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Study to Assess Efficacy and Safety of NS-018 Compared to BAT in Patients With Myelofibrosis

Phase 2
Terminated
Conditions
Primary Myelofibrosis
Post-polycythemia Vera Myelofibrosis
Post-essential Thrombocythemia Myelofibrosis
Interventions
Drug: NS-018
Drug: Best Available Therapy
Registration Number
NCT04854096
Lead Sponsor
NS Pharma, Inc.
Brief Summary

This study will enroll male and female subjects who are 18 years of age or older with Primary Myelofibrosis, post-polycythemia Vera Myelofibrosis, or post-essential Thrombocythemia Myelofibrosis with severe thrombocytopenia (platelet count \<50,000/µL) including subjects with intermediate-2 or high-risk MF according to the Dynamic International Prognostic Scoring System (DIPSS).

Detailed Description

NS-018 will be self-administered orally at a dose of 300 mg BID. The BAT will be administered according to manufacturer's instructions and Investigator discretion. Subjects will complete study visits at Screening, Day 1 and Day 15 of Cycle 1, 2, 3, 4, 5, 6 and Day 1 of every cycle thereafter. At these visits, blood/urine sampling, spleen measurements, bone marrow assessments, patient-reported outcome (PRO) assessments, and safety assessments may be performed.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
7
Inclusion Criteria
  • Primary MF, post-PVMF or post-ETMF according to the DIPSS risk categories of intermediate-2 or high-risk MF
  • Average platelet count of <50,000/µL at Screening based on 2 measurements taken on different days; both measurements must be <50,000/µL.
  • ECOG performance status ≤2.
  • Life expectancy >6 months.
  • Spleen volume of at least 450 cm3 measured by MRI (or by CT for applicable subjects).
  • Total Symptom Score (TSS) ≥10 on the Myelofibrosis Symptom Assessment Form (MFSAF) version 4.0.
  • Peripheral blast count <10%.
  • No MF-directed treatment for at least 2 weeks prior to initiation of NS-018, including JAK inhibitor, erythropoietic, thrombopoietic agent, or any use of corticosteroids for MF symptom or blood count management. Low dose corticosteroids <10 mg/day prednisone or equivalent is allowed for non-MF purposes.
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Exclusion Criteria
  • Active, uncontrolled systemic infection.
  • Any prior treatment with more than two JAK inhibitors.
  • Previous treatment with NS-018.
  • Subjects actively receiving a concurrent investigational agent.
  • Subjects with any unresolved AE greater than Grade 1 other than hematological AEs from previous anticancer therapy.
  • Currently taking medication that is substantially metabolized by cytochrome P450 (CYP) 1A2 or CYP3A4 (see Appendix 5) or taking medication known to be strong inhibitors or inducers of CYP3A4 (see Appendix 5).
  • Radiation therapy for splenomegaly within 6 months prior to study entry (screening).
  • History of splenectomy or planning to undergo splenectomy.
  • Subjects with a serious cardiac condition within the past 6 months such as uncontrolled arrhythmias, myocardial infarction, angina or heart disease
  • Subjects diagnosed with another malignancy within 2 years prior to an enrollment.
  • Subjects who have had surgery (other than placement of vascular access and bone marrow biopsy) within 4 weeks of study entry (screening), or subjects with incomplete recovery from any prior surgical procedures.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
NS-018NS-018Self-administered NS-018 300 mg orally, twice daily, preferably at the same time each day in consecutive 4-week (28-day) cycles
Best Available Therapy (BAT)Best Available TherapySingle agent per Investigator discretion or no therapy
Primary Outcome Measures
NameTimeMethod
Change in spleen volumefrom baseline to week 24

Proportion of subjects who achieve ≥35% change in spleen volume from baseline to Week 24 as measured by MRI (or by CT for applicable subjects)

Change in Total Symptom Score (TSS)from baseline to week 24

Proportion of subjects who achieve ≥50% change in total symptom score from baseline to Week 24 as measured by the MFSAF v4.0

Secondary Outcome Measures
NameTimeMethod
Change in spleen volumefrom baseline at anytime up to week 24

Proportion of subjects in NS-018 vs BAT arm who achieve ≥35% change in spleen volume from baseline at any time up to Week 24 as measured by MRI (or by CT for applicable subjects)

Comparison of treatment-emergent AEsfrom baseline to week 24

Laboratory events graded by the NCI CTCAE v5.0 will be assessed in both arms, NS-018 vs BAT.

Trial Locations

Locations (51)

University of Massachusetts Chan Medical School

🇺🇸

Worcester, Massachusetts, United States

Houston Methodist Hospital

🇺🇸

Houston, Texas, United States

Universitaetsklinikum Halle (Saale)

🇩🇪

Halle, Germany

Hamatologisch-onkologische Praxis Heinric/Bangerter Ausgsburg GbR

🇩🇪

Augsburg, Germany

Universitaetsklinikum Jena

🇩🇪

Jena, Germany

Universitätsmedizin Rostock

🇩🇪

Rostock, Germany

Azienda Ospedaliera SS. Antonio

🇮🇹

Alessandria, Italy

ASST Spedali Civili di Brescia

🇮🇹

Brescia, Italy

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

🇮🇹

Brescia, Italy

AOU "Policlinico - San Marco"

🇮🇹

Catania, Italy

Azienda Ospedaliera di Rilievo Nazionale

🇮🇹

Naples, Italy

Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico

🇮🇹

Milano, Italy

Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone

🇮🇹

Palermo, Italy

AO di Rilievo Nazionale

🇮🇹

Napoli, Italy

AO di Rilievo Ntl A Cardarelli

🇮🇹

Naples, Italy

Azienda Ospedaliera di Padova

🇮🇹

Padova, Italy

AO Uni Policlinico Umberto I

🇮🇹

Rome, Italy

Azienda Ospedaliera Universitaria Policlinico Umberto I

🇮🇹

Roma, Italy

Istituto Nazionale Tumori Regina Elena IRCCS

🇮🇹

Roma, Italy

The Catholic University of Korea, Seoul St. Mary's Hospital

🇰🇷

Banpo-dong, Korea, Republic of

Gachon University Gil Medical Center

🇰🇷

Incheon, Korea, Republic of

Gyeongsang National University Hospital

🇰🇷

Jinju-si, Korea, Republic of

CHA Bundang Medical Center, CHA University

🇰🇷

Seongnam, Korea, Republic of

Soon Chun Hyang Central Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Pulau Pinang

🇲🇾

Pulau Pinang, Malaysia

Namik Kemal University Medicine School

🇹🇷

Tekirdağ, Turkey

Karadeniz Teknik Universitesi Tip Fak,

🇹🇷

Trabzon, Turkey

Guys Hospital

🇬🇧

London, England, United Kingdom

Derriford Hospital

🇬🇧

Plymouth, England, United Kingdom

Hospital Sultanah Aminah

🇲🇾

Johor Bahru, Malaysia

Hospital Ampang

🇲🇾

Ampang, Malaysia

University Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

Western General Hospital

🇬🇧

Edinburgh, Scotland, United Kingdom

Pratia Onkologia Katowice

🇵🇱

Katowice, Poland

Royal United Hospitals - Bath

🇬🇧

Bath, England, United Kingdom

Sandwell & West Birmingham Hospital

🇬🇧

West Bromwich, England, United Kingdom

Sunway Medical Centre

🇲🇾

Petaling Jaya, Malaysia

Szpital Uniwersytecki nr 2 im. dr J. Biziela

🇵🇱

Bydgoszcz, Poland

Srinagarind Hospital

🇹🇭

Khon Kaen, Thailand

Hospital Raja Perempuan Zainab II

🇲🇾

Kota Bahru, Malaysia

Songklanagarind Hospital

🇹🇭

Songkla, Thailand

Istanbul Medipol University

🇹🇷

Bagcilar, Istanbul, Turkey

Hospital Queen Elizabeth

🇲🇾

Kota Kinabalu, Malaysia

Dolnośląskie Centrum Onkologii we Wrocławiu, Oddział Hematologiczny

🇵🇱

Wrocław, Poland

The Christie NHS Foundation Trust

🇬🇧

Manchester, England, United Kingdom

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Hospital Raja Permaisuri Bainun

🇲🇾

Ipoh, Perak, Malaysia

University College London Hospitals

🇬🇧

London, England, United Kingdom

AO SS Antonio

🇮🇹

Alessandria, Italy

Ege Universitesi Tip Fak,

🇹🇷

İzmir, Turkey

ASST Fatebenefratelli Sacco

🇮🇹

Milano, Italy

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