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The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
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  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   44334   clinical trials with a EudraCT protocol, of which   7366   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
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    Summary
    EudraCT Number:2018-001671-21
    Sponsor's Protocol Code Number:KRT-232-101
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Trial now transitioned
    Date on which this record was first entered in the EudraCT database:2021-05-20
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-001671-21
    A.3Full title of the trial
    A Phase 2/3 Randomized, Controlled, Open-Label Study of KRT-232 in Subjects With Primary Myelofibrosis (PMF), Post-Polycythemia Vera MF (Post-PV-MF), Or Post-Essential Thrombocythemia MF (Post-ET-MF) who are Relapsed or Refractory to Janus Kinase (JAK) Inhibitor Treatment
    Studio di fase 2/3 randomizzato, controllato, in aperto di KRT-232 in soggetti con mielofibrosi primaria (PMF), MF post- policitemia vera (post-PV-MF) o MF post-trombocitopenia essenziale (post-ET- MF) recidivati o refrattari al trattamento con inibitori delle Janus chinasi (JAK)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    This global, multicenter, Phase 2 (Part A)/3 (Part B) randomized, controlled, open-label study will evaluate the safety and efficacy of KRT232 versus BAT for the treatment PMF, post PV MF, or post ET MF in subjects who are relapsed or refractory to JAK inhibitor treatment.
    Questo è uno studio globale, multicentrico, di Fase 2 (Parte A)/ 3 (Parte B) randomizzato, controllato, in aperto che valuterà la sicurezza e l'efficacia di KRT232 rispetto a BAT per il trattamento PMF, post PV MF o post ET MF nei soggetti che sono recidivanti o refrattari al trattamento con inibitori della JAK.
    A.3.2Name or abbreviated title of the trial where available
    NA
    NA
    A.4.1Sponsor's protocol code numberKRT-232-101
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorKartos Therapeutics, Inc
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportKartos Therapeutics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationKartos Therapeutics, Inc.
    B.5.2Functional name of contact pointRegulatory Affairs
    B.5.3 Address:
    B.5.3.1Street Address275 Shoreline Drive
    B.5.3.2Town/ cityRedwood City, California
    B.5.3.3Post code94065
    B.5.3.4CountryUnited States
    B.5.6E-mailpryan@kartosthera.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKRT-232
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.9.3Other descriptive nameAMG-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCura di supporto (incluso ma non limitato a corticosteroidi o androgeni)
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeNA
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKRT-232
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.9.3Other descriptive nameAMG-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number60
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKRT-232
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.9.3Other descriptive nameAMG-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameHydroxyurea
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIDROSSICARBAMIDE
    D.3.9.1CAS number 127-07-1
    D.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB08076MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameNA
    D.3.2Product code [KRT-232]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.9.3Other descriptive nameAMG-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number120
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 7
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKRT-232
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 8
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameChemioterapia
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeNA
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 9
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKRT-232
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INN-
    D.3.9.2Current sponsor codeKRT-232
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number60
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 10
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameNA
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLOPERAMIDE CLORIDRATO
    D.3.9.2Current sponsor codeNA
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 11
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameNA
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Orodispersible film
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNONDANSETRON
    D.3.9.2Current sponsor codeNA
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number8
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Primary Or Secondary (Post-PV MF or Post-ET-MF) Myelofibrosis (MF) with Intermediate Or High-Risk TP53 Wild-Type (TP53 WT) who Are Relapsed Or Refractory to Janus Kinase (JAK) - Inhibitor Treatment.
    Soggetti adulti con MF primaria o secondaria (MF post-PV o MF post-ET-) a rischio intermedio o alto, con TP53 wild-type (TP53WT), recidivati o refrattari al trattamento con inibitori delle Janus chinasi (JAK)
    E.1.1.1Medical condition in easily understood language
    A disorder of the bone marrow
    Una patologia del midollo osseo
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10074689
    E.1.2Term Post polycythemia vera myelofibrosis
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10074690
    E.1.2Term Post essential thrombocythemia myelofibrosis
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10077161
    E.1.2Term Primary myelofibrosis
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Part A: to determine spleen response.
    Part B: To compare the spleen volume reduction (SVR) at Week 24 between Arm 1 and Arm 2
    Parte A: Determinare la risposta della milza
    Parte B: Confrontare la riduzione del volume splenico (SVR) alla Settimana 24 tra il Braccio 1 e il Braccio 2
    E.2.2Secondary objectives of the trial
    Part A:
    To determine the change in modified MPN-SAF Total Symptom Score (TSS) at Week 24 and Week 48;
    To determine the duration of spleen response (DoR-spleen);
    To determine spleen size reduction as measured by palpation;
    To determine RBC transfusion usage;
    To determine the clinical response rate at Week 24;
    To determine the overall survival (OS) rate;
    To determine the safety and tolerability of KRT-232;
    To determine the PK/PD profile of KRT-232

