Trial Outcomes & Findings for To Demonstrate Superiority of Decitabine Over Azacitidine in Subjects With Intermediate- or High-risk MDS. (NCT NCT01011283)

NCT ID: NCT01011283

Last Updated: 2014-10-29

Results Overview

Based on Modified International Working Group Response Criteria for Altering Natural History of Myelodysplastic Syndromes. Complete Response: Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines. Persistent dysplasia will be noted. Peripheral blood Hgb ≥ 11 g/dL; Platelets ≥ 100 X 10\^9/L; Neutrophils ≥ 1.0 X 10\^9/Lb; Blasts 0%. Marrow Complete Response: Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment. Peripheral blood: if hematological improvement responses, they will be noted in addition to marrow CR.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

26 participants

Primary outcome timeframe

13 Weeks

Results posted on

2014-10-29

Participant Flow

This study was recruited at 20 centers in U.S. during the period of Feb 2010 to Jan 2011.

Participant milestones

Participant milestones
Measure
Decitabine 20 mg/m^2
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Overall Study
STARTED
13
13
Overall Study
COMPLETED
2
2
Overall Study
NOT COMPLETED
11
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Decitabine 20 mg/m^2
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Overall Study
Adverse Event
4
2
Overall Study
Progressive Disease
0
2
Overall Study
Terminated by Sponsor
5
5
Overall Study
Other
2
2

Baseline Characteristics

To Demonstrate Superiority of Decitabine Over Azacitidine in Subjects With Intermediate- or High-risk MDS.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Decitabine 20 mg/m^2
n=13 Participants
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
n=13 Participants
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Total
n=26 Participants
Total of all reporting groups
Age, Continuous
73.8 years
STANDARD_DEVIATION 11.60 • n=5 Participants
70.8 years
STANDARD_DEVIATION 9.13 • n=7 Participants
72.3 years
STANDARD_DEVIATION 10.35 • n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
10 Participants
n=7 Participants
21 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
13 Participants
n=5 Participants
11 Participants
n=7 Participants
24 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
13 Participants
n=5 Participants
12 Participants
n=7 Participants
25 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 13 Weeks

Population: Intent to Treat Population

Based on Modified International Working Group Response Criteria for Altering Natural History of Myelodysplastic Syndromes. Complete Response: Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines. Persistent dysplasia will be noted. Peripheral blood Hgb ≥ 11 g/dL; Platelets ≥ 100 X 10\^9/L; Neutrophils ≥ 1.0 X 10\^9/Lb; Blasts 0%. Marrow Complete Response: Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment. Peripheral blood: if hematological improvement responses, they will be noted in addition to marrow CR.

Outcome measures

Outcome measures
Measure
Decitabine 20 mg/m^2
n=11 Participants
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
n=12 Participants
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 3 Cycles of Study Drug.
Overall Response Rate
0 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 3 Cycles of Study Drug.
Complete Response
0 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 3 Cycles of Study Drug.
Marrow Complete Response
0 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 3 Cycles of Study Drug.
Partial Response
0 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 3 Cycles of Study Drug.
Stable Disease
45.5 Percentage of Participants
25.0 Percentage of Participants

SECONDARY outcome

Timeframe: 36 Weeks

Population: Intent to Treat Population

Based on Modified International Working Group Response Criteria for Altering Natural History of Myelodysplastic Syndromes. Complete Response: Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines. Persistent dysplasia will be noted. Peripheral blood Hgb ≥ 11 g/dL; Platelets ≥ 100 X 10\^9/L; Neutrophils ≥ 1.0 X 10\^9/Lb; Blasts 0%. Marrow Complete Response: Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment. Peripheral blood: if hematological improvement responses, they will be noted in addition to marrow CR.

Outcome measures

Outcome measures
Measure
Decitabine 20 mg/m^2
n=11 Participants
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
n=12 Participants
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 6 Cycles of Study Drug.
Overall Response Rate
9.1 Percentage of Participants
8.3 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 6 Cycles of Study Drug.
Complete Response
9.1 Percentage of Participants
8.3 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 6 Cycles of Study Drug.
Marrow Complete Response
0 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 6 Cycles of Study Drug.
Partial Response
9.1 Percentage of Participants
0 Percentage of Participants
Overall Response Rate (ORR), Defined as Proportion of Patients Having Complete Response (CR) and Marrow Complete Response (mCR) After Completion of 6 Cycles of Study Drug.
Stable Disease
36.4 Percentage of Participants
16.7 Percentage of Participants

Adverse Events

Decitabine 20 mg/m^2

Serious events: 7 serious events
Other events: 13 other events
Deaths: 0 deaths

Azacitidine 75 mg/m^2

Serious events: 7 serious events
Other events: 13 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Decitabine 20 mg/m^2
n=13 participants at risk
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
n=13 participants at risk
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Blood and lymphatic system disorders
Pancytopenia
23.1%
3/13
7.7%
1/13
Blood and lymphatic system disorders
Febrile neutropenia
15.4%
2/13
15.4%
2/13
Cardiac disorders
Thrombocytopenia
15.4%
2/13
0.00%
0/13
Blood and lymphatic system disorders
Anemia
7.7%
1/13
7.7%
1/13
Infections and infestations
Pneumonia
15.4%
2/13
0.00%
0/13
Infections and infestations
Aspergillosis
7.7%
1/13
0.00%
0/13
Infections and infestations
Neutropenia sepsis
0.00%
0/13
7.7%
1/13
Infections and infestations
Diverticulitis
0.00%
0/13
7.7%
1/13
Infections and infestations
Sepsis
7.7%
1/13
0.00%
0/13
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
7.7%
1/13
0.00%
0/13
Nervous system disorders
Cerebrovascular accident
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Gastrointestinal hemorrhage
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Rectal hemorrhage
0.00%
0/13
7.7%
1/13
Cardiac disorders
Cardiac failure congestive
0.00%
0/13
7.7%
1/13
General disorders
Pyrexia
0.00%
0/13
7.7%
1/13
Injury, poisoning and procedural complications
Subdural hematoma
0.00%
0/13
7.7%
1/13

Other adverse events

Other adverse events
Measure
Decitabine 20 mg/m^2
n=13 participants at risk
decitabine : decitabine 20 mg/m\^2 /day intravenous (IV) infusion for 5 days every 28 days
Azacitidine 75 mg/m^2
n=13 participants at risk
azacitidine : azacitidine 75 mg/m\^2 /day subcutaneous (SC) injection for 7 days every 28 days
Blood and lymphatic system disorders
Anemia
53.8%
7/13
38.5%
5/13
Blood and lymphatic system disorders
Febrile neutropenia
15.4%
2/13
7.7%
1/13
Blood and lymphatic system disorders
Leukopenia
30.8%
4/13
23.1%
3/13
Blood and lymphatic system disorders
Neutropenia
46.2%
6/13
46.2%
6/13
Blood and lymphatic system disorders
Thrombocytopenia
46.2%
6/13
38.5%
5/13
Cardiac disorders
Angina pectoris
0.00%
0/13
7.7%
1/13
Cardiac disorders
Atrial fibrillation
0.00%
0/13
7.7%
1/13
Cardiac disorders
Palpitations
7.7%
1/13
7.7%
1/13
Cardiac disorders
Tachycardia
15.4%
2/13
0.00%
0/13
Eye disorders
Erythema of eyelid
7.7%
1/13
0.00%
0/13
Eye disorders
Eye irritation
0.00%
0/13
15.4%
2/13
Eye disorders
Eye pain
0.00%
0/13
7.7%
1/13
Gastrointestinal disorders
Abdominal discomfort
0.00%
0/13
7.7%
1/13
Gastrointestinal disorders
Abdominal pain
23.1%
3/13
7.7%
1/13
Gastrointestinal disorders
Abdominal tenderness
0.00%
0/13
7.7%
1/13
Gastrointestinal disorders
Constipation
23.1%
3/13
23.1%
3/13
Gastrointestinal disorders
Diarrhea
30.8%
4/13
38.5%
5/13
Gastrointestinal disorders
Fecal incontinence
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Gastritis
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Gastrointestinal hemorrhage
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Gingival bleeding
0.00%
0/13
7.7%
1/13
Gastrointestinal disorders
Gingival pain
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Hemorrhoidal hemorrhage
0.00%
0/13
7.7%
1/13
Gastrointestinal disorders
Nausea
7.7%
1/13
69.2%
9/13
Gastrointestinal disorders
Stomatitis
7.7%
1/13
0.00%
0/13
Gastrointestinal disorders
Vomiting
0.00%
0/13
61.5%
8/13
General disorders
Asthenia
7.7%
1/13
15.4%
2/13
General disorders
Catheter site erythema
7.7%
1/13
0.00%
0/13
General disorders
Catheter site pain
7.7%
1/13
0.00%
0/13
General disorders
Chills
15.4%
2/13
7.7%
1/13
General disorders
Facial pain
0.00%
0/13
7.7%
1/13
General disorders
Fatigue
38.5%
5/13
53.8%
7/13
General disorders
Feeling jittery
0.00%
0/13
7.7%
1/13
General disorders
Injection site erythema
0.00%
0/13
30.8%
4/13
General disorders
Injection site hemorrhage
0.00%
0/13
7.7%
1/13
General disorders
Injection site edema
0.00%
0/13
7.7%
1/13
General disorders
Injection site pain
0.00%
0/13
23.1%
3/13
General disorders
Injection site rash
0.00%
0/13
7.7%
1/13
General disorders
Injection site reaction
0.00%
0/13
30.8%
4/13
General disorders
Nodule
0.00%
0/13
7.7%
1/13
General disorders
Non-cardiac chest pain
0.00%
0/13
7.7%
1/13
General disorders
Edema peripheral
0.00%
0/13
7.7%
1/13
General disorders
Pain
7.7%
1/13
0.00%
0/13
General disorders
Pyrexia
23.1%
3/13
15.4%
2/13
Infections and infestations
Acute sinusitis
0.00%
0/13
7.7%
1/13
Infections and infestations
Bronchitis
7.7%
1/13
0.00%
0/13
Infections and infestations
Oral herpes
15.4%
2/13
0.00%
0/13
Infections and infestations
Paronchia
7.7%
1/13
0.00%
0/13
Infections and infestations
Sinusitis
0.00%
0/13
7.7%
1/13
Infections and infestations
Skin infection
7.7%
1/13
0.00%
0/13
Infections and infestations
Subcutaneous abscess
0.00%
0/13
7.7%
1/13
Infections and infestations
Upper respiratory infection
7.7%
1/13
15.4%
2/13
Infections and infestations
Contusion
7.7%
1/13
7.7%
1/13
Infections and infestations
Post procedural discharge
0.00%
0/13
7.7%
1/13
Infections and infestations
Skin laceration
0.00%
0/13
7.7%
1/13
Investigations
Blood alkaline phosphatase increased
7.7%
1/13
0.00%
0/13
Investigations
Blood potassium increased
0.00%
0/13
7.7%
1/13
Investigations
Blood pressure increased
0.00%
0/13
7.7%
1/13
Investigations
Breath sounds abnormal
7.7%
1/13
0.00%
0/13
Investigations
Hepatic enzyme increased
0.00%
0/13
7.7%
1/13
Investigations
Weight decreased
0.00%
0/13
7.7%
1/13
Metabolism and nutrition disorders
Decreased appetite
15.4%
2/13
23.1%
3/13
Metabolism and nutrition disorders
Dehydration
7.7%
1/13
7.7%
1/13
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/13
7.7%
1/13
Metabolism and nutrition disorders
Hypocalcemia
0.00%
0/13
7.7%
1/13
Metabolism and nutrition disorders
Hypokalemia
7.7%
1/13
0.00%
0/13
Metabolism and nutrition disorders
Hypomagnesemia
7.7%
1/13
0.00%
0/13
Metabolism and nutrition disorders
Hyponatremia
0.00%
0/13
7.7%
1/13
Metabolism and nutrition disorders
Hypophosphatemia
7.7%
1/13
0.00%
0/13
Metabolism and nutrition disorders
Metabolic acidosis
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Pain in extremity
7.7%
1/13
15.4%
2/13
Musculoskeletal and connective tissue disorders
Pain in jaw
0.00%
0/13
7.7%
1/13
Musculoskeletal and connective tissue disorders
Trigger finger
7.7%
1/13
0.00%
0/13
Nervous system disorders
Complex partial seizures
0.00%
0/13
7.7%
1/13
Nervous system disorders
Dizziness
15.4%
2/13
15.4%
2/13
Nervous system disorders
Encephalopathy
0.00%
0/13
7.7%
1/13
Nervous system disorders
Headache
15.4%
2/13
23.1%
3/13
Nervous system disorders
Memory impairment
7.7%
1/13
0.00%
0/13
Nervous system disorders
Syncope
7.7%
1/13
0.00%
0/13
Psychiatric disorders
Agitation
0.00%
0/13
7.7%
1/13
Psychiatric disorders
Insomnia
15.4%
2/13
15.4%
2/13
Psychiatric disorders
Mental status changes
0.00%
0/13
7.7%
1/13
Psychiatric disorders
Restlessness
0.00%
0/13
7.7%
1/13
Renal and urinary disorders
Dysuria
7.7%
1/13
0.00%
0/13
Renal and urinary disorders
Nocturia
7.7%
1/13
0.00%
0/13
Renal and urinary disorders
Pollakiuria
0.00%
0/13
7.7%
1/13
Renal and urinary disorders
Renal failure
0.00%
0/13
7.7%
1/13
Renal and urinary disorders
Urinary retention
15.4%
2/13
0.00%
0/13
Reproductive system and breast disorders
Benign prostatic hyperplasia
7.7%
1/13
0.00%
0/13
Respiratory, thoracic and mediastinal disorders
Acute pulmonary edema
0.00%
0/13
7.7%
1/13
Respiratory, thoracic and mediastinal disorders
Atelectasis
0.00%
0/13
7.7%
1/13
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
7.7%
1/13
0.00%
0/13
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/13
23.1%
3/13
Respiratory, thoracic and mediastinal disorders
Dyspnea
15.4%
2/13
15.4%
2/13
Respiratory, thoracic and mediastinal disorders
Dyspnea exertional
0.00%
0/13
15.4%
2/13
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
0.00%
0/13
7.7%
1/13
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.00%
0/13
7.7%
1/13
Respiratory, thoracic and mediastinal disorders
Productive cough
7.7%
1/13
0.00%
0/13
Respiratory, thoracic and mediastinal disorders
Upper airway cough syndrome
7.7%
1/13
0.00%
0/13
Respiratory, thoracic and mediastinal disorders
Wheezing
0.00%
0/13
7.7%
1/13
Skin and subcutaneous tissue disorders
Alopecia
0.00%
0/13
7.7%
1/13
Skin and subcutaneous tissue disorders
Ecchymosis
7.7%
1/13
0.00%
0/13
Skin and subcutaneous tissue disorders
Erythema
0.00%
0/13
7.7%
1/13
Skin and subcutaneous tissue disorders
Purpura
0.00%
0/13
7.7%
1/13
Skin and subcutaneous tissue disorders
Rash
0.00%
0/13
15.4%
2/13
Skin and subcutaneous tissue disorders
Rash papular
7.7%
1/13
0.00%
0/13
Skin and subcutaneous tissue disorders
Skin exfoliation
0.00%
0/13
7.7%
1/13
Skin and subcutaneous tissue disorders
Skin lesion
15.4%
2/13
0.00%
0/13
Skin and subcutaneous tissue disorders
Skin nodule
0.00%
0/13
7.7%
1/13
Vascular disorders
Hypotension
7.7%
1/13
7.7%
1/13

Additional Information

Erhan Berrack, M.D.

Eisai Inc.

Phone: 888-422-4743

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place