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A Study of Anagrelide Controlled Release (GALE-401) in Patients With High Platelet Counts Due to Bone Marrow Disorders

Primary Purpose

Thrombocytosis, Myeloproliferative Neoplasms

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Anagrelide CR
Sponsored by
Galena Biopharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thrombocytosis focused on measuring myeloproliferative neoplasm, chronic myelogenous leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, anagrelide, thrombocytosis, GALE-401

Eligibility Criteria

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

Inclusion Criteria:

  1. Provide written informed consent prior to any study specific procedure
  2. Male or female patients aged ≥ 18 years
  3. Diagnosis of a myeloproliferative neoplasm (i.e., chronic myelogenous leukemia (CML), polycythemia vera (PV), primary myelofibrosis (PMF), essential thrombocythemia (ET)) as determined by the treating physician, such as based on the 2008 World Health Organization (WHO) classification of myeloid malignancies
  4. Baseline platelet count ≥600 x 10e9/L as determined on two occasions at least 14 days apart prior to the first dose of study drug
  5. Requirement for platelet reduction therapy as assessed by the Investigator
  6. Currently not receiving therapy specifically intended to reduce platelet counts
  7. For patients with ET, prior platelet lowering therapy (e.g., hydroxyurea, anagrelide or interferon) may not be administered within 2 weeks prior to the first dose of study drug.

    For patients with MPN diagnoses other than ET, concurrent anti-MPN treatment is permitted provided that the treatment has been administered at stable doses for at least 4 weeks prior to the first dose of study drug. Examples of permitted medications include but are not limited to hydroxyurea for PV, ruxolitinib for MF, and imatinib for CML. All patients must have discontinued anagrelide at least 2 weeks prior to the first dose of study drug.

    EXCEPTION: busulfan, melphalan and phosphate P-32 must have been discontinued at least 4 weeks prior to the first dose of study drug.

  8. Adequate hepatic function defined as bilirubin ≤1.5 x ULN, INR ≤1.5 x ULN, albumin >3.5 g/dL, ALT < 3.0 x ULN, AST < 3.0 x ULN
  9. If female, must be of non-childbearing potential, i.e. post- menopausal (defined as > 12 months since last menstrual period) or surgically sterilized (i.e. tubal ligation or hysterectomy at least 6 months prior to screening) or, if of childbearing potential, must not be pregnant or nursing
  10. Males and females of child bearing must agree to use an acceptable form of birth control until 28 days following the last dose of study drug

Exclusion Criteria:

  1. Other MPN diagnoses not specifically included above: Chronic neutrophilic leukemia, chronic eosinophilic leukemia, mastocytosis, and unclassifiable MPNs
  2. Previously found to be refractory to anagrelide therapy (i.e., failure to achieve a platelet count <600 x 10e9/L for reasons other than anagrelide-related toxicity)
  3. History of coronary artery disease requiring a revascularization procedure within 3 months prior to screening
  4. Left bundle branch block or sustained ventricular tachycardia (>30 seconds) evident on 12-lead ECG at screening
  5. Tachycardia defined as resting heart rate >100 bpm at screening
  6. Unstable angina (characterized by increasingly frequent episodes with modest exertion or at rest, worsening severity, or prolonged duration) within 3 months prior to screening
  7. Transient ischemic attack (TIA) or stroke within 3 months prior to screening
  8. Unstable or clinically significant concurrent medical condition that would, in the opinion of the Investigator, jeopardize the safety of a subject and/or their compliance with the protocol.
  9. Current alcohol or drug abuse, or a significant medical condition that, in the opinion of the Investigator, may impair compliance with the requirements of the protocol
  10. History of allergic hypersensitivity to anagrelide or any component of its formulations
  11. Administration of Type 3 phosphodiesterase (PDE3) inhibitors (e.g., inamrinone, cilostazol, milrinone) within 2 weeks prior to initiating study treatment
  12. Administration of any investigational product within 4 weeks prior to initiating study treatment
  13. History of intolerance of other PDE3 inhibitors

Sites / Locations

  • East Valley Hematology and Oncology Medical Group
  • California Cancer Associates for Research & Excellence (cCARE)
  • California Cancer Associates for Research & Excellence (cCARE)
  • California Cancer Associates For Research and Excellence
  • Innovative Medical Research of South Florida, Inc.
  • Cancer Center of Kansas
  • Wake Forest Baptist Health
  • Gettysburg Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • Cancer Care Centers of South Texas
  • Cancer Care Centers of South Texas

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Anagrelide CR (GALE-401)

Arm Description

Outcomes

Primary Outcome Measures

Platelet Response
The primary efficacy endpoint will be the proportion of subjects who achieve a platelet response (complete or partial response), with response defined according to the following criteria: Complete response (CR): platelet count of ≤400 x 10e9/L maintained for at least 4 weeks Partial response (PR): a platelet count of ≤600 x 10e9/L or a ≥50% reduction from baseline and maintenance of the reduction for at least 4 weeks Nonresponse: failure to meet CR or PR criteria

Secondary Outcome Measures

Number of subjects with adverse events
Frequency and severity of adverse events as determined by NCI CTCAE (v 4.03).
Plasma concentrations of anagrelide
Monitor anagrelide levels during dose titration and assess pharmacokinetic profile at starting and final dose levels.

Full Information

First Posted
April 23, 2014
Last Updated
February 23, 2017
Sponsor
Galena Biopharma, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02125318
Brief Title
A Study of Anagrelide Controlled Release (GALE-401) in Patients With High Platelet Counts Due to Bone Marrow Disorders
Official Title
A Phase 2, Open Label Efficacy and Safety Study of Anagrelide Controlled Release (CR) in Subjects With Thrombocytosis Secondary to Essential Thrombocythemia and Other Myeloproliferative Neoplasms (MPN)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
May 2014 (undefined)
Primary Completion Date
May 2016 (Actual)
Study Completion Date
May 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Galena Biopharma, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Anagrelide is a drug that has been shown to slow down how fast platelets are made in the bone marrow, and has been approved by the FDA for treating high platelets counts in patients with bone marrow disorders. Anagrelide Controlled Release ("CR") is a new preparation of anagrelide that is made to dissolve more slowly than currently marketed versions of this drug. Because of this, the anagrelide is taken up into the blood more slowly. Researchers think that this slower release of the drug could help to lower side effects that might be caused by high blood levels when the drug dissolves as quickly as it does with the currently marketed product. The main purposes of this study are to see how well Anagrelide CR can control platelet counts in patients with high platelet levels, to see what kind of side effects it causes, and to measure blood levels of the drug.
Detailed Description
This is an open-label, single-arm, multicenter, Phase 2 study of anagrelide CR in subjects with an MPN-related thrombocytosis. Eligible subjects will include those who have not been previously treated for thrombocytosis or have not received platelet-lowering therapy for at least 2 weeks prior to study treatment. Each subject will receive anagrelide CR at a starting dose of 0.5 mg b.i.d. (1.0 mg/day), and is anticipated to continue study treatment for at least 24 weeks. Subjects who have achieved clinical benefit in the opinion of the Investigator and who are tolerating the study drug may continue study treatment until they develop unacceptable toxicity or other discontinuation criteria have been met. The primary efficacy endpoint will be the proportion of subjects who achieve a platelet response (CR or PR). The safety and tolerability of study treatment will be assessed by the frequency and severity of adverse events as determined by NCI Common Terminology Criteria for Adverse Events (CTCAE) v 4.03. The PK profile of anagrelide CR will be assessed at the initial (0.5mg b.i.d.) and final titrated dose levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombocytosis, Myeloproliferative Neoplasms
Keywords
myeloproliferative neoplasm, chronic myelogenous leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, anagrelide, thrombocytosis, GALE-401

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Anagrelide CR (GALE-401)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Anagrelide CR
Other Intervention Name(s)
GALE-401
Intervention Description
Starting dose of 0.5 mg b.i.d. (1.0 mg/day) titrated at weekly intervals, on an individual basis, to achieve the lowest dose required to achieve and maintain a target platelet count of 150 - 400 x 10e9/L, tolerability permitting. The dose will be increased at weekly intervals in steps not exceeding 0.5 mg/day; the rate of dose titration may be reduced (i.e., up to once every 2 weeks) at the discretion of the Investigator.
Primary Outcome Measure Information:
Title
Platelet Response
Description
The primary efficacy endpoint will be the proportion of subjects who achieve a platelet response (complete or partial response), with response defined according to the following criteria: Complete response (CR): platelet count of ≤400 x 10e9/L maintained for at least 4 weeks Partial response (PR): a platelet count of ≤600 x 10e9/L or a ≥50% reduction from baseline and maintenance of the reduction for at least 4 weeks Nonresponse: failure to meet CR or PR criteria
Time Frame
Up to 24 weeks
Secondary Outcome Measure Information:
Title
Number of subjects with adverse events
Description
Frequency and severity of adverse events as determined by NCI CTCAE (v 4.03).
Time Frame
Throughout study treatment (expected average of 12 months)
Title
Plasma concentrations of anagrelide
Description
Monitor anagrelide levels during dose titration and assess pharmacokinetic profile at starting and final dose levels.
Time Frame
Up to 13 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent prior to any study specific procedure Male or female patients aged ≥ 18 years Diagnosis of a myeloproliferative neoplasm (i.e., chronic myelogenous leukemia (CML), polycythemia vera (PV), primary myelofibrosis (PMF), essential thrombocythemia (ET)) as determined by the treating physician, such as based on the 2008 World Health Organization (WHO) classification of myeloid malignancies Baseline platelet count ≥600 x 10e9/L as determined on two occasions at least 14 days apart prior to the first dose of study drug Requirement for platelet reduction therapy as assessed by the Investigator Currently not receiving therapy specifically intended to reduce platelet counts For patients with ET, prior platelet lowering therapy (e.g., hydroxyurea, anagrelide or interferon) may not be administered within 2 weeks prior to the first dose of study drug. For patients with MPN diagnoses other than ET, concurrent anti-MPN treatment is permitted provided that the treatment has been administered at stable doses for at least 4 weeks prior to the first dose of study drug. Examples of permitted medications include but are not limited to hydroxyurea for PV, ruxolitinib for MF, and imatinib for CML. All patients must have discontinued anagrelide at least 2 weeks prior to the first dose of study drug. EXCEPTION: busulfan, melphalan and phosphate P-32 must have been discontinued at least 4 weeks prior to the first dose of study drug. Adequate hepatic function defined as bilirubin ≤1.5 x ULN, INR ≤1.5 x ULN, albumin >3.5 g/dL, ALT < 3.0 x ULN, AST < 3.0 x ULN If female, must be of non-childbearing potential, i.e. post- menopausal (defined as > 12 months since last menstrual period) or surgically sterilized (i.e. tubal ligation or hysterectomy at least 6 months prior to screening) or, if of childbearing potential, must not be pregnant or nursing Males and females of child bearing must agree to use an acceptable form of birth control until 28 days following the last dose of study drug Exclusion Criteria: Other MPN diagnoses not specifically included above: Chronic neutrophilic leukemia, chronic eosinophilic leukemia, mastocytosis, and unclassifiable MPNs Previously found to be refractory to anagrelide therapy (i.e., failure to achieve a platelet count <600 x 10e9/L for reasons other than anagrelide-related toxicity) History of coronary artery disease requiring a revascularization procedure within 3 months prior to screening Left bundle branch block or sustained ventricular tachycardia (>30 seconds) evident on 12-lead ECG at screening Tachycardia defined as resting heart rate >100 bpm at screening Unstable angina (characterized by increasingly frequent episodes with modest exertion or at rest, worsening severity, or prolonged duration) within 3 months prior to screening Transient ischemic attack (TIA) or stroke within 3 months prior to screening Unstable or clinically significant concurrent medical condition that would, in the opinion of the Investigator, jeopardize the safety of a subject and/or their compliance with the protocol. Current alcohol or drug abuse, or a significant medical condition that, in the opinion of the Investigator, may impair compliance with the requirements of the protocol History of allergic hypersensitivity to anagrelide or any component of its formulations Administration of Type 3 phosphodiesterase (PDE3) inhibitors (e.g., inamrinone, cilostazol, milrinone) within 2 weeks prior to initiating study treatment Administration of any investigational product within 4 weeks prior to initiating study treatment History of intolerance of other PDE3 inhibitors
Facility Information:
Facility Name
East Valley Hematology and Oncology Medical Group
City
Burbank
State/Province
California
ZIP/Postal Code
91505
Country
United States
Facility Name
California Cancer Associates for Research & Excellence (cCARE)
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
California Cancer Associates for Research & Excellence (cCARE)
City
Escondido
State/Province
California
ZIP/Postal Code
92025
Country
United States
Facility Name
California Cancer Associates For Research and Excellence
City
Fresno
State/Province
California
ZIP/Postal Code
93720
Country
United States
Facility Name
Innovative Medical Research of South Florida, Inc.
City
Aventura
State/Province
Florida
ZIP/Postal Code
33180
Country
United States
Facility Name
Cancer Center of Kansas
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
Wake Forest Baptist Health
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Gettysburg Cancer Center
City
Gettysburgh
State/Province
Pennsylvania
ZIP/Postal Code
17325
Country
United States
Facility Name
The University of Texas MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Cancer Care Centers of South Texas
City
New Braunfels
State/Province
Texas
ZIP/Postal Code
78130
Country
United States
Facility Name
Cancer Care Centers of South Texas
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study of Anagrelide Controlled Release (GALE-401) in Patients With High Platelet Counts Due to Bone Marrow Disorders

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