Clinical trial NCT05020652: A Clinical Trial of TQ05105 Tablets in the Treatment of Moderate and High Risk Myelofibrosis
Official title: A Randomized, Double Blind, Double Dummy, Parallel Controlled, Multicenter Phase II Clinical Trial of TQ05105 Tablets Versus Hydroxyurea Tablets in the Treatment of Moderate and High Risk Myelofibrosis
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
Conditions: Moderate and High Risk Myelofibrosis
Lead sponsor: Chia Tai Tianqing Pharmaceutical Group Co., Ltd.
Sponsor class: INDUSTRY
First posted: 2021-08-25
Enrollment: 105
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Q05105 tablet is a Janus kinase 2 (JAK2) inhibitor, which can be used to treat JAK2 target related diseases, such as moderate or high-risk multiple myelofibrosis


Eligibility criteria: Inclusion Criteria:

1. The subjects volunteered to join the study and signed informed consent, with good compliance;
2. Age: 18-75 years old (when signing the informed consent form); Eastern Cooperative oncology Group (ECoG) Performance Status (PS) score: 0-2; The expected survival time is more than 24 weeks;
3. Primary Myelofibrosis (PMF) was diagnosed according to World Health Organization (WHO) standard (2016 Edition), or Post Polycythemia Vera(PV)-MF or Post Essential Thrombocythemia (ET)-MF was diagnosed according to International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) standard; JAK2 mutation or not was included in the study;
4. According to Dynamic International Prognostic Scoring System (DIPSS) prognosis grading criteria, the patients with myelofibrosis were assessed as medium risk (including medium risk-1, medium risk-2) or high risk;
5. Splenomegaly: palpate the splenic margin at least 5cm below the ribs (the distance from the costal margin to the farthest point of splenic protrusion);
6. Peripheral blood primordial cells ≤ 10%;
7. If anti myelofibrosis therapy (except JAK inhibitor) is being received before screening, the drug must be stopped at least 4 weeks before the random date;
8. No growth factor, colony stimulating factor, thrombopoietin or platelet transfusion was received within 2 weeks before the examination, and hemoglobin (Hgb) ≥ 80g / L, platelet count (PLT) ≥ 100 within 7 days before the random date × 10\^9 / L and neutrophil absolute value (neut) ≥ 1.0 × 10\^9/L;
9. The main organs were functional 7 days before the random date, which was in accordance with the following criteria: Total Bilirubin (TBIL) was less than 2 times the upper limit of normal value (ULN); Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) were less than 2.5 times of ULN; Serum creatinine (Cr) \< 1.5 times of ULN or creatinine clearance rate (Ccr) ≥ 50ml/min; The blood coagulation function should be checked in accordance with: prothrombin time (PT), activated partial thromboplastin time (APTT), international standardized ratio (INR) \< 1.5 × ULN (not anticoagulant treatment); Left ventricular ejection fraction (LVEF) evaluated by color Doppler ultrasonography ≥ 50%;
10. Female subjects of childbearing age should agree to use contraceptive measures (such as intrauterine device, contraceptive or condom) during the study period and within 6 months after the end of the study; The serum pregnancy test was negative within 7 days before the date of randomization and must be non lactating subjects; Male subjects should agree to use contraception during the study period and within 6 months after the end of the study period.

Exclusion Criteria:

1. Those who have received allogeneic stem cell transplantation in the past, or autologous stem cell transplantation within 3 months before the random date, or recently planned stem cell transplantation;
2. Patients who have received JAK inhibitors in the past;
3. Those who had undergone splenectomy or received splenic radiotherapy within 6 months before the date of randomization (including internal and external radiotherapy);
4. Other malignancies were present or present within 3 years before the date of randomization. The following two cases can be included: other malignant tumors treated by single operation have achieved 5-year disease-free survival (DFS) in a row; Cured cervical carcinoma in situ, non melanoma skin cancer and superficial bladder tumor \[ta (non-invasive tumor), tis (carcinoma in situ) and T1 (tumor infiltrating basement membrane)\];
5. Patients with multiple factors (such as inability to swallow, postoperative gastrointestinal resection, acute and chronic diarrhea, intestinal obstruction, etc.) affecting oral or absorption of drugs;
6. Non hematological toxicity caused by previous treatment did not return to ≤ 1 (excluding alopecia);
7. Patients who received major surgical treatment or had obvious traumatic injury within 4 weeks before the date of randomization;
8. At present, there are congenital bleeding or coagulation diseases, or are using anticoagulant therapy;
9. Arteriovenous thrombotic events occurred within 6 months before the random date, such as cerebrovascular accident (including transient ischemic attack, cerebral hemorrhage, cerebral infarction), deep venous thrombosis and pulmonary embolism;
10. A history of psychotropic substance abuse or mental disorder;
11. Active or uncontrolled severe infection (≥ Common Terminology Criteria for Adverse Events(CTCAE)2 infection);
12. Hepatitis B Virus (HBV) DNA≥ULN； Hepatitis C antibody positive and Hepatitis C Virus (HCV) RNA ≥ ULN;
13. Myocardial ischemia or myocardial infarction, arrhythmia, QT interval prolongation (corrected QT interval (QTc) ≥ 450 ms for male, QTc ≥ 470 ms for female) and congestive heart failure (NYHA classification) of grade 2 or above;
14. Blood pressure control is not ideal (systolic blood pressure ≥ 150 mmHg or diastolic blood pressure ≥ 100 mmHg);
15. Renal failure requires hemodialysis or peritoneal dialysis;
16. Newly diagnosed pulmonary fibrosis or drug-related interstitial lung disease within 3 months before the date of randomization;
17. History of immunodeficiency, including Human Immunodeficiency Virus (HIV) positive or other acquired or congenital immunodeficiency diseases, or organ transplantation;
18. Patients with epilepsy and need treatment;
19. Had received chemotherapy, radiotherapy or other anti-cancer therapy within 4 weeks before the date of randomization;
20. Within 2 weeks before the date of randomization, he received Chinese patent medicines (including compound cantharis capsule, Kang'ai injection, kang'laite capsule / injection, Aidi injection, Brucea javanica oil injection / capsule, Xiaoaiping tablet / injection, cinobufagin capsule, etc.) with anti-tumor indications specified in nmpa approved drug instructions;
21. Uncontrolled pleural effusion, pericardial effusion or ascites;
22. Patients with central nervous system involvement;
23. There was a history of live attenuated vaccine inoculation within 4 weeks before the date of randomization or live attenuated vaccine inoculation was planned during the study period;

Primary outcomes:
measure: Spleen Volume was Reduced by more than 35% from baseline（SVR35） assessed by Independent Review Committee (IRC)
timeFrame: up to 24 weeks
Secondary outcomes:
measure: SVR35 assessed by the researchers and objective response rate (ORR)
timeFrame: up to 24 weeks
measure: optimal response rate of splenic response
timeFrame: up to 120 weeks
measure: onset time of splenic response
timeFrame: up to 120 weeks
measure: Duration of Maintenance of a Least 35% Reduction in Spleen Volume(DoMSR)
timeFrame: up to 120 weeks
measure: the proportion of subjects whose total symptom score of Myeloproliferative neoplasm- Symptom Assessment Form- Total Symptom Score(MPN-SAF TSS) decreased by more than 50% compared with baseline
timeFrame: up to 24 weeks
measure: The total symptom score of MPN-SAF TSS decreased compared with baseline
timeFrame: up to 24 weeks
measure: Progression-free survival (PFS)
timeFrame: up to 120 weeks
measure: Leukemia free survival (LFS)
timeFrame: up to 120 weeks
measure: Overall survival (OS)
timeFrame: up to 120 weeks
measure: The incidence and severity of adverse events (AEs) occurred during the study
timeFrame: up to 120 weeks
Other outcomes:
Locations:
city: Beijing
country: China
facility: Peking Union Medical College Hospital
state: Beijing
city: Guangzhou
country: China
facility: Guangdong Provincial Peoples Hospital
state: Guangdong
city: Chengdu
country: China
facility: West China School of Medicine / West China Hospital, Sichuan University
state: Sichuan
city: Tianjin
country: China
facility: Institute of Hematology & Blood Diseases Hostpital, Chinese Academy of medical sciences & Peking Union Medical College
state: Tianjin
Study officials:
References: