Overview

Pilot Study to Assess the Safety, PK and Iron Chelating Activity of DST-0509 (Deferasirox) in Thalassemia Patients Refractory to Chelation

Status:
Recruiting
Trial end date:
2021-10-30
Target enrollment:
0
Participant gender:
All
Summary
This study is a multicenter, open-label, two-period crossover design that evaluates the safety, tolerability, pharmacokinetics and preliminary evidence of iron chelating activity of DST-0509 as compared to Jadenu and Exjade in transfusion-dependent thalassemia patients with transfusional iron overload, requiring iron chelation therapy and demonstrating an inadequate response to Jadenu or Exjade for greater than 3 months duration. Up to 36 patients will be evaluated (18 in each treatment arm), however, the balanced randomization may enroll fewer patients based on recruitment status.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
DisperSol Technologies, LLC
Treatments:
Deferasirox
Iron
Iron Chelating Agents
Criteria
Inclusion Criteria:

1. Written informed consent or assent as appropriate obtained prior to any study-related
procedure being performed;

2. Patients at least 8 years of age or older at the time of consent or assent;

3. Patient with TDT syndrome and iron overload currently receiving iron chelation therapy
with Jadenu or Exjade and demonstrating inadequate response assessed with serum
ferritin and LIC;

4. At least 8 or more blood transfusions in the past year;

5. Survival expected of >12 months;

6. Patient previously on dual iron chelation therapy will be transfered to iron chelation
monotherapy ,stable dosing with Jadenu or Exjade for ≥1month prior to screening and
receiving doses in the maximal dose range per day (e.g., Jadenu: >21 mg/kg or Exjade:
>30 mg/kg, with specific doses in these ranges prescribed at the physician's
discretion);

7. Serum ferritin levels that are persistently >800 mcg/L determined by 2 separate
assessments during screening over the previous 2-4 weeks prior to study treatment and
not showing a decreasing trend over these weeks OR, an LIC of >5 mg Fe/g dw measured
by MRI in the 52 weeks prior to study entry, OR clearly identified as a poor responder
in medical records within 3 months prior to the study

8. Compliant with chelation therapy in the 3 months prior to enrollment in the opinion of
the Investigator; has taken at least 75% of medication prescribed on a regular basis
was taken (Investigator enquiry into patient prescription refill records, preferably 3
months if available, SICT scores); and

1. Willing to comply with chelation therapy for the duration of the study;

2. The determination of compliance is at the discretion of the investigator.

9. Agree not to use other anti-chelating agents concurrently;

10. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-1;

11. Women of childbearing potential (WOCBP) must use an adequate method of birth control
(double barrier, e.g. hormonal control and barrier contraception) at least 28 days
prior to the first administration of the study drug, during the study and for at least
30 days after the last dose of the study drug;

12. Male patients whose partners are WOCBP must use an adequate method of birth control
(double barrier control) at least 28 days prior to the first administration of the
study drug, during the study and for at least 30 days after the last dose of the study
drug; and

13. Patient is willing and able to comply with all protocol required visits and
assessments.

Exclusion Criteria:

1. Females of childbearing potential not on an adequate method of birth control, or who
are pregnant or lactating;

2. History of non-compliance with chelation therapy (determined by the investigator).

3. Known history of human immunodeficiency virus (HIV)

4. Active hepatitis B virus (HBV), hepatitis C virus (HCV), or other known active viral
hepatitis;

5. Screening blood counts as follows:

1. Absolute neutrophil count < 1,000/μL

2. Platelets < 50,000/μL

3. Hemoglobin < 7 g/dL (transfusion support is permitted);

6. Screening chemistry values as follows:

1. Alanine aminotransferase (ALT) and aspartate transaminase (AST) > 3 × upper limit
of the normal reference range (ULN)

2. Total bilirubin > 5 × ULN

3. Creatinine > 1.5 × ULN

4. Urine protein/creatinine ratio (UPCR) > 0.5 mg/mg

5. Albumin < 2.8 g/dL;

7. History of congestive heart failure New York Heart Association (NYHA) class III or IV
or uncontrolled hypertension at screening;

8. History of other malignancy within the previous 3 years, except basal cell or squamous
cell carcinoma, or non-muscle invasive bladder cancer;

9. In the opinion of the Investigator, evidence of major inflammatory disease that would
affect ferritin levels within 14 days prior to the start of study medication;

10. Major surgery within 30 days prior to the start of study medication;

11. Serious persistent infection within 14 days prior to the start of study medication;

12. Serious concurrent medical condition including central nervous system (CNS) disorders;

13. Requires concomitant treatment with systemic corticosteroids, or any other
immunosuppressive agents, or has used such treatment in the past 10 days before study
entry (use of prednisone or equivalent <10 mg/day orally or use of inhaled
corticosteroids or topical steroids is permitted);

14. Previous history of difficulty swallowing oral medications;

15. Any condition that, in the opinion of the Investigator, would impair the patient's
ability to comply with study procedures or study medication; or

16. Concomitant treatment with medications described in Section "Prohibited Medications".

Patients who screen fail for out-of-protocol laboratory values may be re-screened at the
Investigator's discretion provided that more than 30 days have passed since their previous
screening. Up to three re-screenings will be permitted.