- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT04455841
INCB000928 Administreras som monoterapi eller i kombination med Ruxolitinib hos deltagare med anemi på grund av myeloproliferativa störningar (LIMBER)
En fas 1/2 öppen multicenterstudie av INCB000928 administrerad som monoterapi eller i kombination med ruxolitinib hos deltagare med anemi på grund av myeloproliferativa störningar
Studieöversikt
Status
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
- Fas 1
Kontakter och platser
Studieorter
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Angers, Frankrike, 49033
- Centre Hospitalier D'Angers
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Marseille, Frankrike, 13273
- Institut Paoli Calmettes
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Paris, Frankrike, 75010
- Hospital Saint Louis
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California
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Duarte, California, Förenta staterna, 91010
- City of Hope National Medical Center
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Irvine, California, Förenta staterna, 92618
- City of Hope Orange County
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Los Angeles, California, Förenta staterna, 90089
- USC Norris Comprehensive Cancer Center
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Palo Alto, California, Förenta staterna, 94304
- Stanford Cancer Center
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San Diego, California, Förenta staterna, 92103
- Prebys Cancer Center
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Georgia
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Atlanta, Georgia, Förenta staterna, 30322
- Emory University - Winship Cancer Institute
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Atlanta, Georgia, Förenta staterna, 30322
- Emory University-Winship Cancer Institute
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Michigan
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Grand Rapids, Michigan, Förenta staterna, 49546
- START MidWest
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Missouri
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St Louis, Missouri, Förenta staterna, 63110
- Washington University School of Medicine
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New York
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New York, New York, Förenta staterna, 10065
- Weill Cornell Medical Centers
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North Carolina
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Durham, North Carolina, Förenta staterna, 27705
- Duke University Medical Center, Department of Hematologic Malignancies and Cellular Therapy
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Tennessee
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Nashville, Tennessee, Förenta staterna, 37232
- Vanderbilt University Medical Center
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Texas
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Houston, Texas, Förenta staterna, 77030
- MD Anderson Cancer Center
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Bergamo, Italien, 24127
- Azienda Ospedaliera Papa Giovanni XXIII
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Bologna, Italien, 40138
- S Orsolas University Hospital Seragnoli Institute of Hematology
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Florence, Italien, 50134
- Azienda Ospedaliero-Universitaria Careggi (Aouc)
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Orbassano, Italien, 10043
- Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano
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Pavia, Italien, 27100
- Comitato Di Bioetica Della Fondazione Irccs Policlinico San Matteo
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Perugia, Italien, 06124
- Ospedale Santa Maria Della Misericordia Perugia
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Bunkyō City, Japan, 113-8519
- Tokyo Medical and Dental University Hospital
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Chiba, Japan, 260-8717
- Chiba Cancer Center
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Gifu, Japan, 500-8513
- Gifu Municipal Hospital
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Hirakata, Japan, 573-1191
- Kansai Medical University Hospital
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Kumamoto, Japan, 862-8655
- Kumamoto Shinto General Hospital
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Osaka, Japan, 541-8567
- Osaka International Cancer Institute
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Ontario
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Toronto, Ontario, Kanada, M5G 2M9
- Princess Margaret Cancer Center
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Quebec
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Montreal, Quebec, Kanada, H3T1E2
- McGill University Jewish General Hospital
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Boston, Storbritannien, PE21 9QS
- United Lincolnshire Hospitals
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Lincoln, Storbritannien, LN2 5QY
- Lincoln County Hospital
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Truro, Storbritannien, TR1 3LJ
- Royal Cornwall Hospital Truro Sunrise Centre
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WLS
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Cardiff, WLS, Storbritannien, CF14 4XW
- University Hospital of Wales
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Beskrivning
Inklusionskriterier:
Deltagare med MF som är transfusionsberoende eller har symptomatisk anemi, definieras enligt följande:
- Anemi: Ett Hgb-värde < 10 g/dL visat under screening registrerat vid 3 separata tillfällen med minst 7 dagar mellan mätningarna (Obs: RBC-transfusion måste ske minst 2 veckor före Hgb-mätningen under screening).
- Transfusionsberoende: Deltagaren har fått minst 4 enheter RBC-transfusioner under de 28 dagarna närmast före cykel 1 dag 1 ELLER har i genomsnitt fått minst 4 enheter RBC-transfusioner under de 8 veckorna omedelbart före cykel 1 dag 1, för en Hgb-nivå på < 8,5 g/dL, i frånvaro av blödning eller behandlingsinducerad anemi. Dessutom måste den senaste transfusionsepisoden ha inträffat under de 28 dagarna före cykel 1 dag 1.
ECOG prestandastatuspoäng för följande:
- 0 eller 1 för dosökningsstegen.
- 0, 1 eller 2 för dosexpansionssteget.
- Den förväntade livslängden är längre än 6 månader
- Överenskommelse om att undvika graviditet eller föda barn.
- Ej kvalificerad att ta emot eller har inte svarat på tillgängliga terapier för anemi såsom ESA.
- För TGA:
- Deltagare som tidigare behandlats med JAK-hämmare i minst 12 veckor.