    Part B:
    To compare the improvement of TSS at Week 24 between Arm 1 and Arm 2;
    To compare the OS between Arm 1 and Arm 2;
    To compare the progression free survival (PFS) between Arm 1 and Arm 2;
    To compare the overall SVR at any time in each study arm;
    PLEASE REFER TO THE PROTOCOL FOR FURTHER SECONDARY OBJECTIVES
    Parte A:
    Determinare la variazione nel punteggio totale dei sintomi (TSS) al questionario MPN-SAF modificato alla Settimana 24 e alla Settimana 48
    Determinare la durata della risposta (DoR) della milza
    Determinare la riduzione del volume splenico alla palpazione
    Determinare l’utilizzo di trasfusioni di globuli rossi (RBC)
    Determinare il tasso di risposta clinica alla Settimana 24
    Determinare il tasso di sopravvivenza globale (OS)
    Determinare la sicurezza e la tollerabilità di KRT-232
    Determinare il profilo di farmacocinetica/farmacodinamica (PK/PD) di KRT-232

    Parte B:
    Confrontare la riduzione del volume splenico (SVR) alla Settimana 24 tra il Braccio 1 e il Braccio 2
    Confrontare la sopravvivenza globale (OS) nel Braccio 1 e nel Braccio 2.
    Confrontare la sopravvivenza libera da progressione (PFS) nel Braccio 1 e nel Braccio 2
    Confrontare la SVR complessiva in qualsiasi momento in ciascun braccio di studio.
    SI PREGA DI FARE RIFERIMENTO AL PROTOCOLLO PER ULTERIORI OBIETTIVI SECONDARI
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Part A:
    1. Adults >18 years of age
    2. Palpable spleen measuring >= 5 cm below the left lower costal margin or spleen volume of >= 450 cm3 by MRI or CT scan assessment
    3. Confirmed diagnosis of PMF, post–PV-MF, or post–ET-MF according to the World Health Organization (WHO) criteria
    4. High-risk, intermediate-2 risk, or intermediate-1 risk, defined by Dynamic International Prognostic System (DIPSS)
    5. ECOG performance status of 0 to 2
    6. Adequate hematological, hepatic, and renal organ function (as per protocol definition and within 28 days prior to the first dose of KRT-232)
    7. Female subjects of childbearing potential and their male partners, or male subjects who have female partners of childbearing potential must both use an effective contraception method during the study. In addition, male subjects must continue to use contraception for 3 months and 1 week after the last dose of study drug and female subjects must continue to use contraception for 1 month and 1 week after the last dose of study drug. Effective birth control for males includes either vasectomy or use of condoms. Effective birth control for females includes (a) combined, estrogen and progestogen containing, hormonal contraception (oral, intravaginal, transdermal); (b) progestogen-only hormonal contraception (oral, injectable, implantable); (c) intrauterine device; (d) intrauterine hormone-releasing system; (e) bilateral tubal occlusion; and (f) sexual abstinence, when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
    Subjects in Part A must meet the following JAK inhibitor treatment failure criteria in order to be eligible for the study:
    JAK Inhibitor treatment failure in Part A must meet either criterion (a) or (b) below:
    a) Either a lack of spleen response defined as receiving at least 12 weeks of JAK inhibitor treatment and having both of the following:
    • Persistent splenomegaly, by physical exam, that is palpable = 5 cm below the LLCM
    • and TSS of >10 on the MPN-SAF TSS v.2.0 or patients with a single symptom score of >5 or two symptoms of >3, including only the symptoms of left upper quadrant pain, bone pain, itching, or night
    sweats
    b) Or progressive disease any time while on JAK inhibitor treatment as
    defined by any one of the following:
    • Spleen volume increase by >= 25% from the nadir as assessed by MRI or CT
    • Appearance of new splenomegaly that is palpable at least 5 cm below the LCM
    • A >= 100% increase in palpable distance, below the LCM, for baseline splenomegaly of 5 to 10 cm
    • A >= 50% increase in palpable distance, below the LCM, for baseline splenomegaly of > 10 cm

