This study is looking at a treatment for certain types of advanced solid tumors, which are cancers that have spread or come back after previous treatment. The study focuses on tumors that have specific changes in genes involved in a process called chromatin remodeling, which affects how cells control their growth. These gene changes include problems in SMARCB1, SMARCA4, SMARCA2, SMARCC1, SMARCC2, ARID1A, ARID1B, PBRM1, BAP1, and other related genes. The study also includes patients with clear cell endometrial cancer or clear cell ovarian cancer that do not have these specific gene changes. The treatment being tested is called valemetostat tosylate, which is also known by its code name DS-3201b. This medicine works by blocking two proteins called EZH1 and EZH2, which play a role in controlling how genes are turned on and off in cancer cells. The medicine comes as a film-coated tablet that is taken by mouth.
The purpose of this study is to see how well valemetostat works in shrinking or controlling these specific types of tumors and to check how safe it is for patients. The study will measure how many patients respond to the treatment, which means their tumors get smaller or disappear. The study will also look at how long the response lasts, how long patients live without their cancer getting worse, overall survival, and any side effects that occur. Patients will be divided into different groups based on which gene change their tumor has or what type of cancer they have, such as clear cell kidney cancer, mesothelioma (a cancer that affects the lining of organs), or other types of solid tumors with these specific gene changes.
During the study, patients will take valemetostat tablets for up to 24 weeks, and possibly longer depending on how well the treatment works. Patients will have regular visits where doctors will check the size of their tumors using imaging scans and monitor their health through blood tests and physical examinations. The study will also collect tumor tissue samples to confirm the presence of the gene changes and to study how the treatment affects the cancer cells. Patients will be asked to complete questionnaires about their quality of life and any symptoms they experience. Some patients may also be asked to wear a device that tracks physical activity and other health measurements, and to participate in interviews about their experience with the treatment.



France