Allo vs Hypomethylating/Best Supportive Care in MDS (BMT CTN 1102)

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2016 by Medical College of Wisconsin
Sponsor:
Collaborators:
National Heart, Lung, and Blood Institute (NHLBI)
National Cancer Institute (NCI)
Blood and Marrow Transplant Clinical Trials Network
Information provided by (Responsible Party):
Medical College of Wisconsin
ClinicalTrials.gov Identifier:
NCT02016781
First received: December 16, 2013
Last updated: April 18, 2016
Last verified: April 2016
  Purpose
This study is designed as a multicenter trial, with biological assignment to one of two study arms; Arm 1: Reduced intensity conditioning allogeneic hematopoietic cell transplantation (RIC-alloHCT), Arm 2: Non-Transplant Therapy/Best Supportive Care.

Condition Intervention Phase
MDS
Procedure: Allogeneic Hematopoietic Cell Transplant
Procedure: Hypomethylating Therapy / Best Supportive Care
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multi-Center Biologic Assignment Trial Comparing Allogeneic Hematopoietic Cell Transplant to Hypomethylating Therapy or Best Supportive Care in Patients w/Intermediate-2 & High Risk Myelodysplastic Syndrome (BMT CTN #1102)

Resource links provided by NLM:


Further study details as provided by Medical College of Wisconsin:

Primary Outcome Measures:
  • Overall survival probabilities [ Time Frame: 3 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Leukemia-free survival (LFS) [ Time Frame: 3 years ] [ Designated as safety issue: No ]
  • QOL measures [ Time Frame: 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 400
Study Start Date: December 2013
Estimated Study Completion Date: December 2019
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Transplant
Reduced intensity conditioning allogeneic hematopoietic cell transplantation (RIC-alloHCT)
Procedure: Allogeneic Hematopoietic Cell Transplant
Bone marrow or peripheral blood stem cell transplant. The specific transplant treatment regimen will be at the discretion of the treating physician.
Other Name: RIC alloHCT
Active Comparator: Non-Transplant
Hypomethylating Therapy / Best Supportive Care
Procedure: Hypomethylating Therapy / Best Supportive Care
The specific non-transplant treatment regimen will be at the discretion of the treating physician.
Other Name: Non-transplant

Detailed Description:

Background: MDS is a clonal disorder of hematopoietic precursors and stem cells, which may evolve to a terminal phase resembling acute leukemia. A subject of clinical urgency for researchers, clinicians, patients, and health care underwriters such as Medicare, is the role of allogeneic hematopoietic cell transplantation (alloHCT) in the treatment of older patients with higher risk myelodysplastic syndromes (MDS). The use of reduced intensity conditioning (RIC) regimens has extended HCT to the care of older patients with acute myelogenous leukemia (AML) and lymphoma and a number of retrospective and phase II trials for patients with MDS now show the curative potential of RIC alloHCT in selected patients.

This protocol is designed to evaluate the relative benefits of RIC alloHCT compared to non-transplant therapies focusing on overall survival. This will be done by having patients biologically assigned to the alloHCT arm or the hypomethylating therapy/best supportive care arm and following them for survival at 3 years.

  Eligibility

Ages Eligible for Study:   50 Years to 75 Years   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients fulfilling the following criteria will be eligible for entry into this study:

    1. Patients with de novo MDS who have, or have previously had, Intermediate-2 or High risk disease as determined by the International Prognostic Scoring System (IPSS). Current Intermediate-2 or High risk disease is NOT a requirement.
    2. Patients must have an acceptable MDS subtype:

      • Refractory cytopenia with unilineage dysplasia (RCUD) (includes refractory anemia (RA))
      • Refractory anemia with ringed sideroblasts (RARS)
      • Refractory anemia with excess blasts (RAEB-1)
      • Refractory anemia with excess blasts (RAEB-2)
      • Refractory cytopenia with multilineage dysplasia (RCMD)
      • Myelodysplastic syndrome with isolated del(5q) (5q-syndrome)
      • Myelodysplastic syndrome (MDS), unclassifiable
    3. Patients must have fewer than 20% marrow blasts within 60 days of consent.
    4. Patients may have received prior therapy for the treatment of MDS, including but not limited to: growth factor, transfusion support, immunomodulatory (IMID) therapy, DNA hypomethylating therapy, or cytotoxic chemotherapy prior to enrollment.
    5. Age 50.0-75.0 years.
    6. Karnofsky performance status > 70 or Eastern Cooperative Oncology Group (ECOG) ≤ 1.
    7. Patients are eligible if no formal unrelated donor search has been activated prior to date of consent. A formal unrelated donor search begins at the time at which samples are requested from potential National Marrow Donor Program (NMDP) donors. Patients who have started a sibling donor search or who have found a matched sibling donor are eligible.
    8. Patients and physicians must be willing to comply with treatment assignment:

      1. No intent to proceed with alloHCT using donor sources not specified in this protocol, including human leukocyte antigen (HLA)-mismatched related or unrelated donors (< 6/6 HLA related matched or < 8/8 HLA unrelated matched) or umbilical cord blood unit(s).
      2. No intent to use myeloablative conditioning regimens.
      3. Intent to proceed with RIC alloHCT if a matched sibling or matched unrelated donor is identified. There is no requirement as to the timing of the transplantation.
    9. Patients must be considered to be suitable RIC alloHCT candidates at the time of enrollment based on medical history, physical examination, and available laboratory tests. Specific testing for organ function is not required for eligibility but, if available, these tests should be used to judge eligibility.
    10. Signed informed consent

Exclusion Criteria:

  • Patients with the following will be ineligible for registration onto this study:

    1. Therapy-related MDS (defined as the occurrence of MDS due to prior exposure to systemic chemotherapy and/or radiation for malignancy)
    2. Current or prior diagnosis of AML
    3. Chronic myelomonocytic leukemia or myelodysplastic/myeloproliferative neoplasm (unacceptable MDS subtypes); uncontrolled bacterial, viral or fungal infection (currently taking medication and with progression or no clinical improvement) at time of enrollment.
    4. Patients with prior malignancies, except treated non-melanoma skin cancer or treated cervical carcinoma in situ. Cancer treated with curative surgery without chemotherapy/radiation therapy > 5 years previously will be allowed. Cancer treated with curative surgery < 5 years previously will not be allowed unless approved by the Protocol Officer or one of the Protocol Chairs.
    5. Prior autologous or allogeneic HCT
    6. Human Immunodeficiency Virus (HIV) infection
    7. Patients of childbearing potential unwilling to use contraceptive techniques
    8. Patients with psychosocial conditions that would prevent study compliance
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02016781

Contacts
Contact: Heather Wittsack hwittsack@emmes.com
Contact: Adam Mendizabal, PhD amendizabal@emmes.com

  Show 36 Study Locations
Sponsors and Collaborators
Medical College of Wisconsin
National Heart, Lung, and Blood Institute (NHLBI)
National Cancer Institute (NCI)
Blood and Marrow Transplant Clinical Trials Network
Investigators
Study Director: Mary Horowitz, MD, MS Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin
  More Information

Publications:
Responsible Party: Medical College of Wisconsin
ClinicalTrials.gov Identifier: NCT02016781     History of Changes
Other Study ID Numbers: BMTCTN1102  2U10HL069294-11 
Study First Received: December 16, 2013
Last Updated: April 18, 2016
Health Authority: United States: Federal Government
United States: Food and Drug Administration
Individual Participant Data  
Plan to Share IPD: Yes
Plan Description: Findings will be published in a manuscript.

Keywords provided by Medical College of Wisconsin:
Myelodysplastic Syndrome

Additional relevant MeSH terms:
Myelodysplastic Syndromes
Bone Marrow Diseases
Hematologic Diseases

ClinicalTrials.gov processed this record on August 30, 2016