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A Study of Itacitinib for the Prevention of Cytokine Release Syndrome Induced by Immune Effector Cell Therapy

Primary Purpose

Cytokine Release Syndrome

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Itacitinib
Immune effector cell therapy
Placebo
Yescarta
Sponsored by
Incyte Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Cytokine Release Syndrome focused on measuring Cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, Janus kinase inhibitor, immune effector cell therapy

Eligibility Criteria

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

Inclusion Criteria:

  • Part 1: Eligible to receive any IEC therapy for any approved indication.
  • Part 2: Eligible to receive Yescarta for relapsed or refractory large B-cell lymphoma or follicular lymphoma.
  • Eastern Cooperative Oncology Group performance status 0 to 1.
  • Willingness to avoid pregnancy or fathering children

Exclusion Criteria:

  • Evidence of active uncontrolled/untreated infection (viral, bacterial, fungal, opportunistic) of any origin.
  • Evidence of active hepatitis B virus or hepatitis C virus infection.
  • Known human immunodeficiency virus.
  • Active acute or chronic graft-versus-host disease requiring systemic therapy.
  • Concurrent use of chronic systemic steroids or immunosuppressant medications.
  • Any unresolved toxicity ≥ Grade 2 (except stable Grade 2 peripheral neuropathy or alopecia) from previous anticancer therapy.
  • Known history or prior diagnosis of immunologic or inflammatory/autoimmune disease affecting the central nervous system (CNS) and unrelated to their disease under study or previous treatment.
  • Clinically significant or uncontrolled cardiac disease.
  • Acute lymphoblastic leukemia participants with protocol-defined CNS status are eligible only in the absence of neurologic symptoms suggestive of CNS leukemia.
  • Diffuse large B-cell lymphoma participants must have no signs or symptoms of CNS disease or detectable evidence of CNS disease; participants who have been previously treated for CNS disease but have no evidence of disease at screening are eligible.
  • Laboratory values at screening outside the protocol-defined ranges.

Sites / Locations

  • University of Miami Sylvester Comprehensive Cancer Center
  • Moffitt Cancer Center
  • Massachusetts General Hospital
  • Washington University School of Medicine
  • Columbia University Medical Center
  • Memorial Sloan Kettering Cancer Center
  • Cincinnati Childrens Hospital Medical Center
  • Oregon Health & Science University
  • University of Pennsylvania Hospital
  • Medical College of Wisconsin

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Part 1: Open Label Itacitinib Once Daily

Part 2: Double-Blind Itacitinib Twice Daily

Arm Description

During Part 1, all participants receive itacitinib 200mg once daily (open label) for 30 days. The study population will include participants receiving any approved IEC for an approved indication.

During Part 2, participants will be randomized to receive itacitinib 200mg or placebo twice daily for 30 days. The study population also includes participants who are receiving Yescarta for relapsed or refractory large B-cell lymphoma or follicular lymphoma.

Outcomes

Primary Outcome Measures

Proportion of participants who develop ≥ Grade 2 CRS
Assessed using American Society for Blood and Marrow Transplantation (ASBMT) CRS Consensus Grading.

Secondary Outcome Measures

Proportion of participants with immune effector cell-associated neurotoxicity syndrome (ICANS) after IEC therapy
Assessed using the ICANS Consensus Grading. Complete response or partial response for ICANS is defined as either complete disappearance or decrease in the grade of severity as measured by ASTCT Consensus Grading for ICANS. The ASTCT grade is from 1 to 5 for ICANS with 1 being mild symptoms and 5 being severe symptoms.
Duration of ICANS regardless of CRS
Assessed using the ICANS Consensus Grading.
Duration of all grades of CRS
Assessed using ASBMT CRS Consensus Grading.
Proportion of participants with any grade of CRS after IEC therapy
Assessed using ASBMT CRS Consensus Grading.
Proportion of participants with ≥ Grade 2 CRS after first IEC therapy
Assessed using ASBMT CRS Consensus Grading.
Number of treatment-emergent adverse events
Defined as adverse events reported for the first time or worsening of a pre-existing event after first dose of itacitinib.
Number of Particpants with ≥ Grade 3 Cytopenias
Cytopenia is diagnosed with a blood test called a complete blood count (CBC). A CBC shows white blood cell, red blood cell, and platelet counts.
Number of hospital admissions for participants with CRS and/or ICANS
Assessed using ASBMT CRS Consensus Grading.
Duration of hospital stay for participants with CRS and/or ICANS
Assessed using ASBMT CRS Consensus Grading.
Percentage of participants who were treated with tocilizumab for CRS
Assessed using ASBMT CRS Consensus Grading.
Percentage of participants requiring >1 dose of dexamethasone (or equivalent) for ICANS.
Assessed using the ICANS Consensus Grading.

Full Information

First Posted
August 26, 2019
Last Updated
August 29, 2023
Sponsor
Incyte Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04071366
Brief Title
A Study of Itacitinib for the Prevention of Cytokine Release Syndrome Induced by Immune Effector Cell Therapy
Official Title
A Phase 2 Study of Itacitinib, for the Prevention of Cytokine Release Syndrome Induced by Immune Effector Cell Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
February 7, 2020 (Actual)
Primary Completion Date
February 23, 2023 (Actual)
Study Completion Date
August 22, 2023 (Actual)

3. Sponsor/Collaborators

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

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
"The purpose of this study is to assess the safety and efficacy of oral administration of itacitinib for the prevention of cytokine release syndrome (CRS) in male or female participants aged 12 years or older and who are planning to receive an approved immune effector cell (IEC) therapy for hematologic malignancies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cytokine Release Syndrome
Keywords
Cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, Janus kinase inhibitor, immune effector cell therapy

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Part 1: Singe Group Assignment Part 2: Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
Part 1 is not masked (open label). Part 2 is double blinded (participant, investigator)
Allocation
Randomized
Enrollment
112 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1: Open Label Itacitinib Once Daily
Arm Type
Experimental
Arm Description
During Part 1, all participants receive itacitinib 200mg once daily (open label) for 30 days. The study population will include participants receiving any approved IEC for an approved indication.
Arm Title
Part 2: Double-Blind Itacitinib Twice Daily
Arm Type
Experimental
Arm Description
During Part 2, participants will be randomized to receive itacitinib 200mg or placebo twice daily for 30 days. The study population also includes participants who are receiving Yescarta for relapsed or refractory large B-cell lymphoma or follicular lymphoma.
Intervention Type
Drug
Intervention Name(s)
Itacitinib
Other Intervention Name(s)
INCB039110
Intervention Description
Part 1: Itacitinib 200 mg once daily for 30 days. Part 2: Itacitinib 200 mg twice daily for 30 days.
Intervention Type
Drug
Intervention Name(s)
Immune effector cell therapy
Other Intervention Name(s)
CAR-T cell therapy
Intervention Description
Participants will receive IEC therapy that is approved by the health authority in the country where the study is being conducted for any approved hematologic indication.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Participants will receive placebo twice daily.
Intervention Type
Biological
Intervention Name(s)
Yescarta
Other Intervention Name(s)
axicabtagene ciloleucel KTE-C19
Intervention Description
Eligible participants are receiving Yescarta (An infusion of chimeric antigen receptor (CAR)-transduced autologous T cells) for relapsed or refractory larbe B-cell lymphoma or follicular lymphoma intravenously.
Primary Outcome Measure Information:
Title
Proportion of participants who develop ≥ Grade 2 CRS
Description
Assessed using American Society for Blood and Marrow Transplantation (ASBMT) CRS Consensus Grading.
Time Frame
Day 14
Secondary Outcome Measure Information:
Title
Proportion of participants with immune effector cell-associated neurotoxicity syndrome (ICANS) after IEC therapy
Description
Assessed using the ICANS Consensus Grading. Complete response or partial response for ICANS is defined as either complete disappearance or decrease in the grade of severity as measured by ASTCT Consensus Grading for ICANS. The ASTCT grade is from 1 to 5 for ICANS with 1 being mild symptoms and 5 being severe symptoms.
Time Frame
Day 28
Title
Duration of ICANS regardless of CRS
Description
Assessed using the ICANS Consensus Grading.
Time Frame
Day 28
Title
Duration of all grades of CRS
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
Day 28
Title
Proportion of participants with any grade of CRS after IEC therapy
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
48 hours
Title
Proportion of participants with ≥ Grade 2 CRS after first IEC therapy
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
Day 28
Title
Number of treatment-emergent adverse events
Description
Defined as adverse events reported for the first time or worsening of a pre-existing event after first dose of itacitinib.
Time Frame
Day -3 through safety follow-up, up to approximately 60 days.
Title
Number of Particpants with ≥ Grade 3 Cytopenias
Description
Cytopenia is diagnosed with a blood test called a complete blood count (CBC). A CBC shows white blood cell, red blood cell, and platelet counts.
Time Frame
Through end of study, up to 90 days.
Title
Number of hospital admissions for participants with CRS and/or ICANS
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
Through end of study, up to 180 days.
Title
Duration of hospital stay for participants with CRS and/or ICANS
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
Through end of study, up to 180 days.
Title
Percentage of participants who were treated with tocilizumab for CRS
Description
Assessed using ASBMT CRS Consensus Grading.
Time Frame
30 days
Title
Percentage of participants requiring >1 dose of dexamethasone (or equivalent) for ICANS.
Description
Assessed using the ICANS Consensus Grading.
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Part 1: Eligible to receive any IEC therapy for any approved indication. Part 2: Eligible to receive Yescarta for relapsed or refractory large B-cell lymphoma or follicular lymphoma. Eastern Cooperative Oncology Group performance status 0 to 1. Willingness to avoid pregnancy or fathering children Exclusion Criteria: Evidence of active uncontrolled/untreated infection (viral, bacterial, fungal, opportunistic) of any origin. Evidence of active hepatitis B virus or hepatitis C virus infection. Known human immunodeficiency virus. Active acute or chronic graft-versus-host disease requiring systemic therapy. Concurrent use of chronic systemic steroids or immunosuppressant medications. Any unresolved toxicity ≥ Grade 2 (except stable Grade 2 peripheral neuropathy or alopecia) from previous anticancer therapy. Known history or prior diagnosis of immunologic or inflammatory/autoimmune disease affecting the central nervous system (CNS) and unrelated to their disease under study or previous treatment. Clinically significant or uncontrolled cardiac disease. Acute lymphoblastic leukemia participants with protocol-defined CNS status are eligible only in the absence of neurologic symptoms suggestive of CNS leukemia. Diffuse large B-cell lymphoma participants must have no signs or symptoms of CNS disease or detectable evidence of CNS disease; participants who have been previously treated for CNS disease but have no evidence of disease at screening are eligible. Laboratory values at screening outside the protocol-defined ranges.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Langmuir, MD
Organizational Affiliation
Incyte Corporation
Official's Role
Study Director
Facility Information:
Facility Name
University of Miami Sylvester Comprehensive Cancer Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Cincinnati Childrens Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pennsylvania Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32998963
Citation
Huarte E, O'Connor RS, Peel MT, Nunez-Cruz S, Leferovich J, Juvekar A, Yang YO, Truong L, Huang T, Naim A, Milone MC, Smith PA. Itacitinib (INCB039110), a JAK1 Inhibitor, Reduces Cytokines Associated with Cytokine Release Syndrome Induced by CAR T-cell Therapy. Clin Cancer Res. 2020 Dec 1;26(23):6299-6309. doi: 10.1158/1078-0432.CCR-20-1739. Epub 2020 Sep 30.
Results Reference
derived

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A Study of Itacitinib for the Prevention of Cytokine Release Syndrome Induced by Immune Effector Cell Therapy

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