Phase II Study to Evaluate Overall Response in Patients With Higher Risk Myelodysplastic Syndromes (MDS) Treated With Azacitidine With or Without Deferasirox.



Status:Completed
Conditions:Blood Cancer, Blood Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - 80
Updated:4/21/2016
Start Date:September 2014
End Date:June 2015

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A 2-year, Multi-center, Phase II, Open-label, Fixed-dose, Randomized Comparative Trial of Azacitidine, With or Without Deferasirox in Patients With Higher Risk Myelodysplastic Syndromes

The primary objective of the study is to compare the overall response rate (inclusive of
complete response, partial response and hematologic improvement) per IWG 2006 criteria in
patients with higher risk MDS treated with azacitidine with or without deferasirox achieved
over the course of one year. Hematologic improvement must be maintained for at least 8
weeks.


Inclusion Criteria:

Male or Female, age ≥ 18 years Patients with higher risk MDS with a blast count < 20% at
the time of screening IPSS Int-2 or High Risk Serum Ferritin ≥ 300 ng/mL at screening.

Sexually active women must use an effective method of contraception, or must have
undergone clinically documented total hysterectomy and/or oophorectomy, or tubal ligation
or be postmenopausal (defined as amenorrhea for at least 12 months)

Exclusion Criteria:

Patients currently receiving any therapy other than AZA for MDS (a ≥ 4 week washout period
for any agent (excluding AZA) used to treat MDS prior to first dose of study treatment is
required).

Patients who have received > 2 cycles of AZA or decitabine at the time of randomization.
Patients who have received iron chelation therapy within 1 month of screening.

Patients who have received growth factors within 1 month of screening. Patients who have
received Revlimid within 1 month of screening. Patients who have undergone hematopoietic
stem cell transplant. ECOG Performance Status > 2 Systemic diseases (cardiovascular,
renal, hepatic, etc.) which would prevent study treatment Patients with uncontrolled
systemic hypertension Severe cardiac insufficiency (NYHA III or IV), with uncontrolled
and/or unstable cardiac or coronary artery disease not controlled by standard medical
therapy Patients with a diagnosis of or history of clinically relevant ocular toxicity
related to iron chelation Diagnosis of liver cirrhosis (either established diagnosis or
diagnosis by liver biopsy or central ultrasound reading) Clinical or laboratory evidence
of active Hepatitis B or Hepatitis C (HBsAg in the absence of HBsAb OR HCV Ab positive
with HCV RNA positive and ALT above the normal range). History of HIV positive test result
(ELISA or Western blot) Presence of a surgical or medical condition which might
significantly alter the absorption, distribution, metabolism or excretion of study drug
Patients with an active malignancy (currently or within the past two years) with the
exception of basal cell skin carcinoma or cervical carcinoma in situ or completely
resected colonic polyps carcinoma in situ. History of drug or alcohol abuse within the 12
months prior to enrollment. History of non-compliance to medical regimens or patients who
are considered potentially unreliable and/or not cooperative.

Patients with a known hypersensitivity to azacitidine, mannitol, or deferasirox.
Calculated creatinine clearance <40mL/min Serum creatinine greater than 1.5x ULN at
screening Urine protein/creatinine ratio> 1 AST or ALT greater than 3x ULN at screening
Direct Bilirubin greater than 1.5x ULN at screening. Patients who received treatment with
systemic investigational drug within the past 4 weeks or topical investigational drug
within the past 7 days or are planning to receive other investigational drugs while
participating in the study Patients participating in another therapeutic clinical trial
Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female
after conception and until the termination of gestation, confirmed by a positive hCG
laboratory test. Women of child-bearing potential, defined as all women physiologically
capable of becoming pregnant, unless they are using effective methods of contraception
during dosing of study treatment. Sexually active males unless they use a condom during
intercourse while taking drug and for 3 months after stopping AZA and should not father a
child in this period.
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Salt Lake City, Utah 84106
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