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A Study of Momelotinib Versus Danazol in Symptomatic and Anemic Myelofibrosis Patients (MOMENTUM)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04173494
Recruitment Status : Recruiting
First Posted : November 22, 2019
Last Update Posted : February 11, 2020
Sponsor:
Information provided by (Responsible Party):
Sierra Oncology, Inc.

Tracking Information
First Submitted Date  ICMJE November 20, 2019
First Posted Date  ICMJE November 22, 2019
Last Update Posted Date February 11, 2020
Actual Study Start Date  ICMJE November 20, 2019
Estimated Primary Completion Date December 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: November 20, 2019)
Total Symptom Score (TSS) response rate at Week 24 measured using the Myelofibrosis Symptom Assessment Form v4.0 [ Time Frame: Week 24 landmark. ]
Difference in TSS response rate at Week 24. TSS response is defined as the proportion of subjects who achieve a ≥ 50% reduction in TSS over the 28 days immediately prior to the end of Week 24 compared to baseline
Original Primary Outcome Measures  ICMJE Same as current
Change History Complete list of historical versions of study NCT04173494 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: November 20, 2019)
  • Transfusion independence (TI) status at Week 24 [ Time Frame: Week 24 landmark. ]
    Proportion of subjects with TI status at the end of Week 24. TI is defined as not requiring RBC transfusion (except in the case of clinically overt bleeding) for ≥ 12 weeks immediately prior to the end of Week 24, with Hgb levels ≥ 8 g/dL.
  • Splenic response rate (SRR) at Week 24 [ Time Frame: Week 24 ]
    Proportion of subjects who have splenic response (reduction in spleen volume of ≥ 35% from baseline) at the end of Week 24
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE A Study of Momelotinib Versus Danazol in Symptomatic and Anemic Myelofibrosis Patients (MOMENTUM)
Official Title  ICMJE A Randomized, Double-Blind, Phase 3 Study of Momelotinib vs Danazol in Symptomatic, Anemic Subjects With Previously JAKi Treated Primary Myelofibrosis, Post-Polycythemia Vera Myelofibrosis, or Post Essential Thrombocythemia Myelofibrosis
Brief Summary

MOMENTUM is a randomized, double-blind, active control Phase 3 trial intended to confirm the differentiated clinical benefits of the investigational drug momelotinib (MMB) versus danazol (DAN) in symptomatic and anemic subjects who have previously received an approved Janus kinase inhibitor (JAKi) therapy for myelofibrosis (MF). The purpose of this clinical study is to compare the effectiveness and safety of MMB to DAN in treating and reducing: 1) disease related symptoms, 2) the need for blood transfusions and 3) splenomegaly, in adults with primary MF, post-polycythemia vera MF or post-essential thrombocythemia MF. The study is planned in countries including, but not limited to: Australia, Austria, Belgium, Bulgaria, Canada, Czech Republic, Denmark, France, Germany, Hungary, Israel, Italy, New Zealand, Poland, Romania, Singapore, South Korea, Spain, Sweden, Taiwan, UK, and US.

Subjects must be symptomatic with a MFSAF v4.0 Total Symptom Score of ≥ 10 at screening, and be anemic with Hgb < 10 g/dL. For subjects with ongoing JAKi therapy at screening, JAKi therapy must be tapered over a period of at least 1 week, followed by a 2-week non-treatment washout interval prior to randomization.

Subjects will be randomized 2:1 to orally self-administer blinded treatment: MMB plus placebo or DAN plus placebo. Subjects randomized to receive MMB who complete the randomized treatment period to the end of Week 24 may continue to receive MMB in the open-label extended treatment period to the end of Week 204 (a total period of treatment of approximately 4 years) if the subject tolerates and continues to benefit from MMB.

