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MyelofibrosisPhase 1NCT02593760

A Study to Evaluate the Efficacy and Safety of Vismodegib in Combination With Ruxolitinib for the Treatment of Intermediate- or High-Risk Myelofibrosis (MF)

A Phase 1 study testing Ruxolitinib and Vismodegib in people with Myelofibrosis, run by Hoffmann-La Roche at 13 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This multicenter, randomized, double-blind, placebo-controlled study will evaluate the efficacy and safety of vismodegib plus (+) ruxolitinib versus placebo + ruxolitinib in participants with intermediate- or high-risk MF. The study will be divided into 2 components. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Myelofibrosis
What is being tested?
Ruxolitinib and Vismodegib
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
10 participants
Where
13 sitesin 4 countries
Study dates
25 Jan 2016to 12 Jul 2017
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pathologically confirmed diagnosis of primary MF, post-polycythemia vera MF, or post-essential thrombocythemia MF, according to the 2008 revised World Health Organization criteria
  • Intermediate-1, intermediate-2, or high-risk according to the IWG-MRT Dynamic International Prognostic Scoring System
  • Life expectancy >= 6 months
  • Peripheral blood blast count of less than (<) 10%
  • Palpable splenomegaly of greater than (>) 5 centimeters (cm) below the left costal margin
  • Eastern Cooperative Oncology Group performance status of 0 to 2
  • Adequate hepatic and renal function

Who cannot join

  • Prior treatment with a Hedgehog or Janus kinase pathway inhibitor
  • Treatment with strong cytochrome P450 3A4 inhibitors/inducers within 28 days prior to Day 1
  • Prior therapy for the treatment of intermediate- or high-risk MF including chemotherapy, interferon, thalidomide, busulfan, lenalidomide, anagrelide, or androgens within 28 days prior to Day 1
  • Prior splenectomy or splenic irradiation
  • Inadequate bone marrow reserve
  • Participants with any history of platelet counts of < 50,000/mccL or ANC of < 500/mL, except during treatment for myeloproliferative neoplasm or treatment with cytotoxic therapy for any other reason
  • Planned allogeneic bone marrow transplant during the study

Trial locations and contacts

13 sites in 4 countries.

13 sites in 4 countries

United States6 sites
  • Oncology Hematology Care Inc

    Cincinnati, Ohio, 45242

  • Florida Cancer Specialists-Broadway, Fort Myers

    Fort Myers, Florida, 33908

  • Uni of Texas - Md Anderson Cancer Center; Dept of Leukemia

    Houston, Texas, 77030

  • Sarah Cannon Research Institute

    Nashville, Tennessee, 37203

  • Florida Cancer Specialist, North Region

    St. Petersburg, Florida, 33705

  • Florida Cancer Specialists

    West Palm Beach, Florida, 33401

Other trials in United States

Canada3 sites
  • Tom Baker Cancer Centre-Calgary; Clinical Research Unit

    Calgary, Alberta, T2N 4N2

  • Queen Elizabeth II Health Sciences Centre; Oncology

    Halifax, Nova Scotia, B3H 2Y9

  • Centre Hospitalier De L'Universite De Montreal, Hopital Notre-Dame

    Montreal, Quebec, H2L 4M1

Other trials in Canada

Germany2 sites
  • Uniklinik RWTH Aachen; Med. Klinik IV; Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammz

    Aachen, 52074

  • Campus Virchow-Klinikum Charité Centrum 14; Medizinische Klinik m.S. Hämatologie u. Onkologie

    Berlin, 13353

Other trials in Germany

Italy2 sites
  • Az. Osp. Di Careggi; Divisione Di Ematologia

    Florence, Tuscany, 50135

  • A.O.U. Citta' Della Salute E Della Scienza-P.O. Molinette;S.C. Ematologia

    Turin, Piedmont, 10126

Other trials in Italy

About this study

Official title: A Phase IB/III, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Vismodegib in Combination With Ruxolitinib Versus Placebo and Ruxolitinib in Patients With Intermediate- or High-Risk Myelofibrosis

This multicenter, randomized, double-blind, placebo-controlled study will evaluate the efficacy and safety of vismodegib plus (+) ruxolitinib versus placebo + ruxolitinib in participants with intermediate- or high-risk MF. The study will be divided into 2 components. The Phase Ib portion of the study consists of participants receiving open-label vismodegib (150 milligrams [mg] orally [PO] once daily [QD]) + ruxolitinib (PO twice daily [BID]). A safety assessment will be performed after the first 10 participants have been treated for 6 weeks. An analysis for efficacy and safety is planned in the first 10 participants at Week 24. There will be a hold on participant screening and enrollment during this assessment. Another 10 participants may be enrolled, thereafter, to further assess efficacy and safety (at Week 24) before the initiation of the Phase III randomization portion of the study. Similarly, there will be another hold on participant screening and enrollment during this assessment. The participants enrolled in the Phase Ib portion of the study will continue to receive vismodegib (150 mg PO QD) + ruxolitinib (PO BID) for up to 48 weeks, if clinical benefit is observed after 24 weeks. The Phase III randomized, double-blind portion of the study will enroll approximately 84 participants. Participants will be randomly assigned in a 1:1 ratio (double blind) to receive either vismodegib (150 mg PO QD) + ruxolitinib (PO BID) or placebo (PO QD) + ruxolitinib (PO BID) for up to 48 weeks.

Conditions
Myelofibrosis
Being tested
Placebo, Ruxolitinib, Vismodegib
Medical subject headings
Primary Myelofibrosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PlaceboOther

    Placebo will be administered PO QD for up to 48 weeks.

  • RuxolitinibDrug

    Ruxolitinib will be administered PO BID at a starting dose depending on the participants's baseline platelet count for up to 48 weeks.

  • VismodegibDrug

    Also called Erivedge

    Vismodegib will be administered at a dose of 150 mg PO QD for up to 48 weeks.

Study groups in NCT02593760
Study groupRoleWhat they receive
Placebo + RuxolitinibActive comparatorParticipants will receive placebo (PO QD) in combination with ruxolitinib (dose will depend on the participant's baseline platelet count) for up to 48 weeks.
Receives: Other: Placebo; Drug: Ruxolitinib
Vismodegib + RuxolitinibExperimentalParticipants will receive vismodegib (150 mg PO QD) in combination with ruxolitinib (dose will depend on the participant's baseline platelet count) for up to 48 weeks.
Receives: Drug: Ruxolitinib; Drug: Vismodegib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants who Achieve a Greater Than or Equal to (>=) 35% Reduction in Spleen Volume from Baseline at Week 24

    Determined by an Independent Review Committee (IRC) Using International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) Revised Response Criteria

    Measured: Week 24

  2. Percentage of Participants with Complete Remission (CR) and Partial Remission (PR) at Week 24, as Determined by an IRC Using IWG-MRT Revised Response Criteria

    Measured: Week 24

Secondary outcomes (20)
  1. Plasma Vismodegib Concentration at Steady State

    Measured: Predose (0 hour) on Weeks 6, 12, 24, 36, and 48

  2. Unbound Vismodegib Concentration at Steady State

    Measured: Predose (0 hour) on Weeks 6, 12, 24, 36, and 48

  3. Alpha 1-Acid Glycoprotein Concentration at Steady State

    Measured: Predose (0 hour) on Weeks 6, 12, 24, 36, and 48

  4. Percentage of Participants who Achieve a >= 35% Reduction in Spleen Volume from Baseline, as Determined by an IRC Using IWG-MRT Revised Response Criteria at Week 48

    Measured: Baseline, Week 48

  5. Percentage of Participants who Achieve a >= 35% Reduction in Spleen Volume from Baseline, as Determined by an Investigator at Weeks 24 and 48

    Measured: Baseline, Weeks 24 and 48

  6. Percentage of Participants with CR and PR, as Determined by an IRC Using IWG-MRT Revised Response Criteria at Week 48

    Measured: Week 48

  7. Percentage of Participants with CR and PR, as Determined by an Investigator at Weeks 24 and 48

    Measured: Weeks 24 and 48

  8. Percentage of Participants with Overall Response Rate (CR, PR, and Clinical Improvement) at Weeks 24 and 48, as Determined by an IRC Using IWG-MRT Revised Response Criteria

    Measured: Weeks 24 and 48

  9. Percentage of Participants with Overall Response Rate (CR, PR, and Clinical Improvement) at Weeks 24 and 48, as Determined by the Investigator Using IWG-MRT Revised Response Criteria

    Measured: Weeks 24 and 48

  10. Percentage of Participants who Achieve Anemia Response at Weeks 24 and 48, as Determined by the Investigator Using IWG-MRT Revised Response Criteria

    Measured: Weeks 24 and 48

  11. Percentage of Participants with Symptom Response (Participants who Achieve a >= 50% Reduction from Baseline in the Myeloproliferative Neoplasm Symptom Assessment Form [MPN-SAF] Total Symptom Score [TSS])

    Measured: Baseline, Weeks 24 and 48

  12. Duration of Response, as Determined by the Investigator and an IRC Using IWG-MRT Revised Response Criteria or Death from Any Cause During the Study

    Measured: Baseline up to 28 days after the last dose of study drug (52 weeks)

  13. Percentage of Participants with Improvement from Baseline in Bone Marrow Fibrosis at Weeks 24 and 48, as Determined by the Investigator Using the European Consensus Grading System

    Measured: Baseline, Weeks 24 and 48

  14. Percentage of Participants with Improvement from Baseline in Bone Marrow Fibrosis at Weeks 24 and 48, as Determined by Independent Pathology Review Using the European Consensus Grading System

    Measured: Baseline, Weeks 24 and 48

  15. Progression-Free Survival

    Measured: Baseline up to the end of the study (up to 1 year after completing 48 weeks of treatment by the last participant)

  16. Percentage of Participants who Achieve a >= 50% Reduction in Fatigue from Baseline to Weeks 24 and 48 as Measured by MPN-SAF TSS

    Measured: Baseline, Weeks 24 and 48

  17. Percentage of Participants who Achieve a >= 50% Reduction in Other Symptom and Impact Item Scores from Baseline to Weeks 24 and 48, as Measured by the MPN-SAF

    Measured: Baseline, Weeks 24 and 48

  18. Percentage of Participants who Achieve a Meaningful Improvement on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 Scale Scores from Baseline to Weeks 24 and 48

    Meaningful improvement is defined as a 10-point change.

    Measured: Baseline, Weeks 24 and 48

  19. Overall Survival

    Measured: Baseline up to the end of the study (up to 1 year after completing 48 weeks treatment by the last participant)

  20. Percentage of Participants with Adverse Events (AEs)

    Measured: Baseline up to Month 48

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Nov 2015 (estimated)
  2. Study start25 Jan 2016
  3. Primary completion29 Mar 2017
  4. Study completion12 Jul 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02593760
Sponsor's protocol ID
WO29806
Other IDs
2015-001620-33, 2015
Status last verified
May 2018
First submitted
29 Oct 2015
Last updated
11 May 2018
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Couban S, Benevolo G, Donnellan W, Cultrera J, Koschmieder S, Verstovsek S, Hooper G, Hertig C, Tandon M, Dimier N, Malhi V, Passamonti F. A phase Ib study to assess the efficacy and safety of vismodegib in combination with ruxolitinib in patients with intermediate- or high-risk myelofibrosis. J Hematol Oncol. 2018 Sep 24;11(1):122. doi: 10.1186/s13045-018-0661-x.

    PubMed 30249277

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Ruxolitinib and Vismodegib in people with Myelofibrosis, run by Hoffmann-La Roche at 13 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 May 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in United States, Canada, Germany, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants who Achieve a Greater Than or Equal to (>=) 35% Reduction in Spleen Volume from Baseline at Week 24 (time frame: Week 24). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02593760, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 May 2018.

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