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Sikkerhed og effektivitet af Ponatinib til behandling af pædiatriske tilbagevendende eller refraktære leukæmier, lymfomer eller solide tumorer

12. november 2026 opdateret af: Incyte Biosciences International Sàrl

Et åbent, enkeltarms, fase 1/2-studie, der evaluerer sikkerheden og effektiviteten af ​​Ponatinib til behandling af tilbagevendende eller refraktære leukæmier, lymfomer eller solide tumorer hos pædiatriske deltagere

The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and efficacy of ponatinib in children aged 1 to < 18 years with advanced leukemias, lymphomas, and solid tumors.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

70

Fase

  • Fase 2
  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Ghent, Belgien, 09000
        • Rekruttering
        • Ghent University Hospital
      • Glasgow, Det Forenede Kongerige, G514TF
        • Rekruttering
        • Royal Hospital For Sick Children Yorkhill Glasgow
      • Liverpool, Det Forenede Kongerige, L12 2AP
        • Rekruttering
        • Alder Hey Childrens Nhs Foundation Trust
      • Sutton, Det Forenede Kongerige, SM2 5PT
        • Rekruttering
        • The Royal Marsden Nhs Foundation Trust - Sutton
      • Paris, Frankrig, 75019
        • Rekruttering
        • Hopital Robert Debre
      • Paris, Frankrig, 75571
        • Rekruttering
        • Armand Trousseau Hospital
      • Poitiers, Frankrig, 86021
        • Rekruttering
        • Centre Hospitalier Universitaire de Poitiers
      • Rennes, Frankrig, 35203
        • Afsluttet
        • Chu de Rennes - Hospital Sud
      • Utrecht, Holland, 03584
        • Rekruttering
        • Princess Maxima Center For Pediatric Oncology
      • Bologna, Italien, 40138
        • Rekruttering
        • Aou Policlinico S. Orsola-Malpighi
      • Brescia, Italien, 25123
        • Rekruttering
        • Asst Degli Spedali Civili Di Brescia
      • Genova, Italien, 16147
        • Rekruttering
        • Ospedale Pediatrico G. Gaslini
      • Milan, Italien, 20133
        • Rekruttering
        • Comitato Etico Fondazione Irccs Istituto Nazionale Dei Tumori Milano
      • Monza, Italien, 20900
        • Rekruttering
        • University of Milano Bicocca
      • Naples, Italien, 80123
        • Rekruttering
        • Aorn Santobono Pausilipon
      • Pavia, Italien, 27100
        • Rekruttering
        • Comitato Di Bioetica Della Fondazione Irccs Policlinico San Matteo
      • Rome, Italien, 00165
        • Rekruttering
        • Ospedale Pediatrico Bambino Gesu Irccs
      • Torino, Italien, 10126
        • Rekruttering
        • A.O.U Citta Della Salute E Della Scienza Di Torino Presidio Ospedaliero Infantile Regina Margherita
      • Barcelona, Spanien, 08035
        • Rekruttering
        • Hospital General Universitario Vall D Hebron
      • Barcelona, Spanien, 08035
        • Rekruttering
        • Hospital Sant Joan de Deu de Manresa
      • Madrid, Spanien, 28009
        • Rekruttering
        • Hospital Infantil Unversitario Nino Jesus
      • Valencia, Spanien, 46026
        • Rekruttering
        • Hospital Universitari I Politecnic La Fe
      • Stockholm, Sverige, 14141
        • Rekruttering
        • Karolinska University Hospital Solna

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

1 år til 17 år (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

Histologically or cytologically confirmed diagnosis of the following malignancies:

- Phase 1: CP-CML, BP-CML, AP-CML ALL. AML. Other leukemias. Lymphoma. Any other tumors, including tumors of the CNS, for which standard therapy is not available or is not indicated.

- Phase 2, Group A with CP-CML: CP-CML at the time of study entry and must be resistant to or intolerant of at least 1 prior BCR-ABL-targeted TKI therapy or be in "warning" response status or have the T315I kinase domain mutation.

Must have 1 bone marrow aspirate with documentation of BCR-ABL translocation by conventional cytogenetics, metaphase FISH, or q-PCR performed within 42 days before the first dose of ponatinib.

- Phase 2, Group B with other leukemias or solid tumors: ALL. AML. Other leukemias. Lymphoma. Any other tumors, including tumors of the CNS, with mutations of RET, FLT3, KIT, FGFR, PDGFR, TIE2, VEGFR, or any other mutations where ponatinib may have biological activity (eg, EPH receptors and SRC families of kinases) as assessed on fresh or archived tumor tissue.

Participants with solid tumors or with lymphoma must have measurable disease by CT or MRI based on RECIST v1.1 or the Lugano lymphoma guidelines as determined by site radiology.

Prior therapies as follows:

- Phase 1: Participants with CML who are resistant to or intolerant of (as defined Appendix F) to at least 1 prior BCR-ABL-targeted TKI therapy.

Participants with ALL who have progressed on or after all available or indicated therapies, which may have included 1 prior BCR-ABL-targeted TKI therapy.

Participants with AML or other leukemias who have progressed on or after at least 1 prior induction attempt (for France only) or for whom no effective standard therapy is available or indicated (other countries).

Participants with solid tumors (including tumors of the CNS) or lymphomas who have progressed despite standard therapy or for whom no effective standard therapy is available or indicated.

- Phase 2, Group A with CP-CML: Participants who are resistant to or intolerant of at least 1 prior BCR-ABL-targeted TKI therapy.

- Phase 2, Group B with other leukemias or solid tumors: Participants with ALL who have progressed on or after all available or indicated therapies, which must have included 1 prior BCR-ABL-targeted TKI therapy.

Participants with AML or other leukemias who have progressed on or after at least 1 prior induction attempt (for France only) or for whom no effective standard therapy is available or indicated (other countries).

Participants with solid tumors (including tumors of the CNS) or lymphomas who progressed despite standard therapy or for whom no effective standard therapy is available or indicated.

  • Karnofsky performance status ≥ 40% for participants ≥ 16 years old or Lansky Play Scale ≥ 40% for pediatric participants < 16 years old.
  • Participants must have recovered to < Grade 2 per the NCI CTCAE v5.0 or to baseline from any non-hematologic toxicities (except alopecia) due to previous therapy.
  • Willingness to avoid pregnancy or fathering children.

Exclusion Criteria:

Prior therapies:

- Participants with BP-CML, ALL, or AML who have received any of the following: Corticosteroids or hydroxyurea within 24 hours before the first dose of ponatinib.

Vincristine within 7 days before the first dose of ponatinib. Other chemotherapy (excluding intrathecal chemotherapy) within 14 days before the first dose of ponatinib.

- Participants (except the BP-CML, ALL, and AML participants described above) who: Have had cytotoxic chemotherapy within 21 days (or 42 days for nitrosoureas or mitomycin C) before the first dose of ponatinib.

Prior radiation therapy or radio-isotope therapy within 6 weeks before the first dose of ponatinib except local radiotherapy for palliative indication within 14 days before the first dose of ponatinib.

Autologous or allogeneic stem cell transplant < 3 months before the first dose of ponatinib.

Major surgery within 14 days before the first dose of ponatinib. Inadequate recovery and/or complications from a major surgery before starting therapy.

