This study will evaluate the safety, efficacy, pharmacokinetics (PK), and pharmacodynamics of the orally administered lysine-specific demethylase 1 (LSD1) inhibitor bomedemstat, in participants with polycythemia vera (PV). At Week 36 of dosing, participants will be assessed for eligibility to receive additional treatment through Week 52. Participants deriving clinical benefit and safely tolerating bomedemstat will qualify for continued treatment at the Investigator's discretion.
With Amendment 3, after all ongoing participants have reached 52 weeks of treatment, eligible participants may transition to a bomedemstat extension study if available. With Amendment 4, all secondary PK and participant reported outcome measures were designated as exploratory. Per protocol, participants who derived clinical benefit (no progressive disease) and safely tolerated drug may have qualified for enrollment into the bomedemstat extension study (NCT06351631).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Oral capsule
BRCR Global ( Site 0120)
Plantation, Florida, United States
Hematology Oncology of the North Shore ( Site 0104)
Skokie, Illinois, United States
University of Michigan Comprehensive Cancer Center ( Site 0008)
Ann Arbor, Michigan, United States
Comprehensive Cancer Centers of Nevada - Peak ( Site 0118)
Las Vegas, Nevada, United States
Duke University Medical Center ( Site 0016)
Durham, North Carolina, United States
Ohio State University Comprehensive Cancer Center ( Site 0103)
Columbus, Ohio, United States
OHSU Knight Cardiovascular Institute Cardiology Clinic - South Waterfront ( Site 0102)
Portland, Oregon, United States
Huntsman Cancer Hospital at the University of Utah ( Site 0119)
Salt Lake City, Utah, United States
Sunshine Coast Hematology and Oncology Clinic (Site 0506)
Sunshine Coast, Queensland, Australia
Monash Medical Centre ( Site 0006)
Clayton, Victoria, Australia
...and 7 more locations
Number of Participants With Adverse Events (AEs)
An AE was defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants with one or more AEs are reported.
Time frame: Up to approximately 52 weeks
Number of Participants Who Discontinued Study Intervention Due to AEs
An AE was defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinued study intervention due to an AE are reported.
Time frame: Up to approximately 52 weeks
Percentage of Participants With Sustained 12-week Reduction of Hematocrit (Hct) to <45% Without Concomitant Phlebotomy by Week 36
Hematocrit (Hct) was analyzed by taking blood samples from participants at designated time points during the study. Participants were considered responders if they achieved a sustained reduction of Hct to \<45% for 12 weeks (84 calendar days) by Week 36 AND there was no concomitant phlebotomy performed during the sustained reduction. Baseline data was defined as the data most recently collected prior to the first dose. A Clopper-Pearson (exact binomial) two-sided 95% confidence interval for the percentage of responders was presented. The percentage of participants who achieved a sustained 12-week reduction of Hct to \<45% without concomitant phlebotomy at Week 36 are reported.
Time frame: Up to approximately 36 weeks
Duration of Reduction of Hematocrit (Hct) to <45% Without Phlebotomy
Total response duration was defined as the summation of all Hct \<45% response durations, where an individual response duration starts at the timepoint where the Hct \<45% and ends at the first subsequent occurrence of phlebotomy or Hct \>=45%. Hct was analyzed by taking blood samples from participants at designated time points during the study. Duration of reduction of Hct to \<45% without phlebotomy was presented.
Time frame: Up to approximately 22 months
Percentage of Participants With Platelet Count ≤ 450 x 10^9/L by Week 36
Platelet count was analyzed by taking blood samples from participants at designated time points during the study. Participants who enter the study with platelet counts ≤450 X 10\^9/L must achieve an additional on-study platelet count ≤450 X 10\^9/L to be considered responders. A Clopper-Pearson (exact binomial) two-sided 95% confidence interval for the percentage of responders is presented. Baseline data was defined as the data most recently collected prior to the first dose. The percentage of participants who have a platelet count ≤450 X 10\^9/L by week 36 are reported.
Time frame: Up to approximately 36 weeks
Duration of Platelet Count ≤ 450 x 10^9/L
Total response duration was defined as the summation of all platelet ≤450 x 10\^9/L response durations, where an individual response duration starts at the timepoint where platelet count ≤450 x 10\^9/L and ends at the first subsequent occurrence of platelet \>450 x 10\^9/L. Platelet counts were analyzed by taking blood samples from participants at designated time points during the study. The duration of platelet count ≤450 X 10\^9/L in participants are reported.
Time frame: Up to approximately 22 months
Percentage of Participants With White Blood Cell (WBC) Count <10 x 10^9/L by Week 36
WBC count was analyzed by taking blood samples from participants at designated time points during the study. Participants who enter the study with WBC counts \<10 X 10\^9/L must achieve an additional on-study WBC count \<10 X 10\^9/L to be considered responders. A Clopper-Pearson (exact binomial) two-sided 95% confidence interval for the percentage of responders is presented. Baseline data was defined as the data most recently collected prior to the first dose. The percentage of participants who have a WBC count \<10 X 10\^9/L week 36 are reported.
Time frame: Up to approximately 36 weeks
Duration of White Blood Cell (WBC) Count <10 x 10^9/L
Total response duration was defined as the summation of all WBC \<10 x 10\^9/L response durations, where an individual response duration starts at the timepoint when WBC \<10 x 10\^9/L and ends at the first subsequent occurrence of WBC ≥ 10 x 10\^9/L. WBC count was analyzed by taking blood samples from participants at designated time points during the study. The duration of WBC count \<10 X 10\^9/L in participants are reported.
Time frame: Up to approximately 22 months
Number of Participants With Thrombotic Events
Thrombotic events are defined as: new or recurrent acute myocardial infarction; unstable angina; stroke; transient ischemic attack (TIA); deep venous thrombosis (DVT); pulmonary embolism (PE); thrombotic digital ischemia; other thrombotic events such as peripheral limb ischemia or Budd-Chiari syndrome that are assessed to be due to underlying polycythemia vera (PV); other vascular occlusive events such as symptoms of cardiac, abdominal or peripheral limb ischemia supported by objective evidence of vessel disease and/or ischemia. Baseline data was defined as the data most recently collected prior to the first dose. The number of participants with thrombotic events are reported.
Time frame: Up to approximately 22 months
Number of Participants With Major Hemorrhagic Events
Hemorrhagic events were defined as: Major Bleeding (MB) Events such as fatal bleeding, and/or symptomatic bleeding in a critical area or organ such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, or intramuscular with compartment syndrome, and/or bleeding causing a fall in hemoglobin level of 2 g/dL or more, or leading to transfusion of 2 or more units of whole blood or red cells; Clinically Relevant Non-Major Bleeding (CRNMB) Events Leading to hospitalization or increased level of care or clinically important, prompting a face-to-face medical evaluation. Baseline data was defined as the data most recently collected prior to the first dose. The number of participants with major hemorrhagic events are reported.
Time frame: Up to approximately 22 months
Number of Participants With an Enlarged Spleen at Baseline Who Had a Reduction in Splenic Volume by 36 Weeks
Spleen volume was measured by magnetic resonance imaging (MRI) (or computerized tomography \[CT\] if participant is not a candidate for MRI) of the abdomen according to standard procedures. Baseline data was defined as the data most recently collected prior to the first dose. The number of participants with an enlarged spleen at baseline (volume \>450 cm\^3) who achieved any reduction in spleen volume by Week 36 are reported.
Time frame: Up to approximately 36 weeks
Number of Participants With Progressive Disease (PD)
PD was defined as the worsening of Polycythemia Vera (PV) to post-PV myelofibrosis, myelodysplastic syndrome or transformation to acute myeloid leukemia. Baseline data was defined as the data most recently collected prior to the first dose. The number of participants with PD are reported.
Time frame: Up to approximately 52 weeks
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