Phase 2
N=48
A Two-part Study to Assess the Safety and Preliminary Efficacy of Givinostat in Patients With Polycythemia Vera
Polycythemia Vera
Bottom Line
View on ClinicalTrials.gov: NCT01901432 ↗Enrolled (actual)
48
Serious AEs
8.5%
Results posted
Jun 2019
Primary outcome: Primary: Number of Patients Experiencing Treatment-emergent Adverse Events (TEAEs) in Part A of the Study — 3; 3; 3; 3 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Givinostat (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Italfarmaco
- Primary completion
- Jun 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Patients Experiencing Treatment-emergent Adverse Events (TEAEs) in Part A of the Study |
3; 3; 3; 3; 1; 3 | — |
| PRIMARY Number of Dose Limiting Toxicities (DLTs) After 1 Cycle in Part A of the Study |
0; 1; 0; 0 | — |
| PRIMARY Number of Patients Experiencing TEAEs After 3 Cycles in Part B of the Study |
35; 33; 2; 1; 0; 10 | — |
| PRIMARY Overall Response Rate (ORR) (i.e. Complete Response [CR] and Partial Response [PR]) After 3 Cycles in Part B of the Study |
80.6; 9.7; 71.0 | — |
| SECONDARY ORR After 3 Cycles and After 6 Cycles in Part A of the Study |
72.7; 72.7 | — |
| SECONDARY ORR After 6 Cycles in Part B of the Study |
80.6 | — |
| SECONDARY Number of Patients Experiencing TEAEs After 6 Cycles in Part B of the Study |
35; 33; 2; 1; 0; 12 | — |
| SECONDARY Assessment of Maximum Plasma Concentration (Cmax) of Givinostat and Metabolites (ITF2374 and ITF2375) in Part A of the Study |
60.2; 54.3; 82.5; 3.74; 5.69; 68.6 | — |
| SECONDARY Assessment of Time to Maximum Plasma Concentration (Tmax) of Givinostat and Metabolites (ITF2374 and ITF2375) in Part A of the Study |
2.00; 2.00; 3.00; 8.00; 8.00; 3.00 | — |
| SECONDARY Assessment of Time of the Last Detectable Concentration (Tlast) of Givinostat and Metabolites (ITF2374 and ITF2375) in Part A of the Study |
7.97; 8.00; 8.00; 8.00; 8.00; 8.00 | — |
| SECONDARY Assessment of Area Under Plasma Concentration Versus the Time Curve up to the Last Detectable Concentration (AUClast) of Givinostat and Metabolites (ITF2374 and ITF2375) in Part A of the Study |
208; 238; 429; 14.4; 29.6; 416 | — |
| SECONDARY Assessment of Area Under Plasma Concentration Versus the Time Curve in the Dosing Interval (0-12 Hours) (AUC0-12) of Givinostat and Metabolites (ITF2374 and ITF2375) in Part A of the Study |
235; 289; 508; 598; 870; 161 | — |
| SECONDARY Assessment of Cmax of Givinostat and Metabolites (ITF2374 and ITF2375) in Part B of the Study |
71.5; 7.85; 161; 90.8; 64.0; 62.6 | — |
| SECONDARY Assessment of Tmax of Givinostat and Metabolites (ITF2374 and ITF2375) in Part B of the Study |
2.00; 8.00; 3.00; 2.00; 2.00; 0.985 | — |
| SECONDARY Assessment of Tlast of Givinostat and Metabolites (ITF2374 and ITF2375) in Part B of the Study |
7.42; 7.42; 8.00; 8.00; 7.98; 7.99 | — |
| SECONDARY Assessment of AUClast of Givinostat and Metabolites (ITF2374 and ITF2375) in Part B of the Study |
289; 28.5; 888; 459; 323; 269 | — |
| SECONDARY Assessment of AUC0-12 of Givinostat and Metabolites (ITF2374 and ITF2375) in Part B of the Study |
372; 1080; 561; 410; 326; 2460 | — |
Summary
This is a two-part, multicenter, open label, non-randomized, phase Ib/II study to assess the safety and tolerability, Maximum Tolerated Dose and preliminary efficacy of Givinostat in patients with JAK2V617F positive Polycythemia Vera. Part A is the dose finding part while Part B is assessing the preliminary efficacy. Patients will be enrolled either in Part A or Part B and transition from one part to the other is not allowed.
Eligible patients for this study will have a confirmed diagnosis of Polycythemia Vera according to the revised World Health Organization criteria. Only if the enrolment in Part A is slow (i.e. < 5 patients enrolled in 3 months), eligibility for this part of the study may be expanded to all patients with chronic myeloproliferative neoplasms.
Study therapy will be administered in 28 day cycles (4 weeks of treatment). Disease response will be evaluated according to the European LeukemiaNet criteria after 3 and 6 cycles (i.e. at weeks 12 and 24, respectively) of treatment with Givinostat for both parts of the study. All phlebotomies performed in the first 3 weeks of treatment will not be counted to assess the clinico-haematological response.
The study will last up to a maximum of 24 weeks of treatment. However, after completion of the trial, all patients achieving clinical benefit will be allowed to continue treatment with Givinostat (at the same dose and schedule) in a long-term study.
Safety will be monitored at each visit throughout the entire duration of the study. Treatment will be administered on an outpatient basis and patients will be followed regularly with physical and laboratory tests, as specified in the protocol; in case of hospitalization, the treatment will be continued or interrupted according to the Investigators' decision.
Eligibility Criteria
Inclusion Criteria
- Patients must be able to provide informed consent and be willing to sign an informed consent form;
- Patients must have an age ≥18 years;
- Patients must have a confirmed diagnosis of Polycythemia Vera according to the revised World Health Organization criteria;
- Patients must have mutated Janus Kinase 2 (mutation V617F) positive disease;
- Patients must have an active/not controlled disease defined as
- hematocrit ≥ 45% or hematocrit 400 x109/L, and
- white blood cell count > 10 x109/L;
- Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 in Part A, ECOG performance status ≤ 2 in Part B within 7 days of initiating study drug;
- Female patient of childbearing potential has a negative serum or urine pregnancy test within 72 hours of the first dose of study therapy;
- Use of an effective means of contraception for women of childbearing potential and men with partners of childbearing potential;
- Adequate and acceptable organ function within 7 days of initiating study drug;
- Willingness and capability to comply with the requirements of the study.
Note that if the enrolment in Part A is slow (i.e. 600 x109/L;
- Myelofibrosis patients: no response according to European Myelofibrosis Network criteria.
Exclusion Criteria
- Active bacterial or mycotic infection requiring antimicrobial treatment;
- Pregnancy or nursing;
- A clinically significant corrected QT interval prolongation at baseline;
- Use of concomitant medications known to prolong the corrected QT interval;
- Clinically significant cardiovascular disease including:
- Uncontrolled hypertension despite medical treatment, myocardial infarction, unstable angina within 6 months from study start;
- New York Heart Association Grade II or greater congestive heart failure;
- History of any cardiac arrhythmia requiring medication (irrespective of its severity);
- A history of additional risk factors for torsade de pointes;
- Known positivity for human immunodeficiency;
- Known active hepatitis B virus and/or hepatitis C virus infection;
- Platelet count 2 times the upper limit of normal;
- Total serum bilirubin > 1.5 times the upper limit of normal except in case of Gilbert's disease;
- Serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) > 3 times the upper limit of normal;
- History of other diseases (including active tumours), metabolic dysfunctions, physical examination findings, or clinical laboratory findings giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug or that might affect interpretation of the results of the study or render the subject at high risk from treatment complications;
- Prior treatment with a Janus Kinase 2 or Histone Deacetylase inhibitor or participation in an interventional clinical trial for chronic myeloproliferative neoplasms;
- Systemic treatment for chronic myeloproliferative neoplasms other than aspirin/cardio aspirin;
- Hydroxyurea within 28 days before enrolment;
- Interferon alpha within 14 days before enrolment;
- Anagrelide within 7 days before enrolment;
- Any other investigational drug or device within 28 days before enrolment;
- Patient with known hypersensitivity to the components of study therapy.
Data sourced from ClinicalTrials.gov (NCT01901432). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.