AnemiaPhase 1/2NCT04455841
INCB000928 Administered as a Monotherapy or in Combination With Ruxolitinib in Participants With Anemia Due to Myeloproliferative Disorders
A Phase 1/2 study testing INCB000928 and ruxolitinib in people with Anemia and Post-essential Thrombocythemia Myelofibrosis, run by Incyte Corporation at 34 sites in 6 countries.
Trial summary
This Phase 1/2, open-label, dose-finding study is intended to evaluate the safety and tolerability, PK, PD, and efficacy of INCB000928 administered as monotherapy or in combination with ruxolitinib in participants with MF who are transfusion-dependent or presenting with symptomatic anemia. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Anemia, Post-essential Thrombocythemia Myelofibrosis, Post-polycythemia Vera Myelofibrosis
- What is being tested?
- INCB000928 and ruxolitinib
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 84 participants
- Where
- 34 sitesin 6 countries
- Study dates
- 19 Mar 2021to 8 Sep 2026
- Phase
- Phase 1/2
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
- Participants with MF who are transfusion-dependent or present with symptomatic anemia, defined as follows:
- Anemia: An Hgb value < 10 g/dL demonstrated during screening recorded on 3 separate occasions with at least 7 days between measurements (Note: RBC transfusion must be at least 2 weeks before the Hgb measurement during screening).
- Transfusion-dependent: Participant has received at least 4 units of RBC transfusions during the 28 days immediately preceding Cycle 1 Day 1 OR has received an average of at least 4 units of RBC transfusions in the 8 weeks immediately preceding Cycle 1 Day 1, for an Hgb level of < 8.5 g/dL, in the absence of bleeding or treatment-induced anemia. In addition, the most recent transfusion episode must have occurred in the 28 days before Cycle 1 Day 1.
- ECOG performance status score of the following:
- 0 or 1 for the dose-escalation stages.
- 0, 1, or 2 for the dose-expansion stage.
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- Life expectancy is greater than 6 months
- Agreement to avoid pregnancy or fathering children.
- Ineligible to receive or have not responded to available therapies for anemia such as ESAs.
- For TGA:
- Participants previously treated with JAK inhibitors for at least 12 weeks.
- Participants with intermediate-2 or high DIPSS MF according to IWG-MRT criteria.
- For TGB:
- Participants must have been on a therapeutic and stable regimen of ruxolitinib for at least 12 consecutive weeks immediately preceding the first dose of study treatment.
- Participants with intermediate-1, intermediate-2, or high DIPSS MF according to IWG-MRT criteria.
- For TGC:
- Participants must be JAK inhibitor treatment naive (no prior treatment with any JAK inhibitor) and have an indication for initiation of ruxolitinib treatment.
- Participants with intermediate-1, intermediate-2, or high DIPSS MF according to IWG-MRT criteria.
Who cannot join
- Undergone any prior allogenic or autologous stem cell transplantation or a candidate for such transplantation.
- Any prior chemotherapy, immunomodulatory drug therapy, immunosuppressive therapy, biological therapy, endocrine therapy, targeted therapy, antibody or hypomethylating agent to treat the participant's disease, with the exception of ruxolitinib for TGB only, within 5 half-lives or 28 days (whichever is shorter) before the first dose of study treatment.
- Laboratory Values outside of protocol defined range at screening.
Trial locations and contacts
34 sites in 6 countries.
34 sites in 6 countries
United States13 sites
Emory University - Winship Cancer Institute
Atlanta, Georgia, 30322
Emory University-Winship Cancer Institute
Atlanta, Georgia, 30322
City of Hope National Medical Center
Duarte, California, 91010
Duke University Medical Center, Department of Hematologic Malignancies and Cellular Therapy
Durham, North Carolina, 27705
Start Midwest
Grand Rapids, Michigan, 49546
Md Anderson Cancer Center
Houston, Texas, 77030
City of Hope Orange County
Irvine, California, 92618
Usc Norris Comprehensive Cancer Center
Los Angeles, California, 90089
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Weill Cornell Medical Centers
New York, New York, 10065
Stanford Cancer Center
Palo Alto, California, 94304
Prebys Cancer Center
San Diego, California, 92103
Washington University School of Medicine
St Louis, Missouri, 63110
Italy6 sites
Azienda Ospedaliera Papa Giovanni Xxiii
Bergamo, 24127
S Orsolas University Hospital Seragnoli Institute of Hematology
Bologna, 40138
Azienda Ospedaliero-Universitaria Careggi (Aouc)
Florence, 50134
Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano
Orbassano, 10043
Comitato Di Bioetica Della Fondazione Irccs Policlinico San Matteo
Pavia, 27100
Ospedale Santa Maria Della Misericordia Perugia
Perugia, 06124
Japan6 sites
Tokyo Medical and Dental University Hospital
Bunkyō City, 113-8519
Chiba Cancer Center
Chiba, 260-8717
Gifu Municipal Hospital
Gifu, 500-8513
Kansai Medical University Hospital
Hirakata, 573-1191
Kumamoto Shinto General Hospital
Kumamoto, 862-8655
Osaka International Cancer Institute
Osaka, 541-8567
United Kingdom4 sites
United Lincolnshire Hospitals
Boston, PE21 9QS
University Hospital of Wales
Cardiff, WLS, CF14 4XW
Lincoln County Hospital
Lincoln, LN2 5QY
Royal Cornwall Hospital Truro Sunrise Centre
Truro, TR1 3LJ
France3 sites
Centre Hospitalier D'Angers
Angers, 49033
Institut Paoli Calmettes
Marseille, 13273
Hospital Saint Louis
Paris, 75010
Canada2 sites
McGill University Jewish General Hospital
Montreal, Quebec, H3T1E2
Princess Margaret Cancer Center
Toronto, Ontario, M5G 2M9
About this study
Official title: A Phase 1/2 Open-Label, Multicenter Study of INCB000928 Administered as a Monotherapy or in Combination With Ruxolitinib in Participants With Anemia Due to Myeloproliferative Disorders
This Phase 1/2, open-label, dose-finding study is intended to evaluate the safety and tolerability, PK, PD, and efficacy of INCB000928 administered as monotherapy or in combination with ruxolitinib in participants with MF who are transfusion-dependent or presenting with symptomatic anemia. This study will consist of 2 parts: dose escalation and expansion.
- Conditions
- Anemia, Post-essential Thrombocythemia Myelofibrosis, Post-polycythemia Vera Myelofibrosis
- Being tested
- INCB000928, ruxolitinib
- Keywords
- anemia
- Medical subject headings
- Anemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
INCB000928Drug
INCB000928 will be administered at protocol defined dose.
ruxolitinibDrug
Ruxolitinib will be administered at protocol defined dose.
| Study group | Role | What they receive |
|---|---|---|
| Treatment Group A (TGA) | Experimental | INCB000928 will be administered once daily (QD). Receives: Drug: INCB000928 |
| Treatment Group B (TGB) | Experimental | INCB000928 will be administered in combination with ruxolitinib. Receives: Drug: INCB000928; Drug: ruxolitinib |
| Treatment Group C (TGC) | Experimental | INCB000928 will be administered in combination with ruxolitinib. Receives: Drug: INCB000928; Drug: ruxolitinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Any Treatment-emergent Adverse Event (TEAE) and Any Treatment-emergent Serious Adverse Event (SAE)
An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study drug/treatment. A TEAE was defined as any AE either reported for the first time or the worsening of a pre-existing event after the first dose of study drug until 30 days after the last dose of study drug.
Measured: up to approximately 4 years
Number of Participants With Any ≥Grade 3 TEAE and Any Treatment-emergent SAE
An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. A TEAE was defined as any AE either reported for the first time or the worsening of a pre-existing event after the first dose of study drug until 30 days after the last dose of study drug. The severity of AEs was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 Grades 1 through 5. Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; treatment not indicated. Grade 2: moderate; minimal, local, or noninvasive treatment indicated; limiting age-appropriate activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent treatment indicated. Grade 5: fatal.
Measured: up to approximately 4 years
Number of Participants With Dose-limiting Toxicities (DLTs)
A DLT was defined as the occurrence of any protocol-defined toxicity occurring during the first treatment cycle, from Cycle 1 Day 1 up to and including Cycle 1 Day 28 (per regimen cycle schedule), except those with a clear alternative explanation (e.g., disease progression) or transient (≤72 hours) abnormal laboratory values without associated clinically significant signs or symptoms based on investigator determination. The DLT-Evaluable Population included all non-backfill participants eligible for dose escalation who met the criteria outlined in the Analysis Population field.
Measured: from Cycle 1 Day 1 to Cycle 1 Day 28
Maximum Tolerated Dose (MTD)
The MTD was defined as the dose at which the observed DLT rate was closest to the target DLT rate of 28% using an isotonical method that took the assumption of a monotonic dose-toxicity relationship into account. Per the protocol, the stopping rule was either (a) reaching a certain number of participants at one dose level under the early stopping rule or (b) reaching the pre-defined maximum sample size. Dose escalation was to be considered complete only when one of these conditions was met. After completion, the MTD was to be defined as the dose level closest to the target DLT rate. The MTD could not be concluded until the stopping rule was met.
Measured: from Cycle 1 Day 1 to Cycle 1 Day 28
Recommended Dose for Expansion (RDE)
The RDE was defined as a pharmacodynamically active dose. The RDE was determined in an independent fashion by evaluation of all available data (i.e., safety, pharmacokinetic, and pharmacodynamic data) from the respective dose-escalation stage of the study for further investigation in the expansion cohort, including safety (e.g., low-grade but chronic toxicities, dose reduction, dose interruption, or missed doses of zilurgisertib and/or ruxolitinib). The RDE(s) could not exceed the MTD in each treatment group
Measured: from Cycle 1 Day 1 to Cycle 1 Day 28
Secondary outcomes (15)
Percentage of Participants With Anemia Response
Anemia response was defined as (a) a hemoglobin (Hgb) increase of 1.5 grams per deciliter (g/dL) relative to baseline for any "rolling" 12-week period (84 days with each assessment that met this requirement) during the first 24 weeks of treatment if transfusion independent (TI) at baseline; or (b) transfusion independence for any "rolling" 12-week period (absence of any red blood cell [RBC] transfusion over any 84-day period) during the first 24 weeks of treatment if transfusion dependent (TD) at baseline.
Measured: up to Week 24
Duration of Anemia Response
Duration of anemia response was defined as (a) the interval from the first onset of anemia response to the earliest date of loss of anemia response that persisted for at least 4 weeks or death from any cause (for TI participants at baseline); or (b) the duration of the RBC-TI period for participants who achieved RBC-TI for at least 12 consecutive weeks during the first 24 weeks of treatment (for TD participants at baseline).
Measured: up to 1530 days
Mean Change From Baseline in the Hgb Value Over 12-week Treatment Periods
Mean change from baseline was assessed as the largest increase from baseline in the mean Hgb values over any rolling 12-week treatment period during the first 24 weeks of treatment. Change from baseline was calculated as the post-baseline value minus the baseline value.
Measured: Baseline; up to 24 weeks
Rate of Red Blood Cell (RBC) Transfusion From Week 24 Through Week 48
The rate of RBC transfusion was defined as the average number of RBC units per participant-month during the treatment period.
Measured: from Week 24 through Week 48
Splenic Volume Response Rate at Week 24
Splenic volume response rate was defined as the percentage of participants achieving a ≥35% reduction in spleen volume at Week 24 relative to baseline as measured by magnetic resonance imaging or computed tomography scan.
Measured: Week 24
Spleen Length Response
Spleen length response was defined as the percentage of participants achieving a ≥50% reduction in spleen length at any visit relative to baseline as measured by palpation.
Measured: Week 24
Overall Response Rate (ORR)
ORR was defined as the percentage of participants with complete response (CR) or partial response (PR) (including the morphologic effects of the combination of zilurgisertib with ruxolitinib on bone marrow) according to Tefferi et al (2013) definitions.
Measured: Week 24
Progression-free Survival (PFS)
PFS was defined as the interval from the first dose of study treatment until the first documented progression or death according to Tefferi et al (2013) definitions.
Measured: Week 24
Leukemia-free Survival (LFS)
LFS was defined as the interval from the first dose of study treatment until the first documented leukemia transformation or death from any cause.
Measured: Week 24
Cmax of Zilurgisertib Alone
Cmax was defined as the maximum concentration of zilurgisertib.
Measured: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
Tmax of Zilurgisertib
tmax was defined as the time to the maximum concentration of zilurgisertib.
Measured: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
AUC0-t of Zilurgisertib
AUC0-t was defined as the area under the plasma concentration-time curve from time 0 to the last quantifiable measurable plasma concentration of zilurgisertib.
Measured: Cycle 1 Day 1 (first dose) and Cycle 1 Day 15 (steady state): pre-dose and 2 hours, 4 hours, and 6-8 hours post-dose
Percentage Change in Hepcidin From Cycle 1 Day 15 to Cycle 7 Day 1
Percentage change was calculated as the ([post-baseline value minus the baseline value] / [baseline value]) * 100.
Measured: from Cycle 1 Day 15 to Cycle 7 Day 1
Change From Baseline in Ferritin
Change from Baseline (CFB) was calculated as the post-Baseline value minus the Baseline value.
Measured: Baseline; Cycle 1 Day 8; Cycle 1 Day 15; Cycle 1 Day 22; Cycles 2, 3, 4, 5, 6, and 7 Day 1; Cycle 2 Day 15
Change From Baseline in Hemoglobin at the End of Treatment
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
Measured: up to 1530 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jul 2020
- Study start19 Mar 2021
- Primary completion1 Apr 2025
- Study completion8 Sep 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for AnemiaStudies of the same condition, open and under way.
- More trials run by Incyte CorporationThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 84 participants (actual)
Sponsor and investigators
- Lead sponsor
- Incyte Corporation
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Amanda McBride, MD, Study director, Incyte Corporation
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04455841
- Sponsor's protocol ID
- INCB 00928-104
- Other IDs
- 2023-503625-19-00, 2020-004029-21, 2023
- Status last verified
- Sep 2026
- First submitted
- 19 Jun 2020
- Last updated
- 1 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Incyte shares data with qualified external researchers after a research proposal is submitted. These requests are reviewed and approved by a review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. The trial data availability is according to the criteria and process described on https://www.incyte.com/our-company/compliance-and-transparency
Publications
Gangat N, Tefferi A. Targeting anemia in myeloid neoplasms. Am J Hematol. 2024 Sep;99(9):1663-1666. doi: 10.1002/ajh.27408. Epub 2024 Jun 5.
PubMed 38837732