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Completed

NCT Number: NCT02593760

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

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.

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Key information

Conditions

Myelofibrosis Bone Marrow Diseases Hematologic Diseases Hemic and Lymphatic Diseases Myeloproliferative Disorders Primary Myelofibrosis

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Tom Baker Cancer Centre-Calgary; Clinical Research Unit, Calgary, Alberta, Canada

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

Placebo

Other

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

Ruxolitinib

Drug

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

vismodegib

Drug

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

Other names: Erivedge

Primary outcomes

  1. 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

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

  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

    Time frame: Week 24

Secondary outcomes

  1. Plasma Vismodegib Concentration at Steady State

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

  2. Unbound Vismodegib Concentration at Steady State

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

  3. Alpha 1-Acid Glycoprotein Concentration at Steady State

    Time frame: 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

    Time frame: 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

    Time frame: 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

    Time frame: Week 48

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

    Time frame: 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

    Time frame: 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

    Time frame: 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

    Time frame: 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])

    Time frame: 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

    Time frame: 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

    Time frame: 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

    Time frame: Baseline, Weeks 24 and 48

  15. Progression-Free Survival

    Time frame: 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

    Time frame: 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

    Time frame: 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

    Time frame: Baseline, Weeks 24 and 48

    Meaningful improvement is defined as a 10-point change.

  19. Overall Survival

    Time frame: 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)

    Time frame: Baseline up to Month 48

Sponsors and collaborators

Lead sponsor

Hoffmann-La Roche

Industry

Registry information

Official study 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

Important dates

Study start
2016
Primary completion
2017
Study completion
2017
First posted
Nov 2, 2015
Registry last updated
May 11, 2018

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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