Safety and efficacy of itacitinib, a selective JAK1 inhibitor, in advanced hepatocellular cancer: Phase 1b trial (JAKAL)

Future Oncol. 2024;20(36):2839-2847. doi: 10.1080/14796694.2024.2396795. Epub 2024 Sep 16.

Abstract

Overactivation of the JAK/STAT pathway is one of the drivers for the pathophysiology of hepatocellular carcinoma (HCC). We propose a Phase Ib study to evaluate the safety and efficacy of itacitinib, a selective JAK1 inhibitor, as a second-line treatment for patients with advanced or metastatic HCC.Twenty-five patients will receive 400 mg itacitinib orally daily, 28-day cycle. Safety will be reviewed prior to each cycle. Tumor response assessed every 2 months until disease progression, death or withdrawal. Tumor biopsies and blood samples will be taken for presence of JAK1 mutations.Activation of JAK/STAT pathway drives HCC development and is associated with immunotherapy resistance. Itacitinib is hypothesized to be safe and effective in HCC patients that have progressed after first-line therapies.Clinical Trial Registration: EudraCT: 2017-004437-81 NCT04358185 (ClinicalTrials.gov).

Keywords: INCB039110; JAK/STAT; Phase I; efficacy; hepatocellular cancer; itacitinib; liver cirrhosis; safety.

Plain language summary

[Box: see text].

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular* / drug therapy
  • Carcinoma, Hepatocellular* / pathology
  • Clinical Trials, Phase I as Topic*
  • Female
  • Humans
  • Janus Kinase 1* / antagonists & inhibitors
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Piperidines / therapeutic use
  • Protein Kinase Inhibitors* / adverse effects
  • Protein Kinase Inhibitors* / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Treatment Outcome

Substances

  • JAK1 protein, human
  • Janus Kinase 1
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • itacitinib

Associated data

  • ClinicalTrials.gov/NCT04358185