E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
High Risk Polycythemia Vera or High Risk Essential Thrombocythemia |
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E.1.1.1 | Medical condition in easily understood language |
Patients with Polycythemia Vera or Essential Thrombocythemia |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10036057 |
E.1.2 | Term | Polycythaemia vera |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015493 |
E.1.2 | Term | Essential thrombocythaemia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the complete hematologic response rates (by LeukemiaNet Criteria) in patients randomized to treatment with the Pegylated Interferon Alfa-2a (PEGASYS) vs. Hydroxyurea in two strata of patients with (1) high risk polycythemia vera or (2) high risk essential thrombocythemia. All comparisons will be carried out separately within each disease stratum. |
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E.2.2 | Secondary objectives of the trial |
-toxicity, safety and tolerability of therapy. -hematologic partial response rates on therapy. -specific pre-defined toxicity and tolerance of therapy and validate the utility of sequential structured symptom assessment package of patient reported outcome instruments. -impact of therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea) to impact key biomarkers of the disease. -survival and incidence of development of myelodysplastic syndrome, myelofibrosis, or leukemic transformation. -incidence of major cardiovascular events. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Inclusion Criteria: High risk PV ANY ONE of the following: Age >60 years Previous documented thrombosis, erythromelalgia or migraine either after diagnosis or within 10 years before diagnosis and considered to be disease related Significant (i.e. > 5cm below costal margin on palpation) or symptomatic (pain, early satiety) splenomegaly Platelets > 1000 x 109/L Diabetes or hypertension requiring pharmacological therapy High risk ET ANY ONE of the following factors: Age > 60 years Platelet count > 1500 x 109/L Previous thrombosis Previous hemorrhage related to ET Diabetes or hypertension requiring pharmacological therapy Other Inclusion criteria Diagnosed less than 3 years prior to entry on trial Never treated with cytoreductive drugs except hydroxyurea for up to 3 months maximum (phlebotomy, aspirin allowed) Age: > 18 years (no upper limit) Ability and willingness to comply with all study requirements Signed informed consent to participate in this study. Willing to participate in associated correlative science biomarker study |
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E.4 | Principal exclusion criteria |
Exclusion criteria: (ANY of) Any contraindications to pegylated interferon or hydroxyurea Presence of any life-threatening co-morbidity History of active substance or alcohol abuse within the last year Subjects who are pregnant, lactating or of reproductive potential and not practicing an effective means of contraception History of psychiatric disorder (e.g. depression) History of autoimmune disorder (e.g. hepatitis) Hypersensitivity to IFN-α HIV, HBV, or systemic infection Evidence of severe retinopathy (e.g. CMV retinitis, macular degeneration) or clinically relevant ophthalmological disorder (e.g. due to diabetes mellitus or hypertension) History or other evidence of decompensated liver disease Splanchnic vein thrombosis (includes Budd-Chiari, portal vein, splenic and mesenteric thrombosis) History or other evidence of chronic pulmonary disease associated with functional limitation Thyroid dysfunction not adequately controlled Any investigational drug <6 weeks prior to the first dose of study drug Neutrophil count <1.5 x 109/L JAK2 exon 12 mutation Patients should not meet criteria for post PV or post ET-MF (see appendix B) No previous exposure to any formulation of pegylated interferon Subjects with any other medical condition, which in the opinion of the investigator would compromise the results of the study by deleterious effects of treatment. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Complete Response. Criteria for complete response in ET: -Platelet count </= 400 x 109/L AND -No disease-related symptoms* AND -Normal spleen size on imaging AND -WBC </= 10 x 109/L Criteria for complete response in PV: -Hematocrit <0.45 without phlebotomy AND -Platelet count < 400 x 109/L AND -WBC < 10 x 109/L AND -Normal spleen size on imaging AND -No disease related symptoms |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
-To compare the toxicity, safety and tolerability of therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea) in the study populations. -To compare the hematologic partial response rates on therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea) by LeukemiaNet criteria. -To compare specific pre-defined toxicity and tolerance of therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea) and validate the utility of sequential structured symptom assessment package of patient reported outcome instruments. -To compare the impact of therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea) to impact key biomarkers of the disease(s) – JAK2-V617F, hematopoietic cell clonality in platelets and granulocytes in females, bone marrow histopathology, and cytogenetic abnormalities. -To estimate survival and incidence of development of myelodysplastic syndrome, myelofibrosis, or leukemic transformation after therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea). -To estimate incidence of major cardiovascular events (defined as cardiovascular death, myocardial infarction, stroke, transient ischemic attack, pulmonary embolism, Budd Chiari syndrome, deep vein thrombosis, and any other clinically relevant thrombotic event) after therapy (Pegylated Interferon Alfa-2a vs. Hydroxyurea). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Canada |
Israel |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |