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Phase 2 Study of Pracinostat With Azacitidine in Patients With Previously Untreated Myelodysplastic Syndrome

This study is ongoing, but not recruiting participants.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01873703
First Posted: June 10, 2013
Last Update Posted: April 24, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Helsinn Healthcare SA
  Purpose
The purpose of this randomized, double-blind, placebo-controlled study is to determine the safety and efficacy of pracinostat compared to placebo when combined with azacitidine, and FDA approved treatment for Myelodysplastic Syndrome (MDS).

Condition Intervention Phase
Myelodysplastic Syndrome Drug: pracinostat Drug: Placebo Drug: Azacitidine Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2 Randomized Double-Blind Placebo-Controlled Study of Pracinostat in Combination With Azacitidine in Patients With Previously Untreated International Prognostic Scoring System (IPSS) Intermediate Risk-2 or High-Risk Myelodysplastic Syndrome (MDS)

Resource links provided by NLM:


Further study details as provided by Helsinn Healthcare SA:

Primary Outcome Measures:
  • Estimate efficacy [ Time Frame: 6 months ]
    Estimate the relative efficacy, measured by complete remission rate of treatment wiht pracinostat plus azacitidine versus placebo plus azacitidine


Secondary Outcome Measures:
  • Overall response rate [ Time Frame: 6 months ]
    Estimate the overall response rate [ORR = CR + complete remission + partial response (PR)]

  • Hematologic Improvement [ Time Frame: 6 months ]
    Estimate the overall hematologic improvement (HI) response rate by review of hematologic lab values each cycle including bone marrow blast counts, platelets and erythrocytes.

  • Duration of response [ Time Frame: 6 months ]
    Estimate the duration of response

  • Progression free survival [ Time Frame: 12 months ]
    Estimate the progression-free survival (PFS) duration of pracinostat plus azacitidine and the relative benefit of that combination versus placebo plus azacitidine as assessed by the PFS hazard ratio

  • Rate of leukemic transformation [ Time Frame: 6 - 24 months ]
    Estimate the rate of leukemic transformation at landmark time points (6 months, 12 months, 18 months, and 24 months) using clinical review of hematologic lab counts each cycle

  • Overall survival [ Time Frame: 6-24 months ]
    Estimate the overall survival (OS) duration of pracinostat plus azacitidine and the relative benefit of that combination versus placebo plus azacitidine as assessed by the OS hazard ratio

  • AE profile [ Time Frame: 12 months ]
    Assess the adverse event (AE) profile of pracinostat and placebo when combined with azacitidine by clinical review of safety events by grade, relationship and event outcomes.


Enrollment: 102
Study Start Date: June 2013
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: December 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: pracinostat plus azacitadine

60 mg of pracinostat by mouth 3 times a week for 3 weeks followed by 1 week of rest repeated every 28 days.

75 mg/m2 Azacitidine for 7 days of each 28 day cycle, via subcutaneous (SC) injection or intravenous infusion if SC injections are intolerable

Drug: pracinostat
Histone deacetylase inhibitor (HDACi)
Other Name: SB939
Drug: Azacitidine
Active comparator 75 mg/m2 Azacitidine for 7 days of each 28 day cycle, via subcutaneous (SC) injection or intravenous infusion if SC injections are intolerable
Other Name: Vidaza
Placebo Comparator: Placebo with Azacitadine

Placebo by mouth 3 times a week for 3 weeks followed by 1 week of rest repeated every 28 days.

75 mg/m2 Azacitidine for 7 days of each 28 day cycle, via subcutaneous (SC) injection or intravenous infusion if SC injections are intolerable

Drug: Placebo
Placebo
Drug: Azacitidine
Active comparator 75 mg/m2 Azacitidine for 7 days of each 28 day cycle, via subcutaneous (SC) injection or intravenous infusion if SC injections are intolerable
Other Name: Vidaza

  Eligibility

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Voluntary written informed consent
  • Histologically or cytologically documented diagnosis of MDS (any French-American-British [FAB] classification subtype; that is classified as intermediate 2 (1.5 to 2.0 points) or high risk (≥2.5 points) according to the International Prognostic Scoring System risk category, with >5% and <30% blasts, and a peripheral blast count of <20,000
  • Bone marrow aspirate smears and bone marrow biopsies within 28 days of first study treatment
  • There must be a clinical indication for treatment with azacitidine.
  • Previously untreated with hypomethylating agents (prior therapy with transfusions, hematopoietic growth factors, or immunosuppressive therapy is allowed)
  • Eastern Cooperative Oncology Group performance status of 0, 1, or 2
  • Adequate organ function as evidenced by:

    1. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 x the upper limit of normal (ULN) (≤5 x ULN for patients with hepatic metastases
    2. Total bilirubin ≤1.5 x ULN or total bilirubin of 2, whichever is higher
    3. Serum creatinine <2 mg/dL, or creatinine clearance ≤1.5 x ULN
    4. QTcF interval ≤470 msec
  • Female or male patients ≥18 years-of-age
  • Male patients who are surgically sterile or willing to use adequate contraceptive measures or abstain from heterosexual intercourse during the entire study treatment period
  • Female patients who are surgically sterile or post menopausal or female patients who are not of child-bearing potential and female patients of child-bearing potential who agree to use adequate contraceptive measures or abstain from intercourse during the study treatment period, who are not breastfeeding, and who have had a negative serum pregnancy test ≤7 days prior to first study treatment.
  • Willingness and ability to comply with the trial and follow-up procedures

Exclusion Criteria:

  • Received any of the following within the specified time frame prior to administration of study medication:

    1. Any investigational agent within 14 days or 5 half-lives prior to first study treatment, whichever is longer
    2. Previous therapy for malignancy within 21 days prior to first study treatment, including any chemotherapy, immunotherapy, biological or hormonal therapy (6 weeks for nitrosoureas or mitomycin C)
    3. Hydroxyurea within 48 hours prior to first study treatment
    4. Hematopoietic growth factors: erythropoietin, granulocyte colony stimulating factor (G-CSF), granulocyte macrophage colony stimulating factor (GM-CSF), or thrombopoietin receptor agonists at least 7 days (14 days for Aranesp) prior to study enrollment
    5. Major surgery within 4 weeks prior to first study treatment
  • Patients that have not recovered from side effects of previous therapy
  • Cardiopulmonary function exclusion:

    1. Current unstable arrhythmia requiring treatment
    2. History of symptomatic congestive heart failure (New York Heart Association Classes III or IV)
    3. History of myocardial infarction within 6 months of enrollment
    4. Current unstable angina
  • Concomitant treatment with histone deacetylase (HDAC) inhibitors or drugs with significant action as HDAC inhibitors, such as valproic acid, is not permitted
  • Clinical evidence of central nervous system involvement
  • Patients with gastrointestinal (GI) tract disease, causing the inability to take oral medication, malabsorption syndrome, a requirement for IV alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's disease, ulcerative colitis).
  • Active infection with HIV or chronic hepatitis B or C
  • Life-threatening illness unrelated to cancer, or any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with participation in this study
  • Presence of a malignant disease within the last 12 months, with the exception of adequately treated in-situ carcinomas, basal or squamous cell carcinoma, or non-melanomatous skin cancer
  • Inability (including psychological, familial, sociological, or geographical conditions) to comply with trial and/or follow-up procedures
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01873703


  Hide Study Locations
Locations
United States, Alabama
Southern Cancer Center
Mobile, Alabama, United States, 36608
United States, California
Scripps Cancer Center
La Jolla, California, United States, 92037
United States, Colorado
Colorado Blood Cancer Institute
Denver, Colorado, United States, 80218
United States, Florida
Florida Cancer Specialists South
Fort Myers, Florida, United States, 33916
Woodlands Medical Specialists
Pensacola, Florida, United States, 32503
Florida Cancer Specialists North
Saint Petersburg, Florida, United States, 33705
Florida Cancer Specialist and Research Institute
Tallahassee, Florida, United States, 32308
H. Lee Moffitt Cancer Center
Tampa, Florida, United States, 33612
United States, Indiana
Fort Wayne Medical Oncology and Hematology
Fort Wayne, Indiana, United States, 46804
Indiana University Simon Cancer Ctr
Indianapolis, Indiana, United States, 46202
United States, Maryland
Sidney Kimmel Comprehensive Cancer at Johns Hopkins
Baltimore, Maryland, United States, 21287
Center for Cancer and Blood Disorders
Bethesda, Maryland, United States, 20817
United States, Michigan
Henry Ford Hospital
Detroit, Michigan, United States, 48202
Michigan State University
Lansing, Michigan, United States, 48910
United States, Nebraska
Nebraska Methodist
Omaha, Nebraska, United States, 68114
United States, Nevada
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, United States, 89148
United States, New York
Weill Cornell Medical Center
New York, New York, United States, 10065
United States, Ohio
Oncology Hematology Care
Cincinnati, Ohio, United States, 45242
Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
United States, Tennessee
Tennessee Oncology - Chattanooga
Chattanooga, Tennessee, United States, 37404
Sarah Cannon Cancer Center, Tennessee Oncology
Nashville, Tennessee, United States, 37203
United States, Texas
MD Anderson Cancer Center
Houston, Texas, United States, 77030
Cancer Care Centers of South Texas
San Antonio, Texas, United States, 78229
United States, Washington
Swedish Cancer Institute
Seattle, Washington, United States, 98104
Sponsors and Collaborators
Helsinn Healthcare SA
Investigators
Principal Investigator: Guillermo Garcia-Manero, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
Responsible Party: Helsinn Healthcare SA
ClinicalTrials.gov Identifier: NCT01873703     History of Changes
Other Study ID Numbers: MEI-003
First Submitted: May 22, 2013
First Posted: June 10, 2013
Last Update Posted: April 24, 2017
Last Verified: April 2017

Keywords provided by Helsinn Healthcare SA:
MDS
High risk myelodysplastic syndrome
Intermediate-2 Myelodysplastic syndrome
Untreated

Additional relevant MeSH terms:
Syndrome
Myelodysplastic Syndromes
Preleukemia
Disease
Pathologic Processes
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Neoplasms
Azacitidine
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors