Overview

Testing the Effect of Taking Ruxolitinib and CPX-351 in Combination for the Treatment of Advanced Phase Myeloproliferative Neoplasms

Status:
Recruiting
Trial end date:
2022-12-31
Target enrollment:
0
Participant gender:
All
Summary
This phase I/II trial studies the best dose of ruxolitinib when given together with CPX-351 and to see how well they work in treating patients with accelerated phase or blast phase myeloproliferative neoplasm. Ruxolitinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. CPX-351 is a mixture of 2 chemotherapy drugs (daunorubicin and cytarabine) given for leukemia in small fat-based particles (liposomes) to improve the drug getting into cancer cells. Giving ruxolitinib and CPX-351 may work better in treating patients with secondary acute myeloid leukemia compared to CPX-351 alone.
Phase:
Phase 1/Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
OHSU Knight Cancer Institute
Uma Borate
Collaborators:
Incyte Corporation
Jazz Pharmaceuticals
National Cancer Institute (NCI)
Oregon Health and Science University
Treatments:
Cytarabine
Daunorubicin
Janus Kinase Inhibitors
Criteria
Inclusion Criteria:

- Ability to understand and the willingness to sign a written informed consent document

- Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2

- Participants eligible for this study have either MPN in accelerated phase (AP) or
blast phase (BP), defined as:

- MPN-AP is defined by 10% to 19% blasts in the peripheral blood or bone marrow

- MPN-BP is defined by >= 20% blasts in the blood or bone marrow

- Either MPN-AP or MPN-BP requires a previous diagnosis of polycythemia vera
(PV), essential thrombocythemia (ET), or primary myelofibrosis (PMF)

- Participants with ET, PV, or MF that have received prior MPN-associated
therapy (e.g., hydroxyurea, hypomethylating agents [azacitidine,
decitabine], anti-platelet therapies [e.g., aspirin, anagrelide], as well as
JAK2 inhibitor therapy [e.g., ruxolitinib or other investigational JAK2
inhibitor]) are eligible

- Female participants of childbearing potential must agree to use adequate contraception
(2 forms of contraception or abstinence) from the screening visit until 30 days
following the last dose of study treatment. Should a woman become pregnant or suspect
she is pregnant while she or her partner is participating in this study, she should
inform her treating physician immediately

- Male participants of childbearing potential having intercourse with females of
childbearing potential must agree to abstain from heterosexual intercourse or have
their partner use 2 forms of contraception from the screening visit until 90 days
until the last dose of study treatment. They must also refrain from sperm donation
from the screening visit until 90 days following the last dose of study treatment

- Left ventricular ejection fraction at >= 50% as measured by echocardiogram (ECHO) or
multigated acquisition (MUGA) scan (14 days prior to initiating study treatment)

- Candidate for cytotoxic-intensive induction chemotherapy

- Willing to take oral medication

- Serum creatinine =< 2 x the upper limit of normal (ULN), or glomerular filtration rate
> 20 ml/min/1.73m^2 as calculated by Cockcroft-Gault formula

- Serum potassium, magnesium, and calcium (corrected for albumin) within institutional
normal limits or can be corrected with supplementation

- Total serum bilirubin =< 2.5 x ULN

- Serum aspartate transaminase (AST) and/or alanine transaminase (ALT) =< 2.5 x ULN

Exclusion Criteria:

- Ongoing participation in another clinical trial

- Isolated myeloid sarcoma (i.e., participants must have blood or marrow involvement
with AML to enter the study)

- Acute promyelocytic leukemia (French-American-British [FAB] M3 classification)

- Active central nervous system (CNS) involvement by AML

- Current treatment or treatment within 2 weeks or 5 half-lives (whichever is longer)
prior to the first dose of study medication with another investigational medication or
current enrollment in another investigational drug protocol (unless there is evidence
of rapidly progressive disease in which case a shorter interval from last therapy may
be acceptable)

- Any unresolved toxicity equal to or greater than grade 2 from previous anticancer
therapy, except for stable chronic toxicities not expected to resolve, such as
peripheral neurotoxicity

- Incomplete recovery from any prior surgical procedures or had surgery within 4 weeks
prior to study entry, excluding the placement of vascular access

- Disseminated intravascular coagulopathy with active bleeding or signs of thrombosis

- Participants with rapidly progressive disease (defined by blast count doubling within
48 hours) or organ dysfunction that would prevent them from receiving these agents

- Participants with uncontrolled infection will not be enrolled until infection is
treated and symptoms controlled

- Participants with an infection receiving treatment (antibiotic, antifungal or
antiviral treatment) may be entered into the study but must be afebrile and
hemodynamically stable for >= 72 hours (hrs)

- Known hypersensitivity to ruxolitinib, cytarabine, daunorubicin, or liposomal products

- History of Wilson's disease or other copper metabolism disorder

- Uncontrolled intercurrent illness or any concurrent condition that, in the
investigator's opinion, would jeopardize the safety of the participant or compliance
with the protocol per investigator's discretion. Including, but not limited to,
symptomatic congestive heart failure, unstable angina pectoris, serious cardiac
arrhythmia, myocardial infarction within 6 months prior to enrollment, New York Heart
Association (NYHA) class III or IV heart failure, severe uncontrolled ventricular
arrhythmias

- Participants with prior cumulative anthracycline exposure of greater than 368 mg/m^2
daunorubicin (or equivalent)

- All participants must discontinue anti-platelet agents or anticoagulants prior to
initiation of study drug, including therapeutic doses of aspirin and clopidogrel