Lenalidomide for Myelodysplastic Syndrome Refractory to Hypomethylating Agents

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Washington University School of Medicine
ClinicalTrials.gov Identifier:
First received: November 15, 2010
Last updated: March 23, 2015
Last verified: March 2015

The purpose of this study is to determine the proportion of confirmed responses (complete response, partial response, and hematologic improvement as defined by revised IWG criteria during the 12 months of treatment.

Condition Intervention Phase
Myelodysplastic Syndromes
Drug: Lenalidomide
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Trial of High Dose Lenalidomide in Patients With Myelodysplastic Syndrome Refractory to Hypomethylating Agents

Resource links provided by NLM:

Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • Responses based on bone marrow and peripheral blood as defined by the International Working Group Response Criteria to total patients treated. [ Time Frame: 56 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to progression [ Time Frame: Until 6 months after end of treatment ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: Until 6 months after end of treatment ] [ Designated as safety issue: No ]
  • Duration of response [ Time Frame: Until 6 months after end of treatment ] [ Designated as safety issue: No ]
  • Time to discontinuation of treatment [ Time Frame: Up to 56 weeks ] [ Designated as safety issue: No ]
  • Toxicity, as measured by number and grade of adverse events based on CTCAE version 4 [ Time Frame: 30 days after end of treatment ] [ Designated as safety issue: Yes ]

Enrollment: 24
Study Start Date: June 2011
Estimated Study Completion Date: December 2015
Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Lenalidomide

Lenalidomide 50 mg/day for two 28 day cycles.

Patients who have bone marrow aplasia as defined by a cellularity of <10% will be observed till counts recover. If patients do not progress following 2 cycles of HD lenalidomide, they will receive low dose lenalidomide 10 mg daily for 12 cycles.

Drug: Lenalidomide
Other Name: Revlimid


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient must be able to understand and voluntarily sign an informed consent form.
  • Patient must be ≥ 18 years old.
  • Patient must be able to adhere to the study visit schedule and other protocol requirements.
  • Patient must have histologically confirmed Myelodysplastic Syndrome as defined by FAB Classification including CMML and secondary MDS which has either:

    • progressed at any time during treatment with hypomethylating agents
    • failed to achieve a response after 6 cycles
    • progressed after treatment with hypomethylating agents had been discontinued Criteria for response and for progression as defined by revised IWG criteria
  • Patient must have discontinued all previous cancer therapy, including radiation, hormonal therapy and surgery at least 4 weeks prior to treatment in this study.
  • Patient must have an ECOG performance status of ≤ 2 at study entry
  • Patient must have laboratory test results within these ranges:

    • calculated creatinine clearance ≥ 30ml/min by Cockcroft-Gault formula
    • total bilirubin ≤ 1.5 x ULN
    • AST (SGOT) and ALT (SGPT) ≤ 3 x ULN
  • Patient must be disease free of prior malignancies for at least 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
  • Patient must be registered into the mandatory Revlimid REMS® program and be willing and able to comply with the requirements of Revlimid REMS®.
  • If a female of childbearing potential (FCBP), patient must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 to 14 days prior to initiation of therapy and again within 24 hours prior to prescribing lenalidomide for Cycle 1 (prescriptions must be filled within 7 days).

Females of reproductive potential must adhere to the scheduled pregnancy testing as required in the Revlimid REMS® program. A FCBP is defined as a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months).

-If a FCBP, patient must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed

Exclusion Criteria:

  • Patient must not have any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Patient must not be pregnant or breastfeeding.
  • Patient must not have any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Patient must not use any other experimental drug or therapy within 28 days of baseline.
  • Patient must not have a known hypersensitivity to thalidomide.
  • Patient must not have developed of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Patient must not have any prior use of lenalidomide.
  • Patient must not be concurrently using other anti-cancer agents or treatments.
  • Patient must not have known seropositivity for or active viral infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). Patients who are seropositive because of hepatitis B virus vaccine are eligible.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01246076

United States, Arizona
Mayo Clinic Scottsdale AZ
Scottsdale, Arizona, United States
United States, Missouri
Washington University School of Medicine
St. Louis, Missouri, United States, 63110
United States, Ohio
Ohio State University Medical Center
Columbus, Ohio, United States, 43210
Sponsors and Collaborators
Washington University School of Medicine
Principal Investigator: Ravi Vij, M.D. Washington University School of Medicine
  More Information

Additional Information:
No publications provided

Responsible Party: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT01246076     History of Changes
Other Study ID Numbers: 201011810
Study First Received: November 15, 2010
Last Updated: March 23, 2015
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Myelodysplastic Syndromes
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Antineoplastic Agents
Growth Inhibitors
Growth Substances
Immunologic Factors
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on March 30, 2015