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Study to Assess Efficacy and Safety of NS-018 Compared to BAT in Patients With Myelofibrosis

Primary Purpose

Primary Myelofibrosis, Post-essential Thrombocythemia Myelofibrosis, Post-polycythemia Vera Myelofibrosis

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
NS-018
Best Available Therapy
Sponsored by
NS Pharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Myelofibrosis

Eligibility Criteria

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

Inclusion Criteria:

  • Primary MF, post-PVMF or post-ETMF according to the DIPSS risk categories of intermediate-2 or high-risk MF
  • Average platelet count of <50,000/µL at Screening based on 2 measurements taken on different days; both measurements must be <50,000/µL.
  • ECOG performance status ≤2.
  • Life expectancy >6 months.
  • Spleen volume of at least 450 cm3 measured by MRI (or by CT for applicable subjects).
  • Total Symptom Score (TSS) ≥10 on the Myelofibrosis Symptom Assessment Form (MFSAF) version 4.0.
  • Peripheral blast count <10%.
  • No MF-directed treatment for at least 2 weeks prior to initiation of NS-018, including JAK inhibitor, erythropoietic, thrombopoietic agent, or any use of corticosteroids for MF symptom or blood count management. Low dose corticosteroids <10 mg/day prednisone or equivalent is allowed for non-MF purposes.

Exclusion Criteria:

  • Active, uncontrolled systemic infection.
  • Any prior treatment with more than one JAK inhibitor.
  • Subject has received prior JAK inhibitor treatment and meets one of the following criteria:

    1. A duration of the treatment is 180 days or more.
    2. Loss of spleen response (response defined as at least 50% decrease in spleen length by palpation; loss of response defined as >50% increase in spleen length from the best response).
  • Previous treatment with NS-018.
  • Subjects actively receiving a concurrent investigational agent.
  • Subjects with any unresolved AE greater than Grade 1 other than hematological AEs from previous anticancer therapy.
  • Currently taking medication that is substantially metabolized by cytochrome P450 (CYP) 1A2 or CYP3A4 (see Appendix 5) or taking medication known to be strong inhibitors or inducers of CYP3A4 (see Appendix 5).
  • Radiation therapy for splenomegaly within 6 months prior to study entry (screening).
  • History of splenectomy or planning to undergo splenectomy.
  • Subjects with a serious cardiac condition within the past 6 months such as uncontrolled arrhythmias, myocardial infarction, angina or heart disease
  • Subjects diagnosed with another malignancy within 2 years prior to an enrollment.
  • Subjects who have had surgery (other than placement of vascular access and bone marrow biopsy) within 4 weeks of study entry (screening), or subjects with incomplete recovery from any prior surgical procedures.

Sites / Locations

  • University of Massachusetts Chan Medical SchoolRecruiting
  • Houston Methodist HospitalRecruiting
  • MD Anderson Cancer CenterRecruiting
  • Hamatologisch-onkologische Praxis Heinric/Bangerter Ausgsburg GbRRecruiting
  • Universitaetsklinikum Halle (Saale)Recruiting
  • Universitaetsklinikum JenaRecruiting
  • Universitätsmedizin RostockRecruiting
  • AO SS Antonio
  • Azienda Ospedaliera SS. Antonio
  • ASST Spedali Civili di BresciaRecruiting
  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di BresciaRecruiting
  • AOU "Policlinico - San Marco"
  • ASST Fatebenefratelli Sacco
  • Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico
  • AO di Rilievo Ntl A Cardarelli
  • Azienda Ospedaliera di Rilievo Nazionale
  • AO di Rilievo NazionaleRecruiting
  • Azienda Ospedaliera di Padova
  • Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone
  • Istituto Nazionale Tumori Regina Elena IRCCS
  • Azienda Ospedaliera Universitaria Policlinico Umberto I
  • AO Uni Policlinico Umberto I
  • The Catholic University of Korea, Seoul St. Mary's HospitalRecruiting
  • Gachon University Gil Medical CenterRecruiting
  • Gyeongsang National University HospitalRecruiting
  • CHA Bundang Medical Center, CHA UniversityRecruiting
  • Soon Chun Hyang Central Medical CenterRecruiting
  • Hospital Raja Permaisuri BainunRecruiting
  • Hospital AmpangRecruiting
  • Hospital Sultanah AminahRecruiting
  • Hospital Raja Perempuan Zainab IIRecruiting
  • Hospital Queen ElizabethRecruiting
  • University Malaya Medical CentreRecruiting
  • Sunway Medical CentreRecruiting
  • Hospital Pulau PinangRecruiting
  • Szpital Uniwersytecki nr 2 im. dr J. Biziela
  • Pratia Onkologia Katowice
  • Srinagarind HospitalRecruiting
  • Songklanagarind HospitalRecruiting
  • Royal United Hospitals - BathRecruiting
  • Guys Hospital
  • University College London Hospitals
  • The Christie NHS Foundation TrustRecruiting
  • Derriford HospitalRecruiting
  • Sandwell & West Birmingham HospitalRecruiting
  • Western General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

NS-018

Best Available Therapy (BAT)

Arm Description

Self-administered NS-018 300 mg orally, twice daily, preferably at the same time each day in consecutive 4-week (28-day) cycles

Single agent per Investigator discretion or no therapy

Outcomes

Primary Outcome Measures

Change in spleen volume
Proportion of subjects who achieve ≥35% change in spleen volume from baseline to Week 24 as measured by MRI (or by CT for applicable subjects)
Change in Total Symptom Score (TSS)
Proportion of subjects who achieve ≥50% change in total symptom score from baseline to Week 24 as measured by the MFSAF v4.0

Secondary Outcome Measures

Change in spleen volume
Proportion of subjects in NS-018 vs BAT arm who achieve ≥35% change in spleen volume from baseline at any time up to Week 24 as measured by MRI (or by CT for applicable subjects)
Comparison of treatment-emergent AEs
Laboratory events graded by the NCI CTCAE v5.0 will be assessed in both arms, NS-018 vs BAT.

Full Information

First Posted
April 9, 2021
Last Updated
October 20, 2023
Sponsor
NS Pharma, Inc.
Collaborators
Nippon Shinyaku Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04854096
Brief Title
Study to Assess Efficacy and Safety of NS-018 Compared to BAT in Patients With Myelofibrosis
Official Title
A Phase 2b, Open-label, Multicenter, Randomized, Controlled, 2-Arm Study to Assess the Efficacy and Safety of Orally Administered NS-018 Versus Best Available Therapy in Subjects With Primary Myelofibrosis, Post Polycythemia Vera Myelofibrosis, or Post-Essential Thrombocythemia Myelofibrosis With Severe Thrombocytopenia (Platelet Count <50,000/μL)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 31, 2023 (Actual)
Primary Completion Date
March 24, 2024 (Anticipated)
Study Completion Date
April 24, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NS Pharma, Inc.
Collaborators
Nippon Shinyaku Co., Ltd.

