Clinical Trials /

Ropeginterferon Alfa-2b (P1101) vs. Anagrelide in Essential Thrombocythemia Patients With Hydroxyurea Resistance or Intolerance

NCT04285086

Description:

This is a Phase 3 open-label, multicenter, randomized, active-controlled study designed to compare the efficacy and safety and tolerability of P1101 compared with ANA after 12 months of treatment as second-line therapy for subjects with ET who have had a suboptimal or failed response to HU.

Related Conditions:
  • Essential Thrombocythemia
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Ropeginterferon Alfa-2b (P1101) vs. Anagrelide in Essential Thrombocythemia Patients With Hydroxyurea Resistance or Intolerance
  • Official Title: A Phase 3, Open-Label, Multicenter, Randomized, Active-controlled Study to Assess Pharmacokinetics and Compare the Efficacy, Safety, and Tolerability of P1101 vs Anagrelide as Second Line Therapy for Essential Thrombocythemia

Clinical Trial IDs

  • ORG STUDY ID: P1101 ET
  • NCT ID: NCT04285086

Conditions

  • Essential Thrombocythemia

Interventions

DrugSynonymsArms
Ropeginterferon alfa-2bAnagrelideAnagrelide

Purpose

This is a Phase 3 open-label, multicenter, randomized, active-controlled study designed to compare the efficacy and safety and tolerability of P1101 compared with ANA after 12 months of treatment as second-line therapy for subjects with ET who have had a suboptimal or failed response to HU.

Detailed Description

      PharmaEssentia Corporation is developing a pegylated (PEG) IFN-α product, P1101, for the
      treatment of ET.

      Available clinical data and experience with P1101 in PV shows that the compound, with proper
      dose modifications, is effective in controlling disease in a significant proportion of
      subjects with ET. Further, its increased serum half-life presents distinct advantages for ET
      treatment over that of standard IFN-α and other available PEG IFN-α therapy. This pivotal
      Phase 3 study will establish the efficacy and safety of P1101 in ET subjects.

      The enrolled subjects will be randomized into two arms, the test arm is P1101, the control
      arm is ANA. The overall duration for each eligible patient is 14 months, including screening
      (1 month), treatment (12 months) and follow-up (1 month) period. Efficacy evaluations, safety
      assessments, and PK and immunogenicity evaluations of P1101 will be performed.

      Evaluation of efficacy will include clinical laboratory assessments, allelic burden
      measurements of CALR, JAK-2, and MPL, spleen size measurements, bone marrow sampling,
      EQ-5D-3L, and MPN-SAF TSS completion.

      Evaluation of safety will include assessing vital signs, clinical safety laboratory tests,
      physical examinations, ECG evaluation, heart ECHO, lung X-ray, ECOG performance status,
      ocular examination, and AEs.
    

Trial Arms

NameTypeDescriptionInterventions
Ropeginterferon alfa-2b (P1101)ExperimentalPre-filled Syringe, Q2W, SC injection
  • Ropeginterferon alfa-2b
AnagrelideActive ComparatorCapsules, Daily, p.o.
  • Ropeginterferon alfa-2b

Eligibility Criteria

        Inclusion Criteria:

          1. Male or female subjects ≥18 years old

          2. Subjects diagnosed with high-risk ET (either older than 60 years and JAK2V617-positive
             at screening, or having disease-related thrombosis or hemorrhage in the past),
             diagnosed according to the World Health Organization (WHO) 2016 criteria

          3. Subjects have received prior HU for ET, while the washout between the last dose of HU
             and the screening visit should not be shorter than 14 days

          4. Interferon treatment-naïve

          5. Documented resistance/intolerance to prior HU for ET, as defined by modified ELN
             criteria (Barosi, et al, 2007), whereby at least one of the following criteria is met:

             Platelet count >600 x 109/L at ≥2 g/day (or ≥2.5 g/day if subject body weight >80 kg)
             or maximally tolerated dose if <2 g/day after at least 3 months of HU, or Platelet
             count >400 x 109/L and WBC count <2.5 x 109/L at any dose and any duration of HU, or
             Platelet count >400 x 109/L and hemoglobin (HGB) <10 g/dL at any dose and any duration
             of HU, or Presence of HU-related toxicities at any dose and any duration of therapy
             (e.g., leg ulcers, mucocutaneous manifestations, pneumonitis, or HU-related fever)

          6. Platelets >450 x 109/L at screening

          7. WBC >10 x 109/L at screening

          8. HGB ≥11 g/dL at screening for males and 10 g/dL at screening for females

          9. Neutrophil count ≥1.0 x 109/L at screening

         10. Adequate hepatic function defined as bilirubin ≤1.5 x upper limit normal (ULN),
             prothrombin time (PT) (international normalized ratio, INR) ≤1.5 x ULN, albumin >3.5
             g/dL, alanine aminotransferase ≤2.0 x ULN, aspartate aminotransferase ≤2.0 x ULN at
             screening

         11. Creatinine clearance ≥40 mL/min (by Cockcroft-Gault equation)

         12. Males and females of childbearing potential, as well as all women <2 years after the
             onset of menopause, must agree to use an acceptable form of birth control until 28
             days following the last dose of the study drug, and females must agree to not
             breastfeed during the study

         13. Written informed consent obtained from the subject and ability for the subject to
             comply with the requirements of the study

        Exclusion Criteria:

          1. Any subject requiring a legally authorized representative

          2. Any contraindications or hypersensitivity to IFN-α or ANA and their excipients

          3. Known risk factors for QT-prolongation (e.g., congenital long QT, known history of
             acquired QT-prolongations). Medications that can prolong QTc and induce hypokalemia
             will not be allowed in the study.

