Brief Summary
This study will evaluate the safety and efficacy of tafasitamab in adult participants with primary autoimmune blood cell disorders.
Brief Title
Study to Assess the Safety and Tolerability of Tafasitamab in Adult Participants With Primary Autoimmune Blood Cell Disorders
Categories
Central Contacts
Central Contact Role
Contact
Central Contact Phone
1.855.463.3463
Central Contact Email
medinfo@incyte.com
Central Contact Role
Contact
Central Contact Phone
+800 00027423
Central Contact Email
eumedinfo@incyte.com
Completion Date
Completion Date Type
Estimated
Conditions
Immune Thrombocytopenia
Eligibility Criteria
Inclusion Criteria:
\- Ability to comprehend and willingness to sign a written ICF for the study.
* Aged ≥ 18 years.
* Confirmed historical diagnosis of one of the following autoimmune blood disorders:
* Primary ITP.
* Primary wAIHA.
* No history of splenectomy.
* Confirmed transient response to at least 1 prior early-line treatment (eg, corticosteroids, IVIG, rituximab):
* Primary ITP: Increase in platelet count to ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count.
* Primary wAIHA: Increase in hemoglobin to ≥ 10 g/dL with an increase of at least 2 g/dL from baseline.
* Received ≥ 1 standard course of rituximab (375 mg/kg × 4 weekly doses or 2 doses of 1000 mg flat dose every 2 weeks) with last dose given at least 6 months prior to initiation of study treatment. Note: If rituximab was the only prior therapy, individuals with NR to rituximab will not be eligible.
* Primary ITP: a PR (platelet count ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count) within 6 months of the last administered dose followed by relapse OR a CR (platelet count \> 100 × 109/L) lasting \< 48 weeks OR NR (platelet count \< 30 × 109/L or less than 2-fold increase of baseline platelet count or bleeding) within 6 months of the last administered dose.
* Primary wAIHA: a PR with hemoglobin ≥ 10 g/dL and with an increase of at least 2 g/dL from baseline OR a CR (hemoglobin ≥ 12 g/dL and normalization of hemolytic markers) OR NR (hemoglobin \< 10 g/dL or \< 2 g/dL increase of baseline hemoglobin).
* Persistent or chronic active primary ITP or active primary wAIHA with indication for treatment at the time of inclusion.
* Primary ITP: platelet count \< 30 × 109/L within the 15 days before treatment is scheduled to begin (Day 1).
Note: Participants treated with a rescue therapy during screening in response to a documented platelet count \< 30 × 109/L are eligible, irrespective of platelet count within 15 days of Day 1.
• Primary wAIHA: hemoglobin \< 10 g/dL documented with DAT result positive for IgG, with or without C3d, and evidence of hemolysis based on low haptoglobin, elevated LDH, and/or indirect bilirubin.
* ECOG performance status of 0 to 2.
* Willingness to avoid pregnancy or fathering children.
* Further inclusion criteria apply.
Exclusion Criteria:
* Clinical manifestations typical for cold agglutinin disease.
* Life-threatening bleeding or urgent need to elevate the platelet count for primary ITP or hemodynamic instability or hemoglobin \< 6 g/dL with urgent need to elevate hemoglobin for primary wAIHA within 2 weeks prior to Day 1.
* Prior treatment with anti-CD19 therapy (eg, mAb, bispecific T-cell engager, or CAR T cell) for any indication.
* Previous severe allergic reaction to a mAb or known allergy to any component/excipient of tafasitamab.
* Changes in doses (\> 10%) of permitted disease-related therapies, including oral corticosteroids and TPO-RA (primary ITP participants) within 2 weeks prior to Day 1, or change in ESA (primary wAIHA participants) dose within 2 weeks prior to Day 1.
* Evidence of hypogammaglobulinemia during screening (IgA \< 70 mg/dL, IgG \< 700 mg/dL, and/or IgM \< 40 mg/dL) and frequent and/or severe infections.
* Women who are pregnant or breastfeeding.
* History of malignancy except for the following:
* Malignancy treated with curative intent with no evidence of active disease for more than 2 years before screening.
* Adequately treated lentigo maligna melanoma without current evidence of disease or adequately controlled nonmelanoma skin cancer.
* Adequately treated carcinoma in situ without current evidence of disease.
* Congestive heart failure (left ventricular ejection fraction of \< 50%, assessed by 2 dimensional echocardiography or a multigated acquisition scan).
* Participants with:
* Known positive test result for HCV (with HCV antibody serology testing) and a positive test for HCV RNA.
Note: Participants with positive serology must have been tested for HCV RNA and are eligible only in the case of negative HCV RNA test result.
• Known positive test result for chronic HBV infection (defined by HBsAg positivity or positive HBV DNA test result).
Note: Participants with occult or prior HBV infection (defined as negative HBsAg and positive total HBcAb) may be included if HBV DNA was undetectable, provided that they are willing to undergo monthly ongoing DNA testing. Antiviral prophylaxis may be administered as per institutional guidelines.
Note: Participants who have protective titers of HBsAb (HBsAb positive, HBcAb negative, and HBsAg negative) after vaccination or prior HBV infection are eligible.
• Seropositivity for or history of active viral infection with HIV.
* Active systemic infection (including infection with SARS-CoV-2).
* Participants in a severely immunocompromised state, per investigator's clinical assessment.
* Receipt of a live-attenuated vaccine within 4 weeks prior to the first infusion of tafasitamab (inactivated and killed vaccines are acceptable).
* Coagulation or platelet function abnormality.
* An active medical condition with a strong indication for treatment with anticoagulation agents (eg, intracoronary stent within 12 months).
* Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study treatment and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
* Toxicities related to prior therapies must be CTCAE (v5.0) ≤ Grade 1 at the time of study treatment/enrollment (except for chronic toxicities \[≤ Grade 2\] not expected to resolve).
* Chronic infectious disease requiring systemic antibiotics or antifungal or antiviral medications.
* Unwillingness to undergo transfusion with blood components.
* Current use of prohibited medication as described in the protocol.
* Inadequate recovery from toxicity and/or complications from a major surgery before starting therapy.
* Further exclusion criteria apply.
\- Ability to comprehend and willingness to sign a written ICF for the study.
* Aged ≥ 18 years.
* Confirmed historical diagnosis of one of the following autoimmune blood disorders:
* Primary ITP.
* Primary wAIHA.
* No history of splenectomy.
* Confirmed transient response to at least 1 prior early-line treatment (eg, corticosteroids, IVIG, rituximab):
* Primary ITP: Increase in platelet count to ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count.
* Primary wAIHA: Increase in hemoglobin to ≥ 10 g/dL with an increase of at least 2 g/dL from baseline.
* Received ≥ 1 standard course of rituximab (375 mg/kg × 4 weekly doses or 2 doses of 1000 mg flat dose every 2 weeks) with last dose given at least 6 months prior to initiation of study treatment. Note: If rituximab was the only prior therapy, individuals with NR to rituximab will not be eligible.
* Primary ITP: a PR (platelet count ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count) within 6 months of the last administered dose followed by relapse OR a CR (platelet count \> 100 × 109/L) lasting \< 48 weeks OR NR (platelet count \< 30 × 109/L or less than 2-fold increase of baseline platelet count or bleeding) within 6 months of the last administered dose.
* Primary wAIHA: a PR with hemoglobin ≥ 10 g/dL and with an increase of at least 2 g/dL from baseline OR a CR (hemoglobin ≥ 12 g/dL and normalization of hemolytic markers) OR NR (hemoglobin \< 10 g/dL or \< 2 g/dL increase of baseline hemoglobin).
* Persistent or chronic active primary ITP or active primary wAIHA with indication for treatment at the time of inclusion.
* Primary ITP: platelet count \< 30 × 109/L within the 15 days before treatment is scheduled to begin (Day 1).
Note: Participants treated with a rescue therapy during screening in response to a documented platelet count \< 30 × 109/L are eligible, irrespective of platelet count within 15 days of Day 1.
• Primary wAIHA: hemoglobin \< 10 g/dL documented with DAT result positive for IgG, with or without C3d, and evidence of hemolysis based on low haptoglobin, elevated LDH, and/or indirect bilirubin.
* ECOG performance status of 0 to 2.
* Willingness to avoid pregnancy or fathering children.
* Further inclusion criteria apply.
Exclusion Criteria:
* Clinical manifestations typical for cold agglutinin disease.
* Life-threatening bleeding or urgent need to elevate the platelet count for primary ITP or hemodynamic instability or hemoglobin \< 6 g/dL with urgent need to elevate hemoglobin for primary wAIHA within 2 weeks prior to Day 1.
* Prior treatment with anti-CD19 therapy (eg, mAb, bispecific T-cell engager, or CAR T cell) for any indication.
* Previous severe allergic reaction to a mAb or known allergy to any component/excipient of tafasitamab.
* Changes in doses (\> 10%) of permitted disease-related therapies, including oral corticosteroids and TPO-RA (primary ITP participants) within 2 weeks prior to Day 1, or change in ESA (primary wAIHA participants) dose within 2 weeks prior to Day 1.