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 study will enroll male and female subjects who are 18 years of age or older with Primary Myelofibrosis, post-polycythemia Vera Myelofibrosis, or post-essential Thrombocythemia Myelofibrosis with severe thrombocytopenia (platelet count <50,000/µL) including subjects with intermediate-2 or high-risk MF according to the Dynamic International Prognostic Scoring System (DIPSS).
Detailed Description
NS-018 will be self-administered orally at a dose of 300 mg BID. The BAT will be administered according to manufacturer's instructions and Investigator discretion. Subjects will complete study visits at Screening, Day 1 and Day 15 of Cycle 1, 2, 3, 4, 5, 6 and Day 1 of every cycle thereafter. At these visits, blood/urine sampling, spleen measurements, bone marrow assessments, patient-reported outcome (PRO) assessments, and safety assessments may be performed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Myelofibrosis, Post-essential Thrombocythemia Myelofibrosis, Post-polycythemia Vera Myelofibrosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
NS-018
Arm Type
Experimental
Arm Description
Self-administered NS-018 300 mg orally, twice daily, preferably at the same time each day in consecutive 4-week (28-day) cycles
Arm Title
Best Available Therapy (BAT)
Arm Type
Active Comparator
Arm Description
Single agent per Investigator discretion or no therapy
Intervention Type
Drug
Intervention Name(s)
NS-018
Intervention Description
Experimental
Intervention Type
Drug
Intervention Name(s)
Best Available Therapy
Intervention Description
Active Comparator
Primary Outcome Measure Information:
Title
Change in spleen volume
Description
Proportion of subjects who achieve ≥35% change in spleen volume from baseline to Week 24 as measured by MRI (or by CT for applicable subjects)
Time Frame
from baseline to week 24
Title
Change in Total Symptom Score (TSS)
Description
Proportion of subjects who achieve ≥50% change in total symptom score from baseline to Week 24 as measured by the MFSAF v4.0
Time Frame
from baseline to week 24
Secondary Outcome Measure Information:
Title
Change in spleen volume
Description
Proportion of subjects in NS-018 vs BAT arm who achieve ≥35% change in spleen volume from baseline at any time up to Week 24 as measured by MRI (or by CT for applicable subjects)
Time Frame
from baseline at anytime up to week 24
Title
Comparison of treatment-emergent AEs
Description
Laboratory events graded by the NCI CTCAE v5.0 will be assessed in both arms, NS-018 vs BAT.
Time Frame
from baseline to week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Primary MF, post-PVMF or post-ETMF according to the DIPSS risk categories of intermediate-2 or high-risk MF Average platelet count of <50,000/µL at Screening based on 2 measurements taken on different days; both measurements must be <50,000/µL. ECOG performance status ≤2. Life expectancy >6 months. Spleen volume of at least 450 cm3 measured by MRI (or by CT for applicable subjects). Total Symptom Score (TSS) ≥10 on the Myelofibrosis Symptom Assessment Form (MFSAF) version 4.0. Peripheral blast count <10%. No MF-directed treatment for at least 2 weeks prior to initiation of NS-018, including JAK inhibitor, erythropoietic, thrombopoietic agent, or any use of corticosteroids for MF symptom or blood count management. Low dose corticosteroids <10 mg/day prednisone or equivalent is allowed for non-MF purposes. Exclusion Criteria: Active, uncontrolled systemic infection. Any prior treatment with more than two JAK inhibitors. Previous treatment with NS-018. Subjects actively receiving a concurrent investigational agent. Subjects with any unresolved AE greater than Grade 1 other than hematological AEs from previous anticancer therapy. Currently taking medication that is substantially metabolized by cytochrome P450 (CYP) 1A2 or CYP3A4 (see Appendix 5) or taking medication known to be strong inhibitors or inducers of CYP3A4 (see Appendix 5). Radiation therapy for splenomegaly within 6 months prior to study entry (screening). History of splenectomy or planning to undergo splenectomy. Subjects with a serious cardiac condition within the past 6 months such as uncontrolled arrhythmias, myocardial infarction, angina or heart disease Subjects diagnosed with another malignancy within 2 years prior to an enrollment. Subjects who have had surgery (other than placement of vascular access and bone marrow biopsy) within 4 weeks of study entry (screening), or subjects with incomplete recovery from any prior surgical procedures.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
NS Pharma, Inc.
Email
trialinfo@nspharma.com
Facility Information:
Facility Name
University of Massachusetts Chan Medical School
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Individual Site Status
Recruiting
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77002
Country
United States
Individual Site Status
Recruiting
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
Hamatologisch-onkologische Praxis Heinric/Bangerter Ausgsburg GbR
City
Augsburg
ZIP/Postal Code
86150
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitaetsklinikum Halle (Saale)
City
Halle
ZIP/Postal Code
6120
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitaetsklinikum Jena
