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    Summary
    EudraCT Number:2021-005724-38
    Sponsor's Protocol Code Number:TL-895-209
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2022-05-02
    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 number2021-005724-38
    A.3Full title of the trial
    An Open-Label, Multicenter, Phase 1b/2 Study of the Safety and Efficacy of TL-895 Combined with Ruxolitinib in Janus associated Kinase Inhibitor (JAKi) Treatment-Naïve Myelofibrosis (MF) Subjects and Subjects with MF who have a Suboptimal Response to Ruxolitinib
    Studio di fase 1b/2, in aperto, multicentrico, sulla sicurezza e sull’efficacia di TL-895 in combinazione con ruxolitinib in soggetti con mielofibrosi (MF) naïve al trattamento con inibitori della Janus chinasi (JAKi) e soggetti con MF che presentano una risposta subottimale a ruxolitinib
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 1b/2 Study of TL-895 Combined with Ruxolitinib in JAKi Treatment-Naïve MF Subjects and Subjects with MF who have a Suboptimal Response to Ruxolitinib
    Studio di fase 1b/2 di TL-895 in combinazione con ruxolitinib in soggetti con mielofibrosi (MF) naïve al trattamento con JAKi e soggetti con MF che presentano una risposta subottimale a ruxolitinib
    A.3.2Name or abbreviated title of the trial where available
    Phase 1b/2 Study of TL-895 Combined with Ruxolitinib
    Studio di fase 1b/2 di TL-895 in combinazione con ruxolitinib
    A.4.1Sponsor's protocol code numberTL-895-209
    A.5.4Other Identifiers
    Name:INDNumber:150807
    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 SponsorTelios Pharma, 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 supportTelios Pharma, Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationTelios Pharma, Inc.
    B.5.2Functional name of contact pointRegulatory Affairs
    B.5.3 Address:
    B.5.3.1Street Address275 Shoreline Drive, Suite 235
    B.5.3.2Town/ cityRedwood City
    B.5.3.3Post codeCA 94065
    B.5.3.4CountryUnited States
    B.5.6E-mailkvyas@teliospharma.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 nameTL-895
    D.3.2Product code [TL-895]
    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.3.9.1CAS number 1415823-49-2
    D.3.9.2Current sponsor codeTL-895
    D.3.9.4EV Substance CodeSUB216480
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTL-895
    D.3.2Product code [TL-895]
    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.3.9.1CAS number 1415823-49-2
    D.3.9.2Current sponsor codeTL-895
    D.3.9.4EV Substance CodeSUB216480
    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: 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 nameTL-895
    D.3.2Product code [TL-895]
    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.3.9.1CAS number 1415823-49-2
    D.3.9.2Current sponsor codeTL-895
    D.3.9.4EV Substance CodeSUB216480
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    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 Yes
    D.2.1.1.1Trade name Jakavi
    D.2.1.1.2Name of the Marketing Authorisation holderNovartis
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameRuxolitinib
    D.3.2Product code [-]
    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 INNRUXOLITINIB
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB32273
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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
    Janus associated Kinase Inhibitor (JAKi) Treatment-Naïve Myelofibrosis (MF) Subjects and Subjects with MF who have a Suboptimal Response to Ruxolitinib
    Mielofibrosi (MF) naïve al trattamento con inibitori della chinasi associata a Janus (JAKi) e soggetti con MF che hanno una risposta non ottimale a Ruxolitinib
    E.1.1.1Medical condition in easily understood language
    Myelofibrosis is an uncommon type of bone marrow cancer that disrupts the body's normal production of blood cells.
    La mielofibrosi è un tipo raro di cancro del midollo osseo che altera la normale produzione di cellule del sangue da parte del corpo.
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    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.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 1b: To determine the recommended Phase 2 dose (RP2D) of TL-895 in combination with ruxolitinib.
    Phase 2: To determine the spleen reduction volume (SVR) rate at Week 24.
    Fase 1b: determinare la dose raccomandata per la fase 2 (RP2D) di TL-895 in combinazione con ruxolitinib
    Fase 2: determinare il tasso di riduzione del volume della milza (SVR) alla settimana 24.
    E.2.2Secondary objectives of the trial
    Phase 1b:
    To determine:
    -the spleen volume reduction (SVR) rate at Week 24
    -the improvement in Total Symptom Score (TSS) at Week 24
    -spleen response
    -the duration of spleen response (DoR-spleen)
    -the rate of conversion from Red Blood Cell (RBC) transfusion dependent to independent
    -the clinical response rate: complete response (CR) and partial response (PR)
    -the overall survival (OS) rate
    -progression-free survival (PFS)
    To characterize the pharmacokinetic (PK) profile of TL-895 and ruxolitinib
    To determine the safety and tolerability of TL 895

    Phase 2:
    To determine the improvement in TSS at Week 24
    To determine spleen response
    To determine the DoR-spleen
    To determine the rate of conversion from RBC transfusion dependent to independent
    To determine the clinical response rate: CR and PR
    To determine the OS rate
    To determine PFS
    Fase 1b:
    Determinare:
    -il tasso di riduzione del volume della milza (SVR) alla settimana 24
    -il miglioramento del punteggio totale dei sintomi (TSS) alla settimana 24
    -risposta splenica
    -la durata della risposta della milza (DoR-milza)
    -il tasso di conversione da trasfusione eritrocitaria (RBC) dipendente a indipendente
    -il tasso di risposta clinica: risposta completa (CR) e risposta parziale (PR)
    -il tasso di sopravvivenza globale (OS).
    -sopravvivenza libera da progressione (PFS)
    Per caratterizzare il profilo farmacocinetico (PK) di TL-895 e ruxolitinib
    Per determinare la sicurezza e la tollerabilità di TL 895

    Fase 2:
    Per determinare il miglioramento del TSS alla settimana 24
    Per determinare la risposta splenica
    Per determinare la DoR della milza
    Determinare il tasso di conversione da trasfusione eritrocitaria dipendente a indipendente
    Per determinare il tasso di risposta clinica: CR e PR
    Per determinare il tasso di OS
    Per determinare la PFS
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Phase 1b and Phase 2 Cohort 2
    1. Treatment with ruxolitinib for = 12 weeks prior to study entry, and on a stable dose of ruxolitinib in the 8 weeks prior to Sponsor approval of the enrollment form
    • A stable dose is defined as a ruxolitinib dose that has not required a treatment hold or dose adjustment
    • Subjects must be taking a stable dose of ruxolitinib of at least 5 mg BID or 10 mg QD
    Phase 1b and Phase 2 (both cohorts)
    2. Subjects = 18 years of age and able to provide informed consent.
    3. Confirmed diagnosis of PMF, post-PV MF, or post-ET MF, as assessed by treating physician 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. Palpable spleen measuring = 5 cm below the left lower coastal margin (LLCM) or spleen volume of = 450 cm3 by MRI or CT scan assessment
    6. MF symptoms as defined by having at least 2 symptoms with a score of at least 1 each on the MFSAF v4.0
    7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
    8. Adequate hematological function within 7 days (Phase 1b) or 28 days (Phase 2) prior to first dose, independent of growth factor support for at least 7 days, with the exception of pegylated Granulocyte Colony-Stimulating Factor (G-CSF) which requires at least 14 days, defined as:
    • Absolute neutrophil count (ANC) = 1.0 × 109/L
    • Platelet count = 50 × 109/L
    9. Adequate hepatic function within 7 days (Phase 1b) or 28 days (Phase 2) prior to first dose of study treatment defined as:
    • Total serum bilirubin = 2.0 x upper limit of normal (ULN). Subjects with known Gilbert’s syndrome or disease-related hemolysis must have a total bilirubin =3.0 × ULN
    • Aspartate aminotransferase (AST) = 2.5 × ULN, and alanine aminotransferase (ALT) = 2.5 × ULN.
    10. Adequate renal function within 7 days (Phase 1b) or 28 days (Phase 2) defined as an estimated creatinine clearance = 30 mL/min according to Cockcroft Gault.
    11. Female subjects of childbearing potential and their male partners, or male subjects who have female partners of childbearing potential, must both use a highly effective contraception method during the study. In addition, after the last dose of study drug, female subjects must continue to use contraception for 1 month and 1 week and male subjects must continue to use contraception for 3 months and 1 week. A woman is considered of childbearing potential
    Fase 1b e Fase 2 Coorte 2
    1. Trattamento con ruxolitinib per =12 settimane prima dell’ingresso nello studio e con una dose stabile di ruxolitinib nelle 8 settimane precedenti l’approvazione del modulo di arruolamento da parte dello Sponsor
    • Una dose stabile è definita come una dose di ruxolitinib che non abbia richiesto una sospensione del trattamento o un aggiustamento della dose
    • I soggetti devono assumere una dose stabile di ruxolitinib di almeno 5 mg BID o 10 mg QD
    Fase 1b e Fase 2 (entrambe le Coorti)
    2. Soggetti di età =18 anni e in grado di esprimere il consenso informato.
    3. Diagnosi confermata di mielofibrosi primaria (PMF), MF post-PV o mielofibrosi post-ET, come valutato dal medico curante secondo i criteri dell’Organizzazione Mondiale della Sanità (OMS)
    4. Alto rischio, rischio intermedio 2 o rischio intermedio 1, definito mediante il Sistema prognostico internazionale dinamico (DIPSS)
    5. Milza palpabile che misura =5 cm sotto il margine costale inferiore sinistro (LLCM) o volume della milza =450 cm3 secondo valutazione mediante RMI o TAC
    6. Sintomi di MF come definito in base alla presenza di almeno 2 sintomi con un punteggio di almeno 1 ciascuno sul modulo MFSAF v4.0
    7. Scala di valutazione del Gruppo cooperativo orientale di oncologia (ECOG) da 0 a 2
    8. Adeguata funzione ematologica entro 7 giorni (Fase 1b) o 28 giorni (Fase 2) prima della prima dose, indipendentemente dal supporto del fattore di crescita per almeno 7 giorni, ad eccezione del fattore di stimolazione delle colonie di granulociti pegilato (G-CSF) richiedente almeno 14 giorni, definita come:
    • Conta assoluta dei neutrofili (ANC) =1,0 × 109/l
    • Conta piastrinica =50 × 109/l
    9. Adeguata funzione epatica entro 7 giorni (Fase 1b) o 28 giorni (Fase 2) precedenti la prima dose del trattamento in studio, definita come:
    • bilirubina sierica totale =2,0 volte il limite superiore dell’intervallo normale (ULN). I soggetti con nota sindrome di Gilbert o emolisi correlata alla malattia devono avere una bilirubina totale =3,0 volte l’ULN
    • Aspartato aminotransferasi (AST) =2,5 volte l’ULN e alanina aminotransferasi (ALT) =2,5 volte l’ULN.
    10. Adeguata funzione renale entro 7 giorni (Fase 1b) o 28 giorni (Fase 2) precedenti la prima dose, definita come clearance della creatinina stimata =30 ml/min secondo l’equazione Cockcroft Gault.
    11. I soggetti di sesso femminile in età fertile e i rispettivi partner di sesso maschile o i soggetti di sesso maschile con partner di sesso femminile in età fertile devono utilizzare un metodo contraccettivo altamente efficace durante lo studio. Inoltre, dopo l’ultima dose del farmaco in studio, i soggetti di sesso femminile devono continuare ad utilizzare la contraccezione per 1 mese e 1 settimana e i soggetti di sesso maschile devono continuare a utilizzare la contraccezione per 3 mesi e 1 settimana. Una donna è considerata potenzialmente fertile (ovvero, fertile, dopo il menarca e fino alla postmenopausa) a meno che non sia permanentemente sterile
    E.4Principal exclusion criteria
    Phase 2 Cohort 1
    1. Prior treatment with any JAKi
    Phase 1b and Phase 2 Cohort 2
    2. Documented disease progression while on ruxolitinib treatment, defined as any of the following:
    • =100% increase in palpable distance, below the LLCM from nadir for baseline splenomegaly of 5 to 10 cm while on ruxolitinib, or
    • = 50% increase in palpable distance, below the LLCM from nadir, for baseline splenomegaly of >10 cm while on ruxolitinib, or
    • =25% increase from nadir in spleen volume by radiographic imaging while on ruxolitinib treatment, or
    • Regrowth after achieving complete response
    Phase 1b and Phase 2 (both cohorts)
    3. Prior splenectomy or splenic irradiation within 24 weeks prior to first dose of study treatment
    4. Prior treatment with a BTK or BMX inhibitor
    5. Chemotherapy, cytoreductive therapy, immune therapy, cytokine therapy or any investigational therapy within 28 days prior to first dose of study treatment. Subjects on hydroxyurea therapy may continue treatment until 1 day prior to the first dose of study drug.
    6. Active participation in other therapeutic clinical trials including supportive care trials
    7. Subjects with a history of bleeding diathesis; major hemorrhage or intracranial hemorrhage within 6 months prior to first dose of study treatment
    8. Major surgery or planned major surgery within 28 days prior to first dose of study treatment.
    9. History of major organ transplant
    10. Having history of difficulty swallowing, gastric or small bowel surgery with history of malabsorption or other chronic gastrointestinal disease or conditions that may hamper compliance and/or absorption of the study treatment
    11. Uncontrolled intercurrent illness including, but not limited to clinically significant cardiac disease (New York Heart Association Class III or IV); symptomatic congestive heart failure; unstable angina pectoris; ventricular arrhythmia; history of myocardial infarction within 3 months
    12. Grade 2 or higher QTc prolongation (> 480 milliseconds [ms] per National Cancer Institute Common Terminology of Adverse Events [v 5.0])
    13. Clinically significant bacterial, mycobacterial, fungal, parasitic, or viral infection. Intravenous (IV) antibiotics within 2 weeks prior to first dose of study treatment.
    14. Subjects with active hepatitis B virus (HBV) or hepatitis C virus (HCV)
    15. Known infection with HIV
    16. Known hypersensitivity or contraindications to the study drugs or any of their excipients.
    17. History of another 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
    18. Requires treatment with proton-pump inhibitors (e.g., omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). Subjects receiving proton-pump inhibitors who switch to H2-receptor antagonists or antacids are eligible for enrollment in this study provided the proton pump inhibitor is discontinued at least 3 days prior to first dose of study drug.
    19. Women who are pregnant or breastfeeding.
    Fase 2 Coorte 1
    1. Precedente trattamento con qualsiasi JAKi
    Fase 1b e Fase 2 Coorte 2
    2. Progressione della malattia documentata durante il trattamento con ruxolitinib, definita come una qualsiasi delle seguenti condizioni:
    • aumento =100% della distanza palpabile, al di sotto del LLCM rispetto al nadir, per splenomegalia al basale di 5-10 cm durante il trattamento con ruxolitinib, oppure
    • aumento =50% della distanza palpabile, al di sotto del LLCM
    rispetto al nadir, per splenomegalia al basale di >10 cm durante il trattamento con ruxolitinib, oppure
    • aumento =25% del volume splenico rispetto al nadir osservato mediante diagnostica per immagini radiografica durante il trattamento con ruxolitinib, oppure
    • ricrescita dopo il raggiungimento di una risposta completa
    Fase 1b e Fase 2 (entrambe le Coorti)
    3. Precedente splenectomia o irradiazione splenica nelle 24 settimane precedenti la prima dose del trattamento in studio
    4. Precedente trattamento con un inibitore di BTK o BMX
    5. Chemioterapia, terapia citoriduttiva, terapia immunitaria, terapia citochinica o qualsiasi terapia sperimentale entro 28 giorni precedenti alla prima dose del trattamento in studio. I soggetti in terapia con idrossiurea possono proseguire il trattamento fino a 1 giorno prima della prima dose del farmaco in studio
    6. Partecipazione attiva ad altre sperimentazioni cliniche terapeutiche, incluse sperimentazioni che prevedono cure di supporto
    7. Soggetti con una storia di diatesi emorragica; emorragia maggiore o emorragia intracranica entro 6 mesi precedenti la prima dose del trattamento in studio
    8. Intervento chirurgico maggiore o intervento chirurgico maggiore programmato nei 28 giorni precedenti la prima dose del trattamento dello studio
    9. Storia di trapianto di organo maggiore
    10. Storia di difficoltà nella deglutizione, chirurgia gastrica o dell’intestino tenue con anamnesi di malassorbimento o altra malattia gastrointestinale cronica o condizioni che potrebbero compromettere la compliance e/o l’assorbimento del trattamento in studio
    11. Malattia intercorrente non controllata, tra cui, ma non limitatamente, cardiopatia clinicamente significativa (Classe III o IV della New York Heart Association); insufficienza cardiaca congestizia sintomatica, angina pectoris instabile, aritmia ventricolare, storia di infarto miocardico entro 3 mesi
    12. Prolungamento dell’intervallo QTc di grado 2 o superiore (>480 millisecondi [ms] secondo i Criteri di terminologia comuni degli eventi avversi [v 5.0] del National Cancer Institute)
    13. Infezione batterica, micobatterica, micotica, parassitaria o virale clinicamente significativa. Antibiotici per via endovenosa (EV) nelle 2 settimane precedenti la prima dose del trattamento in studio
    14. Soggetti con infezione attiva da virus dell’epatite B (HBV) o virus dell’epatite C (HCV)
    15. Nota infezione da HIV
    16. Nota ipersensibilità o controindicazioni ai farmaci in studio o a uno qualsiasi dei loro eccipienti
    17. Storia di altre neoplasie negli ultimi 3 anni, diverse dal carcinoma cutaneo basocellulare o squamocellulare trattato in modo curativo, carcinoma in situ della cervice, carcinoma prostatico non metastatico confinato agli organi o trattato con antigene prostatico specifico nella norma, carcinoma mammario in situ dopo resezione chirurgica completa o carcinoma vescicale superficiale a cellule transizionali
    18. Necessità di trattamento con inibitori della pompa protonica (ad es. omeprazolo, esomeprazolo, lansoprazolo, dexlansoprazolo, rabeprazolo o pantoprazolo). I soggetti che ricevono inibitori della pompa protonica che passano agli antagonisti del recettore H2 o agli antiacidi sono idonei all’arruolamento a questo studio a condizione che l’inibitore della pompa protonica venga interrotto almeno 3 giorni precedenti la prima dose del farmaco in studio
    19. Soggetti di sesso femminile in gravidanza o che stanno allattando al seno
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1b: Dose-limiting toxicities (DLTs) will be used to establish the maximum-tolerated dose (MTD) of TL-895 in combination with ruxolitinib. The safety review committee (SRC) will determine the RP2D based on safety and efficacy data of the combination of TL-895 and ruxolitinib.
    Phase 2: The proportion of subjects achieving SVR of =35% at Week 24 by MRI or CT scan (central review)
    Fase 1b: le tossicità dose-limitanti (DLT) saranno utilizzate per stabilire la dose massima tollerata (MTD) di TL-895 in combinazione con ruxolitinib. Il comitato di revisione della sicurezza (SRC) determinerà l'RP2D sulla base dei dati di sicurezza ed efficacia della combinazione di TL-895 e ruxolitinib.
    Fase 2: la percentuale di soggetti che hanno raggiunto una SVR =35% alla settimana 24 mediante risonanza magnetica o TC (revisione centrale)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1b: End of Phase
    Phase 2: Week 24
    Fase 1b: conclusione della fase
    Fase 2: settimana 24
    E.5.2Secondary end point(s)
    Phase 1b:
    The proportion of subjects achieving =35% SVR at Week 24 by magnetic resonance imaging (MRI) or computed tomography (CT) scan (central review)
    The proportion of subjects achieving =50% reduction in TSS at Week 24 by Myelofibrosis Symptom Assessment Form (MFSAF) v4.0
    The proportion of subjects achieving =35% SVR at any time point from Baseline while on study, as assessed by MRI (or by CT scan for applicable subjects)
    Time from initial SVR of = 35% by MRI/CT (central review) until the first occurrence of disease progression or death
    The proportion of RBC dependent subjects achieving RBC transfusion independence at Week 24
    The proportion of subjects with CR and PR at any time point, from Baseline while on study, defined according to International Working
    Group-Myeloproliferative Neoplasms Research and Treatment (IWGMRT) and modified European LeukemiaNet (ELN) criteria
    OS is defined as the time from first dose to death from any cause
    PFS is the time from first dose date to:
    • Disease progression (=25% increase in spleen volume)
    or
    • Leukemic transformation (bone marrow blasts =20% or peripheral blood blasts =20% associated with an absolute blast count of at least 1x 10^9/L that lasts for at least 2 weeks)
    or
    • Death from any cause
    TL-895 and ruxolitinib PK parameters, including but not limited to:
    • Maximum observed concentration (Cmax)
    • Area under the plasma concentration-time curve (AUC)
    • Time of maximum plasma concentration (Tmax)
    Analyses of the safety endpoints will include the following measurements or assessments: physical examinations, laboratory tests,
    adverse events (AEs), serious AEs (SAEs), electrocardiograms (ECGs), and vital signs
    Phase 2:
    The proportion of subjects achieving =50% reduction in TSS at Week 24 by MFSAF v4.0
    The proportion of subjects achieving =35% SVR at any time point from Baseline while on study, as assessed by MRI (or by CT scan for
    applicable subjects)
    Time from initial SVR of = 35% by MRI/CT (central review) until the first occurrence of disease progression or death
    The proportion of RBC dependent subjects achieving RBC transfusion independence at Week 24
    The proportion of subjects with CR and PR at any time point, from Baseline while on study, defined according to IWG-MRT and modified
    ELN criteria
    OS is defined as the time from first dose to death from any cause
    PFS is the time from first dose date to:
    • Disease progression (=25% increase in spleen volume)
    or
    • Leukemic transformation (bone marrow blasts =20% or peripheral blood blasts =20% associated with an absolute blast count of at least 1 x 10^9/L that lasts for at least 2 weeks)
    or
    • Death from any cause
    TL-895 and ruxolitinib plasma concentrations monitored using sparse sampling.
    Analyses of the safety endpoints will include the following measurements or assessments: physical examinations, laboratory tests,
    AEs, SAEs, ECGs, and vital signs
    Fase 1b:
    La percentuale di soggetti che hanno raggiunto =35% SVR alla settimana 24 mediante risonanza magnetica (MRI) o tomografia computerizzata (TAC) (revisione centrale)
    La percentuale di soggetti che hanno ottenuto una riduzione =50% del TSS alla settimana 24 mediante Myelofibrosis Symptom Assessment Form (MFSAF) v4.0
    La percentuale di soggetti che hanno raggiunto una SVR =35% in qualsiasi momento dal basale durante lo studio, come valutato mediante risonanza magnetica (o scansione TAC per soggetti pertinenti)
    Tempo dall'SVR iniziale di = 35% mediante risonanza magnetica/TAC (revisione centrale) fino alla prima occorrenza di progressione della malattia o morte
    La percentuale di soggetti RBC dipendenti che hanno raggiunto l'indipendenza dalla trasfusione di RBC alla settimana 24
    La proporzione di soggetti con CR e PR in qualsiasi momento, dal basale durante lo studio, definita secondo i criteri del Gruppo di lavoro internazionale–Ricerca e trattamento delle neoplasie mieloproliferative (IWG-MRT) e ai criteri modificati dell’European LeukemiaNet (ELN)
    La OS è definita come il tempo tra la prima dose e il decesso per qualsiasi causa
    La PFS è il tempo intercorrente tra la data della prima dose e:
    • la progressione della malattia (aumento =25% del volume splenico)
    oppure
    • la trasformazione leucemica (blasti nel midollo osseo =20% o blasti nel sangue periferico =20% associati a una conta assoluta dei blasti di almeno 1 x 10^9/l avente una durata almeno pari a 2 settimane)
    oppure
    • il decesso per qualsiasi causa
    Parametri PK di TL-895 e ruxolitinib, inclusi, ma non limitatamente:
    • Concentrazione massima osservata (Cmax)
    • Area sotto la curva (AUC) della concentrazione plasmatica in funzione del tempo
    • Tempo necessario al raggiungimento della massima concentrazione plasmatica (Tmax)
    Le analisi degli endpoint di sicurezza includeranno le seguenti misurazioni o valutazioni: esami obiettivi, esami di laboratorio, eventi avversi (AE), eventi avversi seri (SAE), elettrocardiogrammi (ECG) e segni vitali.
    Fase 2:
    La percentuale di soggetti che hanno ottenuto una riduzione =50% del TSS alla settimana 24 valutata con MFSAF v4.0
    La percentuale di soggetti che hanno raggiunto una SVR =35% in qualsiasi momento dal basale durante lo studio, come valutato mediante risonanza magnetica (o scansione TAC per i soggetti pertinenti)
    Tempo dall'SVR iniziale di = 35% mediante risonanza magnetica/TAC (revisione centrale) fino alla prima occorrenza di progressione della malattia o morte
    Percentuale di soggetti RBC dipendenti che raggiungono l’indipendenza da trasfusioni di RBC alla Settimana 24
    Percentuale di soggetti con CR e PR in qualsiasi punto temporale, dal basale nel corso dello studio, definita in base ai criteri dell’IWG-MRT e ai criteri modificati dell’ELN
    La OS è definita come il tempo intercorrente tra la prima dose e il decesso per qualsiasi causa
    La PFS è il tempo intercorrente tra la data
    della prima dose e:
    • la progressione della malattia (aumento =25% del volume splenico)
    oppure
    • la trasformazione leucemica (blasti nel midollo osseo =20% o blasti nel sangue periferico =20% associati a una conta assoluta dei blasti di almeno 1 x 10^9/l avente una durata almeno pari a 2 settimane)
    oppure
    • il decesso per qualsiasi causa
    Concentrazioni plasmatiche di TL-895 e ruxolitinib monitorate mediante campionamento sparso
    Le analisi degli endpoint di sicurezza includeranno le seguenti misurazioni o valutazioni: esami obiettivi, esami di laboratorio, AE, SAE, ECG e segni vitali
    E.5.2.1Timepoint(s) of evaluation of this end point
    Phase 1b: End of Phase
    Phase 2: Week 24
    Fase 1b: Fine della Fase
    Fase 2: settimana 24
    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 No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Dose escalation
    aumento della dose
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    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 No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA25
    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
    Israel
    United States
    France
    Hungary
    Poland
    United Kingdom
    Spain
    Italy
    E.8.7Trial has a data monitoring committee No
    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
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months2
    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: 18
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 52
    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 state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 50
    F.4.2.2In the whole clinical trial 70
    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)
    Subjects will be treated until disease progression, unacceptable toxicity, death or withdrawal of consent.
    For disease progression, unacceptable toxicity, or withdrawal of consent, subject would move on to standard care based on local practices.
    I soggetti saranno trattati fino a progressione della malattia, tossicità inaccettabile, decesso o revoca del consenso.
    In caso di progressione della malattia, tossicità inaccettabile o revoca del consenso, il soggetto passerebbe alle cure standard basate sulle pratiche locali.
    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 Decision2022-07-12
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-06-16
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2023-07-18
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    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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