          4. Co-morbidity with severe or serious condition that, in the Investigator's opinion,
             would jeopardize the safety of the subject or their compliance with the protocol,
             including significant cardiac disease (including New York Heart Association Class
             III-IV congestive heart failure and clinically significant arrhythmias) and pulmonary
             hypertension

          5. History of major organ transplantation

          6. Pregnant or lactating females

          7. Subjects with any other significant medical conditions that, in the opinion of the
             Investigator, would compromise the results of the study or may impair compliance with
             the requirements of the protocol, including but not limited to:

               1. Documented autoimmune disease at screening or in the history (e.g., thyroid
                  dysfunction, hepatitis, idiopathic thrombocytopenic purpura, scleroderma,
                  psoriasis, or any arthritis of autoimmune origin)

               2. Clinically relevant pulmonary infiltrates, pneumonia, and pneumonitis at
                  screening that, in the Investigator's opinion, would jeopardize the safety of the
                  subject or their compliance with the protocol

               3. Infections with systemic manifestations (e.g., bacterial, fungal, or human
                  immunodeficiency virus [HIV], except hepatitis B [HBV] and/or hepatitis C [HCV],
                  at screening)

               4. Evidence of severe retinopathy (e.g., cytomegalovirus retinitis, macular
                  degeneration) or clinically relevant ophthalmological disorder (due to diabetes
                  mellitus or hypertension)

               5. History or presence of clinically relevant depression, or previous suicide
                  attempts or at any risk of suicide at screening, in the judgement of the
                  Investigator

               6. History or presence of clinically significant neurodegenerative diseases

               7. History of any malignancy within 5 years (except Stage 0 chronic lymphocytic
                  leukemia, basal cell, squamous cell, and superficial melanoma)

               8. History of alcohol or drug abuse within the last year

               9. History or evidence of any other MPN

          8. Use of any investigational drug <4 weeks prior to the first dose of study drug or not
             recovered from effects of prior administration of any investigational agent

          9. Subjects with documented ANA resistance or intolerance (see Appendix 8 for
             definition).
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Peripheral blood count remission
Time Frame:month 9 and month 12
Safety Issue:
Description:platelets ≤400 x 109/L AND white blood cells (WBC) <9.5 x 109/L

Secondary Outcome Measures

Measure:Durable response
Time Frame:month 3 and month 6
Safety Issue:
Description:measure durable response at month 3 and 6
Measure:Longitudinal rate
Time Frame:over the 12 months
Safety Issue:
Description:measure longitudinal rate of change in the ELN response rates over the 12 months
Measure:Response rates
Time Frame:3, 6, 9, and 12 months
Safety Issue:
Description:measure response rate based on peripheral blood count remission, no signs of progressive disease, and absence of any hemorrhagic or thrombotic events
Measure:Occurrence of thromboembolic events
Time Frame:over the 12 months
Safety Issue:
Description:measure occurrence of thromboembolic events over the 12 months
Measure:Time to first peripheral blood count remission response
Time Frame:over the 12 months
Safety Issue:
Description:measure time to first peripheral blood count remission response over the 12 months
Measure:Duration of peripheral blood count remission response
Time Frame:over the 12 months
Safety Issue:
Description:measure duration of peripheral blood count remission response over the 12 months
Measure:Symptomatic improvement assessed by the EuroQOL 5 dimensions 3 level version (EQ-5D-3L) questionnaire
Time Frame:over the 12 months
Safety Issue:
Description:measure symptomatic improvement assessed by the EuroQOL 5 dimensions 3 level version (EQ-5D-3L) questionnaire over the 12 months
Measure:Symptomatic improvement assessed by the 10-item MPN-SAF TSS
Time Frame:over the 12 months
Safety Issue:
Description:measure symptomatic improvement assessed by the 10-item MPN-SAF TSS over the 12 months
Measure:Change of CALR, MPL, and JAK-2 allelic burden over time
Time Frame:over the 12 months
Safety Issue:
Description:measure change of CALR, MPL, and JAK-2 allelic burden over time
Measure:Improvement or non-progression of spleen size assessment
Time Frame:over the 12 months
Safety Issue:
Description:measure spleen size over time

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:PharmaEssentia

Trial Keywords

  • Essential Thrombocythemia
  • Ropeginterferon
  • P1101
  • PharmaEssentia

Last Updated

March 10, 2021