City
Jena
ZIP/Postal Code
07747
Country
Germany
Individual Site Status
Recruiting
Facility Name
Universitätsmedizin Rostock
City
Rostock
ZIP/Postal Code
18057
Country
Germany
Individual Site Status
Recruiting
Facility Name
AO SS Antonio
City
Alessandria
ZIP/Postal Code
15121
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Azienda Ospedaliera SS. Antonio
City
Alessandria
ZIP/Postal Code
15121
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
ASST Spedali Civili di Brescia
City
Brescia
ZIP/Postal Code
25123
Country
Italy
Individual Site Status
Recruiting
Facility Name
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
City
Brescia
ZIP/Postal Code
25123
Country
Italy
Individual Site Status
Recruiting
Facility Name
AOU "Policlinico - San Marco"
City
Catania
ZIP/Postal Code
95123
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
ASST Fatebenefratelli Sacco
City
Milano
ZIP/Postal Code
20121
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico
City
Milano
ZIP/Postal Code
20122
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
AO di Rilievo Ntl A Cardarelli
City
Naples
ZIP/Postal Code
80131
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Azienda Ospedaliera di Rilievo Nazionale
City
Naples
ZIP/Postal Code
80131
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
AO di Rilievo Nazionale
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Individual Site Status
Recruiting
Facility Name
Azienda Ospedaliera di Padova
City
Padova
ZIP/Postal Code
35128
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone
City
Palermo
ZIP/Postal Code
90127
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Istituto Nazionale Tumori Regina Elena IRCCS
City
Roma
ZIP/Postal Code
00144
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Azienda Ospedaliera Universitaria Policlinico Umberto I
City
Roma
ZIP/Postal Code
00161
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
AO Uni Policlinico Umberto I
City
Rome
ZIP/Postal Code
161
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
The Catholic University of Korea, Seoul St. Mary's Hospital
City
Banpo-dong
ZIP/Postal Code
164 KR
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Gachon University Gil Medical Center
City
Incheon
ZIP/Postal Code
21565
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Gyeongsang National University Hospital
City
Jinju-si
ZIP/Postal Code
52727
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
CHA Bundang Medical Center, CHA University
City
Seongnam
ZIP/Postal Code
164 KR
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Soon Chun Hyang Central Medical Center
City
Seoul
ZIP/Postal Code
4401
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Hospital Raja Permaisuri Bainun
City
Ipoh
State/Province
Perak
ZIP/Postal Code
30450
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Hospital Ampang
City
Ampang
ZIP/Postal Code
68000
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Hospital Sultanah Aminah
City
Johor Bahru
ZIP/Postal Code
80100
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Hospital Raja Perempuan Zainab II
City
Kota Bahru
ZIP/Postal Code
15586
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Hospital Queen Elizabeth
City
Kota Kinabalu
ZIP/Postal Code
88586
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
University Malaya Medical Centre
City
Kuala Lumpur
ZIP/Postal Code
59100
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Sunway Medical Centre
City
Petaling Jaya
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Hospital Pulau Pinang
City
Pulau Pinang
ZIP/Postal Code
10990
Country
Malaysia
Individual Site Status
Recruiting
Facility Name
Szpital Uniwersytecki nr 2 im. dr J. Biziela
City
Bydgoszcz
ZIP/Postal Code
85-168
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Pratia Onkologia Katowice
City
Katowice
ZIP/Postal Code
40-519
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Srinagarind Hospital
City
Khon Kaen
ZIP/Postal Code
40002
Country
Thailand
Individual Site Status
Recruiting
Facility Name
Songklanagarind Hospital
City
Songkla
ZIP/Postal Code
90110
Country
Thailand
Individual Site Status
Recruiting
Facility Name
Royal United Hospitals - Bath
City
Bath
State/Province
England
ZIP/Postal Code
BA1 3NG
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Guys Hospital
City
London
State/Province
England
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Name
University College London Hospitals
City
London
State/Province
England
ZIP/Postal Code
WC1E 6HX
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Name
The Christie NHS Foundation Trust
City
Manchester
State/Province
England
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Derriford Hospital
City
Plymouth
State/Province
England
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Sandwell & West Birmingham Hospital
City
West Bromwich
State/Province
England
ZIP/Postal Code
B71 4HJ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Western General Hospital
City
Edinburgh
State/Province
Scotland
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Submission to the FDA

Learn more about this trial

Study to Assess Efficacy and Safety of NS-018 Compared to BAT in Patients With Myelofibrosis

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