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A Phase II Study of Oral JAK1/JAK2 Inhibitor INC424 in Adult Patients With Relapsed/Refractory Classical Hodgkin's Lymphoma (HIJAK)

Primary Purpose

Hodgkin's Lymphoma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Ruxolitinib
Sponsored by
The Lymphoma Academic Research Organisation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hodgkin's Lymphoma focused on measuring Multicenter, single arm and opened label phase II study

Eligibility Criteria

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

Inclusion critera:

  • Patients ≥ 18 years with classical HL relapsing or refractory after at least 1 prior systemic therapy. Patients must have relapsed after high-dose therapy with ASCT, or have been deemed ineligible for high-dose therapy with ASCT
  • ECOG performance status ≤ 3
  • Measurable nodal disease: 1 cm in the longest transverse diameter and clearly measurable in at least two perpendicular dimensions, as determined by CT scan (MRI is allowed only if CT scan cannot be performed).
  • Patient has the following laboratory values:

    • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L [SI units 1.0 x 10^9/L]
    • Platelet count ≥ 75 x 10^9/L]
    • Serum creatinine ≤ 1.5 x upper limit of normal (ULN)
    • Serum bilirubin ≤ 1.5 x ULN (or ≤ 3.0 x ULN, if patient has Gilbert syndrome)
    • AST/SGOT and/or ALT/SGPT ≤ 2.5 x ULN or ≤ 5.0 x ULN if the transaminase elevation is due to liver disease involvement
  • Signed written informed consent
  • Life expectancy ≥ 3 months
  • Corrected QT interval ≤ 450 mSec
  • Men and women of childbearing potential must agree to use an adequate method of contraception during the study treatment and for at least 1 week after the last study drug administration
  • The patient must be covered by a social security system (for inclusions in France)

Exclusion criteria:

  • Previous treatment with ruxolitinib or another JAK inhibitor
  • Contraindication to ruxolitinib
  • Patient received chemotherapy or radiotherapy or any investigational drug within 14 days prior to starting study drug or whose side effects of such therapy have not resolved to ≤ grade 1
  • Patient treated with allogeneic hematopoietic stem cell transplant who is currently on, or has received immunosuppressive therapy within 90 days prior to start of screening and/or have ≥ Grade 2 graft versus host disease (GvHD).
  • Patient with prior history of another active primary malignancy ≤ 2 years before study entry, with the exception of non-melanoma skin cancer, and carcinoma in situ of uterine cervix
  • Any serious active disease or co-morbid medical condition that, according to the investigator's decision, will substantially increase the risk associated with the subject's participation in the study.
  • Uncontrolled infectious disease, including active HBV infection defined by either detection of HBs Antigen or presence of anti HBc antibody without detectable anti HBs antibody.
  • HIV, HCV or HTLV serology positivity and/or documented infection with active hepatitis B
  • Prior history of CNS involvement with lymphoma
  • Pregnant or lactating woman
  • Adult patient unable to provide informed consent because of intellectual impairment, any serious medical condition, laboratory abnormality or psychiatric illness.

Sites / Locations

  • UCL Louvain St Luc
  • Université Catholique de Louvain Mont Godinne
  • Chu Cote de Nacre
  • Hopital Henri Mondor
  • Chu Dijon
  • Chru de Lille
  • Centre Leon Berard
  • Centre Hospitalier Lyon Sud
  • CHU de Nantes, Hotel Dieu
  • Centre Henri Becquerel

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ruxolitinib

Arm Description

Induction period: Ruxolitinib will be given twice daily during 6 cycles of 28 days. Maintenance period: patients who achieve at least a stable disease (according Cheson 2007) at the end of cycle 6 and for whose a clinical benefit is observed according to the Investigator's opinion will be eligible for maintenance treatment by ruxolitinib twice daily every day of 28-day cycles.

Outcomes

Primary Outcome Measures

Overall response Rate (ORR) according to Cheson 2007
Overall Response Rate according to the International Working Group criteria (Cheson 2007) is defined as patient with Complete response or Partial response. Patient without response assessment (due to whatever reason) will be considered as non responder.

