Trial Outcomes & Findings for Clinical Trial of Aplidin® in Patients With Primary Myelofibrosis (NCT NCT01149681)

NCT ID: NCT01149681

Last Updated: 2020-10-12

Results Overview

Objective response rate (ORR) of plitidepsin in patients with: primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis or post-essential thrombocythemia myelofibrosis. ORR according to the International Working Group for Myelofibrosis Research and Treatment (IWG-MRT) response criteria (Tefferi et al., 2006) in the evaluable population: defined as a confirmed disease response, on two consecutive evaluations performed at least eight weeks apart. Overall response (OR) = Complete Response (CR) + Partial response (PR) + Clinical improvement (CI).

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

12 participants

Primary outcome timeframe

All patients were followed up to progressive disease, start of a new anti-cancer therapy, death or one year after the last treatment visit of the last patient, whichever occured first

Results posted on

2020-10-12

Participant Flow

Participant milestones

Participant milestones
Measure
Aplidin®
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Overall Study
STARTED
12
Overall Study
COMPLETED
0
Overall Study
NOT COMPLETED
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Aplidin®
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Overall Study
Withdrawal by Subject
7
Overall Study
Progressive disease
1
Overall Study
Physician Decision
2
Overall Study
adverse events nonrelated study drug
2

Baseline Characteristics

Clinical Trial of Aplidin® in Patients With Primary Myelofibrosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Aplidin®
n=12 Participants
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
3 Participants
n=5 Participants
Age, Categorical
>=65 years
9 Participants
n=5 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
Region of Enrollment
United States
10 participants
n=5 Participants
Region of Enrollment
Italy
2 participants
n=5 Participants

PRIMARY outcome

Timeframe: All patients were followed up to progressive disease, start of a new anti-cancer therapy, death or one year after the last treatment visit of the last patient, whichever occured first

Population: 1 of the 12 patients treated was excluded. This patient received 1 complete infusion of plitidepsin in Cycle 1, and had the second infusion interrupted due to plitidepsin-related grade 3 chest and epigastric pain (reported as SAEs). Although the episode resolved a day later, she refused to continue treatment and had no disease evaluations done

Objective response rate (ORR) of plitidepsin in patients with: primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis or post-essential thrombocythemia myelofibrosis. ORR according to the International Working Group for Myelofibrosis Research and Treatment (IWG-MRT) response criteria (Tefferi et al., 2006) in the evaluable population: defined as a confirmed disease response, on two consecutive evaluations performed at least eight weeks apart. Overall response (OR) = Complete Response (CR) + Partial response (PR) + Clinical improvement (CI).

Outcome measures

Outcome measures
Measure
Arm One
n=11 Participants
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Objective Response Rate (ORR)
Clinical improvement
1 Participants
Objective Response Rate (ORR)
Stable disease
9 Participants
Objective Response Rate (ORR)
Progressive disease
1 Participants

SECONDARY outcome

Timeframe: All patients were followed up to progressive disease, start of a new anti-cancer therapy, death or one year after the last treatment visit of the last patient, whichever occured first

Quality of life (QoL) and symptoms assessment according to the Myelofibrosis Symptom Assessment Form (MFSAF), after treatment with plitidepsin. For full details please refer to Mesa RA, Schwager S, Radia D, Cheville A, Hussein K, Niblack J, et al. The Myelofibrosis Symptom Assessment Form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res 2009;33(9):1199-203. Scale measures: 0 to 10 (0 if absent) ranking being 1 the most favorable and 10 least favorable.

Outcome measures

Outcome measures
Measure
Arm One
n=12 Participants
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Quality of Life (QoL)
Overall quality of life - Baseline
5.7 score on a scale
Interval 4.8 to 6.6
Quality of Life (QoL)
Overall quality of life - Cycle 1
5.0 score on a scale
Interval 4.1 to 5.9
Quality of Life (QoL)
Overall quality of life - Cycle 2
5.4 score on a scale
Interval 3.8 to 6.9
Quality of Life (QoL)
Overall quality of life - Cycle 3
6.3 score on a scale
Interval 3.5 to 9.2
Quality of Life (QoL)
Overall quality of life - Cycle 4
7.5 score on a scale
Interval -24.3 to 39.3

OTHER_PRE_SPECIFIED outcome

Timeframe: All patients were followed up to progressive disease or death, whichever occured first, up to 30 days after their last dose

Population: 1 of the 12 patients treated was excluded. This patient received 1 complete infusion of plitidepsin in Cycle 1, and had the second infusion interrupted due to plitidepsin-related grade 3 chest and epigastric pain (reported as SAEs). Although the episode resolved a day later, she refused to continue treatment and had no disease evaluations done

Progression free survival (PFS) is defined as the time from start of treatment to the date of documented progressive disease (PD) by IWG-MRT criteria or death (regardless of the cause of death), whichever comes first. Patients who progress or die will be considered to have had an event, except if this event occurs after the start of subsequent antitumor therapy, in which case the patient will be censored at the time of last disease assessment prior to or on the first day of the first subsequent antitumor therapy. If the patient is lost for the assessment of progression during the follow-up period, or has more than one missing follow-up between the date of last tumor assessment and the date of progression, death or further antitumor therapy, the PFS will be censored at the date of last valid disease assessment before the missing evaluations.

Outcome measures

Outcome measures
Measure
Arm One
n=11 Participants
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Progression-free Survival (PFS)
4.6 months
Interval 1.4 to 4.6

Adverse Events

Aplidin®

Serious events: 5 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Aplidin®
n=12 participants at risk
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Blood and lymphatic system disorders
Anaemia
8.3%
1/12
Cardiac disorders
Acute myocardial infarction
8.3%
1/12
Gastrointestinal disorders
Abdominal pain upper
8.3%
1/12
Gastrointestinal disorders
Gastrointestinal haemorrhage
16.7%
2/12
Gastrointestinal disorders
Oesophageal varices haemorrhage
8.3%
1/12
General disorders
Chest pain
8.3%
1/12
Infections and infestations
Bronchopneumonia
8.3%
1/12
Respiratory, thoracic and mediastinal disorders
Pulmonary oedema
8.3%
1/12
Vascular disorders
Deep vein thrombosis
8.3%
1/12

Other adverse events

Other adverse events
Measure
Aplidin®
n=12 participants at risk
APLIDIN (plitidepsin): Aplidin® (plitidepsin) lyophilized powder and solvent for concentrate for solution for infusion. (2 mg plitidepsin vial and 4 ml ampoule). Plitidepsin will be administered at 5 mg/m2 intravenously diluted to a total volume of 250 ml in 0.9% saline or 5% dextrose solution on Day 1 and 15 every four weeks for a maximum period of 6 cycles.
Blood and lymphatic system disorders
Anaemia
8.3%
1/12
Blood and lymphatic system disorders
Neutropenia
8.3%
1/12
Blood and lymphatic system disorders
Thrombocytopenia
8.3%
1/12
Cardiac disorders
Aortic valve disease
8.3%
1/12
Cardiac disorders
Mitral valve incompetence
8.3%
1/12
Cardiac disorders
Palpitations
8.3%
1/12
Cardiac disorders
Sinus arrhythmia
8.3%
1/12
Cardiac disorders
Sinus bradycardia
8.3%
1/12
Cardiac disorders
Sinus tachycardia
8.3%
1/12
Eye disorders
Ocular hyperaemia
8.3%
1/12
Gastrointestinal disorders
Abdominal pain
66.7%
8/12
Gastrointestinal disorders
Diarrhoea
41.7%
5/12
Gastrointestinal disorders
Faeces discoloured
8.3%
1/12
Gastrointestinal disorders
Nausea
83.3%
10/12
Gastrointestinal disorders
Vomiting
41.7%
5/12
General disorders
Early satiety
66.7%
8/12
General disorders
Fatigue
100.0%
12/12
General disorders
Infusion related reaction
8.3%
1/12
General disorders
Oedema
25.0%
3/12
General disorders
Oedema peripheral
8.3%
1/12
General disorders
Pyrexia
16.7%
2/12
Infections and infestations
Bronchitis
8.3%
1/12
Infections and infestations
Cellulitis
8.3%
1/12
Investigations
Blood creatine phosphokinase increased
8.3%
1/12
Investigations
Blood creatinine increased
8.3%
1/12
Investigations
Ejection fraction decreased
8.3%
1/12
Investigations
Electrocardiogram QT prolonged
25.0%
3/12
Investigations
Electrocardiogram T wave abnormal
16.7%
2/12
Investigations
Troponin T increased
8.3%
1/12
Investigations
Weight decreased
58.3%
7/12
Metabolism and nutrition disorders
Anorexia
8.3%
1/12
Metabolism and nutrition disorders
Gout
8.3%
1/12
Metabolism and nutrition disorders
Hyperuricaemia
8.3%
1/12
Metabolism and nutrition disorders
Iron overload
8.3%
1/12
Musculoskeletal and connective tissue disorders
Arthralgia
16.7%
2/12
Musculoskeletal and connective tissue disorders
Bone pain
50.0%
6/12
Musculoskeletal and connective tissue disorders
Joint swelling
8.3%
1/12
Musculoskeletal and connective tissue disorders
Muscular weakness
41.7%
5/12
Musculoskeletal and connective tissue disorders
Myalgia
8.3%
1/12
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Tumour pain
8.3%
1/12
Nervous system disorders
Balance disorder
8.3%
1/12
Nervous system disorders
Dizziness
8.3%
1/12
Nervous system disorders
Dysgeusia
8.3%
1/12
Nervous system disorders
Peripheral sensory neuropathy
16.7%
2/12
Psychiatric disorders
Insomnia
16.7%
2/12
Renal and urinary disorders
Haematuria
8.3%
1/12
Renal and urinary disorders
Micturition urgency
8.3%
1/12
Renal and urinary disorders
Pollakiuria
8.3%
1/12
Respiratory, thoracic and mediastinal disorders
Cough
8.3%
1/12
Respiratory, thoracic and mediastinal disorders
Dyspnoea
8.3%
1/12
Respiratory, thoracic and mediastinal disorders
Emphysema
8.3%
1/12
Skin and subcutaneous tissue disorders
Alopecia
8.3%
1/12
Skin and subcutaneous tissue disorders
Erythema
8.3%
1/12
Skin and subcutaneous tissue disorders
Night sweats
58.3%
7/12
Skin and subcutaneous tissue disorders
Pruritus
33.3%
4/12
Skin and subcutaneous tissue disorders
Rash macular
8.3%
1/12
Vascular disorders
Deep vein thrombosis
8.3%
1/12
Vascular disorders
Hypertension
16.7%
2/12
Vascular disorders
Pallor
8.3%
1/12

Additional Information

Clinical Development Department of PharmaMar´s Oncology,Business Unit.,

Pharma Mar, S.A.

Phone: +34 918466000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60