Trial Outcomes & Findings for Phase II Hedgehog Inhibitor for Myelodysplastic Syndrome (MDS) (NCT NCT01842646)

NCT ID: NCT01842646

Last Updated: 2021-06-14

Results Overview

Response recorded from the start of the treatment until disease progression/recurrence. All responses must last for at least 8 weeks. Complete Remission (CR): Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines, Persistent dysplasia will be noted, Peripheral blood: Hemoglobin ≥ 11 g/dL, Platelets ≥ 100 x 10\^9/L, Neutrophils ≥ 1.0 x 10\^9/L, Blasts 0% ; Partial Remission (PR): All CR criteria if abnormal before treatment, except: Bone marrow blasts decreased by ≥ 50% over pretreatment but still \> 5%, Cellularity and morphology not relevant; Marrow CR or Hematological Improvement (HI): Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment Peripheral blood: if HI responses, they will be noted in addition to marrow CR. Further investigation of PF-04449913 would not be warranted if it produced an overall response rate (CR + PR + marrow CR+HI) of 10% or less (p0), and would be warranted if it produced an overall response rate of 30% or more (p1).

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

35 participants

Primary outcome timeframe

Up to 2 years, 4 months

Results posted on

2021-06-14

Participant Flow

Recruitment began in August 2013 and participants were enrolled at Moffitt Cancer Center between September 2013 and September 2015.

Participant milestones

Participant milestones
Measure
Experimental: PF-04449913 Treatment
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Overall Study
STARTED
35
Overall Study
COMPLETED
35
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Phase II Hedgehog Inhibitor for Myelodysplastic Syndrome (MDS)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Experimental: PF-04449913 Treatment
n=35 Participants
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
n=5 Participants
Age, Categorical
>=65 years
29 Participants
n=5 Participants
Age, Continuous
75 years
n=5 Participants
Sex: Female, Male
Female
11 Participants
n=5 Participants
Sex: Female, Male
Male
24 Participants
n=5 Participants
Region of Enrollment
United States
35 participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to 2 years, 4 months

Population: All participants

Response recorded from the start of the treatment until disease progression/recurrence. All responses must last for at least 8 weeks. Complete Remission (CR): Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines, Persistent dysplasia will be noted, Peripheral blood: Hemoglobin ≥ 11 g/dL, Platelets ≥ 100 x 10\^9/L, Neutrophils ≥ 1.0 x 10\^9/L, Blasts 0% ; Partial Remission (PR): All CR criteria if abnormal before treatment, except: Bone marrow blasts decreased by ≥ 50% over pretreatment but still \> 5%, Cellularity and morphology not relevant; Marrow CR or Hematological Improvement (HI): Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment Peripheral blood: if HI responses, they will be noted in addition to marrow CR. Further investigation of PF-04449913 would not be warranted if it produced an overall response rate (CR + PR + marrow CR+HI) of 10% or less (p0), and would be warranted if it produced an overall response rate of 30% or more (p1).

Outcome measures

Outcome measures
Measure
Experimental: PF-04449913 Treatment
n=35 Participants
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Overall International Working Group (IWG) 2006 Response Rate
Complete Remission (CR)
0 Participants
Overall International Working Group (IWG) 2006 Response Rate
Hematological Improvement (HI)
2 Participants
Overall International Working Group (IWG) 2006 Response Rate
Stable Disease (SD)
19 Participants
Overall International Working Group (IWG) 2006 Response Rate
Progressive Disease (PD)
14 Participants

SECONDARY outcome

Timeframe: Up to 2 years, 4 months

Population: All participants

To estimate the overall survival of patients with refractory/relapsed myelodysplastic Syndrome (MDS) and chronic myelo-monocytic leukemia (CMML) treated with PF-0444913. Overall survival will be defined as the time period between the date of the first dose of drug until the time of death.

Outcome measures

Outcome measures
Measure
Experimental: PF-04449913 Treatment
n=35 Participants
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Median Overall Survival (OS)
10.2 months
Interval 6.8 to 13.6

SECONDARY outcome

Timeframe: Up to 2 years, 4 months

Population: All participants

To estimate the event-free survival of patients of this population. Event-free survival will be defined as the date of the first dose of study drug until failure (disease progression) or death from any cause.

Outcome measures

Outcome measures
Measure
Experimental: PF-04449913 Treatment
n=35 Participants
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Median Event Free Survival
6.4 months
Interval 1.9 to 18.33

SECONDARY outcome

Timeframe: Up to 2 years, 4 months

Population: NA- The median time to AML was not reached due to insufficient number of participants with events.

To estimate the time to transformation to AML in patients with \<20% blasts. In patients with less than 20% blasts, the time to transformation to AML will be defined as the date of the first dose of drug until either the percentage of bone marrow blasts or the percentage of peripheral blasts exceeds 20%, whichever is first.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 2 years, 4 months

Population: All participants

Treatment emergent adverse events occurring in equal to or more than 10% of participants.

Outcome measures

Outcome measures
Measure
Experimental: PF-04449913 Treatment
n=35 Participants
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Pain
22 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Dysgeusia
21 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Nausea
11 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Anorexia
11 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Skin/rash
8 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Oral mucositis
9 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : AST elevated
8 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Alopecia
8 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : ALT elevated
6 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Dizziness
6 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Dyspnea
5 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Infections
2 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Fatigue
6 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Diarrhea
6 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Constipation
5 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Fever
5 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Hyperkalemia
5 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Hyperglycemia
4 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Thrombocytopenia
2 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Headache
4 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 1-2 : Vomiting
4 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Pain
1 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Dysgeusia
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Nausea
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Anorexia
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Skin/rash
1 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Oral mucositis
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : AST elevated
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Alopecia
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : ALT elevated
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Dizziness
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Dyspnea
1 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Infections
4 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Fatigue
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Diarrhea
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Constipation
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Fever
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Hyperkalemia
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Hyperglycemia
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Thrombocytopenia
2 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Headache
0 Participants
Number of Participants With Treatment Emergent Adverse Events
Grade 3-4 : Vomiting
0 Participants

Adverse Events

Experimental: PF-04449913 Treatment

Serious events: 11 serious events
Other events: 35 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Experimental: PF-04449913 Treatment
n=35 participants at risk
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
Blood and lymphatic system disorders
Febrile neutropenia
2.9%
1/35 • Number of events 2 • 2 years, 4 months
Cardiac disorders
Cardiac arrest
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Gastrointestinal disorders
Ileus
2.9%
1/35 • Number of events 2 • 2 years, 4 months
General disorders
Death NOS
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Infections and infestations
Abdominal infection
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Bone infection
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Infections and infestations - Other, GI
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Infections and infestations - Other, Rhinovirus/Enterovirus
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Lung infection
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Infections and infestations
Sepsis
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other, possible DLBCL NHL
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Nervous system disorders
Intracranial hemorrhage
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
2.9%
1/35 • Number of events 1 • 2 years, 4 months

Other adverse events

Other adverse events
Measure
Experimental: PF-04449913 Treatment
n=35 participants at risk
Treatment to be administered on an outpatient basis. All participants to be treated with an oral dose PF-04449913 at 100 mg daily in 4-week cycles for a total of 4 cycles.
General disorders
Pain
65.7%
23/35 • Number of events 30 • 2 years, 4 months
General disorders
Fatigue
17.1%
6/35 • Number of events 6 • 2 years, 4 months
General disorders
Fever
14.3%
5/35 • Number of events 5 • 2 years, 4 months
General disorders
Edema limbs
8.6%
3/35 • Number of events 3 • 2 years, 4 months
General disorders
Flu like symptoms
5.7%
2/35 • Number of events 2 • 2 years, 4 months
General disorders
Chills
2.9%
1/35 • Number of events 1 • 2 years, 4 months
General disorders
Gait disturbance
2.9%
1/35 • Number of events 1 • 2 years, 4 months
General disorders
General disorders and administration site conditions - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
General disorders
Infusion related reaction
2.9%
1/35 • Number of events 1 • 2 years, 4 months
General disorders
Non-cardiac chest pain
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Nervous system disorders
Dysgeusia
60.0%
21/35 • Number of events 25 • 2 years, 4 months
Nervous system disorders
Dizziness
17.1%
6/35 • Number of events 6 • 2 years, 4 months
Nervous system disorders
Headache
11.4%
4/35 • Number of events 5 • 2 years, 4 months
Nervous system disorders
Memory impairment
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Nervous system disorders
Peripheral sensory neuropathy
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Nervous system disorders
Tremor
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Nervous system disorders
Dysarthria
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Nervous system disorders
Dysphasia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Nervous system disorders
Encephalopathy
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Nervous system disorders
Nervous system disorders - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Investigations
Aspartate aminotransferase increased
22.9%
8/35 • Number of events 9 • 2 years, 4 months
Investigations
Alanine aminotransferase increased
17.1%
6/35 • Number of events 10 • 2 years, 4 months
Investigations
Weight loss
14.3%
5/35 • Number of events 5 • 2 years, 4 months
Investigations
Platelet count decreased
11.4%
4/35 • Number of events 6 • 2 years, 4 months
Investigations
Alkaline phosphatase increased
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Investigations
Creatinine increased
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Investigations
Neutrophil count decreased
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Investigations
Investigations - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Metabolism and nutrition disorders
Anorexia
31.4%
11/35 • Number of events 14 • 2 years, 4 months
Metabolism and nutrition disorders
Hyperkalemia
14.3%
5/35 • Number of events 6 • 2 years, 4 months
Metabolism and nutrition disorders
Hyperglycemia
11.4%
4/35 • Number of events 4 • 2 years, 4 months
Metabolism and nutrition disorders
Hypomagnesemia
5.7%
2/35 • Number of events 3 • 2 years, 4 months
Metabolism and nutrition disorders
Hyponatremia
5.7%
2/35 • Number of events 3 • 2 years, 4 months
Metabolism and nutrition disorders
Dehydration
2.9%
1/35 • Number of events 2 • 2 years, 4 months
Metabolism and nutrition disorders
Hypercalcemia
2.9%
1/35 • Number of events 2 • 2 years, 4 months
Metabolism and nutrition disorders
Hyperuricemia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Metabolism and nutrition disorders
Hypoalbuminemia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Metabolism and nutrition disorders
Hypocalcemia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Metabolism and nutrition disorders
Hypokalemia
2.9%
1/35 • Number of events 4 • 2 years, 4 months
Metabolism and nutrition disorders
Metabolism and nutrition disorders - Other
2.9%
1/35 • Number of events 2 • 2 years, 4 months
Gastrointestinal disorders
Nausea
31.4%
11/35 • Number of events 13 • 2 years, 4 months
Gastrointestinal disorders
Mucositis oral
25.7%
9/35 • Number of events 9 • 2 years, 4 months
Gastrointestinal disorders
Diarrhea
17.1%
6/35 • Number of events 6 • 2 years, 4 months
Gastrointestinal disorders
Constipation
14.3%
5/35 • Number of events 5 • 2 years, 4 months
Gastrointestinal disorders
Vomiting
11.4%
4/35 • Number of events 4 • 2 years, 4 months
Gastrointestinal disorders
Abdominal pain
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Gastrointestinal disorders
Gastrointestinal disorders - Other
5.7%
2/35 • Number of events 3 • 2 years, 4 months
Gastrointestinal disorders
Rectal hemorrhage
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Gastrointestinal disorders
Dysphagia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Gastrointestinal disorders
Gastroesophageal reflux disease
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Gastrointestinal disorders
Hemorrhoids
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Gastrointestinal disorders
Periodontal disease
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Infections and infestations - Other
11.4%
4/35 • Number of events 7 • 2 years, 4 months
Infections and infestations
Skin infection
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Infections and infestations
Tooth infection
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Infections and infestations
Sinusitis
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Upper respiratory infection
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Infections and infestations
Urinary tract infection
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Alopecia
22.9%
8/35 • Number of events 8 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other
14.3%
5/35 • Number of events 6 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Pruritus
8.6%
3/35 • Number of events 3 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Rash maculo-papular
8.6%
3/35 • Number of events 3 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Rash acneiform
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Skin and subcutaneous tissue disorders
Skin induration
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Blood and lymphatic system disorders
Anemia
8.6%
3/35 • Number of events 4 • 2 years, 4 months
Blood and lymphatic system disorders
Blood and lymphatic system disorders - Other
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Blood and lymphatic system disorders
Leukocytosis
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Pain in extremity
8.6%
3/35 • Number of events 3 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Arthralgia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Back pain
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Bone pain
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Muscle weakness upper limb
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Musculoskeletal and connective tissue disorders
Musculoskeletal and connective tissue disorder - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
17.1%
6/35 • Number of events 7 • 2 years, 4 months
Respiratory, thoracic and mediastinal disorders
Epistaxis
5.7%
2/35 • Number of events 4 • 2 years, 4 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Respiratory, thoracic and mediastinal disorders
Cough
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Cardiac disorders
Chest pain - cardiac
5.7%
2/35 • Number of events 3 • 2 years, 4 months
Cardiac disorders
Ventricular arrhythmia
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Psychiatric disorders
Confusion
5.7%
2/35 • Number of events 3 • 2 years, 4 months
Psychiatric disorders
Depression
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Psychiatric disorders
Anxiety
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Vascular disorders
Flushing
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Vascular disorders
Hypertension
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Vascular disorders
Hypotension
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Vascular disorders
Lymphedema
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Injury, poisoning and procedural complications
Fall
5.7%
2/35 • Number of events 2 • 2 years, 4 months
Injury, poisoning and procedural complications
Injury, poisoning and procedural complications - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Eye disorders
Eye disorders - Other, specify
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Hepatobiliary disorders
Hepatobiliary disorders - Other
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Immune system disorders
Allergic reaction
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Renal and urinary disorders
Hematuria
2.9%
1/35 • Number of events 1 • 2 years, 4 months
Reproductive system and breast disorders
Testicular hemorrhage
2.9%
1/35 • Number of events 1 • 2 years, 4 months

Additional Information

Dr. Jeffrey Lancet

H. Lee Moffitt Cancer Center and Research Institute

Phone: 813-745-1387

Results disclosure agreements

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