Results of a phase 2 study of pacritinib (SB1518), a JAK2/JAK2(V617F) inhibitor, in patients with myelofibrosis.

Abstract

Pacritinib (SB1518) is a Janus kinase 2 (JAK2), JAK2(V617F), and Fms-like tyrosine kinase 3 inhibitor that does not inhibit JAK1. It demonstrated a favorable safety profile with promising efficacy in phase 1 studies in patients with primary and secondary myelofibrosis (MF). This multicenter phase 2 study further characterized the safety and efficacy of pacritinib in the treatment of patients with MF. Eligible patients had clinical splenomegaly poorly controlled with standard therapies or were newly diagnosed with intermediate- or high-risk Lille score. Patients with any degree of cytopenia were eligible. Thirty-five patients were enrolled. At entry, 40% had hemoglobin <10 g/dL and 43% had platelets <100 000× 10(9)/L. Up to week 24, 8 of 26 evaluable patients (31%) achieved a ≥35% decrease in spleen volume determined by magnetic resonance imaging and 14 of 33 (42%) attained a ≥50% reduction in spleen size by physical examination. Median MF symptom improvement was ≥50% for all symptoms except fatigue. Grade 1 or 2 diarrhea (69%) and nausea (49%) were the most common treatment-emergent adverse events. The study drug was discontinued in 9 patients (26%) due to adverse events (4 severe). Pacritinib is an active agent in patients with MF, offering a potential treatment option for patients with preexisting anemia and thrombocytopenia. This trial was registered at www.clinicaltrials.gov as #NCT00745550.

• Authors: Rami S Komrokji, John F Seymour, Andrew W Roberts, Martha Wadleigh, L Bik To, Robyn Scherber, Elyce Turba, Andrew Dorr, Joy Zhu, Lixia Wang, Tanya Granston, Mary S Campbell, Ruben A Mesa
• Journal: Blood (Blood) Vol. 125 Issue 17 Pg. 2649-55 (Apr 23 2015) ISSN: 1528-0020 [Electronic] United States
• PMID: 25762180 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 by The American Society of Hematology.

Chemical References

• 11-(2-pyrrolidin-1-ylethoxy)-14,19-dioxa-5,7,26-triazatetracyclo(19.3.1.1(2,6).1(8,12))heptacosa-1(25),2(26),3,5,8,10,12(27),16,21,23-decaene
• Bridged-Ring Compounds
• Pyrimidines
• fms-Like Tyrosine Kinase 3
• Janus Kinase 2

Topics

• Adult
• Aged
• Aged, 80 and over
• Bridged-Ring Compounds (adverse effects, therapeutic use)
• Female
• Humans
• Janus Kinase 2 (antagonists & inhibitors)
• Male
• Middle Aged
• Primary Myelofibrosis (complications, drug therapy, pathology)
• Pyrimidines (adverse effects, therapeutic use)
• Spleen (drug effects, pathology)
• Splenomegaly (complications, drug therapy, pathology)
• fms-Like Tyrosine Kinase 3 (antagonists & inhibitors)