CC-4047 in Treating Patients With Myelofibrosis

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Mayo Clinic
ClinicalTrials.gov Identifier:
NCT00669578
First received: April 29, 2008
Last updated: June 20, 2014
Last verified: June 2014

April 29, 2008
June 20, 2014
May 2008
July 2010   (final data collection date for primary outcome measure)
  • Determine the Maximum Tolerated Dose of CC-4047 [ Time Frame: The first 28-day cycle of treatment. ] [ Designated as safety issue: Yes ]
    Starting at a dose level of 2.5 mg/d on days 1-21 in every 28 day cycle, participants were accrued in cohorts of three to assess dose limiting toxicities (DLT) and determine the maximum tolerated dose (MTD). Dose escalation at increments of 0.5 mg/d was done if no subject had a DLT (a grade 4 or higher hematologic toxicity or a grade 3 or higher febrile neutropenia or a grade 3 or higher non-hematologic toxicity) in cycle 1. Subsequent cohorts were treated until the maximum tolerated dose (MTD) was reached (dose level before that which results in a DLT in >1 of 6 subjects). Subsequent participants were treated at the MTD, those without response at the MTD after 3 cycles were lowered to the minimal efficacious dose (MED) of 0.5 mg daily. Here, we are reporting the percentage of participants in Phase I with a DLT at each dose level.
  • Best Overall Response Over the First 6 Cycles of Treatment [ Time Frame: Every cycle of treatment for 6 cycles. Each cycle is 28 days. ] [ Designated as safety issue: No ]

    Response evaluation:

    Complete Remission (CR):

    Neutrophil count between 1 to 10 x 10^9/L without peripheral blasts in blood or bone marrow.

    Partial Hematologic Response/Partial Remission (PR):

    Increase in neutrophil by 50% + above 10^9/L for neutropenia)

    Clinical Improvement (CI):

    Increase in Neutrophil count, hemoglobin, platelet count or reduction in blood/marrow blasts.

  • Best overall response over the first 6 courses of treatment [ Designated as safety issue: No ]
  • Rate and frequency of dose-limiting toxicity as measured by NCI CTCAE version 3.0 [ Designated as safety issue: Yes ]
  • Safety [ Designated as safety issue: Yes ]
Complete list of historical versions of study NCT00669578 on ClinicalTrials.gov Archive Site
  • Number of Participants With Treatment Related Adverse Events. [ Time Frame: During treatment and every 6 months until 3 years from registration or progression. ] [ Designated as safety issue: Yes ]
    Adverse events (AE) that are classified as either possibly, probably, or definitely related to study treatment according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE version 3.0). The maximum grade for each type of AE will be recorded for each patient. The number of participants with grade 3 or higher adverse events at least possibly related to study treatment are reported here.
  • Duration of Response Time [ Time Frame: Time from response to disease progression, intolerance of study drug, or death. ] [ Designated as safety issue: No ]
    Duration of response is defined as the date at which the patient's objective status is first noted to be a CR, PR or CI to the date progression is documented (if one has occurred) or to the date of last follow-up(for those patients who have not progressed).
  • Time to Response [ Time Frame: Time from registration to the first date of response within twelve 28-day cycles of treatment. ] [ Designated as safety issue: No ]
    The time to response is defined as the time from study registration to the first date at which the patient's objective status was classified as a response (CR, PR or CI). In patients who do not achieve a response, time to response will be censored at the patient's last evaluation date. The distribution for each of these event-time variables (duration of response and time to response) will be estimated by Kaplan-Meier curves.
  • Duration of response [ Designated as safety issue: No ]
  • Time to response [ Designated as safety issue: No ]
  • Best overall response over the first 12 courses of treatment [ Designated as safety issue: No ]
  • Cytogenetic response in patients with a baseline abnormality [ Designated as safety issue: No ]
  • Molecular response (JAK2V617F mutation burden) in peripheral blood in mutation positive patients with granulocytosis [ Designated as safety issue: No ]
  • Bone marrow fibrosis [ Designated as safety issue: No ]
  • Quality of life [ Designated as safety issue: No ]
Not Provided
Not Provided
 
CC-4047 in Treating Patients With Myelofibrosis
A Phase I/II, Prospective, Open-Label Study to Determine the Safety and Efficacy of CC-4047 in Patients With Primary, Post Polycythemia Vera, or Post Essential Thrombocythemia Myelofibrosis®

RATIONALE: Biological therapies, such as CC-4047, may stimulate the immune system in different ways and stop cancer cells from growing. CC-4047 may also stop the growth of cancer cells by blocking blood flow to the cancer.

