A study of ruxolitinib for early myelofibrosis

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Blood cancers

Myelofibrosis

Status:

Closed

Phase:

Phase 3

This study is looking at a drug called ruxolitinib for myelofibrosis. It is for people who have certain high risk gene changes (mutations).

More about this trial

Myelofibrosis is a rare blood disorder. It is a condition that causes scarring of the bone marrow. You don’t usually have treatment for early myelofibrosis that isn’t causing symptoms. Instead you have regular check ups to see how you are getting on.

Some myelofibrosis cells have faulty (mutated Open a glossary item ) genes. Research suggests there are 5 genes possibly linked to developing more severe myelofibrosis. These are called these high risk mutations.

Researchers are looking at ways of delaying or lowering the chances of early myelofibrosis becoming more severe in people at high risk. In this study, they are looking at ruxolitinib.

Ruxolitinib is type of biological therapy Open a glossary item called a cancer growth blocker. It stops signals that cancer cells use to divide and grow.

It is already used to treat more severe myelofibrosis. Doctors aren’t sure how well it will work for early myelofibrosis but they want to find out more.

Some people will have ruxolitinib and some won’t and have check ups as usual.

The aims of the study are to:

find out if ruxolitinib is a useful treatment for high risk early myelofibrosis
find out if treatment affects quality of life
learn more about side effects

Who can enter

The following bullet points list the entry conditions for this study. Talk to your doctor or the study team if you are unsure about any of these. They will be able to advise you.

You might be able to join this study if all of the following apply.

You have myelofibrosis with mild (grade 1) scarring of the bone marrow
You have at least 1 gene change (mutation) in 1 of the 5 high risk gene changes
If your spleen is enlarged it is less than 5cm from the bottom of the ribcage
Your myelofibrosis isn’t causing too many symptoms – symptoms might include tiredness, tummy (abdominal) pain and night sweats
Your recent blood test results show:
- a platelet count of > 75000
- a low number of immature blood cells (blasts)
- your haemoglobin is more than 10
- your white blood cell count is 15 or less
- a type of white blood cell (a neutrophil ) is more than 1000
You have other satisfactory blood test results
You are well enough to be up and about for at least half the day (performance status 0,1 or 2)
You are willing to use reliable contraception during the study and for 1 month afterwards
You are at least 18 years old

You cannot join this study if any of the following apply.

Cancer related

You have already had treatment with ruxolitinib or another type of drug that targets and stops the action of the JAK2 gene
You have been deemed as suitable to have a stem cell transplant

Medical conditions

You have had any other cancer in the past 3 years apart from non melanoma skin cancer that was successfully treated
You have had a rare viral disease of the brain called progressive multifocal leuko-encephalopathy (PML)
Your liver and kidneys aren’t working properly
You have problems with your heart, such as a heart attack in the last 6 months, high blood pressure that is not well controlled, angina that is not well controlled or an abnormal rhythm of your heart
You have an infection that needs treatment
You have a problem with your digestive system that could affect how you absorb tablets
You have HIV
You have an active hepatitis A, hepatitis B or hepatitis C infection that needs treatment

Other

You are sensitive to ruxolitinib or anything it contains
You take medication that affects body substances called CYP3A4 enzymes
You have had treatment with experimental drugs in the last 30 days
You have any other serious medical condition or mental health problem that the trial team think could affect you taking part
You are pregnant or breastfeeding

Trial design

This is a phase 3 study. The researchers need 320 people to take part worldwide including 15 from the UK.

It is a randomised study. You are put into 1 of 2 groups.

One group have ruxolitinib
The other group have a dummy drug (placebo )

Neither you nor your doctor will be able to decide which group you are in. And neither of you will know which group you are in either. This is called a double blind study.

study diagram

Ruxolitinib and the dummy drug are tablets. You have ruxolitinib or dummy tablets twice every day. You have treatment for as long as it is helping and the side effects aren’t too bad.

If your spleen enlarges or you develop symptoms you might continue to have treatment. But you will probably have a different dose. The study team can tell you more if this applies.

Research samples
You have extra blood tests as part of this study. Where possible you have these at the same time as your routine blood tests. The researchers want to find out what happens to ruxolitinib in the body (pharmacokinetics Open a glossary item ) and to look for substances called biomarkers to find out why treatment might work for some people and not for others.

Quality of life
The study team will ask you to fill out a questionnaire before you start treatment and at set times during treatment. The questionnaire asks about side effects and how you’ve been feeling. This is called a quality of life study.

Hospital visits

You see a doctor and have some tests before you can take part. These include:

a physical examination
blood tests
urine tests
heart trace (ECG )
bone marrow test
MRI scan or CT scan of your spleen

You see the study team for a check up once a month. You have an MRI scan or CT scan every 3 months.

Side effects

As ruxolitinib is a new treatment for early myelofibrosis, there might be some side effects we don’t know about yet.

The most common side effects of ruxolitinib are:

a drop in blood cells causing an increased risk of infection, bleeding problems, tiredness and breathlessness
kidney or bladder infections
high levels of cholesterol in the blood
dizziness
headache
weight gain
high levels of liver enzymes

The study doctors will explain all the possible side effects before you join the study.