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A Study of TP-0184 to Treat Anemia in Adults With IPSS-R Low or Intermediate Risk MDS

A Phase 1/2, Open-Label Clinical Study To Evaluate Safety And Efficacy Of TP-0184 To Treat Anemia When Administered To Adult Patients With IPSS-R Low Or Intermediate Risk Myelodysplastic Syndromes

Status
Terminated
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04623996
Enrollment
2
Registered
2020-11-10
Start date
2020-12-28
Completion date
2021-04-27
Last updated
2023-11-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Anemia in Myelodysplastic Syndromes

Keywords

Ph 1/2, Hematologic disease, MDS, Anemia, IPSS-R low, IPSS-R intermediate

Brief summary

This study will evaluate preliminary safety and efficacy of TP-0184 to treat anemia when administered to adult patients with Revised International Prognostic Scoring System (IPSS-R) low or intermediate risk MDS. The recommended Phase 2 dose (RP2D) will be determined by the maximum tolerated dose (MTD) or maximum administered dose (MAD) in the Phase 1 portion of the study.

Interventions

Oral dose

Sponsors

Sumitomo Pharma America, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. A documented diagnosis of lower risk MDS (IPSS-R Low, Intermediate) according to WHO 2016 classification, de novo or secondary.. 2. Bone marrow biopsy and/or aspirate performed pre-dose to assess disease status and available for review prior to full screening review. If the bone marrow biopsy and/or aspirate is nonproductive or nondiagnostic, the procedure must be repeated. Bone marrow biopsy/aspirate performed ≤ 12 weeks prior to baseline will not need to be repeated if results and a minimum of 6 slides are available. 3. Relapse, refractory/resistant, intolerant, or inadequate response to ESA treatment, as defined by the following: * Relapse according to IWG 2006 * Refractory/resistant - documented non-response or response that is no longer maintained to prior ESA-containing regimen, either as single agent or combination (e.g., with G-CSF); ESA regimen must have been either: * Recombinant human erythropoietin (rHu EPO) ≥ 500 IU/wk for at least 8 doses or equivalent; OR * Darbepoetin alpha ≥ 300 μg Q3W for at least 4 doses or equivalent; * Intolerant- documented discontinuation of prior ESA containing regimen, either as single agent or combination (e.g., with G-CSF), at any time after introduction due to intolerance or an adverse event Inadequate response - in the absence of transfusions support, patients under ESA treatment for at least 12 weeks that do not show a rise in hemoglobin of greater than equal to 1 g/dl. 4. Patients with 5q deletions are allowed only if they have failed or are intolerant to lenalidomide treatment. o Failure or intolerance to lenalidomide defined as clinical and cytogenetic responses to according to the international working group 2006 MDS: (1) absence of response, or (2) bone marrow progression during treatment with or without prior response, or (3) secondary failure (loss of prior hematological response without bone marrow progression), or (4) intolerance (treatment discontinuation due to adverse events, with or without prior response) based on investigator judgement (Prebet 2017). 7 5. Patients previously treated for anemia with or without RBC transfusion support: 1. Low transfusion burden (LTb), defined as requiring less than 4 red blood cell units in the 8 weeks before treatment (and baseline hemoglobin \< 9.0 g/dL), 2. High transfusion burden (HTb), defined as requiring 4 or more red blood cell units in the 8 weeks before treatment 6. At least 12 weeks of transfusion history immediately preceding the first dose of TP-0184. This transfusion data must include hemoglobin measured prior to transfusion (pre transfusion Hgb). 7. Written, signed consent for trial participation must be obtained from the patient appropriately in accordance with applicable ICH guidelines and local and regulatory requirements prior to the performance of any study specific procedure. 8. Must be ≥18 years of age. 9. Patients with an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score ≤ 2. 10. Patients with a life expectancy of ≥3 months (90 days) per the treating investigator. 11. Patients with adequate major organ functions meeting the following criteria on the basis of laboratory data within 28 days (4 weeks) before screening (if multiple data are available, most recent data during the period): 1. Serum creatinine: ≤1.8 x the upper limit of the normal (ULN) range 2. Total bilirubin ≤ 1.5 x upper limit of normal (ULN) except in patients with Gilbert's syndrome. Patients with Gilbert's syndrome may enroll if direct bilirubin ≤2.0 x ULN or if the elevated total bilirubin can be attributed to active red blood cell precursor destruction within the bone marrow (i.e., ineffective erythropoiesis). Elevated indirect bilirubin due to post-transfusion hemolysis is allowed. 3. Aspartate transaminase (AST) and alanine transaminase (ALT): ≤2.5 x ULN Left ventricular ejection fraction (LVEF) ≥ 45% by echocardiogram or multigated acquisition (MUGA) scan 12. All previous therapy with ESAs, G-CSF and GM-CSF must be discontinued ≥ 14 days before Cycle 1 Day 1 dosing. 13. Twenty-eight-day (4 weeks) washout period from prior treatment with cytotoxic chemotherapeutic agents, HMAs (hypomethylating agents), ImiDs (immunomodulatory imide drugs), luspatercept and / or investigational drugs before study dosing for the patient begins. 14. Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within 5 days prior to the first dose of TP-0184. 15. Non-fertile or agree to use an adequate method of contraception while on study and for 7 months following the study and have a negative pregnancy test (if female of childbearing potential) and not currently nursing; males agree to use an adequate method of contraception while on study and for 4 months following the study. 16. Patients must be able to comply with the requirements of the entire study and accessible for treatment and follow-up. 17. Patient agrees not to participate in other interventional clinical studies during their participation in this trial, while on study treatment. Patients participating in surveys or observational studies are eligible to participate in this study.

