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Phase 2 Midostaurin in Aggressive Systemic Mastocytosis and Mast Cell Leukemia

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ClinicalTrials.gov Identifier: NCT00233454
Recruitment Status : Completed
First Posted : October 5, 2005
Results First Posted : July 9, 2015
Last Update Posted : September 20, 2018
Sponsor:
Collaborators:
Novartis
Novartis Pharmaceuticals
Information provided by (Responsible Party):
Jason Robert Gotlib, Stanford University

Tracking Information
First Submitted Date  ICMJE October 3, 2005
First Posted Date  ICMJE October 5, 2005
Results First Submitted Date  ICMJE June 16, 2015
Results First Posted Date  ICMJE July 9, 2015
Last Update Posted Date September 20, 2018
Actual Study Start Date  ICMJE March 2005
Actual Primary Completion Date June 18, 2010   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 16, 2015)
Subjects With Clinical Response [Partial Response (PR) + Complete Response (CR)] [ Time Frame: 2 months ]
Clinical Response [PR + CR] will be assessed after 2 cycles of treatment, with each cycle being 28 days (4 weeks) in length. Except as otherwise noted, the minimum criteria for PR is improvement by at least 50% from the baseline value towards the indicated value for one or more of the criteria below: BONE MARROW & BLOOD
  • ANC <1000/uL
  • Hb <10 g/dL
  • Platelets >100,000/uL LIVER
  • If hepatomegaly with ascites, decrease in frequency of paracenteses by 50%
  • Elevated enzyme levels > upper limit of normal (ULN)
  • Hypoalbuminemia < ULN
  • Portal hypertension > ULN SPLEEN
  • If palpable splenomegaly with hypersplenism/thrombocytopenia, hypersplenism markers improved GI TRACT
  • If malabsorption with hypoalbuminemia and/or weight loss, albumin improved BONES
  • If huge osteolyses or/and severe osteoporosis with pathologic fractures, partial resolution of osteolyses
Subjects with PR or greater continue, those without response discontinue.
Original Primary Outcome Measures  ICMJE Not Provided
Change History Complete list of historical versions of study NCT00233454 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: September 19, 2018)
  • Overall Survival (OS) [ Time Frame: 11 months ]
    Overall survival will be assessed after 12 cycles of treatment, with each cycle being 28 days (4 weeks) in length. 12 cycles of treatment is considered to be about 11 months.
  • Overall Survival (OS) [ Time Frame: 40 months ]
    Overall survival was assessed as the median duration of survival at the time of data cut-off, and reported with 95% confidence interval.
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Phase 2 Midostaurin in Aggressive Systemic Mastocytosis and Mast Cell Leukemia
Official Title  ICMJE A Single Arm, Phase 2, Open-Label Study to Determine the Efficacy of Twice Daily Oral Dosing of PKC412 <Midostaurin> Administered to Patients With Aggressive Systemic Mastocytosis (ASM) and Mast Cell Leukemia (MCL)
Brief Summary The safety and efficacy of midostaurin (PKC412), a novel investigational drug, will be evaluated on the basis of response rate, when administered to patients with aggressive systemic mastocytosis (ASM) or mast cell leukemia (MCL)
Detailed Description

This study assesses the activity and safety profile of twice-daily oral doses of midostaurin in patients with aggressive systemic mastocytosis (ASM) or mast cell leukemia (MCL) with or without associated clonal hematological non-mast cell lineage disease (AHNMD).

Aggressive systemic mastocytosis (ASM) and mast cell leukemia (MCL) are characterized by excessive bone marrow production of mast cells which can can infiltrate tissues and release harmful substances, resulting in organ damage. These diseases have very limited treatment options and poor prognosis. Existing treatments for in advanced mast cell disease, eg, interferon-alpha; corticosteroids; and/or cladribine, exhibit low response rates that are usually partial in nature.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Systemic Mastocytosis, Aggressive (ASM)
  • Leukemia, Mast Cell
  • Hematological Non-mast Cell Lineage Disease (AHNMD)
Intervention  ICMJE Drug: Midostaurin
Midostaurin is a broad-spectrum protein kinase inhibitor, acting on conventional PKC isoforms (α, β, γ); PDFRβ; VEGFR2; Syk; PKCη; Flk-1; Flt3; Cdk1/B; PKA; c-Kit; c-Fgr; c-Src; VEGFR1; and EGFR
Other Names:
  • PKC412
  • CGP41251
  • CGP41231
Study Arms  ICMJE Experimental: Midostaurin
100 mg midostaurin twice daily as oral capsules
Intervention: Drug: Midostaurin
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: June 16, 2015)
26
Original Enrollment  ICMJE
 (submitted: October 3, 2005)
25
Actual Study Completion Date  ICMJE April 16, 2011
Actual Primary Completion Date June 18, 2010   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion criteria

  • At least 18 years of age.
  • Karnofsky performance status (KPS) of > 30% (equivalent to ECOG 0 to 3)
  • Mast cell disease, histologically confirmed and documented to be

    • Aggressive systemic mastocytosis (ASM) OR
    • Mast cell leukemia (MCL) meeting the following criteria

      • Meets criteria for systemic mastocytosis
      • Biopsy indicates diffuse infiltration by atypical, immature mast cells
      • Bone marrow aspirate smears show at least 20% mast cells
  • Confirmed availability of tissue sample within 6 months prior to entry into study, for evaluation of KIT mutation status of the tumor cells. Subjects who have systemic mastocytosis PLUS eosinophilia AND known positivity for FIP1L1-PDGFR-alpha fusion are eligible only if they have demonstrated relapse or disease progression on prior imatinib therapy
  • Blood levels of liver enzymes within normal limits (EXCEPTION: If the sole cause of elevated blood levels of liver enzymes is ASM/MCL, then AST and ALT ≤ 4X upper limit of normal (ULN), and/or bilirubin ≤ 4X ULN)
  • Serum creatinine < 2.0 mg/dL
  • If ANC < 1500/mm3; Hb < 10 g/dL; platelets < 75,000/mm3; AND/OR other blood values are > grade 2, then the relationship of these cytopenia(s) should be established as related to ASM or MCL on the basis of presence of mast cell infiltrate in the screening bone marrow exam and/or the presence of disease-related hypersplenism
  • Prior use of glucocorticoids must be tapered off within 14 days of Day 1 of midostaurin treatment (EXCEPTION: If in the opinion of the investigator, the subject can be tapered off glucocorticoids, then dosage should be tapered to the minimal dose possible before first treatment with midostaurin)
  • Negative serum pregnancy test for women of childbearing potential within 48 hours prior to administration of study drug
  • Written informed consent.
  • Anyone of reproductive potential must agree to use barrier contraceptives for the duration of the study
  • Women of childbearing potential must have a negative serum pregnancy test 48 hours prior to administration of study drug, and must agree to:

    • Use barrier contraception for the duration of the study
    • Use barrier contraception for 3 months post-study
    • Not breast-feed

Exclusion criteria

  • Active pulmonary disease based on physical assessment or lateral chest X-ray, considered by the investigator to be unrelated to mastocytosis
  • Any pulmonary infiltrate or abnormality on the baseline chest X-ray known to be new in the previous 4 weeks (EXCEPTION: pleural effusion related to systemic mastocytosis, eg, secondary to ascites, AND not causing symptomatic respiratory complaints, may be eligible)
  • Cardiovascular disease, including congestive heart failure
  • Myocardial infarction within 6 months
  • Poorly-controlled hypertension with any Grade 3/4 cardiac problems (per New York Heart Association Criteria)
  • Uncontrolled diabetes
  • Chronic renal disease
  • Active uncontrolled infection
  • Known malignant disease involving the central nervous system (CNS)
  • Known confirmed diagnosis of HIV infection or active viral hepatitis.
  • Any other known disease, or concurrent severe and/or uncontrolled medical condition which could compromise participation in the study, including but not limited to:
  • Received any investigational agent, chemotherapy, or 2-chlorodeoxyadenosine (2-CdA) within 30 days prior to Day 1 of PKC412 treatment.
  • Received interferon-alpha within 30 days prior to Day 1 of midostaurin treatment.
  • Received hematopoietic growth factor support within 14 days of Day 1 of midostaurin treatment.
  • Any surgical procedure, excluding central venous catheter placement or other minor procedures (eg, skin biopsy) within 14 days of Day 1 of midostaurin treatment
  • Pregnant or breast-feeding
  • Unwilling or unable to comply with the protocol
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT00233454
Other Study ID Numbers  ICMJE IRB-13704
95242 ( Other Identifier: Stanford University Secondary IRB Approval Number )
HEMMPD0003 ( Other Identifier: OnCore )
CPKC412D2201 ( Other Identifier: Novartis, Inc )
2213 ( Other Identifier: Novartis, Inc )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Jason Robert Gotlib, Stanford University
Study Sponsor  ICMJE Jason Robert Gotlib
Collaborators  ICMJE
  • Novartis
  • Novartis Pharmaceuticals
Investigators  ICMJE
Principal Investigator: Jason Robert Gotlib Stanford University
PRS Account Stanford University
Verification Date September 2018

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