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This was an open-label, multi-center, randomized phase 2 study. This is a two-stage design.In the first stage, two dose groups were set up, the 100 mg bid dose group and the 200 mg qd dose group, which were randomized at 1:1, with 50 subjects in each group, and a total of 100 cases in the two groups. In the second stage, approximately 36 subjects were added to the randomized group.
According to the results of the interim analysis of the ZGJAK002 of Jaktinib, a comprehensive evaluation of the benefits and risks of subjects in the 100mg bid and 200mg qd groups, the investigator and the sponsor decided to expand the enrollment of approximately 36 subjects taking 100mg bid.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Jaktinib hydrochloride tablets 1 | Experimental | This is the dose group was given once a day. Jaktinib hydrochloride tablets 1 200mg qd dose group |
|
| Jaktinib hydrochloride tablets 2 | Experimental | This is the dose group was given twice a day. Jaktinib hydrochloride tablets 2 100mg bid dose group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Jaktinib hydrochloride tablets | Drug | Jaktinib hydrochloride tablets 100mg bid dose group and Jaktinib hydrochloride tablets 200mg qd dose group |
|
| Measure | Description | Time Frame |
|---|---|---|
| effective rate | The proportion of all subjects whose spleen volume decreased by 35% or more at 24 weeks | 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate (CR+PR) | IWG-MRT efficacy criteria | 24 weeks |
| The spleen response | The time from baseline to the first splenic volume reduction was greater than or equal to 35%;Optimal response: the proportion of patients whose spleen volume decreased by more than 35% compared with the baseline at least once;Effective time: the time from the randomization date to the first time the spleen volume decreased by more than 35% from the baseline;DoMSR: the time between the first occurrence of spleen volume reduction of more than 35% from the baseline to the increase of spleen volume less than 35% from the baseline; |
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Inclusion criteria:
1、18 years age or older ,male or female;
2、Patients diagnosed with Primary Myelofibrosis according to WHO standard (2016 version), or patients diagnosed with Post-Polycythemia Vera Myelofibrosis or Post-Essential Thrombocythemia Myelofibrosis according to International Working Group Myeloproliferative Neoplasms Research and Treatment(IWG-MRT) standard. Both Janus Kinase 2(JAK2)mutation and JAK2 wild can be enrolled;
3、According to Dynamic International Prognostic Scoring System plus(DIPSS-plus) risk grouping criteria, patients with medium-risk-2 or high-risk myelofibrosis were assessed,Patients with grade 1 medium-risk myelofibrosis with hepatosplenomegaly and no response to existing treatment and requiring treatment can also be enrolled;
4、Subjects did not have a recent stem cell transplant program;
5、a life expectancy > 24 weeks;
6、Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2;
7、Splenomegaly: palpation of the splenic margin to or above the subcostal at least 5 cm;
8、Peripheral blood protocells ≤10%;
9、Patients who have not previously been treated with JAK inhibitors;
10、Absolute neutrophil count(ANC) ≥1000/uL, platelet count ≥75 × 109/L without growth factor, platelet production factor or platelet infusion.Subjects did not receive growth factor infusion within 2 weeks before randomization;
11、Seven days before randomization, the main organs were functioning normally, which met the following criteria: alanine transaminase(ALT)and aspartate aminotransferase(AST)≤2.5×upper limit of normal (ULN); direct bilirubin(DBIL)and total bilirubin (TBIL)≤1.5×upper limit of normal (ULN);serum creatinine ≤2.5×upper limit of normal (ULN),calculated creatinine clearance(CrCl)≥50mL/min;
12、 Voluntarily sign informed consent in accordance with the requirements of the ethics committee;
13、Ability to follow study and follow-up procedures;
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jie Jin, MD | The First Affiliated Hospital of Medical School of Zhejiang University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Medical School of Zhejiang University | Hangzhou | Zhejiang | 310003 | China |
No plan to share date of the trial
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| ID | Term |
|---|---|
| D055728 | Primary Myelofibrosis |
| ID | Term |
|---|---|
| D009196 | Myeloproliferative Disorders |
| D001855 | Bone Marrow Diseases |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| 24 weeks |
| Anemia response | Baseline proportion of patients with blood transfusion dependence converted to patients without blood transfusion dependence(Patients without blood transfusion dependence: patients without red blood cell transfusion for more than 12 weeks during the treatment period and with HGB ≥85g/L);The proportion of patients with baseline non-transfusion dependence (HGB ≤100g/L) whose HGB increased by 20g/L;RBC Infusion dependence decreased: RBC infusion frequency decreased by 50%; | 24 weeks |
| MF related symptom response rate | MPN-SAF TSS the proportion of patients whose total symptom score of the scale decreased by more than 50%;MPN-SAF TSS the total scale symptom score was lower than baseline | 24 weeks |
| Progression-free survival (PFS) | PFS was defined as the time from date of randomization to disease progression radiological or death due to any cause, whichever occurs first. Subjects without progression or death at the time of analysis were censored at their last date of disease evaluation. | 24 weeks |
| Leukemia-free survival(LFS) | The time elapsed between the dates of any of the following events from a randomized solstice;The first bone marrow smear showed that the original cells were more than 20% of the date;The initial peripheral blood smear showed that the original cells were more than 20% and A peripheral blood blast content of 20% associated with an absolute blast count of 1*10(9)/L that lasts for at least 2 weeks;Death from any cause. Subjects without anyone of events at the time of analysis were censored at their last date of disease evaluation. | 24 weeks |
| Overall survival (OS) | OS is defined as the time from date of randomization to death due to any cause. Subjects without death at the time of analysis were censored at their last date of follow-up. | 2 years |