Exclusion criteria

1. IPSS-R high or very high risk MDS. 2. Presence of concomitant severe cardiovascular disease; congestive heart failure (CHF), myocardial infarction, angina and/ or uncontrolled cardiac arrhythmia as determined by the investigator within 6 months (180 days) of study onset. 3. Corrected QT interval (using Fridericia's correction formula) of \> 465 msec in men and \> 480 msec in women. 4. History of stroke, deep venous thrombosis (DVT), pulmonary or arterial embolism within 6 months (180 days) prior to enrollment. 5. Presence of clinically significant anemia due to iron, vitamin B12, or folate deficiencies, or autoimmune or hereditary hemolytic anemia, or gastrointestinal bleeding. a. Iron deficiency to be determined by a bone marrow aspirate stain for iron, calculated transferrin saturation (iron/total iron binding capacity) ≤ 20%, or serum ferritin ≤ 15 µg/L. b. Iron-chelating agents, except for subjects on a stable or decreasing dose for at least 8 weeks prior to enrollment, are excluded 6. Prior allogeneic or autologous stem cell transplant due to myeloid disease 7. Known history of diagnosis of AML. 8. Use of corticosteroid, except for subjects on a stable or decreasing (no greater than a 10 mg dose of prednisone or equivalent) for ≥ 2 weeks prior to enrollment for medical conditions other than MDS 9. Patients are excluded if there is evidence of autoimmune hemolytic anemia manifested as a corrected reticulocyte count (reticulocyte index) of \> 2% with either a positive Coombs' test or over 50% indirect bilirubin. 10. Patients with a recent diagnosis of malignancy are excluded except for those with in situ malignancies treated with curative intent (eg, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix). Patients with more advanced malignancies are allowed to enroll, provided they were treated with curative intent and have no evidence of active disease ≥ 2 years prior to Cycle 1 Day 1. 11. Patients requiring systemic antibiotics or antifungals are not eligible until they have completed the prescribed course of antibiotics or antifungals and are clinically stable. Topical antibiotics or antifungals are permitted. 12. Known HIV, active Hepatitis B, and/or active Hepatitis C infection. 13. Patients with clinically active uncontrolled, bleeding in the past month. 14. Thrombocytopenia (platelet count \< 50,000/µL \[50 x 109/L\]). 15. Neutropenia (absolute neutrophil count \[ANC\] \<500 /µL \[0.5 x 109/L\]) 16. Women who are pregnant or breastfeeding. 17. Male patients with partners of childbearing potential who are unwilling to use condoms in combination with a second effective method of contraception during the trial and for 7 months after the last administration of study treatment. 18. Inability to undergo MRI imaging. 19. Parenchymal iron overload by screening MRI. 20. Patients who are unwilling or unable to comply with procedures required in this protocol. 21. Have undergone recent surgery with potential to cause the impairment of gastrointestinal tract absorption or that could cause short bowel syndrome with diarrhea due to malabsorption. 22. Have known hemochromatosis at baseline or a family history of hemochromatosis. 23. Presence of any psychological, familial, sociological or geographical condition that, in the opinion of the investigator, could potentially hinder compliance with the study protocol and follow-up schedule. 24. Patient has any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study. 25. Live vaccines within 14 days prior to first study drug administration. COVID-19 vaccines (non-live) approved by regional health authorities are allowed. 26. Medications that are known strong to moderate CYP3A4 inducers must be discontinued at least 21 days prior to first dose of study drug. Medications that are known strong to moderate CYP3A4 inhibitors must be stopped 21 days (or 5 half-lives, whichever is shorter) prior to the first dose of study drug. 27. Patients who have received medications with known or possible risk of prolonging the QT interval or inducing Torsades de Pointes within the previous 7 days.

Design outcomes

Primary

MeasureTime frameDescription
Phase 1: Tolerability of TP-0184 as Evaluated by Incidence of Dose Limiting Toxicities (DLTs) as Observed in Cycle 1Cycle 1 (28 days)DLTs are defined as follows: Any Gr 3 or greater nonhematologic toxicity; New onset cardiac failure or worsening symptomatic cardiac failure; Echocardiogram (ECHO) or multigated acquisition (MUGA) reduction of ejection fraction (EF) \> 10%; Any Gr 4 neutropenia; Any Gr 3 thrombocytopenia associated with clinically significant bleeding, or Gr 4 thrombocytopenia in the absence of myelodysplasia-related marrow failure or transformation to acute leukemia; All other hematologic toxicity Grade 3 or higher other than defined above for ANC or platelets
Phase 1: Number of Participants With Adverse Events and Serious Adverse EventsThe time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, an average of 4 months.Assessment of safety of TP-0184 administered in participants by reporting of adverse events and serious adverse events
Phase 2: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 8 Weeks56 daysResponse rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 8 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 8 weeks (consecutive) compared with the pretreatment transfusion number in previous 8 weeks; OR patients who are RBC transfusion-free over any consecutive 8-week (56-day) period

Secondary

MeasureTime frameDescription
Phase 1/2: Determine the Median Duration of Hemoglobin Response56 daysDuration of hemoglobin increase greater or equal to 1.5 g/dL maintained for a consecutive period of \> 8 weeks with no transfusions.
Phase 1/2: Determine the Median Duration of Reduction in RBC Transfusions56 daysDuration of reduction in units of greater or equal to 4 RBC transfusions / 8 weeks (consecutive)
Phase 1/2: Determine the Median Duration of RBC-transfusion-free Period Greater or Equal to 8 Weeks56 daysDuration of RBC transfusion-free period
Phase 1/2: Determine the Cardiac Safety of TP-0184 by Assessing the Presence of Cardiac SymptomsThe time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, an average of 4 months.Assessment of cardiac safety of TP-0184 administered in participants by reporting of cardiac symptoms including congestive heart failure (CHF). Assessment of CHF will be based based on NYHA criteria, 12-Lead ECG abnormalities, quantification of cardiac iron by MRI, ECHO or MUGA scans, and peripheral blood cardiac markers
Phase 1/2: Determine the Proportion of Patients Progressing to AML4 monthsProportion of patients progressing to AML
Phase 1/2: Determine Overall SurvivalFrom the first dose of TP-0184 until the time of death due to any cause, up to 4 months off treatment.The effect of TP-0184 on the overall survival
Phase 1: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 8 Weeks56 daysResponse rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 8 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 8 weeks (consecutive) compared with the pretreatment transfusion number in previous 8 weeks; OR patients who are RBC transfusion-free over any consecutive 8-week (56-day) period
Phase 2: Determine the Changes in Neutrophil Counts56 daysProportion of patients achieving hematologic improvement in neutrophil count (HI-N) over any consecutive 8-week (56-day) period and / or decrease in neutrophil count
Phase 2: Determine the Changes in Platelet Counts56 daysProportion of patients achieving hematologic improvement in platelets (HI-P) over any consecutive 8-week (56-day) period and / or decrease in platelet count
Phase 2: Number of Participants With Adverse Events (AEs) & Serious Adverse Events (SAEs)The time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, up to 6 months.Assessment of safety and tolerability of TP-0184 administered in participants by reporting of AEs and SAEs
Phase 2: Determine Steady-state Trough PKCycle 1 Day 1 of Week 4 and Cycle 2 Day 1 of each Week 5, 6, 7, and 9Characterize TP-0184 plasma trough concentration data at various timepoints.
Phase 2: Determine the Level of Fatigue Based Off of the Brief Fatigue Inventory (BFI)From the first dose of TP-0184 up to 4 months or study closureThe BFI measures the severity of fatigue based on the worst fatigue experienced during the past 24-hours
Phase 1: Determination of the Maximum Observed Concentration (Cmax) and Area Under the Plasma Concentration vs. Time Curve (AUClast)Phase 1: Blood samples drawn on days 1, 2, 4, 8, 15, and 22 of the first study cycle; days 1, 8, 15, and 16 of the 2nd cycle. Phase 2: Blood samples drawn on Cycle 1, day 22; cycle 2, days 1, 8 and 15; cycle 3, day 1.To determine the maximum concentration of TP-0184 and the area under the plasma concentration vs. time curve of TP-0184
Phase 1/2: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 12 Weeks84 daysResponse rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 12 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 12 weeks (consecutive) compared with the pretreatment transfusion number in previous 12 weeks; OR patients who are RBC transfusion-free over any consecutive 12-week (84-day) period
Phase 1/2: Determine the Time to RBC Transfusion-free Period56 daysTime from first dose of TP-0184 to the first onset of a transfusion-free period for consecutive 8 weeks

