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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.

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 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
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.
Show all 18Show fewer
  • 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

Other trials in United States

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

Other trials in Italy

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

Other trials in Japan

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

Other trials in United Kingdom

France3 sites
  • Centre Hospitalier D'Angers

    Angers, 49033

  • Institut Paoli Calmettes

    Marseille, 13273

  • Hospital Saint Louis

    Paris, 75010

Other trials in France

Canada2 sites
  • McGill University Jewish General Hospital

    Montreal, Quebec, H3T1E2

  • Princess Margaret Cancer Center

    Toronto, Ontario, M5G 2M9

Other trials in Canada

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.

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 groups in NCT04455841
Study groupRoleWhat they receive
Treatment Group A (TGA)ExperimentalINCB000928 will be administered once daily (QD).
Receives: Drug: INCB000928
Treatment Group B (TGB)ExperimentalINCB000928 will be administered in combination with ruxolitinib.
Receives: Drug: INCB000928; Drug: ruxolitinib
Treatment Group C (TGC)ExperimentalINCB000928 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.

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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)
  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  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.

  1. First posted2 Jul 2020
  2. Study start19 Mar 2021
  3. Primary completion1 Apr 2025
  4. Study completion8 Sep 2026

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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
84 participants (actual)
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
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

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