A Phase 3, Randomized, Double-blind, Add-on Study Evaluating the Safety and Efficacy of Navtemadlin Plus Ruxolitinib vs Placebo Plus Ruxolitinib in JAK Inhibitor-Naïve Patients With Myelofibrosis Who Have a Suboptimal Response to Ruxolitinib

KRT-232-115

This clinical trial is evaluating whether addition of navtemadlin to ruxolitinib treatment will provide more clinical benefit than ruxolitinib alone for patients with Myelofibrosis who have a suboptimal response to ruxolitinib treatment alone. Subjects will start by receiving ruxolitinib alone in the run-in period. Those who demostrate a suboptimal response from ruxolitinib alone will then be randomized 2:1 to receive navtemadlin or navtemadlin placebo as add-on treatment to their ongoing ruxolitinib. Randomized means that subjects will be assigned to a group by chance, like a flip of a coin. The study is blinded, meaning the subjects, doctors, central endpoint assessors and sponsor will not know which add on treatment (navtemadlin or navtemadlin placebo) the subject is receiving.

2024-06-03

2026-12-31

2028-12-31

Recruiting

Early phase I

600

Inclusion Criteria for Ruxolitinib Alone Period: * Confirmed diagnosis of PMF, post-PV MF, or post-ET MF, as assessed by the treating physician according to the World Health Organization (WHO) criteria * High, Intermediate-1, Intermediate-2 risk category International Prognosis System Score (IPSS) * Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 * JAK-inhibitor treatment naive Exclusion Criteria for Ruxolitinib Alone Period: * Prior Splenectomy * Splenic irradiation within 3 months prior to the first dose * Prior BCL-XL, BET, MDM2, PI3K, PIM, or XPO1 inhibitors therapy or p53-directed therapy * Eligible for Bone Marrow Transplant * Peripheral blood or bone marrow blast count ≥ 10 percent Inclusion Criteria for Randomized Period: * PMF, post-PV MF, or post-ET MF that is TP53WT as assessed by central testing * ECOG performance status of 0 to 2 * Treatment with a stable dose of ruxolitinib * Suboptimal response to run-in ruxolitinib treatment Exclusion Criteria for Randomized Period: * Elevated white blood cell count that doubles (or more) during ruxolitinib treatment and exceeds 50 × 10\^9/L * Peripheral blood or bone marrow blast count ≥ 10 percent

{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE3'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'QUADRUPLE', 'maskingDescription': 'Placebo-controlled', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}}, 'enrollmentInfo': {'count': 600, 'type': 'ESTIMATED'}}

2024-06-28