Countries

United States

Participant flow

Recruitment details

Due to limitations imposed by the COVID pandemic and the competitive landscape for myelodysplastic syndrome, this study was unable to enroll a sufficient patient population. The decision was made to terminate the study early and discontinue further development of the TP-0184 program. The 2 patients enrolled into phase 1 of the study withdrew their consent to participate on 30 March 2021 and 27 April 2021; no further patients were enrolled.

Pre-assignment details

Participants who died, withdrew consent to survival follow up or were lost to follow up were considered to have completed the study.

Participants by arm

ArmCount
Phase 1: Single Arm TP-0184
Participants who were enrolled to phase 1 received TP-0184, with starting dose of 20mg, administered orally, once daily, following an overnight fast of at least 6 hours.
2
Phase 2: Single Arm TP-0184
Participants who were enrolled to phase 2 would receive the recommended phase 2 dose (RP2D) as determined in phase 1.
0
Total2

Baseline characteristics

CharacteristicPhase 1: Single Arm TP-0184Total
Age, Categorical
<=18 years
0 Participants0 Participants
Age, Categorical
>=65 years
1 Participants1 Participants
Age, Categorical
Between 18 and 65 years
1 Participants1 Participants
Age, Continuous63 years63 years
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants
Race (NIH/OMB)
Black or African American
1 Participants1 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants
Race (NIH/OMB)
White
1 Participants1 Participants
Sex: Female, Male
Female
2 Participants2 Participants
Sex: Female, Male
Male
0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 2
other
Total, other adverse events
2 / 2
serious
Total, serious adverse events
1 / 2

Outcome results

Primary

Phase 1: Number of Participants With Adverse Events and Serious Adverse Events

Assessment of safety of TP-0184 administered in participants by reporting of adverse events and serious adverse events

Time frame: The time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, an average of 4 months.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Phase 1: Single Arm TP-0184Phase 1: Number of Participants With Adverse Events and Serious Adverse Events2 Participants
Primary

Phase 1: Tolerability of TP-0184 as Evaluated by Incidence of Dose Limiting Toxicities (DLTs) as Observed in Cycle 1

DLTs are defined as follows: Any Gr 3 or greater nonhematologic toxicity; New onset cardiac failure or worsening symptomatic cardiac failure; Echocardiogram (ECHO) or multigated acquisition (MUGA) reduction of ejection fraction (EF) \> 10%; Any Gr 4 neutropenia; Any Gr 3 thrombocytopenia associated with clinically significant bleeding, or Gr 4 thrombocytopenia in the absence of myelodysplasia-related marrow failure or transformation to acute leukemia; All other hematologic toxicity Grade 3 or higher other than defined above for ANC or platelets

Time frame: Cycle 1 (28 days)

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned.

Primary

Phase 2: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 8 Weeks

Response rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 8 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 8 weeks (consecutive) compared with the pretreatment transfusion number in previous 8 weeks; OR patients who are RBC transfusion-free over any consecutive 8-week (56-day) period

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine Overall Survival

The effect of TP-0184 on the overall survival

Time frame: From the first dose of TP-0184 until the time of death due to any cause, up to 4 months off treatment.

