ClinicalTrials.gg
RecruitingNCT03328078Updated Oct 6, 2026

CA-4948-101: Open-Label, Dose Escalation and Expansion Trial of Emavusertib (CA-4948) in Relapsed or Refractory Primary Central Nervous System Lymphoma (R/R PCNSL)

A Phase 1/2 interventional study of Emavusertib and Ibrutinib in Relapsed Hematologic Malignancy, Refractory Hematologic Malignancy and Relapsed Primary Central Nervous System Lymphoma, sponsored by Curis, Inc.. Recruiting at 45 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-06.

Sponsored by Curis, Inc. · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Started Dec 2017; still recruiting 8 years 10 months later.
Updated Oct 6, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Phase 1/2
Study type
Interventional
Enrollment
152
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a multi-center, open-label study to evaluate the safety, pharmacokinetics (PK), and anti-cancer activity of oral administration of emavusertib alone or in combination with ibrutinib in adult participants with relapsed or refractory (R/R) hematologic malignancies.

This trial will be completed in four parts. In Part A1, emavusertib will be evaluated first in a dose escalating monotherapy setting to establish the safety and tolerability (complete). In Part A2, emavusertib will be evaluated in combination with ibrutinib at 560 milligrams (mg) once daily (QD) or 420 mg QD as indicated by disease (Part A2 complete).

Part B will comprise 2 cohorts to assess safety and efficacy of emavusertib in combination with ibrutinib in participants with R/R primary central nervous system lymphoma (PCNSL) who have directly progressed on a bruton tyrosine kinase inhibitor (BTKi). In this part of the study, emavusertib will be dosed at 100 mg or 200 mg twice daily (BID) in combination with ibrutinib in 28-day treatment cycles.

Part C will comprise 3 treatment arms in the second-line setting to assess the efficacy and safety of emavusertib monotherapy, ibrutinib monotherapy, and emavusertib in combination with ibrutinib in participants with R/R PCNSL who are naïve to BTKi treatment. In this part of the study, eligible second-line participants with R/R PCNSL who are naïve to BTKi treatment will be randomized 1:1:1 to 1 of 3 treatment arms: (1) emavusertib 200 mg BID, (2) ibrutinib 560 mg QD, or (3) emavusertib 200 mg BID in combination with ibrutinib 560 mg QD.

02

Conditions studied

  • Relapsed Hematologic Malignancy
  • Refractory Hematologic Malignancy
  • Relapsed Primary Central Nervous System Lymphoma
  • Refractory Primary Central Nervous System Lymphoma

Keywords

  • MYD88
  • IRAK4
  • NHL
  • PCNSL
  • Lymphoma
  • Neoplasms
  • Lymphoproliferative Disorders
  • Lymphatic Diseases
  • Immunoproliferative Disorders
  • Immune System Diseases
  • Lymphoma, Non-Hodgkin
  • Relapsed/refractory Central Nervous System (CNS) Lymphoma
  • Systemic Lymphoma with Concurrent CNS Lymphoma
  • Systemic Lymphoma with a History of Treated CNS Lymphoma
  • Ibrutinib
  • Bruton tyrosine kinase inhibitor (BTKi)
  • Primary CNS Lymphoma
03

In context

Hematologic Neoplasms

1,444 studies on the registry are indexed under Hematologic Neoplasms; 420 are open to participants now.

This study's planned enrollment of 152 is above the median of 46 across 1,044 interventional studies indexed under Hematologic Neoplasms.

Browse Hematologic Neoplasms studies →

Lead sponsor

Curis, Inc. is the lead sponsor of 13 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Males and females greater than or equal to 18 years of age
  2. of at least 3 months
  3. (ECOG) Performance Status of 0, 1 or 2
  4. Histopathologically confirmed diagnosis of PCNSL (medical record is acceptable). Cerebral are not required if imaging reveals typical images of PCNSL.

    1. Participants with parenchymal lesions must have unequivocal evidence of disease progression (e.g., presence of at least 1 measurable target lesion [≥ 10 millimeters (mm) and ≤ 40 mm in the longest diameter on brain magnetic resonance imaging [MRI] or head computed tomography [CT] on imaging within 28 days prior to Cycle 1 Day 1]). In cases where the tumor size is smaller but still measurable and located at a critical central nervous system (CNS) location, disabling the participant and/or causing symptoms, this participant may be eligible following a discussion with the Sponsor Medical Monitor.
    2. For participants limited to , cerebrospinal fluid (CSF) analysis (cytology and/or flow cytometry) with or without additional imaging (MRI) of the spine as clinically indicated is required to document abnormal cells within 28 days prior to Cycle 1 Day 1.

Exclusion criteria

Exclusion Criteria for Part B and Part C

  1. Participants with only intraocular PCNSL without brain lesion or CSF involvement, T-cell lymphoma, systemic presence of lymphoma, or non-CNS lymphoma to the CNS
  2. Evidence of systemic lymphoma. This must be demonstrated by a positron emission tomography (PET) scan (or CT scan with contrast if applicable) of the chest, abdomen, and pelvis at Screening (testicular ultrasound may be considered to exclude a testicular lymphoma disseminated to the brain).
  3. Prior history of other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) or prior history of systemic lymphoma, unless the participant has been free of the disease for ≥ 3 years.
  4. Active malignancy other than PCNSL requiring systemic therapy
  5. Previous BTKi treatment (Part C only).
  6. History of Grade ≥ 3 rhabdomyolysis without complete recovery
  7. Requirement for urgent therapy due to uncontrolled tumor mass/edema effects.
  8. Received external beam radiation therapy to the CNS within 28 days prior to Cycle 1 Day 1.
  9. Received prior drugs (including treatment in clinical research, unapproved combination products, and new dosage forms) within 28 days or 5 half-lives, whichever is shorter, prior to Cycle 1 Day 1; hematopoietic stem cell transplant (HSCT) within 60 days prior to Cycle 1 Day 1; or had (GVHD) requiring ongoing up-titration of medications prior to Screening (with the exception of a BTKi for Part B only).

    Note: The use of a stable or tapering dose of immunosuppressive therapy post-HSCT and/or topical for ongoing skin GVHD is permitted with Sponsor Medical Monitor approval

  10. Any prior systemic anti-cancer treatment such as chemotherapy, immunomodulatory drug therapy, etc., received within 14 days or 5 half-lives, whichever is shorter, prior to Cycle 1 Day 1 (with the exception of ibrutinib or other BTKi for Part B only, which may be continued until the day before Cycle 1 Day 1)
  11. Prior history of or anaphylaxis to emavusertib, ibrutinib or any of their .
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
152 participants (estimated)

Study arms

  • Experimental
    Emavusertib (CA-4948) dose escalation

    Part A1: Dose-level cohorts with up to approximately 6 participants each will be used to define the Maximum Tolerated Dose (MTD) for emavusertib.

    Drug: Emavusertib

  • Experimental
    Emavusertib (CA-4948) and ibrutinib dose escalation

    Part A2: Evaluate escalating dose levels of oral emavusertib in combination with 560 mg QD or 420 mg QD of oral ibrutinib. The starting dose of emavusertib to be used in combination will be 200 mg BID. It is anticipated that 12 to 20 participants at a potential dose level will be required to establish optimal combination dosing.

    Drug: Emavusertib · Drug: Ibrutinib

  • Experimental
    Emavusertib (CA-4948) and ibrutinib dose expansion

    In two Expansion Cohorts (Part B), emavusertib in combination with ibrutinib will be administered in participants with R/R PCNSL who have progressed on a BTKi. In Cohort 1, emavusertib 100 mg BID will be administered with ibrutinib 560 mg QD consecutively in 28-day treatment cycles. In Cohort 2, emavusertib 200 mg BID will be administered with ibrutinib 560 mg QD consecutively in 28-day treatment cycles.

    Drug: Emavusertib · Drug: Ibrutinib

  • Experimental
    Emavusertib (CA-4948) and ibrutinib

    In this part of the study (Part C), eligible second-line participants with R/R PCNSL who are naïve to BTKi treatment will receive 1 of 3 treatment arms: (1) emavusertib 200 mg BID, (2) ibrutinib 560 mg QD, or (3) emavusertib 200 mg BID in combination with ibrutinib 560 mg QD. Treatments will be administered continuously in 28-day treatment cycles.

    Drug: Emavusertib · Drug: Ibrutinib

Interventions

  • Emavusertib will be provided as a tablet dosage form to be taken BID.

    Also known as: CA-4948

  • Ibrutinib will be provided as a tablet or capsule dosage form to be taken QD.

06

What researchers measure

Primary outcomes

  1. Part A: To determine the safety and tolerability of emavusertib as a monotherapy and in combination with ibrutinib: dose-limiting toxicity (DLT)

    The number of participants with a dose-limiting toxicity (DLT) in the first treatment cycle

    Time frame: 12 months

  2. Part A: Maximum tolerated dose (MTD) of emavusertib as a monotherapy and in combination with ibrutinib measured by dose-limiting toxicities (DLTs)

    MTD determined by the highest dose level studied at which fewer than 2 out of 6 subjects (\<33%) experience a dose limiting toxicity.

    Time frame: 12 months

  3. Part A: Recommended Phase 2 Dose (RP2D) of emavusertib as a monotherapy and in combination with ibrutinib based on overall tolerability data

    RP2D selected based on overall tolerability data from all participants treated at different dose levels and will not exceed the MTD.

    Time frame: 12 months

  4. Part B: Overall Response Rate (ORR) in participants with R/R PCNSL

    Time frame: 18 months

  5. Part C: ORR in participants with R/R PCNSL

    Time frame: 18 months

Secondary outcomes

  1. Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by AUC

    Area Under the concentration-time curve (AUC)

    Time frame: 24- 66 months

  2. Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Cmax

    Maximum plasma concentration (Cmax)

    Time frame: 24- 66 months

  3. Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Cmin

    Minimum plasma concentration (Cmin)

    Time frame: 24- 66 months

  4. Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by Tmax

    Time to maximum plasma concentration (Tmax)

    Time frame: 24- 66 months

  5. Parts A, B and C: Pharmacokinetic (PK) profile of emavusertib and ibrutinib measured by plasma terminal half-life

    Plasma terminal elimination half-life (T 1/2)

    Time frame: 24- 66 months

  6. Part A: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib measured by ORR

    Assessed by ORR

    Time frame: 24- 36 months

  7. Parts A, B and C: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib and ibrutinib as monotherapy measured by duration of response (DOR)

    Assessed by DOR

    Time frame: 24- 66 months

  8. Part A: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib measured by disease control rate (DCR)

    Assessed by DCR

    Time frame: 24- 36 months

  9. Parts A, B and C: To assess efficacy of emavusertib as a monotherapy and in combination with ibrutinib and ibrutinib as monotherapy measured by progression free survival (PFS)

    Assessed by PFS

    Time frame: 24- 66 months

  10. Parts A, B and C: To assess efficacy of emavusertib as a monotherapy, in combination with ibrutinib and ibrutinib as monotherapy measured by overall survival (OS)

    Assessed by OS

    Time frame: 24 - 66 months

  11. Parts B and C: To assess the safety and tolerability of emavusertib as monotherapy, ibrutinib as monotherapy and emavusertib in combination with ibrutinib in participants with R/R PCNSL

    Measured by the number of participants with treatment-emergent adverse events (TEAEs) and treatment-related adverse events

    Time frame: up to 66 months

07

Study locations

35 of 45 sites recruiting
08

Updates

1 registry update since Sep 25, 2026
Primary completion
Aug 2026→Jul 2027
Oct 6, 2026
Study completion
Oct 2026→Oct 2027
Oct 6, 2026
Show all 1 update
  1. Oct 6, 2026
    Primary completion Aug 2026→Jul 2027
    Study completion Oct 2026→Oct 2027
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT03328078
Lead sponsor
Curis, Inc.
Responsible party
Sponsor
First posted
Nov 1, 2017
Start date
Dec 28, 2017
Primary completion
Jul 2027 (estimated)
Completion
Oct 2027 (estimated)
Last update
Oct 6, 2026

Study contacts

Ahmed Hamdy, MD
Contact
clinicaltrials@curis.com
617-503-6500

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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