Phase 3
N=439
GRAVITAS-301: A Study of Itacitinib or Placebo in Combination With Corticosteroids for Treatment of Acute Graft-Versus-Host Disease
Graft-versus-host Disease (GVHD)
Bottom Line
View on ClinicalTrials.gov: NCT03139604 ↗Enrolled (actual)
439
Serious AEs
61.3%
Results posted
May 2020
Primary outcome: Primary: Overall Response Rate Based on Center for International Blood and Marrow Transplant Research (CIBMTR) Response Index — 74.0; 66.4 Percentage of Participants — p=0.0782
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Itacitinib (Drug); Placebo (Drug); Prednisone (Drug); Methylprednisolone (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Incyte Corporation
- Primary completion
- May 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate Based on Center for International Blood and Marrow Transplant Research (CIBMTR) Response Index |
74.0; 66.4 | 0.0782 |
| SECONDARY Nonrelapse Mortality |
36; 37; 46; 45; 51; 52 | — |
| SECONDARY Duration of Response |
587; NA | — |
| SECONDARY Cmax of Itacitinib When Administered in Combination With Corticosteroids |
796 | — |
| SECONDARY Cmin of Itacitinib When Administered in Combination With Corticosteroids |
72.5 | — |
| SECONDARY Tmax of Itacitinib When Administered in Combination With Corticosteroids |
2.1 | — |
| SECONDARY AUC of Itacitinib When Administered in Combination With Corticosteroids |
6720 | — |
| SECONDARY CL/F of Itacitinib When Administered in Combination With Corticosteroids |
104 | — |
| SECONDARY Time to Response |
9.9; 10.1 | — |
| SECONDARY Relapse Rate of Malignant and Nonmalignant Hematologic Disease |
12.4; 11.4 | — |
| SECONDARY Malignancy Relapse-related Mortality Rate |
6.4; 7.7 | — |
| SECONDARY Failure-free Survival |
44.29; 40.00 | — |
| SECONDARY Overall Survival (OS) |
365; 348.5 | — |
| SECONDARY Number of Treatment-emergent Adverse Events With INCB39110 |
208; 214 | — |
| SECONDARY Incidence Rate of Secondary Graft Failure |
2; 0 | — |
| SECONDARY Proportion of Subjects Who Discontinue Corticosteroids |
3; 3; 16; 11; 39; 45 | — |
| SECONDARY Proportion of Subjects Who Discontinue Immunosuppressive Medications |
12; 10; 11; 8 | — |
| SECONDARY Incidence Rate of aGVHD Flares |
42; 48 | — |
| SECONDARY Incidence Rate of cGVHD |
25; 36; 43; 58 | — |
| SECONDARY Objective Response Rate |
170; 160; 138; 124; 92; 96 | — |
Summary
The purpose of this study is to evaluate itacitinib or placebo in combination with corticosteroids as first-line treatment of participants with Grade II to IV acute graft-versus-host disease (aGVHD).
Eligibility Criteria
Inclusion Criteria
- Has undergone 1 allo-HSCT from any donor (related or unrelated with any degree of HLA matching) and any donor source (bone marrow, peripheral blood stem cells, or cord blood) for a hematologic malignancy or disorder. Recipients of myeloablative and reduced-intensity conditioning regimens are eligible.
- Clinically suspected Grade II to IV aGVHD as per MAGIC criteria, occurring after allo-HSCT and any GVHD prophylaxis regimen.
- Evidence of myeloid engraftment. Use of growth factor supplementation is allowed.
- Serum creatinine ≤ 2.0 mg/dL or creatinine clearance ≥ 40 mL/min measured or calculated by Cockroft Gault equation.
- Willing to avoid pregnancy or fathering children.
- Able to give written informed consent and comply with all study visits and procedures.
- Able to swallow and retain oral medication.
Exclusion Criteria
- Has received more than 1 allo-HSCT.
- Has received more than 2 days of systemic corticosteroids for aGVHD.
- Presence of GVHD overlap syndrome.
- Presence of an active uncontrolled infection.
- Known human immunodeficiency virus infection.
- Active hepatitis B virus (HBV) or hepatitis C virus infection that requires treatment or at risk for HBV reactivation.
- Participants with evidence of relapsed primary disease, or participants who have been treated for relapse after the allo-HSCT was performed.
- Any corticosteroid therapy for indications other than GVHD at doses > 1 mg/kg per day methylprednisolone (or prednisone equivalent) within 7 days of randomization.
- Severe organ dysfunction unrelated to underlying GVHD, including:
- Cholestatic disorders or unresolved veno-occlusive disease of the liver.
- Clinically significant or uncontrolled cardiac disease.
- Clinically significant respiratory disease that requires mechanical ventilation support or 50% oxygen.
- Currently breast feeding.
- Received JAK inhibitor therapy after allo-HSCT for any indication. Treatment with a JAK inhibitor before allo-HSCT is permitted.
- Treatment with any other investigational agent, device, or procedure within 21 days (or 5 half-lives, whichever is greater) of enrollment.
- Any medical complications or conditions that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
- Known allergies, hypersensitivity, or intolerance to any of the study medications, excipients, or similar compounds.
Data sourced from ClinicalTrials.gov (NCT03139604). 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.