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NCT Number: NCT06585774

A Study to Evaluate Axatilimab and Corticosteroids as Initial Treatment for Chronic Graft-Versus-Host Disease

This study will be conducted to compare the efficacy of axatilimab versus placebo in combination with corticosteroids as initial treatment for moderate or severe chronic graft-versus-host disease (cGVHD).

Recruiting

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Key information

Age range

12 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Royal Prince Alfred Hospital, Sydney, New South Wales, Australia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • ≥ 12 years of age at the time of informed consent.
  • New-onset moderate or severe cGVHD, as defined by the 2014 NIH Consensus Development Project Criteria for Clinical Trials in cGVHD, requiring systemic therapy.
  • History of allo-HCT from any donor HLA type (related or unrelated donor with any degree of HLA matching) using any graft source (bone marrow, peripheral blood stem cells, or cord blood). Recipients of myeloablative, nonmyeloablative, or reduced-intensity conditioning are eligible.
  • Adequate hematologic function with ANC ≥ 0.5 × 109/L independent of growth factors for at least 7 days prior to study entry.
  • Willingness to avoid pregnancy or fathering children.

Exclusion criteria

  • Received more than 1 prior allo-HCT. Prior autologous HCT is allowed.
  • Has overlap cGVHD, defined as simultaneous presence of features or characteristics of aGVHD in a patient with cGVHD.
  • Received more than 7 days of systemic corticosteroid treatment for cGVHD or unable to begin a prednisone dose ≥ 1.0 mg/kg per day (or methylprednisolone equivalent) for cGVHD.
  • Received previous systemic treatment for cGVHD, including extracorporeal photopheresis.
  • Systemic treatment with CNIs or mTOR inhibitors started within 2 weeks prior to C1D1.
  • Prior treatment with CSF-1R targeted therapies.
  • Active, uncontrolled bacterial, fungal, parasitic, or viral infection.
  • Evidence of relapse of the primary hematologic disease or treatment for relapse after the allo-HCT was performed, including DLIs for the treatment of molecular relapse.
  • History of acute or chronic pancreatitis.
  • Active symptomatic myositis.
  • History or current diagnosis of cardiac disease indicating significant risk of safety for participation in the study, such as uncontrolled or significant cardiac disease.
  • Severe renal impairment, that is, estimated CrCl < 30 mL/min measured or calculated by Cockcroft-Gault equation in adults and Schwartz formula in pediatric participants, or endstage renal disease on dialysis.
  • Impaired liver function, defined as total bilirubin > 1.5 × ULN and/or ALT and AST > 3 × ULN in participants with no evidence of liver cGVHD.
  • Pregnant or breastfeeding.

Other protocol-defined Inclusion/Exclusion Criteria may apply.

Treatment and study plan

INCA034176

Drug

IV infusion

Other names: Axatilimab

Placebo

Drug

IV infusion

Corticosteroids

Drug

Oral/IV Infusion

Other names: prednisone, methylprednisolone, prednisolone

Primary outcomes

  1. Event Free Survival (EFS)

    Time frame: Up to 3 years

    Defined from the date of randomization to the date of any predefined event, whichever occurs first.

Secondary outcomes

  1. Objective Response (OR)

    Time frame: 6 months

    Defined for each treatment group as CR or PR at 6 months Cycle 7 (28-day cycles), Day 1, in the absence of new systemic therapy for cGVHD. Responses defined by the 2014 NIH consensus criteria.

  2. Event Free Survival 2

    Time frame: Up to 3 years

    Defined from the date of randomization to the date of any predefined event, whichever occurs first.

  3. Proportion of participants with a ≥ 7-point improvement in mLSS total score

    Time frame: Up to 3 years

  4. Overall Response

    Time frame: 12 Months

    Defined as CR or PR at 12 months in the absence of new systemic therapy for cGVHD.

  5. DOR (in responders only)

    Time frame: Up to 3 years

    Defined as the time from the date of first response (PR or CR) to the date of progression of cGVHD from nadir in any organ, start of new systemic treatment for cGVHD, or death from any cause, whichever comes first.

  6. Best Overall Response (BOR)

    Time frame: Up to 3 years

    Defined as the best response of CR or PR at any timepoint up to the initiation of new therapy for cGVHD.

  7. Overall Survival (OS)

    Time frame: Up to 3 years

    Defined as the time from the date of randomization to the date of death due to any cause.

  8. Nonrelapse mortality (NRM)

    Time frame: Up to 3 years

    Defined as the time from the date of randomization to the date of death in the absence of primary hematologic disease relapse.

  9. Failure-free survival (FFS)

    Time frame: Up to 3 years

    Defined as the time from the date of randomization to the date of addition or initiation of another systemic therapy for cGVHD, relapse of underlying disease, or death due to any cause.

  10. Relapse of hematologic diseases

    Time frame: Up to 3 years

    Defined as the reappearance of symptoms of underlying disease.

  11. Time to primary hematologic disease relapse

    Time frame: Up to 3 years

    Defined as the time from the date of randomization to the date of relapse.

  12. Percent reduction in daily corticosteroid dose

    Time frame: 6 months

  13. Proportion of participants who tapered off all corticosteroids

    Time frame: 6 months

  14. Number of participants with Treatment-emergent Adverse Events (TEAEs)

    Time frame: Up to 3 years and 30 days

    Defined as adverse events reported for the first time or worsening of a pre-existing event after the first dose of study treatment.

  15. Change from baseline in circulating monocyte number and phenotype (CD14/16)

    Time frame: Up to 3 years and 30 days

  16. Change from baseline in soluble markers for bone resorption and formation, including bone-specific alkaline phosphatase (BAP) and C-terminal telopeptide (CTX)

    Time frame: Up to 3 years and 30 days

Study contacts

Contact information is provided by the study sponsor or research team.

Incyte Corporation Call Center (US)

CONTACT

[email protected]

1.855.463.3463

Incyte Corporation Call Center (ex-US)

CONTACT

[email protected]

+800 00027423

Sponsors and collaborators

Lead sponsor

Incyte Corporation

Industry

Registry information

Official study title

A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of Axatilimab and Corticosteroids as Initial Treatment for Chronic Graft-Versus-Host Disease (AXemplify-357)

Acronym: AXemplify-357

Important dates

Study start
2025
Primary completion
2027
Study completion
2030
First posted
Sep 19, 2024
Registry last updated
Jul 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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