Ruxolitinib and Pomalidomide Combination Therapy in Patients With Primary and Secondary MF

Prior treatment

• Patients eligible for hematopoietic stem cell transplantation (suitable candidate and suitable donor is available)
• Patients with response to standard therapy as recommended by the Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO/Onkopedia)
• Prior treatment with IMiDs (thalidomide, lenalidomide, pomalidomide) or with Interferon-alpha within a 3 month time period before Screening-phase
• Patient treatment with Ruxolitinib within a 14 days time period before Screening-phase
• History of thrombosis or pulmonary embolism within 6 months prior to study entry
• Drug or alcohol abuse within the last 6 months
• Patients undergoing treatment with hematopoietic growth factor receptor agonists (i.e., erythropoietin \[Epo\], granulocyte colony stimulating factor (GCSF \[Neupogen; Neulasta\], romiplostim, eltrombopag) within a 4 weeks period prior to screening-phase.
• Patients receiving any medication listed in the Appendix V "Prohibited Medications" (within 7 days prior to the first dose of study drug).
• Patients under ongoing treatment with another investigational medication or having been treated with an investigational medication within 28 days of screening.

Other illness

• Known positive status for HIV, HBV or HCV
• No consent for registration, storage and processing of the individual disease-characteristics and course as well as information of the family physician about study participation.
• Patients with clinically significant bacterial, fungal, parasitic or viral infection which require therapy. Patients with acute bacterial infections requiring antibiotic use should delay screening/enrollment until the course of antibiotic therapy has been completed.

Lab values

• Presence of any medical/psychiatric condition or laboratory abnormalities which may limit full compliance with the study, increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the patient inappropriate for entry into this study

Age

• History of malignancy except for i) adequately treated local basal cell or squamous cell carcinoma of the skin, ii) asymptomatic prostate cancer without known metastatic disease and with no requirement for therapy or requiring only hormonal therapy and with normal prostate-specific antigen for ≥ 1 year prior to randomization, or iii) any other cancer that has been in complete remission for ≥ 5 years

Other

• Pregnant or breast feeding females
• BCR/ABL-positivity
• Diagnosis of ET (according to WHO 2016 criteria)
• Diagnosis of PV (according to WHO 2016 criteria)
• \>20% blasts in peripheral blood or bone marrow
• thrombocytopenia \<100 /nl or transfusion-dependent thrombocytopenia
• neutropenia \<0.5 /nl
• Peripheral neuropathy \>grade 1 CTC
• No consent for biobanking.

• Age ≥18 years at the time of voluntarily signing an IRB/IEC-approved informed consent
• Diagnosis of Myeloproliferative Neoplasms (MPN) either de novo myelofibrosis according to current WHO criteria (PMF), secondary myelofibrosis (post-PV MF and post-ET MF) according to the IWG-MRT consensus terminology) (Appendix I)
• Anemia with hemoglobin level of \<10 g/dl or transfusion-dependent anemia\*
• Splenomegaly (\>11 cm total diameter) and/or leukoerythroblastosis
• Adequate organ function, i.e. ALT and/or AST \<3 x upper limit of normal (ULN), total bilirubin \<3 x ULN, and serum creatinine \<2 mg/dl
• Subject must be willing to receive transfusion of blood products
• ECOG performance status \<3
• Females of childbearing potential (FCBP) must undergo repetitive pregnancy testing (serum or urine) and pregnancy results must be negative.\*\*
• Reliable contraception should be maintained throughout the study and for 28 days after study treatment discontinuation\*
• Unless practicing complete abstinence from heterosexual intercourse, sexually active FCBP must agree to use adequate contraceptive methods\*
• Males (including those who have had a vasectomy) must use barrier contraception (condoms) when engaging in sexual activity with FCBP. Males must agree not to donate semen or sperm\*
• All subjects must:
  • understand that the investigational product could have a potential teratogenic risk.
  • be counseled about pregnancy precautions and risks of fetal exposure.
  • agree to abstain from donating blood while taking investigational product.
  • agree not to share study medication with another person and to return all unused study drug to the investigator.