Peginterferon α-2b Injection for Hydroxyurea Resistant or Intolerant ET

A Phase 2 Multicenter, Randomized, Open-label Study to Evaluate the Pharmacokinetic, Safety and Efficacy of Peginterferon Alfa-2b Injection in Subjects With Essential Thrombocythemia Who Are Resistant to or Intolerant of Hydroxyurea.

This is a multicenter, randomized, open-label Phase 2 clinical study. It is aimed to enroll 27 essential thrombocytopenia (ET) patients who are resistant to or intolerant of hydroxyurea(HU). Eligible patients will be randomized to receive either Peginterferon α-2b 135 mcg or Peginterferon α-2b 180 mcg at a ratio of 1:2, and all subjects will go through a target treatment period (Weeks 1 ~ Week 48), an extension treatment period (Weeks 49 ~ Week 96) and a follow-up period (Weeks 97 ~ Week 100). Pharmacokinetics, safety, efficacy will be evaluated.

Study Overview

• Status: Recruiting
• Conditions: Essential Thrombocythemia
• Intervention / Treatment: Drug: Peginterferon α-2b injection; Drug: Peginterferon α-2b injection

• Study Type: Interventional
• Enrollment (Estimated): 27
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Lei Zhang; Phone Number: 13502118379; Email: zhanglei1@ihcams.ac.cn
• Study Contact Backup: Name: Rongfeng Fu; Phone Number: 13502118379; Email: furongfeng@ihcams.ac.cn

Study Locations

• China
  • Beijing, China
    • Recruiting
    • Peking University People's Hospital
    • Contact: Hongxia Shi; Phone Number: 13661049635; Email: hxshi55@sina.com
  • Beijing, China
    • Recruiting
    • Peking Union Hospital, Chinese Academy of Medical Sciences
    • Contact: Minghui Duan; Phone Number: 13621262462; Email: mhduan@sina.com
  • Fujian, China
    • Recruiting
    • Union Hospital Affiliated to Fujian Medical University
    • Contact: Yong Wu; Phone Number: 13365910911; Email: wuyong9195@126.com
  • Guangzhou, China
    • Recruiting
    • Nanfang Hospital, Southern Medical University
    • Contact: Na Xu; Phone Number: 18620698390; Email: sprenaa@163.com
  • Harbin, China
    • Recruiting
    • Harbin First Hospital
    • Contact: Tiejun Gong; Phone Number: 13836027737; Email: arac@sina.com
  • Henan, China
    • Recruiting
    • Henan Cancer Hospital
    • Contact: Hu Zhou; Phone Number: 13939068863; Email: tigerzhoupumc@163.com
  • Shanghai, China
    • Recruiting
    • Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
    • Contact: Wen Wu; Phone Number: 13611770009; Email: ww10649@rjh.com.cn
  • Zhejiang, China
    • Recruiting
    • The First Affiliated Hospital of Zhejiang University School of Medicine
    • Contact: Hongyan Tong; Phone Number: 13958122357; Email: hongyantong@aliyun.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male or female subjects, aged greater or equal to 18 years old at screening;
• Subjects diagnosed as high-risk ET according to the World Health Organization (WHO) 2016 criteria：1) who is older than 60 years and JAK2V617F positive at screening, 2) or who previously suffered from disease-related thrombosis or hemorrhage;
• Subjects who have previously received HU for ET, and the time interval between the last HU dose and the first dose of the study drug should not be less than 7 days;
• Interferon treatment-naïve, and for those who have previously received interferon the the time interval between the last dose of interferon and randomization should not be less than 1 month;

• Patients with confirmed hydroxyurea resistance or intolerant, as at least one of the following criteria is met:

  1. Platelet count remain greater than 600×10^9 /L after at least 3 months of HU treatment at a dose ≥2g/d (dose ≥2.5 g/d if subject weight > 80 kg);
  2. Platelet count greater than 400*10^9/L while white blood cell (WBC) count lower than 2.5*10^9/L, or platelet count greater than 400*10^9 /L while hemoglobin lower than 100 g/L at any dose of HU;
  3. Presence of HU-related toxicities at any dose of HU: e.g. ulcers in legs, or any unacceptable skin mucosal manifestations or fever;
• Platelet counts > 450*10^9/L at screening;
• Neutrophil count ≥1.0*10^9/L at screening;
• Haemoglobin ≥11 g/dL at screening for males and 10 g/dL for females at screening;
• There is no serious function damage in liver and kidney: total bilirubin ≤1.5 upper limit of normal (ULN), alanine aminotransferase≤2.0 ULN, aspartate aminotransferase≤2.0 ULN, prothrombin time is prolonged by less than 4 seconds, Creatinine clearance ≥50 mL/min (according to Cockcroft-Gault formula) at screening;

• Both male and female subjects must agree take an appropriate contraceptive method, including:

  1. Male subjects: must agree to use reliable contraception from inform consent until 6 months following the last dose of the study drug.
  2. Female subjects: Must meet at least one of the following conditions:

  i) Women without childbearing potential; ii) Women of childbearing potential: no pregnant or breastfeed, negative in blood pregnancy test within 4 days prior to the first dosing, and must agree to use reliable contraception from inform consent until 6 months following the last dose of the study drug;

• Subjects understand the objective, characteristic, method and possible adverse reactions of the study, voluntarily participate in this study, and sign informed consent.

Exclusion Criteria:

• History of any other myeloproliferative tumors, or evidence of the presence of any other myeloproliferative tumors;
• Contraindications or hypersensitivities to interferons of any of its excipients;
• Severe medical conditions or serious comorbidities that the investigators determined could jeopardize the safety or protocol adherence, e.g. New York Heart Association [NYHA] Class III-IV, congestive heart failure, symptomatic arrhythmias，pulmonary hypertension;
• History of major organ transplantation;
• Documented autoimmune disease or history of autoimmune disease at screening, e.g. medication un-controlled thyroid dysfunction, autoimmune hepatitis, idiopathic thrombocytopenic purpura, scleroderma, psoriasis, or any autoimmune arthritis;
• Clinically significant pulmonary infiltration, infectious pneumonia, and non-infectious pneumonia at screening that, in the investigator's opinion, would jeopardize the safety of the subject or their compliance with the protocol;
• Infection with systemic clinical manifestations at screening, e.g., bacteria, fungi, human immunodeficiency virus, excluding hepatitis B and/or C;
• Evidence of severe retinopathy, e.g., cytomegalovirus retinitis, symptomatic macular degeneration, or clinically significant eye disease, e.g. due to diabetes mellitus or hypertension;
• Diagnosed clinically significant depression or a history of depression and, in the investigator's opinion, previous suicide attempts or at any risk of suicide at screening;
• Diagnosed clinically significant neurological disease or a history of clinically significant neurological disease, except for a history of stable cerebral thrombosis or cerebral hemorrhage;
• History of any malignancy within 5 years (except stage 0 chronic lymphocytic leukemia, basal cell carcinoma, squamous cell carcinoma, and superficial melanoma);
• A history of alcohol or drug abuse within 1 year;
• Have used any investigational drug within 4 weeks prior to first dose of investigational drug, or not recovered from the effects of prior investigational drug administration;
• Other situations that, in the investigator's opinion, not appropriate for inclusion.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Peginterferon α-2b 135 mcg dose group	Drug: Peginterferon α-2b injection; Peginterferon α-2b injection, 135 mcg, s.c., once a week, during the targeted treatment period (the first 48 week), peginterferon α-2b dose is depended on the patient's response and tolerability during the extension treatment (week 49 to week 96).; Drug: Peginterferon α-2b injection; Peginterferon α-2b injection, 180 mcg, s.c., once a week, during the targeted treatment period (the first 48 week), peginterferon α-2b dose is depended on the patient's response and tolerability during the extension treatment (week 49 to week 96).
Experimental: Peginterferon α-2b 180 mcg dose group	Drug: Peginterferon α-2b injection; Peginterferon α-2b injection, 135 mcg, s.c., once a week, during the targeted treatment period (the first 48 week), peginterferon α-2b dose is depended on the patient's response and tolerability during the extension treatment (week 49 to week 96).; Drug: Peginterferon α-2b injection; Peginterferon α-2b injection, 180 mcg, s.c., once a week, during the targeted treatment period (the first 48 week), peginterferon α-2b dose is depended on the patient's response and tolerability during the extension treatment (week 49 to week 96).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Maximum concentration (Cmax)	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Time to maximum concentration (Tmax)	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Area under the plasma concentration-time curve	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Apparent volume of distribution after oral administration (Vz/f)	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Apparent plasma clearance (CL/F)	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Plasma elimination half-life (t1/2)	week1,4, 8, 12, 24, 36, 48, 60, 72, 84, 96.
Relationship between exposure and the effect (desired-effectiveness or undesirable-toxicity) in a pharmacokinetic model and pharmacodynamic model.	up to 96 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of complete hematological remission.		Week 24, 36, 48, 60, 72, 84, 96.
Platelet counts change from baseline.		Week 12, 24, 36, 48, 60, 72, 84, 96.
White blood cell counts change from baseline.		Week 12, 24, 36, 48, 60, 72, 84, 96.
Complete remission rate.		Week 24, 36, 48, 60, 72, 84, 96.
Time to complete remission from baseline.		Week 48, 96.
Duration of complete remission.		Week 48, 96.
Remission rate of bone marrow.		Week 48, 96.
Incidence of disease progression.		Week 48, 96.
Change of JAK2V617F mutations load from baseline.	JAK2V617F mutations were quantitatively detected using next-generation sequencing	Week 48, 96.
Change of CALR mutations load from baseline.	CALR mutations were quantitatively detected using next-generation sequencing	Week 48, 96.
Change of MPL mutations load from baseline.	MPL mutations were quantitatively detected using next-generation sequencing	Week 48, 96.
Change of MPN-SAF TSS scores from baseline		Week 12, 24, 36, 48, 60, 72, 84,96.
Change of spleen size from baseline	The maximum length of the spleen was measured by ultrasound.	Week 12, 24, 36, 48, 60, 72, 84, 96.
Rate of complete hematological remission maintenance in patients received dose-reduction extension therapy		Week 96.
Duration of complete hematological remission in patients received dose-reduction extension therapy		Week 96.
Change of 3-level Version of EuroQol Five Dimensions(EQ-5D-3L) scores from baseline.		Week 12, 24, 36, 48, 60, 72, 84, 96.
Incidence of thrombotic and bleeding events.		through study completion, an average of 2 year

Collaborators and Investigators

• Sponsor: Xiamen Amoytop Biotech Co., Ltd.
• Investigators: Principal Investigator: Lei Zhang, Chinese Academy of Medical Sciences

Study record dates

Study Major Dates

• Study Start (Actual): August 29, 2024
• Primary Completion (Actual): October 26, 2025
• Study Completion (Estimated): September 1, 2027

Study Registration Dates

• First Submitted: July 27, 2024
• First Submitted That Met QC Criteria: August 11, 2024
• First Posted (Actual): August 14, 2024

Study Record Updates

• Last Update Posted (Actual): November 17, 2025
• Last Update Submitted That Met QC Criteria: November 13, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Essential Thrombocythemia; Peginterferon α-2b; hydroxyurea resistant; hydroxyurea intolerant
• Additional Relevant MeSH Terms: Hematologic Diseases; Blood Coagulation Disorders; Bone Marrow Diseases; Hemorrhagic Disorders; Blood Platelet Disorders; Myeloproliferative Disorders; Hemic and Lymphatic Diseases; Thrombocytosis; Thrombocythemia, Essential
• Other Study ID Numbers: P2b-4-3-002

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No