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Safety of Itacitinib in Combination With Corticosteroids for Treatment of Steroid-Naive Acute Graft-Versus-Host Disease in Japanese Subjects

Phase 1
Completed
Conditions
Acute Graft-versus-host Disease
Interventions
Drug: Corticosteroid
Registration Number
NCT03497273
Lead Sponsor
Incyte Corporation
Brief Summary

The purpose of this study is to assess the safety and tolerability of itacitinib in combination with corticosteroids in Japanese subjects with Grades II to IV acute graft-versus-host disease (aGVHD).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
14
Inclusion Criteria
  • Japanese; subject was born in Japan and has not lived outside of Japan for a total of > 10 years, and subject can trace maternal and paternal Japanese ancestry.
  • Has undergone 1 allo-hematopoietic stem cell transplant (HSCT) from any donor and source (unrelated, sibling, haploidentical donors with any matching) using bone marrow, peripheral blood or cord blood for hematologic malignancies. Recipients of myeloablative and reduced-intensity conditioning regimens are eligible.
  • Clinically suspected Grades II to IV aGVHD as per Mount Sinai Acute GVHD International Consortium (MAGIC) criteria, occurring after allo-HSCT and any anti-GVHD prophylactic medication.
  • Evidence of myeloid engraftment (eg, absolute neutrophil count [ANC] ≥ 0.5 × 10^9/L for 3 consecutive assessments if ablative therapy was previously used). Use of growth factor supplementation is allowed.
  • Female subjects should agree to use medically acceptable contraceptive measures, should not be breastfeeding, and must have a negative pregnancy test before the start of study drug administration if of childbearing potential or must have evidence of non-childbearing potential by fulfilling protocol-defined criteria at screening.
Exclusion Criteria
  • Has received more than 1 allo-HSCT.

  • Has received more than 2 days of systemic corticosteroids for aGVHD.

  • Presence of GVHD overlap syndrome.

  • Presence of an active uncontrolled infection (defined as hemodynamic instability attributable to sepsis or new symptoms, worsening physical signs, or radiographic findings attributable to infection; persisting fever without signs or symptoms will not be interpreted as an active uncontrolled infection).

  • Known human immunodeficiency virus infection.

  • Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection that requires treatment or at risk for HBV reactivation. For subjects with negative HBsAg and positive total hepatitis B core antibody and for subjects who are positive for HCV antibody, HBV DNA and HCV RNA must be undetectable upon testing.

  • Evidence of relapsed primary disease or having been treated for relapse after the allo-HSCT was performed.

  • Any corticosteroid therapy (for indication other than GVHD) at doses > 1 mg/kg per day methylprednisolone or equivalent within 7 days of enrollment.

  • Severe organ dysfunction unrelated to underlying GVHD, including the following:

    • Cholestatic disorders or unresolved veno-occlusive disease of the liver.
    • Clinically significant or uncontrolled cardiac disease.
    • Clinically significant respiratory disease that requires mechanical ventilation support or 50% oxygen.
  • Serum creatinine > 2.0 mg/dL or creatinine clearance < 40 mL/min measured or calculated by Cockroft-Gault equation

  • Received Janus kinase (JAK) inhibitor therapy after allo-HSCT for any indication. Treatment with a JAK inhibitor before allo-HSCT is permitted.

  • Known allergies, hypersensitivity, or intolerance to any of the study medications, excipients, or similar compounds.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Itacitinib + corticosteroidsCorticosteroidItacitinib administered in combination with corticosteroids.
Itacitinib + corticosteroidsItacitinibItacitinib administered in combination with corticosteroids.
Primary Outcome Measures
NameTimeMethod
Number of treatment-emergent adverse eventsUp to approximately 12 months

Defined as any adverse event reported for the first time or worsening of a pre-existing event after first dose of study drug.

Secondary Outcome Measures
NameTimeMethod
Failure-free survivalUp to 6 months

Defined as the proportion of participants who are still alive, have not relapsed, have not required additional therapy for aGVHD, and have not demonstrated signs or symptoms of chronic GVHD (cGVHD).

Time to responseUp to approximately 12 months

Defined as the interval from treatment initiation to first response.

Nonrelapse mortalityUp to approximately 12 months

Defined as the proportion of participants who died due to causes other than malignancy.

Duration of responseUp to approximately 12 months

Defined as the interval from first response until GVHD progression or death.

Malignancy relapse rateUp to approximately 12 months

Defined as the proportion of participants whose underlying malignancy relapses.

Overall survivalUp to approximately 12 months

Defined as the interval from study enrollment to death due to any cause.

Cmax of INCB039110Up to approximately 1 month

Maximum observed plasma concentration.

Cl/F of INCB039110Up to approximately 1 month

Apparent oral dose clearance.

Objective response rateUp to 100 days

Defined as the proportion of participants demonstrating a complete response, very good partial response, or partial response.

Trial Locations

Locations (17)

JA-Aichi Anjo Kosei Hospital

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Anjo-Shi, Aichi, Japan

Hokkaido University Hospital

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Sapporo-shi, Hokkaido, Japan

Kanagawa Cancer Center

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Yokohama-shi, Kanagawa-Ken, Japan

Jiaikai Imamura General Hospital

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Kagoshima-Shi, Kagoshima, Japan

Tokai University Hospital

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Isehara-Shi, Kanagawa, Japan

Tohoku University Hospital

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Sendai-shi, Miyagi-Ken, Japan

NHO Kumamoto Medical Center

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Kumamoto-shi, Kumamoto-Ken, Japan

St. Luke's International Hospital

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Chuo Ku, Tokyo-To, Japan

Okayama University Hospital

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Okayama-shi, Okayama-Ken, Japan

Osaka City University Hospital

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Osaka-Shi, Osaka, Japan

Jikei University Hospital

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Minato-ku, Tokyo-To, Japan

Hokuyukai Sapporo Hokuyu Hospital

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Sapporo-Shi, Hokkaido, Japan

University of Tsukuba Hospital

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Tsukuba-shi, Ibaraki-Ken, Japan

Jichi Medical University Hospital

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Shimotsuke-shi, Tochigi-Ken, Japan

Shizuoka Cancer Center

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Nagaizumi-cho, Shizuoka-Ken, Japan

Nagoya University Hospital

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Nagoya-Shi, Aichi, Japan

Hyogo College of Medicine Hospital

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Nishinomiya-Shi, Hyogo, Japan

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