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This trial adopts an open, randomized, parallel controlled, multicenter clinical trial design planning to enroll patients with polycythemia vera who are resistant/intolerant to hydroxyurea or interferon。The study divided into two stages: dose exploration stage: three dose groups are tentatively set, with three subjects in each group, totaling nine subjects in each group; Dose extension stage: Based on the safety, efficacy, and pharmacokinetic results of the comprehensive dose exploration stage, 2-3 dose groups are planned to be selected for dose extension trials.
The treatment goal of polycythemia vera is to avoid initial or recurrent thrombosis, control disease-related symptoms, prevent post PV MF and/or acute leukemia transformation after polycythemia vera. Almost all PV patients have non receptor type Janus kinase 2 (JAK2) gene mutations, typically JAK2 V617F. This drug is intended for patients with myeloproliferative neoplasms (MPN), mainly including moderate to high-risk myelofibrosis (FM) (including primary myelofibrosis (PMF)), post polycythemia vera myelofibrosis (PPV-MF), and post thrombocytopenia myelofibrosis (PET-MF), polycythemia vera (PV), and primary thrombocytosis (ET).
Flonoltinib Maleate (FM), a triple target inhibitor of JAK2/FLT3/CDK6, has the potential to inhibit JAK2 signaling pathway activity and treat bone marrow proliferative tumors.
This trial adopts an open, randomized, parallel controlled, multicenter clinical trial design. The plan is to recruit patients with polycythemia vera who are resistant/intolerant to hydroxyurea or interferon. The study is divided into two stages: dose exploration stage: three dose groups are tentatively set, with three subjects in each group,for a total of 9 subjects; Dose extension phase: Based on the safety, efficacy, and pharmacokinetic results of the comprehensive dose exploration phase, it is planned to select 2-3 dose groups for dose extension trials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose exploration stage group 1 | Experimental | Flonoltinib 75mg |
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| Dose exploration stage group 2 | Experimental | Flonoltinib 100mg |
|
| Dose exploration stage group 3 | Experimental | Flonoltinib 125mg |
|
| Extended Phase Dose Group | Experimental | Based on the safety, efficacy, and pharmacokinetic results of the comprehensive dose exploration stage,Flonoltinib xxmg,QD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Flonoltinib 75mg | Drug | Flonoltinib Maleate Tablet 75mg, oral administration, once daily, given on an empty stomach for 8 consecutive weeks of treatment. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of subjects who achieved HCT control | Achieve HCT<45% without undergoing venous bloodletting or apheresis treatmen | At the end of the 28th week |
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of subjects who achieved complete hematological remission | Without undergoing venous bloodletting or apheresis, achieve HCT<45%, PLT <= 400×10^9/L, and WBC<10×10^9/L | week 28 and 52 |
| The duration of HCT control |
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Inclusion Criteria:
1)At least 2 venous bloodletting and/or apheresis treatments have been performed within 24 weeks prior to screening, with a minimum interval of 4 weeks between each treatment, and at least 1 treatment has occurred within 16 weeks prior to screening; 2)At least one venous bloodletting and/or apheresis treatment has been performed within the 16 weeks and HCT>45% at the time of screening; 5.When screening, laboratory test indicators meet the following criteria: neutrophil count >= 1.0 × 10 ^ 9/L, platelet count >= 100 × 10 ^ 9/L and <= 1000 × 10 ^ 9/L; ALT and AST<= 2.5 × ULN; TBIL<=2.0×ULN; Serum creatinine <= 1.5 × ULN; 6.ECOG 0-2 points; 7.Can understand and voluntarily sign an informed consent form.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fangmei Wang | Contact | +8613808086495 | fangmei.wang@zenitar.cn | |
| Liangkun Sun | Contact | +8615885742617 | liangkunsun@zenitar.cn |
| Name | Affiliation | Role |
|---|---|---|
| Lei Zhang, Doctor | Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences (IHCAMS) | Principal Investigator |
| Ting Niu, Doctor | West China Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences (IHCAMS) | Recruiting | Tianjin | China |
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| ID | Term |
|---|---|
| D011087 | Polycythemia Vera |
| ID | Term |
|---|---|
| D019046 | Bone Marrow Neoplasms |
| D019337 | Hematologic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Flonoltinib 100mg | Drug | Flonoltinib Maleate Tablet 100mg, oral administration, once daily, given on an empty stomach for 8 consecutive weeks of treatment. |
|
| Flonoltinib 125mg | Drug | Flonoltinib Maleate Tablet 125mg, oral administration, once daily, given on an empty stomach for 8 consecutive weeks of treatment. |
|
| Extended Phase Dose Group | Drug | Based on the safety, efficacy, and pharmacokinetic results of the comprehensive dose exploration stage |
|
The duration of HCT control (defined as the time elapsed from the date when HCT control was first recorded from the start of Day 29 treatment to the date when HCT increased to >= 45%)
| The time elapsed from the date when HCT control was first recorded from the start of Day 29 treatment to the date when HCT increased to >= 45% |
| Changes in the total symptom score of MPN-SAF TSS scale | The MPN-SAF-TSS is used to assess the symptom burden of patients with myeloproliferative neoplasms. The questionnaire also reflects the quality of life of patients to a certain extent. During the diagnosis and treatment process, the MPN-10 questionnaire includes 10 sub symptoms (fatigue, early satiety, abdominal discomfort, poor activity, lack of concentration, night sweats, skin itching, bone pain, fever, and weight loss). Each item is graded from 0 (none) to 10 (heaviest), with a total score of 0-100 points. The higher the total score, the heavier the symptom burden. | week 16, 28, 40, and 52 |
| Proportion of subjects who did not experience thrombosis or bleeding events | Proportion of subjects who did not experience thrombosis or bleeding events at the end of treatment in weeks 28 and 52 | week 28 and 52 |
| Changes in gene mutation burden relative to baseline | Subjects with JAK2V617F quantification>0% during the screening period will undergo JAK2V617F quantification testing at weeks 28 and 52 | week 28 and 52 |
| Wei Yang, Doctor | Shengjing Hospital | Principal Investigator |
| D001855 |
| Bone Marrow Diseases |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D009196 | Myeloproliferative Disorders |