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Study of the JAK Inhibitor Ruxolitinib Administered Orally to Patients With Primary Myelofibrosis (PMF), Post-Polycythemia Vera-Myelofibrosis (PPV-MF) or Post-Essential Thrombocythemia-Myelofibrosis (PET-MF)

Primary Purpose

Myelofibrosis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Ruxolitinib
Sponsored by
Incyte Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelofibrosis

Eligibility Criteria

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

Inclusion Criteria:

  • Require treatment for MF and classified at least as intermediate risk level 1 defined by the International Working Group.
  • Platelet count < 100x10 ^9/L at screening or at Study Day 1.

Exclusion Criteria:

  • Received platelet transfusion within 14 days prior to Screening evaluations.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Stratum -1

Stratum -2

Arm Description

Participants with baseline Platelet counts of 75-99 x10^9/L

Participants with baseline Platelet counts of 50-74 x10^9/L

Outcomes

Primary Outcome Measures

Number of Participants With Dose Limiting Toxicities
DLT was defined as the occurrence of any of the following treatment-related toxicities, occurring through Day 28: Any grade ≥ 2 hemorrhagic event ; Any grade thrombocytopenia requiring PLT transfusion; PLT count < 25x109/L*; Grade 4 neutropenia (absolute neutrophil count < 0.5x109/L)*; Grade ≥ 3 febrile neutropenia*; Grade ≥ 2 total serum bilirubin with coincident direct bilirubin ≥ 0.5 mg/dL; Grade 3 non-hematologic toxicity for ≥ 7 consecutive days; Grade 4 non-hematologic toxicity. In the dose escalation stage in the core study period, the starting does in both strata was 5mg bid. Successive cohorts of newly enrolled patients received increasing doses of ruxolitinib until the Maximum Safe Starting Dose (MSSD) was determined. Initially, only patients with PLT counts 75-99 x10^9/L (stratum 1) were allowed to be enrolled. Once safety was established in stratum 1 at the first 2 dose cohorts, eligible population was further expanded to patients with PLT counts 50-74 x10^9/L (stratum 2).

Secondary Outcome Measures

Number of Treatment Emergent Adverse Events (TEAE's)
Adverse events reported for the first time or worsening of a pre-existing event after first dose of study drug/treatment.
Number of Subjects Achieving ≥ 50% Reduction in Palpable Spleen Length
Participants achieving ≥ 50% reduction in palpable spleen length relative to study day 1 by treatment and stratum
Change in Spleen Length as Measure by Palpation Over Time
Defined as measurement of change in spleen length by palpation from baseline
PK- C Reactive Protein Levels by PK Quartile (AUC0-12)
To define the PK and C Reactive Protein relationship using PK Quartiles (AUC 0-12, ng*h/mL)
PK- Interleukin 1 Receptor Antagonist Levels by PK Quartile (AUC0-12)
To define the PK and Interleukin 1 Receptor Antagonist relationship relationship using PK Quartiles (AUC 0-12, ng*h/mL)
PK- Tissue Necrosis Factor Receptor 2 Levels by PK Quartile (AUC0-12)
To define the PK and Tissue Necrosis Factor Receptor 2 relationship using PK Quartiles (AUC 0-12, ng*h/mL)
AUC 0-Inf
Area Under the Serum Concentration Versus Time Curve,Time 0 to Infinity

Full Information

First Posted
March 14, 2011
Last Updated
January 10, 2022
Sponsor
Incyte Corporation
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT01317875
Brief Title
Study of the JAK Inhibitor Ruxolitinib Administered Orally to Patients With Primary Myelofibrosis (PMF), Post-Polycythemia Vera-Myelofibrosis (PPV-MF) or Post-Essential Thrombocythemia-Myelofibrosis (PET-MF)
Official Title
A Phase Ib, Open-label, Dose-finding Study of the JAK Inhibitor INC424 Tablets Administered Orally to Patients With Primary Myelofibrosis (PMF), Post-polycythemia Veramyelofibrosis (PPV-MF) or Post-essentialthrombocythemia-myelofibrosis (PET-MF) and Baseline Platelet Counts ≥50 x109/L and <100 x109/L (EXPAND)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
March 31, 2011 (Actual)
Primary Completion Date
December 31, 2019 (Actual)
Study Completion Date
December 31, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Incyte Corporation
Collaborators
Novartis

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
This is a Phase IB, open-label, dose-finding study of the JAK 1 and 2 inhibitor ruxolitinib in patients with myelofibrosis (MF). The study consists of two periods: the core study period, comprising the dose escalation stage and the safety extension phase up to Week 24, then the extension study period beyond Week 24 and up to 3 years, to further characterize the safety and efficacy of ruxolitinib in this patient population. The dose escalation phase will enroll successive cohorts of patients who receive increasing doses of ruxolitinib until the maximum safe starting dose (MSSD) is determined. In the safety expansion phase, additional patients will be treated with ruxolitinib at the MSSD defined during dose escalation. The primary objective is to establish the MSSD of ruxolitinib in patients with MF and starting platelet counts < 100 x 10 ^9/L

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelofibrosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
69 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stratum -1
Arm Type
Experimental
Arm Description
Participants with baseline Platelet counts of 75-99 x10^9/L
Arm Title
Stratum -2
Arm Type
Experimental
Arm Description
Participants with baseline Platelet counts of 50-74 x10^9/L
Intervention Type
Drug
Intervention Name(s)
Ruxolitinib
Other Intervention Name(s)
INCB018424
Intervention Description
Starting dose of ruxolitinib for cohort 1 in dose escalation phase - 5mg twice a day (BID) Doses will be increased a total of approximately 5mg for successive dosing cohorts based on baseline platelet count
Primary Outcome Measure Information:
Title
Number of Participants With Dose Limiting Toxicities
Description
DLT was defined as the occurrence of any of the following treatment-related toxicities, occurring through Day 28: Any grade ≥ 2 hemorrhagic event ; Any grade thrombocytopenia requiring PLT transfusion; PLT count < 25x109/L*; Grade 4 neutropenia (absolute neutrophil count < 0.5x109/L)*; Grade ≥ 3 febrile neutropenia*; Grade ≥ 2 total serum bilirubin with coincident direct bilirubin ≥ 0.5 mg/dL; Grade 3 non-hematologic toxicity for ≥ 7 consecutive days; Grade 4 non-hematologic toxicity. In the dose escalation stage in the core study period, the starting does in both strata was 5mg bid. Successive cohorts of newly enrolled patients received increasing doses of ruxolitinib until the Maximum Safe Starting Dose (MSSD) was determined. Initially, only patients with PLT counts 75-99 x10^9/L (stratum 1) were allowed to be enrolled. Once safety was established in stratum 1 at the first 2 dose cohorts, eligible population was further expanded to patients with PLT counts 50-74 x10^9/L (stratum 2).
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Number of Treatment Emergent Adverse Events (TEAE's)
Description
Adverse events reported for the first time or worsening of a pre-existing event after first dose of study drug/treatment.
Time Frame
approximately 4 years
Title
Number of Subjects Achieving ≥ 50% Reduction in Palpable Spleen Length
Description
Participants achieving ≥ 50% reduction in palpable spleen length relative to study day 1 by treatment and stratum
Time Frame
24 weeks
Title
Change in Spleen Length as Measure by Palpation Over Time
Description
Defined as measurement of change in spleen length by palpation from baseline
Time Frame
Day 8, 15, 22, 29, 43, 57, 85, 113, 141, 168, 252, 336, 420, 504, 588, 672, 756, 1008, 1092
Title
PK- C Reactive Protein Levels by PK Quartile (AUC0-12)
Description
To define the PK and C Reactive Protein relationship using PK Quartiles (AUC 0-12, ng*h/mL)
Time Frame
24 weeks
Title
PK- Interleukin 1 Receptor Antagonist Levels by PK Quartile (AUC0-12)
Description
To define the PK and Interleukin 1 Receptor Antagonist relationship relationship using PK Quartiles (AUC 0-12, ng*h/mL)
Time Frame
24 weeks
Title
PK- Tissue Necrosis Factor Receptor 2 Levels by PK Quartile (AUC0-12)
Description
To define the PK and Tissue Necrosis Factor Receptor 2 relationship using PK Quartiles (AUC 0-12, ng*h/mL)
Time Frame
24 weeks
Title
AUC 0-Inf
Description
Area Under the Serum Concentration Versus Time Curve,Time 0 to Infinity
Time Frame
0.25 to 0.75, 1 to 3, and 4 to 12 hours postdose on Day 1 and predose, 0.25 to 0.75 hours, and 1 to 3 hours postdose on Day 15, with a random sample on Days 29 and 57

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Require treatment for MF and classified at least as intermediate risk level 1 defined by the International Working Group. Platelet count < 100x10 ^9/L at screening or at Study Day 1. Exclusion Criteria: Received platelet transfusion within 14 days prior to Screening evaluations.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Jones, MD
Organizational Affiliation
Incyte Corporation
Official's Role
Study Director
Facility Information:
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21229
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
City
Vienna
Country
Austria
City
Nanjing
State/Province
Jiangsu
Country
China
City
Chengdu
State/Province
Sichuan
Country
China
City
Hangzhou
State/Province
Zhejiang
Country
China
City
Beijing
Country
China
City
Angers
Country
France
City
Paris
Country
France
City
Pierre-Benite
Country
France
City
Leipzig
Country
Germany
City
Firenze
Country
Italy
City
Milano
Country
Italy
City
Terni
Country
Italy
City
Rotterdam
Country
Netherlands
City
Belfast
Country
United Kingdom
City
London
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36105914
Citation
Guglielmelli P, Kiladjian JJ, Vannucchi AM, Duan M, Meng H, Pan L, He G, Verstovsek S, Boyer F, Barraco F, Niederwieser D, Pungolino E, Liberati AM, Harrison C, Roussou P, Wroclawska M, Karumanchi D, Sinclair K, Te Boekhorst PAW, Gisslinger H. Efficacy and safety of ruxolitinib in patients with myelofibrosis and low platelet count (50 x 109/L to <100 x 109/L) at baseline: the final analysis of EXPAND. Ther Adv Hematol. 2022 Sep 10;13:20406207221118429. doi: 10.1177/20406207221118429. eCollection 2022.
Results Reference
derived

Learn more about this trial

Study of the JAK Inhibitor Ruxolitinib Administered Orally to Patients With Primary Myelofibrosis (PMF), Post-Polycythemia Vera-Myelofibrosis (PPV-MF) or Post-Essential Thrombocythemia-Myelofibrosis (PET-MF)

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