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LBH589 in Refractory Myelodysplastic Syndromes (MDS)

Primary Purpose

Myelodysplastic Syndromes (MDS)

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Panobinostat
Sponsored by
SCRI Development Innovations, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes (MDS) focused on measuring Myelodysplastic Syndromes (MDS), Refractory, LBH589

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically or cytological documented diagnosis of myelodysplastic syndrome (MDS).
  • Male or female patients aged >= 18 years old.
  • MDS patients who have failed hypomethylating (azacitidine or decitabine) therapy.
  • Patients with 5q-cytogenic abnormalities must also have progressed on or been intolerant to lenalidomide.
  • Patients with up to and including 30% blasts (FAB RAEB-T) will be eligible to enroll.
  • CMML with >= 5% blasts will be eligible to enroll.
  • ECOG PS 0, 1 or 2.
  • Laboratory values must be as follows:

Bilirubin <= 1.5 mg/dL AST/SGOT <= 2.5 x ULN ALT/SGPT Creatinine <= 2.0 mg/dL or 24-hour Creatinine Clearance >= 50 ml/min Albumin >= 3 g/dL Potassium >= lower limit normal (LLN) Phosphorous >= LLN Calcium >= LLN Magnesium >= LLN

  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to start of treatment.
  • Life expectancy >= 12 weeks.

Exclusion Criteria:

  • Prior treatment with an HDAC inhibitor.
  • Prior intensive chemotherapy or high dose ara-C (>= 1 gm/m2)
  • More than one prior single agent chemotherapy regimen. Prior hydroxyurea for cytoreduction will be permitted however.
  • Impaired cardiac function
  • Active CNS disease, including leptomeningeal metastases.
  • Unresolved diarrhea > CTCAE grade 1.
  • Chemotherapy, investigational drug therapy, major surgery < 4 weeks prior to starting study drug or patients that have not recovered from side effects of previous therapy.
  • Patient is < 5 years free of another primary malignancy except if the other primary malignancy is not currently clinically significant or requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed.
  • Women who are pregnant or breast feeding or women of childbearing potential (WOCBP) not willing to use a double barrier method of contraception during the study and 3 months after the end of treatment. One of these methods of contraception must be a barrier method.
  • Male patients whose sexual partners are WOCBP not using a double method of contraception during the study and 3 months after the end of treatment. One of these methods must be a condom.
  • Patients with gastrointestinal (GI) tract disease, causing the inability to take oral medication, malabsorption syndrome, a requirement for intravenous (IV) alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's disease, ulcerative colitis).
  • Other concurrent severe, uncontrolled systemic fungal, bacterial, viral or other infection or intercurrent illness, including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Patients with uncontrolled coagulopathy.
  • Abnormal thyroid function (TSH or free T4) detected at screening. Patients with known hypothyroidism who are stable on thyroid replacement are eligible.

Sites / Locations

  • Florida Cancer Specialists
  • Northeast Georgia Medical Center
  • Consultants in Blood Disorders and Cancer
  • Center for Cancer and Blood Disorders
  • Oncology Hematology Care
  • Chattanooga Oncology Hematology Associates
  • Tennessee Oncology, PLLC

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Panobinostat 20 mg

Panobinostat 30 mg

Arm Description

Treatment with LBH589 (Panobinostat) 20 mg

Treatment with LBH589 (Panobinostat) 30 mg

Outcomes

Primary Outcome Measures

Overall Response Rate (CR, Marrow CR + PR) of LBH in Patients With Relapsed or Refractory MDS.
Overall response rate (ORR) is defined by the modified International Working Group (IWG) Response Criteria for MDS. In the marrow, Complete Response (CR) is <= 5% blasts present with normal maturation of all cell lines. In peripheral blood, CR is defined as hemoglobin >= 11 g/dL, ANC >= 1000/mL, and platelets >= 100,000 with 0% blasts present. Partial Response (PR) is defined the same as CR with blasts decreased by >= 50% and >= 5% blasts in the marrow.

Secondary Outcome Measures

Time to Disease Progression
Time to disease progression is defined as the time between day 1 cycle 1 and time to first documented disease progression. Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Hematologic Improvement, Including Transfusion Independence
Hematologic measures will include total WBC and platelets
Duration of Response
Duration of response is defined as the time from when objective response is realized until time to first documented disease progression. Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Objective Response = CR + PR. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI or CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions.
Median Time to Treatment Failure
Time to treatment failure is defined as measuring the time between cycle 1 day 1 to discontinuation for any reason.
Median Overall Survival
The Length of Time, in Months, That Patients Were Alive From Their First Date of Protocol Treatment Until Death
Safety and Tolerability of LBH589 in Patients With Relapsed/Refractory MDS by Measuring the Number of Participants With Adverse Events
The reported incidence of AEs and SAEs with an onset on or after the initiation of therapy was graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0

Full Information

First Posted
December 19, 2007
Last Updated
November 18, 2021
Sponsor
SCRI Development Innovations, LLC
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00594230
Brief Title
LBH589 in Refractory Myelodysplastic Syndromes (MDS)
Official Title
A Phase II Trial of LBH589 in Refractory Myelodysplastic Syndromes (MDS) Patients
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Terminated
Why Stopped
Per protocol, the results of a planned interim analysis demonstrated insufficient efficacy and led to early termination of the study.
Study Start Date
January 2008 (undefined)
Primary Completion Date
March 2011 (Actual)
Study Completion Date
March 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SCRI Development Innovations, LLC
Collaborators
Novartis Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This will be a single arm Phase II study.
Detailed Description
LBH589 (20 mg PO) will be administered three times a week on Monday, Wednesday and Friday. Treatment will be given over 21 days followed by a 7 day rest period and repeated every 28 days. Patients will be assessed for toxicity on an ongoing basis and disease assessment will be determined every 2 treatment cycles (8 weeks). Patients will be allowed to continue on treatment for a maximum of eight four week treatment cycles. Treatment will be discontinued if there is evidence of disease progression, unacceptable toxicity and/or at the discretion of the investigator.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes (MDS)
Keywords
Myelodysplastic Syndromes (MDS), Refractory, LBH589

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
26 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Panobinostat 20 mg
Arm Type
Experimental
Arm Description
Treatment with LBH589 (Panobinostat) 20 mg
Arm Title
Panobinostat 30 mg
Arm Type
Experimental
Arm Description
Treatment with LBH589 (Panobinostat) 30 mg
Intervention Type
Drug
Intervention Name(s)
Panobinostat
Other Intervention Name(s)
LBH589
Intervention Description
Panobinostat(20 mg or 30 mg PO) will be administered three times a week on Monday, Wednesday and Friday. Treatment will be given over 21 days followed by a 7 day rest period and repeated every 28 days. Patients will be assessed for toxicity on an ongoing basis and disease assessment will be determined every 2 treatment cycles (8 weeks). Patients will be allowed to continue on treatment for a maximum of eight four week treatment cycles. Treatment will be discontinued if there is evidence of disease progression, unacceptable toxicity and/or at the discretion of the investigator.
Primary Outcome Measure Information:
Title
Overall Response Rate (CR, Marrow CR + PR) of LBH in Patients With Relapsed or Refractory MDS.
Description
Overall response rate (ORR) is defined by the modified International Working Group (IWG) Response Criteria for MDS. In the marrow, Complete Response (CR) is <= 5% blasts present with normal maturation of all cell lines. In peripheral blood, CR is defined as hemoglobin >= 11 g/dL, ANC >= 1000/mL, and platelets >= 100,000 with 0% blasts present. Partial Response (PR) is defined the same as CR with blasts decreased by >= 50% and >= 5% blasts in the marrow.
Time Frame
Every 8 weeks up to 24 months on-study.
Secondary Outcome Measure Information:
Title
Time to Disease Progression
Description
Time to disease progression is defined as the time between day 1 cycle 1 and time to first documented disease progression. Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
Every 8 weeks up to 24 months on-study, every 3 months in follow-up until progression of disease
Title
Hematologic Improvement, Including Transfusion Independence
Description
Hematologic measures will include total WBC and platelets
Time Frame
Every 8 weeks up to 24 months on-study
Title
Duration of Response
Description
Duration of response is defined as the time from when objective response is realized until time to first documented disease progression. Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Objective Response = CR + PR. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI or CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions.
Time Frame
Every 8 weeks up to 24 months on-study
Title
Median Time to Treatment Failure
Description
Time to treatment failure is defined as measuring the time between cycle 1 day 1 to discontinuation for any reason.
Time Frame
24 months
Title
Median Overall Survival
Description
The Length of Time, in Months, That Patients Were Alive From Their First Date of Protocol Treatment Until Death
Time Frame
24 months on-study, patients followed every 3 months in follow-up
Title
Safety and Tolerability of LBH589 in Patients With Relapsed/Refractory MDS by Measuring the Number of Participants With Adverse Events
Description
The reported incidence of AEs and SAEs with an onset on or after the initiation of therapy was graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytological documented diagnosis of myelodysplastic syndrome (MDS). Male or female patients aged >= 18 years old. MDS patients who have failed hypomethylating (azacitidine or decitabine) therapy. Patients with 5q-cytogenic abnormalities must also have progressed on or been intolerant to lenalidomide. Patients with up to and including 30% blasts (FAB RAEB-T) will be eligible to enroll. CMML with >= 5% blasts will be eligible to enroll. ECOG PS 0, 1 or 2. Laboratory values must be as follows: Bilirubin <= 1.5 mg/dL AST/SGOT <= 2.5 x ULN ALT/SGPT Creatinine <= 2.0 mg/dL or 24-hour Creatinine Clearance >= 50 ml/min Albumin >= 3 g/dL Potassium >= lower limit normal (LLN) Phosphorous >= LLN Calcium >= LLN Magnesium >= LLN Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to start of treatment. Life expectancy >= 12 weeks. Exclusion Criteria: Prior treatment with an HDAC inhibitor. Prior intensive chemotherapy or high dose ara-C (>= 1 gm/m2) More than one prior single agent chemotherapy regimen. Prior hydroxyurea for cytoreduction will be permitted however. Impaired cardiac function Active CNS disease, including leptomeningeal metastases. Unresolved diarrhea > CTCAE grade 1. Chemotherapy, investigational drug therapy, major surgery < 4 weeks prior to starting study drug or patients that have not recovered from side effects of previous therapy. Patient is < 5 years free of another primary malignancy except if the other primary malignancy is not currently clinically significant or requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed. Women who are pregnant or breast feeding or women of childbearing potential (WOCBP) not willing to use a double barrier method of contraception during the study and 3 months after the end of treatment. One of these methods of contraception must be a barrier method. Male patients whose sexual partners are WOCBP not using a double method of contraception during the study and 3 months after the end of treatment. One of these methods must be a condom. Patients with gastrointestinal (GI) tract disease, causing the inability to take oral medication, malabsorption syndrome, a requirement for intravenous (IV) alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's disease, ulcerative colitis). Other concurrent severe, uncontrolled systemic fungal, bacterial, viral or other infection or intercurrent illness, including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Patients with uncontrolled coagulopathy. Abnormal thyroid function (TSH or free T4) detected at screening. Patients with known hypothyroidism who are stable on thyroid replacement are eligible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ian W. Flinn, M.D.
Organizational Affiliation
SCRI Development Innovations, LLC
Official's Role
Study Chair
Facility Information:
Facility Name
Florida Cancer Specialists
City
Fort Myers
State/Province
Florida
ZIP/Postal Code
33901
Country
United States
Facility Name
Northeast Georgia Medical Center
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501
Country
United States
Facility Name
Consultants in Blood Disorders and Cancer
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40207
Country
United States
Facility Name
Center for Cancer and Blood Disorders
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20817
Country
United States
Facility Name
Oncology Hematology Care
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
Chattanooga Oncology Hematology Associates
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
Tennessee Oncology, PLLC
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37023
Country
United States

12. IPD Sharing Statement

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LBH589 in Refractory Myelodysplastic Syndromes (MDS)

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