Pilot Study of CC 486 (Oral Azacitidine) Plus BSC as Maintenance After sc Azacitidine in Elderly HR-IPSS-R MDS Patients

Launched by UNIVERSITY OF FLORENCE · Mar 16, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a new oral medication called CC-486 (oral azacitidine) to see if it can help patients with higher-risk Myelodysplastic Syndromes (MDS) after they've had a positive response to an earlier treatment with subcutaneous azacitidine, which is given by injection in a hospital. The goal is to improve the quality of life for elderly patients who often face challenges with frequent hospital visits for their treatment. By taking the medication at home, they may have a better experience while still receiving effective care.

To participate in this study, patients need to be 65 years or older and have been diagnosed with a specific type of MDS. They should have completed at least 4 to 6 cycles of subcutaneous azacitidine and shown a positive response to it. Participants will receive CC-486 along with supportive care and will be monitored for its safety and effectiveness. It's important to note that there are specific health criteria that must be met to join the study, so not everyone will qualify. Overall, this trial aims to offer a more convenient and potentially effective treatment option for elderly patients with MDS.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Subjects must satisfy the following criteria to be enrolled in the study:
• • 1. Male or female subjects ≥ 65 years of age at the time of signing the ICD;
• • 2. Diagnosed, histologically confirmed at inclusion,
• • Int-2 or High according to IPSS, or
• • Very High, High or Intermediate according to IPSS-R, or
• • Hypoplastic AML (20-30% BM blasts, previosuly considered MDS RAEB-T)
• • myelodysplastic CMML (included in IPSS scoring, WBC \< 13.x 109/L);
• • 3. Should have undergone therapy with subcutaneous azacitidine for at least 4-6 cycles ( + 2 cycles)
• 4. Must have achieved CR/CRi, PR or SD with HI status, as evidenced by IWG Criteria 2006 ( APPENDIX E):
• • 5. ECOG performance status of 0, 1, 2 (Appendix C);
• • 6. Adequate bone marrow function based on ANCs ≥ 1.0 x 109/L and platelet counts ≥ 70 x 109/L.
• 7. Adequate organ function, defined as:
• • Serum bilirubin ≤1.5 times the upper limit of normal (ULN); Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 times the ULN; Serum creatinine ≤ 2.5 times the ULN; 8.Male subjects with a female partner of childbearing potential must agree to practice abstinence or to the use of a physician-approved contraceptive method throughout the course of the study and avoid fathering a child during the course of the study and for 3 months following the last dose of azacitidine; 10. Understand and voluntarily sign an ICD prior to any study related assessments/procedures are conducted; 11. Able to adhere to the study visit schedule and other protocol requirements; 12. Ability to swallow study medication.
• Exclusion Criteria:
• • Absence of confirmed hematological response ( IWG HI/PR/CR) after at least 4 to 6 months of azacitidine sc and maintenance of response for 2 additional cycles.
• • Inability to provide a valid informed consent.
• • Eligibility for HSCT
• • Active infection
• • Serum creatinine \> 2 x ULN at screening.
• • ECOG performance status \> 2
• • Left ventricular ejection fraction \< 50% by echocardiography
• • A history of repeated hospitalization for severe infections Systemic diseases that would prevent study treatment (e.g. uncontrolled hypertension, cardiovascular, renal, hepatic, metabolic, etc.)
• • Clinical or laboratory evidence of chronic Hepatitis B or Hepatitis C (definition of
• • chronic hepatitis follows EASL 2017 criteria).
• • History of HIV positive test result (ELISA or Western blot).
• • ALT or AST over 3 times superior to ULN at screening.
• • Total bilirubin over 1.5 times superior to ULN at screening (patients with Gilbert syndrome are allowed to enter the study)
• • Patients participating in another clinical trial other than an observational registry study.
• • Patients with a history of another malignancy within the past 3 years, with the exception of basal skin carcinoma or cervical carcinoma in situ or completely resected colonic polyps carcinoma in situ.
• • History of non-compliance to medical regimens, or patients who are considered potentially unreliable and/or not cooperative.
• • Presence of a surgical or medical condition which might significantly alter the absorption, distribution, metabolism or excretion of study drug.
• • History of drug or alcohol abuse within the 12 months prior to enrollment.