Clinical Trials /

Study of Oral Navitoclax Tablet In Combination With Oral Ruxolitinib Tablet When Compared With Oral Ruxolitinib Tablet To Assess Change In Spleen Volume In Adult Participants With Myelofibrosis

NCT04472598

Description:

Myelofibrosis is a type of bone marrow cancer that usually develops slowly and disrupts body's normal production of blood cells. It causes bone marrow scarring, leading to severe anemia that can cause weakness and fatigue. It can also cause a low number of blood-clotting cells called platelets, which increases risk of bleeding. Myelofibrosis often causes an enlarged spleen. The purpose of this study is to see if a combination of navitoclax and ruxolitinib is more effective and safe in assessment of change in spleen volume when compared to ruxolitinib in participants with myelofibrosis. Navitoclax is an investigational drug for the treatment of myelofibrosis. Participants in this study are divided into two groups, called treatment arms. Each group receives a different treatment. Adult participants with a diagnosis of myelofibrosis will be enrolled. Around 230 participants will be enrolled in approximately 190 sites worldwide. Participants will receive oral navitoclax tablet with oral ruxolitinib tablet or oral ruxolitinib tablet with oral placebo (no active drug) tablet and treatment may continue till the participant cannot tolerate the study drug, or benefit is not achieved, or other reasons which qualify for discontinuation of the study drug. There may be a higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the course of the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, magnetic resonance imaging (MRI) or computed tomography (CT) scan, bone marrow tests, checking for side effects, and completing questionnaires.

Related Conditions:
  • Myelofibrosis
Recruiting Status:

Recruiting

Phase:

Phase 3

URL:

https://clinicaltrials.gov/show/NCT04472598

Trial Eligibility

Document

Title

  • Brief Title: Study of Oral Navitoclax Tablet In Combination With Oral Ruxolitinib Tablet When Compared With Oral Ruxolitinib Tablet To Assess Change In Spleen Volume In Adult Participants With Myelofibrosis
  • Official Title: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study Of Navitoclax In Combination With Ruxolitinib Versus Ruxolitinib In Subjects With Myelofibrosis (TRANSFORM-1)

Clinical Trial IDs

  • ORG STUDY ID: M16-191
  • SECONDARY ID: 2020-000097-15
  • NCT ID: NCT04472598

Conditions

  • Myelofibrosis (MF)

Interventions

DrugSynonymsArms
NavitoclaxABT-263Navitoclax + Ruxolitinib
RuxolitinibNavitoclax + Ruxolitinib
Placebo for NavitoclaxPlacebo for Navitoclax + Ruxolitinib

Purpose

Myelofibrosis is a type of bone marrow cancer that usually develops slowly and disrupts body's normal production of blood cells. It causes bone marrow scarring, leading to severe anemia that can cause weakness and fatigue. It can also cause a low number of blood-clotting cells called platelets, which increases risk of bleeding. Myelofibrosis often causes an enlarged spleen. The purpose of this study is to see if a combination of navitoclax and ruxolitinib is more effective and safe in assessment of change in spleen volume when compared to ruxolitinib in participants with myelofibrosis. Navitoclax is an investigational drug for the treatment of myelofibrosis. Participants in this study are divided into two groups, called treatment arms. Each group receives a different treatment. Adult participants with a diagnosis of myelofibrosis will be enrolled. Around 230 participants will be enrolled in approximately 190 sites worldwide. Participants will receive oral navitoclax tablet with oral ruxolitinib tablet or oral ruxolitinib tablet with oral placebo (no active drug) tablet and treatment may continue till the participant cannot tolerate the study drug, or benefit is not achieved, or other reasons which qualify for discontinuation of the study drug. There may be a higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the course of the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, magnetic resonance imaging (MRI) or computed tomography (CT) scan, bone marrow tests, checking for side effects, and completing questionnaires.

Trial Arms

NameTypeDescriptionInterventions
Navitoclax + RuxolitinibExperimentalParticipants will receive Navitoclax in combination with Ruxolitinib
  • Navitoclax
  • Ruxolitinib
Placebo for Navitoclax + RuxolitinibActive ComparatorParticipants will receive placebo for Navitoclax and Ruxolitinib
  • Ruxolitinib
  • Placebo for Navitoclax

Eligibility Criteria

        Inclusion Criteria:

          -  Documented diagnosis of Primary MyeloFibrosis (MF) as defined by World Health
             Organization (WHO) classification or Secondary MF (post polycythemia vera [PPV] - MF
             or Post Essential Thrombocytopenia [PET] - MF) .

          -  Must be able to complete the MF Symptom Assessment Form (MFSAF) v4.0 on at least 4 out
             of 7 days prior to randomization.

             -- Must have at least 2 symptoms with a score >=3 or a total score of >=12, as
             measured by the MFSAF v4.0.

          -  Classified as intermediate-2, or high-Risk MF as defined by the Dynamic International
             Prognostic Scoring System Plus (DIPSS+).

          -  Has splenomegaly defined as spleen palpation measurement >= 5 centimeters (cm) below
             costal margin or spleen volume greater than or equal to 450 cubic cm as assessed
             centrally by magnetic resonance imaging (MRI) or computed tomography (CT) scan.

          -  Ineligible for stem cell transplantation at time of study entry due to age,
             comorbidities, or unfit for unrelated or unmatched donor transplant.

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

        Exclusion Criteria:

          -  Prior treatment with a Janus Kinase-2 (JAK-2) inhibitor.

          -  Prior treatment with a BH3-mimetic compound or bromodomain and extra-terminal motif
             (BET) inhibitor or stem cell transplant.

          -  Receiving medication that interferes with coagulation or platelet function within 3
             days prior to the first dose of study drug or during the study treatment period except
             for low dose aspirin (up to 100 milligram daily) and low molecular weight heparin
             (LMWH).
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 at least 35% at Week 24 (SVR35W24)
Time Frame:At Week 24
Safety Issue:
Description:Reduction in spleen volume is measured by magnetic resonance imaging (MRI) or computed tomography (CT), per International Working Group (IWG) criteria.

Secondary Outcome Measures

Measure:Percentage of Participants who achieve at least 50% Reduction in Total Symptom Score (TSS)
Time Frame:Baseline (Week 0) Up to Week 24
Safety Issue:
Description:Reduction in TSS is measured by Myelofibrosis Symptom Assessment Form (MFSAF) v4.0.
Measure:Percentage of Participants who achieve Spleen Volume Reduction of at least 35% (SVR35)
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:Reduction in spleen volume is measured by MRI or CT, per IWG criteria.
Measure:Duration of 35% Spleen Volume Reduction (SVR35)
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:Duration of SVR35 is defined as the time between the date of first response of spleen volume reduction of 35% achievement to the date of the first assessment where the spleen volume is less than 35% reduction from baseline and is at least 25% increase from the nadir (the lowest spleen volume).
Measure:Change In Fatigue
Time Frame:Baseline (Week 0) Up to Week 24
Safety Issue:
Description:Change in fatigue will be assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue SF 7a.
Measure:Time to Deterioration of Physical Functioning
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:Time to deterioration of physical functioning is measured by the physical functioning domain of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 or death.
Measure:Proportion of Participants who achieve Anemia Response
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:The rate of anemia response will be assessed according to current International Working Group-Myeloproliferative Neoplasms Research and European LeukemiaNet (IWG-MRT/ELN) criteria.
Measure:Overall Survival (OS)
Time Frame:Up To approximately 8 Years
Safety Issue:
Description:OS is defined as the time from the date of randomization to the date of death from any cause.
Measure:Leukemia-Free Survival
Time Frame:Up To approximately 8 Years
Safety Issue:
Description:Leukemia-free survival is defined as the number of days from the date of randomization to the onset date of documented leukemia, disease progression due to leukemia, or death due to leukemia, whichever occurs first.
Measure:Overall Response of Clinical Improvement
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:Clinical improvement is defined as the achievement of anemia, spleen, or symptoms response without progressive disease, per International Working Group (IWG) criteria.
Measure:Percentage of Participants who achieve reduction in Grade of Bone Marrow Fibrosis
Time Frame:Baseline (Week 0) Up to Week 96
Safety Issue:
Description:Change in grade of bone marrow fibrosis will be measured per the European consensus grading system through bone marrow biopsy.

Details

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

Trial Keywords

  • Myelofibrosis
  • Navitoclax
  • Ruxolitinib
  • Cancer
  • ABT-263
  • TRANSFORM-1

Last Updated

August 26, 2021