Prior treatment with any of the following:

  • Immunosuppressive therapy (including post stem cell transplant regimens) within 14 days before the first dose of ponatinib.
  • Any targeted cancer therapy (including TKIs) within 7 days before the first dose of ponatinib.
  • Any other investigational anticancer agents within 30 days or 5 half-lives, whichever is longer, before randomization.
  • Any monoclonal antibody-directed anticancer therapy within 5 half-lives of the first dose of ponatinib.
  • Any chimeric antigen receptor therapy within 28 days before the first dose of ponatinib
  • Ponatinib
  • Protocol-defined lab Values
  • Significant concurrent, uncontrolled medical condition, including but not limited to the following:
  • Pancreatic: clinical, radiological, or laboratory evidence of pancreatitis.
  • Cardiac:
  • SF < 27% by ECHO, OR EF < 50% by MUGA.
  • Abnormal QTcF on screening ECG, defined as QTcF of ≥ 450 ms.
  • Clinically significant or uncontrolled cardiovascular disease, including unstable angina, acute MI within 6 months from Day 1 of study drug administration, New York Heart Association Class III or IV CHF (see Appendix P), and arrhythmia requiring therapy unless approved by the medical monitor/sponsor.
  • Uncontrolled hypertension.
  • Currently taking drug(s) that are known to have a risk of causing prolonged QTc or TdP unless the drug(s) can be changed to acceptable alternatives (ie, an alternate class of agents that do not affect the cardiac conduction system), or the participant can safely discontinue the drug(s).
  • Cerebral:
  • Participants with solid tumors with intracranial metastasis OR participants with active CNS leukemia (ie, CNS-2 status [< 5/μL WBCs and cytospin positive for blasts, or ≥ 5 /μL WBCs but negative by Steinherz/Bleyer algorithm (equation used for traumatic lumbar punctures), disseminated leptomeningeal disease, or CNS chloroma.
  • Pre-existing significant CNS pathology including history of severe brain injury, dementia, cerebellar disease, organic brain syndrome, psychosis, coordination/movement disorder, or autoimmune disease with CNS involvement.
  • History of cerebrovascular ischemia/hemorrhage with residual deficits.
  • Note: Participants with a history of cerebrovascular ischemia/hemorrhage remain eligible provided all neurologic deficits have resolved clinically according to Inclusion Criterion 6.
  • Uncontrolled seizure disorder.
  • Coagulation:
  • Significant bleeding disorder or thrombophilia unrelated to the underlying malignancy indication for study participation.
  • Gastrointestinal:
  • Gastrointestinal disorders, such as malabsorption syndrome or any other illness that could affect oral absorption.
  • Genetic:
  • Participants with DNA fragility syndromes, such as Fanconi anemia and Bloom syndrome.
  • Participants with Down syndrome.
  • Participants with any active ≥ Grade 2 graft versus host disease.
  • Chronic or current active uncontrolled infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment.
  • Active HBV or HCV infection that requires treatment or at risk for HBV reactivation. Hepatitis B virus DNA and HCV RNA must be undetectable upon testing. At risk for HBV reactivation is defined as hepatitis B surface antigen positive or anti-hepatitis B core antibody positive.
  • Known HIV infection.
  • Current use of prohibited medication (see Section 6.7.2).
  • Known hypersensitivity or severe reaction to ponatinib or excipients of ponatinib.
  • Receipt of live (including attenuated) vaccines or anticipation of need for such vaccines during the study.
  • Inability or unlikeliness to comply with the dose schedule and study evaluations, in the opinion of the investigator.
  • Females who are pregnant or lactating.
  • Other exclusions may apply.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Ponatinib

Phase 1: Ponatinib administered according to age-based cohort doses and formulations to determine the maximum tolerated dose and recommended Phase 2 dose. Phase 2: Ponatinib administered at the recommended Phase 2 dose.

Ponatinib administered as a tablet or age-appropriate formulation for pediatric participants according to age-based cohort assignment.

Andre navne:
  • Iclusig, INCB84344

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fase 2: Effekten af ​​ponatinib vurderet ved fuldstændig respons (CR) hos deltagere med andre leukæmier end BCR-ABL-positive leukæmier for at bestemme effekten af ​​ponatinib
Tidsramme: 6 måneder
6 måneder
Phase 1: Number of dose-limiting toxicities
Tidsramme: 28 days

Defined as the occurrence of any protocol-defined toxicities occurring after dosing and up to and including Day 28, except those toxicities with a clear alternative explanation.

