Study of Pomalidomide in Persons With Myeloproliferative-Neoplasm-Associated Myelofibrosis and RBC-Transfusion-Dependence (RESUME)
Primary Myelofibrosis, MPN-associated Myelofibrosis
About this trial
This is an interventional treatment trial for Primary Myelofibrosis focused on measuring Myelofibrosis, Post-polycythemia vera myelofibrosis, Post-essential thrombocythemia myelofibrosis, RBC-transfusion-dependence, Primary Myelofibrosis
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years
- Myeloproliferative-neoplasm (MPN)-associated myelofibrosis
RBC-transfusion-dependence (global study):
- Average RBC-transfusion frequency ≥ 2 units/28 days over at least the 84 days immediately prior to randomization. There must be no interval > 42 days without ≥ 1 RBC-transfusion.
- Only RBC-transfusions given when the hemoglobin ≤ 90 g/L³ are scored in
determining eligibility.
- RBC-transfusions due to bleeding are not scored in determining eligibility.
RBC-transfusions due to chemotherapy-induced anemia are not scored in determining eligibility.
- Severe anemia (China-specific extension):
- ≥ 2 hemoglobin concentrations ≤ 80 g/L for ≥ 84 days immediately before the day of enrollment.
No RBC-transfusion within 6 months prior to enrollment.
- Hemoglobin ≤ 130 g/L at randomization (global study); ≤ 80 g/L at enrollment in the China-specific extension.
- Bone marrow biopsy within 6 months (global study only).
- Inappropriate to receive blood cell or bone marrow allotransplant, erythropoietin and androgenic steroids
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
- Agree to follow pregnancy precautions as required by the protocol.
- Agree to receive counseling related to teratogenic and other risks of pomalidomide.
- Agree not to donate blood or semen.
Exclusion Criteria:
- Prior blood cell or bone marrow allotransplant.
- Use of drugs to treat MPN-associated myelofibrosis ≤ 30 days before starting study drug.
- Treatment with erythropoietin or androgenic steroids ≤ 84 days before starting study drug.
- Anemia due to reasons other than MPN-associated myelofibrosis.
- Pregnant or lactating females.
- More than 10% blasts by bone marrow examination or more than 10% blasts in blood in consecutive measurements spanning at least 8 weeks
Prior history of malignancies,other than the disease being studied, unless the subject has been free of the malignancy for ≥ 5 years with the following exceptions:
- Carcinoma in situ of the cervix
- Carcinoma in situ of the breast
- Incidental histologic finding of prostate cancer (T 1a or T 1b using TNM [tumor, nodes, metastasis] clinical staging system)
- Human immunodeficiency virus (HIV) infection, active hepatitis B virus (HBV) or hepatitis C virus (HCV) infections.
- Prior treatment with pomalidomide.
- Allergic reaction or rash after treatment with thalidomide or lenalidomide
Any of the following laboratory abnormalities:
- Neutrophils < 0.5x10^9 /L
- Platelets < 25 x 10^9 /L
- Estimated glomerular filtration rate (kidney function) < 30 mL/min/1.73 m²
- Aspartate aminotransferase (AST) and alanine transaminase (ALT) > 3.0 x upper limit of normal (ULN)
- Total bilirubin ≥ 4 x ULN;
- Uncontrolled hyperthyroidism or hypothyroidism.
