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal (measured within 14 days prior to administration of study treatment)
Prothrombin time (PT)/international normalized ratio (INR) and partial thromboplastin time (PTT) test \< 1.5 x ULN (measured within 14 days prior to administration of study treatment)
Albumin \> 2.5 g/dL (measured within 14 days prior to administration of study treatment)
Patients with treated brain metastases are eligible if follow-up brain imaging at least 4 weeks after central nervous system (CNS)-directed therapy shows no evidence of progression
Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
Patients should be New York Heart Association Functional Classification of class 2B or better
Patients must be able to swallow and retain orally administered medication
Women of childbearing potential must have a negative pregnancy test within 7 days of starting treatment
The effects of entinostat and ZEN003694 on the developing human fetus are unknown. For this reason and because histone deacetylase inhibitor (HDACi) and BET inhibitor (BETi) agents are known to be teratogenic, women of child-bearing potential and their male partner must agree to use contraception from the time of the screening pregnancy test, continuing for the duration of study participation, and for 3 months after completing the study treatment
Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity who have a legally-authorized representative (LAR) and/or family member available will also be eligible
Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

Exclusion

Patients who have had any anti-cancer therapy within 30 days (or 5 half-lives, whichever is shorter) prior to the first dose of the investigational products
Patients who have received radiation therapy within 21 days prior to the first dose of the investigational products
Patients who have a diagnosis of NK cell lymphoma
Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> grade 1) with the exception of alopecia, or stable chronic grade 2 toxicities that do not overlap with presumed toxicities of entinostat or ZEN003694
Patients who are receiving any other investigational agents
Patients with known untreated or symptomatic brain or leptomeningeal metastases are excluded. Patients with previously treated CNS metastasis may be included provided that they have stable CNS disease for at least 4 weeks (confirmed by imaging) without symptoms and are off corticosteroids (above physiologic dose) for that indication
Patients with significant malabsorption or nausea and vomiting that would interfere with oral therapies
Patients with bleeding diathesis or clinically significant bleeding within the prior 6 months
History of allergic reactions attributed to compounds of similar chemical or biologic composition to entinostat (e.g. medications that have a benzamide structure (tiapride, remoxipride, clebopride) or ZEN003694
Patients receiving any medications or substances that are strong inhibitors or strong inducers of CYP3A4 or substrates of CYP1A2 with narrow therapeutic windows are ineligible. Strong inhibitors or inducers of CYP3A4 and substrates of CYP1A2 must be discontinued at least 7 days prior to the first dose of ZEN003694. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently updated medical reference. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
Patients with uncontrolled intercurrent illness
Pregnant women are excluded from this study because entinostat is an HDACi and ZEN003694 is a BETi with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with entinostat or ZEN003694, breastfeeding should be discontinued throughout the treatment period and for at least 28 days following the last dose of study treatment if the mother is treated with entinostat or ZEN003694
Patients with any of the following cardiac criteria:
Patients with a corrected QT interval calculated by the Fridericia formula (QTcF) \> 450 msec by electrocardiogram (ECG).
Concomitant use of any agent known to cause corrected QT interval (QTc) prolongation.
Clinically significant conduction abnormalities or arrhythmias.
Presence of a cardiac pacemaker or defibrillator with a paced ventricular rhythm limiting ECG analysis.
History or evidence of current \>= Class II congestive heart failure as defined by New York Heart Association (NYHA).
History of acute coronary syndromes (including unstable angina and myocardial infarction), coronary angioplasty, or stenting within the past 6 months. Subjects with a history of stent placement requiring ongoing antithrombotic therapy (e.g. clopidogrel, prasugrel) will not be permitted to enroll. Clinically significant cardiomegaly, ventricular hypertrophy, or cardiomyopathy
Use of oral Factor Xa inhibitors (i.e., rivaroxaban, apixaban, betrixaban, edoxaban otamixaban, letaxaban, eribaxaban) and Factor IIa inhibitors (i.e., dabigatran). Low molecular weight heparin is allowed
Patients with radiation to \> 25% of the bone marrow
Patients who have had a bone-targeted radionuclide within 6 weeks of the first dose of ZEN003694
Patients who have previously received ZEN003694 or who have been treated with an HDAC inhibitor or investigational BET inhibitor
Major surgery other than diagnostic surgery, dental surgery or stenting within 4 weeks prior to the first dose of ZEN003694
  • Maximum tolerated dose (MTD) (Phase Ib)Up to 28 days

    The MTD is defined as the highest dose level at which \< 33% of the dose cohort (0 of 3 or 1 of 6) experience a dose-limiting toxicity (DLT) in the first cycle. Up to 3 additional patients (maximum enrollment 6) will be added at the MTD level to more fully characterize the safety of the drug combination. If \< 33% (2) patients in this expanded cohort experience a DLT, this will be declared the MTD, and thus the phase 2 dose. If 2 or more patients experience a DLT, this dose level will be adopted as the maximum administered dose (MAD) and drop to the dose level immediately below, for the MTD and the phase 2 dose.

  • Recommended phase 2 dose (RP2D) (Phase Ib)Up to 28 days

    The RP2D is generally defined as =\<1 out of 6 at highest dose level below the maximally administered dose.

  • Objective response rate (ORR) (Phase II)Up to 4 weeks post intervention

    Each patient will be assigned one of the following categories: 1) complete response, 2) partial response, 3) stable disease, 4) progressive disease, 5) early death from malignant disease, 6) early death from toxicity, 7) early death because of other cause, or 9) unknown (not assessable, insufficient data). All of the patients who met the eligibility criteria (with the possible exception of those who received no study medication) should be included in the main analysis of the response rate. Patients in response categories 4-9 should be considered to have a treatment failure (disease progression). Thus, an incorrect treatment schedule or drug administration does not result in exclusion from the analysis of the response rate. Precise definitions for categories 4-9 will be protocol specific.