Actuate 1901: 9-ING-41 in Myelofibrosis
Hematopoietic Malignancies
Leukemia
Unknown Primary
18 Years and older, Male and Female
1901 (primary)
NCI-2020-01824
Summary
9-ING-41 has anti-cancer clinical activity while not causing myelosuppression, and has both
pre-clinical anti-fibrotic activity and activity against myelofibrosis. This Phase 2 study
will study its efficacy in patients with advanced myelofibrosis.
Objectives
9-ING-41 is a first-in-class, intravenously administered, maleimide-based, small molecule,
potent selective GSK-3ß inhibitor with significant pre-clinical and clinical anticancer
activity. In the ongoing Actuate 1801 study in a cohort of over 90 patients with advanced
refractory malignancies, 9-ING-41 has exhibited no significant toxicity, including no
myelosuppression, and significant anti-tumor activity. 9-ING-41 also has significant
pre-clinical ability to reverse pathologic fibrosis in multiple models of pulmonary and
pleural fibrosis. Reversal of fibrosis by an anti-fibrotic agent in patients with advanced
myelofibrosis (MF) has recently been demonstrated to be of clinical benefit. 9-ING-41 has the
potential to act both as an anti-neoplastic agent (without causing myelosuppression) and an
anti-fibrotic agent in patients with MF. The efficacy of Ruxolitinib is limited in many
patients by the inability to tolerate adequate doses for an adequate duration with
myelosuppression being a frequent dose limiting toxicity. 9-ING-41 may reduce the dose of
Ruxolitinib needed for optimal therapeutic response and/or reverse myelosuppression so than
an adequate dose of Ruxolitinib can be tolerated. Pre-clinical data show synergy in MF
between 9-ING-41 and Ruxolitinib. This Phase 2 study is designed to evaluate the efficacy of
9-ING-41, as a single agent or in combination with Ruxolitinib, in patients with advanced,
poor prognosis MF.
Eligibility
- Inclusion Criteria:
Patient -
1. Is able to understand and voluntarily sign a written informed consent and is willing
and able to comply with the protocol requirements including scheduled visits,
treatment plan, laboratory tests and other study procedures
2. Is aged = 18 years
3. Has documented diagnosis of symptomatic primary MF, PPV-MF or PET-MF as defined by the
World Health Organization classification
4. Is ineligible or unwilling to undergo stem cell transplantation at time of study entry
5. Has laboratory function within specified parameters per local laboratory (may be
repeated):
- Absolute neutrophil count (ANC) = 100/mL; platelets = 20,000/mL
- Transaminases (AST/ALT) and alkaline phosphatase = 3 (= 10 X the upper limit of
normal (ULN) if considered to be MF-related) x ULN; bilirubin = 1.5 x ULN (unless
patient has Gilbert's Syndrome)
- Serum amylase and lipase = 1.5 x ULN
6. Has adequate performance status (PS): Eastern Co-operative Oncology Group (ECOG) PS
0-2
7. Has received the final dose of any of the following treatments/procedures with the
specified minimum intervals before first dose of 9-ING-41 (unless in the opinion of
the investigator and the study medical coordinator the treatments/procedures will not
compromise patient safety or interfere with study conduct:
- Chemotherapy, immunotherapy, or systemic radiation therapy - 14 days maximum, or
= 5 half-lives (whichever is shorter)
- Surgery with general anesthesia - 7 days
8. Patients who are to receive 9-ING-41 plus Ruxolitinib must have attempted =12 weeks of
Ruxolitinib therapy and required dose reductions/interruptions and/or had an
inadequate response
9. Women of childbearing potential must have a negative baseline blood or urine pregnancy
test within 72 hours of first study therapy. Women may be neither breastfeeding nor
intending to become pregnant during study participation and must agree to use
effective contraceptive methods (hormonal or barrier method of birth control, or true
abstinence) for the duration of study participation and in the following 100 days
after discontinuation of study treatment
10. Male patients with partners of childbearing potential must take appropriate
precautions to avoid fathering a child from screening until 100 days after
discontinuation of study treatment and use appropriate barrier contraception or true
abstinence
11. Must not be receiving any other investigational product
Exclusion Criteria:
Patient -
1. Is pregnant or lactating
2. Is known to be hypersensitive to any of the components of 9-ING-41 or to the
excipients used in its formulation
3. Has >10% blasts in peripheral blood or bone marrow biopsy
4. Has had a myocardial infarction within 12 weeks of the first dose of 9-ING-41
5. Has any medical and/or social condition which, in the opinion of the investigator or
study medical coordinator would preclude study participation
6. Is considered to be a member of a vulnerable population (for example, prisoners)
7. Herbal preparations / medications are prohibited throughout the study. These herbal
medications include, but are not limited to St. John's wort, Kava, ephedra (ma huang),
Gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and Ginseng.
Patients should stop using cannabinoids or herbal preparations/medications at least 7
days prior to first dose of study treatment -
**Clinical trials are research studies that involve people. These studies test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved cancer treatments. They also receive state-of-the-art care from cancer experts...
Click here to learn more about clinical trials.