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    Summary
    EudraCT Number:2020-001989-10
    Sponsor's Protocol Code Number:CPI0610-04
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-05-24
    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 number2020-001989-10
    A.3Full title of the trial
    A Phase 3, Randomized, Double-blind, Active-Control Study of CPI-0610 and Ruxolitinib vs. Placebo and Ruxolitinib in JAKi Treatment Naive MF Patients
    Studio di fase 3, randomizzato, in doppio cieco, con controllo attivo di CPI-0610 e Ruxolitinib rispetto a placebo e Ruxolitinib nei pazienti con MF naïve al trattamento con JAKi
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Myelofibrosis is commonly treated with a drug called Ruxolitinib. Since Ruxolitinib is approved, it is usually your doctor’s first choice of treatment.

    This study is being done to find out if taking Ruxolitinib and the study medication, CPI-0610, together work better than taking only Ruxolitinib, and if it can help decrease your spleen size and make you feel better.
    To be part of this study, you may not have taken Ruxolitinib before.
    La mielofibrosi viene comunemente trattata con un farmaco chiamato Ruxolitinib. Poiché Ruxolitinib è approvato, di solito è la prima scelta di trattamento del medico.

    Questo studio è stato condotto per scoprire se l'assunzione di Ruxolitinib e il farmaco in studio, CPI-0610, insieme funzionano meglio dell'assunzione solo di Ruxolitinib e se può aiutare a ridurre le dimensioni della milza e sentirsi meglio.
    Per partecipare a questo studio, potrebbe non aver preso Ruxolitinib prima.
    A.3.2Name or abbreviated title of the trial where available
    Phase 3 Study of CPI-0610 in MF
    Studio di Fase 3 CPI-0610 in MF
    A.4.1Sponsor's protocol code numberCPI0610-04
    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 SponsorConstellation Pharmaceuticals, 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 supportConstellation Pharmaceuticals, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationConstellation Pharmaceuticals, Inc.
    B.5.2Functional name of contact pointJennifer Callahan
    B.5.3 Address:
    B.5.3.1Street Address215 First Street, Suite 200
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeMA 02142
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16177140572
    B.5.5Fax number+16175770342
    B.5.6E-mailJennifer.Callahan@constellationpharma.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 Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2247
    D.3 Description of the IMP
    D.3.1Product nameCPI-0610 Tablets, 100 mg
    D.3.2Product code [CPI-0610 Tablets, 100 mg]
    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 INNCPI-0610
    D.3.9.1CAS number 1380087-89-7
    D.3.9.2Current sponsor codeCPI-0610
    D.3.9.4EV Substance CodeSUB193136
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 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 Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2247
    D.3 Description of the IMP
    D.3.1Product nameCPI-0610 Tablets, 25mg
    D.3.2Product code [CPI-0610 Tablets, 25mg]
    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 INNCPI-0610
    D.3.9.1CAS number 1380087-89-7
    D.3.9.2Current sponsor codeCPI-0610
    D.3.9.3Other descriptive nameCPI-0610 MONOHYDRATE
    D.3.9.4EV Substance CodeSUB193136
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Myelofibrosis
    Mielofibrosi
    E.1.1.1Medical condition in easily understood language
    Myelofibrosis
    Mielofibrosi
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10028537
    E.1.2Term 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 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
    To determine the efficacy of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib
    Determinare l'efficacia di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib
    E.2.2Secondary objectives of the trial
    - To determine the efficacy of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib
    - To characterize the effects of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib in the bone marrow
    - To determine the effect of CPI-0610 + ruxolitinib on the durability of splenic response compared with placebo + ruxolitinib
    - To determine the effect of CPI-0610 + ruxolitinib on the durability of TSS response compared with placebo + ruxolitinib
    - To determine the effect of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib on the rate of RBC transfusion over the first 24 weeks of treatment
    - To determine the effect of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib on RBC transfusion dependence rate at Week 24
    - To determine the effect of CPI-0610 + ruxolitinib compared with placebo + ruxolitinib on conversion from RBC transfusion dependence to independence

    and further as described in the protocol
    - Determinare l'efficacia di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib
    - Caratterizzare gli effetti di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib nel midollo osseo
    - Determinare l'effetto di CPI-0610 + ruxolitinib sulla durata della risposta splenica rispetto a placebo + ruxolitinib
    - Determinare l'effetto di CPI-0610 + ruxolitinib sulla durata della risposta TSS rispetto a placebo + ruxolitinib
