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A Study Evaluating Tolerability and Efficacy of Navitoclax Alone or in Combination With Ruxolitinib in Participants With Myelofibrosis

NCT03222609

Description:

This is a Phase 2 open-label, multicenter study evaluating tolerability and efficacy of navitoclax alone or when added to ruxolitinib in participants with myelofibrosis.

Related Conditions:
  • Myelofibrosis Transformation in Essential Thrombocythemia
  • Polycythemia Vera, Post-Polycythemic Myelofibrosis Phase
  • Primary Myelofibrosis
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study Evaluating Tolerability and Efficacy of Navitoclax Alone or in Combination With Ruxolitinib in Participants With Myelofibrosis
  • Official Title: A Phase 2 Open-Label Study Evaluating Tolerability and Efficacy of Navitoclax Alone or in Combination With Ruxolitinib in Subjects With Myelofibrosis (REFINE)

Clinical Trial IDs

  • ORG STUDY ID: M16-109
  • SECONDARY ID: 2017-001398-17
  • NCT ID: NCT03222609

Conditions

  • Myelofibrosis (MF)

Interventions

DrugSynonymsArms
RuxolitinibJakafiNavitoclax + ruxolitinib
NavitoclaxABT-263Navitoclax

Purpose

This is a Phase 2 open-label, multicenter study evaluating tolerability and efficacy of navitoclax alone or when added to ruxolitinib in participants with myelofibrosis.

Trial Arms

NameTypeDescriptionInterventions
Navitoclax + ruxolitinibExperimentalParticipants will be administered navitoclax once daily (QD) at various doses and a dose greater than or equal to 10 mg of ruxolitinib twice daily (BID).
  • Ruxolitinib
  • Navitoclax
NavitoclaxExperimentalParticipants will be administered various doses of navitoclax once daily (QD)
  • Navitoclax

Eligibility Criteria

        Inclusion Criteria:

          -  Participants with documented diagnosis of intermediate-2 or high-risk primary
             Myelofibrosis, Post Polycythemia Vera Myelofibrosis or Post-essential Thrombocythemia
             Myelofibrosis.

          -  Participant must be ineligible due to age, comorbidities, or unfit for unrelated or
             unmatched donor transplantation or unwilling to undergo stem cell transplantation at
             time of study entry.

          -  Eastern Cooperative Oncology Group (ECOG) of 0, 1, or 2.

          -  Prior treatment must meet at least one of the following criteria:

               -  Prior or current treatment with ruxolitinib and no prior treatment with a
                  Bromodomain and Extra-Terminal motif (BET) proteins inhibitor or another Janus
                  Kinase 2 (JAK-2) inhibitor, and meet all of the following criteria:

                    -  Ruxolitinib treatment must meet at least one of the following criteria:

                         -  Ruxolitinib treatment for >=24 weeks with lack of efficacy defined as a
                            lack of spleen response (refractory) or a loss of spleen or symptom
                            response (relapsed)

                         -  Ruxolitinib treatment for <24 weeks with documented disease progression
                            on spleen measurements while on ruxolitinib as defined in the protocol:

                         -  Ruxolitinib treatment for >=28 days with intolerance defined as new red
                            blood cell transfusion requirement (at least 2 units/month for 2
                            months) while receiving a total daily ruxolitinib dose of >=30 mg but
                            unable to reduce dose further due to lack of efficacy.

                    -  If receiving ruxolitinib at the time of screening, must currently be on a
                       stable dose >=10 mg twice daily of ruxolitinib for >=4 weeks prior to the
                       1st dose of navitoclax.

                    -  Participant has at least 2 symptoms each with a score >=3 or a total score
                       of >=12, as measured by the Myelofibrosis Symptom Assessment Form (MFSAF)
                       v4.0 on at least 4 out of 7 days during screening prior to study drug
                       dosing; OR

               -  Prior treatment with a JAK-2 inhibitor and meet one of the following criteria:

                    -  Prior treatment with a JAK-2 inhibitor for at least 12 weeks

                    -  Prior treatment with a JAK-2 inhibitor for >=28 days complicated by either
                       development of red blood cell transfusion requirement (at least 2
                       units/month for 2 months) OR Grade >= 3 adverse events of thrombocytopenia,
                       anemia, hematoma and/or hemorrhage while on JAK-2 inhibitor treatment; OR

               -  No prior treatment with a JAK-2 or BET inhibitor:

                    -  Participant has at least 2 symptoms each with a score >=3 or a total score
                       of >= 12, as measured by the MFSAF v4.0 on at least 4 out of 7 days during
                       screening prior to study drug dosing.

          -  Participant has splenomegaly as defined in the protocol.

          -  Participant must meet the laboratory parameters (adequate bone marrow, renal and
             hepatic function) as defined in the protocol.

        Exclusion Criteria:

          -  Splenic irradiation within 6 months prior to screening, or prior splenectomy.

          -  Leukemic transformation (> 10% blasts in peripheral blood or bone marrow
             aspirate/biopsy).

          -  Participant is currently on medications that interfere with coagulation (including
             warfarin) or platelet function within 3 days prior to the first dose of study drug or
             during the study treatment period with the exception of low dose aspirin (up to 100
             mg/day) and low-molecular-weight heparin.

          -  Prior therapy with a BH3 mimetic compound or stem cell transplantation.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Percentage of Participants who achieve Spleen Volume Reduction of greater than or equal to 35% (SVR35) from baseline
Time Frame:From Baseline (Week 0) through Week 24
Safety Issue:
Description:Reduction in spleen volume is measured by magnetic resonance imaging (MRI).

Secondary Outcome Measures

Measure:Percentage of participants achieving 50% Reduction in Total System Score (TSS)
Time Frame:From Baseline (Week 0) through Week 24
Safety Issue:
Description:TSS is assessed by the Myelofibrosis Symptom Assessment Form (MFSAF) version 4.0.
Measure:Anemia Response
Time Frame:Every 12 weeks up to approximately 96 weeks
Safety Issue:
Description:The anemia response will be assessed according to current International Working Group-Myeloproliferative Neoplasms Research and European LeukemiaNet (IWG-MRT/ELN) criteria.
Measure:Change in Grade of Bone Marrow Fibrosis
Time Frame:Through Week 96
Safety Issue:
Description:Bone marrow grading is assessed according to the European Consensus Grading System.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:AbbVie

Trial Keywords

  • Post-polycythemia vera MF (PPV-MF)
  • Post-essential thrombocythemia (PET-MF)
  • ruxolitinib
  • navitoclax
  • splenic volume
  • Primary Myelofibrosis
  • Jakafi
  • enlarged spleen
  • splenomegaly
  • ABT 263
  • bone marrow fibrosis

Last Updated

August 25, 2021