Treatment of High Risk Myelodysplastic Syndromes (MDS) Not Candidates for Allogeneic Transplantation of Hematopoietic Progenitors (ALO-HSCT)
NCT ID: NCT04602273
Last Updated: 2020-10-26
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
UNKNOWN
150 participants
OBSERVATIONAL
2016-12-12
2021-06-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Primary objectives are to asses mutational status of target genes by Next Generation Sequencing, to evaluate prognostic value of geriatric assessment scales and to evaluate overall survival.
The main hypothesis is that mutation status of target genes and geriatric scales have statistical significant impact on overall survival.
Study time points will be at diagnosis, 6, 12, 18 and 24 months, always taking into account the routine clinical practice, when sample to assess mutational status will be collected. Geriatric assessment will only be performed at diagnosis.
Upon the signature of informed consent and the checking of inclusion criteria, patients will receive treatment with Azacitidine 75 mg/sqm on a 28 days based cycles (both 7-0-0 and 5-0-2 regimens are allowed) until disease progression, unacceptable toxicity or investigator decision.
150 patients are expected to be recruited at study sites.
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
COHORT
PROSPECTIVE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
High Risk MDS
New diagnosed patients treated with Azacitidine 75 mg/sqm SC QD on a 28 days based cycles (both 7-0-0 and 5-0-2 regimens are allowed) until disease progression, unacceptable toxicity, death or investigator decision
Azacitidine Injection [Vidaza]
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Azacitidine Injection [Vidaza]
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* High-risk MDS: (following the Grupo Español Síndrome Mielodisplásico, GESDM MDS guides) and the recommendations of Valcárcel, D. et al).
Median expected OS less than 30 months. Intermediate-2 or high risk IPSS and / or high or very high risk WPSS and / or high or very high risk IPSSS-R.
IPSS of intermediate risk and / or WPSS of intermediate risk and / or IPSS-R of intermediate risk that present at least one of the following characteristics:
Cytogenetic abnormality of the IPSS-R high or very high cytogenetic risk group Platelet count \<30 x10E9/l Neutrophil count \<0.5 x 10E9 / l Presence of dense and diffuse myelofibrosis, with or without collagen formation (grades 2-3 of the European consensus) Category 3 of the LRSS score (MD Anderson low risk score system)
* Patient diagnosed with LAM de novo according to WHO criteria, with 20-30% blasts count in bone marrow, trilineal dysplasia and more than 70 years and not candidate for intensive chemotherapy.
* Willing to provide voluntary written informed consent
Exclusion Criteria
* Presence of other active malignant disease
* Organic function parameters: (except when the alteration is due to MDS) Hepatic: Bilirubin\> 2 x upper limit of normal (ULN) Renal: Creatinine\> 2 x upper limit of normal (ULN)
* Ejection fraction (\<40%) and / or symptomatic heart failure.
* Leukaemia secondary to Myeloproliferative Syndrome.
* Serious psychiatric or neurological disease.
* Positive Serology for HIV.
* Proliferative CMML
18 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Hospital Son Llatzer
OTHER
Germans Trias i Pujol Hospital
OTHER
Celgene Corporation
INDUSTRY
Grupo Cooperativo de Estudio y Tratamiento de las Leucemias Agudas y Mielodisplasias
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Joan Bargay, MD PhD
Role: PRINCIPAL_INVESTIGATOR
Hospital Son Llatzer
Lurdes Zamora, PhD
Role: PRINCIPAL_INVESTIGATOR
Germans Trias i Pujol Hospital
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Son Llàtzer
Palma, Balearic Islands, Spain
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
References
Explore related publications, articles, or registry entries linked to this study.
Tefferi A, Vardiman JW. Myelodysplastic syndromes. N Engl J Med. 2009 Nov 5;361(19):1872-85. doi: 10.1056/NEJMra0902908. No abstract available.
Germing U, Strupp C, Kundgen A, Bowen D, Aul C, Haas R, Gattermann N. No increase in age-specific incidence of myelodysplastic syndromes. Haematologica. 2004 Aug;89(8):905-10.
Cazzola M, Malcovati L. Myelodysplastic syndromes--coping with ineffective hematopoiesis. N Engl J Med. 2005 Feb 10;352(6):536-8. doi: 10.1056/NEJMp048266. No abstract available.
Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, Harris NL, Le Beau MM, Hellstrom-Lindberg E, Tefferi A, Bloomfield CD. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009 Jul 30;114(5):937-51. doi: 10.1182/blood-2009-03-209262. Epub 2009 Apr 8.
Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Sole F, Bennett JM, Bowen D, Fenaux P, Dreyfus F, Kantarjian H, Kuendgen A, Levis A, Malcovati L, Cazzola M, Cermak J, Fonatsch C, Le Beau MM, Slovak ML, Krieger O, Luebbert M, Maciejewski J, Magalhaes SM, Miyazaki Y, Pfeilstocker M, Sekeres M, Sperr WR, Stauder R, Tauro S, Valent P, Vallespi T, van de Loosdrecht AA, Germing U, Haase D. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012 Sep 20;120(12):2454-65. doi: 10.1182/blood-2012-03-420489. Epub 2012 Jun 27.
Fega KR, Abel GA, Motyckova G, Sherman AE, DeAngelo DJ, Steensma DP, Galinsky I, Wadleigh M, Stone RM, Driver JA. Non-hematologic predictors of mortality improve the prognostic value of the international prognostic scoring system for MDS in older adults. J Geriatr Oncol. 2015 Jul;6(4):288-98. doi: 10.1016/j.jgo.2015.05.003. Epub 2015 Jun 11.
Hamaker ME, Mitrovic M, Stauder R. The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy. Ann Hematol. 2014 Jun;93(6):1031-40. doi: 10.1007/s00277-013-2001-0. Epub 2014 Feb 2.
Bonanad S, De la Rubia J, Gironella M, Perez Persona E, Gonzalez B, Fernandez Lago C, Arnan M, Zudaire M, Hernandez Rivas JA, Soler A, Marrero C, Olivier C, Altes A, Valcarcel D, Hernandez MT, Oiartzabal I, Fernandez Ordono R, Arnao M, Esquerra A, Sarra J, Gonzalez-Barca E, Gonzalez J, Calvo X, Nomdedeu M, Garcia Guinon A, Ramirez Payer A, Casado A, Lopez S, Duran M, Marcos M, Cruz-Jentoft AJ; GAH Group. Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale. J Geriatr Oncol. 2015 Sep;6(5):353-61. doi: 10.1016/j.jgo.2015.03.003. Epub 2015 Jun 29.
Rollison DE, Howlader N, Smith MT, Strom SS, Merritt WD, Ries LA, Edwards BK, List AF. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs. Blood. 2008 Jul 1;112(1):45-52. doi: 10.1182/blood-2008-01-134858. Epub 2008 Apr 28.
Klepin HD. Myelodysplastic Syndromes and Acute Myeloid Leukemia in the Elderly. Clin Geriatr Med. 2016 Feb;32(1):155-73. doi: 10.1016/j.cger.2015.08.010.
Xicoy B, Jimenez MJ, Garcia O, Bargay J, Martinez-Robles V, Brunet S, Arilla MJ, Perez de Oteyza J, Andreu R, Casano FJ, Cervero CJ, Bailen A, Diez M, Gonzalez B, Vicente AI, Pedro C, Bernal T, Luno E, Cedena MT, Palomera L, Simiele A, Calvo JM, Marco V, Gomez E, Gomez M, Gallardo D, Munoz J, de Paz R, Grau J, Ribera JM, Benlloch LE, Sanz G. Results of treatment with azacitidine in patients aged >/= 75 years included in the Spanish Registry of Myelodysplastic Syndromes. Leuk Lymphoma. 2014 Jun;55(6):1300-3. doi: 10.3109/10428194.2013.834532. Epub 2013 Sep 16.
Gangat N, Patnaik MM, Tefferi A. Myelodysplastic syndromes: Contemporary review and how we treat. Am J Hematol. 2016 Jan;91(1):76-89. doi: 10.1002/ajh.24253.
Bejar R, Lord A, Stevenson K, Bar-Natan M, Perez-Ladaga A, Zaneveld J, Wang H, Caughey B, Stojanov P, Getz G, Garcia-Manero G, Kantarjian H, Chen R, Stone RM, Neuberg D, Steensma DP, Ebert BL. TET2 mutations predict response to hypomethylating agents in myelodysplastic syndrome patients. Blood. 2014 Oct 23;124(17):2705-12. doi: 10.1182/blood-2014-06-582809. Epub 2014 Sep 15.
Itzykson R, Kosmider O, Cluzeau T, Mansat-De Mas V, Dreyfus F, Beyne-Rauzy O, Quesnel B, Vey N, Gelsi-Boyer V, Raynaud S, Preudhomme C, Ades L, Fenaux P, Fontenay M; Groupe Francophone des Myelodysplasies (GFM). Impact of TET2 mutations on response rate to azacitidine in myelodysplastic syndromes and low blast count acute myeloid leukemias. Leukemia. 2011 Jul;25(7):1147-52. doi: 10.1038/leu.2011.71. Epub 2011 Apr 15.
Fenaux P, Mufti GJ, Hellstrom-Lindberg E, Santini V, Finelli C, Giagounidis A, Schoch R, Gattermann N, Sanz G, List A, Gore SD, Seymour JF, Bennett JM, Byrd J, Backstrom J, Zimmerman L, McKenzie D, Beach C, Silverman LR; International Vidaza High-Risk MDS Survival Study Group. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol. 2009 Mar;10(3):223-32. doi: 10.1016/S1470-2045(09)70003-8. Epub 2009 Feb 21.
Deschler B, Ihorst G, Platzbecker U, Germing U, Marz E, de Figuerido M, Fritzsche K, Haas P, Salih HR, Giagounidis A, Selleslag D, Labar B, de Witte T, Wijermans P, Lubbert M. Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome. Haematologica. 2013 Feb;98(2):208-16. doi: 10.3324/haematol.2012.067892. Epub 2012 Aug 8.
Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005 Oct 15;106(8):2912-9. doi: 10.1182/blood-2005-05-2004. Epub 2005 Jun 30.
Related Links
Access external resources that provide additional context or updates about the study.
Grupo Español de Sindrome Mielodiplásico (GESMD) MDS treatment guides
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
CET-AZA-2016-01
Identifier Type: -
Identifier Source: org_study_id