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CompletedNCT03497273Updated Mar 3, 2020

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

A Phase 1 interventional study of Itacitinib and Corticosteroid in Acute Graft-versus-host Disease, sponsored by Incyte Corporation. Completed at 17 sites in Japan. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2020-03-03.

Sponsored by Incyte Corporation · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
14
Allocation
Not applicable
Ages
20 Years and older
Sex
All
01

Study 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).

02

Conditions studied

  • Acute Graft-versus-host Disease

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Keywords

  • JAK1 inhibitor
  • GVHD
  • acute GVHD
  • Japan
  • corticosteroids
03

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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

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.
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
14 participants (actual)

Study arms

  • Experimental
    Itacitinib + corticosteroids

    Itacitinib administered in combination with corticosteroids.

    Drug: Itacitinib · Drug: Corticosteroid

Interventions

  • DrugItacitinib

    Itacitinib administered orally once daily at the protocol-defined dose.

    Also known as: INCB039110

  • DrugCorticosteroid

    Either oral prednisolone or intravenous methylprednisolone at the investigator's discretion.

05

What researchers measure

Primary outcomes

  1. Number of treatment-emergent adverse events

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

    Time frame: Up to approximately 12 months

Secondary outcomes

  1. Cmax of INCB039110

    Maximum observed plasma concentration.

    Time frame: Up to approximately 1 month

  2. Cl/F of INCB039110

    Apparent oral dose clearance.

    Time frame: Up to approximately 1 month

  3. Objective response rate

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

    Time frame: Up to 100 days

  4. Nonrelapse mortality

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

    Time frame: Up to approximately 12 months

  5. Duration of response

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

    Time frame: Up to approximately 12 months

  6. Time to response

    Defined as the interval from treatment initiation to first response.

    Time frame: Up to approximately 12 months

  7. Malignancy relapse rate

    Defined as the proportion of participants whose underlying malignancy relapses.

    Time frame: Up to approximately 12 months

  8. Failure-free survival

    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 frame: Up to 6 months

  9. Overall survival

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

    Time frame: Up to approximately 12 months

06

Study locations

17 sites
  • JA-Aichi Anjo Kosei Hospital
    Anjo-Shi, Aichi 446-8602, Japan
  • Nagoya University Hospital
    Nagoya-Shi, Aichi 466-8560, Japan
  • Hokuyukai Sapporo Hokuyu Hospital
    Sapporo-Shi, Hokkaido 003-0006, Japan
  • Hokkaido University Hospital
    Sapporo-shi, Hokkaido 060-8648, Japan
  • Hyogo College of Medicine Hospital
    Nishinomiya-Shi, Hyogo 663-8501, Japan
  • University of Tsukuba Hospital
    Tsukuba-shi, Ibaraki-Ken 305-8576, Japan
  • Jiaikai Imamura General Hospital
    Kagoshima-Shi, Kagoshima 890-0064, Japan
  • Kanagawa Cancer Center
    Yokohama-shi, Kanagawa-Ken 241-8515, Japan
  • Tokai University Hospital
    Isehara-Shi, Kanagawa 259-1193, Japan
  • NHO Kumamoto Medical Center
    Kumamoto-shi, Kumamoto-Ken 860-0008, Japan
  • Tohoku University Hospital
    Sendai-shi, Miyagi-Ken 980-8574, Japan
  • Okayama University Hospital
    Okayama-shi, Okayama-Ken 700-8558, Japan
  • Osaka City University Hospital
    Osaka-Shi, Osaka 545-8586, Japan
  • Shizuoka Cancer Center
    Nagaizumi-cho, Shizuoka-Ken 411-8777, Japan
  • Jichi Medical University Hospital
    Shimotsuke-shi, Tochigi-Ken 329-0498, Japan
  • St. Luke's International Hospital
    Chuo Ku, Tokyo-To 104-8560, Japan
  • Jikei University Hospital
    Minato-ku, Tokyo-To 105-8471, Japan
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03497273
Lead sponsor
Incyte Corporation
Responsible party
Sponsor
First posted
Apr 13, 2018
Start date
Mar 20, 2018
Primary completion
Nov 30, 2019
Completion
Feb 17, 2020
Last update
Mar 3, 2020

Study contacts

Rodica Morariu-Zamfir, MD
study director · Incyte Corporation

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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