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Study of Jaktinib In Patients With Myelofibrosis Who Were Relapsed or Refractory of Ruxolitinib Treatment.

Primary Purpose

Myelofibrosis

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Jaktinib Hydrochloride Tablets
Sponsored by
Suzhou Zelgen Biopharmaceuticals Co.,Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelofibrosis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Subjects voluntarily sign the informed consent form (ICF);
  • Age ≥ 18 years, either male or female;
  • Subjects diagnosed with a PMF according to World Health Organiztion (WHO) criteria (2016 Edition), or patients diagnosed with a Post-PV-MF or Post-EF-MF according to International Working Group for Myeloproliferative Neoplasms Research and Treatment (2007 IWG-MRT) criteria;
  • Subjects with intermediate-2 or high-risk myelofibrosis, or Intermediate-1 myelofibrosis with symptoms according to the Dynamic International Prognostic System (DIPSS) scoring system;
  • Subjects are relapsed/refractory to Ruxolitinib:

    1. Relapsed defined as Ruxolitinib treatment for ≥ 3 months, following an initial response, regrowth to < 10% spleen volume reduction (SVR) by MRI or < 30% decrease in spleen size by palpation from baseline;
    2. Refractory defeined as Ruxolitinib treatment for ≥ 3 months observed inadequate efficacy response: < 10%volume SVR by MRI or < 30% decrease in spleen size by palpation from baseline.
  • Subject has a measurable splenomegaly: spleen volume of ≥ 450 cm3 by MRI/CT and ≥ 5 cm below left costal margin by palpation spleen measuring;
  • Expected life expectancy is greater than 24 weeks;
  • Eastern Cooperative Oncology Group (ECOG) performance Score 0-2;
  • Laboratory examination within 7 days before the randomization, fulfilling the following criteria:

Neutrophil count ≥ 0.75 x 109/L, platelet count ≥ 75 x 109/L; Peripheral blood blasts ≤ 10%; ALT and AST≤ 3 ULN, DBIL ≤ 2.0 ULN; Serum creatinine ≤ 2.0 ULN.

Exclusion Criteria:

  • Subjects who have been previously exposed to Janus kinase (JAK) inhibitors other than Ruxolitinib for a total of> 2 weeks;
  • Subjects who have taken Ruxolitinib or other JAK inhibitor within 1 week prior to screening;
  • Subjects with any significant clinical and laboratory abnormalities which may affect the safety evaluation, such as uncontrolled diabetes, uncontrolled hypertension after taking two or more hypotensive drugs or peripheral neuropathy;
  • Subjects with congestive heart failure (NCI-CTCAE V5.0) Class II or above, uncontrolled or unstable angina or myocardial infarction, cerebrovascular accident, or pulmonary embolism within 6 months prior to screening;
  • Subjects who have a history of chronic or recurrent respiratory diseases, such as: chronic obstructive pulmonary disease, recurrent lung infections, etc., or have a history of lung infections within 3 months before screening, or currently have upper respiratory tract infections that have not recovered;
  • Subjects who have not fully recovered from surgical operation within 4 weeks prior to screening;
  • Subjects suffering from arrhythmia and requiring treatment, or QTcB > 480ms at screening;
  • Subjects with clinical symptoms of active bacterial, viral, parasitic or fungal infections requiring treatment at screening;
  • Subjects who had undergone splenectomy, or received radiotherapy to the spleen within 6 months before screening;
  • Subjects with known human immunodeficiency virus (HIV), known active infectious Hepatitis B (HepB), and/or known active infectious Hepatitis C (HepC);
  • Female subjects who are pregnant, currently breastfeeding, planning to become pregnant;
  • Subjects who had experienced malignant tumors (except for adequately treated local basal cell or squamous cell carcinoma of the skin and cervical carcinoma in situ that have been cured) or in combination with other serious diseases within the past 5 years;
  • Subjects who have participated in another clinical trial of a new drug or medical instrument within 1 month before screening.
  • Subjects who have any other conditions that are not specified in the protocol but the investigator believes that they are not suitable for inclusion in this trial.

Sites / Locations

  • The First Affiliated Hospital of Medical School of Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Jaktinib 100mg Bid

Arm Description

Jaktinib twice daily for 6 consecutive 28-day cycles, orally, empty stomach

Outcomes

Primary Outcome Measures

Spleen Volume Response rate (SVRR) at Week 24
The proportion of subjects with spleen volume reduction from baseline ≥ 35% measured by MRI or CT.

Secondary Outcome Measures

Clinical Objective Response Rate (complete remission (CR) + partial remission (PR))
International Working Group for Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) response criteria.
Spleen Response
Best response rate: the proportion of subjects with at least one spleen volume reduction ≥ 35% against the baseline; Time to response: the length of time from the date of first dose to the date on which the first spleen volume reduction ≥ 35% against the baseline; Duration of maintenance of at least 35% Reduction in Spleen Volume (DoMSR): the length of time from the date of the first spleen volume reduction ≥ 35% against the baseline to the date of the spleen volume reduction is less than 35% against the baseline due to spleen volume increase.
Anemia Response
Proportion of transfusion dependent patients(Transfusion dependent patients:received RBC transfusion ≥ 12 U within 12 weeks before receiving the investigational drug) at baseline turned to non-transfusion dependent patients (non-transfusion dependent patients: no transfusion for at least 12 consecutive weeks and Hgb ≥ 85 g/L); Proportion of hemoglobin (Hgb) elevation ≥ 20 g/L in non-transfusion dependent patients (Hgb ≤ 100 g/L) at baseline; Decline in red blood cell (RBC) transfusion dependence: Number of RBC transfusions decreases by 50%.
Response rate of MF-related symptoms
Proportion of patients with Myeloproliferative neoplasm symptom assessment form (MPN-SAF) TSS decreasing from baseline by ≥ 50%; The change in MPN-SAF TSS from baseline.
Progression free survival (PFS)
The length of time from the date of first dose to the date of any of the following events: 1) ≥ 25% increase in spleen volume over nadir since the treatment; 2) death from any cause.
Leukemia free survival (LFS)
The length of time from the date of first dose to the date of any of the following events: 1) the first bone marrow blast count ≥ 20%; 2) the first peripheral blast count ≥ 20% ; 3) death from any cause.
Overall survival (OS)
The length of time from the date of first dose to death from any cause.

Full Information

First Posted
April 8, 2021
Last Updated
September 18, 2023
Sponsor
Suzhou Zelgen Biopharmaceuticals Co.,Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04851535
Brief Title
Study of Jaktinib In Patients With Myelofibrosis Who Were Relapsed or Refractory of Ruxolitinib Treatment.
Official Title
A Phase II Study To Evaluate The Efficacy And Safety of Jaktinib Hydrochloride Tablets In Patients With Myelofibrosis Who Were Relapsed or Refractory of Ruxolitinib Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Completed
Study Start Date
July 28, 2021 (Actual)
Primary Completion Date
November 1, 2022 (Actual)
Study Completion Date
November 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Suzhou Zelgen Biopharmaceuticals Co.,Ltd

4. Oversight

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

5. Study Description

Brief Summary
This was a phase 2, single-arm, open-label, non-randomised, multicentre, study to evaluate the efficacy and safety of Jaktinib in patients with myelofibrosis who were relapsed or refractory of ruxolitinib treatment.
Detailed Description
All subjects will receive a minimum of 6 treatment cycles or 24 weeks (a 28-day treatment cycle is defined as one treatment cycle).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelofibrosis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Jaktinib 100mg Bid
Arm Type
Experimental
Arm Description
Jaktinib twice daily for 6 consecutive 28-day cycles, orally, empty stomach
Intervention Type
Drug
Intervention Name(s)
Jaktinib Hydrochloride Tablets
Intervention Description
Jaktinib 100mg Bid
Primary Outcome Measure Information:
Title
Spleen Volume Response rate (SVRR) at Week 24
Description
The proportion of subjects with spleen volume reduction from baseline ≥ 35% measured by MRI or CT.
Time Frame
at Week 24
Secondary Outcome Measure Information:
Title
Clinical Objective Response Rate (complete remission (CR) + partial remission (PR))
Description
International Working Group for Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) response criteria.
Time Frame
Baseline, up to Year 2
Title
Spleen Response
Description
Best response rate: the proportion of subjects with at least one spleen volume reduction ≥ 35% against the baseline; Time to response: the length of time from the date of first dose to the date on which the first spleen volume reduction ≥ 35% against the baseline; Duration of maintenance of at least 35% Reduction in Spleen Volume (DoMSR): the length of time from the date of the first spleen volume reduction ≥ 35% against the baseline to the date of the spleen volume reduction is less than 35% against the baseline due to spleen volume increase.
Time Frame
up to Year 2
Title
Anemia Response
Description
Proportion of transfusion dependent patients(Transfusion dependent patients:received RBC transfusion ≥ 12 U within 12 weeks before receiving the investigational drug) at baseline turned to non-transfusion dependent patients (non-transfusion dependent patients: no transfusion for at least 12 consecutive weeks and Hgb ≥ 85 g/L); Proportion of hemoglobin (Hgb) elevation ≥ 20 g/L in non-transfusion dependent patients (Hgb ≤ 100 g/L) at baseline; Decline in red blood cell (RBC) transfusion dependence: Number of RBC transfusions decreases by 50%.
Time Frame
up to Year 2
Title
Response rate of MF-related symptoms
Description
Proportion of patients with Myeloproliferative neoplasm symptom assessment form (MPN-SAF) TSS decreasing from baseline by ≥ 50%; The change in MPN-SAF TSS from baseline.
Time Frame
Baseline, up to Year 2
Title
Progression free survival (PFS)
Description
The length of time from the date of first dose to the date of any of the following events: 1) ≥ 25% increase in spleen volume over nadir since the treatment; 2) death from any cause.
Time Frame
From the date of first dose to the earliest date of either increase in spleen volume ≥ 25% from on-study nadir or death, up to Year 2
Title
Leukemia free survival (LFS)
Description
The length of time from the date of first dose to the date of any of the following events: 1) the first bone marrow blast count ≥ 20%; 2) the first peripheral blast count ≥ 20% ; 3) death from any cause.
Time Frame
From the date of first dose to the earliest date of either leukemia or death, up to Year 2
Title
Overall survival (OS)
Description
The length of time from the date of first dose to death from any cause.
Time Frame
From the date of first dose to the date of death, up to Year 2

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects voluntarily sign the informed consent form (ICF); Age ≥ 18 years, either male or female; Subjects diagnosed with a PMF according to World Health Organization (WHO) criteria (2016 Edition), or patients diagnosed with a Post-PV-MF or Post-EF-MF according to International Working Group for Myeloproliferative Neoplasms Research and Treatment (2007 IWG-MRT) criteria; Subjects with intermediate-2 or high-risk myelofibrosis, or Intermediate-1 myelofibrosis with symptoms according to the Dynamic International Prognostic System (DIPSS) scoring system; Subjects are relapsed/refractory to Ruxolitinib: Relapsed defined as Ruxolitinib treatment for ≥ 3 months, following an initial response, regrowth to < 10% spleen volume reduction (SVR) by MRI or < 30% decrease in spleen size by palpation from baseline; Refractory defined as Ruxolitinib treatment for ≥ 3 months observed inadequate efficacy response: < 10%volume SVR by MRI or < 30% decrease in spleen size by palpation from baseline. Subject has a measurable splenomegaly: spleen volume of ≥ 450 cm3 by MRI/CT and ≥ 5 cm below left costal margin by palpation spleen measuring; Expected life expectancy is greater than 24 weeks; Eastern Cooperative Oncology Group (ECOG) performance Score 0-2; Laboratory examination within 7 days before the randomization, fulfilling the following criteria: Neutrophil count ≥ 0.75 x 109/L, platelet count ≥ 75 x 109/L; Peripheral blood blasts ≤ 10%; ALT and AST≤ 3 ULN, DBIL ≤ 2.0 ULN; Serum creatinine ≤ 2.0 ULN. Exclusion Criteria: Subjects who have been previously exposed to Janus kinase (JAK) inhibitors other than Ruxolitinib for a total of> 2 weeks; Subjects who have taken Ruxolitinib or other JAK inhibitor within 1 week prior to screening; Subjects with any significant clinical and laboratory abnormalities which may affect the safety evaluation, such as uncontrolled diabetes, uncontrolled hypertension after taking two or more hypotensive drugs or peripheral neuropathy; Subjects with congestive heart failure (NCI-CTCAE V5.0) Class II or above, uncontrolled or unstable angina or myocardial infarction, cerebrovascular accident, or pulmonary embolism within 6 months prior to screening; Subjects who have a history of chronic or recurrent respiratory diseases, such as: chronic obstructive pulmonary disease, recurrent lung infections, etc., or have a history of lung infections within 3 months before screening, or currently have upper respiratory tract infections that have not recovered; Subjects who have not fully recovered from surgical operation within 4 weeks prior to screening; Subjects suffering from arrhythmia and requiring treatment, or QTcB > 480ms at screening; Subjects with clinical symptoms of active bacterial, viral, parasitic or fungal infections requiring treatment at screening; Subjects who had undergone splenectomy, or received radiotherapy to the spleen within 6 months before screening; Subjects with known human immunodeficiency virus (HIV), known active infectious Hepatitis B (HepB), and/or known active infectious Hepatitis C (HepC); Female subjects who are pregnant, currently breastfeeding, planning to become pregnant; Subjects who had experienced malignant tumors (except for adequately treated local basal cell or squamous cell carcinoma of the skin and cervical carcinoma in situ that have been cured) or in combination with other serious diseases within the past 5 years; Subjects who have participated in another clinical trial of a new drug or medical instrument within 1 month before screening. Subjects who have any other conditions that are not specified in the protocol but the investigator believes that they are not suitable for inclusion in this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jie Jin, PhD
Organizational Affiliation
The First Affiliated Hospital of Medical School of Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital of Medical School of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
Country
China

12. IPD Sharing Statement

Learn more about this trial

Study of Jaktinib In Patients With Myelofibrosis Who Were Relapsed or Refractory of Ruxolitinib Treatment.

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