Clinical trial NCT01842646: Phase II Hedgehog Inhibitor for Myelodysplastic Syndrome (MDS)
Official title: A Phase II Study Evaluating the Oral Smoothened Inhibitor PF-04449913 in Patients With Myelodysplastic Syndrome (MDS)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Myelodysplastic Syndrome (MDS)
Chronic Myelomonocytic Leukemia (CMML)
Keywords: Leukemia
Myeloid Malignancies
Lead sponsor: H. Lee Moffitt Cancer Center and Research Institute
Sponsor class: OTHER
Collaborators: name: Pfizer
First posted: 2013-04-29
Enrollment: 35
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study is being done to see how safe an investigational drug is and test how well it will work to help people with refractory/relapsed myelodysplastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML).

Detailed description: The main purpose of this study is to see whether the participant's disease responds favorably to the investigational drug, PF-04449913.

Post treatment Phase: After coming off of active treatment study drug (PF-04449913), participants will be followed monthly for survival only. No other data will be captured during this time.

Eligibility criteria: Inclusion Criteria:

* Must have a pathologically confirmed diagnosis by World Health Organization (WHO) Criteria of MDS, CMML, or acute myeloid leukemia (AML) (except acute promyelocytic leukemia) with \< 30% bone marrow blasts (RAEB-t by French American British criteria)
* Hypomethylating agent (azacitidine and/or decitabine) failure, defined as lack of response, disease progression, loss of response, or intolerance as deemed by the study investigator
* Adequate renal function, as evidenced by a serum creatinine ≤ 2 times the institutional upper limit of normal
* Adequate hepatic function, as evidenced by a serum bilirubin \< 2 times the institutional upper limit of normal and an aspartic transaminase (AST) and alanine transaminase (ALT) \< 2 times the institutional upper limit of normal. Indirect hyperbilirubinemia due to Gilbert's disease or hemolysis is permitted.
* Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
* Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
* Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

* Patients with a history of prior therapy with another investigational agent within 4 weeks of the first planned dose of PF-0444913
* Patients may not be receiving any other investigational agents.
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to PF-04449913
* Prior therapy with another hedgehog inhibitor
* Concurrent use of any other agent for MDS, CMML, or AML. Growth factor use with epoetin, darbepoetin, or granulocyte colony-stimulating factor must be terminated at least 2 weeks before initiation of study treatment.
* Any uncontrolled concurrent illness that would, in the opinion of the investigator, limit compliance with study requirements
* Second malignancy requiring active therapy
* A prolonged corrected QT interval (QTc) of ≥480 ms interval on electrocardiogram
* History of metastatic cancer diagnosed less than 2 years prior to the first planned dose of PF-0444913
* Uncontrolled concurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* Pregnant women are excluded from this study because PF-04449913 is smoothened inhibitor with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with PF-04449913. Breastfeeding should be discontinued if the mother is treated with PF-04449913.
* Patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy. Therefore, HIV-positive patients receiving combination antiretroviral therapy are excluded from the study because of possible pharmacokinetic interactions with PF-04449913.

Primary outcomes:
measure: Overall International Working Group (IWG) 2006 Response Rate
timeFrame: Up to 2 years, 4 months
Secondary outcomes:
measure: Median Overall Survival (OS)
timeFrame: Up to 2 years, 4 months
measure: Median Event Free Survival
timeFrame: Up to 2 years, 4 months
measure: Median Time to Transformation to Acute Myeloid Leukemia (AML)
timeFrame: Up to 2 years, 4 months
measure: Number of Participants With Treatment Emergent Adverse Events
timeFrame: 2 years, 4 months
Other outcomes:
Locations:
city: Tampa
country: United States
facility: H. Lee Moffitt Cancer Center and Research Institute
state: Florida
Study officials:
affiliation: H. Lee Moffitt Cancer Center and Research Institute
name: Jeffrey Lancet, M.D.
role: PRINCIPAL_INVESTIGATOR
References: