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Study to Evaluate KER-050 as a Monotherapy or in Combination With Ruxolitinib in Myelofibrosis

Primary Purpose

Myelofibrosis

Status
Recruiting
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
KER-050 monotherapy
KER-050 in combination with ruxolitinib
Sponsored by
Keros Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelofibrosis focused on measuring Thrombocytopenia, Anemia, Red blood cells, Bone marrow

Eligibility Criteria

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

Key Inclusion Criteria:

  • Male or female ≥18 years of age, at the time of signing informed consent.
  • Diagnosis of PMF, post-PV MF, or post-ET MF according to the 2017 World Health Organization criteria.

Arm-specific criteria:

Arm 1A:

  • Previously treated with JAK inhibitor(s) or Participant is ineligible for JAK inhibitor(s)
  • Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions

Arm 2A:

  • Previously treated with JAK inhibitor(s) or Participant is ineligible for JAK inhibitor(s)
  • Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions

Arm-specific criteria for 1B and 2B:

  • Has been receiving ruxolitinib for ≥8 weeks prior to C1D1 and on a stable dose for ≥4 weeks prior to C1D1.
  • Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions

Key Exclusion Criteria:

  • Presence of the following cardiac conditions:

    1. New York Heart Association Class 3 or 4 heart failure
    2. QTcF >500 msec on the screening or C1D1 electrocardiogram (ECG)
    3. Uncontrolled clinically significant arrhythmia (participants with rate-controlled atrial fibrillation are not excluded)
    4. Acute myocardial infarction or unstable angina pectoris <6 months prior to C1D1
  • History of stroke, deep venous thrombosis, or arterial embolism within 6 months prior to C1D1.
  • Any malignancy other than PMF, post-ET MF, or post-PV MF that has not been in remission and/or has required systemic therapy including radiation, chemotherapy, hormonal therapy, or surgery, within 1 year prior to C1D1. In-situ cancers, squamous cell, and basal cell carcinomas which have been fully excised, and monoclonal gammopathy of unclear significance are allowed at the discretion of the Investigator.
  • History of solid organ or hematological transplantation.
  • Presence of uncontrolled hypertension, defined as systolic blood pressure ≥150 mm Hg or diastolic blood pressure ≥100 mm Hg despite adequate treatment.
  • Diagnosis of hemolytic anemia, active bleeding, hemoglobinopathies, or congenital disorders as a cause of the participant's anemia.
  • CTCAE Grade ≥2 bleeding events within the 3 months prior to C1D1.
  • Bone marrow blast percentage >2%. Participants with blast % between 2-5% are allowed if at least 2 bone marrows >6 months apart demonstrate stability of blast percentage, these participants must be reviewed with the Medical Monitor prior to study entry.
  • Prior treatment with luspatercept, sotatercept, or other commercially available or investigational TGF-β inhibitors (all Arms)
  • Treatment within 28 days prior to C1D1 with:

    1. Erythropoiesis stimulating agent (ESA)
    2. Granulocyte colony-stimulating factor (G-CSF)
    3. Granulocyte-macrophage colony-stimulating factor (GM-CSF)
    4. Thrombopoietin agonists (TPO)
    5. Immunomodulator imide drugs (IMiDs; e.g., thalidomide, pomalidomide, lenalidomide)
    6. Interferon

Sites / Locations

  • The Tweed HospitalRecruiting
  • Flinders Medical CentreRecruiting
  • St. Vincent's Hospital MelbourneRecruiting
  • Royal Melbourne HospitalRecruiting
  • Ballarat Oncology & Hematology ServiceRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Arm 1a

Arm 1b

Arm 2a

Arm 2b

Arm Description

Dose Escalation KER-050 (SC, solution for injection, every 4 weeks) monotherapy

Dose Escalation KER-050 (SC, solution for injection, every 4 weeks) in combination with standard of care ruxolitinib (oral, tablet, twice daily)

Dose Expansion KER-050 (SC, solution for injection, every 4 weeks) monotherapy

Dose Expansion KER-050 (SC, solution for injection, every 4 weeks) in combination with standard of care ruxolitinib (oral, tablet, twice daily)

Outcomes

Primary Outcome Measures

Incidence of adverse events (Safety and Tolerability)
Safety and tolerability as determined by the incidence of adverse events (AEs), including severe AEs and serious AEs (SAEs)

Secondary Outcome Measures

Subgroup of transfusion-independent participants
Proportion of participants with mean hemoglobin increase ≥1.5 g/dL from baseline over a period of >12 consecutive weeks Proportion of participants with mean hemoglobin increase ≥2.0 g/dL from baseline over a period of >12 consecutive weeks Proportion of participants with a decrease of ≥1 in Brief Fatigue Inventory (BFI) score from baseline
Subgroup of participants with anemia requiring red blood cell (RBC) transfusions
Proportion of participants with RBC transfusion independence over a period of >12 consecutive weeks Proportion of participants with decrease in number of RBC transfusions from baseline over a period of >12 consecutive weeks
Proportion of participants with decrease in spleen volume of ≥35% from baseline as measured by computed tomography (CT) (excluding participants status post splenectomy or splenic irradiation)
Proportion of participants with improvement in the Myelofibrosis Symptom Assessment Form Total Symptom Score (MF-SAF-TSS) of ≥50% from baseline
Proportion of participants with progression to AML (bone marrow blasts >20%)
Proportion of participants with progression to accelerated MF (bone marrow blasts ≥10%)

Full Information

First Posted
August 23, 2021
Last Updated
March 2, 2022
Sponsor
Keros Therapeutics, Inc.
Collaborators
IQVIA Biotech
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1. Study Identification

Unique Protocol Identification Number
NCT05037760
Brief Title
Study to Evaluate KER-050 as a Monotherapy or in Combination With Ruxolitinib in Myelofibrosis
Official Title
A Phase 2 Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of KER-050 as Monotherapy or in Combination With Ruxolitinib in Participants With Myelofibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Recruiting
Study Start Date
December 16, 2021 (Actual)
Primary Completion Date
April 2025 (Anticipated)
Study Completion Date
June 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Keros Therapeutics, Inc.
Collaborators
IQVIA Biotech

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 2, multicenter, open-label study to evaluate the safety and efficacy of KER-050 as monotherapy or in combination with ruxolitinib in participants with Myelofibrosis.
Detailed Description
KER-050 is an investigational therapeutic protein designed to increase red blood cell and platelet production by inhibiting the signaling of a subset of the transforming growth factor beta (TGF-ß) family of proteins to promote hematopoiesis. It is being developed for the treatment of low blood cell counts, or cytopenias including anemia and thrombocytopenia in patients with Myelodysplastic Syndrome (MDS) and Myelofibrosis (MF)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelofibrosis
Keywords
Thrombocytopenia, Anemia, Red blood cells, Bone marrow