Subjects randomized to receive DAN may cross-over to MMB open-label treatment in the following circumstances:

  • at the end of Week 24 if they complete the randomized treatment period; or
  • at the end of Week 24 if they discontinue treatment with DAN but continue study assessments and do not receive prohibited medications including alternative active anti-MF therapy; or
  • at any time during the randomized treatment period if they meet the protocol-defined criteria for radiographically-confirmed symptomatic splenic progression.

Subjects randomized to receive DAN who are receiving clinical benefit at the end of Week 24 may choose to continue DAN therapy up to Week 48. The comparator treatment, DAN, is an approved medication in the US and in some other countries and is recommended by national guidelines as a treatment for anemia in MF.

Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description:
During the 24 week randomized treatment phase of the study, subjects, investigators and sponsor and relevant vendor personnel (with the exception of specified unblinded personnel, for example clinical supply) will remain blinded to the subject's treatment assignment and to aggregate data that may lead to inadvertent unblinding. Subjects who continue treatment with momelotinib or danazol after Week 24 in the extended treatment phase will receive unblinded treatment.
Primary Purpose: Treatment
Condition  ICMJE
  • Primary Myelofibrosis
  • Post-polycythemia Vera Myelofibrosis
  • Post-essential Thrombocythemia Myelofibrosis
Intervention  ICMJE
  • Drug: Momelotinib
    Momelotinib tablets will be self-administered orally once daily
    Other Name: MMB, GS-0387, CYT387
  • Drug: Danazol
    Danazol capsules will be self-administered orally twice daily
    Other Name: Danocrine
  • Drug: Placebo to match momelotinib
    Momelotinib placebo tablets will be self-administered orally once daily
  • Drug: Placebo to match danazol
    Danazol placebo capsules will be self-administered orally twice daily
Study Arms  ICMJE
  • Experimental: Momelotinib
    Participants will receive momelotinib plus placebo to match danazol
    Interventions:
    • Drug: Momelotinib
    • Drug: Placebo to match danazol
  • Active Comparator: Danazol
    Participants will receive danazol plus placebo to match momelotinib
    Interventions:
    • Drug: Danazol
    • Drug: Placebo to match momelotinib
Publications * Not Provided

*   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 Recruiting
Estimated Enrollment  ICMJE
 (submitted: November 20, 2019)
180
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE April 2028
Estimated Primary Completion Date December 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Age ≥ 18 years.
  2. Confirmed diagnosis of PMF in accordance with the World Health Organization (WHO) 2016 criteria, or Post-PV/ET MF in accordance with the International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT criteria).
  3. Symptomatic, defined as a TSS of ≥ 10 units assessed by a single MFSAF v4.0 assessment at a Screening visit.
  4. Anemic, defined as a Hgb < 10 g/dL in Screening/Baseline period.
  5. Previously treated with an approved JAK inhibitor for PMF or Post-PV/ET MF for ≥ 90 days, or ≥ 28 days if JAK inhibitor therapy is complicated by RBC transfusion requirement of ≥ 4 units in 8 weeks, or Grade 3/4 AEs of thrombocytopenia, anemia, or hematoma.
  6. Baseline splenomegaly, defined as having a palpable spleen at ≥ 5 cm, below the left costal margin, or with volume ≥ 450 cm³ on imaging (ultrasound, MRI or CT are acceptable), assessed during Screening at any point prior to Randomization.
  7. High risk, intermediate-2, or intermediate-1 risk MF as defined by DIPSS, or DIPSS-plus.
  8. No allogeneic stem cell transplant planned.
  9. Acceptable laboratory assessments:

    • Absolute neutrophil count (ANC) ≥ 0.75 × 10⁹/L.
    • Platelet count (PLT) ≥ 25 × 10⁹/L.
    • Peripheral blast count < 10%.
    • Alanine aminotransferase/ glutamic-oxaloacetic transaminase (AST/SGOT) and alanine aminotransferase/ serum glutamic-pyruvic transaminase (ALT/SGPT) ≤ 3 × ULN (≤ 5 × ULN if liver is involved by extramedullary hematopoiesis as judged by the investigator or if related to iron chelator therapy that was started within the prior 60 days).
    • Calculated creatinine clearance (CCr) ≥ 30 mL/min according to Cockcroft-Gault.
    • Direct bilirubin ≤ 2.0 × ULN.

Exclusion Criteria:

  1. Use of the following treatments within the time periods noted:

    1. Prior momelotinib treatment at any time.
    2. JAK inhibitor therapy within 2 weeks prior to Randomization.
    3. Active anti-MF therapy within 2 weeks prior to Randomization.
    4. Potent Cytochrome P450 3A4 (CYP3A4) inducers within 1 week prior to Randomization.
    5. Investigational agent within 4 weeks prior to Randomization.
    6. Erythropoiesis stimulating agent (ESA) within 4 weeks prior to Randomization.
    7. Danazol within 3 months prior to Randomization.
    8. Splenic irradiation within 3 months prior to Randomization.
    9. Current treatment with simvastatin, atorvastatin, lovastatin or rosuvastatin.
  2. History of prostate cancer, with the exception of localized prostate cancer that has been treated surgically or by radiotherapy with curative intent and presumed cured.
  3. Prostate specific antigen (PSA) > 4 ng/mL.
  4. Unsuitable for spleen volume measurements due to prior splenectomy or unwilling or unable to undergo an MRI or CT scan for spleen volume measurement per protocol requirements.
  5. Any of the following (criteria a - k):

    1. Uncontrolled intercurrent illness including, but not limited to: active uncontrolled infection (subjects receiving outpatient antibacterial and/or antiviral treatments for infection that is under control or as infection prophylaxis may be included in the trial).
    2. Significant active or chronic bleeding event ≥ Grade 2 per Common Terminology Criteria for Adverse Events (CTCAE) v5.0, within 4 weeks prior to Randomization.
    3. Unstable angina pectoris within 6 months prior to Randomization.
    4. Symptomatic congestive heart failure within 6 months prior to Randomization.
    5. Uncontrolled cardiac arrhythmia within 6 months prior to Randomization.
    6. QTcF interval > 500 msec, unless attributed to bundle branch block.
    7. Current progressive thrombosis despite treatment.
    8. History of porphyria.
    9. Child-Pugh score ≥ 10.
    10. Psychiatric illness, social situation, or any other condition that would limit compliance with trial requirements or may interfere with the interpretation of study results, as judged by investigator or sponsor.
    11. Inability or unwillingness to comply with the protocol restrictions on MF therapy and other medications prior to and during study treatment.
  6. Subjects with a prior or concurrent malignancy, whose natural history or treatment has a significant potential to interfere with the safety or efficacy assessment of the investigational regimen.
  7. Known clinically significant anemia due to iron, vitamin B12, or folate deficiencies, or autoimmune or hereditary hemolytic anemia, or gastrointestinal bleeding.
  8. Known positive status for HIV.
  9. Chronic active or acute viral hepatitis A, B, or C infection, or hepatitis B or C carrier (testing required for hepatitis B and C).
  10. Unresolved non-hematologic toxicities from prior therapies that are > Grade 1 per CTCAE v5.0.
  11. Presence of peripheral neuropathy ≥ Grade 2 per CTCAE v5.0.
  12. Women who are already pregnant or lactating.
  13. Additional inclusion/exclusion criteria may apply.
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: MOMENTUM contact Sierra_Momentum_ct.gov@clin-edge.com
Listed Location Countries  ICMJE Australia,   Hungary,   Israel,   Korea, Republic of,   New Zealand,   United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04173494
Other Study ID Numbers  ICMJE SRA-MMB-301
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Sierra Oncology, Inc.
Study Sponsor  ICMJE Sierra Oncology, Inc.
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Srdan Verstovsek, M.D., Ph.D. Department of Leukemia, The University of Texas MD Anderson Cancer Center
PRS Account Sierra Oncology, Inc.
Verification Date February 2020

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