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Myeloproliferative NeoplasmPhase 1NCT07679334

Phase I Trial of Pacritinib in Combination With Venetoclax and Azacitidine for the Treatment of Accelerated and Blast Phase Myeloproliferative Neoplasms

A Phase 1 study testing Pacritinib, Venetoclax and Azacitidine in people with Myeloproliferative Neoplasm, run by Roswell Park Cancer Institute at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This phase I trial studies the side effects and best dose of pacritinib when given together with venetoclax and azacitidine in treating patients with accelerated and blast phase myeloproliferative neoplasms (MPN-AP/BP). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Myeloproliferative Neoplasm
What is being tested?
Pacritinib, Venetoclax and Azacitidine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
1 Dec 2026to 1 Sep 2029
Phase
Phase 1
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
  • Subjects must have accelerated phase MPN as defined by 10-19% blasts or blast phase MPN (AML) as defined by ≥ 20% blasts in the blood or bone marrow by manual aspirate differential, immunohistochemistry staining, or flow cytometry, with a documented prior diagnosis of essential thrombocythemia (ET), polycythemia vera (PV), or primary myelofibrosis (PMF), The absence of a spleen, lack of splenomegaly, or history of splenic irradiation is not exclusionary.
  • Subjects with blast phase MPN must be newly diagnosed/untreated (no prior blast reduction therapy for blast phase disease except for hydroxyurea and/or a JAK inhibitor; treatment of a prior accelerated phase is allowed). Prior treatment with a hypomethylating agent (with or without a JAK inhibitor) is allowed for accelerated phase MPN. Prior treatment with any JAK inhibitor (including pacritinib) is allowed for any phase of disease (chronic, accelerated, or blast); however, must not have discontinued pacritinib due to toxicity. If a participant previously required dose reduction during pacritinib therapy and tolerated it well, then may enroll into a cohort utilizing that dose level or lower.
  • WBC < 25 x 109/L prior to treatment initiation- subjects with WBC ≥ 25 x 109/L may still be eligible after receiving cytoreduction measures such as hydroxyurea and/or leukapheresis if WBC becomes < 25 x 109/L prior to treatment initiation. Cytoreduction with hydroxyurea and/or leukapheresis is allowed prior to treatment. Hydroxyurea must be discontinued ≥ 12 hours prior to treatment initiation.
  • Demonstrate adequate organ function as defined below. All screening labs to be obtained within 28 days prior to registration:
  • Total bilirubin: ≤ 1.5 x upper limit of normal (ULN) unless considered to be due to Gilbert's Syndrome, hemolysis, or leukemic organ involvement. Total bilirubin WBC < 25 x 109/L prior to treatment initiation- subjects with WBC ≥ 25 x 109/L may still be eligible after receiving cytoreduction measures such as hydroxyurea and/or leukapheresis if WBC becomes < 25 x 109/L prior to treatment initiation. Cytoreduction with hydroxyurea and/or leukapheresis is allowed prior to treatment. Hydroxyurea must be discontinued ≥ 12 hours prior to treatment initiation.
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  • Demonstrate adequate organ function as defined below. All screening labs to be obtained within 28 days prior to registration:
  • Total bilirubin: ≤ 1.5 x upper limit of normal (ULN) unless considered to be due to Gilbert's Syndrome, hemolysis, or leukemic organ involvement. Total bilirubin must be < 3 x upper limit normal in subjects with Gilbert's Syndrome, hemolysis, or leukemic organ involvement.
  • Aspartate aminotransferase (AST): ≤ 3 x ULN (≤ 5 x ULN if considered to be due to myelofibrosis or leukemic organ involvement).
  • Alanine aminotransferase (ALT): ≤ 3 x ULN (≤ 5 x ULN if considered to be due to myelofibrosis or leukemic organ involvement).
  • Creatinine clearance: ≥ 30 mL/min by Cockcroft-gault formula or measured by 24-hour urine collection.
  • Participants of child-bearing potential must agree to use highly effective contraceptive methods prior to study entry. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.

Who cannot join

  • Diagnosis of de novo AML, acute promyelocytic leukemia, or accelerated or blast phase MPN without a documented prior diagnosis of ET, PV, or PMF.
  • Known CNS leukemia involvement. NOTE: Subjects with clinical suspicion or signs of neurologic deficit should undergo a screening lumbar puncture prior to enrollment to confirm lack of CNS leukemia.
  • Previous treatment with BCL-2/BCL-X inhibitors (including venetoclax and navitoclax).
  • Prior allogeneic stem cell transplantation for blast phase disease. Prior allogeneic stem cell transplantation for chronic and accelerated phase MPN is allowed. Subjects must not have received transplant within 60 days. Cannot be receiving immunosuppression therapy, with the exception of prednisone ≤10mg/d (or equivalent), for the treatment or prophylaxis of GVHD. If the subject has been on immunosuppressant treatment or prophylaxis for GVHD, the treatment must have been discontinued at least 14 days prior to study treatment and there must be no evidence of Grade ≥ 2 GVHD.
  • Treatment with moderate or strong CYP3A4 inhibitors or strong CYP3A4 inducers within five half-lives or 14 days, whichever is shorter, prior to the initiation of study treatment.
  • Treatment with chemotherapy, wide-field radiation, or biologic therapy, with the exception of hydroxyurea as above, and all trans-retinoic acid given initially for presumed APML, within 14 days of study entry. Prior JAK inhibitor (other than pacritinib) must be held for five half-lives prior to study entry. Administration of steroids to prevent withdrawal symptoms is allowed.
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  • Treatment with investigational drug within five half-lives or 14 days, whichever is shorter, prior to study entry.
  • Baseline prolonged QTc of > 480 msec. QTc measured by Fridericia's formula (QTc=QT/[RR1/3]) based on the mean of triplicate reads. Repeat EKGs after correction of electrolytes or discontinuation of QT prolonging medications are allowed to meet entry criteria.
  • Grade ≥2 bleeding event within the previous 3 months. Treatment with anticoagulation or antiplatelet agents (except for aspirin at dosages ≤100 mg per day or prophylactic doses of enoxaparin or heparin) within five half-lives or 7 days, whichever is shorter.
  • Any GI or metabolic condition that could interfere with absorption of oral medication.
  • Known severe (Child-Turcotte-Pugh class C) hepatic cirrhosis. Testing not required.
  • Pre-existing uncontrolled pathology such as heart failure (congestive/ischemic, NYHA classes III and IV), clinically significant abnormalities on a 12-lead electrocardiogram, significant pulmonary disease, severe/unstable arrhythmias/angina pectoris/hypertension, acute or chronic pancreatitis, etc. Acute myocardial infarction or stroke within 6 months of study entry.
  • Known active HIV, Hepatitis B, or Hepatitis C infection; testing not required.
  • Active uncontrolled or severe systemic infection. Enrollment is possible after control of infection, at discretion of the treating physician.
  • History of another active malignancy in the previous 2 years, with the exception of:
  • adequately treated in situ carcinoma of the cervix, breast, prostate; basal cell carcinoma pf the skin or localized squamous cell carcinoma of the skin.
  • Pregnant or nursing female participants

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site
  • Roswell Park Comprehensive Cancer Center

    Buffalo, New York, 14263

    ASK Roswell, 800-767-9355, AskRoswell@roswellpark.org

    Steven Green, MD

Other trials in United States

About this study

This phase I trial studies the side effects and best dose of pacritinib when given together with venetoclax and azacitidine in treating patients with accelerated and blast phase myeloproliferative neoplasms (MPN-AP/BP). Pacritinib and azacitidine may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Giving pacritinib together with venetoclax and azacitidine may be safe, tolerable, and/or effective in treating patients with MPN-AP/BP

Read the detailed description

PRIMARY OBJECTIVE:

  1. To estimate the maximum tolerated dose (MTD) of pacritinib when used in combination with venetoclax and azacitidine in subjects with MPN-AP/BP.

SECONDARY OBJECTIVES:

  1. To evaluate the frequency and nature of adverse events of the combination of venetoclax, azacitidine, and pacritinib in subjects with accelerated and blast phase myeloproliferative neoplasms (MPN-AP/BP).

II. To estimate the rate of responses as defined by European LeukemiaNet (ELN) 2022 response criteria for acute myeloid leukemia (AML).

III. To estimate the rate of responses as defined by Post-Myeloproliferative Neoplasm (MPN) AML Consortium 2012 criteria.

IV. To estimate the average reduction in spleen volume from baseline to week 12 and week 24 OUTLINE: This is a dose-escalation study of pacritinib in combination with venetoclax and azacitidine.

Patients receive pacritinib orally (PO) once daily (QD) or twice daily (BID) on days 1-28 of each cycle, venetoclax PO QD on days 1-21 of each cycle, and azacitidine subcutaneously (SC) or intravenously (IV) over 10-40 minutes on days 1-7 of each cycle. Cycles repeat every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo magnetic resonance imaging (MRI) or computed tomography (CT) as well as bone marrow aspiration and biopsy throughout the trial. Patients also undergo blood sample collection on study.

After completion of study treatment, patients are followed up at 30 days and then every 3 months for up to 1 year from the start of treatment.

Being tested
Pacritinib, Venetoclax, Azacitidine, Magnetic Resonance Imaging, Computed Tomography
Medical subject headings
Myeloproliferative Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PacritinibDrug

    Also called 937272-79-2, SB-1518

    Subjects will be dosed until MTD is reached

  • VenetoclaxDrug

    Also called 1257044-40-8

    Given PO

  • AzacitidineDrug

    Also called 320-67-2

    Given SC or IV

  • Magnetic Resonance ImagingProcedure or surgery

    Also called MRI

    Undergo MRI

  • Computed TomographyProcedure or surgery

    Also called CAT Scan

    Undergo CT

  • Bone Marrow AspirationProcedure or surgery

    Undergo bone marrrow aspiration

Study groups in NCT07679334
Study groupRoleWhat they receive
Treatment Arm 1ExperimentalPacritinib in combination with venetoclax and azacitidne. Dose will increase until side effects occur or maximum tolerated dose is reached. Additionally, patients undergo MRI or CT as well as bone marrow aspiration and biopsy throughout the trial.
Receives: Drug: Pacritinib; Drug: Venetoclax; Drug: Azacitidine; Procedure: Magnetic Resonance Imaging; Procedure: Computed Tomography; Procedure: Bone Marrow Aspiration

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To determine the maximum tolerated dose (MTD) of the treatment regimen.

    WIll be measured by assessing DLTS in a Bayesian optimal interval )BOIN design to determine the MTD

    Measured: At the end of Cycle 1 (each cycle is 28 days)

Secondary outcomes (12)
  1. Incidence of adverse events (AEs)

    Will be assessed and graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0, including but not limited to AEs, serious adverse events, DLTs, and clinical laboratory and electrocardiogram abnormalities.

    Measured: Up to 30 days post treatment

  2. Percentage of Complete Response

    Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: 24 months

  3. Complete response with incomplete hematologic recovery rate

    As defined by ELN 2022 AML response criteria. Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: Up to 1 year post start of treatment

  4. Complete response with partial hematologic recovery rate

    As defined by ELN 2022 AML response criteria. Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: UP to 1 year post start of treatment

  5. Complete Response without evidence of measurable residual disease rate

    Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: UP to 1 year post start of treatment

  6. Morphological leukemia-free state rate

    Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: Up to 1 year post start of treatment

  7. Partial remission Rate

    Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: Up to 1 year post start of treatment

  8. Complete molecular response rate

    Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: Up to 1 year post start of treatment

  9. Complete cytogenetic response rate

    As defined by Post-MPN AML Consortium 2012 criteria. Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals

    Measured: Up to 1 year post start of treatment

  10. Acute leukemia response - complete rate

    As defined by Post-MPN AML Consortium 2012 criteria. Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals.

    Measured: Up to 1 year post start of treatment

  11. Acute leukemia - partial rate

    As defined by Post-MPN AML Consortium 2012 criteria. Will be summarized using frequencies and relative frequencies. Response rates will be presented along with the corresponding 90% confidence intervals

    Measured: Up to 1 year post start of treatment

  12. Change in Spleen volume

    summarized by MRI or CT

    Measured: fAt baseline to week 12 and 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jul 2026
  2. Study start1 Dec 2026 (estimated)
  3. Primary completion1 Sep 2028 (estimated)
  4. Study completion1 Sep 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07679334
Sponsor's protocol ID
I-3685225
Status last verified
Oct 2026
First submitted
25 Jun 2026
Last updated
21 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Pacritinib, Venetoclax and Azacitidine in people with Myeloproliferative Neoplasm, run by Roswell Park Cancer Institute at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 21 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact ASK ROSWELL (1-800-767-9355, AskRoswell@roswellpark.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To determine the maximum tolerated dose (MTD) of the treatment regimen. (time frame: At the end of Cycle 1 (each cycle is 28 days)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Oct 2026.

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Clinical Trial NCT07679334 | AzTrials