Primary myelofibrosis, post-polycythemia vera myelofibrosis , or post-essential thrombocythemia myelofibrosis MedDRA version: 20.0 Level: PT Classification code 10028537 Term: Myelofibrosis System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Subject is at least 18 years of age at the time of signing the informed consent form (ICF) 2. Subject has an Eastern Cooperative Oncology Group (ECOG) Performance Score (PS) of 0, 1 or 2 3. Subject has diagnosis of primary myelofibrosis (PMF) according to the 2016 World Health Organization (WHO) criteria, or diagnosis of post-ET or post-PV myelofibrosis according to the IWG-MRT 2007 criteria, onfirmed by the most recent local pathology report 4. Subject has a DIPSS Risk score of Intermediate-2 or High 5. Subject has a measurable splenomegaly during the screening period as demonstrated by spleen volume of = 450 cm3 by MRI or CT-scan and by palpable spleen measuring = 5 cm below the left costal margin 6. Subject has a measurable total symptoms score (= 1) as measured by the Myelofibrosis Symptom Assessment Form (MFSAF) 7. Subject has been previously exposed to ruxolitinib, and must meet at least one of the following criteria (a and/or b) a. Treatment with ruxolitinib for = 3 months with inadequate efficacy response (refractory) defined as =65 years) yes F.1.3.1 Number of subjects for this age range 105
Exclusion criteria
Exclusion criteria: 1. Any of the following laboratory abnormalities: a. Platelets 100 x 10^9/L d. Myeloblasts = 5 % in peripheral blood e. Estimated glomerular filtration rate 1.5 x upper limit of normal (ULN) g. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 3 x upper limit of normal (ULN) h. Total bilirubin > 1.5 x ULN, subject’s total bilirubin between 1.5 – 3.0 x ULN are eligible if the direct bilirubin fraction is 10 mg/day prednisone or equivalent. Subjects who have had prior exposure to hydroxyurea (eg, Hydrea) in the past may be enrolled into the study as long as it has not been administered within 14 days prior to randomization 10. Subject has received ruxolitinib within 14 days prior to randomization 11. Subject with previous exposure to Janus kinase (JAK) inhibitor(s) other than ruxolitinib treatment 12. Subject on treatment with aspirin with doses > 150 mg daily 13. Subject with major surgery within 28 days prior to randomization 14. Subject with diagnosis of chronic liver disease (eg, chronic alcoholic liver disease, autoimmune hepatitis, sclerosing cholangitis, primary biliary cirrhosis, hemochromatosis, non-alcoholic steatohepatitis) 15. Subject with prior malignancy other than the disease under study unless the subject has not required treatment for the malignancy for at least 3 years prior to randomization. However, subject with the following history/concurrent conditions provided successfully treated may enroll: non-invasive skin cancer, in situ cervical cancer, carcinoma in situ of the breast, incidental histologic finding of prostate cancer (T1a or T1b using the tumor, nodes, metastasis [TNM] clinical staging system), or is free of disease and on hormonal treatment only 16. Subject with uncontrolled congestive heart failure (New York Heart Association Classification 3 or 4) 17. Subject with known human immunodeficiency virus (HIV), known active infectious Hepatitis B (HepB), and/or known active infectious Hepatitis C (HepC) 18. Subject with serious active infection 19. Subject with presence of any significant gastric or other disorder that would inhibit absorption of oral medication 20. Subject is unable to swallow capsule 21. Subject with any significant medical condition, laboratory abnormality, or p
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To evaluate the percentage of subjects with at least 35% spleen volume reduction in the fedratinib and the BAT arms.;Secondary Objective: To evaluate myelofibrosis (MF)-associated symptoms as measured by the Myelofibrosis Symptom Assessment Form (MFSAF) (Appendix B) To evaluate the percentage of subjects with at least 25% spleen volume reduction (SVR) To evaluate the safety of fedratinib To evaluate the reduction of spleen size by palpation To evaluate durability of spleen response by MRI/CT and by palpation To evaluate the durability of symptoms response To evaluate spleen and disease progression free survival To assess the effectiveness of the risk mitigation strategy for gastrointestinal events and Encephalopathy including Wernicke To evaluate Health-Related Quality of Life (HRQoL) as measured by the European Organization for Research and Treatment of Cancer Quality of Life C30 (EORTC QLQ-C30) (Appendix C) To evaluate Patient Reported Outcomes (PRO) as measured by the EQ-5D-5L questionnaire (Appendix D) To evaluate Overall Survival (OS);Primary end point(s): Spleen volume response rate (RR);Timepoint(s) of evaluation of this end point: From Screening to the end of Cycle 6 | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): 1. Symptom response rate (SRR) 2. Spleen volume response rate (RR25);Timepoint(s) of evaluation of this end point: 1. From C1D1 to the end of Cycle 6 2. From Screening to the end of Cycle 6 | — |
Countries
Australia, Austria, Belgium, China, Czechia, France, Germany, Hungary, Ireland, Italy, Korea, Republic of, Netherlands, Poland, Russian Federation, Spain, United Kingdom
Contacts
Bristol-Meyers Squibb International Corporation