Secondary Outcome Measures

Overall response rate (ORR) according to Cheson 1999
Overall Response Rate according to the International Working Group criteria (Cheson 1999) is defined as patient with Complete response, unconfirmed Complete response or Partial response. Patient without response assessment (due to whatever reason) will be considered as non responder.
Complete response rates (CR) according to Cheson 2007 and 1999
Assessment of response will be based on the International Workshop to Standardize Response criteria for lymphoma: Cheson, 1999 and 2007. Patient without response assessment (due to whatever reason) will be considered as nonresponder.
Best Response Rate (BRR) according to Cheson 1999 and 2007
Disease response evaluation at 2; 4 and 6 months will be used to determine the Best Response Rate, according to Cheson 1999 and 2007. The Best Complete Response and Best Overall Response will be presented. Patient without response assessment (due to whatever reason) will be considered as nonresponder.
Safety endpoints
Description of all adverse events, vital signs measurements, clinical laboratory measurements and concomitant medications.
Time to response
Time to response will be defined as the time from inclusion into the study to the time of attainment of PR or CR according to Cheson 2007 criteria.
Duration of response
Duration of response will be measured from the time of attainment of CR or PR according to Cheson 2007 cirteria to the date of first documented disease progression, relapse or death from any cause. Patients alive and free of progression will be censored at their last follow-up date.
Progression Free Survival (PFS)
PFS is defined at the time from inclusion into the study to the first observation of documented disease progression/relapse according to Cheson 2007 criteria or death due to any cause. If a subject has not progressed or died, PFS will be censored at the time of last visit.
Overall Survival (OS)
OS will be measured from the date of inclusion to the date of death from any cause. Patients who did not died will be censored at the time of last visit.
Evaluation of systemic symptoms
Evaluation of efficacy of ruxolitinib on systemic symptoms such as fever, sweating, fatigue and itching will be done via systemic symptoms Questionnaire designed for this purpose and completed at Baseline and then at Day1 of each visit during Induction and Maintenance period of the study

Full Information

First Posted
June 11, 2013
Last Updated
August 21, 2018
Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT01877005
Brief Title
A Phase II Study of Oral JAK1/JAK2 Inhibitor INC424 in Adult Patients With Relapsed/Refractory Classical Hodgkin's Lymphoma
Acronym
HIJAK
Official Title
A Phase II Study of Oral JAK1/JAK2 Inhibitor INC424 in Adult Patients With Relapsed/Refractory Classical Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
July 4, 2013 (Actual)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
June 12, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Novartis

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Phase II study to assess the efficacy of 6 cycles of oral JAK1/2 inhibitor ruxolitinib in patients with advanced Hodgkin's lymphoma for whom no curative option is available.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hodgkin's Lymphoma
Keywords
Multicenter, single arm and opened label phase II study

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ruxolitinib
Arm Type
Experimental
Arm Description
Induction period: Ruxolitinib will be given twice daily during 6 cycles of 28 days. Maintenance period: patients who achieve at least a stable disease (according Cheson 2007) at the end of cycle 6 and for whose a clinical benefit is observed according to the Investigator's opinion will be eligible for maintenance treatment by ruxolitinib twice daily every day of 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Ruxolitinib
Other Intervention Name(s)
JAKAVI
Primary Outcome Measure Information:
Title
Overall response Rate (ORR) according to Cheson 2007
Description
Overall Response Rate according to the International Working Group criteria (Cheson 2007) is defined as patient with Complete response or Partial response. Patient without response assessment (due to whatever reason) will be considered as non responder.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Overall response rate (ORR) according to Cheson 1999
Description
Overall Response Rate according to the International Working Group criteria (Cheson 1999) is defined as patient with Complete response, unconfirmed Complete response or Partial response. Patient without response assessment (due to whatever reason) will be considered as non responder.
Time Frame
6 months
Title
Complete response rates (CR) according to Cheson 2007 and 1999
Description
Assessment of response will be based on the International Workshop to Standardize Response criteria for lymphoma: Cheson, 1999 and 2007. Patient without response assessment (due to whatever reason) will be considered as nonresponder.
Time Frame
2 months, 4 months and 6 months
Title
Best Response Rate (BRR) according to Cheson 1999 and 2007
Description
Disease response evaluation at 2; 4 and 6 months will be used to determine the Best Response Rate, according to Cheson 1999 and 2007. The Best Complete Response and Best Overall Response will be presented. Patient without response assessment (due to whatever reason) will be considered as nonresponder.
Time Frame
6 months
Title
Safety endpoints
Description
Description of all adverse events, vital signs measurements, clinical laboratory measurements and concomitant medications.
Time Frame
30 months
Title
Time to response
Description
Time to response will be defined as the time from inclusion into the study to the time of attainment of PR or CR according to Cheson 2007 criteria.
Time Frame
Up to 30 months
Title
Duration of response
Description
Duration of response will be measured from the time of attainment of CR or PR according to Cheson 2007 cirteria to the date of first documented disease progression, relapse or death from any cause. Patients alive and free of progression will be censored at their last follow-up date.
Time Frame
Up to 4.5 years
Title
Progression Free Survival (PFS)
Description
PFS is defined at the time from inclusion into the study to the first observation of documented disease progression/relapse according to Cheson 2007 criteria or death due to any cause. If a subject has not progressed or died, PFS will be censored at the time of last visit.
Time Frame
Up to 4.5 years
Title
Overall Survival (OS)
Description
OS will be measured from the date of inclusion to the date of death from any cause. Patients who did not died will be censored at the time of last visit.
Time Frame
Up to 4.5 years
Title
Evaluation of systemic symptoms
Description
Evaluation of efficacy of ruxolitinib on systemic symptoms such as fever, sweating, fatigue and itching will be done via systemic symptoms Questionnaire designed for this purpose and completed at Baseline and then at Day1 of each visit during Induction and Maintenance period of the study
Time Frame
Up to 30 months
Other Pre-specified Outcome Measures:
Title
Anatomopahtological study
Description
FISH: JAK2 copies and rearrangements Immunohistochemistry: JAK2 overexpression
Time Frame
baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion critera: Patients ≥ 18 years with classical HL relapsing or refractory after at least 1 prior systemic therapy. Patients must have relapsed after high-dose therapy with ASCT, or have been deemed ineligible for high-dose therapy with ASCT ECOG performance status ≤ 3 Measurable nodal disease: 1 cm in the longest transverse diameter and clearly measurable in at least two perpendicular dimensions, as determined by CT scan (MRI is allowed only if CT scan cannot be performed). Patient has the following laboratory values: Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L [SI units 1.0 x 10^9/L] Platelet count ≥ 75 x 10^9/L] Serum creatinine ≤ 1.5 x upper limit of normal (ULN) Serum bilirubin ≤ 1.5 x ULN (or ≤ 3.0 x ULN, if patient has Gilbert syndrome) AST/SGOT and/or ALT/SGPT ≤ 2.5 x ULN or ≤ 5.0 x ULN if the transaminase elevation is due to liver disease involvement Signed written informed consent Life expectancy ≥ 3 months Corrected QT interval ≤ 450 mSec Men and women of childbearing potential must agree to use an adequate method of contraception during the study treatment and for at least 1 week after the last study drug administration The patient must be covered by a social security system (for inclusions in France) Exclusion criteria: Previous treatment with ruxolitinib or another JAK inhibitor Contraindication to ruxolitinib Patient received chemotherapy or radiotherapy or any investigational drug within 14 days prior to starting study drug or whose side effects of such therapy have not resolved to ≤ grade 1 Patient treated with allogeneic hematopoietic stem cell transplant who is currently on, or has received immunosuppressive therapy within 90 days prior to start of screening and/or have ≥ Grade 2 graft versus host disease (GvHD). Patient with prior history of another active primary malignancy ≤ 2 years before study entry, with the exception of non-melanoma skin cancer, and carcinoma in situ of uterine cervix Any serious active disease or co-morbid medical condition that, according to the investigator's decision, will substantially increase the risk associated with the subject's participation in the study. Uncontrolled infectious disease, including active HBV infection defined by either detection of HBs Antigen or presence of anti HBc antibody without detectable anti HBs antibody. HIV, HCV or HTLV serology positivity and/or documented infection with active hepatitis B Prior history of CNS involvement with lymphoma Pregnant or lactating woman Adult patient unable to provide informed consent because of intellectual impairment, any serious medical condition, laboratory abnormality or psychiatric illness.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric Van Den Neste, MD
Organizational Affiliation
Lymphoma Study Association
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Franck Morschhauser, MD
Organizational Affiliation
Lymphoma Study Association
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCL Louvain St Luc
City
Brussels
ZIP/Postal Code
10200
Country
Belgium
Facility Name
Université Catholique de Louvain Mont Godinne
City
Yvoir
ZIP/Postal Code
5530
Country
Belgium
Facility Name
Chu Cote de Nacre
City
Caen
ZIP/Postal Code
14000
Country
France
Facility Name
Hopital Henri Mondor
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
Chu Dijon
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
Chru de Lille
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Centre Leon Berard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
Centre Hospitalier Lyon Sud
City
Lyon
ZIP/Postal Code
69495
Country
France
Facility Name
CHU de Nantes, Hotel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
Centre Henri Becquerel
City
Rouen
ZIP/Postal Code
76038
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
29351986
Citation
Van Den Neste E, Andre M, Gastinne T, Stamatoullas A, Haioun C, Belhabri A, Reman O, Casasnovas O, Ghesquieres H, Verhoef G, Claessen MJ, Poirel HA, Copin MC, Dubois R, Vandenberghe P, Stoian IA, Cottereau AS, Bailly S, Knoops L, Morschhauser F. A phase II study of the oral JAK1/JAK2 inhibitor ruxolitinib in advanced relapsed/refractory Hodgkin lymphoma. Haematologica. 2018 May;103(5):840-848. doi: 10.3324/haematol.2017.180554. Epub 2018 Jan 19.
Results Reference
derived
Links:
URL
http://lysa-lymphoma.org
Description
LYSA (the Lymphoma Study Association)

Learn more about this trial

A Phase II Study of Oral JAK1/JAK2 Inhibitor INC424 in Adult Patients With Relapsed/Refractory Classical Hodgkin's Lymphoma

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