- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05393674
Fedratinib in Combination With Nivolumab
A Phase II Study of Fedratinib and Nivolumab Combination in Patients With Myelofibrosis and Resistance or Suboptimal Response to JAK-inhibitor Treatment
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Florian Heidel, Prof. Dr.
- Phone Number: 3020 (+49) 511 532
- Email: heidel.florian@mh-hannover.de
Study Contact Backup
- Name: Luisa Wohn
- Email: wohn.luisa@ikf-khnw.de
Study Locations
-
-
-
Berlin, Germany
- Recruiting
- Charité
-
Contact:
- Philipp le Coutre, Prof. Dr.
-
Freiburg, Germany
- Recruiting
- Universitätsklinikum Freiburg
-
Contact:
- Heiko Becker, Prof. Dr.
-
Greifswald, Germany
- Recruiting
- University Medicine Greifswald
-
Contact:
- Florian Heidel, Prof. Dr.
-
Halle (Saale), Germany
- Recruiting
- Universitatsklinikum Halle (Saale)
-
Contact:
- Haifa Kathrin Al-Ali, Dr.
-
Hannover, Germany
- Recruiting
- Medizinische Hochschule
-
Contact:
- Florian Heidel, Prof. Dr.
-
Lübeck, Germany
- Recruiting
- Universitätsklinikum Schleswig-Holstein
-
Contact:
- Nikolas von Bubnoff, Prof. Dr.
-
Minden, Germany
- Recruiting
- Johannes Wesling Klinikum
-
Contact:
- Martin Griesshammer, Prof. Dr.
-
Ulm, Germany
- Recruiting
- Uniklinik Ulm
-
Contact:
- Konstanze Döhner, Prof. Dr.
-
-
Hessen
-
Frankfurt am Main, Hessen, Germany
- Recruiting
- Krankenhaus Nordwest
-
Contact:
- Thorsten Götze, Prof. Dr.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed Informed Consent Form available and patient willing and able to adhere to the study visit schedule and other protocol requirements.
- Patients* ≥18 years of age
- diagnosed with myelofibrosis (MF) according to the WHO 2008 or 2016 criteria, including primary (pre-fibrotic or overt) and secondary myelofibrosis.
- Patients with an indication for therapy (either symptomatic patients with splenomegaly >11cm diameter and/or symptoms restricting their daily activity or patients with DIPSS int-2, or high risk or MIPSS70 int or high)
Patients with no response or suboptimal response to any JAK-inhibitor therapy (regarding persistence of symptoms, splenomegaly, cytopenia or hyperproliferation) defined either by
- Persisting Splenomegaly >11cm total diameter
- Persisting leukoerythroblastosis
- Anemia <6.2 mmol/l (<10g/dl)
- Elevated WBC (>11 Gpt/l)
- Persisting general or constitutional symptoms (persistence is defined as less than 50% reduction to baseline when using the MPN10 TSS Score) OR failure [secondary resistance] to JAK-inhibitor treatment as defined by IWG-MRT criteria.
- ECOG performance status <3 at screening and adequate organ function
- Reliable contraception should be maintained throughout the study and for 1 month after discontinuation of Fedratinib or 5 months after discontinuation of Nivolumab**
- Subject must be willing to receive transfusion of blood products
- Thiamine levels not below lower limit of normal (prior substitution is possible)
- Normal nutritional status, as judged by the physician
- Females of childbearing potential (FCBP) must undergo repetitive pregnancy testing (serum or urine) and pregnancy results must be negative.
- Unless practicing complete abstinence from heterosexual intercourse, sexually active FCBP must agree to use adequate contraceptive methods (i.e. failure rate of < 1% per year).
- Males (including those who have had a vasectomy) must use barrier contraception (condoms) when engaging in sexual activity with FCBP. Males must agree not to donate semen or sperm.
Exclusion Criteria:
- Planned hematopoietic stem cell transplantation within 3 months and suitable donor available
- >10% blasts in bone marrow smear (cytology) or >2x in blood smear within the screening phase or >20% blasts at any time in bone marrow or peripheral blood smears
- Creatinine >2xULN and Creatinine-Clearance <45ml/min; ALAT, ASAT & bilirubin >3xULN (if MF impact on liver >5xULN)
- Baseline platelets count below 50 x 10^9/L and ANC < 1.0 x 10^9/L
- Diagnosis of PV, ET (according to WHO 2016) or positive molecular test for BCR-ABL
- Patients on ongoing medication for myelofibrosis including systemic corticosteroids (detailed list of permitted medications is provided in paragraph 9.1.10.4 and Appendix V). Use of steroids within 14 days prior to the first dose of study drug and until end of treatment is prohibited by patients.
- Uncontrolled infection
- Evidence of acute or chronic infection with hepatitis B, hepatitis C, human immunodeficiency virus (HIV) or tuberculosis
- Current participation in any other interventional clinical study within 30 days before the first administration of the investigational product or at any time during the study, unless it is an observational (non-interventional) study, or during the follow-up period of an interventional study with last dose of investigational product ≥30 days prior first administration of investigational product within this study.
- No consent for registration, storage and processing of the individual disease characteristics and course as well as information of the family physician about study participation
- No consent for biobanking of patient's biological specimens
- Prior therapy with checkpoint-inhibitors
- Vaccination within 4 weeks prior to treatment start
- Hypersensitivity to the IMPs or to any of the excipients
- History of or uncontrolled autoimmune disease such as autoimmune-hepatitis, -pneumonitis, -thyroiditis, chronic inflammatory bowel disease, multiple sclerosis, or rheumatologic diseases (including but not limited to systemic lupus and vasculitis)
- History of malignancy except for i) adequately treated local basal cell or squamous cell carcinoma of the skin, ii) asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy or requiring only hormonal therapy and with normal prostate-specific antigen for ≥ 1 year prior to randomization, or iii) any other cancer that has been in complete remission for ≥ 5 years
- Secondary malignancy that limits survival to less than 6 months.
- Drug or alcohol abuse within the last 6 months
- Patients who cannot adhere to the Pregnancy Prevention Plan
- Pregnant or breast-feeding females
- Thiamine levels below normal limit despite supplementation
- Patients who are unable to consent because they do not understand the nature, significance and implications of the clinical trial and therefore cannot form a rational intention in the light of the facts [§ 40 Abs. 1 S. 3 Nr. 3a AMG]
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental
Fedratinib (Cycle 1: Run-in-Phase with 400 mg QD for 4 weeks, Cycle 2-12: 400 mg QD, Dose modifications will be allowed based on observed toxicity to a 300 mg or a 200 mg daily dose) + Nivolumab (Cycle 2-12: 240 mg, i.v., q2w) Patients will receive study treatment until loss of response, death or study discontinuation for other reasons. |
400 mg once daily p.o. from cycle 1-n, dose adjustment will be made according to the protocol
240 mg every 2 weeks i.v. from cycle 2-n
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Best response rate within 12 treatment cycles
Time Frame: 12 months after therapy start.
|
Best response rate within 12 treatment cycles according to the IWG-MRT criteria (including complete remission, CR, partial remission, PR, clinical improvement, CI, stable disease, SD 1, and red cell transfusion (RCT) independency according to Gale et al.)
|
12 months after therapy start.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety: Incidence and severity of adverse events according to CTC criteria
Time Frame: From informed consent until 100 days after last study drug
|
Incidence and severity of adverse events according to CTC criteria
|
From informed consent until 100 days after last study drug
|
Safety: Timing of adverse events according to CTC criteria
Time Frame: From informed consent until 100 days after last study drug
|
Timing of adverse events according to CTC criteria
|
From informed consent until 100 days after last study drug
|
Safety: Incidence of Laboratory abnormalities
Time Frame: From informed consent until 100 days after last study drug
|
Incidence of laboratory abnormalities including timing and relatedness.
|
From informed consent until 100 days after last study drug
|
Safety: leukemic transformation
Time Frame: From informed consent until 100 days after last study drug
|
Cumulative incidence of leukemic transformation
|
From informed consent until 100 days after last study drug
|
Clinical benefit
Time Frame: 3.5 years
|
Proportion of patients with clinical benefit defined as stable disease (SD) plus hematologic improvement or stable disease (SD) plus improvement of MF-associated symptoms
|
3.5 years
|
Efficacy: PFS
Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 42 months
|
Progression-free survival
|
From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 42 months
|
Efficacy: Duration of response
Time Frame: 3.5 years
|
Time from first response including RBC-TI, CI, PR and CR (Appendix III) to date of loss of response.
Times of patients without loss of response are censored at last tumor assessment.
|
3.5 years
|
Efficacy: Overall survival
Time Frame: 3.5 years
|
Time from study entry to the last date known to be alive or death.
Survival times of patients alive at last follow-up are censored.
|
3.5 years
|
Efficacy: Disease burden
Time Frame: 3.5 years
|
Change of disease burden assessed by allelic ratio of the respective driver mutation and of high-risk mutations by next-generation sequencing [NGS]
|
3.5 years
|
Collaborators and Investigators
Investigators
- Study Director: Salah-Eddin Al-Batran, Prof. Dr., Institut für Klinische Krebsforschung IKF GmbH
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- FRACTION_2021
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Primary Myelofibrosis
-
The University of Hong KongRecruitingMyelofibrosis | Primary Myelofibrosis, Prefibrotic StageHong Kong
-
Assaf-Harofeh Medical CenterUnknownMyelofibrosis, Primary | Myelofibrosis, Post PV | Myelofibrosis, Post ETIsrael
-
Centre Hospitalier Annecy GenevoisCompleted
-
AbbVieRecruitingMyelofibrosis (MF)United States, Australia, Austria, Belgium, Bulgaria, Canada, Croatia, Denmark, France, Germany, Greece, Hungary, Israel, Italy, Japan, Korea, Republic of, Poland, Puerto Rico, Russian Federation, Serbia, Spain, Taiwan, Turkey, United... and more
-
AbbVieActive, not recruitingMyelofibrosis (MF)United States, Australia, Austria, Belgium, Bulgaria, Canada, Croatia, France, Germany, Greece, Israel, Italy, Japan, Korea, Republic of, Netherlands, New Zealand, Russian Federation, Serbia, South Africa, Spain, Sweden, Taiwan, Turkey and more
-
AbbVieActive, not recruitingMyelofibrosis (MF)United States, Argentina, Australia, Brazil, Bulgaria, Chile, Hungary, Israel, Italy, Japan, Korea, Republic of, Spain, Sweden, Turkey
-
AbbVieTerminatedMyelofibrosis (MF)United States, Korea, Republic of, South Africa
-
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.RecruitingModerate and High Risk MyelofibrosisChina
-
National Taiwan University HospitalRecruitingPre-fibrotic MyelofibrosisTaiwan
-
Telios Pharma, Inc.RecruitingPrimary Myelofibrosis | Myelofibrosis | Post-PV MF | Post-ET MyelofibrosisSpain, United States, France, Poland, Italy, Germany
Clinical Trials on Fedratinib Oral Capsule [Inrebic]
-
H. Lee Moffitt Cancer Center and Research InstituteBristol-Myers SquibbRecruitingMDS | Myeloproliferative Neoplasm | Chronic Neutrophilic LeukemiaUnited States
-
Joseph JurcicBristol-Myers SquibbTerminatedMyeloproliferative NeoplasmUnited States
-
H. Lee Moffitt Cancer Center and Research InstituteBristol-Myers SquibbRecruitingMyeloproliferative NeoplasmUnited States
-
CelgeneImpact Biomedicines, Inc., a wholly owned subsidiary of Celgene CorporationAvailable
-
University of ChicagoRecruitingMyeloproliferative Neoplasm | Blood Cancer | IDH2 Gene Mutation | IDH1 Mutation | IDH MutationUnited States
-
Brigham and Women's HospitalCompleted
-
Aelis FarmaNational Institute on Drug Abuse (NIDA)CompletedHealthy VolunteersUnited States
-
Brigham and Women's HospitalEnrolling by invitation
-
EicOsis Human Health Inc.National Institute of Neurological Disorders and Stroke (NINDS)CompletedHealthy AdultsUnited States
-
Brigham and Women's HospitalCompleted