Low-Dose Sirolimus to Increase Hematopoietic Function in Patients With RUNX1 Familial Platelet Disorder
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Primary Objective:
• Evaluate the safety and tolerability of low-dose sirolimus in participants with RUNX1 familial platelet disorder (RUNX1-FPD)
Secondary Objectives:
- Evaluate increases in platelet counts during and after treatment with low-dose sirolimus
- Evaluate changes in somatic mutation variant allele frequency (VAF)
- Monitor the rate of somatic mutation acquisition (ie, mutation burden)
- Assess change in platelet aggregation score
- Measure the change from baseline in bleeding score (ISTH-BAT)
- Evaluate change in mTORC1 downstream signaling (pS6/EBP)
Exploratory Objectives:
- Measure rescue of elevated cytokine profiles
- Evaluate reversal of myeloid skewing using flow cytometry
- Determine changes in bone marrow (eg, megakaryocytic atypia and cellularity)
- Assess changes in patient-reported outcomes measures (eg, EORTC and PRO-CTCAE)
- Describe the pharmacokinetics of sirolimus in patients with RUNX1-FPD
- Determine the correlation between sirolimus trough levels and each endpoint
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Courtney DiNardo, MD
- Phone Number: (713) 794-1141
- Email: cdinardo@mdanderson.org
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- MD Anderson Cancer Center
-
Contact:
- Courtney DiNardo, MD
- Phone Number: 713-794-1141
- Email: cdinardo@mdanderson.org
-
Principal Investigator:
- Courtney DiNardo, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Participants has provided signed, informed consent before initiation of any study specific procedures
- Aged ≥18 years at the time of signing the informed consent
- Confirmed P/LP germline RUNX1 variant per ClinGen Myeloid Malignancy Variant Curation Expert Panel (MM-VCEP) RUNX1-specific variant curation rules80
- Participants must be willing to provide bone marrow sample at time of screening and at the end of treatment with sirolimus
- Platelet count of ≥50,000/µL
- Adequate renal function: estimated glomerular filtration rate based on Modification of Diet in Renal Disease (MDRD) calculation, >30 mL/min/1.73m2
- Adequate hepatic function: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <3 × upper limit of normal (ULN) and total bilirubin <1.5 × ULN
- Adequate cardiac function: left ventricular ejection fraction >50%
Exclusion Criteria:
- Known allergy to sirolimus
- History of lymphoma or other hematologic malignancies
- Uncontrolled bleeding
- Any prior diagnosis of myelodysplastic syndrome or other hematologic malignancy using International Working Group criteria
- Prior treatment with sirolimus or a rapalog, mTOR inhibitor, or B-cell-depleting therapy within 28 days before study day 1
- Treatment with strong inhibitors of cytochrome P450 3A4 (CYP3A4; eg, ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, and clarithromycin), strong inducers of CYP3A4 (eg, rifampin and rifabutin), other drugs that could increase sirolimus blood concentrations (eg, bromocriptine, cimetidine, cisapride, clotrimazole, danazol, diltiazem, fluconazole, letermovir, protease inhibitors [eg, ritonavir, indinavir, boceprevir, and telaprevir], metoclopramide, nicardipine, troleandomycin, and verapamil), other drugs that could decrease sirolimus blood concentrations (eg, carbamazepine, phenobarbital, phenytoin, rifapentine, St. John's Wort [Hypericum perforatum]), or drugs with blood concentrations that could increase (eg, verapamil) within 7 days before study day 1
- Use of cannabidiol, which can increase blood levels of sirolimus, within 7 days before study day 1
- Myocardial infarction within 6 months before study day 1, congestive heart failure (New York Heart Association > class II)
- Total cholesterol >300 mg/dL or triglyceride >400 mg/dL
- Arterial thrombosis (eg, stroke or transient ischemic attack) within 6 months before study day 1
- Infection requiring intravenous anti-infective treatment within 1 week of study day 1
- Live vaccines (eg, measles, mumps, rubella, oral polio, BCG, yellow fever, varicella, and TY21a typhoid) within 28 days before study day 1
- Known diagnosis of chronic viral infection (eg, hepatitis B or C or HIV, and Epstein-Barr) or tuberculosis
- Women who are pregnant, may become pregnant, or who are breastfeeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm 1
Participants will visit the study clinic 2 times during Week 1, one (1) time during Weeks 2-4, and then 1 time every 2 weeks after that (Weeks 6, 8, 10, and so on) until Week 22 (Month 6).
Then participants will have a follow-up visit at Week 24 and again at Week 52 (Month 12).
Participants will take sirolimus by mouth every day, at about the same time each day.
Swallow the tablet(s) whole with a full glass of water (about 1 cup).
Do not crush or chew the tablet(s).
Participants may take sirolimus with or without food.
|
Given by PO
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety and adverse events (AEs)
Time Frame: Through study completion; an average of 1 year
|
Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0
|
Through study completion; an average of 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Courtney DiNardo, MD, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2023-0918
- NCI-2024-01333 (Other Identifier: NCI-CTRP Clinical Registry)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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