- Deep venous thrombosis (DVT) or pulmonary embolus (PE) < 6 months before starting study drug
- Clinically-important heart disease within the past 6 months
Sites / Locations
- Mayo Clinic
- UCLA School of Medicine
- University of Florida Shands Cancer Center
- Mayo Clinic
- University of Illinois at Chicago
- University of Michigan Comprehensive Cancer Center
- Mayo Clinic
- Mount Sinai School of Medicine Brookdale University Hospital
- Weill Medical College of Cornell University
- Ruttenberg Treatment Center
- Memorial Sloan Kettering Cancer Center
- Medicine Taussig Cancer Institute
- Thomas Jefferson University
- Avera Hematology and Transplant
- MD Anderson Cancer Center
- University of Utah
- Fred Hutchinson Cancer Center
- Gosford Hospital
- Royal North Shore Hospital
- Frankston Hospital
- Royal Melbourne Hospital
- Medizinische Universitatklinik Graz
- Medizinische Universitat Innsbruck
- Medizinische Universitat Wien
- Algemeen Ziekenhuis Sint-Jan
- Grand Hopital de Charleroi
- Universitaire Ziekenhuis Leuven Gathuisberg
- Cross Cancer Institute
- Vancouver General Hospital
- Princess Margaret Hospital
- Centre Hospitalier de L'Universite de Montreal
- Peking University People's Hospital
- Peking Union Medical College Hospital
- Jiangsu Province Hospital
- Shanghai Ruijin Hospital
- West China Hospital, Sichuan University
- Blood Disease Hospital Chinese Academy of Medical Sciences
- Hopital Albert Michallon
- Hopital Saint Vincent de Paul
- CHU Dupuytren
- Hopital Saint-Louis
- CHRU - Hopital du Haut Leveque
- Hopitaux Universitaires de Strasbourg, CHU Haute-Pierre
- Hopital Purpan
- Institut Gustave Roussy
- Universitatsklinikum Aachen
- Medizinische Hochschule Hannover
- Universitatsklinikum Leipzig
- Johannes Wesling Klinikum Minden
- Universitatsklinikum Ulm
- Azienda Ospedaliera Universitaria Consorziale Policlinico di Bari
- Ospedali Riuniti di Bergamo
- Azienda Ospedaliera Universitaria Careggi
- Azienda Ospedaliera Universitaria Federico II di Napoli
- Azienda Ospedaliera San Luigi Gonzaga
- IRCCS Fondazione Policlinico San Matteo, Universita di Pavia, Centro per lo Studio della Mielofibrosi
- IRCCS Fondazione Policlinico San Matteo, Universita di Pavia, Ematologia
- Ospedale di Circolo e Fondazione Macchi Varese
- Juntendo University Hospital
- Kyushu University Hospital
- Tokai University Hospital
- Kyoto University Hospital
- Nagasaki University Hospital
- Tokyo Medical University Hospital
- VU University Medical Center
- Erasmus Medish Centrum
- University Medical Center Utrecht
- Wojewodzki Szpital Specjalistyczny im. F.Chopina
- Samodzielny Publiczny Szpital Kliniczny Nr 1 PAM
- Centralny Szpital Kliniczny MSWiA
- Russian Scientific Haematology Centre
- Federal State Institution Russian Scientific-research Institute of Hematology and Transfusiology of Federal Medical-Biological Agency of Russia
- State Pavlov Medical University
- Federal State Institution "Federal Centre of Heart, Blood and Endocrinology of Rosmedtechnologies named after V.A. Almazov"
- Hospital Clinic I Provincial de Barcelona
- Hospital Universitario Puerta De Hierro Majadahonda
- Hospital Clinico de Salamanca
- Hospital Clinico de Valencia
- Skane University Hospital
- Karolinska University Hospital Huddinge
- Belfast City Hospital
- Beatson Oncology Centre
- John Radcliffe Hospital NHS Trust
- St. Thomas Hospital
- Hammersmith Hospital
- Freeman Hospital
- Royal Hallamshire Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Placebo Comparator
Experimental
Pomalidomide 0.5 mg
Placebo
China Extension: Pomalidomide 0.5 mg
Participants received pomalidomide 0.5 mg/day by mouth for at least 168 days unless there were unacceptable side effects or disease progression. Participants who were RBC-transfusion independent or experienced clinical benefit (defined as a reduction from Baseline of ≥ 50% in RBC-transfusion frequency during the prior 84-day interval) could continue to receive pomalidomide until loss of RBC-transfusion independence response or clinical benefit, or other criteria for treatment discontinuation applied.
Participants received placebo taken by mouth once daily for at least 168 days unless there were unacceptable side effects or disease progression. Participants who were RBC-transfusion independent or experienced clinical benefit could continue to receive placebo until loss of RBC- transfusion independence response or clinical benefit, or other criteria for treatment discontinuation applied.
Participants received pomalidomide 0.5 mg/day by mouth for at least 168 days unless there were unacceptable side effects, disease progression, or they received a RBC-transfusion. Participants who experienced anemia response could continue treatment until the response was lost or other criteria for treatment discontinuation applied.