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A Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Axatilimab Monotherapy in Japanese Participants With Recurrent or Refractory Active Chronic Graft-Versus-Host Disease

Phase 3
Active, not recruiting
Conditions
Chronic Graft-versus-host-disease
Interventions
Registration Number
NCT06263478
Lead Sponsor
Incyte Biosciences Japan GK
Brief Summary

This study will be conducted to determine the clinical efficacy of axatilimab in Japanese participants with chronic graft-versus-host disease (cGVHD).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
21
Inclusion Criteria
  • At least 6 years of age at the time of signing the ICF.

  • Ability to comprehend and willingness to sign a written ICF for the study.

    • For participants 6 to 17 years old, a parent/guardian must provide consent for pediatric participants; when applicable, pediatric participants should also sign an assent form.

  • Japanese participants who are allo-HSCT recipients with active, refractory, or recurrent cGVHD requiring systemic immune suppression despite at least 2 lines of prior systemic therapy.

    • Active cGVHD is defined as the presence of signs and symptoms of cGVHD per the 2014 NIH Consensus Development Project on Criteria for Clinical Trials in cGVHD.

    • Refractory disease is defined as meeting any of the following criteria:

      • The development of 1 or more new sites of disease while being treated for cGVHD.
      • Progression of existing sites of disease despite at least 1 month of standard or investigational therapy for cGVHD.
      • Participants who did not achieve a response within 3 months on prior therapy for cGVHD and for whom the treating physician believes a new systemic therapy is required.
    • Recurrent cGVHD is defined as active, symptomatic disease (after an initial response to prior therapy) based on the NIH 2014 consensus criteria by organ-specific or global assessment or for which the physician believes a new line of systemic therapy is required.

  • Participants may have persistent, active aGVHD and cGVHD manifestations (overlap syndrome), as defined by the 2014 NIH Consensus Development Project on Criteria for Clinical Trials in cGVHD.

  • Karnofsky performance score of ≥ 60 (if aged 16 years or older); Lansky performance score of ≥ 60 (if aged younger than 16 years).

  • Adequate organ and bone marrow functions evaluated during the 14 days prior to the start of study treatment.

  • Creatinine clearance ≥ 30 mL/min based on the Cockcroft-Gault formula in adult participants and Schwartz formula in pediatric participants.

  • Concomitant use of a systemic corticosteroid is allowed but not required. Topical and inhaled corticosteroid agents are allowed. If a participant is taking a corticosteroid, it must be a stable dose for at least 2 weeks prior to the start of study treatment.

  • Concomitant use of protocol-defined immunosuppressant is allowed but not required.

  • Willingness to avoid pregnancy or fathering children based on protocol-defined criteria.

Exclusion Criteria
  • Has aGVHD without manifestations of cGVHD.
  • Any evidence (histologic, cytogenetic, molecular, hematologic, or mixed) of relapse of the underlying cancer or post-transplant lymphoproliferative disease at the time of screening.
  • History of acute or chronic pancreatitis.
  • History of myositis.
  • History or other evidence of severe illness, uncontrolled infection, allergy to excipients, or any other conditions that would make the participant, in the opinion of the investigator, unsuitable for the study.
  • Has acquired immunodeficiency syndrome.
  • History of latent or active TB based on protocol-defined criteria.
  • Active HBV or HCV infection that requires treatment, or at risk for HBV reactivation (ie, positive HBsAg).
  • Pregnant or breastfeeding.
  • Previous exposure to CSF-1R targeted therapies.
  • Use of any agent other than corticosteroids, or the immunosuppressant for the treatment of cGVHD within 2 weeks or 5 half-lives, whichever is shorter, prior to the start of study treatment.
  • Has received an investigational treatment within 28 days prior to the start of study treatment.
  • Currently participating in any other interventional study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Axatilimab DoseINCA034176Axatilimab at the protocol-defined dose.
Primary Outcome Measures
NameTimeMethod
Overall Response Rate in the First 6 CyclesUp to Cycle 7 (Day 169)

The overall response rate will be assessed by the number of participants with objective response by Cycle 7 (28-day cycles), Day 1, with responses defined by the 2014 NIH consensus criteria.

Secondary Outcome Measures
NameTimeMethod
Number of Participants with Anti-Drug Antibody (ADA)Up to 2 years and 30 days
Proportion of participants with a ≥ 7-point improvement in modified Lee symptom scale (mLSS) scoreUp to 2 years
Overall Response RateUp to 2 years

Defined by the 2014 NIH Consensus Development Project on Criteria for Clinical Trials in cGVHD.

Duration of ResponseUp to 2 years

Defined as the time from initial partial response or complete response until documented progression of cGVHD, start of new therapy, or death for any reason.

Organ-specific Response RateUp to 2 years

Organ-specific response is defined as the number of participants with objective response for the nine individual organs based on 2014 NIH Consensus Development Project on Criteria for Clinical Trials in cGVHD (skin, eyes, mouth, esophagus, upper gastrointestinal \[GI\], lower GI, liver, lungs and joints and fascia).

Percent reduction in average daily dose (or equivalent) of corticosteroidsUp to 2 years
Proportion of participants who discontinue corticosteroid useUp to 2 years
Change from baseline in Karnofsky/Lansky performance statusUp to 2 years and 30 days
Number of participants with Treatment-emergent Adverse Events (TEAEs)Up to 2 years and 30 days

Defined as adverse events reported for the first time or worsening of a pre-existing event from the time the participant signs the informed consent form (ICF) until at least 30 days after the end of trial (EOT) or until start of new cGVHD therapy.

Axatilimab pharmacokinetic (PK) in PlasmaUp to 2 years and 30 days

Axatilimab concentration in plasma.

Trial Locations

Locations (16)

Okayama University Hospital

🇯🇵

Okayama, Japan

Osaka Prefectural Hospital Organization Osaka International Cancer Institute

🇯🇵

Osaka, Japan

Fujita Health University Hospital

🇯🇵

Aichi, Japan

University of Fukui Hospital

🇯🇵

Fukui, Japan

Kyushu University Hospital

🇯🇵

Fukuoka, Japan

Hiroshima University Hospital

🇯🇵

Hiroshima-shi, Japan

Hokkaido University Hospital

🇯🇵

Hokkaido, Japan

Kobe City Medical Center General Hospital

🇯🇵

Hyogo, Japan

Tokai University Hospital

🇯🇵

Kanagawa, Japan

National Hospital Organization Kumamoto Medical Center

🇯🇵

Kumamoto, Japan

Tohoku University Hospital

🇯🇵

Miyagi, Japan

Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital

🇯🇵

Nagoya-shi, Japan

Osaka Metropolitan University Hospital

🇯🇵

Osaka, Japan

Saitama Prefectural Children'S Medical Center

🇯🇵

Saitama-shi, Saitama,, Japan

Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital

🇯🇵

Tokyo, Japan

National Center For Child Health and Development

🇯🇵

Tokyo, Japan

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