A Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of Imetelstat in Combination With Ruxolitinib in Participants With Myelofibrosis
Study Phase: Phase 1
Recruitment Status: Recruiting
Start Date: May 04, 2022
End Date: August 01, 2028
Inclusion Criteria:
- Diagnosis of primary myelofibrosis (PMF) according to the revised World Health Organization (WHO) criteria or post-essential thrombocythemia-MF or post-polycythemia vera according to the International Working Group for Myelofibrosis Research and Treatment (IWG-MRT) criteria.
- Dynamic International Prognostic Scoring System (DIPSS) intermediate-1, intermediate-2 or high-risk MF.
- Candidate for ruxolitinib treatment:
- Part 1 participants: On ruxolitinib treatment for at least 12 weeks with at least 4 consecutive weeks immediately prior to enrollment at a stable dose.
- Part 2 participants: Candidate for ruxolitinib treatment as assessed by the investigator and has not previously been treated with a JAK inhibitor (Cohort A) OR currently receiving ruxolitinib per standard of care for at least 12 weeks with at least 4 consecutive weeks at a stable dose prior to enrollment (Cohort B). Note that the study will no longer recruit participants into Cohort A.
- Active symptoms of MF on the MFSAF v4.0 demonstrated by:
- Part 1 participants only: At least 2 symptoms with a score ≥ 1
- Part 2 participants only: At least 2 symptoms with a score of ≥ 3, or a total score of at least 10.
- Ineligible for or unwilling to undergo hematopoietic stem cell transplant at time of study entry.
- Hematology laboratory test values within protocol defined limits.
- Biochemical laboratory test values within protocol defined limits.
- Eastern Cooperative Oncology Group Performance Status score of 0, 1, or 2.
- Participants should follow protocol defined contraceptives procedures.
- A woman of childbearing potential must have a negative serum or urine pregnancy test at screening.
Exclusion Criteria:
- Peripheral blood blast count of ≥10% or bone marrow blast count of ≥10%.
- Prior treatment with JAK inhibitor (except for participants being dosed optimized on ruxolitinib treatment prior to screening and enrollment in part 1 or Part 2 Cohort B).
- Known allergies, hypersensitivity, or intolerance to imetelstat or ruxolitinib or excipients.
- Prior treatment with imetelstat.
- Major surgery within 28 days prior to enrollment.
- Any investigational drug regardless of class or mechanism of action, hydroxyurea, chemotherapy, (except for ruxolitinib for participants being dose optimized prior to enrollment), immunomodulatory or immunosuppressive therapy, corticosteroids >30 mg/day prednisone or equivalent ≤14 days prior to enrollment.
- Prior history of hematopoietic stem cell transplant.
- Diagnosis or treatment for malignancy other than MF, except:
- Malignancy treated with curative intent and with no known active disease present for ≥3 years before enrollment.
- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease.
- Adequately treated cervical carcinoma in situ without evidence of disease.
- Clinically significant cardiovascular disease.
- Known history of human immunodeficiency virus (HIV) or any uncontrolled active systemic infection requiring IV antibiotics.
- Active systemic hepatitis infection requiring treatment or any known acute or chronic liver disease unless related to MF. Carriers of hepatitis virus are permitted to enter the study.
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Conditions:
- Primary Myelofibrosis