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A Study to Evaluate P1101 in Japanese PV Patients

Primary Purpose

Polycythemia Vera (PV)

Status
Recruiting
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
P1101
Low-dose aspirin
Phlebotomy
Sponsored by
PharmaEssentia Japan K.K.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Polycythemia Vera (PV) focused on measuring Myeloproliferative Neoplasms

Eligibility Criteria

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

Inclusion Criteria: Male or female patients ≥18 years old at the time of informed consent to participate in the study Patients diagnosed with PV according to the WHO 2008 or 2016 criteria Patients with PV who have the inadequate response to an existing therapy or whom the existing therapy is inappropriate to apply (see Appendix 6) Patients with adequate hepatic function at screening defined as total bilirubin ≤1.5 x upper limit of normal (ULN), international normalized ratio (INR) of prothrombin time (PT) ≤1.5 x ULN, albumin >3.5 g/dL, alanine aminotransferase (ALT) ≤2.0 x ULN, and aspartate aminotransferase (AST) ≤2.0 x ULN. Patients with hemoglobin (HGB) ≥10 g/dL in female and ≥11 g/dL in male at screening Patients with a neutrophil count ≥1.5 x 10^9/L at screening Patients with serum creatinine ≤1.5 x ULN at screening Males, and females of childbearing potential, as well as all women <2 years after the onset of menopause, must agree to use an acceptable form of birth control until 14 days following the last dose of the study drug. Also, women must agree not to breastfeed during the study (see Appendix 4 for details) Written informed consent has been obtained from the patient or the patient's legally authorized representative, and the patient is capable of complying with the study requirements. Exclusion Criteria: Patients with contraindications to or hypersensitivity to IFN-α Patients with previous use of IFN-α, or previous treatment with ruxolitinib Patients with comorbidity with severe or serious condition that, in the opinion of the Investigator, may impact the patient's participation in the study Patients with a history of major organ transplantation Pregnant or lactating females Patients with any other medical condition that, in the opinion of the Investigator, might impair the outcome of the study or compliance with the requirements of the protocol. These diseases include, but are not limited to, the following: 6.1 Patients with a history or presence of autoimmune thyroid dysfunction (clinical symptoms of hyper- or hypo-thyroidism), except late stages cases on the oral thyroid substitution therapy, where potential exacerbation under interferon therapy will not constitute any further harm to the patient 6.2 Patients with any documented history of autoimmune disease (for example, hepatitis, idiopathic thrombocytopenic purpura [ITP], scleroderma, psoriasis, or autoimmune arthritis) 6.3 Patients with clinically relevant pulmonary infiltrates, infectious pneumonia or noninfectious pneumonia at screening, or a history of interstitial pulmonary disease. 6.4 Patients with active infection with systemic symptoms (for example, bacterial, fungal, hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection at screening). 6.5 Patients with any evidence of severe retinal disease (e.g., cytomegalovirus [CMV] retinitis, macular degeneration) or clinically relevant ophthalmologic disease (due to diabetes mellitus or hypertension) based on the ophthalmological assessment by specialists. 6.6 Patients with uncontrolled depression in the opinion of the Investigator 6.7 Patients with a history of suicide attempts or at risk for suicide at screening 6.8 Patients with uncontrolled diabetes mellitus (baseline HbA1c >7%) 6.9 Patients with active thromboembolism or active abdominal bleeding due to PV 6.10 Patients with a history of malignancy within the last 5 years [excluding adequately treated non-melanoma skin cancers, post-prostatectomy prostate-specific antigen (PSA) failure, healed cervical intraepithelial neoplasia and ductal carcinoma in situ (DCIS), stage 1 endometrial carcinoma, or solid tumors (without myelopathy), including other lymphomas that have not had evidence of disease for at least 2 years after treatment]. 6.11 Patients with a history of alcohol or drug abuse within the recent one year 6.12 Patients with a history or evidence of post-polycythemia vera myelofibrosis (post-PV MF), essential thrombocythemia, or MPN other than PV Patients who received any other study treatment or concomitant medication with other study drug within 4 weeks prior to the first dose of study drug in this study or not recovered from any prior exposure to any other study drug. Patients with symptomatic splenomegaly Patients with circulating blasts in the peripheral blood within the last 12 weeks

Sites / Locations

  • Mie University HospitalRecruiting
  • Osaka University HospitalRecruiting
  • Kansai Medical University HospitalRecruiting
  • Juntendo University HospitalRecruiting
  • Tokyo Medical University HospitalRecruiting
  • University of Yamanashi HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

P1101

Arm Description

Conventional treatment based on phlebotomies, low-dose aspirin (acetylsalicylic acid, 75-150 mg/day) plus the subcutaneous administration of pegylated proline-interferon alpha-2b (P1101, ropeginterferon alfa-2b) once every 2 weeks.

Outcomes

Primary Outcome Measures

Proportion of Subjects Who Achieved Durable Phlebotomy-free Complete Hematological Response (CHR) at Week 24

Secondary Outcome Measures

Rate of achieving "phlebotomy-free complete hematologic response (CHR)" (the same criteria as for the primary efficacy endpoint) at both Week 12 and Week 24.
Time to achieve CHR
Time to reach response maintenance dose (three consecutive doses of the same dose)
Numbers of phlebotomy required and changes in numbers of phlebotomy required from baseline
Time to first response in peripheral blood count (Hct, WBC, and PLT)
Duration of response in peripheral blood count (Hct, WBC, and PLT)
Improvement of symptoms assessed by MPN-SAF TSS at each visit
Rated on a scale of 0-10 on an 11-point scale, with 0 being no symptoms, 1 being the best, and 10 being the worst.
Proportion of subjects without thrombotic or hemorrhagic events at Weeks 12 and 24
Change from baseline to Week 24 in JAK2 V617F allele burden level
Collect and measure Pharmacokinetics (PK) at trough

Full Information

First Posted
July 31, 2023
Last Updated
October 1, 2023
Sponsor
PharmaEssentia Japan K.K.
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1. Study Identification

Unique Protocol Identification Number
NCT06002490
Brief Title
A Study to Evaluate P1101 in Japanese PV Patients
Official Title
A Phase III b, Single-arm, Multicenter, Optimal Dose Finding Study to Assess the Efficacy and Safety of P1101 in Japanese Patients With Polycythemia Vera (PV).
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 1, 2023 (Anticipated)
Primary Completion Date
July 31, 2024 (Anticipated)
Study Completion Date
July 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PharmaEssentia Japan K.K.

