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Azacitidine With or Without Ceplene/Interleukin-2 in Patients With Higher Risk Myelodysplastic Syndromes

Primary Purpose

Myelodysplastic Syndromes

Status
Withdrawn
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Ceplene®, IL-2, Azacitidine
Azacitidine
Sponsored by
Groupe Francophone des Myelodysplasies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes focused on measuring IPSS, High risk, Azacitidine, Ceplene

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥ 18 years
  • Must understand and voluntarily sign an informed consent form
  • Must be able to adhere to the study visit schedule and other protocol requirements
  • Documented diagnosis of MDS according to WHO classification, that meets IPSS criteria for intermediate-2 or high-risk disease
  • Must have achieved a response (CR, PR, mCR or HI according to IWG 2006 criteria) after 6 cycles of Azacitidine.
  • Patients must have ECOG performance status (PS) of 0 - 2.
  • Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must have a negative serum or urine pregnancy test within 2 weeks prior to beginning treatment on this study. Nursing patients are excluded.
  • Creatinine clearance >50 ml/min
  • Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) < 3.0 x upper limit of normal (ULN)
  • Serum total bilirubin < 1.5 mg/dL. (except for unconjugated hyperbilirubinemia due to Gilbert's disease or secondary to MDS).

Exclusion Criteria:

  • Known positive status for human immunodeficiency virus (HIV) or hepatitis B or C
  • Uncontrolled intercurrent illness including, but not limited to uncontrolled infection, symptomatic congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Patients receiving any other standard or investigational cytotoxic treatment for their hematologic malignancy
  • Any medical condition which in the opinion of the investigator places the patient at an unacceptably high risk for toxicities
  • Prior history of malignancy other than MDS (except basal cell or squamous cell carcinoma or carcinoma in situ of the cervix or breast) unless the subject has been free of disease for ≥ 3 years
  • Class III or IV cardiac disease, hypotension or severe hypertension, vasomotor instability, serious or uncontrolled cardiac dysrhythmias (including ventricular arrhythmias) at any time, acute myocardial infarction within the past 12 months, active uncontrolled angina pectoris or symptomatic arteriosclerotic blood vessel disease
  • History of seizures, central nervous disorders, stroke within the last 12 months, or psychiatric disability thought to be clinically significant in the opinion of the investigator
  • Prior history of autoimmune disease (including but not limited to systemic lupus, inflammatory bowel disease, and psoriasis)
  • Patients with active peptic or esophageal ulcer disease or with past peptic ulcer or esophageal disease with a history of bleeding
  • Patients continuing systemic treatment with clonidine, steroids, and/or H2 receptor blocking agents Patients with a history of hypersensitivity to histamine or histamine products, severe allergies to food or contrast media requiring treatment within the last five years.

Sites / Locations

  • CHU de Bicêtre
  • CHU Cochin
  • CHU d'Amiens
  • CHU Angers
  • CH d'Avignon
  • Hôpital de la Côte Basque
  • Hopital Avicenne
  • CHU de Caen
  • CHU de
  • Centre Hospitalier Sud-Francilien
  • CHU Grenoble
  • Hôpital Versailles
  • Hôpital Saint Vincent
  • CHRU Hurriez
  • CHRU Limoges
  • Hôpital Edouard Heriot, dpt Hématologie Clinique
  • Hôpital Paoli-Calmettes
  • Hematology Dpt, Hopital de l'Hotel Dieu
  • CHU Archet
  • Hopital Saint Louis
  • Hôpital Saint Antoine
  • Centre Hospitalier Joffre
  • Hôpital Jean-Bernard
  • CHRU de Reims
  • Centre Henri Bequerel
  • Centre Hospitalier Universitaire de STRASBOURG
  • Hopital Purpan Service d'Hématologie Clinique
  • Hopital Bretonneau

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ceplene® / IL2 + Azacitidine

Azacitidine

Arm Description

Azacitidine 75 mg/m2 subcutaneously daily for 7 days every 4 weeks. Ceplene® / IL2: Patients will receive Ceplene (EpiCept Corporation, Tarrytown, NY) at 0.5 mg subcutaneous twice daily and human recombinant IL-2 (aldesleukin; Novartis) 16 400 U/kg subcutaneous twice daily during 15 days for up to 10 cycles, on days 8 to 21 of AZA cycles.

Azacitidine 75 mg/m2 subcutaneously daily for 7 days every 4 weeks

Outcomes

Primary Outcome Measures

Time to progression according to IWG2006 criteria
Progression will be assessed by monitoring the bone marrow, blood and hematologic supportive care according IWG 2006 criteria .

Secondary Outcome Measures

Types and numbers of adverse events occuring in all treated patients
The safety profile will be determine by assessements of clinical symptoms, physical examinations, vital signs and clinical laboratory tests. The types and numbers of adverse events occuring in all treated patients will be tabulated.
Improvement of the quality and the duration of responses compared to maintenance with AZA alone
The response will be assessed every 4 cycles according IWG 2006 criteria and it will be evaluated if there is an improvement of the level of response and the response duration

Full Information

First Posted
March 7, 2011
Last Updated
March 19, 2014
Sponsor
Groupe Francophone des Myelodysplasies
Collaborators
EpiCept Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01324960
Brief Title
Azacitidine With or Without Ceplene/Interleukin-2 in Patients With Higher Risk Myelodysplastic Syndromes
Official Title
A Phase I and Phase II Study of the Efficacy and Safety of Maintenance Treatment With Azacitidine With or Without Ceplene/Interleukin-2 in Patients With Higher Risk Myelodysplastic Syndromes Who Achieved Hematological Response to Azacitidine
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Withdrawn
Study Start Date
March 2011 (undefined)
Primary Completion Date
December 2014 (Anticipated)
Study Completion Date
December 2014 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Groupe Francophone des Myelodysplasies
Collaborators
EpiCept Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A phase I study of azacitidine with Ceplene/interleukin-2 will first evaluate the safety and tolerability of this regimen in patients with higher risk myelodysplastic syndromes (MDS) who achieved a hematological response after 6 cycles of azacitidine. After approval by an independent Data Safety Monitoring Board (DSMB), the phase I study will be followed by an open label randomized phase II study designed to characterize the efficacy, safety, and tolerability of the addition of Ceplene/interleukin-2 to azacytidine in patients with higher risk myelodysplastic syndrome (MDS) who achieved a hematological response after 6 cycles of azacitidine.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes
Keywords
IPSS, High risk, Azacitidine, Ceplene

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ceplene® / IL2 + Azacitidine
Arm Type
Experimental
Arm Description
Azacitidine 75 mg/m2 subcutaneously daily for 7 days every 4 weeks. Ceplene® / IL2: Patients will receive Ceplene (EpiCept Corporation, Tarrytown, NY) at 0.5 mg subcutaneous twice daily and human recombinant IL-2 (aldesleukin; Novartis) 16 400 U/kg subcutaneous twice daily during 15 days for up to 10 cycles, on days 8 to 21 of AZA cycles.
Arm Title
Azacitidine
Arm Type
Active Comparator
Arm Description
Azacitidine 75 mg/m2 subcutaneously daily for 7 days every 4 weeks
Intervention Type
Drug
Intervention Name(s)
Ceplene®, IL-2, Azacitidine
Other Intervention Name(s)
Human recombinant IL-2 = Aldesleukin® (Novartis), Azacitidine = Vidaza® (Celgene)
Intervention Description
Azacitidine: 75 mg/m2 subcutaneously daily for 7 days every 4 weeks. Ceplene® / IL2: Patients will receive Ceplene at 0.5 mg subcutaneous twice daily and human recombinant IL-2 at 16 400 U/kg subcutaneous twice daily during 15 days for up to 10 cycles, on days 8 to 21 of AZA cycles.
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Other Intervention Name(s)
Azacitidine = Vidaza® (Celgene)
Intervention Description
Azacitidine 75 mg/m2 subcutaneously daily for 7 days every 4 weeks
Primary Outcome Measure Information:
Title
Time to progression according to IWG2006 criteria
Description
Progression will be assessed by monitoring the bone marrow, blood and hematologic supportive care according IWG 2006 criteria .
Time Frame
Every 4 cycles (during average 2 years)
Secondary Outcome Measure Information:
Title
Types and numbers of adverse events occuring in all treated patients
Description
The safety profile will be determine by assessements of clinical symptoms, physical examinations, vital signs and clinical laboratory tests. The types and numbers of adverse events occuring in all treated patients will be tabulated.
Time Frame
Every cycle, during the follow-up on average during 2 years
Title
Improvement of the quality and the duration of responses compared to maintenance with AZA alone
Description
The response will be assessed every 4 cycles according IWG 2006 criteria and it will be evaluated if there is an improvement of the level of response and the response duration
Time Frame
While patient is on study, during follow up on average during 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Must understand and voluntarily sign an informed consent form Must be able to adhere to the study visit schedule and other protocol requirements Documented diagnosis of MDS according to WHO classification, that meets IPSS criteria for intermediate-2 or high-risk disease Must have achieved a response (CR, PR, mCR or HI according to IWG 2006 criteria) after 6 cycles of Azacitidine. Patients must have ECOG performance status (PS) of 0 - 2. Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must have a negative serum or urine pregnancy test within 2 weeks prior to beginning treatment on this study. Nursing patients are excluded. Creatinine clearance >50 ml/min Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) < 3.0 x upper limit of normal (ULN) Serum total bilirubin < 1.5 mg/dL. (except for unconjugated hyperbilirubinemia due to Gilbert's disease or secondary to MDS). Exclusion Criteria: Known positive status for human immunodeficiency virus (HIV) or hepatitis B or C Uncontrolled intercurrent illness including, but not limited to uncontrolled infection, symptomatic congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Patients receiving any other standard or investigational cytotoxic treatment for their hematologic malignancy Any medical condition which in the opinion of the investigator places the patient at an unacceptably high risk for toxicities Prior history of malignancy other than MDS (except basal cell or squamous cell carcinoma or carcinoma in situ of the cervix or breast) unless the subject has been free of disease for ≥ 3 years Class III or IV cardiac disease, hypotension or severe hypertension, vasomotor instability, serious or uncontrolled cardiac dysrhythmias (including ventricular arrhythmias) at any time, acute myocardial infarction within the past 12 months, active uncontrolled angina pectoris or symptomatic arteriosclerotic blood vessel disease History of seizures, central nervous disorders, stroke within the last 12 months, or psychiatric disability thought to be clinically significant in the opinion of the investigator Prior history of autoimmune disease (including but not limited to systemic lupus, inflammatory bowel disease, and psoriasis) Patients with active peptic or esophageal ulcer disease or with past peptic ulcer or esophageal disease with a history of bleeding Patients continuing systemic treatment with clonidine, steroids, and/or H2 receptor blocking agents Patients with a history of hypersensitivity to histamine or histamine products, severe allergies to food or contrast media requiring treatment within the last five years.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Céline BERTHON, MD
Organizational Affiliation
Groupe Francophone des Myelodisplasies
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Bruno QUESNEL, MD, PhD
Organizational Affiliation
Groupe Francophone des Myelodisplasies
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Pierre Fenaux, MD
Organizational Affiliation
Groupe francophone des Myelodisplasies
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU de Bicêtre
City
Le Kremlin-Bicêtre
State/Province
Ile de France
ZIP/Postal Code
94275
Country
France
Facility Name
CHU Cochin
City
Paris
State/Province
Ile de France
ZIP/Postal Code
75679
Country
France
Facility Name
CHU d'Amiens
City
Amiens
ZIP/Postal Code
80054
Country
France
Facility Name
CHU Angers
City
Angers
ZIP/Postal Code
43033
Country
France
Facility Name
CH d'Avignon
City
Avignon
ZIP/Postal Code
84000
Country
France
Facility Name
Hôpital de la Côte Basque
City
Bayonne
ZIP/Postal Code
64100
Country
France
Facility Name
Hopital Avicenne
City
Bobigny
ZIP/Postal Code
93009
Country
France
Facility Name
CHU de Caen
City
Caen
ZIP/Postal Code
14033
Country
France
Facility Name
CHU de
City
Clermont Ferrand
ZIP/Postal Code
63058
Country
France
Facility Name
Centre Hospitalier Sud-Francilien
City
Corbeil-Essonnes
ZIP/Postal Code
91106
Country
France
Facility Name
CHU Grenoble
City
Grenoble
ZIP/Postal Code
38043
Country
France
Facility Name
Hôpital Versailles
City
Le Chesnay
ZIP/Postal Code
78157
Country
France
Facility Name
Hôpital Saint Vincent
City
Lille
ZIP/Postal Code
59020
Country
France
Facility Name
CHRU Hurriez
City
Lille
ZIP/Postal Code
59057
Country
France
Facility Name
CHRU Limoges
City
Limoges
ZIP/Postal Code
87046
Country
France
Facility Name
Hôpital Edouard Heriot, dpt Hématologie Clinique
City
Lyon
ZIP/Postal Code
69437
Country
France
Facility Name
Hôpital Paoli-Calmettes
City
Marseille
ZIP/Postal Code
13273
Country
France
Facility Name
Hematology Dpt, Hopital de l'Hotel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
CHU Archet
City
Nice
ZIP/Postal Code
06202
Country
France
Facility Name
Hopital Saint Louis
City
Paris
ZIP/Postal Code
75475
Country
France
Facility Name
Hôpital Saint Antoine
City
Paris
ZIP/Postal Code
75571
Country
France
Facility Name
Centre Hospitalier Joffre
City
Perpignan
ZIP/Postal Code
66046
Country
France
Facility Name
Hôpital Jean-Bernard
City
Poitiers
ZIP/Postal Code
86021
Country
France
Facility Name
CHRU de Reims
City
Reims
ZIP/Postal Code
51092
Country
France
Facility Name
Centre Henri Bequerel
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Name
Centre Hospitalier Universitaire de STRASBOURG
City
Strasbourg
ZIP/Postal Code
67098
Country
France
Facility Name
Hopital Purpan Service d'Hématologie Clinique
City
Toulouse
Country
France
Facility Name
Hopital Bretonneau
City
Tours
ZIP/Postal Code
37044
Country
France

12. IPD Sharing Statement

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Azacitidine With or Without Ceplene/Interleukin-2 in Patients With Higher Risk Myelodysplastic Syndromes

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