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Ruxolitinib Phosphate in Reducing Fatigue in Patients With Chronic Lymphocytic Leukemia

Primary Purpose

Chronic Lymphocytic Leukemia

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Questionnaire Administration
Ruxolitinib Phosphate
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Chronic Lymphocytic Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects who are able to understand and sign an informed consent document
  • Subjects must be diagnosed with CLL and do not meet the IWCLL criteria for treatment
  • Patients may have been previously treated or previously untreated
  • Symptomatic patients with a BFI symptom scale of 2 points or greater
  • Subjects with hemoglobin values at the screening visit equal to or greater than 12.0 g/dL
  • Subjects with a platelet count of at least 75 x 10^9/L at the screening visit
  • Subjects with an absolute neutrophil count (ANC) of equal to or higher than 0.5 x 10^9/L at the screening visit
  • Subjects must have discontinued all drugs used to treat CLL no later than day -30
  • Subjects with an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2

Exclusion Criteria:

  • Females who are pregnant or are currently breastfeeding
  • Subjects of childbearing potential who are unwilling to take appropriate precautions (throughout the study from screening, including 30 days after discontinuation of the study drug) to avoid becoming pregnant or fathering a child

    • Females of non-childbearing potential are defined as women who (a) are equal to or greater than 55 years of age with history of amenorrhea for 1 year, or (b) are surgically sterile for at least 3 months
    • For females of childbearing potential, or for males, appropriate precautions are those that are at least 99% effective in preventing the occurrence of pregnancy; these methods should be communicated to the subjects and their understanding confirmed:

      • Complete abstinence from sexual intercourse
      • Double barrier methods
      • Condom with spermicide in conjunction with use of an intrauterine device (IUD)
      • Condom with spermicide in conjunction with use of a diaphragm
      • Oral, injectable, or implanted contraceptives
      • Tubal ligation or vasectomy (surgical sterilization)
  • Subjects with recent history of inadequate bone marrow reserve as demonstrated by previous transfusions except for acute blood loss (e.g. surgery) in the month prior to screening
  • Alanine aminotransferase (ALT) > 2.5 x upper limit of normal (ULN)
  • Modification of diet in renal disease (MDRD) calculated glomerular filtration rate (GFR) < 30 mL/min
  • Subjects with active uncontrolled infection or who are human immunodeficiency virus (HIV) positive (subjects with acute infections requiring treatment should delay screening/enrollment until the course of therapy has been completed and the event is considered controlled)
  • Subjects with an invasive malignancy over the previous 2 years except treated basal or squamous carcinomas of the skin completely resected intraepithelial carcinoma of the cervix and completely resected papillary thyroid and follicular thyroid cancers; other completely resected cancers greater than 2 years may be considered after review by the principal investigator (PI)
  • Subjects with clinically significant uncontrolled cardiac disease
  • Subjects being treated concurrently with any prohibited medications, including investigational medication, rifampin, St. John's wort, and potent cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors (excluding ketoconazole) unless continuation of such medications are determined by the investigator to be in the best interest of the patient
  • Subjects who have previously received JAK inhibitor therapy
  • Subjects with active alcohol or drug addiction that would interfere with their ability to comply with the study requirements
  • Subjects with any concurrent condition that, in the investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol
  • Subjects who have unknown transfusion history for at least the 12 weeks prior to screening
  • Subjects who are unable to complete the symptom diary
  • Subjects who will need conventional therapy during the course of the study

Sites / Locations

  • M D Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Supportive care (ruxolitinib phosphate)

Arm Description

Patients receive ruxolitinib phosphate PO BID (approximately 12 hours apart) for up to 2 years in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Change in fatigue
As measured by the Brief Fatigue Inventory (BFI) question 3 regarding the worst fatigue in the past 24 hours. Will be analyzed in a continuous fashion.

Secondary Outcome Measures

Proportion of patients with 2 point reductions in the BFI #3 score
Proportion of patients at 3 months versus at enrollment tabulated.
20% improvement in symptoms
As measured by the M. D. Anderson Symptom Inventory (MDASI).

Full Information

First Posted
May 2, 2014
Last Updated
August 24, 2023
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02131584
Brief Title
Ruxolitinib Phosphate in Reducing Fatigue in Patients With Chronic Lymphocytic Leukemia
Official Title
Administration of Jakafi (Ruxolitinib) for Symptom Control of Patients With Chronic Lymphocytic Leukemia (CLL): A Phase II Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 2, 2014 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

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

5. Study Description

Brief Summary
This phase II trial studies how well ruxolitinib phosphate works in reducing fatigue in patients with chronic lymphocytic leukemia. Ruxolitinib phosphate may stop the growth of cancer cells by blocking a protein called Janus kinase (JAK) that is needed for cell growth and may also help control fatigue, decrease the size of lymph nodes and/or lower the number of chronic lymphocytic leukemia cells in the blood.
Detailed Description
PRIMARY OBJECTIVE: I. To estimate the reduction in fatigue as measured by the Brief Fatigue Inventory (BFI) of patients with chronic lymphocytic leukemia (CLL) who do not require anti-neoplastic therapy according to the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 recommendations. SECONDARY OBJECTIVE: I. To estimate the reduction in other symptoms using the M. D. Anderson Symptom Inventory (MDASI) and to assess disease burden and response by the IWCLL 2008 response criteria. OUTLINE: Patients receive ruxolitinib phosphate orally (PO) twice daily (BID) (approximately 12 hours apart) for up to 2 years in the absence of disease progression or unacceptable toxicity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Supportive care (ruxolitinib phosphate)
Arm Type
Experimental
Arm Description
Patients receive ruxolitinib phosphate PO BID (approximately 12 hours apart) for up to 2 years in the absence of disease progression or unacceptable toxicity.
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Intervention Type
Drug
Intervention Name(s)
Ruxolitinib Phosphate
Other Intervention Name(s)
INCB-18424 Phosphate, Jakafi
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Change in fatigue
Description
As measured by the Brief Fatigue Inventory (BFI) question 3 regarding the worst fatigue in the past 24 hours. Will be analyzed in a continuous fashion.
Time Frame
Baseline to 3 months
Secondary Outcome Measure Information:
Title
Proportion of patients with 2 point reductions in the BFI #3 score
Description
Proportion of patients at 3 months versus at enrollment tabulated.
Time Frame
Up to 3 months
Title
20% improvement in symptoms
Description
As measured by the M. D. Anderson Symptom Inventory (MDASI).
Time Frame
Up to 3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who are able to understand and sign an informed consent document Subjects must be diagnosed with CLL and do not meet the IWCLL criteria for treatment Patients may have been previously treated or previously untreated Symptomatic patients with a BFI symptom scale of 2 points or greater Subjects with hemoglobin values at the screening visit equal to or greater than 12.0 g/dL Subjects with a platelet count of at least 75 x 10^9/L at the screening visit Subjects with an absolute neutrophil count (ANC) of equal to or higher than 0.5 x 10^9/L at the screening visit Subjects must have discontinued all drugs used to treat CLL no later than day -30 Subjects with an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 Exclusion Criteria: Females who are pregnant or are currently breastfeeding Subjects of childbearing potential who are unwilling to take appropriate precautions (throughout the study from screening, including 30 days after discontinuation of the study drug) to avoid becoming pregnant or fathering a child Females of non-childbearing potential are defined as women who (a) are equal to or greater than 55 years of age with history of amenorrhea for 1 year, or (b) are surgically sterile for at least 3 months For females of childbearing potential, or for males, appropriate precautions are those that are at least 99% effective in preventing the occurrence of pregnancy; these methods should be communicated to the subjects and their understanding confirmed: Complete abstinence from sexual intercourse Double barrier methods Condom with spermicide in conjunction with use of an intrauterine device (IUD) Condom with spermicide in conjunction with use of a diaphragm Oral, injectable, or implanted contraceptives Tubal ligation or vasectomy (surgical sterilization) Subjects with recent history of inadequate bone marrow reserve as demonstrated by previous transfusions except for acute blood loss (e.g. surgery) in the month prior to screening Alanine aminotransferase (ALT) > 2.5 x upper limit of normal (ULN) Modification of diet in renal disease (MDRD) calculated glomerular filtration rate (GFR) < 30 mL/min Subjects with active uncontrolled infection or who are human immunodeficiency virus (HIV) positive (subjects with acute infections requiring treatment should delay screening/enrollment until the course of therapy has been completed and the event is considered controlled) Subjects with an invasive malignancy over the previous 2 years except treated basal or squamous carcinomas of the skin completely resected intraepithelial carcinoma of the cervix and completely resected papillary thyroid and follicular thyroid cancers; other completely resected cancers greater than 2 years may be considered after review by the principal investigator (PI) Subjects with clinically significant uncontrolled cardiac disease Subjects being treated concurrently with any prohibited medications, including investigational medication, rifampin, St. John's wort, and potent cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors (excluding ketoconazole) unless continuation of such medications are determined by the investigator to be in the best interest of the patient Subjects who have previously received JAK inhibitor therapy Subjects with active alcohol or drug addiction that would interfere with their ability to comply with the study requirements Subjects with any concurrent condition that, in the investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol Subjects who have unknown transfusion history for at least the 12 weeks prior to screening Subjects who are unable to complete the symptom diary Subjects who will need conventional therapy during the course of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alessandra Ferrajoli
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
28089238
Citation
Jain P, Keating M, Renner S, Cleeland C, Xuelin H, Gonzalez GN, Harris D, Li P, Liu Z, Veletic I, Rozovski U, Jain N, Thompson P, Bose P, DiNardo C, Ferrajoli A, O'Brien S, Burger J, Wierda W, Verstovsek S, Kantarjian H, Estrov Z. Ruxolitinib for symptom control in patients with chronic lymphocytic leukaemia: a single-group, phase 2 trial. Lancet Haematol. 2017 Feb;4(2):e67-e74. doi: 10.1016/S2352-3026(16)30194-6. Epub 2017 Jan 12.
Results Reference
derived
Links:
URL
http://www.mdanderson.org
Description
M D Anderson Cancer Center

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Ruxolitinib Phosphate in Reducing Fatigue in Patients With Chronic Lymphocytic Leukemia

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