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 is a Phase 3 single arm study to investigate efficacy and safety of P1101's rapid titration for adult Japanese patients with PV.
Detailed Description
Eligible patients will be treated with P1101, starting at 250 μg. A starting dose of P1101 is 250 mcg, an intermediate dose is 350 mcg, and a target dose is 500 mcg. As such, subjects will not be exposed to below optimal doses within the first 4 weeks. The maximum recommended single dose is 500 μg injected every two weeks. A primary efficacy endpoint is the rate of phlebotomy-free complete hematologic response (CHR) at Week 24, where CHR is defined as the proportion of patients who have achieved a CHR and have not required phlebotomy in the previous 12 weeks. A responder for the primary endpoint is defined as meeting all of the following criteria at Week 24: Hct (<45%), WBC (≤10 x 10^9/L), and PLT (≤400 x 10^9/L).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Polycythemia Vera (PV)
Keywords
Myeloproliferative Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Model Description
Conventional treatment based on phlebotomies, low-dose aspirin (acetylsalicylic acid, 75-150 mg/day) plus the subcutaneous administration of P1101 (ropeginterferon alfa-2b) once every 2 weeks
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
P1101
Arm Type
Experimental
Arm Description
Conventional treatment based on phlebotomies, low-dose aspirin (acetylsalicylic acid, 75-150 mg/day) plus the subcutaneous administration of pegylated proline-interferon alpha-2b (P1101, ropeginterferon alfa-2b) once every 2 weeks.
Intervention Type
Drug
Intervention Name(s)
P1101
Other Intervention Name(s)
Ropeginterferon alfa-2b
Intervention Description
The subjects will be treated with P1101(ropeginterferon alfa-2b), starting at a dose of 250 micrograms. The dose of P1101 will be increased to 350 micrograms 2 weeks later and to 500 micrograms another 2 weeks later, and then P1101 will be administered at a fixed dose of 500 micrograms throughout the treatment period. Although the dose may be reduced to the prior dose for reasons related to the safety or tolerability, the increased dose should be preferably maintained throughout the treatment period. The dose of P1101 will be increased or decreased appropriately depending on the pathological condition in the range up to 500 micrograms.
Intervention Type
Drug
Intervention Name(s)
Low-dose aspirin
Other Intervention Name(s)
Low-doaw Acetylsalicylic acid
Intervention Description
Low-dose aspirin (acetylsalicylic acid) (75-150 mg/day) will be given as background therapy during the 12 months of study treatment, unless contraindicated.
Intervention Type
Procedure
Intervention Name(s)
Phlebotomy
Intervention Description
Phlebotomy is performed aiming at a hematocrit < 45%. When the hematocrit value is 45% or higher, phlebotomy is performed. The volume of phlebotomy per procedure should be 200 to 400 mL while monitoring the circulatory dynamics such as blood pressure and pulse. In the elderly and patients with cardiovascular disorders, a small volume (100-200 mL) should be considered to avoid rapid changes in hemodynamics.
Primary Outcome Measure Information:
Title
Proportion of Subjects Who Achieved Durable Phlebotomy-free Complete Hematological Response (CHR) at Week 24
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Rate of achieving "phlebotomy-free complete hematologic response (CHR)" (the same criteria as for the primary efficacy endpoint) at both Week 12 and Week 24.
Time Frame
Week12, Week24
Title
Time to achieve CHR
Time Frame
Up to Week24
Title
Time to reach response maintenance dose (three consecutive doses of the same dose)
Time Frame
Up to Week24
Title
Numbers of phlebotomy required and changes in numbers of phlebotomy required from baseline
Time Frame
Baseline, up to Week24
Title
Time to first response in peripheral blood count (Hct, WBC, and PLT)
Time Frame
Up to Week24
Title
Duration of response in peripheral blood count (Hct, WBC, and PLT)
Time Frame
Up to Week24
Title
Improvement of symptoms assessed by MPN-SAF TSS at each visit
Description
Rated on a scale of 0-10 on an 11-point scale, with 0 being no symptoms, 1 being the best, and 10 being the worst.
Time Frame
Up to Week24
Title
Proportion of subjects without thrombotic or hemorrhagic events at Weeks 12 and 24
Time Frame
Week12, week24
Title
Change from baseline to Week 24 in JAK2 V617F allele burden level
Time Frame
Baseline, week24
Title
Collect and measure Pharmacokinetics (PK) at trough
Time Frame
