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Open Label Ruxolitinib (INCB018424) in Patients With Myelofibrosis and Post Polycythemia Vera/Essential Thrombocythemia Myelofibrosis

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. Read our disclaimer for details. Identifier: NCT00509899
Recruitment Status : Completed
First Posted : August 1, 2007
Results First Posted : August 2, 2012
Last Update Posted : March 12, 2018
Information provided by (Responsible Party):
Incyte Corporation

Brief Summary:
To determine the safety, tolerability and effectiveness of ruxolitinib (INCB018424), administered orally to patients with Primary Myelofibrosis (PMF), Post Polycythemia Vera Myelofibrosis (PPV-MF) and Essential Thrombocythemia Myelofibrosis (PET-MF).

Condition or disease Intervention/treatment Phase
Myelofibrosis Polycythemia Vera Thrombocytosis Drug: Ruxolitinib Phase 1 Phase 2

Detailed Description:

This is a multicenter, open-label, non-randomized, dose escalation study of ruxolitinib, a small molecule Janus kinase (JAK) inhibitor, administered orally to patients with PMF, PPEV-MF or PET-MF. The study is comprised of 3 parts:

Part 1: Dose escalation and determination of maximum tolerated dose (complete).

Part 2: Exploration of alternative dosing schedules (complete).

Part 3: Further evaluation of selected dose regimens, including additional response measures to explore effect of ruxolitinib on symptoms and other parameters including daily physical activity and long-term survival (ongoing).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 154 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2, Open-Label Study of the JAK2 Inhibitor INCB018424 Administered Orally to Patients With Primary Myelofibrosis (PMF) and Post Polycythemia Vera/Essential Thrombocythemia Myelofibrosis (Post-PV/ET)
Study Start Date : June 2007
Actual Primary Completion Date : December 2007
Actual Study Completion Date : February 2017

Arm Intervention/treatment
Experimental: Ruxolitinib
All participants received oral ruxolitinib. Patients began treatment with either 10 mg twice a day (bid), 15 mg bid, 25 mg bid, 50 mg bid, 25 mg once a day (qd), 50 mg qd, 100 mg qd, or 200 mg qd, depending on the time period when they entered the study. The doses were titrated based on efficacy and safety to a maximum of 25 mg bid for patients who entered the study after sufficient dosing information had been obtained to define the maximum dose for patients in the study. Patients could continue receiving treatment indefinitely if receiving benefit at a dose that continues to maintain benefit but does not exceed a maximum dose of 25 mg BID.
Drug: Ruxolitinib
5 and 25 mg tablets with a daily dosing range from 10 to 200 mg qd or bid.
Other Names:
  • INCB018424
  • Jakafi(TM)

Primary Outcome Measures :
  1. Number of Participants With Adverse Events (AEs) [ Time Frame: From Baseline to the interim clinical cut-off date (31 December 2009). The median time on study was 14.8 months, with a range of 26 days to 29.7 months. As of March 1, 2011 the total exposure to ruxolitinib was 269 patient-years. ]

    Treatment-Emergent AEs are events occurring after first drug administration or worsened from baseline.

    Treatment-Related AEs are those with a definite, probable, possible or missing causality.

    A serious AE is a medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is a medical event requiring intervention to prevent 1 of the above.

    A severe or life-threatening AE is based on intensity, according to National Cancer Institute-Common Toxicity Criteria for Adverse Effects (NCI-CTCAE) v3.0.

  2. Percentage of Participants With Clinical Improvement (CI) Over Time [ Time Frame: Week 12, 24, 36, 48 and 60 ]

    Clinical improvement was defined according to the International Working Group Myelofibrosis Research and Treatment criteria, and required 1 of the following:

    1. A ≥ 2 g/dL increase in Hemoglobin level or becoming transfusion independent;
    2. Either a ≥ 50% reduction in palpable splenomegaly if spleen was ≥ 10 cm at Baseline or a spleen palpable at > 5 cm at Baseline becomes not palpable;
    3. A ≥ 100% increase in platelet count and an absolute platelet count of ≥ 50,000 x 10^9/L or
    4. A ≥ 100% increase in absolute neutrophil count (ANC) and an ANC of ≥ 0.5 x 10^9/L.