28 days
Phase 2: Efficacy of ponatinib assessed by major cytogenetic response (MCyR) in participants with chronic-phase chronic myeloid leukemia (CP-CML)
Tidsramme: 12 months

Defined as complete cytogenetic response (CCyR) or partial cytogenetic response (PCyR) as assessed by conventional cytogenetics or fluorescence in situ hybridization (FISH).

12 months
Phase 2: Efficacy of ponatinib assessed by major hematologic response (MaHR) or major molecular response (MMR) in participants with BCR-ABL-positive leukemias
Tidsramme: 3 months

Assessed by polymerase chain reaction (PCR).

3 months
Phase 2: Efficacy of ponatinib assessed by incomplete complete response (iCR) in participants with leukemias other than BCR-ABL-positive leukemias
Tidsramme: 6 months

Assessed by conventional cytogenetics, FISH, or PCR.

6 months
Phase 2: Efficacy of ponatinib assessed by CR in participants with lymphoma
Tidsramme: 6 months

According to Lugano criteria based on computed tomography (CT) or magnetic resonance imaging (MRI) (or positron emission tomography [PET]).

6 months
Phase 2: Efficacy of ponatinib assessed by overall response rate in participants with solid tumors
Tidsramme: 6 months

Defined as the percentage of participants having CR or PR, as determined by investigator assessment of radiographic disease per tumors per RANO for central nervous system (CNS) tumors or Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) for other solid tumors based on CT or MRI (or PET).

6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fase 1: Antal behandlingsudløste bivirkninger
Tidsramme: 6 måneder
6 måneder
Fase 1 og fase 2: Komplet hæmatologisk respons (CHR) hos deltagere med CP-CML
Tidsramme: 6 måneder
6 måneder
Fase 1 og fase 2: CCyR hos deltagere med CP-CML
Tidsramme: 12 måneder
12 måneder
Fase 1 og fase 2: MFR hos deltagere med CP-CML
Tidsramme: 12 måneder
12 måneder
Fase 1: CR hos deltagere med andre leukæmier end BCR-ABL-positiv leukæmi eller CP-CML.
Tidsramme: 6 måneder
6 måneder
Fase 2: Anticanceraktivitet af ponatinib vurderet ved MaHR eller MMR hos deltagere med BCR-ABL-positive leukæmier (AP-CML, BP-CML eller Ph+ALL)
Tidsramme: 3 måneder
3 måneder
Fase 2: Anticanceraktivitet af ponatinib vurderet ved CR hos deltagere med andre leukæmier end BCR-ABL-positive leukæmier
Tidsramme: 6 måneder
6 måneder
Fase 2: Antal behandlingsudløste bivirkninger
Tidsramme: 6 måneder
6 måneder
Fase 2: Clearance af pædiatrisk-venlig formulering af ponatinib
Tidsramme: 6 måneder
6 måneder
Fase 2: Distributionsvolumen af ​​pædiatrisk-venlig formulering af ponatinib
Tidsramme: 6 måneder
6 måneder
Fase 2: AUC for pædiatrisk-venlig formulering af ponatinib
Tidsramme: 6 måneder
6 måneder
Phase 1: Tmax of ponatinib
Tidsramme: 6 months

Time to maximum concentration.

6 months
Phase 1: AUCss,0-24 of ponatinib
Tidsramme: 6 months

Area under the steady-state plasma or serum concentration-time curve from Hour 0 to 24.

6 months
Phase 1: t½ of ponatinib
Tidsramme: 6 months

Apparent terminal-phase disposition half-life.

6 months
Phase 1: CLss/F of ponatinib
Tidsramme: 6 months

Apparent oral dose clearance at steady state.

6 months
Phase 1: Vz/F of ponatinib
Tidsramme: 6 months

Apparent oral dose volume of distribution.

6 months
Phase 1: MCyR in participants with BCR-ABL-positive leukemias
Tidsramme: 3 months

Defined as CCyR or PCyR as assessed by conventional cytogenetics or FISH.

3 months
Phase 1: MMR in participants with BCR-ABL-positive leukemias
Tidsramme: 3 months

Assessed by quantitative PCR (q-PCR).

3 months
Phase 1 and Phase 2: Time to response (TTR) in participants with CP-CML
Tidsramme: 6 months

Defined as the interval from the date of the first dose of study treatment to first response.

6 months
Phase 1 and Phase 2: Duration of response (DOR) in participants with CP-CML
Tidsramme: 6 months

Defined as the interval between the first assessment at which the criteria for response are met until the criteria for progression are met.

6 months
Phase 1 and Phase 2: Progression-free survival (PFS) in participants with CP-CML
Tidsramme: 6 months

Defined as the interval from the date of the first dose of study treatment until the date of progression of disease or the date of death from any cause, whichever is earlier.

6 months
Phase 1 and Phase 2: Overall survival (OS) in participants with CP-CML
Tidsramme: 6 months

Defined as the interval from the date of the first dose of study treatment until death from any cause.

6 months
Phase 1: CRi in participants with leukemias other than BCR-ABL-positive leukemia or CP-CML
Tidsramme: 6 months

Assessed by conventional cytogenetics, FISH, or q-PCR.

6 months
Phase 1: CR in participants with lymphoma
Tidsramme: 6 months

According to Lugano criteria based on CT or MRI (or PET).

6 months
Phase 1: Overall response rate in participants with solid tumors
Tidsramme: 6 months

Defined as the percentage of participants having CR or PR, as determined by investigator assessment of radiographic disease per tumors per RANO for CNS tumors or RECIST v1.1 for other solid tumors based on CT or MRI (or PET).

6 months
Phase 2: Anticancer activity of ponatinib assessed by CRi in participants with leukemias other than BCR-ABL-positive leukemias.
Tidsramme: 6 months

Assessed by conventional cytogenetics, FISH, or PCR.

6 months
Phase 2: Anticancer activity of ponatinib assessed by CR in participants with lymphoma
Tidsramme: 6 months

According to Lugano criteria based on CT or MRI (or PET).

6 months
Phase 2: Anticancer activity of ponatinib assessed by overall response rate in participants with solid tumors
Tidsramme: 6 months

Defined as the percentage of participants having CR or PR, as determined by investigator assessment of radiographic disease per tumors per RANO for CNS tumors or RECIST v1.1 for other solid tumors based on CT or MRI (or PET).

6 months
Phase 2: OS in participants with solid tumors
Tidsramme: 6 months

Defined as the interval from the date of the first dose of study treatment until death from any cause.

6 months
Phase 2: DOR in participants with solid tumors
Tidsramme: 6 months

Defined as the interval between the first assessment at which the criteria for response are met until the criteria for progression are met.

6 months
Phase 2: PFS in participants with solid tumors
Tidsramme: 6 months

Defined as the interval from the date of the first dose of study treatment until the date of progression of disease or the date of death from any cause, whichever is earlier.

6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studieleder: Mohammed-El-Amine Bensmaine, MD, Incyte Biosciences International Sàrl

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

29. januar 2020

Primær færdiggørelse (Anslået)

1. februar 2028

Studieafslutning (Anslået)

1. februar 2028

Datoer for studieregistrering

Først indsendt

29. april 2019

Først indsendt, der opfyldte QC-kriterier

29. april 2019

Først opslået (Faktiske)

1. maj 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • INCB 84344-102
  • 2018 (U.S. NIH-bevilling/kontrakt)
  • 2018-004878-99 (EudraCT nummer)
  • 2023-509699-41-00 (Registry Identifier: EU CT Number)
  • 2023 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .