Ruxolitinib for the Treatment of Chronic Myelomonocytic Leukemia (CMML): A Phase 2 Expansion
A Sequential Two-Stage Dose Escalation Study to Evaluate the Safety and Efficacy of Ruxolitinib for the Treatment of Chronic Myelomonocytic Leukemia (CMML): A Phase 2 Expansion
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Florida
-
Tampa, Florida, United States, 33612
- H. Lee Moffitt Cancer Center and Research Institute
-
-
Maryland
-
Baltimore, Maryland, United States, 21231
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
-
-
Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana Farber Cancer Institute
-
-
New York
-
New York, New York, United States, 10021
- Weill Medical College of Cornell University
-
-
Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Confirmed diagnosis of Chronic Myelomonocytic Leukemia (CMML)using the World Health Organization (WHO) classification.
- 18 years of age or older at the time of obtaining informed consent.
- Must be able to adhere to the study visit schedule and other protocol requirements.
- Participants must be able to provide adequate BM aspirate and biopsy specimens for histopathological analysis and standard cytogenetic analysis during the screening procedure.
- An Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2 is required.
- Women of childbearing potential must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study.
- Must understand and voluntarily sign an informed consent form.
- Must have a life expectancy of greater than 3 months at time of screening.
- Must have symptomatic splenomegaly and/or an Myeloproliferative Neoplasms Symptom Assessment Form Total Symptom Score >17.
Exclusion Criteria:
- Any of the following lab abnormalities: Platelet count of less than 35,000/uL, Absolute Neutrophil Count (ANC) less than 250/uL, Serum Creatinine ≥ 2.0, Serum total bilirubin >1.5x ULN
- Use of cytotoxic chemotherapeutic agents, or experimental agents (agents that are not commercially available) for the treatment of CMML within 28 days of the first day of study drug treatment.
- Prior history of metastatic malignancy in past 2 years
- Any serious medical condition or psychiatric illness that will prevent the subject from signing the informed consent form or will place the subject at unacceptable risk if he/she participates in the study.
- Concurrent use of Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF). Granulocyte Colony Stimulating Factor (G-CSF) could be used for the short-term management of neutropenic infection. Stable doses of erythropoietin stimulating agents that were started >8 weeks from first ruxolitinib dose or corticosteroids that were being administered prior to screening are allowed.
- Uncontrolled current illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Pregnant women are excluded from this study because ruxolitinib has not been studied in pregnant participants. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ruxolitinib, breastfeeding should be discontinued if the mother is treated with ruxolitinib.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ruxolitinib
All patients will be given their first dose of oral Ruxolitinib, 20 mg at first scheduled visit.
After that dose and on all other days patients will self-administer oral Ruxolitinib at a dose of 40 mg daily divided into two equal doses approximately 12 hours apart.
Patients will be treated for a total of 16 weeks.
After treatment, patients will be followed monthly.
|
Ruxolitinib 5 mg tablets, 4 per dose
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Response
Time Frame: At week 16
|
Number of participants achieving clinical benefit defined as hematologic improvement, complete remission, partial remission, or stable disease by the International Working Group Myelodysplastic/Myeloproliferative Neoplasms (MDS/MPN) Criteria.
|
At week 16
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Survival
Time Frame: Up to 2 years
|
Overall survival will be from first dose of study drug until failure or death from any cause.
|
Up to 2 years
|
|
Duration of Response
Time Frame: Up to 2 years
|
Duration of response measured using time to AML transformation according to WHO Critieria
|
Up to 2 years
|
|
Time to Acute Myeloid Leukemia (AML) Transformation
Time Frame: Every 6 months after conclusion of treatment until end of study (40.3 months)
|
Time to AML transformation according to World Health Organization (WHO) Critieria
|
Every 6 months after conclusion of treatment until end of study (40.3 months)
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in symptom score
Time Frame: Baseline, Week 17
|
Change in symptom score as defined by the Myeloproliferative Neoplasms Symptom Assessment Form-Total Symptom Score (MPN-SAF TSS).
The MPN -SAF TSS scores symptoms of myeloproliferative neoplasm by rankings of 0 (symptom is absent) to 10 (Worst imaginable)
|
Baseline, Week 17
|
|
Pathological Response
Time Frame: Baseline, Week 17
|
>/- 35% decrease in splenic volume as measured by CT scan
|
Baseline, Week 17
|
|
Mutational Status
Time Frame: Baseline up to end of study (24 months)
|
Mutational Status in CMML patients measured by sanger sequencing of JAK2, c-CBL, N-RAS, K-RAS, RUNX-1, TET2, SRSF2, EZH2, ASXL1 and DNMT3a.
|
Baseline up to end of study (24 months)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Eric Padron, MD, H. Lee Moffitt Cancer Center and Research Institute
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Chronic Disease
- Disease Attributes
- Neoplasms by Histologic Type
- Hematologic Diseases
- Leukemia, Myeloid
- Myelodysplastic-Myeloproliferative Diseases
- Bone Marrow Diseases
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Leukemia
- Leukemia, Myelomonocytic, Chronic
- ruxolitinib
Other Study ID Numbers
Other Study ID Numbers
- MCC-19727
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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