    Part B:
    1. Adults >18 years of age
    2. Confirmed diagnosis of PMF, post PV MF, or post ET MF, as assessed by treating physician according to the World Health Organization (WHO) criteria (Appendix 3)

    PLEASE REFER TO THE PROTOCOL FOR FURTHER INCLUSION CRITERIA
    Parte A:
    1. Adulti di età > 18 anni
    2. Misurazione della milza palpabile >= 5 cm sotto il margine costale inferiore sinistro o volume della milza >= 450 cm3 in base alla valutazione mediante risonanza magnetica (RM) o tomografia computerizzata (TAC)
    3. Diagnosi confermata di mielofibrosi primaria (MFP), MF post policitemia vera (post-PV) o MF post trombocitemia essenziale (post-ET) secondo i criteri dell’Organizzazione Mondiale della Sanità (OMS)
    4. Gruppi a rischio elevato, rischio intermedio-2 o rischio intermedio-1 in base al sistema di punteggio DIPSS (Dynamic International Prognostic Scoring System)
    5. Stato di validità ECOG da 0 a 2
    6. Adeguata funzione ematologica, epatica e renale (come da definizione da protocollo ed entro i 28 giorni precedenti la prima dose di KRT-232)
    7. I soggetti di sesso femminile in età fertile e i loro partner di sesso maschile, oppure i soggetti di sesso maschile con partner di sesso femminile in età fertile, devono entrambi utilizzare un metodo contraccettivo efficace durante lo studio. Inoltre, i soggetti di sesso maschile devono continuare a usare la contraccezione per 3 mesi e 1 settimana dopo l’ultima dose di farmaco dello studio e i soggetti di sesso femminile devono continuare a usare la contraccezione per 1 mese e 1 settimana dopo l’ultima dose di farmaco dello studio. I metodi efficaci di contraccezione per i soggetti di sesso maschile includono la vasectomia o l’uso di preservativi. Tra i metodi contraccettivi efficaci per i soggetti di sesso femminile rientrano: (a) contraccezione ormonale combinata a base di estrogeni e progesterone (orale, intravaginale, transdermica); (b) contraccezione ormonale a base di solo progestinico (orale, iniettabile, impiantabile); (c) dispositivo intrauterino; (d) sistema intrauterino a rilascio di ormoni; (e) occlusione tubarica bilaterale; e (f) astinenza sessuale, se in linea con lo stile di vita consueto e preferito del soggetto. L’astinenza periodica (per es. metodo del calendario, dell’ovulazione, sintotermico o della fase post-ovulatoria) e il coito interrotto non sono metodi contraccettivi accettabili.
    I soggetti nella Parte A devono soddisfare i seguenti criteri di fallimento del trattamento con un inibitore della Janus chinasi (JAK) per essere idonei per lo studio:
    Il fallimento del trattamento con un inibitore della JAK nella Parte A deve soddisfare il criterio (a) o (b) di seguito:
    a) Mancanza di risposta della milza definita come somministrazione di almeno 12 settimane di trattamento con un inibitore della JAK e presenza di entrambe le seguenti condizioni:
    • Splenomegalia persistente, rilevata mediante esame obiettivo, palpabile = 5 cm sotto il sotto il margine costale inferiore sinistro (LLCM)
    • e punteggio sintomatico totale (TSS) di > 10 su TSS misurato in base al modulo di valutazione dei sintomi del neoplasma mieloproliferativo (MPN-SAF) v.2.0 o pazienti con un punteggio di sintomo singolo di > 5 o due sintomi di > 3, inclusi solo i sintomi del dolore nel quadrante superiore sinistro, dolore osseo, prurito o sudorazione notturna
    b) Oppure malattia progressiva in qualsiasi momento durante il trattamento con un inibitore della JAK definita da una qualsiasi delle seguenti condizioni:
    • Aumento del volume della milza di >= 25% rispetto al nadir, come valutato mediante RM o TAC
    • Comparsa di nuova splenomegalia palpabile almeno 5 cm sotto il margine costale sinistro (LCM)
    • Aumento di >= 100% nella distanza palpabile, sotto il LCM, per splenomegalia al basale da 5 a 10 cm
    • Aumento di >= 50% nella distanza palpabile, sotto il LCM, per splenomegalia al basale di > 10 cm

    Parte B:
    1. Adulti di età > 18 anni
    2. Diagnosi confermata di MFP, MF post-PV o MF post-ET valutata dal medico curante secondo i criteri dell’Organizzazione Mondiale della Sanità (OMS) (Appendice 3)

    SI PREGA DI FARE RIFERIMENTO AL PROTOCOLLO PER ULTERIORI CRITERI DI INCLUSIONE
    E.4Principal exclusion criteria
    Part A:
    1. Patients who are positive for p53 mutations
    2. Participation in another interventional clinical trial within the past 4 weeks of the first dose of KRT-232 (participation in observational studies is permitted)
    3. Major surgery within the first 28 days of KRT-232
    4. Chemotherapy, immunomodulatory drug therapy within 14 days prior to first dose of KRT-232
    5. Prior splenectomy
    6. Splenic irradiation within 3 months prior to the first dose of KRT-232
    7. Prior allogeneic stem-cell transplantation or eligible for allogeneic stem cell transplantation
    8. Previous treatment with histone deacetylase (HDAC) inhibitors or BCL-2 inhibitors
    9. Prior MDM2 inhibitor therapy or p53-directed therapy
    10. Women who are pregnant or breastfeeding
    11. History of major organ transplant
    12. Uncontrolled intercurrent illness including, but not limited to, acute hepatitis A; known history of human immunodeficiency virus (HIV)- positive; clinically significant cardiac disease (New York Heart Association Class III or IV); symptomatic congestive heart failure; unstable angina pectoris; ventricular arrhythmia; or psychiatric illness/social situations that would limit compliance with study
    requirements
    13. Subjects with clinically significant bacterial, fungal, parasitic, or viral infection that requires therapy. Subjects with acute bacterial infections requiring antibiotic use should delay screening/enrollment until the course of antibiotic therapy has been completed.
    14. Other malignancy within the last 3 years, other than curatively treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, organ-confined or treated nonmetastatic prostate cancer with normal prostate-specific antigen, in situ breast carcinoma after complete surgical resection, or superficial transitional cell bladder carcinoma
    15. Grade 2 or higher QTc prolongation (>480 milliseconds per NCICTCAE criteria, version 5.0)
    16. Growth factor treatment (e.g., erythropoeitin) within 14 days prior to first dose of KRT-232; no darbepoetin within 28 days prior to first dose of KRT-232
    17. Active or chronic bleeding within 4 weeks prior to the first dose of KRT-232

    Part B:
    1. Prior MDM2 inhibitor therapy or p53-directed therapy
    2. Participation in an interventional clinical trial within 28 days before randomization (participation in observational studies is permitted)
    3. Major surgery or radiotherapy within 21 days prior to randomization, or anticipation of needing such procedures while receiving study treatment
    4. JAK-, PI3k-, SYK-, BTK-, BET- or MTOR inhibitor treatment within 28 days prior to the Screening MRI/CT scan
    5. Treatment with any other anticancer agent including chemotherapy, immunotherapy or biologic therapy within 28 days prior to randomization. Hydroxyurea may be taken within 1 day prior to Cycle 1 Day 1
    6. Prior splenectomy
    7. Splenic irradiation within 12 weeks of randomization.
    8. Prior allogeneic stem-cell transplantation or plans for allogeneic stem cell transplantation
    9. Women who are pregnant, lactating, breastfeeding or intending to become pregnant during the study.
    10. History of major organ transplant

    PLEASE REFER TO THE PROTOCOL FOR FURTHER EXCLUSION CRITERIA
    Parte A:
    1. Pazienti positivi per mutazioni di p53
    2. Partecipazione a un’altra sperimentazione clinica interventistica nelle ultime 4 settimane prima della prima dose di KRT-232 (la partecipazione a studi osservazionali è consentita)
    3. Intervento chirurgico maggiore entro i primi 28 giorni di KRT-232
    4. Chemioterapia, terapia con farmaco immunomodulatore entro i 14 giorni precedenti la prima dose di KRT-232
    5. Precedente splenectomia
    6. Irradiazione splenica entro i 3 mesi precedenti la prima dose di KRT-232
    7. Precedente trapianto allogenico di cellule staminali o soggetti idonei per un trapianto allogenico di cellule staminali
    8. Precedente trattamento con inibitori dell’istone deacetilasi (HDAC) o inibitori di BCL-2
    9. Precedente terapia con un inibitore di MDM2 o terapia mirata a p53
    10. Donne in gravidanza o che allattano al seno
    11. Anamnesi di trapianto di organo maggiore
    12. Malattia intercorrente non controllata, comprese, a titolo esemplificativo ma non esaustivo, epatite acuta A, anamnesi nota di virus dell’immunodeficienza umana (HIV) - positivo, cardiopatia clinicamente significativa (Classe III o IV della New York Heart Association), insufficienza cardiaca congestizia sintomatica, angina pectoris instabile, aritmia ventricolare, o malattia psichiatrica/situazioni sociali che potrebbero limitare la conformità ai requisiti dello studio
    13. Soggetti con infezione batterica, micotica, parassitaria o virale clinicamente significativa che richiede terapia. I soggetti con infezione batterica acuta che richiede l’uso di antibiotici devono ritardare lo screening/l’arruolamento fino a quando il ciclo di terapia antibiotica non è stato completato.
    14. Altro tumore maligno negli ultimi 3 anni, diverso dal carcinoma cutaneo a cellule basali o a cellule squamose trattato a scopo curativo, dal carcinoma in situ del collo dell’utero, dal carcinoma prostatico non metastatico confinato all’organo o trattato con antigene prostatico specifico normale, dal carcinoma mammario in situ dopo resezione chirurgica completa o carcinoma della vescica a cellule transizionali superficiale
    15. Prolungamento del QTc di Grado 2 o superiore (> 480 millisecondi secondo i criteri comuni di terminologia per gli eventi avversi del National Cancer Institute [NCI-CTCAE], versione 5.0)
    16. Trattamento con il fattore di crescita (per es., eritropoietina) entro i 14 giorni precedenti la prima dose di KRT-232; nessuna darbepoetina entro i 28 giorni precedenti la prima dose di KRT-232
    17. Emorragia attiva o cronica nelle 4 settimane precedenti la prima dose di KRT-232