- Deltagare med mellan-2 eller hög DIPSS MF enligt IWG-MRT kriterier.
- För TGB:
- Deltagarna måste ha haft en terapeutisk och stabil ruxolitinibkur i minst 12 veckor i följd omedelbart före den första dosen av studiebehandlingen.
- Deltagare med mellan-1, mellan-2 eller hög DIPSS MF enligt IWG-MRT-kriterier.
Exklusions kriterier:
- Genomgått någon tidigare allogen eller autolog stamcellstransplantation eller en kandidat för sådan transplantation.
- All tidigare kemoterapi, immunmodulerande läkemedelsterapi, immunsuppressiv terapi, biologisk terapi, endokrin terapi, riktad terapi, antikropp eller hypometylerande medel för att behandla deltagarens sjukdom, med undantag för ruxolitinib endast för TGB, inom 5 halveringstider eller 28 dagar (beroende på vilket som är kortare) före den första dosen av studiebehandlingen.
- Laboratorievärden utanför protokolldefinierat område vid screening.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Sekventiell tilldelning
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
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Experimentell: Behandlingsgrupp B (TGB)
INCB000928 kommer att administreras i kombination med ruxolitinib.
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INCB000928 kommer att administreras i protokolldefinierad dos.
Ruxolitinib kommer att administreras i protokolldefinierad dos.
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Experimentell: Behandlingsgrupp A (TGA)
INCB000928 kommer att administreras en gång dagligen (QD).
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INCB000928 kommer att administreras i protokolldefinierad dos.
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Experimentell: Behandlingsgrupp C (TGC)
INCB000928 kommer att administreras i kombination med ruxolitinib.
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INCB000928 kommer att administreras i protokolldefinierad dos.
Ruxolitinib kommer att administreras i protokolldefinierad dos.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Number of Participants With Any Treatment-emergent Adverse Event (TEAE) and Any Treatment-emergent Serious Adverse Event (SAE)
Tidsram: up to approximately 4 years
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An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related.
An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug/treatment.
A TEAE was defined as any AE either reported for the first time or the worsening of a pre-existing event after the first dose of study drug until 30 days after the last dose of study drug.
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up to approximately 4 years
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Number of Participants With Any ≥Grade 3 TEAE and Any Treatment-emergent SAE
Tidsram: up to approximately 4 years
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An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related.
A TEAE was defined as any AE either reported for the first time or the worsening of a pre-existing event after the first dose of study drug until 30 days after the last dose of study drug.
The severity of AEs was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 Grades 1 through 5. Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated.
Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living.
Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living.
Grade 4: life-threatening consequences; urgent treatment indicated.
Grade 5: fatal.
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up to approximately 4 years
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Number of Participants With Dose-limiting Toxicities (DLTs)
Tidsram: from Cycle 1 Day 1 to Cycle 1 Day 28
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A DLT was defined as the occurrence of any protocol-defined toxicity occurring during the first treatment cycle, from Cycle 1 Day 1 up to and including Cycle 1 Day 28 (per regimen cycle schedule), except those with a clear alternative explanation (e.g., disease progression) or transient (≤72 hours) abnormal laboratory values without associated clinically significant signs or symptoms based on investigator determination.
The DLT-Evaluable Population included all non-backfill participants eligible for dose escalation who met the criteria outlined in the Analysis Population field.
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from Cycle 1 Day 1 to Cycle 1 Day 28
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Maximum Tolerated Dose (MTD)
Tidsram: from Cycle 1 Day 1 to Cycle 1 Day 28
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The MTD was defined as the dose at which the observed DLT rate was closest to the target DLT rate of 28% using an isotonical method that took the assumption of a monotonic dose-toxicity relationship into account.
Per the protocol, the stopping rule was either (a) reaching a certain number of participants at one dose level under the early stopping rule or (b) reaching the pre-defined maximum sample size.
Dose escalation was to be considered complete only when one of these conditions was met.
After completion, the MTD was to be defined as the dose level closest to the target DLT rate.
The MTD could not be concluded until the stopping rule was met.
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from Cycle 1 Day 1 to Cycle 1 Day 28
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Recommended Dose for Expansion (RDE)
Tidsram: from Cycle 1 Day 1 to Cycle 1 Day 28
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The RDE was defined as a pharmacodynamically active dose.
The RDE was determined in an independent fashion by evaluation of all available data (i.e., safety, pharmacokinetic, and pharmacodynamic data) from the respective dose-escalation stage of the study for further investigation in the expansion cohort, including safety (e.g., low-grade but chronic toxicities, dose reduction, dose interruption, or missed doses of zilurgisertib and/or ruxolitinib).
The RDE(s) could not exceed the MTD in each treatment group
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from Cycle 1 Day 1 to Cycle 1 Day 28
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Procentuell förändring av hepcidin från cykel 1 dag 15 till cykel 7 dag 1
Tidsram: från cykel 1 dag 15 till cykel 7 dag 1
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Procentuell förändring beräknades som ([post-baseline-värdet minus baseline-värdet] / [baseline-värdet]) * 100.
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från cykel 1 dag 15 till cykel 7 dag 1
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Percentage of Participants With Anemia Response
Tidsram: up to Week 24
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Anemia response was defined as (a) a hemoglobin (Hgb) increase of 1.5 grams per deciliter (g/dL) relative to baseline for any "rolling" 12-week period (84 days with each assessment that met this requirement) during the first 24 weeks of treatment if transfusion independent (TI) at baseline; or (b) transfusion independence for any "rolling" 12-week period (absence of any red blood cell [RBC] transfusion over any 84-day period) during the first 24 weeks of treatment if transfusion dependent (TD) at baseline.
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up to Week 24
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Duration of Anemia Response
Tidsram: up to 1530 days
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Duration of anemia response was defined as (a) the interval from the first onset of anemia response to the earliest date of loss of anemia response that persisted for at least 4 weeks or death from any cause (for TI participants at baseline); or (b) the duration of the RBC-TI period for participants who achieved RBC-TI for at least 12 consecutive weeks during the first 24 weeks of treatment (for TD participants at baseline).
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up to 1530 days
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Mean Change From Baseline in the Hgb Value Over 12-week Treatment Periods
Tidsram: Baseline; up to 24 weeks
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Mean change from baseline was assessed as the largest increase from baseline in the mean Hgb values over any rolling 12-week treatment period during the first 24 weeks of treatment.
Change from baseline was calculated as the post-baseline value minus the baseline value.
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Baseline; up to 24 weeks
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Rate of Red Blood Cell (RBC) Transfusion From Week 24 Through Week 48
Tidsram: from Week 24 through Week 48
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The rate of RBC transfusion was defined as the average number of RBC units per participant-month during the treatment period.
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from Week 24 through Week 48
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Splenic Volume Response Rate at Week 24
Tidsram: Week 24
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Splenic volume response rate was defined as the percentage of participants achieving a ≥35% reduction in spleen volume at Week 24 relative to baseline as measured by magnetic resonance imaging or computed tomography scan.
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Week 24
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Spleen Length Response
Tidsram: Week 24
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Spleen length response was defined as the percentage of participants achieving a ≥50% reduction in spleen length at any visit relative to baseline as measured by palpation.
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Week 24
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Overall Response Rate (ORR)
Tidsram: Week 24
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ORR was defined as the percentage of participants with complete response (CR) or partial response (PR) (including the morphologic effects of the combination of zilurgisertib with ruxolitinib on bone marrow) according to Tefferi et al (2013) definitions.
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Week 24
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Progression-free Survival (PFS)
Tidsram: Week 24
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PFS was defined as the interval from the first dose of study treatment until the first documented progression or death according to Tefferi et al (2013) definitions.
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Week 24
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Leukemia-free Survival (LFS)
Tidsram: Week 24
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LFS was defined as the interval from the first dose of study treatment until the first documented leukemia transformation or death from any cause.
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Week 24
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Cmax of Zilurgisertib Alone
Tidsram: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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Cmax was defined as the maximum concentration of zilurgisertib.
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Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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Tmax of Zilurgisertib
Tidsram: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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tmax was defined as the time to the maximum concentration of zilurgisertib.
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Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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AUC0-t of Zilurgisertib
Tidsram: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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AUC0-t was defined as the area under the plasma concentration-time curve from time 0 to the last quantifiable measurable plasma concentration of zilurgisertib.
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Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
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Change From Baseline in Ferritin
Tidsram: Baseline; Cycle 1 Day 8; Cycle 1 Day 15; Cycle 1 Day 22; Cycles 2, 3, 4, 5, 6, and 7 Day 1; Cycle 2 Day 15
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Change from Baseline (CFB) was calculated as the post-Baseline value minus the Baseline value.
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Baseline; Cycle 1 Day 8; Cycle 1 Day 15; Cycle 1 Day 22; Cycles 2, 3, 4, 5, 6, and 7 Day 1; Cycle 2 Day 15
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Change From Baseline in Hemoglobin at the End of Treatment
Tidsram: up to 1530 days
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Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
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up to 1530 days
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Samarbetspartners och utredare
Sponsor
Utredare
- Studierektor: Amanda McBride, MD, Incyte Corporation
Publikationer och användbara länkar
Allmänna publikationer
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- INCB 00928-104
- 2020-004029-21 (EudraCT-nummer)
- 2023-503625-19-00 (Registeridentifierare: EU CT Number)
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
Incyte delar data med kvalificerade externa forskare efter att ett forskningsförslag lämnats in. Dessa förfrågningar granskas och godkänns av en granskningspanel på grundval av vetenskapliga meriter. All data som tillhandahålls är anonymiserad för att respektera integriteten för patienter som har deltagit i prövningen i enlighet med tillämpliga lagar och förordningar.
Tillgängligheten av testdata är enligt kriterierna och processen som beskrivs på https://www.incyte.com/our-company/compliance-and-transparency
Tidsram för IPD-delning
Kriterier för IPD Sharing Access
IPD-delning som stöder informationstyp
- STUDY_PROTOCOL
- SAV
Läkemedels- och apparatinformation, studiedokument
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