This is a Phase 2 single arm study to investigate efficacy and safety of P1101 for adult Japanese patients with PV.
Eligible patients will be treated with P1101, starting at 100 μg (or 50 μg in patients under another cytoreductive therapy). The dose should be gradually increased by 50 μg every two weeks (in parallel, other cytoreductive therapy should be decreased gradually, as appropriate) until stabilization of the hematological parameters is achieved (hematocrit \<45%, platelets \<400 x 10\^9/L and leukocytes \<10 x 10\^9/L). The maximum recommended single dose is 500 μg injected every two weeks. At week 36 (month 9) and week 52 (month 12), the primary study endpoint, phlebotomy-free CHR, will be analyzed. After completion of the 52-week study duration, provision and administration of P1101, collection of the long-term follow up information (blood parameters, molecular and cytogenetic data, safety parameters and as also the optional bone marrow data) will be continued until the drug becomes commercially available for all study subjects..
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
29
P1101 (ropeginterferon alfa-2b) will be administered subcutaneously every 2 weeks at the starting dose of 100 μg every two weeks (or 50 μg in patients under another cytoreductive therapy). The dose should be gradually increased by 50 μg every two weeks (in parallel, other cytoreductive therapy should be decreased gradually, as appropriate) until stabilization of the hematological parameters is achieved (hematocrit \<45%, platelets \<400 x 10\^9/L and leukocytes \<10 x 10\^9/L). The maximum recommended single dose is 500 μg injected every two weeks. The dose will be maintained at the highest level which can be tolerated and delivers best possible disease response.
Low-dose aspirin (acetylsalicylic acid) (75-150 mg/day) will be given as background therapy during the 12 months of study treatment, unless contraindicated.
Ehime University Hospital
Toon-shi, Ehime, Japan
Mie University Hospital
Tsu, Mie-ken, Japan
Osaka University Hospital
Suita-shi, Osaka, Japan
Juntendo University Hospital
Bunkyo-ku, Tokyo, Japan
Proportion of Subjects Who Achieved Durable Phlebotomy-free Complete Hematological Response (CHR) at Month 12
The primary efficacy endpoint was the phlebotomy-free CHR rate at Months 9 and 12. The phlebotomy-free CHR rate was defined as the proportion of patients who achieved phlebotomy-free CHR at both Months 9 and 12 without phlebotomies during the previous 3 months. A responder in sense of the primary endpoint was a patient who met all of the following criteria at Months 9 and 12: Hematocrit \<45% phlebotomy-free (absence of phlebotomy during the previous 3 months) Platelet count ≤400 × 10\^9/L Leukocyte count ≤10 × 10\^9/L
Time frame: 12 months
Changes in Hct From Baseline
Hct will be recorded every 3 months.
Time frame: Baseline, 3 months, 6 months, 9 months and 12 months
Changes in WBC Count From Baseline
WBC count will be recorded every 3 months.
Time frame: Baseline, 3 months, 6 months, 9 months and 12 months
Changes in Plt Count From Baseline
Plt count will be recorded every 3 months.
Time frame: Baseline, 3 months, 6 months, 9 months and 12 months
Changes in Spleen Size From Baseline
Spleen size will be recorded every 3 months.
Time frame: Baseline, 3 months, 6 months, 9 months and 12 months
Time to Requiring no Phlebotomy
Time to requiring no phlebotomy is recorded.
Time frame: Up to 12 months
Time Required to First Response
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Phlebotomy is performed aiming at a hematocrit \< 45%. When the hematocrit value is 45% or higher, phlebotomy is performed. The volume of phlebotomy per procedure should be 200 to 400 mL while monitoring the circulatory dynamics such as blood pressure and pulse. In the elderly and patients with cardiovascular disorders, a small volume (100-200 mL) should be considered to avoid rapid changes in hemodynamics.
NTT Medical Center Tokyo
Shinagawa-ku, Tokyo, Japan
Tokyo Medical University Hospital
Shinjuku-ku, Tokyo, Japan
Keio University Hospital
Shinjuku-ku, Tokyo, Japan
University of Yamanashi Hospital
Chuo-shi, Yamanashi, Japan
Time required to first response is defined as time to achieve complete hematological response (CHR) without phlebotomy.
Time frame: Up to 12 months
Duration of Response Maintenance
Duration of maintained complete hematologic response (CHR) since first achievement of CHR after administration of the study drug will be calculated.
Time frame: Up to 12 months
Proportion of Subjects Without Thrombotic or Hemorrhagic Events
Thrombotic or hemorrhagic events will be recorded any time during the study. The proportion of subjects without thrombotic or hemorrhagic events is defined as the proportion of subjects experienced no thrombotic and hemorrhagic events during the study period (12 months).
Time frame: Up to 12 months
Change of JAK2 Mutant Allelic Burden Over Time vs. Baseline
Quantitative JAK2 measurements at screening, Months 3, 6, 9 and 12 (central laboratory) for subjects who signed consent form. Change of JAK2 allelic burden over time will be assessed.
Time frame: Baseline, 3 months, 6 months, 9 months and 12 months
PK of P1101
Trough concentration is the measured concentration of a drug at the end of a dosing interval at steady state every 2 weeks. Additionally, serum concentration is measured at hours 0, 24, 48, 96 and 168 after administration at Week 0 and Week 28.
Time frame: Up to 12 months