    Parte B:
    1. Precedente terapia con un inibitore di MDM2 o terapia mirata a p53
    2. Partecipazione a una sperimentazione clinica interventistica entro i 28 giorni precedenti la randomizzazione (la partecipazione a studi osservazionali è consentita)
    3. Intervento di chirurgia maggiore o radioterapia entro i 21 giorni precedenti la randomizzazione, oppure necessità prevista di tali procedure mediche durante il trattamento dello studio
    4. Trattamento con inibitore di JAK, PI3k, SYK, BTK, BET o MTOR entro i 28 giorni precedenti la RM/TAC di screening
    5. Trattamento con qualsiasi altro agente antitumorale, comprese chemioterapia, immunoterapia o terapia biologica entro i 28 giorni precedenti la randomizzazione. L’idrossiurea può essere assunta entro 1 giorno prima del Giorno 1 del Ciclo 1
    6. Precedente splenectomia
    7. Irradiazione splenica entro le 12 settimane precedenti la randomizzazione.
    8. Precedente trapianto allogenico di cellule staminali o trapianto di cellule staminali allogeniche programmato
    9. Donne in gravidanza, che stanno allattando al seno o che intendono iniziare una gravidanza durante lo studio.
    10. Anamnesi di trapianto di organo maggiore

    SI PREGA DI FARE RIFERIMENTO AL PROTOCOLLO PER ULTERIORI CRITERI DI INCLUSIONE
    E.5 End points
    E.5.1Primary end point(s)
    Part A: The proportion of subjects achieving a >=35% spleen volume reduction from Baseline to Week 24, as assessed by magnetic resonance imaging (MRI) or computed tomography (CT) scan

    Part B: The proportion of subjects in each arm achieving SVR of >=35% at Week 24 by MRI/CT scan (central review)
    Parte A: La percentuale di soggetti che raggiungono una riduzione >=35% del volume splenico dal Basale alla Settimana 24, come valutato mediante risonanza magnetica per immagini (RMI) o tomografia computerizzata (TC)

    Parte B: Percentuale di soggetti in ciascun braccio che raggiungono una SVR >=35% alla Settimana 24 come evidenziato da scansione RM/TC (revisione centrale)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Part A: The Primary Endpoint will be assessed 24 weeks after each subject is enrolled.

    Part B: Week 24
    Parte A: l'endpoint primario verrà valutato dopo 24 settimane dall'arruolamento di ciascun soggetto

    Parte B: Settimana 24
    E.5.2Secondary end point(s)
    Part A:
    Proportion of subjects who have at least a 50% reduction from baseline to Week 24 and Week 48 in the total symptom score as measured by the
    modified MPN-SAF v2.0.
    Duration of a >=35% or more reduction from Baseline in spleen volume as measured by MRI (or by CT for applicable subjects)
    Reduction in spleen size from Baseline to each visit at which spleen is palpated, including the proportion of subjects who have a >=50% decrease
    • RBC transfusions (average number of RBC units per patient-month)
    • RBC transfusion independence at Week 24 (proportion of patients who were transfusion-independent at Week 24, defined as absence of RBC
    transfusions and no hemoglobin <8 g/dL in the previous 12 weeks)
    Complete remission (CR) and partial remission (PR) defined according to International Working Group-Myeloproliferative Neoplasms Research
    and Treatment (IWG-MRT) and modified European LeukemiaNet (ELN) criteria
    Overall survival is defined as the interval from randomization to death from any cause
    Analyses of the safety endpoints will include the following measurements or assessments: physical examinations, laboratory tests, adverse events (AEs), serious AEs, (SAEs), ECGs, vital signs
    KRT-232 and acyl glucuronide metabolite (M1) PK parameters, including but not limited to, maximum observed concentration Cmax), minimum observed concentration (Cmin), area under the plasma concentration time curve (AUC), and terminal elimination half-life (t1/2z)

    Part B:
    The proportion of subjects in each arm with >= 50% reduction in TSS (MFSAF v4.0) at Week 24
    Time from randomization to death from any cause in each arm
    PFS is defined as the time from randomization to either the first
    occurrence of disease progression or death due to any cause. Disease progression is defined as any occurrence of the following:
    • Spleen progression (>=25% increase in spleen volume from baseline)
    • Leukemic transformation (bone marrow blast count of >=20% or a peripheral blood blast content of >=20% associated with an absolute blast count of >=1x109/L that lasts for at least 2 weeks)
    • Transformation to accelerated phase (peripheral blood blasts >= 15% or peripheral blood blast >= 10% confirmed with a repeat assessment at least 3 days later)
    • Leukocytosis (WBC >= 50x109/L (associated with at least 1% blasts and an increase in WBC of at least 1.5x from baseline)
    The proportion of subjects in each arm achieving SVR of >= 35% at any time by MRI/CT scan (central review)
    Time from initial SVR of >= 35% by MRI/CT (central review) until the first occurrence of disease progression
    The proportion of RBC dependent subjects achieving RBC transfusion independence at Week 24
    Analyses of the safety endpoints will include the following measurements or assessments: physical examinations, laboratory tests,
    adverse events (AEs), serious AEs (SAEs), ECGs, vital signs
    KRT-232 and acyl glucuronide metabolite (M1) plasma concentrations will be monitored in Cycles 1 and 2 with sparse sampling.
    Parte A:
    Percentuale di soggetti che presentano una riduzione di almeno il 50% nel punteggio totale dei sintomi (Total Symptom Score, TSS) dal Basale alla Settimana 24 e alla Settimana 48, misurato con il MPN-SAF modificato v2.0
    Durata di una riduzione del volume splenico >=35% o più rispetto al Basale misurata mediante RM (o TC per i soggetti applicabili)
    Riduzione della dimensione della milza dal Basale a ogni visita con palpazione della milza, inclusa la percentuale di soggetti che presentano una riduzione >=50%
    • Trasfusioni RBC (numero medio di unità di RBC per mese-paziente)
    • Indipendenza dalle trasfusioni di RBC alla Settimana 24 (percentuale di soggetti che presentano indipendenza dalle trasfusioni alla Settimana 24, definita come assenza di trasfusioni di RBC e nessun valore di emoglobina <8 g/dL rilevato nelle 12 settimane precedenti)
    Remissione completa (CR) e remissione parziale (PR) definite secondo i criteri IWG-MRT (International Working Group-Myeloproliferative Neoplasms Research and Treatment) e i criteri ELN (European LeukemiaNet) modificati
    La sopravvivenza globale è definita come l’intervallo che intercorre tra la randomizzazione e il decesso per qualsiasi causa
    Le analisi degli endpoint di sicurezza comprenderanno le seguenti misurazioni o valutazioni: esami obiettivi, esami di laboratorio, eventi avversi (AE), AE seri (SEA), ECG, segni vitali
    Parametri PK di KRT-232 e del metabolita acil glucuronide (M1), inclusi a titolo puramente esemplificativo, la concentrazione massima osservata (Cmax), la concentrazione minima osservata (Cmin), l’area sotto la curva concentrazione plasmatica-tempo (AUC) e l’emivita di eliminazione terminale (t1/2z)

    Parte B:
    Percentuale di soggetti in ciascun braccio che mostrano una riduzione >=50% del TSS (MFSAF v4.0) alla Settimana 24
    Tempo dalla randomizzazione al decesso per qualsiasi causa in ciascun braccio
    La PFS è definita come il tempo dalla randomizzazione alla prima comparsa di progressione della malattia o al decesso per qualsiasi causa. La progressione della malattia è definita come uno qualsiasi dei seguenti eventi:
    • progressione della milza (aumento del volume splenico >=25% rispetto al basale)
    • trasformazione leucemica (conta dei blasti nel midollo osseo >=20% o contenuto di blasti nel sangue periferico =20% associato a una conta assoluta dei blasti >=1x109/L presente da almeno 2 settimane)
    • trasformazione in fase accelerata (blasti nel sangue periferico >=15% oppure blasti nel sangue periferico >=10% confermati da una valutazione ripetuta ad almeno 3 giorni di distanza)
    • Leucocitosi (WBC >= 50x109/L (associata a una presenza di blasti di almeno l’1% e aumento della conta WBC di almeno 1,5 volte rispetto al basale)
    Percentuale di soggetti in ciascun braccio che in qualsiasi momento raggiungono una SVR >= 35%, come evidenziato da scansione RMI/TC (revisione centrale)
    Tempo dalla SVR iniziale >= 35% alla scansione RMI/TC (revisione centrale) fino alla prima comparsa di progressione della malattia
    Tempo dalla SVR iniziale >= 35% alla scansione RMI/TC (revisione centrale) fino alla prima comparsa di progressione della malattia
    Percentuale di soggetti dipendenti da trasfusione di RBC che raggiungono l’indipendenza da trasfusioni di RBC alla Settimana 24
    Le analisi degli endpoint di sicurezza comprenderanno le seguenti misurazioni o valutazioni: esami obiettivi, esami di laboratorio, eventi avversi (AE), AE seri (SEA), ECG, segni vitali
    Le concentrazioni plasmatiche di KRT-232 e del metabolita acil glucuronide (M1) saranno monitorate nei Cicli 1 e 2 mediante campionamento ridotto
    E.5.2.1Timepoint(s) of evaluation of this end point
    Part A: Week 24, Week 48 and duration of study. Please refer to the protocol for full details.

    Part B: Week 24, study duration, time from randomization to death from any cause, time from randomization to either the first occurrence of disease progression or death due to any cause, the first occurrence of disease progression. Please refer to the protocol for full details
    Parte A: settimana 24, settimana 48 e durata dello studio. Fare riferimento al protocollo per tutti i dettagli.

    Parte B: Settimana 24, durata dello studio, tempo dalla randomizzazione alla morte per qualsiasi causa, tempo dalla randomizzazione alla prima occorrenza di progressione della malattia o morte per qualsiasi causa, la prima occorrenza di progressione della malattia. Fare riferimento al protocollo per tutti i dettagli
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over Yes
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    BAT: 1) idrossiurea, 2) chemioterapia o 3) terapia di supporto
    BAT: 1) hydroxyurea, 2) chemotherapy or 3) supportive care
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA128
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Canada
    Israel
    United States
    Bulgaria
    France
    Germany
    Hungary
    Italy
    Poland
    Spain
    United Kingdom
    Czechia
    E.8.7Trial 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
    LVLS which could be long term survival follow-up phone call
    LVLS che potrebbe essere una telefonata di follow-up di sopravvivenza a lungo termine
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 135
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 250
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Due to anticipated age of patients it's possible a Legally authorised representative may consent for patients.
    A causa dell'età prevista dei pazienti è possibile che un rappresentante legalmente autorizzato possa acconsentire ai pazienti.
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 261
    F.4.2.2In the whole clinical trial 385
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    The study will be considered complete 2 years after the last subject is enrolled, at which time subjects will be evaluated for eligibility for a rollover study.
    Subjects will be treated until disease progression or lack of tolerability.
    Subjects who discontinue study treatment for any reason during the study will enter long-term follow-up and be followed for survival and subsequent anticancer therapy.
    Lo studio sarà considerato completo 2 anni dopo l'arruolamento dell'ultimo soggetto, momento in cui i soggetti saranno valutati per l'idoneità a uno studio di rollover.
    I soggetti verranno trattati fino alla progressione della malattia o alla mancanza di tollerabilità.
    I soggetti che interrompono il trattamento in studio per qualsiasi motivo durante lo studio entreranno in follow-up a lungo termine e saranno seguiti per la sopravvivenza e la successiva terapia antitumorale.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-03-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-03-30
    P. End of Trial
    P.End of Trial StatusTrial now transitioned
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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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