* Evidence of hypogammaglobulinemia during screening (IgA \< 70 mg/dL, IgG \< 700 mg/dL, and/or IgM \< 40 mg/dL) and frequent and/or severe infections.
* Women who are pregnant or breastfeeding.
* History of malignancy except for the following:
* Malignancy treated with curative intent with no evidence of active disease for more than 2 years before screening.
* Adequately treated lentigo maligna melanoma without current evidence of disease or adequately controlled nonmelanoma skin cancer.
* Adequately treated carcinoma in situ without current evidence of disease.
* Congestive heart failure (left ventricular ejection fraction of \< 50%, assessed by 2 dimensional echocardiography or a multigated acquisition scan).
* Participants with:
* Known positive test result for HCV (with HCV antibody serology testing) and a positive test for HCV RNA.
Note: Participants with positive serology must have been tested for HCV RNA and are eligible only in the case of negative HCV RNA test result.
• Known positive test result for chronic HBV infection (defined by HBsAg positivity or positive HBV DNA test result).
Note: Participants with occult or prior HBV infection (defined as negative HBsAg and positive total HBcAb) may be included if HBV DNA was undetectable, provided that they are willing to undergo monthly ongoing DNA testing. Antiviral prophylaxis may be administered as per institutional guidelines.
Note: Participants who have protective titers of HBsAb (HBsAb positive, HBcAb negative, and HBsAg negative) after vaccination or prior HBV infection are eligible.
• Seropositivity for or history of active viral infection with HIV.
* Active systemic infection (including infection with SARS-CoV-2).
* Participants in a severely immunocompromised state, per investigator's clinical assessment.
* Receipt of a live-attenuated vaccine within 4 weeks prior to the first infusion of tafasitamab (inactivated and killed vaccines are acceptable).
* Coagulation or platelet function abnormality.
* An active medical condition with a strong indication for treatment with anticoagulation agents (eg, intracoronary stent within 12 months).
* Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study treatment and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
* Toxicities related to prior therapies must be CTCAE (v5.0) ≤ Grade 1 at the time of study treatment/enrollment (except for chronic toxicities \[≤ Grade 2\] not expected to resolve).
* Chronic infectious disease requiring systemic antibiotics or antifungal or antiviral medications.
* Unwillingness to undergo transfusion with blood components.
* Current use of prohibited medication as described in the protocol.
* Inadequate recovery from toxicity and/or complications from a major surgery before starting therapy.
* Further exclusion criteria apply.
Inclusion Criteria
Inclusion Criteria:
\- Ability to comprehend and willingness to sign a written ICF for the study.
* Aged ≥ 18 years.
* Confirmed historical diagnosis of one of the following autoimmune blood disorders:
* Primary ITP.
* Primary wAIHA.
* No history of splenectomy.
* Confirmed transient response to at least 1 prior early-line treatment (eg, corticosteroids, IVIG, rituximab):
* Primary ITP: Increase in platelet count to ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count.
* Primary wAIHA: Increase in hemoglobin to ≥ 10 g/dL with an increase of at least 2 g/dL from baseline.
* Received ≥ 1 standard course of rituximab (375 mg/kg × 4 weekly doses or 2 doses of 1000 mg flat dose every 2 weeks) with last dose given at least 6 months prior to initiation of study treatment. Note: If rituximab was the only prior therapy, individuals with NR to rituximab will not be eligible.
* Primary ITP: a PR (platelet count ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count) within 6 months of the last administered dose followed by relapse OR a CR (platelet count \> 100 × 109/L) lasting \< 48 weeks OR NR (platelet count \< 30 × 109/L or less than 2-fold increase of baseline platelet count or bleeding) within 6 months of the last administered dose.
* Primary wAIHA: a PR with hemoglobin ≥ 10 g/dL and with an increase of at least 2 g/dL from baseline OR a CR (hemoglobin ≥ 12 g/dL and normalization of hemolytic markers) OR NR (hemoglobin \< 10 g/dL or \< 2 g/dL increase of baseline hemoglobin).
* Persistent or chronic active primary ITP or active primary wAIHA with indication for treatment at the time of inclusion.
* Primary ITP: platelet count \< 30 × 109/L within the 15 days before treatment is scheduled to begin (Day 1).
Note: Participants treated with a rescue therapy during screening in response to a documented platelet count \< 30 × 109/L are eligible, irrespective of platelet count within 15 days of Day 1.
• Primary wAIHA: hemoglobin \< 10 g/dL documented with DAT result positive for IgG, with or without C3d, and evidence of hemolysis based on low haptoglobin, elevated LDH, and/or indirect bilirubin.
* ECOG performance status of 0 to 2.
* Willingness to avoid pregnancy or fathering children.
* Further inclusion criteria apply.
\- Ability to comprehend and willingness to sign a written ICF for the study.
* Aged ≥ 18 years.
* Confirmed historical diagnosis of one of the following autoimmune blood disorders:
* Primary ITP.
* Primary wAIHA.
* No history of splenectomy.
* Confirmed transient response to at least 1 prior early-line treatment (eg, corticosteroids, IVIG, rituximab):
* Primary ITP: Increase in platelet count to ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count.
* Primary wAIHA: Increase in hemoglobin to ≥ 10 g/dL with an increase of at least 2 g/dL from baseline.
* Received ≥ 1 standard course of rituximab (375 mg/kg × 4 weekly doses or 2 doses of 1000 mg flat dose every 2 weeks) with last dose given at least 6 months prior to initiation of study treatment. Note: If rituximab was the only prior therapy, individuals with NR to rituximab will not be eligible.
* Primary ITP: a PR (platelet count ≥ 30 × 109/L with at least a 2-fold increase of baseline platelet count) within 6 months of the last administered dose followed by relapse OR a CR (platelet count \> 100 × 109/L) lasting \< 48 weeks OR NR (platelet count \< 30 × 109/L or less than 2-fold increase of baseline platelet count or bleeding) within 6 months of the last administered dose.
* Primary wAIHA: a PR with hemoglobin ≥ 10 g/dL and with an increase of at least 2 g/dL from baseline OR a CR (hemoglobin ≥ 12 g/dL and normalization of hemolytic markers) OR NR (hemoglobin \< 10 g/dL or \< 2 g/dL increase of baseline hemoglobin).
* Persistent or chronic active primary ITP or active primary wAIHA with indication for treatment at the time of inclusion.
* Primary ITP: platelet count \< 30 × 109/L within the 15 days before treatment is scheduled to begin (Day 1).
Note: Participants treated with a rescue therapy during screening in response to a documented platelet count \< 30 × 109/L are eligible, irrespective of platelet count within 15 days of Day 1.
• Primary wAIHA: hemoglobin \< 10 g/dL documented with DAT result positive for IgG, with or without C3d, and evidence of hemolysis based on low haptoglobin, elevated LDH, and/or indirect bilirubin.
* ECOG performance status of 0 to 2.
* Willingness to avoid pregnancy or fathering children.
* Further inclusion criteria apply.
Gender
All
Gender Based
false
Keywords
primary warm autoimmune hemolytic anemia
primary immune thrombocytopenia
anti-CD19 monoclonal antibody
Healthy Volunteers
No
Last Update Post Date
Last Update Post Date Type
Actual
Last Update Submit Date
Minimum Age
18 Years
NCT Id
NCT07104565
Org Class
Industry
Org Full Name
Incyte Corporation
Org Study Id
INCA000585-201
Overall Status
Recruiting
Phases
Phase 2
Primary Completion Date
Primary Completion Date Type
Estimated
Official Title
A Phase 2a, Open-Label, Multicenter Study of Tafasitamab in Adult Participants With Primary Autoimmune Blood Cell Disorders
Primary Outcomes
Outcome Description
Defined as any adverse event, either reported for the first time or worsening of a pre-existing event after the first dose of study drug up to 90 days after the last dose of study drug.
Outcome Measure
Number of participants with Treatment-emergent Adverse Events (TEAEs)
Outcome Time Frame
Up to 52 weeks
Outcome Description
Defined as platelet count ≥ 50 × 109/L in the absence of clinically significant bleeding or rescue therapy at ≥ 2 consecutive assessments any time after Day 56 until Week 48 in participants with primary ITP.
Outcome Measure
Stable platelet response
Outcome Time Frame
After Day 56 up to Week 48
Outcome Description
Defined as hemoglobin ≥ 10 g/dL and a ≥ 2 g/dL increase from baseline in the absence of rescue therapy at ≥ 2 consecutive assessments any time after Day 56 until Week 48 in participants with primary wAIHA.
Outcome Measure
Stable hemoglobin response
Outcome Time Frame
After Day 56 up to Week 48
Secondary Outcomes
Outcome Description
Defined as platelet count ≥ 100 × 109/L at Week 24 in the absence of clinically significant bleeding or rescue therapy in participants with primary ITP.
Outcome Time Frame
Week 24
Outcome Measure
Complete Response (CR)
Outcome Description
Defined as platelet count ≥ 100 × 109/L at Week 48 in the absence of clinically significant bleeding or rescue therapy in participants with primary ITP.
Outcome Time Frame
Week 48
Outcome Measure
CR (complete remission)
Outcome Description
Defined as platelet count ≥ 30 × 109/L and at least a 2-fold increase of baseline platelet count at Week 24 in the absence of clinically significant bleeding or rescue therapy in participants with primary ITP.
Outcome Time Frame
Week 24
Outcome Measure
Partial Response (PR)
Outcome Description
Defined as time from start of stable platelet response to loss of platelet response (\< 50 × 109/L), clinically significant bleeding, need for rescue therapy, or death, whichever occurs first in participants with primary ITP.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of stable platelet response
Outcome Description
Defined as time from the start of CR to loss of CR (platelet count \< 100 × 109/L), clinically significant bleeding, need for rescue therapy, or death, whichever occurs first in participants with primary ITP.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of CR
Outcome Description
Defined as time from the date of the first response (PR or CR) to the loss of response (platelet count \< 30 × 109/L or a less than a 2-fold increase of baseline platelet count), clinically significant bleeding, need for rescue therapy, or death, whichever occurs first in participants with primary ITP.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of response
Outcome Description
Defined as hemoglobin ≥ 12 g/dL and normalization of hemolytic markers (unconjugated bilirubin, LDH, haptoglobin, and reticulocytes) at Week 24 in the absence of rescue therapy in participants with primary wAIHA.
Outcome Time Frame
Week 24
Outcome Measure
CR
Outcome Description
Defined as hemoglobin ≥ 12 g/dL and normalization of hemolytic markers (unconjugated bilirubin, LDH, haptoglobin, and reticulocytes) at Week 48 in the absence of rescue therapy in participants with primary wAIHA.
Outcome Time Frame
Week 48
Outcome Measure
CR (Complete remission)
Outcome Description
Defined as hemoglobin ≥ 10 g/dL and a ≥ 2 g/dL increase from baseline at Week 24 in the absence of rescue therapy in participants with primary wAIHA.
Outcome Time Frame
Week 24
Outcome Measure
PR
Outcome Description
Defined as time from start of stable hemoglobin response to loss of stable hemoglobin response (\< 10 g/dL or a \< 2 g/dL increase from baseline), need for rescue therapy, or death, whichever occurs first in participants with primary wAIHA.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of stable hemoglobin response
Outcome Description
Defined as time from start of CR to loss of CR (hemoglobin \< 12 g/dL or abnormal hemolytic markers \[unconjugated bilirubin, LDH, haptoglobin, and reticulocytes\]), need for rescue therapy, or death, whichever occurs first in participants with primary wAIHA.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of CR
Outcome Description
Defined as time from the date of the first response (PR or CR) to the loss of response (hemoglobin \< 10 g/dL), need for rescue therapy, or death, whichever occurs first in participants with primary wAIHA.
Outcome Time Frame
Up to Week 48
Outcome Measure
Duration of response
Outcome Description
Serum concentrations of tafasitamab at each assessed timepoint.
Outcome Time Frame
Up to Week 48
Outcome Measure
Serum concentrations of tafasitamab
Outcome Time Frame
Up to Week 48
Outcome Measure
Change from baseline in serum antidrug antibody levels
Start Date
Start Date Type
Actual
Status Verified Date
First Post Date
First Post Date Type
Actual
First Submit Date
First Submit QC Date
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
999
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Irina Murakhovskaya
Investigator Email
imurakho@montefiore.org
Investigator Phone
IMURAKHO
Investigator Department
Medicine
Investigator Division
Hematology
Investigator Sponsor Organization
External
Study Department
Medicine
Study Division
Hematology
Categories Mesh Debug
Blood Disorders --- BLOOD COAGULATION DISORDERS
Blood Disorders --- HEMATOLOGIC DISEASES
Blood Disorders --- BLOOD PLATELET DISORDERS
Immune System --- IMMUNE SYSTEM DISEASES
Blood Disorders --- HEMORRHAGE
MeSH Terms
PURPURA, THROMBOCYTOPENIC, IDIOPATHIC
PURPURA, THROMBOCYTOPENIC
PURPURA
BLOOD COAGULATION DISORDERS
HEMATOLOGIC DISEASES
HEMIC AND LYMPHATIC DISEASES
THROMBOTIC MICROANGIOPATHIES
THROMBOCYTOPENIA
BLOOD PLATELET DISORDERS
CYTOPENIA
HEMORRHAGIC DISORDERS
AUTOIMMUNE DISEASES
IMMUNE SYSTEM DISEASES
HEMORRHAGE
PATHOLOGIC PROCESSES
PATHOLOGICAL CONDITIONS, SIGNS AND SYMPTOMS
SKIN MANIFESTATIONS
SIGNS AND SYMPTOMS