Peginterferon α-2b for patients with resistant or intolerant Essential Thrombocythemia

A Phase 2 Multicenter, Randomized, Open-label Study to Evaluate the Pharmacokinetic, Safety and Efficacy of Peginterferon Alfa-2b Injection in Subjects With Essential Thrombocythemia Who Are Resistant to or Intolerant of Hydroxyurea.

This study is testing if a new medication called Peginterferon α-2b can help people with essential thrombocythemia who haven't had success with or can't tolerate their current treatment.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 27 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Xiamen Amoytop Biotech Co., Ltd. (Industry-sponsored)
• Locations: 8 sites (Beijing and 7 other locations)
• Trial ID: NCT06552429 on ClinicalTrials.gov

What this trial studies

This multicenter, randomized, open-label Phase 2 clinical study aims to enroll 27 patients with essential thrombocythemia (ET) who are resistant to or intolerant of hydroxyurea. Participants will be randomized to receive either Peginterferon α-2b at doses of 135 mcg or 180 mcg over a treatment period of 48 weeks, followed by an extension period of 48 weeks and a follow-up period. The study will evaluate pharmacokinetics, safety, and efficacy of the treatment in this specific patient population.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with high-risk essential thrombocythemia who are resistant to or intolerant of hydroxyurea.

Not a fit: Patients who have not been previously treated with hydroxyurea or those with low-risk essential thrombocythemia may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide an effective alternative for patients with essential thrombocythemia who cannot tolerate or respond to hydroxyurea.

How similar studies have performed: While this approach is being tested in this specific context, similar studies using interferon treatments have shown promise in managing essential thrombocythemia.

Eligibility criteria

Inclusion Criteria:

* Male or female subjects, aged greater or equal to 18 years old at screening;
* Subjects diagnosed as high-risk ET according to the World Health Organization (WHO) 2016 criteria：1) who is older than 60 years and JAK2V617F positive at screening, 2) or who previously suffered from disease-related thrombosis or hemorrhage;
* Subjects who have previously received HU for ET, and the time interval between the last HU dose and the first dose of the study drug should not be less than 7 days;
* Interferon treatment-naïve, and for those who have previously received interferon the the time interval between the last dose of interferon and randomization should not be less than 1 month;
* Patients with confirmed hydroxyurea resistance or intolerant, as at least one of the following criteria is met:

  1. Platelet count remain greater than 600×10\^9 /L after at least 3 months of HU treatment at a dose ≥2g/d (dose ≥2.5 g/d if subject weight \> 80 kg);
  2. Platelet count greater than 400\*10\^9/L while white blood cell (WBC) count lower than 2.5\*10\^9/L, or platelet count greater than 400\*10\^9 /L while hemoglobin lower than 100 g/L at any dose of HU;
  3. Presence of HU-related toxicities at any dose of HU: e.g. ulcers in legs, or any unacceptable skin mucosal manifestations or fever;
* Platelet counts \> 450\*10\^9/L at screening;
* Neutrophil count ≥1.0\*10\^9/L at screening;
* Haemoglobin ≥11 g/dL at screening for males and 10 g/dL for females at screening;
* There is no serious function damage in liver and kidney: total bilirubin ≤1.5 upper limit of normal (ULN), alanine aminotransferase≤2.0 ULN, aspartate aminotransferase≤2.0 ULN, prothrombin time is prolonged by less than 4 seconds, Creatinine clearance ≥50 mL/min (according to Cockcroft-Gault formula) at screening;
* Both male and female subjects must agree take an appropriate contraceptive method, including:

  1. Male subjects: must agree to use reliable contraception from inform consent until 6 months following the last dose of the study drug.
  2. Female subjects: Must meet at least one of the following conditions:

  i) Women without childbearing potential; ii) Women of childbearing potential: no pregnant or breastfeed, negative in blood pregnancy test within 4 days prior to the first dosing, and must agree to use reliable contraception from inform consent until 6 months following the last dose of the study drug;
* Subjects understand the objective, characteristic, method and possible adverse reactions of the study, voluntarily participate in this study, and sign informed consent.

Exclusion Criteria:

* History of any other myeloproliferative tumors, or evidence of the presence of any other myeloproliferative tumors;
* Contraindications or hypersensitivities to interferons of any of its excipients;
* Severe medical conditions or serious comorbidities that the investigators determined could jeopardize the safety or protocol adherence, e.g. New York Heart Association \[NYHA\] Class III-IV, congestive heart failure, symptomatic arrhythmias，pulmonary hypertension;
* History of major organ transplantation;
* Documented autoimmune disease or history of autoimmune disease at screening, e.g. medication un-controlled thyroid dysfunction, autoimmune hepatitis, idiopathic thrombocytopenic purpura, scleroderma, psoriasis, or any autoimmune arthritis;
* Clinically significant pulmonary infiltration, infectious pneumonia, and non-infectious pneumonia at screening that, in the investigator's opinion, would jeopardize the safety of the subject or their compliance with the protocol;
* Infection with systemic clinical manifestations at screening, e.g., bacteria, fungi, human immunodeficiency virus, excluding hepatitis B and/or C;
* Evidence of severe retinopathy, e.g., cytomegalovirus retinitis, symptomatic macular degeneration, or clinically significant eye disease, e.g. due to diabetes mellitus or hypertension;
* Diagnosed clinically significant depression or a history of depression and, in the investigator's opinion, previous suicide attempts or at any risk of suicide at screening;
* Diagnosed clinically significant neurological disease or a history of clinically significant neurological disease, except for a history of stable cerebral thrombosis or cerebral hemorrhage;
* History of any malignancy within 5 years (except stage 0 chronic lymphocytic leukemia, basal cell carcinoma, squamous cell carcinoma, and superficial melanoma);
* A history of alcohol or drug abuse within 1 year;
* Have used any investigational drug within 4 weeks prior to first dose of investigational drug, or not recovered from the effects of prior investigational drug administration;
* Other situations that, in the investigator's opinion, not appropriate for inclusion.

Where this trial is running

Beijing and 7 other locations

• Peking Union Hospital, Chinese Academy of Medical Sciences — Beijing, China (Recruiting)
• Peking University People's Hospital — Beijing, China (Recruiting)
• Union Hospital affiliated to Fujian Medical University — Fujian, China (Recruiting)
• Nanfang Hospital, Southern Medical University — Guangzhou, China (Recruiting)
• Harbin First Hospital — Harbin, China (Recruiting)
• Henan Cancer Hospital — Henan, China (Recruiting)
• Ruijin Hospital, Shanghai Jiao Tong University School of Medicine — Shanghai, China (Recruiting)
• The First Affiliated Hospital of Zhejiang University School of Medicine — Zhejiang, China (Recruiting)

Study contacts

• Principal investigator: Lei Zhang — Chinese Academy of Medical Sciences
• Study coordinator: Lei Zhang

Conditions Essential Thrombocythemia; Peginterferon α-2b; hydroxyurea resistant; hydroxyurea intolerant