To Assess the Safety, Tolerability and Efficacy of Itacitinib Immediate Release Tablets in Participants With Primary or Secondary Myelofibrosis Who Have Received Prior Ruxolitinib and/or Fedratinib Monotherapy (LIMBER-213)

Myelofibrosis Clinical Trial

Official title:

A 2-Part, Phase 2, Open-Label Study of the Safety, Tolerability, and Efficacy of Itacitinib Immediate Release in Participants With Primary Myelofibrosis or Secondary Myelofibrosis (Post-Polycythemia Vera Myelofibrosis or Post-Essential Thrombocythemia Myelofibrosis) Who Have Received Prior Ruxolitinib and/or Fedratinib Monotherapy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04629508
• Other study ID #: INCB 39110-213/LIMBER-213
• Status: Completed
• Phase: Phase 2
• Start date: July 12, 2021
• Est. completion date: August 24, 2023

Study information

• Verified date: August 2023
• Source: Incyte Corporation
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a 2-part study. In Part 1, participants will be dosed at 2 different dose levels in order to select the RP2D for Part 2 of the study.

Other known NCT identifiers

• NCT04821791

Recruitment information / eligibility

• Status: Completed
• Enrollment: 4
• Est. completion date: August 24, 2023
• Est. primary completion date: August 24, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Diagnosis of primary MF meeting the 2016 WHO criteria for overt PMF or secondary MF (PPV-MF or PET-MF) meeting the 2008 IWG-MRT criteria.
• At least Intermediate 1 risk MF according to the DIPSS.
• Prior treatment with ruxolitinib and/or fedratinib monotherapy
• Currently receiving ruxolitinib or fedratinib monotherapy for PMF or secondary MF.
• Splenomegaly defined as palpable spleen at least 5 cm below the left costal margin or volume = 450 cm3 on imaging assessed during screening.
• Allogeneic stem cell transplant not planned.
• Platelet is greater than or equal to 50 × 109/L at screening.
• Ability to comprehend and willingness to sign a written ICF for the study.
• Willingness to avoid pregnancy or fathering children.

Exclusion Criteria:

• Prior treatment with a JAK inhibitor other than ruxolitinib or fedratinib
• Record of = 10% myeloid blasts in the peripheral blood (on peripheral blood smear) or bone marrow prior to or at the time of screening
• For participants on ruxolitinib or fedratinib, unable to be tapered from that treatment over the course of 14 days without corticosteroids, hydroxyurea, or other agents
• Treatment with ruxolitinib, fedratinib or other MF-directed therapy (approved or investigational) within 2 weeks of Day 1
• Prior splenectomy or splenic irradiation within 6 months before receiving the first dose of itacitinib
• Unable or unwilling to undergo serial MRI or CT scans for spleen volume measurement
• Unable or unwilling to complete MFSAF v4.0 diary on a daily basis during the study
• ECOG performance status = 3
• Life expectancy less than 24 weeks
• Not willing to receive RBC or platelet transfusions
• Participants with laboratory values at screening outside of protocol defined ranges
• Significant concurrent, uncontrolled medical condition
• Participants with impaired cardiac function or clinically significant cardiac disease unless approved by medical monitor/sponsor
• History or presence of an abnormal ECG that, in the investigator's opinion, is clinically meaningful
• Chronic or current active infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment.
• Evidence of HBV or HCV infection or risk of reactivation
• Known HIV infection.

Related Conditions & MeSH terms

• Myelofibrosis
• Polycythemia
• Polycythemia Vera
• Primary Myelofibrosis
• Thrombocythemia
• Thrombocytosis

Intervention

Drug:
• itacitinib
itacitinb Immediate Release (IR) will be dosed orally twice a day

Locations

Country	Name	City	State
Austria	Interne 1 - Hematologie Mit Stammzelltransplantation, Hemostaseologie Und Medizinische Onkologie Ord	Linz
Belgium	Cliniques Universitaires Ucl Saint-Luc	Brussels
Belgium	Jessa Ziekenhuis	Hasselt
Belgium	AZ DELTA	Roeselare
Belgium	Chu Ucl Namur University Hospital Mont-Godinne	Yvoir
Germany	Universitaetsmedizin Greifswald	Greifswald
Germany	Universitatsklinikum Halle (Saale)	Halle (saale)
Italy	Istituto Di Ricovero E Cura A Carattere Scientifico (Irccs) Ospedale San Raffaele	Milan
Italy	Aou San Giovanni Di Dio E Ruggi	Salerno
Italy	Treviso Hospital	Treviso
Poland	Pratia Hematologia Katowice	Katowice
Spain	Hospital Universitario 12 de Octubre	Madrid
Spain	Hospital Universitari I Politecnic La Fe	Valencia
United States	Rcca Md, Llc	Bethesda	Maryland
United States	New Jersey Hematology Oncology Associates Llc	Brick	New Jersey
United States	Texas Oncology - Baylor Sammons Cancer Center	Dallas	Texas
United States	Midamerica Cancer Care	Kansas City	Missouri
United States	Baptist Cancer Center	Memphis	Tennessee
United States	Vanderbilt University	Nashville	Tennessee
United States	Tulane University	New Orleans	Louisiana
United States	Renovatio Clinical Consultants Llc	Spring	Texas

Sponsors (1)

Lead Sponsor	Collaborator
Incyte Corporation

Countries where clinical trial is conducted

United States,  Austria,  Belgium,  Germany,  Italy,  Poland,  Spain, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Part 1 : Treatment Emergent Adverse Events (TEAE'S)	Defined as any adverse event either reported for the first time or worsening of a pre-existing event after first dose of study treatment up to 30 days after last dose of study treatment.	24 Weeks
Primary	Part 2 : Spleen Volume Reduction by MRI/CT Scan	Defined as the proportion of participants who have a reduction in spleen volume (by imaging) of at least 35 percent when compared with baseline.	24 weeks
Primary	Part 2 : Spleen Volume Reduction	Defined as the proportion of participants who have a reduction in spleen volume (by imaging) of at least 35% when compared with baseline.	24 weeks
Secondary	Part 2 : Treatment Emergent Adverse Events (TEAE'S)	Defined as any adverse event either reported for the first time or worsening of a pre-existing event after first dose of study treatment up to 30 days after last dose of study treatment.	13 months
Secondary	Part 2 : Improvement in Total Symptom Score (TSS)	Defined as the proportion of participants who achieve at least 50% reduction in TSS over the 28 days immediately before the end of Week 24 compared with the 7 days immediately before the initiation of itacitinib IR (baseline).	24 Weeks
Secondary	Part 2 : Improvement in quality of life.	Defined as the mean change in the 5 multi-item functional scale scores and the multi-item global health status scale score (EORTC QLQ-C30).	24 weeks
Secondary	Part 2 : Improvement in Patient Global Impression of Change (PGIC)	Defined as percentage of participants who are categorized as improved	24 Weeks

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