Secondary Outcome Measures :
  1. Percentage of Participants Achieving ≥ 50% Reduction From Baseline in Spleen Palpation Length Over Time [ Time Frame: Baseline and Weeks 4, 8, 12, 24, 36, 48 and 60 ]
    For each visit, patients who had a missing value at the visit, dropped out of the study due to any reasons prior to the visit or had non-palpable spleen at baseline and then became palpable at the time of the visit were all considered as having not achieved the ≥ 50% reduction in spleen palpation length.

  2. Percentage of Participants With ≥ 35% Reduction From Baseline in Spleen Volume Over Time [ Time Frame: Baseline, Weeks 4, 12, 24 and 48 ]

    Spleen volume was assessed in a subgroup of 27 patients using magnetic resonance imaging (MRI) scans (or computed tomography (CT) scans in patients who were not candidates for MRI) of the abdomen in order to allow objective measurement of spleen volume using standard estimation techniques.

    For each visit, patients who had a missing value at the visit or dropped out of the study due to any reason prior to the visit were considered as not having achieved the ≥35% reduction in spleen volume.

  3. Change From Baseline in Myelofibrosis Total Symptom Score at Week 24 [ Time Frame: Baseline and Week 24 ]
    Symptoms of myelofibrosis were assessed using a modified Myelofibrosis Symptom Assessment Form (MFSAF). Abdominal discomfort, itching, muscle or bone pain, and night sweats are prominent and troubling symptoms in patients with MF. Therefore, the MFSAF-derived responses for these symptoms were analyzed as a total symptom score. Each symptom was assessed on a scale from 0 (absent), 1 (most favorable) to 10 (worst). The total symptom score is a sum of the individual scores and ranges from 0-40. A higher score indicates worse symptoms hence a negative change from baseline indicates improvement.

  4. Change From Baseline to Week 24 in Health-Related Quality of Life [ Time Frame: Baseline and Week 24 ]
    Health-related Quality of Life was assessed using the Global Health Status/Quality of Life Scale of the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). This scale ranges from 0 to 100, with higher scores indicating higher quality of life.

  5. Change From Baseline in Body Weight Over Time [ Time Frame: Baseline and Weeks 4, 8, 12, 24, 36, 48 and 60. ]
  6. Change From Baseline to Week 24 in Eastern Cooperative Oncology Group (ECOG) Performance Status [ Time Frame: Baseline and Week 24 ]

    The ECOG performance status measures patients' functional status on the following scale:

    • 0=Fully active, no restrictions;
    • 1=Restricted in physically strenuous activity but ambulatory, able to carry out light work;
    • 2=Ambulatory and capable of all selfcare, unable to carry out any work activities; Up and about > 50% of waking hours;
    • 3=Limited selfcare, confined to bed or chair more than 50% of waking hours;
    • 4=Completely disabled. Totally confined to bed or chair;
    • 5=Dead.

    Data reported indicate the number of participants with a change from Baseline score of -2, -1, 0 and 1.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosed with PMF or Post-PV/ET MF
  • Patients with myelofibrosis requiring therapy
  • Adequate bone marrow reserve

Exclusion Criteria:

  • Received anti-cancer medications or investigational therapy in the past 14 days

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00509899

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United States, Minnesota
Rochester, Minnesota, United States
United States, Texas
Houston, Texas, United States
Sponsors and Collaborators
Incyte Corporation
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Principal Investigator: Srdan Verstovsek, MD, PhD M.D. Anderson Cancer Center, Houston, TX
Principal Investigator: Ayalew Tefferi, MD Mayo Clinic, Rochester, MN
Publications of Results:
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Incyte Corporation Identifier: NCT00509899    
Other Study ID Numbers: INCB 18424-251
First Posted: August 1, 2007    Key Record Dates
Results First Posted: August 2, 2012
Last Update Posted: March 12, 2018
Last Verified: February 2018
Additional relevant MeSH terms:
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Polycythemia Vera
Primary Myelofibrosis
Thrombocythemia, Essential
Myeloproliferative Disorders
Bone Marrow Diseases
Hematologic Diseases
Bone Marrow Neoplasms
Hematologic Neoplasms
Neoplasms by Site
Blood Platelet Disorders
Blood Coagulation Disorders
Hemorrhagic Disorders