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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT03222609
Registration number
NCT03222609
Ethics application status
Date submitted
17/07/2017
Date registered
19/07/2017
Date last updated
3/03/2023
Titles & IDs
Public title
A Study Evaluating Tolerability and Efficacy of Navitoclax Alone or in Combination With Ruxolitinib in Participants With Myelofibrosis
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Scientific title
A Phase 2 Open-Label Study Evaluating Tolerability and Efficacy of Navitoclax Alone or in Combination With Ruxolitinib in Subjects With Myelofibrosis (REFINE)
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Secondary ID [1]
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2017-001398-17
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Secondary ID [2]
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M16-109
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Universal Trial Number (UTN)
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Trial acronym
REFINE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myelofibrosis (MF)
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Condition category
Condition code
Musculoskeletal
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Other muscular and skeletal disorders
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Human Genetics and Inherited Disorders
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0
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Other human genetics and inherited disorders
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Cancer
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0
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Leukaemia - Chronic leukaemia
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Intervention/exposure
Study type
Interventional(has expanded access)
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Description of intervention(s) / exposure
Treatment: Drugs - Ruxolitinib
Treatment: Drugs - Navitoclax
Experimental: Navitoclax + ruxolitinib - Participants will be administered navitoclax once daily (QD) at various doses and a dose greater than or equal to 10 mg of ruxolitinib twice daily (BID).
Experimental: Navitoclax - Participants will be administered various doses of navitoclax once daily (QD)
Treatment: Drugs: Ruxolitinib
Tablet; Oral
Treatment: Drugs: Navitoclax
Tablet; Oral
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants who achieve Spleen Volume Reduction of greater than or equal to 35% (SVR35) from baseline
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Assessment method [1]
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Reduction in spleen volume is measured by magnetic resonance imaging/computerized tomography (MRI/CT).
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Timepoint [1]
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From Baseline (Week 0) through Week 24
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Secondary outcome [1]
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Percentage of participants achieving 50% Reduction in Total System Score (TSS)
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Assessment method [1]
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TSS is assessed by the Myelofibrosis Symptom Assessment Form (MFSAF) version 4.0.
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Timepoint [1]
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From Baseline (Week 0) through Week 24
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Secondary outcome [2]
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Anemia Response
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Assessment method [2]
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The anemia response will be assessed according to current International Working Group-Myeloproliferative Neoplasms Research and European LeukemiaNet (IWG-MRT/ELN) criteria.
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Timepoint [2]
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Every 12 weeks up to approximately 96 weeks
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Secondary outcome [3]
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Change in Grade of Bone Marrow Fibrosis
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Assessment method [3]
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Bone marrow grading is assessed according to the European Consensus Grading System.
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Timepoint [3]
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Through Week 96
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Eligibility
Key inclusion criteria
- Participants with documented diagnosis of intermediate-2 or high-risk primary
Myelofibrosis, Post Polycythemia Vera Myelofibrosis or Post-essential Thrombocythemia
Myelofibrosis.
- Participant must be ineligible due to age, comorbidities, or unfit for unrelated or
unmatched donor transplantation or unwilling to undergo stem cell transplantation at
time of study entry.
- Eastern Cooperative Oncology Group (ECOG) of 0, 1, or 2.
- Prior treatment must meet at least one of the following criteria:
- Prior or current treatment with ruxolitinib and no prior treatment with a
Bromodomain and Extra-Terminal motif (BET) proteins inhibitor or another Janus
Kinase 2 (JAK-2) inhibitor, and meet all of the following criteria:
- Ruxolitinib treatment must meet at least one of the following criteria:
- Ruxolitinib treatment for >=24 weeks with lack of efficacy defined as a
lack of spleen response (refractory) or a loss of spleen or symptom
response (relapsed)
- Ruxolitinib treatment for <24 weeks with documented disease progression
on spleen measurements while on ruxolitinib as defined in the protocol:
- Ruxolitinib treatment for >=28 days with intolerance defined as new red
blood cell transfusion requirement (at least 2 units/month for 2
months) while receiving a total daily ruxolitinib dose of >=30 mg but
unable to reduce dose further due to lack of efficacy.
- If receiving ruxolitinib at the time of screening, must currently be on a
stable dose >=10 mg twice daily of ruxolitinib for >=4 weeks prior to the
1st dose of navitoclax.
- Participant has at least 2 symptoms each with a score >=3 or a total score
of >=12, as measured by the Myelofibrosis Symptom Assessment Form (MFSAF)
v4.0 on at least 4 out of 7 days during screening prior to study drug
dosing; OR
- Prior treatment with a JAK-2 inhibitor and meet one of the following criteria:
- Prior treatment with a JAK-2 inhibitor for at least 12 weeks
- Prior treatment with a JAK-2 inhibitor for >=28 days complicated by either
development of red blood cell transfusion requirement (at least 2
units/month for 2 months) OR Grade >= 3 adverse events of thrombocytopenia,
anemia, hematoma and/or hemorrhage while on JAK-2 inhibitor treatment; OR
- No prior treatment with a JAK-2 or BET inhibitor:
- Participant has at least 2 symptoms each with a score >=3 or a total score
of >= 12, as measured by the MFSAF v4.0 on at least 4 out of 7 days during
screening prior to study drug dosing.
- Participant has splenomegaly as defined in the protocol.
- Participant must meet the laboratory parameters (adequate bone marrow, renal and
hepatic function) as defined in the protocol.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Splenic irradiation within 6 months prior to screening, or prior splenectomy.
- Leukemic transformation (> 10% blasts in peripheral blood or bone marrow
aspirate/biopsy).
- Participant is currently on medications that interfere with coagulation (including
warfarin) or platelet function within 3 days prior to the first dose of study drug or
during the study treatment period with the exception of low dose aspirin (up to 100
mg/day) and low-molecular-weight heparin.
- Prior therapy with a BH3 mimetic compound or stem cell transplantation.
- Participant has received strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin)
or moderate CYP3A inhibitors (e.g., fluconazole) within 14 days prior to the
administration of the first dose of study drug.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
31/10/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
2/02/2029
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Actual
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Sample size
Target
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Accrual to date
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Final
191
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
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Recruitment hospital [1]
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The Kinghorn Cancer Centre /ID# 214657 - Darlinghurst
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Recruitment hospital [2]
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Barwon Health /ID# 222430 - Geelong
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Peter MacCallum Cancer Ctr /ID# 218352 - Melbourne
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Alfred Health /ID# 215545 - Melbourne
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Fiona Stanley Hospital /ID# 216809 - Murdoch
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2010 - Darlinghurst
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3220 - Geelong
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3000 - Melbourne
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3004 - Melbourne
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Recruitment postcode(s) [5]
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6150 - Murdoch
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Newport
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
AbbVie
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Address
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Ethics approval
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Summary
Brief summary
This is a Phase 2 open-label, multicenter study evaluating tolerability and efficacy of
navitoclax alone or when added to ruxolitinib in participants with myelofibrosis.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT03222609
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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ABBVIE INC.
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Address
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AbbVie
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT03222609
Download to PDF