Momelotinib Versus Ruxolitinib in Subjects With Myelofibrosis (Simplify 1)
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Purpose
This study is to determine the efficacy of momelotinib (MMB) versus ruxolitinib in participants with primary myelofibrosis (PMF) or post-polycythemia vera or post-essential thrombocythemia myelofibrosis (post-PV/ET MF) who have not yet received treatment with a Janus kinase inhibitor (JAK inhibitor).
Participants will be randomized to receive either MMB or ruxolitinib for 24 weeks during a double-blind treatment phase, after which they will be eligible to receive open-label MMB for up to an additional 168 weeks. After discontinuation of study medication, assessments will continue for 12 additional weeks, after which participants will be contacted for survival follow-up approximately every 6 months for up to 5 years from the date of enrollment.
| Condition | Intervention | Phase |
|---|---|---|
| Primary Myelofibrosis Post-Polycythemia Vera Myelofibrosis Post-Essential Thrombocythemia Myelofibrosis | Drug: Momelotinib Drug: Ruxolitinib Drug: Placebo to match momelotinib Drug: Placebo to match ruxolitinib | Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Participant, Care Provider, Investigator, Outcomes Assessor Primary Purpose: Treatment |
| Official Title: | A Phase 3, Randomized, Double-blind Active-controlled Study Evaluating Momelotinib vs. Ruxolitinib in Subjects With Primary Myelofibrosis (PMF) or Post-Polycythemia Vera or Post-Essential Thrombocythemia Myelofibrosis (Post-PV/ET MF) |
- Splenic response rate at Week 24 [ Time Frame: Week 24 ]Splenic response rate at Week 24 is defined as the proportion of participants achieving a ≥ 35% reduction in spleen volume at Week 24 from baseline as measured by MRI or CT.
- Response rate in total symptom score at Week 24 [ Time Frame: Week 24 ]Total symptom score (TSS) is defined as the proportion of participants who achieve a ≥ 50% reduction in TSS from baseline to Week 24 as measured by the modified Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (MPNSAF TSS) v2.0 diary.
- Rate of red blood cell (RBC) transfusion through Week 24 [ Time Frame: Baseline to Week 24 ]Rate of RBC transfusion is defined as the average number of RBC units per participant per month.
- RBC transfusion independence rate at Week 24 [ Time Frame: Week 24 ]RBC transfusion independence is the proportion of participants who are transfusion independent at Week 24, defined as absence of RBC transfusions and no hemoglobin level below 8 g/dL in the prior 12 weeks.
- RBC transfusion dependence rate at Week 24 [ Time Frame: Week 24 ]RBC transfusion dependence is the proportion of participants who are transfusion dependent at Week 24, defined as at least 4 units of RBC transfusions, or a hemoglobin level below 8 g/dL in the prior 8 weeks.
| Enrollment: | 432 |
| Actual Study Start Date: | December 6, 2013 |
| Estimated Study Completion Date: | June 2018 |
| Primary Completion Date: | September 12, 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Momelotinib
Participants will receive momelotinib plus placebo to match ruxolitinib.
|
Drug: Momelotinib
Momelotinib tablet administered orally once daily
Other Names:
Drug: Placebo to match ruxolitinib
Placebo to match ruxolitinib tablets administered orally twice daily
|
|
Active Comparator: Ruxolitinib
Participants will receive ruxolitinib plus placebo to match momelotinib.
|
Drug: Ruxolitinib
Ruxolitinib tablets administered orally twice daily
Drug: Placebo to match momelotinib
Placebo to match momelotinib tablets administered orally once daily
|
Eligibility| Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Key Inclusion Criteria:
- Palpable splenomegaly at least 5 cm below the left costal margin
- Confirmed diagnosis of PMF or post-PV/ET MF
- Requires myelofibrosis therapy, in the opinion of the investigator
- Classified as high risk OR intermediate-2 risk as defined by the International Prognostic Scoring System (IPSS) for PMF, or intermediate-1 risk (IPSS) associated with symptomatic splenomegaly, hepatomegaly, anemia (hemoglobin < 10.0 g/dL), and/or unresponsive to available therapy
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Acceptable laboratory assessment obtained within 14 days prior to the first dose of study drug:
- Absolute neutrophil count (ANC) ≥ 0.75 x 10^9/L in the absence of growth factor in the prior 7 days
- Platelet Count ≥ 50 x 10^9/L (≥ 100 x 10^9/L if aspartate aminotransferase [AST] or alanine aminotransferase [ALT] is ≥ 2 x the upper limit of the normal range [ULN]) in the absence of platelet transfusion(s) or thrombopoietin mimetics in the prior 7 days
- Peripheral blood blast count < 10%
- AST and ALT ≤ 3 x ULN (≤ 5 x 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 (CrCL) of ≥ 45 mL/min
- Direct bilirubin ≤ 2.0 x ULN
- Life expectancy of > 24 weeks
- Males and females of childbearing potential must agree to use protocol-specified method(s) of contraception
- Females who are nursing must agree to discontinue nursing before the first dose of study drug
- Able to understand and willing to sign the informed consent form
Key Exclusion Criteria:
- Prior splenectomy
- Splenic irradiation within 3 months prior to the first dose of study drug
- Eligible for allogeneic bone marrow or stem cell transplantation
- Uncontrolled inter-current illness, per protocol.
- Known positive status for human immunodeficiency virus (HIV)
- Chronic active or acute viral hepatitis A, B, or C infection, or a hepatitis B or C carrier
- Prior use of a JAK1 or JAK2 inhibitor
- Use of chemotherapy, immunomodulating therapy, biologic therapy, radiation therapy, or investigational therapy within 4 weeks of the first dose of study drug
- Presence of peripheral neuropathy ≥ Common Terminology Criteria for Adverse Events (CTCAE) Grade 2
- Unwilling or unable to undergo a magnetic resonance imaging (MRI) or computed tomography (CT) scan
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT01969838
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| United States, Arizona | |
| Phoenix, Arizona, United States | |
| United States, California | |
| Escondido, California, United States | |
| Stanford, California, United States | |
| United States, Florida | |
| Jacksonville, Florida, United States | |
| United States, Georgia | |
| Atlanta, Georgia, United States | |
| United States, Illinois | |
| Chicago, Illinois, United States | |
| United States, Maryland | |
| Baltimore, Maryland, United States | |
| United States, Massachusetts | |
| Boston, Massachusetts, United States | |
| United States, Missouri | |
| Saint Louis, Missouri, United States | |
| United States, North Carolina | |
| Durham, North Carolina, United States | |
| United States, Washington | |
| Seattle, Washington, United States | |
| Australia, New South Wales | |
| Darlinghurst, New South Wales, Australia | |
| Parkville, New South Wales, Australia | |
| Saint Leonards, New South Wales, Australia | |
| Australia, Queensland | |
| Brisbane, Queensland, Australia | |
| Herston, Queensland, Australia | |
| Australia, South Australia | |
| Adelaide, South Australia, Australia | |
| Bedford Park, South Australia, Australia | |
| Australia, Victoria | |
| Frankston, Victoria, Australia | |
| Melbourne, Victoria, Australia | |
| Australia, Western Australia | |
| Perth, Western Australia, Australia | |
| Austria | |
| Wien, Vienna, Austria | |
| Belgium | |
| Charleroi, Hainaut, Belgium | |
| Antwerp, Belgium | |
| Leuven, Belgium | |
| Liege, Belgium | |
| Bulgaria | |
| Pleven, Bulgaria | |
| Plovdiv, Bulgaria | |
| Ruse, Bulgaria | |
| Sofia, Bulgaria | |
| Varna, Bulgaria | |
| Canada, Alberta | |
| Edmonton, Alberta, Canada | |
| Canada, British Columbia | |
| Vancouver, British Columbia, Canada | |
| Canada, Ontario | |
| Hamilton, Ontario, Canada | |
| Toronto, Ontario, Canada | |
| Czechia | |
| Hradec Kralove, Vychodocesky Kraj, Czechia | |
| Brno, Czechia | |
| Ostrava, Czechia | |
| Denmark | |
| Aalborg, Denmark | |
| Herlev, Denmark | |
| France | |
| Toulouse cedex 9, Midi-pyrenees, France | |
| Pierre Bénite Cedex, Rhone-alpes, France | |
| Le Kremlin Bicetre Cedex, France | |
| Lens, France | |
| Lille Cedex, France | |
| Marseille Cedex 9, France | |
| Nantes cedex 1, France | |
| Paris, France | |
| Pessac Cedex, France | |
| Villejuif Cedex, France | |
| Germany | |
| München, Bayern, Germany | |
| Leipzig, Sachsen, Germany | |
| Dresden, Germany | |
| Dusseldorf, Germany | |
| Freiburg, Germany | |
| Hamburg, Germany | |
| Mainz, Germany | |
| Mannheim, Germany | |
| Hungary | |
| Budapest, Hungary | |
| Debrecen, Hungary | |
| Kaposvár, Hungary | |
| Israel | |
| Afula, Israel | |
| Ashkelon, Israel | |
| Haifa, Israel | |
| Jerusalem, Israel | |
| Tel Aviv, Israel | |
| Japan | |
| Ogaki City, Gifu, Japan | |
| Kitaku Sapporo, Hokkaido, Japan | |
| Osaka Sayama, Osaka, Japan | |
| Osaka-City, Osaka, Japan | |
| Bunkyo-ku, Tokyo, Japan | |
| Fukushima City, Japan | |
| Kumamoto City, Japan | |
| Matsuyama, Japan | |
| Okayama, Japan | |
| Korea, Republic of | |
| Seoul, Korea, Republic of | |
| Netherlands | |
| Maastricht, Netherlands | |
| Nijmegen, Netherlands | |
| Rotterdam, Netherlands | |
| Utrecht, Netherlands | |
| Poland | |
| Lodz, Lodzkie, Poland | |
| Lublin, Lubelskie, Poland | |
| Kraków, Malopolskie, Poland | |
| Warszawa, Mazowiekie, Poland | |
| Gdansk, Pomorskie, Poland | |
| Poznan, Wielkopolskie, Poland | |
| Bialystok, Poland | |
| Brzozow, Poland | |
| Chorzow, Poland | |
| Romania | |
| Arad, Romania | |
| Brasov, Romania | |
| Bucuresti, Romania | |
| Cluj-Napoca, Romania | |
| Iasi, Romania | |
| Singapore | |
| Singapore, Singapore | |
| Spain | |
| Majadahonda, Madrid, Spain | |
| Pamplona, Navarra, Spain | |
| Badalona, Spain | |
| Barcelona, Spain | |
| Valencia, Spain | |
| Zaragoza, Spain | |
| Sweden | |
| Lund, Skane, Sweden | |
| Stockholm, Sweden | |
| Uddevalla, Sweden | |
| Örebro, Sweden | |
| Taiwan | |
| Kaohsiung, Taiwan | |
| United Kingdom | |
| Leicester, England, United Kingdom | |
| London, England, United Kingdom | |
| Manchester, England, United Kingdom | |
| Newcastle Upon Tyne, England, United Kingdom | |
| Oxford, England, United Kingdom | |
| Cardiff, Wales, United Kingdom | |
| Northern Ireland, United Kingdom | |
| Nottingham, United Kingdom | |
| Study Director: | Gilead Study Director | Gilead Sciences |
More Information
| Responsible Party: | Gilead Sciences |
| ClinicalTrials.gov Identifier: | NCT01969838 History of Changes |
| Other Study ID Numbers: |
GS-US-352-0101 2013-002707-33 ( EudraCT Number ) |
| Study First Received: | October 22, 2013 |
| Last Updated: | May 12, 2017 |
| Studies a U.S. FDA-regulated Drug Product: | Yes | |
| Studies a U.S. FDA-regulated Device Product: | No | |
Additional relevant MeSH terms:
|
Primary Myelofibrosis Polycythemia Polycythemia Vera Thrombocytosis Thrombocythemia, Essential Myeloproliferative Disorders |
Bone Marrow Diseases Hematologic Diseases Blood Platelet Disorders Blood Coagulation Disorders Hemorrhagic Disorders |
ClinicalTrials.gov processed this record on July 17, 2017


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