Therapeutic RSK1 Targeting in Myeloid Malignancies
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
Not stated in the study description — ask the study team about visits and procedures.
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This study tests PMD-026, a drug taken by mouth that blocks a protein called RSK1. It is for adults with myelofibrosis or certain related blood and bone marrow cancers. Researchers will check its safety and whether it improves an enlarged spleen, symptoms, and changes in bone marrow.
This study hypothesizes that PMD-026, an oral inhibitor of ribosomal protein S6 kinase A1 (RSK1), is safe and well tolerated in participants with myelofibrosis (MF) and myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPNs) and will improve spleen response, symptom response, and bone marrow histopathological response.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be at least 18 years old.
- Have a tissue-confirmed diagnosis of myelofibrosis or one of the listed MDS/MPN cancers, which affect blood and bone marrow.
- For myelofibrosis: have chronic-phase disease rated intermediate-2 or high risk. Have tried a JAK inhibitor drug for at least 12 weeks, but it did not work, stopped working, or could not be tolerated.
- Have an enlarged spleen measuring at least 450 cm³ on a scan or felt at least 5 cm below the ribs, OR have a study symptom score of at least 10.
- Be able to care for yourself and be out of bed or a chair for at least half the day.
- Meet study limits for liver and kidney function and blood counts. These include at least 100 neutrophils (infection-fighting cells) and 50,000 platelets (clotting cells) per mm³, and no more than 10% blasts (immature blood cells).
- If pregnancy is possible for you or your partner, agree to use birth control before and during the study and for 30 days afterward. Report any suspected pregnancy right away.
- Be able to understand and agree to join by signing a consent form, or have a legally authorized person sign for you.
Who can't join
- Had a stem cell transplant in the past 12 months, had your spleen removed, or had radiation to your spleen less than 3 months before screening.
- Have another cancer that could affect the study's safety checks or results, or known active disease involving the brain or spinal cord.
- Are receiving another experimental drug or plan to receive one within 28 days before the first PMD-026 dose.
- Are receiving a JAK inhibitor or plan to receive one within 7 days before the first dose. Current treatment must usually be reduced slowly over at least 7 days; low-dose ruxolitinib may be an exception.
- Have a certain abnormal heart rhythm test result, or an uncontrolled illness such as an infection, autoimmune disease, heart failure with symptoms, unstable chest pain, or an irregular heartbeat.
- Have had an allergic reaction to drugs similar to PMD-026 or other study drugs, or had major surgery within 28 days before the first dose.
- Cannot swallow or keep down medicines taken by mouth.
- Are pregnant or breastfeeding. If you can become pregnant, you must have a negative pregnancy test within 35 days before joining and again on the first treatment day.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: * Histologically confirmed diagnosis of one of the following myeloid neoplasms determined by pathology review: * Primary myelofibrosis, post-polycythemia vera myelofibrosis or post-essential thrombocythemia myelofibrosis in chronic phase according to the 2016 WHO criteria. * Patients with MF must have had at least 1 prior JAK inhibitor treatment for a minimum of 12 weeks and their disease must have been determined to be resistant or refractory, and/or their response must have been lost or intolerant to treatment. * MF must be Intermediate-2 or High-risk MF, as defined by the Dynamic International Prognostic Scoring System (DIPSS). * Chronic myelomonocytic leukemia, atypical chronic myeloid leukemia, myelodysplastic / myeloproliferative neoplasm with ring sideroblasts and thrombocytosis, juvenile myelomonocytic leukemia, or myelodysplastic / myeloproliferative neoplasm unclassifiable according to the 2016 WHO criteria * Presence of measurable disease as defined by Splenomegaly defined as estimated spleen volume of ≥450 cm3 by imaging with either MRI, CT or ultrasound, or a palpable spleen \>=5 cm from the costal margin OR Baseline MFSAF v4.0 Total Symptom Score ≥ 10 * At least 18 years of age. * ECOG performance status ≤ 2. * Adequate organ function as defined below: * Total bilirubin ≤ 1.5 x IULN (unless the participant has a history of Gilbert's syndrome) * AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN * Creatinine clearance ≥ 30 mL/min by Cockcroft-Gault * Adequate laboratory parameters: * Absolute Neutrophil Count (ANC) ≥ 100/mm\^3 * Platelets ≥50,000/mm\^3 * Blasts ≤ 10% on manual differential * The effects of PMD-026 on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception prior to study entry, for the duration of study participation, and for 30 days after completion of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study or should a man suspect he has fathered a child, s/he must inform her treating physician immediately. * Ability to understand and willingness to sign an IRB approved written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants. Exclusion Criteria: * Prior allogeneic or autologous stem cell transplantation within the previous 12 months * Prior splenectomy * Prior splenic irradiation if \< 3 months between last radiation and screening visit. * Prior or concurrent malignancy whose natural history has the potential to interfere with the safety or efficacy assessment of the investigational regimen. Patients with prior or concurrent malignancy that does NOT meet that definition are eligible for this trial. * Currently receiving any other investigational agents or planning to receive any investigational agents within 28 days before the planned first dose of PMD-026. * Currently receiving a JAK inhibitor or planning to receive a JAK inhibitor within 7 days before the planned first dose of PMD-026. In patients with ongoing JAK inhibitor therapy (i.e. ruxolitinib) at screening, it must be tapered over a period of at least 7 days. Patients on a low dose of ruxolitinib (e.g. 5 mg QD) may have a reduced taper period or no taper. * Known active disease involving the CNS. * QTcF \>450 msec for males, \>470 msec for females (calculated using Fridericia's formula). * A history of hypersensitivity or allergic reactions attributed to compounds of similar chemical or biologic composition to PMD-026 or other agents used in the study. * Any major surgery within 28 days prior to the first dose of PMD-026. * Uncontrolled intercurrent illness including, but not limited to: ongoing or active infection, autoimmune disease, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia. * Unable to swallow or retain oral medications. * Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 35 days of study entry (repeated on C1D1).
Study sites (1)
MO
- Washington University School of Medicine · St Louis, MO 63110Amy W Zhou, M.D. · Study contact · 314-362-8814 · a.zhou@wustl.eduAmy W Zhou, M.D. · Principal investigatorLiang Huang, M.D. · Sub-investigatorFeng Gao, Ph.D. · Sub-investigatorMore trials in St Louis