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Phase 1a/1b study of Itacitinib (INCB039110) for cytokine release syndrome prevention and minimization of immunosuppression following nonmyeloablative related partially HLA-mismatched peripheral blood stem cell transplant (PBSCT) with high-dose posttransp

Details

Status

open

Study Type

Interventional

Study Phase

I

Location(s)

The Johns Hopkins Hospital

1800 Orleans St Baltimore, MD 21287

Contact Us

(410) 955-8964

Brief Summary

The study will be completed in two stages: Phase 1a, the dose (regimen) finding stage that will examine 4 different dose levels (regimens), and Phase 1b, where the dose and study drug administration schedule determined in the first stage will be given. Approximately 12-24 participants will be enrolled in each stage, for a total of up to 32 participants between both phases. Itacitinib will be started 3 days before transplant to prevent CRS and continued for 90 days after transplant.

Eligibility

Inclusion Criteria:

  • Presence of a suitable related, HLA-haploidentical (partially mismatched) stem cell donor.

  • Eligible diagnoses:

    1. Acute leukemias in complete remission with minimal residual disease
    2. Myelodysplastic syndrome (MDS) with at least one poor-risk feature
    3. Chronic myelomonocytic leukemia with at least one poor-risk feature
    4. T-cell PLL in PR or better prior to transplantation.
    5. Tyrosine kinase-refractory CML in first chronic phase, TKI-intolerant CML in first chronic phase, or CML in second or subsequent chronic phase.
    6. Philadelphia chromosome negative myeloproliferative disease (including myelofibrosis)
    7. Multiple myeloma or plasma cell leukemia with a PR or better to the last treatment regimen
  • Age ≥ 60 years.

  • Adequate end-organ function as measured by:

    1. Left ventricular ejection fraction ≥ 35% or shortening fraction > 25%
    2. Bilirubin ≤ 3.0 mg/dL (unless due to Gilbert's syndrome or hemolysis), and ALT and AST ≤ 5 x ULN
    3. FEV1 and FVC ≥ 40% of predicted
  • ECOG performance status ≤ 2 or Karnofsky score ≥ 60

Exclusion Criteria:

  • No active extramedullary leukemia or known active CNS involvement by malignancy.
  • Any previous autologous HSCT must have occurred at least 3 months prior to start of conditioning.
  • No previous allogeneic HSCT.
  • Not pregnant or breast-feeding
  • No uncontrolled infection.
  • No known HIV infection.
  • No active replicating HBV or HCV infection detected by PCR that requires treatment or at risk for HBV reactivation (positive HBsAg)