Primary Objective: \- To evaluate the efficacy of once daily dose of SAR302503 in subjects previously treated with ruxolitinib and with a current diagnosis of intermediate-1 with symptoms, Intermediate-2 or high-risk primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis (Post-PV MF), or post-essential thrombocythemia myelofibrosis (Post-ET MF) based on the reduction of spleen volume at the end of 6 treatment cycles; Secondary Objectives: * To evaluate the effect of SAR302503 on Myelofibrosis (MF) associated symptoms as measured by the modified Myelofibrosis Symptom Assessment Form (MFSAF) diary * To evaluate the durability of splenic response * To evaluate the splenic response to SAR302503 by palpation at the end of Cycle 6 * To evaluate the splenic response to SAR302503 at the end of Cycle 3 * To evaluate the effect of SAR302503 on the Janus kinase 2 (JAK2) V617F allele burden * To evaluate the safety and tolerability of SAR302503 in this population * To evaluate plasma concentrations of SAR302503 for population PK analysis, if warranted
The expected duration of the treatment in this study is approximately 8 months, based on a maximum 28-day screening period, followed by a 6-month (6-cycle) treatment period, and an EOT visit for subjects who will not continue the treatment after completing the 6 cycles of SAR302503, or discontinue the treatment early for any reasons as well as a follow-up visit which should occur 30 days after the last administration of SAR302503. Patients who continue to benefit clinically will be allowed to remain on study medication beyond the 6-month treatment period until the occurrence of disease progression or unacceptable toxicity.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
97
Pharmaceutical form:capsule Route of administration: oral
Investigational Site Number 840007
Phoenix, Arizona, United States
Investigational Site Number 840003
San Francisco, California, United States
Investigational Site Number 840004
San Francisco, California, United States
Investigational Site Number 840005
Atlanta, Georgia, United States
Investigational Site Number 840014
Chicago, Illinois, United States
Response Rate: Percentage of Participants With >=35% Reduction From Baseline in Spleen Volume at End of Cycle 6
Spleen volume was measured by central imaging MRI (CT scan in participants with contraindications for MRI). Analysis was performed on Per Protocol (PP) population defined as all treated participants with a baseline and at least one post-baseline MRI/CT scan of spleen volume, and had no important protocol deviations that could impact on efficacy outcome. Last observation carried forward (LOCF) method was used to impute the missing data.
Time frame: Baseline, End of Cycle 6
Symptom Response Rate: Percentage of Participants With >=50% Reduction From Baseline in the Total Symptom Score Using MFSAF at End of Cycle 6
The key MF-associated symptoms were assessed using the modified Myelofibrosis Symptom Assessment Form (MFSAF) Diary: night sweats, pruritus, abdominal discomfort, early satiety, pain under ribs on left side, and bone or muscle pain. These were measured on a scale from 0 (absent) to 10 (worst imaginable). Then Total symptom score (range 0 to 60) was defined as the sum of the scores for each of the 6 symptoms of MFSAF. Higher score indicated greater severity of symptoms. Analysis was performed on MFSAF analysis population defined as all treated participants with baseline and at least 1 post-baseline evaluable assessment of total symptom score.
Time frame: Baseline, End of Cycle 6
Percentage of Participants With a ≥50% Reduction From Baseline in Length of Spleen by Palpation at End of Cycle 6
Percentage of Participants with a ≥50% Reduction From Baseline in Length of Spleen by Palpation at End of Cycle 6.
Time frame: Baseline, End of Cycle 6
Response Rate: Percentage of Participants With ≥35% Reduction From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3
Percentage of Participants With ≥35% Reduction From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3. Analysis was performed on PP population.
Time frame: Baseline, End of Cycle 3
Percent Change From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3 and Cycle 6.
Percent Change From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3 and Cycle 6. Analysis was performed on PP population.
Time frame: Baseline, End of Cycle 3, 6
Plasma Concentration of Fedratinib
Analysis was performed on pharmacokinetic population defined as all participants who received at least 1 (even partial) cycle of study treatment and had evaluable drug concentration data.
Time frame: Pre-dose (Hour 0), 0.5, 2.5 hours post-dose on Day 1 of Cycle 1, 2, pre-dose (Hour 0) on Day 1 of Cycle 4
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Investigational Site Number 840001
Kansas City, Kansas, United States
Investigational Site Number 840017
Baltimore, Maryland, United States
Investigational Site Number 840013
Baltimore, Maryland, United States
Investigational Site Number 840010
Ann Arbor, Michigan, United States
Investigational Site Number 840009
New York, New York, United States
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