PURPOSE: This trial is studying the side effects and best dose of CC-4047 and to see how well it works in treating patients with myelofibrosis.

OBJECTIVES:

Phase I:

Primary

  • To determine the Maximum Tolerated Dose of CC-4047 in the treatment of Primary, Post Polycythemia Vera, or Post Essential Thrombocythemia Myelofibrosis (PMF, post-PV MF, or post-ET MF).

Phase II:

Primary

  • Best overall response as determined by International Working Group Criteria over the first 6 cycles (168 days) of study treatment.

Secondary

  • Safety (type, frequency, severity [National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0] of adverse events (AEs), and relationship of AEs to CC-4047.
  • Duration of response.
  • Time to response.
  • Best overall response as determined by International Working Group Criteria over the first 12 cycles (336 days) of study treatment.

OUTLINE: Patients receive oral CC-4047. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 28 days and then every 6 months for up to 3 years.

Interventional
Phase 1
Phase 2
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Chronic Myeloproliferative Disorders
  • Secondary Myelofibrosis
Drug: CC-4047
CC-4047: taken orally each day in a 28 day cycle.
Experimental: CC-4047
Intervention: Drug: CC-4047
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
77
May 2014
July 2010   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • Diagnosis of primary and post essential thrombocythemia (ET) or post polycythemia vera (PV) myelofibrosis requiring therapy

    • De novo presentation (i.e., agnogenic myeloid metaplasia AND post ET or post PV myelofibrosis)
    • Developed after an antecedent history of PV (i.e., post polycythemic myeloid metaplasia) or essential polycythemia (i.e., post thrombocythemic myeloid metaplasia)
  • Total hemoglobin < 10 g/dL OR transfusion dependent anemia (defined by a history of ≥ 2 units of red blood cell (RBC) transfusions within the past 28 days for hemoglobin < 8.5 g/dL that was not associated with overt bleeding) OR marked splenomegaly (e.g., ≥ 10 cm below costal margin)

PATIENT CHARACTERISTICS:

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Absolute neutrophil count (ANC) ≥ 500/μL
  • Platelet count ≥ 20,000/μL
  • Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 3 times upper limit of normal (ULN) (≤ 5 times ULN if attributed to hepatic extramedullary hematopoiesis)
  • Total bilirubin ≤ 3 times ULN OR direct bilirubin ≤ 2 times ULN
  • Serum creatinine ≤ 2.0 mg/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective double-method contraception for ≥ 28 days before, during, and for ≥ 28 days after completion of study treatment
  • Agrees to abstain from donating blood, semen, or sperm during and for ≥ 28 days after completion of study treatment
  • Willing to undergo transfusion of blood products (if applicable)
  • Able to complete questionnaire(s) alone or with assistance
  • No known HIV positivity, hepatitis B carrier, or active hepatitis C infection
  • No serious medical condition, psychiatric illness, or any other condition, including the presence of laboratory abnormalities, that (as judged by the treating physician) would preclude giving informed consent or participating in the study or confound the ability to interpret data from the study
  • No other active malignancies, except basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast
  • No active deep vein thrombosis or pulmonary embolism that has not been therapeutically anticoagulated

PRIOR CONCURRENT THERAPY:

  • Recovered from all prior therapy
  • No prior CC-4047
  • More than 28 days since prior growth factors, cytotoxic chemotherapeutic agents (e.g., hydroxyurea or anagrelide), corticosteroids, or experimental drugs or therapies
  • No other concurrent experimental drugs or therapies or cytotoxic chemotherapeutic agents (e.g., hydroxyurea or anagrelide) for myelofibrosis
  • No concurrent growth factors (including erythropoietin) for myelofibrosis, except G-CSF or pegfilgrastim
  • No concurrent chronic use (i.e., > 2 weeks) of more than physiologic doses of corticosteroids (dose equivalent to > 10 mg/day of prednisone)
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00669578
MC078B, P30CA015083, MC078B, NCI-2009-01331, 07-005317, PO-MMM-PI-0007
Yes
Mayo Clinic
Mayo Clinic
National Cancer Institute (NCI)
Principal Investigator: Ruben A. Mesa, MD Mayo Clinic
Study Chair: Ayalew Tefferi, MD Mayo Clinic
Mayo Clinic
June 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP