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Masitinib in Severe Indolent or Smoldering Systemic Mastocytosis (AB06006)

Primary Purpose

Indolent Systemic Mastocytosis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Masitinib
Placebo
Best Supportive Care
Sponsored by
AB Science
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Indolent Systemic Mastocytosis focused on measuring Mastocytosis with handicap, Mastocytosis, Mast cell, Mast cell infiltration, Skin, Bone marrow, Pruritus, Flushes, c-kit, c-kit mutation, Wild Type, Mutation Asp-816-Val(D816V), Indolent systemic mastocytosis, smoldering systemic mastocytosis

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient with one of the following documented mastocytosis as per WHO classification: Smouldering Systemic Mastocytosis, Severe Indolent Mastocytosis
  2. Patient with documented mastocytosis and evaluable disease based upon histological criteria: typical infiltrates of mast cells in a multifocal or diffuse pattern in skin and/or bone marrow biopsy
  3. Patient with documented treatment failure of his/her handicap(s) with at least one of the following therapy used at optimized dose: Anti H1, Anti H2, Proton pump inhibitor, Osteoclast inhibitor, Cromoglycate Sodium, Antileukotriene
  4. Handicapped status defined as at least two of the following handicaps, including at least one among pruritus, flushes, depression and fatigue: pruritus score ≥ 9, number of flushes per week ≥ 8, Hamilton rating scale for depression (HAMD-17) score ≥ 19, number of stools per day ≥ 4, number of mictions per day ≥ 8, Fatigue Impact Scale total score (asthenia) ≥ 75
  5. Patients with OPA ≥ 2 (moderate to intolerable general handicap)
  6. ECOG ≤ 2
  7. Patient with adequate organ function

Exclusion Criteria:

  1. Patient with one of the following mastocytosis: Cutaneous Mastocytosis, Not documented Smouldering Systemic Mastocytosis or Indolent Systemic Mastocytosis, Systemic Mastocytosis with an Associated clonal Hematologic Non Mast cell lineage Disease (SM-AHNMD), Mast cell leukemia (MCL), Aggressive systemic mastocytosis (ASM)
  2. Previous treatment with any Tyrosine Kinase Inhibitor
  3. Patient with recent cardiac history of: Acute coronary syndrome, Acute heart failure, Significant ventricular arrhythmia; patient with cardiac failure class III or IV; Syncope without known aetiology within 3 months, uncontrolled severe hypertension.
  4. Patient with any condition that the physician judges could be detrimental to subjects participating in this study; including any clinically important deviations from normal clinical laboratory values or concurrent medical events Previous treatment
  5. Change in the symptomatic treatment of mastocytosis or administration of any new treatment of mastocytosis within 4 weeks prior to baseline
  6. Treatment with any investigational agent within 4 weeks prior to baseline

Sites / Locations

  • UC Davis Health System , Department of Dermatology
  • MD Anderson Cancer Centre
  • CHU d'Amiens
  • Hôpital Avicenne
  • CHU de Brest
  • CHU de Caen
  • CHU Clermont Ferrand
  • Hôpital Claude Huriez
  • CHU Dupuytren
  • Hôpital Ambroise Paré
  • Hôpital Nord
  • Hôpital Central
  • CHU Hôtel Dieu
  • Hôpital l'Archet II
  • Hôpital Necker
  • Hôpital Tenon
  • CHU Lyon Sud
  • Centre Hospitalier Lyon Sud
  • CHU Milétrie
  • CHU Hôpital Sud
  • CHU de Saint-Etienne
  • Hôpital Purpan
  • Hôpital Bretonneau
  • Hôpital des Hauts Clos

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Masitinib & BSC

Placebo & BSC

Arm Description

Masitinib (6 mg/kg/day) administered as an add-on to optimal concomitant symptomatic treatment (i.e. best supportive care, BSC)

Matching placebo administered as an add-on to optimal concomitant symptomatic treatment (i.e. best supportive care, BSC)

Outcomes

Primary Outcome Measures

Cumulative response (4R75%)
The prospectively declared primary endpoint (4R75%) was cumulative response in at least one of four severe baseline symptoms of mast cell mediator release (pruritus, flushes, depression, or asthenia). Response was defined as a 75% improvement from baseline for any of these four symptoms. Cumulative response was defined as the number of actual responses between weeks 8 and 24, divided by the total number of possible responses over the same treatment period (ie, with five scheduled visits, each patient had a maximum of five to 20 possible responses depending on the number of severe baseline symptoms).

Secondary Outcome Measures

Cumulative response (3R75%)
Cumulative response in at least one of three severe baseline symptoms (pruritus, flushes, or depression)
Cumulative response (2R75%)
Cumulative response in at least one of three severe baseline symptoms (pruritus or flushes)

Full Information

First Posted
December 22, 2008
Last Updated
November 29, 2019
Sponsor
AB Science
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1. Study Identification

Unique Protocol Identification Number
NCT00814073
Brief Title
Masitinib in Severe Indolent or Smoldering Systemic Mastocytosis
Acronym
AB06006
Official Title
Randomized, Placebo-controlled, Phase 3 Study to Compare Efficacy and Safety of Masitinib at 6 mg/kg/Day to Placebo in Treatment of Patients With Smouldering Systemic, Indolent Systemic or Cutaneous Mastocytosis With Handicap
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AB Science

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to compare the safety and efficacy of masitinib (AB1010) to placebo in patients with mastocytosis with handicap.
Detailed Description
This was a prospective, multicenter, randomized, placebo-controlled, parallel-group, phase 3 study, conducted in 15 countries, evaluating the efficacy and safety of masitinib (6 mg/kg/day administered orally in two daily intakes over 24-weeks with a double-blind extension period possible) for the treatment of indolent systemic mastocytosis, smoldering mastocytosis or cutaneous mastocytosis, in patients with mast cells mediator release symptoms that are refractory to conventional symptomatic treatment. A study protocol amendment restricted enrolment to patients with severe indolent and smoldering systemic mastocytosis. The objective of this phase 3 study was therefore to evaluate masitinib efficacy and safety in severe systemic mastocytosis patients, with or without D816V mutation of c-Kit. The primary objective of the phase 3 study was to detect a statistically significant difference between masitinib (plus optimal concomitant symptomatic treatments) and placebo (plus optimal concomitant symptomatic treatments) in cumulative response on four severe symptoms, referred to also as handicaps.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Indolent Systemic Mastocytosis
Keywords
Mastocytosis with handicap, Mastocytosis, Mast cell, Mast cell infiltration, Skin, Bone marrow, Pruritus, Flushes, c-kit, c-kit mutation, Wild Type, Mutation Asp-816-Val(D816V), Indolent systemic mastocytosis, smoldering systemic mastocytosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
135 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Masitinib & BSC
Arm Type
Experimental
Arm Description
Masitinib (6 mg/kg/day) administered as an add-on to optimal concomitant symptomatic treatment (i.e. best supportive care, BSC)
Arm Title
Placebo & BSC
Arm Type
Placebo Comparator
Arm Description
Matching placebo administered as an add-on to optimal concomitant symptomatic treatment (i.e. best supportive care, BSC)
Intervention Type
Drug
Intervention Name(s)
Masitinib
Other Intervention Name(s)
AB1010
Intervention Description
Masitinib 6 mg/kg/day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo
Intervention Type
Other
Intervention Name(s)
Best Supportive Care
Intervention Description
Optimal concomitant symptomatic treatments. Includes: H1- and H2-antihistamines, proton pump inhibitors (PPI), sodium cromoglicate, antidepressants, leukotriene antagonists, interferon-alpha, 2-CdA, and corticosteroids.
Primary Outcome Measure Information:
Title
Cumulative response (4R75%)
Description
The prospectively declared primary endpoint (4R75%) was cumulative response in at least one of four severe baseline symptoms of mast cell mediator release (pruritus, flushes, depression, or asthenia). Response was defined as a 75% improvement from baseline for any of these four symptoms. Cumulative response was defined as the number of actual responses between weeks 8 and 24, divided by the total number of possible responses over the same treatment period (ie, with five scheduled visits, each patient had a maximum of five to 20 possible responses depending on the number of severe baseline symptoms).
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Cumulative response (3R75%)
Description
Cumulative response in at least one of three severe baseline symptoms (pruritus, flushes, or depression)
Time Frame
24 weeks
Title
Cumulative response (2R75%)
Description
Cumulative response in at least one of three severe baseline symptoms (pruritus or flushes)
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient with one of the following documented mastocytosis as per WHO classification: Smouldering Systemic Mastocytosis, Severe Indolent Mastocytosis Patient with documented mastocytosis and evaluable disease based upon histological criteria: typical infiltrates of mast cells in a multifocal or diffuse pattern in skin and/or bone marrow biopsy Patient with documented treatment failure of his/her handicap(s) with at least one of the following therapy used at optimized dose: Anti H1, Anti H2, Proton pump inhibitor, Osteoclast inhibitor, Cromoglycate Sodium, Antileukotriene Handicapped status defined as at least two of the following handicaps, including at least one among pruritus, flushes, depression and fatigue: pruritus score ≥ 9, number of flushes per week ≥ 8, Hamilton rating scale for depression (HAMD-17) score ≥ 19, number of stools per day ≥ 4, number of mictions per day ≥ 8, Fatigue Impact Scale total score (asthenia) ≥ 75 Patients with OPA ≥ 2 (moderate to intolerable general handicap) ECOG ≤ 2 Patient with adequate organ function Exclusion Criteria: Patient with one of the following mastocytosis: Cutaneous Mastocytosis, Not documented Smouldering Systemic Mastocytosis or Indolent Systemic Mastocytosis, Systemic Mastocytosis with an Associated clonal Hematologic Non Mast cell lineage Disease (SM-AHNMD), Mast cell leukemia (MCL), Aggressive systemic mastocytosis (ASM) Previous treatment with any Tyrosine Kinase Inhibitor Patient with recent cardiac history of: Acute coronary syndrome, Acute heart failure, Significant ventricular arrhythmia; patient with cardiac failure class III or IV; Syncope without known aetiology within 3 months, uncontrolled severe hypertension. Patient with any condition that the physician judges could be detrimental to subjects participating in this study; including any clinically important deviations from normal clinical laboratory values or concurrent medical events Previous treatment Change in the symptomatic treatment of mastocytosis or administration of any new treatment of mastocytosis within 4 weeks prior to baseline Treatment with any investigational agent within 4 weeks prior to baseline
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Olivier Lortholary, MD, PhD
Organizational Affiliation
Hôpital Necker, Paris, France
Official's Role
Principal Investigator
Facility Information:
Facility Name
UC Davis Health System , Department of Dermatology
City
Sacramento
State/Province
California
ZIP/Postal Code
95816
Country
United States
Facility Name
MD Anderson Cancer Centre
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
CHU d'Amiens
City
Amiens
Country
France
Facility Name
Hôpital Avicenne
City
Bobigny
Country
France
Facility Name
CHU de Brest
City
Brest
Country
France
Facility Name
CHU de Caen
City
Caen
Country
France
Facility Name
CHU Clermont Ferrand
City
Clermont Ferrand
ZIP/Postal Code
63000
Country
France
Facility Name
Hôpital Claude Huriez
City
Lille
Country
France
Facility Name
CHU Dupuytren
City
Limoges
Country
France
Facility Name
Hôpital Ambroise Paré
City
Marseille
Country
France
Facility Name
Hôpital Nord
City
Marseille
Country
France
Facility Name
Hôpital Central
City
Nancy
Country
France
Facility Name
CHU Hôtel Dieu
City
Nantes
Country
France
Facility Name
Hôpital l'Archet II
City
Nice
Country
France
Facility Name
Hôpital Necker
City
Paris
Country
France
Facility Name
Hôpital Tenon
City
Paris
Country
France
Facility Name
CHU Lyon Sud
City
Pierre Bénite
ZIP/Postal Code
69495
Country
France
Facility Name
Centre Hospitalier Lyon Sud
City
Pierre-Bénite
Country
France
Facility Name
CHU Milétrie
City
Poitiers
Country
France
Facility Name
CHU Hôpital Sud
City
Rennes
Country
France
Facility Name
CHU de Saint-Etienne
City
Saint-Etienne
Country
France
Facility Name
Hôpital Purpan
City
Toulouse
Country
France
Facility Name
Hôpital Bretonneau
City
Tours
Country
France
Facility Name
Hôpital des Hauts Clos
City
Troyes
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
28069280
Citation
Arock M. A new therapeutic advance for symptomatic systemic mastocytosis? Lancet. 2017 Feb 11;389(10069):576-578. doi: 10.1016/S0140-6736(16)31655-5. Epub 2017 Jan 7. No abstract available.
Results Reference
background
PubMed Identifier
28069279
Citation
Lortholary O, Chandesris MO, Bulai Livideanu C, Paul C, Guillet G, Jassem E, Niedoszytko M, Barete S, Verstovsek S, Grattan C, Damaj G, Canioni D, Fraitag S, Lhermitte L, Georgin Lavialle S, Frenzel L, Afrin LB, Hanssens K, Agopian J, Gaillard R, Kinet JP, Auclair C, Mansfield C, Moussy A, Dubreuil P, Hermine O. Masitinib for treatment of severely symptomatic indolent systemic mastocytosis: a randomised, placebo-controlled, phase 3 study. Lancet. 2017 Feb 11;389(10069):612-620. doi: 10.1016/S0140-6736(16)31403-9. Epub 2017 Jan 7.
Results Reference
result
Links:
URL
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985971/
Description
Publication of results

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Masitinib in Severe Indolent or Smoldering Systemic Mastocytosis

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