Day1, Week2, Week4, Week6, Week8, Week10, Week12, Week14, Week16, Week18, Week20, Week22, Week24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients ≥18 years old at the time of informed consent to participate in the study Patients diagnosed with PV according to the WHO 2008 or 2016 criteria Patients with PV who have the inadequate response to an existing therapy or whom the existing therapy is inappropriate to apply (see Appendix 6) Patients with adequate hepatic function at screening defined as total bilirubin ≤1.5 x upper limit of normal (ULN), international normalized ratio (INR) of prothrombin time (PT) ≤1.5 x ULN, albumin >3.5 g/dL, alanine aminotransferase (ALT) ≤2.0 x ULN, and aspartate aminotransferase (AST) ≤2.0 x ULN. Patients with hemoglobin (HGB) ≥10 g/dL in female and ≥11 g/dL in male at screening Patients with a neutrophil count ≥1.5 x 10^9/L at screening Patients with serum creatinine ≤1.5 x ULN at screening Males, and females of childbearing potential, as well as all women <2 years after the onset of menopause, must agree to use an acceptable form of birth control until 14 days following the last dose of the study drug. Also, women must agree not to breastfeed during the study (see Appendix 4 for details) Written informed consent has been obtained from the patient or the patient's legally authorized representative, and the patient is capable of complying with the study requirements. Exclusion Criteria: Patients with contraindications to or hypersensitivity to IFN-α Patients with previous use of IFN-α, or previous treatment with ruxolitinib Patients with comorbidity with severe or serious condition that, in the opinion of the Investigator, may impact the patient's participation in the study Patients with a history of major organ transplantation Pregnant or lactating females Patients with any other medical condition that, in the opinion of the Investigator, might impair the outcome of the study or compliance with the requirements of the protocol. These diseases include, but are not limited to, the following: 6.1 Patients with a history or presence of autoimmune thyroid dysfunction (clinical symptoms of hyper- or hypo-thyroidism), except late stages cases on the oral thyroid substitution therapy, where potential exacerbation under interferon therapy will not constitute any further harm to the patient 6.2 Patients with any documented history of autoimmune disease (for example, hepatitis, idiopathic thrombocytopenic purpura [ITP], scleroderma, psoriasis, or autoimmune arthritis) 6.3 Patients with clinically relevant pulmonary infiltrates, infectious pneumonia or noninfectious pneumonia at screening, or a history of interstitial pulmonary disease. 6.4 Patients with active infection with systemic symptoms (for example, bacterial, fungal, hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection at screening). 6.5 Patients with any evidence of severe retinal disease (e.g., cytomegalovirus [CMV] retinitis, macular degeneration) or clinically relevant ophthalmologic disease (due to diabetes mellitus or hypertension) based on the ophthalmological assessment by specialists. 6.6 Patients with uncontrolled depression in the opinion of the Investigator 6.7 Patients with a history of suicide attempts or at risk for suicide at screening 6.8 Patients with uncontrolled diabetes mellitus (baseline HbA1c >7%) 6.9 Patients with active thromboembolism or active abdominal bleeding due to PV 6.10 Patients with a history of malignancy within the last 5 years [excluding adequately treated non-melanoma skin cancers, post-prostatectomy prostate-specific antigen (PSA) failure, healed cervical intraepithelial neoplasia and ductal carcinoma in situ (DCIS), stage 1 endometrial carcinoma, or solid tumors (without myelopathy), including other lymphomas that have not had evidence of disease for at least 2 years after treatment]. 6.11 Patients with a history of alcohol or drug abuse within the recent one year 6.12 Patients with a history or evidence of post-polycythemia vera myelofibrosis (post-PV MF), essential thrombocythemia, or MPN other than PV Patients who received any other study treatment or concomitant medication with other study drug within 4 weeks prior to the first dose of study drug in this study or not recovered from any prior exposure to any other study drug. Patients with symptomatic splenomegaly Patients with circulating blasts in the peripheral blood within the last 12 weeks
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hiroaki Kawase
Phone
+81-3-6910-5103
Email
hiroaki_kawase@pharmaessentia.com
Facility Information:
Facility Name
Mie University Hospital
City
Mie
ZIP/Postal Code
514-8507
Country
Japan
Individual Site Status
Recruiting
Facility Name
Osaka University Hospital
City
Osaka
ZIP/Postal Code
565-0871
Country
Japan
Individual Site Status
Recruiting
Facility Name
Kansai Medical University Hospital
City
Osaka
ZIP/Postal Code
573-1191
Country
Japan
Individual Site Status
Recruiting
Facility Name
Juntendo University Hospital
City
Tokyo
ZIP/Postal Code
113-8431
Country
Japan
Individual Site Status
Recruiting
Facility Name
Tokyo Medical University Hospital
City
Tokyo
ZIP/Postal Code
160-0023
Country
Japan
Individual Site Status
Recruiting
Facility Name
University of Yamanashi Hospital
City
Yamanashi
ZIP/Postal Code
409-3898
Country
Japan
Individual Site Status
Recruiting

12. IPD Sharing Statement

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A Study to Evaluate P1101 in Japanese PV Patients

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