Evaluation of Ruxolitinib in Combination With PU-H71 for Treatment of Myelofibrosis

Inclusion Criteria:

Subject has a confirmed diagnosis of myelofibrosis, including PMF, post-PV MF, and post-ET MF.
Subject has been receiving ruxolitinib therapy for intermediate or high-risk myelofibrosis for >6 months prior to enrollment with no more than 1 dose reduction of ruxolitinib in the 2-8 weeks prior to enrollment and a stable daily dose ≥5 mg twice daily (BID) >2 months prior to enrollment.

Subject has MF with evidence of persistent disease despite ruxolitinib monotherapy treatment, consisting of:

Persistent or worsening disease-related symptoms, including but not limited to fatigue, pruritus, night sweats, early satiety, and other symptoms as determined by a MPN-SAF TSS score of >20 points; AND
Documented splenomegaly of at least 5 cm below the costal margin as measured on inspiration by physical exam.
Subject has an Eastern Cooperative Oncology Group performance status of 0-2.

Acceptable pre-study organ function during screening defined as:

Absolute neutrophil count (ANC) ≥ 1000/uL
Hemoglobin (hgb) ≥ 8.0 g/dL (may be supported with transfusion)
Platelets (plt) ≥ 75,000/uL
AST/SGOT and ALT/SGPT ≤2 x Upper Limit of Normal (ULN)
Direct serum bilirubin ≤ 1.5 x ULN
Creatinine clearance >50 mL/min/1.73 m2 based on Cockcroft Gault equation.

Exclusion Criteria:

Subject has known active liver disease, including viral hepatitis or cirrhosis.
Subject has known or suspected HIV or other active infections requiring acute or chronic treatment with systemic antibiotics. Conditions requiring topical antibiotics are acceptable.
Subject has a QTcF > 480 ms (corrected) in the screening or baseline ECG.
Subject has left ventricular ejection fraction (LVEF) ≤ 50%, or below institution's lower limit of normal (whichever is lower) by echocardiogram (ECHO) or multigated acquisition (MUGA) scan.
Subject has a history (or family history) of long QT syndrome.
Subject has coronary artery disease with an ischemic event within 6 months prior to enrollment.
Subject has a permanent cardiac pacemaker.
Subject has history of a second primary malignancy within the past 2 year except for the following (if appropriately treated and considered cured): stage I endometrial, surgically treated cervical or prostate carcinoma, and non-melanoma skin cancer.
Subject has significant uncontrolled medical condition within 6 months prior to enrollment, as determined by the investigator.
Subject has concurrent participation in any interventional studies within 14 days of first dose of study drug.
Subject has uncontrolled diabetes mellitus, in the judgment of the Principal Investigator.
Subject has an active ocular condition that in the opinion of the investigator may alter visual acuity during the course of the study (i.e., ocular inflammatory disease etc.) or a history or anticipation of major ocular surgery (including cataract extraction, intraocular surgery, etc.) during the study.