A Phase 2 interventional study of Tazemetostat in Advanced Malignant Solid Neoplasm, Ann Arbor Stage III Hodgkin Lymphoma and Ann Arbor Stage III Non-Hodgkin Lymphoma, sponsored by National Cancer Institute (NCI). Completed at 117 sites in 2 countries. Open to participants aged 12 Months to 21 Years. Per ClinicalTrials.gov, last updated 2026-04-13.
Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment
This phase II Pediatric MATCH trial studies how well tazemetostat works in treating patients with brain tumors, solid tumors, non-Hodgkin lymphoma, or histiocytic disorders that have come back (relapsed) or do not respond to treatment (refractory) and have EZH2, SMARCB1, or SMARCA4 gene mutations. Tazemetostat may stop the growth of tumor cells by blocking EZH2 and its relation to some of the pathways needed for cell proliferation.
PRIMARY OBJECTIVE:
I. To determine the objective response rate (ORR; complete response + partial response) in pediatric patients treated with tazemetostat with advanced solid tumors (including central nervous system [CNS] tumors), non-Hodgkin lymphoma or histiocytic disorders that harbor gain of function mutations in EZH2, or loss of function mutations in the SWI/SNF complex subunits SMARCB1 or SMARCA4 at a dose of 520 mg/m\^2/dose twice daily for patients without any CNS involvement or 1200 mg/m\^2/dose orally twice daily for patients with CNS involvement.
SECONDARY OBJECTIVES:
I. To estimate the progression-free survival in pediatric patients treated with tazemetostat that harbor gain of function mutations in EZH2, or loss of function mutations in the SWI/SNF complex subunits SMARCB1 or SMARCA4.
II. To obtain information about the tolerability of tazemetostat in children with relapsed or refractory cancer.
EXPLORATORY OBJECTIVES:
I. To evaluate other biomarkers as predictors of response to tazemetostat and specifically, whether tumors that harbor different missense mutations or fusions will demonstrate differential response to tazemetostat treatment.
II. To explore approaches to profiling changes in tumor genomics over time through evaluation of circulating tumor deoxyribonucleic acid (DNA).
OUTLINE:
Patients receive tazemetostat orally (PO) twice daily (BID) on days 1-28. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up periodically.
Patients must have radiographically measurable disease at the time of study enrollment; patients with neuroblastoma who do not have measurable disease but have MIBG+ evaluable disease are eligible; measurable disease in patients with CNS involvement is defined as tumor that is measurable in two perpendicular diameters on magnetic resonance imaging (MRI) and visible on more than one slice; Note: The following do not qualify as measurable disease:
Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment; if after the required timeframe, the numerical eligibility criteria are met, e.g. blood count criteria, the patient is considered to have recovered adequately
Cytotoxic chemotherapy or other anti-cancer agents known to be myelosuppressive
Stem cell Infusions (with or without total body irradiation [TBI]):
For patients with solid tumors without known bone marrow involvement:
Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m\^2 or a serum creatinine based on age/gender as follows:
Exclusion Criteria:
Patients receive tazemetostat PO BID on days 1-28. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity.
Drug: Tazemetostat
Given PO
Also known as: E 7438, E-7438, E7438, EPZ 6438, EPZ-6438, EPZ6438
Objective Response Rate (ORR)
ORR will be defined as complete response + partial response and assessed by Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Will be calculated as the percent of evaluable patients who are responders, and confidence intervals will be constructed using the Wilson score interval method.
Time frame: From enrollment to the end of treatment, up to 2 years
Progression-free Survival (PFS)
Progression free survival will be defined as time from the initiation of protocol treatment to the occurrence of any of the following events: disease progression or disease recurrence or death from any cause. PFS along with the confidence intervals will be estimated using the Kaplan-Meier method.
Time frame: Up to 6 months from study entry
Percentage of Patients Experiencing Grade 3 or 4 Adverse Events
Will be graded according to Common Terminology Criteria for Adverse Events version 5.0. Any eligible patient who receives at least one dose of protocol therapy will be considered in the evaluation of toxicity. A patient will be counted only once for a given toxicity for the worst grade of that toxicity reported for that patient.
Time frame: From initiation of treatment to disease progression, disease recurrence, or death from any cause assessed up to 2 years
Biomarker Predictors of Response to Tazemetostat
Will evaluate other biomarkers as predictors of response to tazemetostat and specifically, whether tumors that harbor different missense mutations or fusions will demonstrate differential response to tazemetostat treatment. Will be performed and will be summarized with simple summary statistics and will be descriptive in nature.
Time frame: Up to 2 years
Change in Tumor Genomics
To explore approaches to profiling changes in tumor genomics over time through evaluation of circulating tumor deoxyribonucleic acid. Will be performed and will be summarized with simple summary statistics and will be descriptive in nature.
Time frame: Up to 2 years
| Milestone | Treatment (Tazemetostat) |
|---|---|
| Started | 20 |
| Completed | 1 |
| Not completed | 19 |
| Withdrew: Adverse event | 1 |
| Withdrew: Physician decision | 2 |
| Withdrew: Withdrawal by subject | 3 |
| Withdrew: Progressive disease | 13 |
ORR will be defined as complete response + partial response and assessed by Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Will be calculated as the percent of evaluable patients who are responders, and confidence intervals will be constructed using the Wilson score interval method.
| Percentage of participants | Treatment (Tazemetostat) |
|---|---|
| Objective Response Rate (ORR) | 5 (1 to 20) |
Progression free survival will be defined as time from the initiation of protocol treatment to the occurrence of any of the following events: disease progression or disease recurrence or death from any cause. PFS along with the confidence intervals will be estimated using the Kaplan-Meier method.
| percentage of participants | Treatment (Tazemetostat) |
|---|---|
| Progression-free Survival (PFS) | 35 (15.7 to 55.2) |
Will be graded according to Common Terminology Criteria for Adverse Events version 5.0. Any eligible patient who receives at least one dose of protocol therapy will be considered in the evaluation of toxicity. A patient will be counted only once for a given toxicity for the worst grade of that toxicity reported for that patient.
| percentage of participants | Treatment (Tazemetostat) |
|---|---|
| Percentage of Patients Experiencing Grade 3 or 4 Adverse Events | 75 (50.9 to 91.3) |
Will evaluate other biomarkers as predictors of response to tazemetostat and specifically, whether tumors that harbor different missense mutations or fusions will demonstrate differential response to tazemetostat treatment. Will be performed and will be summarized with simple summary statistics and will be descriptive in nature.
Results for this outcome have not been posted.
To explore approaches to profiling changes in tumor genomics over time through evaluation of circulating tumor deoxyribonucleic acid. Will be performed and will be summarized with simple summary statistics and will be descriptive in nature.
Results for this outcome have not been posted.
Collected over From enrollment to 30 days after the end of treatment, up to 2 years. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Treatment (Tazemetostat) | 7/20 (35%) | 12/20 (60%) | 16/20 (80%) |
| Event | Treatment (Tazemetostat) |
|---|---|
| Disease progressionGeneral disorders | 6/20 |
| Lung infectionInfections and infestations | 2/20 |
| HydrocephalusNervous system disorders | 2/20 |
| HypoxiaRespiratory, thoracic and mediastinal disorders | 2/20 |
| Respiratory failureRespiratory, thoracic and mediastinal disorders | 2/20 |
| Abdominal painGastrointestinal disorders | 1/20 |
| FeverGeneral disorders | 1/20 |
| Urinary tract infectionInfections and infestations | 1/20 |
| Wound dehiscenceInjury, poisoning and procedural complications | 1/20 |
| DehydrationMetabolism and nutrition disorders | 1/20 |
| Event | Treatment (Tazemetostat) |
|---|---|
| FatigueGeneral disorders | 10/20 |
| AnemiaBlood and lymphatic system disorders | 9/20 |
| VomitingGastrointestinal disorders | 9/20 |
| Lymphocyte count decreasedInvestigations | 8/20 |
| HyperglycemiaMetabolism and nutrition disorders | 8/20 |
| NauseaGastrointestinal disorders | 7/20 |
| White blood cell decreasedInvestigations | 7/20 |
| HypocalcemiaMetabolism and nutrition disorders | 7/20 |
| Abdominal painGastrointestinal disorders | 6/20 |
| Platelet count decreasedInvestigations | 6/20 |
| Age, Categorical(Participants) | Treatment (Tazemetostat) |
|---|---|
| <=18 years | 18 |
| Between 18 and 65 years | 2 |
| >=65 years | 0 |
| Age, Continuous(years) | Treatment (Tazemetostat) |
|---|---|
| Mean | 8.9 ± 7.2 |
| Sex: Female, Male(Participants) | Treatment (Tazemetostat) |
|---|---|
| Female | 7 |
| Male | 13 |
| Ethnicity (NIH/OMB)(Participants) | Treatment (Tazemetostat) |
|---|---|
| Hispanic or Latino | 3 |
| Not Hispanic or Latino | 16 |
| Unknown or Not Reported | 1 |
| Race (NIH/OMB)(Participants) | Treatment (Tazemetostat) |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 1 |
| Black or African American | 3 |
| White | 16 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(participants) | Treatment (Tazemetostat) |
|---|---|
| United States | 20 |
Showing the first 100 of 117 sites across 2 countries.
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Neuroectodermal Tumors, Primitive, Peripheral→
National Cancer Institute (NCI)