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Cardiac Safety of TP-0184 by Assessing the Presence of Cardiac Symptoms

Assessment of cardiac safety of TP-0184 administered in participants by reporting of cardiac symptoms including congestive heart failure (CHF). Assessment of CHF will be based based on NYHA criteria, 12-Lead ECG abnormalities, quantification of cardiac iron by MRI, ECHO or MUGA scans, and peripheral blood cardiac markers

Time frame: The time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, an average of 4 months.

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Median Duration of Hemoglobin Response

Duration of hemoglobin increase greater or equal to 1.5 g/dL maintained for a consecutive period of \> 8 weeks with no transfusions.

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Median Duration of RBC-transfusion-free Period Greater or Equal to 8 Weeks

Duration of RBC transfusion-free period

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Median Duration of Reduction in RBC Transfusions

Duration of reduction in units of greater or equal to 4 RBC transfusions / 8 weeks (consecutive)

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Proportion of Patients Progressing to AML

Proportion of patients progressing to AML

Time frame: 4 months

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: Determine the Time to RBC Transfusion-free Period

Time from first dose of TP-0184 to the first onset of a transfusion-free period for consecutive 8 weeks

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1/2: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 12 Weeks

Response rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 12 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 12 weeks (consecutive) compared with the pretreatment transfusion number in previous 12 weeks; OR patients who are RBC transfusion-free over any consecutive 12-week (84-day) period

Time frame: 84 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 1: Determination of the Maximum Observed Concentration (Cmax) and Area Under the Plasma Concentration vs. Time Curve (AUClast)

To determine the maximum concentration of TP-0184 and the area under the plasma concentration vs. time curve of TP-0184

Time frame: Phase 1: Blood samples drawn on days 1, 2, 4, 8, 15, and 22 of the first study cycle; days 1, 8, 15, and 16 of the 2nd cycle. Phase 2: Blood samples drawn on Cycle 1, day 22; cycle 2, days 1, 8 and 15; cycle 3, day 1.

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned.

Secondary

Phase 1: The Effect of TP-0184 on the Treatment and the Hematologic Improvement of Anemia in Terms of Hemoglobin Increase, Reduction in RBC Transfusions and Transfusion-free Equal or Greater Than 8 Weeks

Response rate based on composite response criteria: Hemoglobin increase greater than or equal to 1.5 g/dL, maintained for a consecutive period of 8 weeks with no transfusions; OR reduction in units of greater than or equal to 4 RBC transfusions / 8 weeks (consecutive) compared with the pretreatment transfusion number in previous 8 weeks; OR patients who are RBC transfusion-free over any consecutive 8-week (56-day) period

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned.

Secondary

Phase 2: Determine Steady-state Trough PK

Characterize TP-0184 plasma trough concentration data at various timepoints.

Time frame: Cycle 1 Day 1 of Week 4 and Cycle 2 Day 1 of each Week 5, 6, 7, and 9

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 2: Determine the Changes in Neutrophil Counts

Proportion of patients achieving hematologic improvement in neutrophil count (HI-N) over any consecutive 8-week (56-day) period and / or decrease in neutrophil count

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients enrolled into phase 2.

Secondary

Phase 2: Determine the Changes in Platelet Counts

Proportion of patients achieving hematologic improvement in platelets (HI-P) over any consecutive 8-week (56-day) period and / or decrease in platelet count

Time frame: 56 days

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 2: Determine the Level of Fatigue Based Off of the Brief Fatigue Inventory (BFI)

The BFI measures the severity of fatigue based on the worst fatigue experienced during the past 24-hours

Time frame: From the first dose of TP-0184 up to 4 months or study closure

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients were enrolled into phase 2.

Secondary

Phase 2: Number of Participants With Adverse Events (AEs) & Serious Adverse Events (SAEs)

Assessment of safety and tolerability of TP-0184 administered in participants by reporting of AEs and SAEs

Time frame: The time from the date of first treatment, while the patient is taking TP-0184, and for 30 days after stopping therapy, up to 6 months.

Population: Sponsor's decision to terminate further development of the TP-0184 program. Data collection and analysis were therefore not conducted as planned. No patients enrolled into phase 2.

Source: ClinicalTrials.gov · Data processed: Feb 14, 2026