Ropeginterferon Alfa-2b (P1101) vs. Anagrelide in Essential Thrombocythemia Patients With Hydroxyurea Resistance or Intolerance

NCT ID: NCT04285086

Last Updated: 2025-08-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

174 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-25

Study Completion Date

2029-08-31

Brief Summary

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This is a Phase 3 open-label, multicenter, randomized, active-controlled study designed to compare the efficacy and safety and tolerability of P1101 compared with ANA after 12 months of treatment as second-line therapy for subjects with ET who have had a suboptimal or failed response to HU.

Detailed Description

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PharmaEssentia Corporation is developing a pegylated (PEG) IFN-α product, P1101, for the treatment of ET.

Available clinical data and experience with P1101 in PV shows that the compound, with proper dose modifications, is effective in controlling disease in a significant proportion of subjects with ET. Further, its increased serum half-life presents distinct advantages for ET treatment over that of standard IFN-α and other available PEG IFN-α therapy. This pivotal Phase 3 study will establish the efficacy and safety of P1101 in ET subjects.

In core study phase, the enrolled subjects will be randomized into two arms, the test arm is P1101, the control arm is ANA. The overall duration for each eligible patient is 14 months, including screening (1 month), treatment (12 months) and follow-up (1 month) period. Efficacy evaluations, safety assessments, and PK and immunogenicity evaluations of P1101 will be performed.

Evaluation of efficacy will include clinical laboratory assessments, allelic burden measurements of CALR, JAK-2, and MPL, spleen size measurements, bone marrow sampling, EQ-5D-3L, and MPN-SAF TSS completion.

Evaluation of safety will include assessing vital signs, clinical safety laboratory tests, physical examinations, ECG evaluation, heart ECHO, lung X-ray, ECOG performance status, ocular examination, and AEs.

Subjects who completed the end of treatment (EoT) and safety follow-up (EoS) visits of the SURPASS ET study and may benefit from P1101 therapy have the opportunity to receive P1101 treatment.

Conditions

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Essential Thrombocythemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Experimental Drug (Biological): Ropeginterferon alfa-2b (P1101), Q2W, SC injection Control Drug: Anagrelide, capsules, daily, p.o.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ropeginterferon alfa-2b (P1101)

Pre-filled Syringe, Q2W, SC injection

Group Type EXPERIMENTAL

Ropeginterferon alfa-2b

Intervention Type BIOLOGICAL

Ropeginterferon alfa-2b (P1101) dosage: from 250 mcg to 500 mcg

Anagrelide

Capsules, Daily, p.o.

Group Type ACTIVE_COMPARATOR

Anagrelide

Intervention Type DRUG

Anagrelide dosage: 0.5 mg per capsule, according to label and physician's judgement

Interventions

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Ropeginterferon alfa-2b

Ropeginterferon alfa-2b (P1101) dosage: from 250 mcg to 500 mcg

Intervention Type BIOLOGICAL

Anagrelide

Anagrelide dosage: 0.5 mg per capsule, according to label and physician's judgement

Intervention Type DRUG

Other Intervention Names

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P1101

Eligibility Criteria

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Inclusion Criteria

1. Male or female subjects ≥18 years old
2. Subjects diagnosed with high-risk ET (either older than 60 years and JAK2V617-positive at screening, or having disease-related thrombosis or hemorrhage in the past), diagnosed according to the World Health Organization (WHO) 2016 criteria
3. Subjects have received prior HU for ET, while the washout between the last dose of HU and randomization should not be shorter than 7 days
4. Interferon treatment-naïve, or anti-P1101 binding antibody negative at screening and the washout between last dose of interferon and randomization should not be shorter than 14 days.
5. Documented resistance/intolerance to prior HU for ET, referencing modified ELN criteria (Barosi, et al, 2007), whereby at least one of the following criteria is met:

Platelet count \>600 x 10\^9/L at ≥2 g/day (or ≥2.5 g/day if subject body weight \>80 kg) or maximally tolerated dose if \<2 g/day after at least 3 months of HU, or Platelet count \>400 x 10\^9/L and WBC count \<2.5 x 10\^9/L at any dose and any duration of HU, or Platelet count \>400 x 10\^9/L and hemoglobin (HGB) \<10 g/dL at any dose and any duration of HU, or Presence of HU-related toxicities at any dose and any duration of therapy (e.g., leg ulcers, mucocutaneous manifestations, pneumonitis, or HU-related fever), or Platelet count \>450 x 10\^9/L at any dose and any duration of HU. The actual dose and duration of HU must be recorded on the eCRF. Moreover, if patient received one dose of HU, the reason why subject was judged to be HU resistance/intolerance must be recorded on the eCRF.
6. Platelets \>450 x 10\^9/L at screening
7. WBC \>10 x 10\^9/L at screening
8. HGB ≥11 g/dL at screening for males and 10 g/dL at screening for females
9. Neutrophil count ≥1.0 x 10\^9/L at screening
10. Adequate hepatic function defined as bilirubin ≤1.5 x upper limit normal (ULN), prothrombin time (PT) (international normalized ratio, INR) ≤1.5 x ULN, albumin \>3.5 g/dL, alanine aminotransferase ≤2.0 x ULN, aspartate aminotransferase ≤2.0 x ULN at screening
11. Creatinine clearance ≥40 mL/min (by Cockcroft-Gault equation)
12. Males and females of childbearing potential, as well as all women \<2 years after the onset of menopause, must agree to use an acceptable form of birth control until 28 days following the last dose of the study drug, and females must agree to not breastfeed during the study
13. Written informed consent obtained from the subject and ability for the subject to comply with the requirements of the study

Exclusion Criteria

1. Any subject requiring a legally authorized representative
2. Any contraindications or hypersensitivity to IFN-α or ANA and their excipients
3. Known risk factors for QT-prolongation (e.g., congenital long QT, known history of acquired QT-prolongations). Medications that can prolong QTc and induce hypokalemia will not be allowed in the study.
4. Co-morbidity with severe or serious condition that, in the Investigator's opinion, would jeopardize the safety of the subject or their compliance with the protocol, including significant cardiac disease (including New York Heart Association Class III-IV congestive heart failure and clinically significant arrhythmias) and pulmonary hypertension
5. History of major organ transplantation
6. Pregnant or lactating females
7. Subjects with any other significant medical conditions that, in the opinion of the Investigator, would compromise the results of the study or may impair compliance with the requirements of the protocol, including but not limited to:

1. Documented autoimmune disease at screening or in the history (e.g., thyroid dysfunction, hepatitis, idiopathic thrombocytopenic purpura, scleroderma, psoriasis, or any arthritis of autoimmune origin)
2. Clinically relevant pulmonary infiltrates, pneumonia, and pneumonitis at screening that, in the Investigator's opinion, would jeopardize the safety of the subject or their compliance with the protocol
3. Infections with systemic manifestations (e.g., bacterial, fungal, or human immunodeficiency virus \[HIV\], except hepatitis B \[HBV\] and/or hepatitis C \[HCV\], at screening)
4. Evidence of severe retinopathy (e.g., cytomegalovirus retinitis, macular degeneration) or clinically relevant ophthalmological disorder (due to diabetes mellitus or hypertension)
5. History or presence of clinically relevant depression
6. Previous suicide attempts or at any risk of suicide at screening, in the judgement of the Investigator
7. History or presence of clinically significant neurologic diseases
8. History of any malignancy within 5 years (except Stage 0 chronic lymphocytic leukemia, basal cell, squamous cell, and superficial melanoma)
9. History of alcohol or drug abuse within the last year
10. History or evidence of any other MPN
11. History of splenectomy
8. Use of any investigational drug \<4 weeks prior to the first dose of study drug or not recovered from effects of prior administration of any investigational agent
9. Subjects with documented ANA resistance or intolerance (see Appendix 8 for definition).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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PharmaEssentia

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Toshiaki Sato, MD/PhD

Role: STUDY_DIRECTOR

PharmaEssentia Japan K.K.

Craig Zimmerman, PhD

Role: STUDY_DIRECTOR

PharmaEssentia USA Corp.

Locations

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Washington University School of Medicine - Division of Oncology

St Louis, Missouri, United States

Site Status

MD Anderson Cancer Center

Houston, Texas, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

St. Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

Peking Union Medical College Hospital

Beijing, Beijing Municipality, China

Site Status

Peking University People's Hospital

Beijing, Beijing Municipality, China

Site Status

The First Affiliated Hospital, Chongqing Medical University

Chongqing, Chongqing Municipality, China

Site Status

NanFang Hospital of Southern Medical University

Guangzhou, Guangdong, China

Site Status

Union Hospital Tongji Medical College Huazhong University of Science and Technolog

Wuhan, Hubei, China

Site Status

Zhongnan Hospital of Wuhan University

Wuhan, Hubei, China

Site Status

The First Affiliated Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status

Shengjing Hospital of China Medical University

Shenyang, Liaoning, China

Site Status

Shaanxi Provincial People's Hospital

Xi'an, Shaanxi, China

Site Status

Qilu Hospital of Shandong University

Jinan, Shandong, China

Site Status

Ruijin Hospital affiliated to Shanghai Jiao Tong University school of Medicine

Shanghai, Shanghai Municipality, China

Site Status

West China Hospital, Sichuan University

Chengdu, Sichuan, China

Site Status

The Second Hospital of Tianjin Medical University

Tianjin, Tianjin Municipality, China

Site Status

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences

Tianjin, Tianjin Municipality, China

Site Status

The First Affiliated Hospital, College of Medicine, Zhejiang University

Hangzhou, Zhejiang, China

Site Status

Queen Mary Hospital

Hong Kong, , Hong Kong

Site Status

Ehime University Hospital

Tōon, Ehime, Japan

Site Status

Kitasato University Hospital

Sagamihara, Kanagawa, Japan

Site Status

Mie University Hospital

Tsu, Mie-ken, Japan

Site Status

University of Miyazaki Hospital

Miyazaki, Miyazaki, Japan

Site Status

Kansai Medical University Hospital

Hirakata, Osaka, Japan

Site Status

Kindai University Hospital

Sayama, Osaka, Japan

Site Status

Osaka University Hospital

Suita, Osaka, Japan

Site Status

Juntendo University Shizuoka Hospital

Izunokuni, Shizuoka, Japan

Site Status

Juntendo University Hospital

Bunkyo City, Tokyo, Japan

Site Status

Nippon Medical School Hospital

Bunkyo City, Tokyo, Japan

Site Status

NTT Medical Center Tokyo

Shinagawa City, Tokyo, Japan

Site Status

Tokyo Medical University Hospital

Shinjuku, Tokyo, Japan

Site Status

University of Yamanashi Hospital

Chūō, Yamanashi, Japan

Site Status

National University Hospital

Singapore, , Singapore

Site Status

Singapore General Hospital

Singapore, , Singapore

Site Status

Daegu Catholic University Hospital

Daegu, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Severance Hospital, Yonsei University Health System

Seoul, , South Korea

Site Status

SoonChunHyang University Seoul Hospital

Seoul, , South Korea

Site Status

Samsung Medical Center

Seoul, , South Korea

Site Status

Seoul St. Mary's Hospital, The Catholic University of Korea

Seoul, , South Korea

Site Status

Korea University Guro Hospital

Seoul, , South Korea

Site Status

Chia-Yi Christian Hospital

Chiayi City, Chiayi County, Taiwan

Site Status

Chiayi Chang Gung Memorial Hospital

Chiayi City, Chiayi County, Taiwan

Site Status

Kaohsiung Veterans General Hospital

Kaohsiung City, Kaohsiung City, Taiwan

Site Status

E-Da Cancer Hospital

Kaohsiung City, Kaohsiung City, Taiwan

Site Status

E-Da Hospital

Kaohsiung City, Kaohsiung City, Taiwan

Site Status

Far Eastern Memorial Hospital

New Taipei City, New Taipei City, Taiwan

Site Status

Tainan Municipal An-Nan Hospital

Tainan City, Tainan City, Taiwan

Site Status

Chi Mei Medical Center

Tainan City, Tainan City, Taiwan

Site Status

Chi-Mei Hospital - Liouying Branch

Tainan City, Tainan City, Taiwan

Site Status

Shin Kong Wu Ho-Su Memorial Hospital

Taipei, Taipei City, Taiwan

Site Status

Taipei Municipal Wan Fang Hospital

Taipei, Taipei City, Taiwan

Site Status

Hualien Tzu Chi Hospital

Hualien City, , Taiwan

Site Status

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, , Taiwan

Site Status

Kaohsiung Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status

China Medical University Hospital

Taichung, , Taiwan

Site Status

National Cheng Kung University Hospital

Tainan City, , Taiwan

Site Status

National Taiwan University Hospital

Taipei, , Taiwan

Site Status

Mackay Memorial Hospital

Taipei, , Taiwan

Site Status

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status

Tri-Service General Hospital

Taipei, , Taiwan

Site Status

Linkou Chang Gung Memorial Hospital

Taoyuan, , Taiwan

Site Status

Countries

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United States Canada China Hong Kong Japan Singapore South Korea Taiwan

References

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Verstovsek S, Komatsu N, Gill H, Jin J, Lee SE, Hou HA, Sato T, Qin A, Urbanski R, Shih W, Zagrijtschuk O, Zimmerman C, Mesa RA. SURPASS-ET: phase III study of ropeginterferon alfa-2b versus anagrelide as second-line therapy in essential thrombocythemia. Future Oncol. 2022 Sep;18(27):2999-3009. doi: 10.2217/fon-2022-0596. Epub 2022 Aug 4.

Reference Type DERIVED
PMID: 35924546 (View on PubMed)

Other Identifiers

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P1101 ET

Identifier Type: -

Identifier Source: org_study_id

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