Anagrelide is a drug that has been shown to slow down how fast platelets are made in the bone marrow, and has been approved by the FDA for treating high platelets counts in patients with bone marrow disorders. Anagrelide Controlled Release ("CR") is a new preparation of anagrelide that is made to dissolve more slowly than currently marketed versions of this drug. Because of this, the anagrelide is taken up into the blood more slowly. Researchers think that this slower release of the drug could help to lower side effects that might be caused by high blood levels when the drug dissolves as quickly as it does with the currently marketed product. The main purposes of this study are to see how well Anagrelide CR can control platelet counts in patients with high platelet levels, to see what kind of side effects it causes, and to measure blood levels of the drug.
This is an open-label, single-arm, multicenter, Phase 2 study of anagrelide CR in subjects with an MPN-related thrombocytosis. Eligible subjects will include those who have not been previously treated for thrombocytosis or have not received platelet-lowering therapy for at least 2 weeks prior to study treatment. Each subject will receive anagrelide CR at a starting dose of 0.5 mg b.i.d. (1.0 mg/day), and is anticipated to continue study treatment for at least 24 weeks. Subjects who have achieved clinical benefit in the opinion of the Investigator and who are tolerating the study drug may continue study treatment until they develop unacceptable toxicity or other discontinuation criteria have been met. The primary efficacy endpoint will be the proportion of subjects who achieve a platelet response (CR or PR). The safety and tolerability of study treatment will be assessed by the frequency and severity of adverse events as determined by NCI Common Terminology Criteria for Adverse Events (CTCAE) v 4.03. The PK profile of anagrelide CR will be assessed at the initial (0.5mg b.i.d.) and final titrated dose levels.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Starting dose of 0.5 mg b.i.d. (1.0 mg/day) titrated at weekly intervals, on an individual basis, to achieve the lowest dose required to achieve and maintain a target platelet count of 150 - 400 x 10e9/L, tolerability permitting. The dose will be increased at weekly intervals in steps not exceeding 0.5 mg/day; the rate of dose titration may be reduced (i.e., up to once every 2 weeks) at the discretion of the Investigator.
East Valley Hematology and Oncology Medical Group
Burbank, California, United States
California Cancer Associates for Research & Excellence (cCARE)
Encinitas, California, United States
California Cancer Associates for Research & Excellence (cCARE)
Escondido, California, United States
California Cancer Associates For Research and Excellence
Fresno, California, United States
Innovative Medical Research of South Florida, Inc.
Aventura, Florida, United States
Cancer Center of Kansas
Wichita, Kansas, United States
Wake Forest Baptist Health
Winston-Salem, North Carolina, United States
Gettysburg Cancer Center
Hillsdale, Pennsylvania, United States
The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Cancer Care Centers of South Texas
New Braunfels, Texas, United States
...and 1 more locations
Platelet Response
The primary efficacy endpoint will be the proportion of subjects who achieve a platelet response (complete or partial response), with response defined according to the following criteria: * Complete response (CR): platelet count of ≤400 x 10e9/L maintained for at least 4 weeks * Partial response (PR): a platelet count of ≤600 x 10e9/L or a ≥50% reduction from baseline and maintenance of the reduction for at least 4 weeks * Nonresponse: failure to meet CR or PR criteria
Time frame: Up to 24 weeks
Number of subjects with adverse events
Frequency and severity of adverse events as determined by NCI CTCAE (v 4.03).
Time frame: Throughout study treatment (expected average of 12 months)
Plasma concentrations of anagrelide
Monitor anagrelide levels during dose titration and assess pharmacokinetic profile at starting and final dose levels.
Time frame: Up to 13 weeks
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