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Tipifarnib in Treating Patients With Myelofibrosis and Myeloid Metaplasia

Primary Purpose

Essential Thrombocythemia, Polycythemia Vera, Primary Myelofibrosis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
tipifarnib
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Essential Thrombocythemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histopathologic confirmation (on bone marrow trephine and aspirate) of myelofibrosis with myeloid metaplasia by a pathologist/hematologist at the registering institution; included in the diagnosis of MMM are AMM (agnogenic myeloid metaplasia), PPMM (post-polycythemic myeloid metaplasia), and PTMM (post-thrombocythemic myeloid metaplasia); the bone marrow should show the presence of reticulin fibrosis, and the peripheral blood smear should show the presence of leukoerythroblastosis and dacrocytosis Bone marrow showing no evidence of other conditions associated with myelofibrosis, such as metastatic carcinoma, lymphoma, myelodysplasia, hairy cell leukemia, mast cell disease, acute leukemia (including M7 type), or acute myelofibrosis Bone marrow chromosome analysis or peripheral blood or bone marrow Fluorescent In Situ Hybridization (FISH) showing absence of chromosomal translocation t(9:22); prior demonstration is sufficient for enrollment purposes At least one of the following: Anemia evidenced by hemoglobin < 10 g/dL Palpable hepato-splenomegaly ANC ≥ 750/mm^3 PLT ≥ 100,000/mm^3 Total bilirubin (direct if total elevated) ≤ UNL Alkaline phosphatase =< 3 x UNL (unless felt to be secondary to disease) AST ≤ 2.5 x UNL Creatinine =< 1.5 x UNL Ability to understand and the willingness to sign a written informed consent document Willingness to follow the schedule for returning to the registering P2C institution (monthly) while receiving protocol treatment ECOG performance status 0, 1, or 2 Exclusion Criteria: Any of the following as this regimen may be harmful to a developing fetus or nursing child: Pregnant women Breastfeeding women Men or women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device [IUD], surgical sterilization, subcutaneous implants, or abstinence, etc.) NOTE: The effects of the agent(s) on the developing human fetus at the recommended therapeutic dose are unknown Use of cytotoxic chemotherapy or other myelosuppressive agents within =< 2 weeks prior to study entry Uncontrolled intercurrent illness or any co-morbid condition that would limit compliance with study requirements or with which the use of R115777 is felt to be potentially harmful; such conditions include, but are not limited to: Ongoing or active infection Symptomatic congestive heart failure Unstable angina pectoris Cardiac arrhythmia, or Psychiatric illness/social situations Other concurrent therapy directed at the disease (including Thalidomide) or use of erythropoietin while enrolled in this study; such agents must be discontinued at the time of or prior to study entry Known quinolone sensitivity

Sites / Locations

  • Mayo Clinic

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm I

Arm Description

Patients receive oral tipifarnib twice daily on days 1-21. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Confirmed response defined as the objective status of complete response (CR) or partial response (PR) on 2 consecutive evaluations at least 4 weeks apart
Confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner.

Secondary Outcome Measures

Overall survival
Estimated using the method of Kaplan-Meier.
Time to progression
Estimated using the method of Kaplan-Meier.
Duration of response

Full Information

First Posted
October 3, 2002
Last Updated
June 3, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00047190
Brief Title
Tipifarnib in Treating Patients With Myelofibrosis and Myeloid Metaplasia
Official Title
A Phase II Trial of R115777 in Myelofibrosis With Myeloid Metaplasia (MMM)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
August 2002 (undefined)
Primary Completion Date
April 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Phase II trial to study the effectiveness of tipifarnib in treating patients who have myelofibrosis with myeloid metaplasia. Tipifarnib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the response rate in MMM patients treated with R115777. II. To evaluate the toxicity of R115777 in patients with MMM. SECONDARY OBJECTIVES: I. To evaluate the benefit of therapy with R115777 in alleviating disease-associated anemia in patients with MMM. II. To evaluate the benefit of R115777 in reducing palpable splenomegaly in patients with MMM. III. To evaluate the effect of R115777 on the hypercatabolic symptoms from MMM. IV. To evaluate the effect of R115777 on the pathologic increase in circulating myeloid progenitors in MMM patients through baseline measurement and measurement after the first cycle. V. To correlate response/relapse with in vitro myeloid colony sensitivity to R115777 at the time of either response or relapse. VI. To evaluate the effect of R115777 on bone marrow histologic features of MMM including osteosclerosis, reticulin fibrosis, and angiogenesis (through serial bone marrow microvessel density grading). OUTLINE: This is a multicenter study. Patients receive oral tipifarnib twice daily on days 1-21. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients are followed every 3 months until disease progression and then every 6 months for up to 2 years. PROJECTED ACCRUAL: A total of 18-35 patients will be accrued for this study within 15 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Essential Thrombocythemia, Polycythemia Vera, Primary Myelofibrosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral tipifarnib twice daily on days 1-21. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
tipifarnib
Other Intervention Name(s)
R115777, Zarnestra
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Confirmed response defined as the objective status of complete response (CR) or partial response (PR) on 2 consecutive evaluations at least 4 weeks apart
Description
Confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner.
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
Estimated using the method of Kaplan-Meier.
Time Frame
Time from registration to death due to any cause, assessed up to 2 years
Title
Time to progression
Description
Estimated using the method of Kaplan-Meier.
Time Frame
Time from registration to the time of progression, assessed up to 2 years
Title
Duration of response
Time Frame
Date of complete response to the date progression is documented (if one has occurred) or to the date of last follow-up (for those patients who have not progressed), assessed up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histopathologic confirmation (on bone marrow trephine and aspirate) of myelofibrosis with myeloid metaplasia by a pathologist/hematologist at the registering institution; included in the diagnosis of MMM are AMM (agnogenic myeloid metaplasia), PPMM (post-polycythemic myeloid metaplasia), and PTMM (post-thrombocythemic myeloid metaplasia); the bone marrow should show the presence of reticulin fibrosis, and the peripheral blood smear should show the presence of leukoerythroblastosis and dacrocytosis Bone marrow showing no evidence of other conditions associated with myelofibrosis, such as metastatic carcinoma, lymphoma, myelodysplasia, hairy cell leukemia, mast cell disease, acute leukemia (including M7 type), or acute myelofibrosis Bone marrow chromosome analysis or peripheral blood or bone marrow Fluorescent In Situ Hybridization (FISH) showing absence of chromosomal translocation t(9:22); prior demonstration is sufficient for enrollment purposes At least one of the following: Anemia evidenced by hemoglobin < 10 g/dL Palpable hepato-splenomegaly ANC ≥ 750/mm^3 PLT ≥ 100,000/mm^3 Total bilirubin (direct if total elevated) ≤ UNL Alkaline phosphatase =< 3 x UNL (unless felt to be secondary to disease) AST ≤ 2.5 x UNL Creatinine =< 1.5 x UNL Ability to understand and the willingness to sign a written informed consent document Willingness to follow the schedule for returning to the registering P2C institution (monthly) while receiving protocol treatment ECOG performance status 0, 1, or 2 Exclusion Criteria: Any of the following as this regimen may be harmful to a developing fetus or nursing child: Pregnant women Breastfeeding women Men or women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device [IUD], surgical sterilization, subcutaneous implants, or abstinence, etc.) NOTE: The effects of the agent(s) on the developing human fetus at the recommended therapeutic dose are unknown Use of cytotoxic chemotherapy or other myelosuppressive agents within =< 2 weeks prior to study entry Uncontrolled intercurrent illness or any co-morbid condition that would limit compliance with study requirements or with which the use of R115777 is felt to be potentially harmful; such conditions include, but are not limited to: Ongoing or active infection Symptomatic congestive heart failure Unstable angina pectoris Cardiac arrhythmia, or Psychiatric illness/social situations Other concurrent therapy directed at the disease (including Thalidomide) or use of erythropoietin while enrolled in this study; such agents must be discontinued at the time of or prior to study entry Known quinolone sensitivity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ruben Mesa
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

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Tipifarnib in Treating Patients With Myelofibrosis and Myeloid Metaplasia

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