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1a
Arm Type
Experimental
Arm Description
Dose Escalation KER-050 (SC, solution for injection, every 4 weeks) monotherapy
Arm Title
Arm 1b
Arm Type
Experimental
Arm Description
Dose Escalation KER-050 (SC, solution for injection, every 4 weeks) in combination with standard of care ruxolitinib (oral, tablet, twice daily)
Arm Title
Arm 2a
Arm Type
Experimental
Arm Description
Dose Expansion KER-050 (SC, solution for injection, every 4 weeks) monotherapy
Arm Title
Arm 2b
Arm Type
Experimental
Arm Description
Dose Expansion KER-050 (SC, solution for injection, every 4 weeks) in combination with standard of care ruxolitinib (oral, tablet, twice daily)
Intervention Type
Drug
Intervention Name(s)
KER-050 monotherapy
Intervention Description
KER-050 administered (SC) for up to 13 cycles
Intervention Type
Drug
Intervention Name(s)
KER-050 in combination with ruxolitinib
Intervention Description
KER-050 administered (SC) for up to 13 cycles in combination with standard of care ruxolitinib
Primary Outcome Measure Information:
Title
Incidence of adverse events (Safety and Tolerability)
Description
Safety and tolerability as determined by the incidence of adverse events (AEs), including severe AEs and serious AEs (SAEs)
Time Frame
64 Weeks
Secondary Outcome Measure Information:
Title
Subgroup of transfusion-independent participants
Description
Proportion of participants with mean hemoglobin increase ≥1.5 g/dL from baseline over a period of >12 consecutive weeks Proportion of participants with mean hemoglobin increase ≥2.0 g/dL from baseline over a period of >12 consecutive weeks Proportion of participants with a decrease of ≥1 in Brief Fatigue Inventory (BFI) score from baseline
Time Frame
24 weeks
Title
Subgroup of participants with anemia requiring red blood cell (RBC) transfusions
Description
Proportion of participants with RBC transfusion independence over a period of >12 consecutive weeks Proportion of participants with decrease in number of RBC transfusions from baseline over a period of >12 consecutive weeks
Time Frame
24 weeks
Title
Proportion of participants with decrease in spleen volume of ≥35% from baseline as measured by computed tomography (CT) (excluding participants status post splenectomy or splenic irradiation)
Time Frame
At Week 24 and at Week 52
Title
Proportion of participants with improvement in the Myelofibrosis Symptom Assessment Form Total Symptom Score (MF-SAF-TSS) of ≥50% from baseline
Time Frame
At Week 24 and at Week 52
Title
Proportion of participants with progression to AML (bone marrow blasts >20%)
Time Frame
At Week 24 and at Week 52
Title
Proportion of participants with progression to accelerated MF (bone marrow blasts ≥10%)
Time Frame
At Week 24 and at Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Male or female ≥18 years of age, at the time of signing informed consent. Diagnosis of PMF, post-PV MF, or post-ET MF according to the 2017 World Health Organization criteria. Arm-specific criteria: Arm 1A: Previously treated with JAK inhibitor(s) or Participant is ineligible for JAK inhibitor(s) Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions Arm 2A: Previously treated with JAK inhibitor(s) or Participant is ineligible for JAK inhibitor(s) Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions Arm-specific criteria for 1B and 2B: Has been receiving ruxolitinib for ≥8 weeks prior to C1D1 and on a stable dose for ≥4 weeks prior to C1D1. Anemia, defined as hemoglobin ≤10 g/dL during screening, or receiving RBC transfusions Key Exclusion Criteria: Presence of the following cardiac conditions: New York Heart Association Class 3 or 4 heart failure QTcF >500 msec on the screening or C1D1 electrocardiogram (ECG) Uncontrolled clinically significant arrhythmia (participants with rate-controlled atrial fibrillation are not excluded) Acute myocardial infarction or unstable angina pectoris <6 months prior to C1D1 History of stroke, deep venous thrombosis, or arterial embolism within 6 months prior to C1D1. Any malignancy other than PMF, post-ET MF, or post-PV MF that has not been in remission and/or has required systemic therapy including radiation, chemotherapy, hormonal therapy, or surgery, within 1 year prior to C1D1. In-situ cancers, squamous cell, and basal cell carcinomas which have been fully excised, and monoclonal gammopathy of unclear significance are allowed at the discretion of the Investigator. History of solid organ or hematological transplantation. Presence of uncontrolled hypertension, defined as systolic blood pressure ≥150 mm Hg or diastolic blood pressure ≥100 mm Hg despite adequate treatment. Diagnosis of hemolytic anemia, active bleeding, hemoglobinopathies, or congenital disorders as a cause of the participant's anemia. CTCAE Grade ≥2 bleeding events within the 3 months prior to C1D1. Bone marrow blast percentage >2%. Participants with blast % between 2-5% are allowed if at least 2 bone marrows >6 months apart demonstrate stability of blast percentage, these participants must be reviewed with the Medical Monitor prior to study entry. Prior treatment with luspatercept, sotatercept, or other commercially available or investigational TGF-β inhibitors (all Arms) Treatment within 28 days prior to C1D1 with: Erythropoiesis stimulating agent (ESA) Granulocyte colony-stimulating factor (G-CSF) Granulocyte-macrophage colony-stimulating factor (GM-CSF) Thrombopoietin agonists (TPO) Immunomodulator imide drugs (IMiDs; e.g., thalidomide, pomalidomide, lenalidomide) Interferon
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rachael Ryzman
Phone
603-548-3907
Email
KER050-MF-301@kerostx.com
Facility Information:
Facility Name
The Tweed Hospital
City
Tweed Heads
State/Province
New South Wales
ZIP/Postal Code
2485
Country
Australia
Individual Site Status
Recruiting
Facility Name
Flinders Medical Centre
City
Woodville South
State/Province
South Australia
ZIP/Postal Code
5042
Country
Australia
Individual Site Status
Recruiting
Facility Name
St. Vincent's Hospital Melbourne
City
Fitzroy
State/Province
Victoria
ZIP/Postal Code
3355
Country
Australia
Individual Site Status
Recruiting
Facility Name
Royal Melbourne Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Individual Site Status
Recruiting
Facility Name
Ballarat Oncology & Hematology Service
City
Wendouree
State/Province
Victoria
ZIP/Postal Code
3355
Country
Australia
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study to Evaluate KER-050 as a Monotherapy or in Combination With Ruxolitinib in Myelofibrosis

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