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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04910685
Registration number
NCT04910685
Ethics application status
Date submitted
17/05/2021
Date registered
2/06/2021
Titles & IDs
Public title
(HARBOR) Study to Evaluate Efficacy and Safety of BLU-263 Versus Placebo in Patients With Indolent Systemic Mastocytosis
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Scientific title
A Randomized, Double-Blind, Placebo-Controlled Phase 2/3 Study of BLU-263 in Indolent Systemic Mastocytosis
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Secondary ID [1]
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BLU-263-1201
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Indolent Systemic Mastocytosis
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Monoclonal Mast Cell Activation Syndrome
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Smoldering Systemic Mastocytosis
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Condition category
Condition code
Skin
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Other skin conditions
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Blood
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Other blood disorders
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Inflammatory and Immune System
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Elenestinib
Treatment: Drugs - Placebo
Experimental: (Part 1) Elenestinib Dose 1 + BSC - Patients will receive best supportive care (BSC) and Dose 1 of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally, once daily until completion of Part 1.
Experimental: (Part 1) Elenestinib Dose 2 + BSC - Patients will receive BSC and Dose 2 of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally, once daily until completion of Part 1.
Experimental: (Part 1) Elenestinib Dose 3 + BSC - Patients will receive BSC and Dose 3 of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally, once daily until completion of Part 1.
Placebo comparator: (Part 1) Placebo + BSC - Patients will receive BSC and matching placebo. BSC will be determined on a per patient basis. Placebo will be administered orally, once daily until completion of Part 1
Experimental: (Part 2) Elenestinib RD + BSC - Patients will receive BSC and the recommended dose (RD) of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally, once daily for approximately 24 weeks
Placebo comparator: (Part 2) Placebo + BSC - Patients will receive BSC and matching placebo. BSC will be determined on a per patient basis. Placebo will be administered orally, once daily once daily for approximately 24 weeks
Experimental: (Part 3) Elenestinib RD + BSC - Patients will receive open-label BSC and the RD of elenestinib for up to approximately 4 years.
Experimental: (Part M) Elenestinib RD + BSC - Patients will receive BSC and the RD of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally, once daily for the duration of participation in the study.
Experimental: PK Groups (Dose 2 or Dose 3) - Patients will receive BSC and Dose 2 or Dose 3 of elenestinib. BSC will be determined on a per patient basis. Elenestinib will be administered orally for the duration of participation in the study.
Experimental: (Part S) Elenestinib + BSC - Participants with Smoldering Systemic Mastocytosis (SSM) will receive open-label BSC and elenestinib for up to approximately 4 years.
Treatment: Drugs: Elenestinib
Elenestinib oral tablet
Treatment: Drugs: Placebo
Placebo oral tablet
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Parts 1 and 3: Number of participants with Adverse Events (AEs)
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Assessment method [1]
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Timepoint [1]
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Up to 4 years
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Primary outcome [2]
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Part 2: Objective Response Rate (ORR), defined as proportion of patients who achieve =30% reduction from baseline in ISM-Symptom in Assessment Form (ISM-SAF) Total Symptom Score (TSS)
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Assessment method [2]
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Timepoint [2]
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Baseline, Week 25
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Primary outcome [3]
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Parts 1 and 3: Mean change from baseline in ISM-SAF TSS
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Assessment method [3]
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The ISM-SAF has a scale of 0-110. A decrease in score corresponds to improvement in symptoms
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Timepoint [3]
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Baseline up to 4 years
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Secondary outcome [1]
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Parts 1, 2, and 3: Mean change from baseline in measures of mast cell burden
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Assessment method [1]
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Timepoint [1]
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Baseline up to 4 years
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Secondary outcome [2]
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Parts 1, 2, and 3: Mean change from baseline in ISM-SAF individual symptom scores
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Assessment method [2]
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Each symptom in the ISM-SAF has a scale of 0-10. A decrease in score corresponds to improvement in symptoms
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Timepoint [2]
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Baseline up to 4 years
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Secondary outcome [3]
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Parts 1, 2, and 3: Time to achieve 30% reduction from baseline in ISM-SAF scores
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Assessment method [3]
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Time to achieve a 30% reduction in scores generated by the ISM-SAF. The ISM-SAF uses a score from 0-110 and a lower score represents lower symptom burden
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Timepoint [3]
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Baseline up to 4 years
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Secondary outcome [4]
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Part 2: Proportion of patients with a =50% reduction from baseline in serum tryptase
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Assessment method [4]
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Timepoint [4]
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Baseline, Week 25
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Secondary outcome [5]
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Part 2: Proportion of patients who achieve at least a 50% reduction in peripheral blood KIT D816V allele fraction, or a reduction to undetectable levels
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Assessment method [5]
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Timepoint [5]
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Baseline, Week 25
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Secondary outcome [6]
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Part 2: Mean change from baseline in ISM-SAF
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Assessment method [6]
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The ISM-SAF has a scale of 0-110. A decrease in score corresponds to improvement in symptoms
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Timepoint [6]
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Baseline, Week 25
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Secondary outcome [7]
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Part 2: Proportion of patients with a =50% reduction in bone marrow mast cells or reduction to no aggregates for patients with aggregates at Baseline
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Assessment method [7]
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Timepoint [7]
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Baseline, Week 25
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Secondary outcome [8]
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Part 2: ORR
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Assessment method [8]
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Timepoint [8]
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Week 25
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Secondary outcome [9]
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Parts 2 and 3: Change form baseline in number of concomitant BSC medications
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Assessment method [9]
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Timepoint [9]
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Baseline up to 4 years
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Secondary outcome [10]
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Parts 2 and 3: Change from baseline in ISM-SAF leading symptom score
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Assessment method [10]
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Each symptom in the ISM-SAF has a scale of 0-10. A decrease in score corresponds to improvement in symptoms
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Timepoint [10]
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Baseline up to 4 years
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Secondary outcome [11]
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Parts 2 and 3: Mean change from baseline in Quality of Life scores
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Assessment method [11]
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Timepoint [11]
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Baseline up to 4 years
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Secondary outcome [12]
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Part 2: Number of participants with AEs
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Assessment method [12]
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Timepoint [12]
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Up to Week 25
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Secondary outcome [13]
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Part S: Number of participants with AEs
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Assessment method [13]
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Timepoint [13]
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Baseline up to 4 years
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Secondary outcome [14]
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Part S: Proportion of participants who achieve a Complete Remission (CR)/Complete remission with partial recovery of peripheral blood counts (CRh), molecular CR/molecular CRh, or Partial Response (PR) based on Pure Pathologic Response (PPR) from Baseline
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Assessment method [14]
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Timepoint [14]
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Baseline up to 4 years
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Secondary outcome [15]
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Part S: Mean change in ISM-SAF from Baseline to after 24 weeks of treatment
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Assessment method [15]
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Timepoint [15]
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Week 25
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Eligibility
Key inclusion criteria
Key
All Patients
-1. Patient must have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 2.
Part 1 and Part 2
* 2. Patient must have moderate-to-severe symptoms based on minimum mean total symptom score (TSS) of the ISM Symptom Assessment Form (ISM-SAF) over the 14-day eligibility screening period.
* 3. Patient has confirmed diagnosis of ISM, confirmed by Central Pathology Review of BM biopsy and central review of B- and C-findings by WHO diagnostic criteria. Archival biopsy may be used if completed within the past 12 months.
* 4. Patient must have failed to achieve adequate symptom control for 1 or more Baseline symptoms, as determined by the Investigator, with at least 2 of the following symptomatic therapies administered: H1 blockers, H2 blockers, proton-pump inhibitors, leukotriene inhibitors, cromolyn sodium, corticosteroids, or omalizumab.
* 5. Patients must have BSC for ISM symptom management stabilized for at least 14 days prior to starting screening procedures.
* 6. For patients receiving corticosteroids, the dose must be = 20 mg/d prednisone or equivalent, and the dose must be stable for = 14 days.
Part M
* 7. Patients must have mMCAS, confirmed by Central Pathology Review of BM biopsy. An archival biopsy may be used if completed within the past 12 months.
* 8. Patients must have tryptase < 20 ng/mL.
* 9. Patients must have KIT D816V in peripheral blood (PB) or BM and/or CD25+ Mast cells in BM.
* 10. Patients must have symptoms consistent with mast cell activation (despite BSC) in at least two organ systems characterized by cutaneous flushing, tachycardia, syncope, hypotension, diarrhea, nausea, vomiting and gastro-intestinal cramping) and serum blood tryptase (sBT) levels above 8 ng/mL OR Severe (Ring and Messmer grading = II, recurrent anaphylaxis, including but not limited to hymenoptera venom, drug or food, regardless of sBT levels.
PK Groups
* 11. See inclusion criteria for All patients and Part 1/Part 2
* 12. Accrual may be limited to patients who have specific disease manifestations (ie, GI involvement) or are taking acid-reducing agents to better explore the impact of these features on PK.
Part S:
-13. Patient has confirmed diagnosis of SSM, confirmed by Central Pathology Review of BM biopsy and central review of B- and C-findings by WHO 2022 diagnostic criteria.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* 1. Patient has been diagnosed with any of the following WHO systemic mastocytosis (SM) sub-classifications: cutaneous mastocytosis only, SM with an associated hematologic neoplasm of non-MC lineage (SM-AHN), aggressive SM, mast cell leukemia, or mast cell sarcoma.
* 2. Patient has been diagnosed with another myeloproliferative disorder.
* 3. Patient has organ damage C-findings attributable to SM.
* 4. Patient has clinically significant, uncontrolled, cardiovascular disease
* 5. Patient has a QT interval corrected using Fridericia's formula (QTcF) > 480 msec.
* 6. Patient has previously received treatment with any targeted KIT inhibitors.
* 7. Patient has a history of a primary malignancy that has been diagnosed or required therapy within 3 years. The following prior malignancies are not exclusionary: completely resected basal cell and squamous cell skin cancer, curatively treated localized prostate cancer, and completely resected carcinoma in situ of any site.
* 8. Time since any cytoreductive therapy including mastinib and midostaurin should be at least 5 half-lives or 14 days (whichever is longer), and for cladribine, interferon alpha, pegylated interferon, or antibody therapy < 28 days or 5 half-lives of the drug (whichever is longer), before beginning the screening period.
* 9.Patient has received radiotherapy or psoralen and ultraviolet A (PUVA) therapy < 14 days before beginning the screening period.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
30/11/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/06/2028
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Actual
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Sample size
Target
463
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD,VIC
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Recruitment hospital [1]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [2]
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The Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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- Woolloongabba
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Recruitment postcode(s) [2]
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3004 - Melbourne
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Recruitment outside Australia
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United States of America
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Alabama
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United States of America
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California
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United States of America
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Massachusetts
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Michigan
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Minnesota
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New York
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Ohio
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Texas
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Utah
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Austria
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Linz
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Belgium
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Antwerpen
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France
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Amiens
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France
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Caen
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France
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Grenoble Cedex 9
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France
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Limoges Cedex
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France
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Nantes
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France
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Paris
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France
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Poitiers
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France
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Toulouse
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Germany
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Aachen
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Germany
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Berlin
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Germany
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Erlangen
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Germany
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Hamburg
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Germany
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Mannheim
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Germany
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Munich
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Italy
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Forli-Cesena
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Italy
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Lombardia
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Italy
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Toscana
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Italy
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Bologna
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Italy
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Pavia
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Italy
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Salerno
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Italy
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Verona
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Groningen
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Norway
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Oslo
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Portugal
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Lisbon
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Portugal
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Porto
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Toledo
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Switzerland
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Basel
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Switzerland
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Luzern
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United Kingdom
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Wales
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United Kingdom
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Oxford
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Blueprint Medicines Corporation
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a randomized, double-blind, placebo-controlled, Phase 2/3 study comparing the efficacy and safety of elenestinib (BLU-263) + best supportive care (BSC) with placebo + BSC in patients with indolent systemic mastocytosis (ISM) whose symptoms are not adequately controlled by BSC. Parts 1 and 2 will enroll patients with ISM. Patients enrolled in Part 1 or Part 2 will roll over onto Part 3 to receive treatment with elenestinib in an open-label fashion following completion of the earlier Part. Part M will enroll patients with monoclonal mast cell activation syndrome (mMCAS). Part S will enroll participants with smoldering systemic mastocytosis (SSM). The study also includes PK groups that will enroll patients with ISM.
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Trial website
https://clinicaltrials.gov/study/NCT04910685
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Contact person for public queries
Name
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Blueprint Medicines
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Address
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Phone
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617-714-6707
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04910685