    - Determinare l'effetto di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib sulla velocità di trasfusione di globuli rossi nelle prime 24 settimane di trattamento
    - Determinare l'effetto di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib sul tasso di dipendenza da trasfusioni di GR alla settimana 24
    - Determinare l'effetto di CPI-0610 + ruxolitinib rispetto a placebo + ruxolitinib sulla conversione dalla dipendenza da trasfusioni RBC all'indipendenza e ulteriormente come descritto nel protocollo
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Patients are eligible to be included in the study only if all of the following criteria apply:
    Age
    1. = 18 years of age at the time of signing the informed consent
    Type of Patient and Disease Characteristics
    2. Have a confirmed diagnosis of MF (PMF or PPV-MF or PET-MF) in accordance with the 2016 WHO criteria (Section 10.4)
    3. Require therapy for MF in the opinion of the Investigator and are eligible for treatment with ruxolitinib
    4. Have DIPSS risk category Intermediate-1 or higher (Section 10.5)
    5. Have spleen volume of = 450 cm3 by MRI or CT scan (either local or central read)
    6. Have completed the MFSAF v4.0 (Section 10.6) at least 5 of 7 days prior to randomization
    7. Have at least 2 symptoms with an average score = 3 over the 7-day period prior to randomization or an average total score of = 10 over the 7-day period prior to randomization using the MFSAF v4.0 (Section 10.6)
    8. Have acceptable laboratory assessments obtained within 28 days prior to the first dose of study medication:
    • ANC = 1 × 109/L in the absence of growth factors or transfusions for the previous 4 weeks
    • Platelet count = 100 × 109/L in the absence of growth factors or transfusions for the previous 4 weeks
    • Peripheral blood blast count < 5%
    • AST and ALT = 2.5 × ULN (= 5 × if the elevation can be ascribed to liver involvement; e.g., presence of hepatomegaly)
    • Serum direct bilirubin < 2.0 × ULN
    • Calculated or measured CrCl of = 45 mL/min
    9. ECOG performance status of = 2
    10. Life expectancy > 24 weeks per Investigator assessment
    11. Have fully recovered from major surgery, intervention, and from the residual Grade 1 toxicity from prior MF-specific therapy (grade 1 peripheral neuropathy and alopecia are allowed).
    12. Male and female patients with reproductive potential must agree to use highly effective contraceptive methods (i.e., condoms or sexual abstinence if the preferred and usual lifestyle of the patient for males and oral, intravaginal, transdermal inhibitors of ovulation that contain estrogen and progesterone; oral, injectable or implantable inhibitors of ovulation that contain progesterone; IUD; IUS; bilateral tubal occlusion; vasectomized partner; sexual abstinence if the preferred and usual lifestyle of the patient for females) while on study therapy and for 3 months after the last dose of study drug. NOTE: Male patients should be informed of the risk of testicular toxicity and provided with adequate advice regarding sperm preservation.
    Informed Consent
    13. Capable of giving signed informed consent as described in Section 10.1.3, which includes compliance with the requirements and restrictions listed in the ICF and in this protocol
    I pazienti possono essere inclusi nello studio solo se si applicano tutti i seguenti criteri:
    Età
    1. = 18 anni di età al momento della firma del consenso informato
    Tipo di paziente e caratteristiche della malattia
    2. Avere una diagnosi confermata di MF (PMF o PPV-MF o PET-MF) in conformità con i criteri dell'OMS del 2016 (Sezione 10.4)
    3. Richiedono una terapia per la MF secondo il parere dello sperimentatore e sono idonei per il trattamento con ruxolitinib
    4. Avere una categoria di rischio DIPSS Intermedio-1 o superiore (Sezione 10.5)
    5. Avere un volume della milza di = 450 cm3 mediante risonanza magnetica o TC (lettura locale o centrale)
    6. Aver completato MFSAF v4.0 (Sezione 10.6) almeno 5 giorni su 7 prima della randomizzazione
    7. Avere almeno 2 sintomi con un punteggio medio = 3 nel periodo di 7 giorni prima della randomizzazione o un punteggio totale medio di = 10 nel periodo di 7 giorni prima della randomizzazione utilizzando MFSAF v4.0 (Sezione 10.6)
    8. Avere valutazioni di laboratorio accettabili ottenute entro 28 giorni prima della prima dose del farmaco in studio:
    • ANC = 1 × 109 / L in assenza di fattori di crescita o trasfusioni nelle 4 settimane precedenti
    • Conta piastrinica = 100 × 109 / L in assenza di fattori di crescita o trasfusioni nelle 4 settimane precedenti
    • Conta dei blasti ematici periferici <5%
    • AST e ALT = 2,5 × ULN (= 5 × se l'aumento può essere attribuito al coinvolgimento del fegato; ad esempio, presenza di epatomegalia)
    • Bilirubina diretta sierica <2,0 × ULN
    • CrCl calcolato o misurato di = 45 mL / min
    9. Performance status ECOG = 2
    10. Aspettativa di vita> 24 settimane per valutazione dello sperimentatore
    11. Si sono completamente ripresi da un intervento chirurgico importante, da un intervento e dalla tossicità residua di Grado 1 da una precedente terapia specifica per MF (sono consentite neuropatia periferica di grado 1 e alopecia).
    12. I pazienti di sesso maschile e femminile con potenziale riproduttivo devono accettare di utilizzare metodi contraccettivi altamente efficaci (ad esempio, preservativi o astinenza sessuale se lo stile di vita preferito e abituale del paziente per i maschi e gli inibitori dell'ovulazione orale, intravaginale e transdermica che contengono estrogeni e progesterone; inibitori dell'ovulazione orali, iniettabili o impiantabili che contengono progesterone; IUD; IUS; occlusione tubarica bilaterale; partner vasectomizzato; astinenza sessuale se lo stile di vita preferito e abituale del paziente per le femmine) durante la terapia in studio e per 3 mesi dopo l'ultima dose di farmaco in studio. NOTA: i pazienti di sesso maschile devono essere informati del rischio di tossicità testicolare e devono essere forniti di un'adeguata consulenza sulla conservazione dello sperma.
    Consenso informato
    13. Capace di dare il consenso informato firmato come descritto nella Sezione 10.1.3, che include la conformità ai requisiti e alle restrizioni elencati nell'ICF e in questo protocollo
    E.4Principal exclusion criteria
    1. Had splenic irradiation within 6 months of starting study drug
    2. Had prior splenectomy
    3. Are a candidate for, and willing to undergo allogeneic HSCT, and, in the opinion of the Investigator, the benefit of proceeding to an allogeneic HSCT prior to treatment with a JAK2 inhibitor outweighs its risks
    4. Have current known active or chronic infection with HIV, hepatitis B, or hepatitis C. Screening of patients with serologic testing for these viruses is not required. However, patients who have a past history of viral hepatitis or in whom there is a current suspicion of viral hepatitis should have serologic testing for hepatitis B and hepatitis C performed to determine whether there is any current evidence for ongoing infection with these viruses. Patients considered to be at risk for HIV infection should have HIV testing performed.
    5. Have an active infection. Patients will not be eligible for enrollment until recovery to = Grade 1 for at least 2 weeks prior to the first dose of study drug.
    6. Have impaired gastrointestinal function or gastrointestinal disease, including active IBD, that could significantly alter the absorption of study drug, including any unresolved nausea, vomiting, or diarrhea > Grade 1
    7. Have known hypersensitivity to the investigational agent or ruxolitinib, or its metabolites or formulation excipients
    8. Have a history of progressive multifocal leukoencephalopathy
    9. Have impaired cardiac function or clinically significant cardiac diseases, including any of the following:
    • Acute myocardial infarction or unstable angina pectoris = 6 months prior to starting study drug
    • QTcF > 500 msec on the screening ECG
    • New York Heart Association Class III or IV congestive heart failure
    • Uncontrolled clinically significant cardiac arrhythmia (patients with rate-controlled atrial fibrillation are not excluded)
    -Patients with a history of coronary artery disease and revascularization are not excluded.
    10. Have ongoing uncontrolled hypertension (resting systolic blood pressure >160 mmHg and resting diastolic blood pressure >100 mmHg) despite maximal treatment with at least 2 anti-hypertensive agents
    11. Have ongoing uncontrolled blood glucose increase (HbA1c =9%) despite maximal treatment with oral and/or injectable anti-hyperglycemic agents
    12. Have a history of a concurrent or second malignancy except for adequately treated local basal cell or squamous cell carcinoma of the skin, cervical carcinoma in situ, superficial bladder cancer, asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy or requiring only hormonal therapy and with normal prostate-specific antigen for = 1 year prior to randomization, adequately treated Stage 1 or 2 cancer currently in complete remission, or any other cancer that has been in complete remission for = 3 years
    13. Have any other concurrent severe and/or uncontrolled concomitant medical condition which acc. to the Investigator could compromise participation in the study or analysis of study data. This includes but is not limited to clinically significant pulmonary disease or neurological disorders.
    14. Had prior treatment with any JAKi or BET inhibitor for treatment of a myeloproliferative neoplasm
    15. Had systemic anti-cancer treatment other than hydroxyurea and anagrelide less than 2 weeks (or 5 half-lives, whichever is longer) before the first dose of study drug. NOTE: Hydroxyurea and anagrelide are permitted up to 24 hours prior to start of study drug.
    16. Had any investigational agent (whether as cancer treatment or not) less than 2 weeks (or 5 half-lives, whichever is longer) before the first dose of study drug
    17. Had hematopoietic growth factor (granulocyte growth factor, erythropoiesis stimulating agent, thrombopoietin mimetic) or androgenic steroids less than 4 weeks before the first dose of study drug
    18. Had a strong CYP3A4 inhibitor or inducer within 2 weeks prior to the first dose of study drug (Section 10.8), ................
    1. Ha avuto irradiazione splenica entro 6 mesi dall'inizio del farmaco in studio
    2. Ha avuto una precedente splenectomia
    3. Sono candidati e disposti a sottoporsi a HSCT allogenico e, a parere dello sperimentatore, il vantaggio di procedere a un HSCT allogenico prima del trattamento con un inibitore della JAK2 supera i suoi rischi
    4. Ha un'infezione attiva o cronica nota in corso da HIV, epatite B o epatite C. Non è richiesto lo screening dei pazienti con test sierologici per questi virus. Tuttavia, i pazienti che hanno una storia passata di epatite virale o in cui vi è un sospetto attuale di epatite virale devono sottoporsi a test sierologici per l'epatite B e l'epatite C per determinare se vi sono prove attuali di infezione in corso con questi virus. I pazienti considerati a rischio di infezione da HIV devono essere sottoposti a test HIV.
    5. Avere un'infezione attiva. I pazienti non saranno idonei all'arruolamento fino al recupero a = Grado 1 per almeno 2 settimane prima della prima dose del farmaco in studio.
    6. Ha una funzione gastrointestinale compromessa o una malattia gastrointestinale, inclusa l'IBD attiva, che potrebbe alterare in modo significativo l'assorbimento del farmaco in studio, inclusi nausea, vomito o diarrea non risolti> Grado 1
    7. Ha nota ipersensibilità all'agente sperimentale o ruxolitinib, o ai suoi metaboliti o eccipienti della formulazione
    8. Avere una storia di leucoencefalopatia multifocale progressiva
    9. Hanno una funzione cardiaca compromessa o malattie cardiache clinicamente significative, tra cui una delle seguenti:
    • Infarto miocardico acuto o angina pectoris instabile = 6 mesi prima dell'inizio del farmaco in studio
    • QTcF> 500 msec sull'ECG di screening
    • Insufficienza cardiaca congestizia di classe III o IV della New York Heart Association
    • Aritmia cardiaca clinicamente significativa non controllata (i pazienti con fibrillazione atriale controllata dalla frequenza non sono esclusi)
    -Non sono esclusi i pazienti con una storia di malattia coronarica e rivascolarizzazione.
    10. Soffre di ipertensione non controllata (pressione sistolica a riposo> 160 mmHg e pressione diastolica a riposo> 100 mmHg) nonostante il massimo trattamento con almeno 2 agenti antipertensivi
    11. Avere un aumento incontrollato della glicemia (HbA1c = 9%) nonostante il trattamento massimo con agenti anti-iperglicemici orali e / o iniettabili
    12. Avere una storia di una concomitante o seconda neoplasia ad eccezione di carcinoma basocellulare locale o squamocellulare della pelle adeguatamente trattato, carcinoma cervicale in situ, carcinoma della vescica superficiale, carcinoma prostatico asintomatico senza malattia metastatica nota e senza necessità di terapia o solo terapia ormonale e con antigene prostatico specifico normale per = 1 anno prima della randomizzazione, cancro in stadio 1 o 2 adeguatamente trattato attualmente in remissione completa, o qualsiasi altro tumore che è stato in remissione completa per = 3 anni
    13. Ha qualsiasi altra condizione medica concomitante concomitante grave e / o incontrollata che acc. allo sperimentatore potrebbe compromettere la partecipazione allo studio o all'analisi dei dati dello studio. Ciò include ma non è limitato a malattie polmonari clinicamente significative o disturbi neurologici.
    14. Ha avuto un precedente trattamento con qualsiasi inibitore JAKi o BET per il trattamento di una neoplasia mieloproliferativa
    15. Ha ricevuto un trattamento antitumorale sistemico diverso da idrossiurea e anagrelide per meno di 2 settimane (o 5 emivite, a seconda di quale sia più lunga) prima della prima dose del farmaco in studio. NOTA: l'idrossiurea e l'anagrelide sono consentite fino a 24 ore prima dell'inizio del farmaco in studio.
    16. Ha avuto un agente sperimentale (sia come trattamento del cancro o meno) meno di 2 settimane (o 5 emivite, a seconda di quale sia più lunga) prima della prima dose del farmaco in studio
    17. Aveva un fattore di crescita ematopoietico ...........................
    E.5 End points
    E.5.1Primary end point(s)
    Splenic response at Week 24
    Risposta splenica alla settimana 24
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 24
    Settimana 24
    E.5.2Secondary end point(s)
    - TSS response at Week 24
    - Improvement in bone marrow fibrosis by at least 1 grade compared to baseline at Week 24
    - Duration of splenic response, defined as the time from onset of splenic response until progressive disease (a =25% increase in spleen volume from baseline, as confirmed by the central review) or death, whichever comes first
    - Duration of TSS response, defined as the time from onset of TSS response until a =25% increase in TSS from baseline or death, whichever comes first
    - Rate of RBC transfusions, defined as the average number of units of RBC transfusion per month (4 weeks), over the first 24 weeks of treatment
    - Conversion from RBC transfusion dependence (=6 units of RBC transfusion during the 12-week baseline period prior to dosing) to independence (no RBC transfusions during any 12-week period post baseline)
    - Duration of RBC transfusion independence post conversion, defined as time from the onset of conversion from RBC transfusion dependence to independence until the first occurrence of RBC transfusion
    - RBC transfusion dependence, defined as = 6 units of RBC transfusion during the prior 12 weeks, at Week 24
    - Hemoglobin response, defined as a = 1.5 g/dL increase in hemoglobin from baseline in the absence of RBC transfusion during the previous 12 weeks
    - PGIC at Week 24
    - Change from baseline to Week 24 in EQ-5D™
    - Splenic and TSS response at Week 24
    - IWG-MRT response (e.g., complete and partial remission, clinical improvement, stable disease, progressive disease, and relapse) at Week 24, based on the revised 2013 IWG-MRT response criteria(Section 10.7)
    - PFS, defined as the time from randomization until documented progression (see definition of progression in Section 7.1), or until death from any cause for patients without documented progression
    - OS, defined as the time from randomization until death from any cause
    - Conversion from MF to AML
    - AEs and SAEs and changes in physical examinations, vital signs, ECGs, and laboratory results
    - PK of CPI-0610: AUC0-t, AUC0-a, AUCtau,ss, Tmax, Cmax, Ctrough, T1/2, Vd/F, CL/F
    - PK of ruxolitinib: AUC0-t, AUC0-a, AUCtau,ss, Tmax, Cmax, Ctrough,T1/2, Vd/F, CL/F
    EXPLORATORY ENDPOINTS
    - Change from baseline in peripheral blood blast percent
    - Assessment of post-treatment transcriptional changes from baseline and changes in signaling pathway activity assessed by measuring levels of mRNA and/or protein
    - Post-treatment changes from baseline in circulating concentrations of cytokines
    - Post-treatment changes from baseline in the ratio of mutant to wild type JAK2, CALR, and other MF-relevant alleles
    - Assessment of MF or BET biology-related features associated with response
    - Risposta TSS alla settimana 24
    - Miglioramento della fibrosi del midollo osseo di almeno 1 grado rispetto al basale alla Settimana 24
    - Durata della risposta splenica, definita come il tempo dall'insorgenza della risposta splenica fino alla progressione della malattia (a = aumento del 25% del volume della milza rispetto al basale, come confermato dalla revisione centrale) o alla morte, a seconda di quale evento si verifica per primo
    - Durata della risposta TSS, definita come il tempo dall'inizio della risposta TSS fino a un aumento = 25% del TSS dal basale o dalla morte, a seconda di quale evento si verifica per primo
    - Tasso di trasfusioni di GR, definito come il numero medio di unità di trasfusione di GR al mese (4 settimane), nelle prime 24 settimane di trattamento
    - Conversione dalla dipendenza dalla trasfusione di GR (= 6 unità di trasfusione di GR durante il periodo basale di 12 settimane prima della somministrazione) all'indipendenza (nessuna trasfusione di GR durante un periodo di 12 settimane successivo al basale)
    - Durata dell'indipendenza dalla trasfusione di GR dopo la conversione, definita come il tempo dall'inizio della conversione dalla dipendenza dalla trasfusione di GR all'indipendenza fino alla prima occorrenza della trasfusione di GR
    - Dipendenza dalla trasfusione di globuli rossi, definita come = 6 unità di trasfusione di globuli rossi durante le 12 settimane precedenti, alla settimana 24
    - Risposta dell'emoglobina, definita come un aumento dell'emoglobina = 1,5 g / dL rispetto al basale in assenza di trasfusione di globuli rossi durante le 12 settimane precedenti
    - PGIC alla settimana 24
    - Modifica dal basale alla settimana 24 in EQ-5D ™
    - Risposta splenica e TSS alla settimana 24
    - Risposta IWG-MRT (ad es. Remissione completa e parziale, miglioramento clinico, malattia stabile, malattia progressiva e recidiva) alla Settimana 24, sulla base dei criteri di risposta IWG-MRT 2013 rivisti (Sezione 10.7)
    - PFS, definita come il tempo dalla randomizzazione fino alla progressione documentata (vedere la definizione di progressione nella sezione 7.1), o fino alla morte per qualsiasi causa per i pazienti senza progressione documentata
    - OS, definito come il tempo dalla randomizzazione fino alla morte per qualsiasi causa
    - Conversione da MF a AML
    - AE e SAE e cambiamenti negli esami fisici, segni vitali, ECG e risultati di laboratorio
    - PK di CPI-0610: AUC0-t, AUC0-a, AUCtau, ss, Tmax, Cmax, Ctrough, T1 / 2, Vd / F, CL / F
    - PK di ruxolitinib: AUC0-t, AUC0-a, AUCtau, ss, Tmax, Cmax, Ctrough, T1 / 2, Vd / F, CL / F
    ENDPOINT ESPLORATIVI
    - Variazione dal basale della percentuale di blasti di sangue periferico
    - Valutazione dei cambiamenti trascrizionali post-trattamento rispetto al basale e cambiamenti nell'attività della via di segnalazione valutati misurando i livelli di mRNA e / o proteine
    - Variazioni post-trattamento rispetto al basale nelle concentrazioni circolanti di citochine
    - Variazioni post-trattamento rispetto al basale nel rapporto tra JAK2 mutante e wild type, CALR e altri alleli rilevanti per MF
    - Valutazione delle caratteristiche legate alla biologia MF o BET associate alla risposta
    E.5.2.1Timepoint(s) of evaluation of this end point
    The key secondary endpoint of the study is TSS response, defined as a = 50% decrease from baseline in TSS as measured by the MFSAF v4.0, at Week 24.
    For other secondary endpoints and exploratory endpoints the evaluation will be performed at
    timepoints as indicated in the protocol and above.
    L'endpoint secondario chiave dello studio è la risposta TSS, definita come una diminuzione = 50% rispetto al basale della TSS misurata dall'MFSAF v4.0, alla settimana 24.
    Per altri endpoint secondari ed endpoint esplorativi verrà eseguita la valutazione
    timepoints come indicato nel protocollo e sopra.
    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 No
    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 No
    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) No
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Il crossover è possibile per il braccio di controllo dopo il trattamento in doppio cieco
    Crossover is possible for control arm after double-blind treatment
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.4.1Number of sites anticipated in Member State concerned1
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA96
    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
    United States
    Austria
    Belgium
    France
    Germany
    Hungary
    Ireland
    Italy
    Netherlands
    Poland
    Romania
    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
    LPLV
    LPLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months9
    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: 155
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 155
    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 No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state42
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 260
    F.4.2.2In the whole clinical trial 310
    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)
    None
    Nessuno
    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 Decision2021-02-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-01-20
    P. End of Trial
    P.End of Trial StatusOngoing
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