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Sicurezza ed efficacia di Ponatinib per il trattamento di leucemie pediatriche ricorrenti o refrattarie, linfomi o tumori solidi

12 novembre 2026 aggiornato da: Incyte Biosciences International Sàrl

Uno studio in aperto, a braccio singolo, di fase 1/2 che valuta la sicurezza e l'efficacia di ponatinib per il trattamento di leucemie, linfomi o tumori solidi ricorrenti o refrattari nei partecipanti pediatrici

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.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

70

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

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

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 1 anno a 17 anni (Bambino)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 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.

Altri nomi:
  • Iclusig, INCB84344

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Fase 2: efficacia di ponatinib valutata mediante risposta completa (CR) nei partecipanti con leucemie diverse dalle leucemie BCR-ABL-positive per determinare l'efficacia di ponatinib
Lasso di tempo: 6 mesi
6 mesi
Phase 1: Number of dose-limiting toxicities
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 6 months

Assessed by conventional cytogenetics, FISH, or PCR.

6 months
Phase 2: Efficacy of ponatinib assessed by CR in participants with lymphoma
Lasso di tempo: 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
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Fase 1: numero di eventi avversi emersi dal trattamento
Lasso di tempo: 6 mesi
6 mesi
Fase 1 e Fase 2: Risposta ematologica completa (CHR) nei partecipanti con CP-CML
Lasso di tempo: 6 mesi
6 mesi
Fase 1 e Fase 2: CCyR nei partecipanti con CP-CML
Lasso di tempo: 12 mesi
12 mesi
Fase 1 e Fase 2: MPR nei partecipanti con CP-CML
Lasso di tempo: 12 mesi
12 mesi
Fase 1: CR in partecipanti con leucemie diverse dalla leucemia BCR-ABL-positiva o CP-CML.
Lasso di tempo: 6 mesi
6 mesi
Fase 2: attività antitumorale di ponatinib valutata da MaHR o MMR nei partecipanti con leucemie positive per BCR-ABL (LMC-FA, LMC-FA o LLA Ph+)
Lasso di tempo: 3 mesi
3 mesi
Fase 2: attività antitumorale di ponatinib valutata da CR in partecipanti con leucemie diverse dalle leucemie BCR-ABL-positive
Lasso di tempo: 6 mesi
6 mesi
Fase 2: numero di eventi avversi emersi dal trattamento
Lasso di tempo: 6 mesi
6 mesi
Fase 2: Autorizzazione della formulazione pediatrica di ponatinib
Lasso di tempo: 6 mesi
6 mesi
Fase 2: volume di distribuzione della formulazione pediatrica di ponatinib
Lasso di tempo: 6 mesi
6 mesi
Fase 2: AUC della formulazione pediatrica di ponatinib
Lasso di tempo: 6 mesi
6 mesi
Phase 1: Tmax of ponatinib
Lasso di tempo: 6 months

Time to maximum concentration.

6 months
Phase 1: AUCss,0-24 of ponatinib
Lasso di tempo: 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
Lasso di tempo: 6 months

Apparent terminal-phase disposition half-life.

6 months
Phase 1: CLss/F of ponatinib
Lasso di tempo: 6 months

Apparent oral dose clearance at steady state.

6 months
Phase 1: Vz/F of ponatinib
Lasso di tempo: 6 months

Apparent oral dose volume of distribution.

6 months
Phase 1: MCyR in participants with BCR-ABL-positive leukemias
Lasso di tempo: 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
Lasso di tempo: 3 months

Assessed by quantitative PCR (q-PCR).

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

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

6 months
Phase 1: CR in participants with lymphoma
Lasso di tempo: 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
Lasso di tempo: 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.
Lasso di tempo: 6 months

Assessed by conventional cytogenetics, FISH, or PCR.

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

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Direttore dello studio: Mohammed-El-Amine Bensmaine, MD, Incyte Biosciences International Sàrl

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

29 gennaio 2020

Completamento primario (Stimato)

1 febbraio 2028

Completamento dello studio (Stimato)

1 febbraio 2028

Date di iscrizione allo studio

Primo inviato

29 aprile 2019

Primo inviato che soddisfa i criteri di controllo qualità

29 aprile 2019

Primo Inserito (Effettivo)

1 maggio 2019

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

13 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

12 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • INCB 84344-102
  • 2018 (Sovvenzione/contratto NIH degli Stati Uniti)
  • 2018-004878-99 (Numero EudraCT)
  • 2023-509699-41-00 (Identificatore di registro: EU CT Number)
  • 2023 (Sovvenzione/contratto NIH degli Stati Uniti)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .