A clinical study to investigate the safety and efficacy of CPI-0610 in patients with and essential thrombocythemia

Phase 1

• Conditions: Myeloproliferative Neoplasms (Myelofibrosis and Essential Thrombocythemia); MedDRA version: 20.0Level: PTClassification code 10028537Term: MyelofibrosisSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 21.0Level: LLTClassification code 10015494Term: Essential thrombocythemiaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); Therapeutic area: Diseases [C] - Blood and lymphatic diseases [C15]

• Registration Number: EUCTR2018-000579-34-PL
• Lead Sponsor: Constellation Pharmaceuticals, Inc.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2019-06-17
• Last Update Posted: 4 March 2024

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: All
• Target Recruitment: 297

Inclusion Criteria

Prior JAKi Arm 1 and Add-on to JAKi Arm 2:
1. Adult (aged = 18 years)
2. Patients with confirmed diagnosis of MF who meet all of the following criteria:
a. Dynamic International Prognostic Scoring System (DIPSS; see
Appendix 3) risk category of intermediate-2 or higher
b. Platelet count = 75 x 109/L without the assistance of thrombopoietic factors or transfusions
c. ANC = 1 x 109/L without the assistance of granulocyte growth factorsd. Spleen volume of =450 cm3 by CT or MRI for Cohorts 1B and 2B OR
RBC TD (defined as an average of =2 units of RBC transfusions per
month [total of = 6 RBC transfusions over the 12 wks] prior to
enrollment) for Cohorts 1A and 2A
e. Peripheral blood blast count <10%
f. At least 2 symptoms measurable (score = 1) using the MFSAF v4.0
g. Monotherapy Arm (Arm 1) patients only: Previously treated with a
JAKi and be intolerant, resistant, refractory or lost response to the JAKi; have not received the JAKi within 2 weeks prior to start of study drug, orare ineligible to be treated with a JAKi
h. Combination Arm (Arm 2) patients only: Must have received
ruxolitinib for at least 6 months and be on a stable ruxolitinib dose for a minimum 8 weeks (prior to start of study drug)
3. ECOG performance status = 2
4. Serum direct bilirubin = 1.5 x ULN (upper limit of normal)
5. Aspartate aminotransferase (AST) and alanine aminotransferase
(ALT) = 2.5 x ULN. The AST and /or ALT may be elevated up to 5 x ULN ifthe elevation can be reasonably ascribed to liver involvement
6. Calculated or measured creatinine clearance (CrCl) = 45 ml/min
(either measured or estimated by the Cockcroft-Gault formula)
7. Patients must have fully recovered from major surgery and from the acute toxic effects of prior chemotherapy and radiotherapy (residual
CTCAE grade 1 toxicity, e.g., grade 1 peripheral neuropathy, and residualalopecia are allowed)
8. Male and WOBCP and partners of patients with reproductive potential must agree to use highly effective contraceptive methods while on study therapy and for 94 days after the last dose of pelabresib for male patients and male partners of female patients, and for 184 days after the last dose of study drug for WOBCP and female partners of male patients. NOTE: Male patients should be informed of the risk of testicular toxicity and provided with adequate advice regarding sperm preservation
JAKi Naive Arm 3:
1. Adult (aged = 18 years)
2. Patients with confirmed diagnosis of MF who meet all of the following criteria:
a. DIPSS (see Appendix 3) risk category of intermediate-2 or higher
b. Platelet count = 100 x 109/L without the assistance of thrombopoieticfactors or transfusions
c. ANC = 1 x 109/L without the assistance of granulocyte growth factorsd. Spleen volume of = 450 cm3 by CT/MRI
e. Peripheral blood blast count <10%
f. At least 2 symptoms measurable (score = 3) or a total score of = 10
using the MFSAF v4.0
g. No prior treatment with JAKi allowed
3. ECOG performance status = 2
4. Life expectancy of >24 weeks
5. Serum direct bilirubin < 2.0 x ULN
6. AST and ALT = 2.5 x ULN. The AST and /or ALT may be elevated up to 5 x ULN if the elevation can be reasonably ascribed to liver involvement7. Calculated or measured CrCl = 45 ml/min (either measured or
estimated by the Cockcroft-Gault formula)
8. Patients with a history of transfusions must have a documented
transfusion record during the 12 weeks prior to the first dose of study
drug
9. Patients must have fully recovered from major surgery and from the acute

Exclusion Criteria

Prior JAKi Arm 1 and Add-on to JAKi Arm 2:
1. Patients in Cohorts 1B and 2B only: Patients who have had prior
splenectomy
2. Patients in Cohorts 1B and 2B only: Patients who have had splenic
irradiation within 3 months of starting study drug
3. Current known active or chronic infection with HIV, Hepatitis B or
Hepatitis C.
4. Patients with active clinically significant infection will not be eligible for enrollment until recovery for at least 2 weeks prior to the first dose of study drug.
5. Patients with anemia from iron deficiency, B12 and folate deficiencies,hemolytic anemia, or infection
6. Patient with a major bleeding event causing a decrease in hemoglobin of = 2g/dL or leading to transfusion of = 2 units of packed red cells in
the last 6 months prior to enrollment
7. Patients with Child-Pugh Class B or C
8. GI function or GI disease that could significantly alter the absorption of pelabresib and/or ruxolitinib
9. Impaired cardiac function or clinically significant cardiac diseases
10. Ongoing uncontrolled hypertension despite maximal
antihypertensive treatment
11. Any other concurrent severe and/or uncontrolled concomitant
medical condition that in the opinion of the investigator could
compromise participation in the study or analysis of study data
12. Systemic anti-cancer treatment (other than ruxolitinib for the
Combination Arm [Arm 2]; see inclusion criterion #2) other than
hydroxyurea and anagrelide less than 2 weeks (or 5 half-lives,
whichever is longer) before the first dose of pelabresib.
13. Any investigational agent >2 weeks (or 5 half-lives) before the first dose of pelabresib
14. Prior treatment with a BET inhibitor
15. Hematopoietic growth factor (granulocyte growth factor,
erythropoiesis stimulating agent, thrombopoietin mimetic) or androgenicsteroids less than 4 weeks before the first dose of study drug
16. Patients in the Combination Arm (Arm 2) who are receiving
treatment with fluconazole
17. Systemic corticosteroids at daily doses = 10 mg of oral prednisone orequivalent within 2 weeks before the first dose of study drug.

(For further exclusion criteria for Arm 1 & 2 and details please refer to
the protocol)

JAKi Naive Arm 3:
1. Prior treatment with a BET inhibitor
2. Patients who have had a prior splenectomy
3. Patients who have had splenic irradiation within 3 months of starting study drug
4. Current known active or chronic infection with HIV, Hepatitis B or
Hepatitis C
5. Patients with active clinically significant infection will not be eligible for enrollment until
recovery for at least 2 weeks prior to the first dose of study drug
6. Patients with anemia from iron deficiency, B12 and folate deficiencies,hemolytic anemia or infection
7. Patient with a major bleeding event causing a decrease in Hgb of =
2g/dL or leading to transfusion of =2 units of packed red cells in the last6 months prior to enrollment
8. Patients with Child-Pugh Class B or C
9. Impairment of GI function or GI disease that could significantly alter the absorption of pelabresib and/or ruxolitinib
10. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption or patients with hypersensitivity to any ingredient in the formulation of ruxolitinib
11. Patients who have or have had PML
12. Impaired cardiac function or clinically significant cardiac diseases
13. Ongoing uncontrolled hypertension despite maximal
antihypertensive treatment
14. Any other concurrent severe and/or un

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified