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Guadecitabine in Treating Patients With Higher-Risk Myelodysplastic Syndromes

Primary Purpose

High Risk Myelodysplastic Syndrome

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Guadecitabine
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for High Risk Myelodysplastic Syndrome

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with higher risk MDS (International Prognostic Scoring System [IPSS] int-2 or high; or >= 10% blasts as defined by World Health Organization [WHO])

    • No prior intensive chemotherapy or high-dose cytarabine (>= 1 g/m^2)
    • Prior biologic therapies (=< 1 cycle of prior decitabine or azacitidine), targeted therapies, or single agent chemotherapy is allowed
    • Off chemotherapy for 2 weeks prior to entering this study with no toxic effects of that therapy, unless there is evidence of rapidly progressive disease
    • Hydroxyurea is permitted for control of counts prior to treatment
    • Hematopoietic growth factors are allowed
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2
  • Serum creatinine =< 1.5 mg/dL
  • Serum bilirubin =< 1.5 x upper limit of normal (ULN)
  • Aspartate transaminase (AST) or alanine transaminase (ALT) =< 2.5 x ULN
  • Alkaline phosphatase =< 2.5 x ULN
  • Provide signed written informed consent
  • Capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent
  • Female patients of childbearing potential must have a negative pregnancy test within 2 weeks prior to entering this study
  • Women who are able to become pregnant and men who can father a child must use birth control while on study and for at least 8 weeks after your last dose of study drug(s); acceptable birth control includes a condom or a diaphragm with spermicidal jelly; and birth control methods that are taken by mouth, injected, or implanted; if you are already using birth control, you must check with the study staff to make sure that it is considered one of the acceptable forms to use in this study

Exclusion Criteria:

  • Current concomitant chemotherapy, radiation therapy, or immunotherapy other than as specified in the protocol
  • Use of investigational agents within 30 days or any anticancer therapy within 2 weeks prior to entering this study with the exception of hydroxyurea; the patient must have recovered from all acute toxicities from any previous therapy
  • Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment
  • Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment)
  • Pregnant or lactating patients
  • Any significant concurrent disease, illness, or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow up, or interpretation of study results
  • Any concurrent malignancy

    • Exceptions

      • Patients with treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are eligible for this study if definitive treatment for the condition has been completed
      • Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen (PSA) values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed

Sites / Locations

  • M D Anderson Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (guadecitabine)

Arm Description

Patients receive guadecitabine SC on days 1-5. Treatment repeats every 4-8 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity. Patients with stable disease after 3 courses are taken off therapy after 6 courses. Patients may continue to receive treatment after 24 courses if the investigator determines it is in the patient's best interest.

Outcomes

Primary Outcome Measures

Complete response rates
Estimated along with 95% credible intervals.

Secondary Outcome Measures

Incidence of adverse events
The method of Thall, Simon, and Estey will be used to monitor toxicity (adverse events). Summarized using frequency and percentage, by organ type, grade and attribution.
Mortality rate
The method of Thall, Simon, and Estey will be used to monitor mortality.
Overall response rates
Estimated along with 95% credible intervals.
Overall survival
Estimated using the Kaplan-Meier method for each patient cohort.
Time to acute myeloid leukemia (AML) transformation
Estimated using the Kaplan-Meier method for each patient cohort.
Event-free survival
Estimated using the Kaplan-Meier method for each patient cohort.

Full Information

First Posted
May 2, 2014
Last Updated
October 3, 2023
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02131597
Brief Title
Guadecitabine in Treating Patients With Higher-Risk Myelodysplastic Syndromes
Official Title
Phase 2 Study of SGI-110 in Patients With Higher Risk MDS
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 10, 2014 (Actual)
Primary Completion Date
November 1, 2023 (Anticipated)
Study Completion Date
November 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase II trial studies how well guadecitabine works in treating patients with myelodysplastic syndromes that are at higher risk for becoming acute myeloid leukemia. Guadecitabine may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
Detailed Description
PRIMARY OBJECTIVES: I. To evaluate the complete response (CR) rate with SGI-110 (guadecitabine) in patients with higher risk myelodysplastic syndrome (MDS). SECONDARY OBJECTIVES: I. Overall response rate, survival, transformation to acute myeloid leukemia (AML), transfusion independence. II. Safety and toxicity. OUTLINE: Patients receive guadecitabine subcutaneously (SC) on days 1-5. Treatment repeats every 4-8 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity. Patients with stable disease after 3 courses are taken off therapy after 6 courses. Patients may continue to receive treatment after 24 courses if the investigator determines it is in the patient's best interest. After completion of study treatment, patients are followed up at 30 days, and then every 2 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
High Risk Myelodysplastic Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
107 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (guadecitabine)
Arm Type
Experimental
Arm Description
Patients receive guadecitabine SC on days 1-5. Treatment repeats every 4-8 weeks for up to 24 courses in the absence of disease progression or unacceptable toxicity. Patients with stable disease after 3 courses are taken off therapy after 6 courses. Patients may continue to receive treatment after 24 courses if the investigator determines it is in the patient's best interest.
Intervention Type
Drug
Intervention Name(s)
Guadecitabine
Other Intervention Name(s)
DNMT inhibitor SGI-110, S110, SGI-110
Intervention Description
Given SC
Primary Outcome Measure Information:
Title
Complete response rates
Description
Estimated along with 95% credible intervals.
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Incidence of adverse events
Description
The method of Thall, Simon, and Estey will be used to monitor toxicity (adverse events). Summarized using frequency and percentage, by organ type, grade and attribution.
Time Frame
Up to 5 years
Title
Mortality rate
Description
The method of Thall, Simon, and Estey will be used to monitor mortality.
Time Frame
At 3 months
Title
Overall response rates
Description
Estimated along with 95% credible intervals.
Time Frame
Up to 5 years
Title
Overall survival
Description
Estimated using the Kaplan-Meier method for each patient cohort.
Time Frame
Up to 5 years
Title
Time to acute myeloid leukemia (AML) transformation
Description
Estimated using the Kaplan-Meier method for each patient cohort.
Time Frame
Up to 5 years
Title
Event-free survival
Description
Estimated using the Kaplan-Meier method for each patient cohort.
Time Frame
Up to 5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with higher risk MDS (International Prognostic Scoring System [IPSS] int-2 or high; or >= 10% blasts as defined by World Health Organization [WHO]) No prior intensive chemotherapy or high-dose cytarabine (>= 1 g/m^2) Prior biologic therapies (=< 1 cycle of prior decitabine or azacitidine), targeted therapies, or single agent chemotherapy is allowed Off chemotherapy for 2 weeks prior to entering this study with no toxic effects of that therapy, unless there is evidence of rapidly progressive disease Hydroxyurea is permitted for control of counts prior to treatment Hematopoietic growth factors are allowed Eastern Cooperative Oncology Group (ECOG) performance status =< 2 Serum creatinine =< 1.5 mg/dL Serum bilirubin =< 1.5 x upper limit of normal (ULN) Aspartate transaminase (AST) or alanine transaminase (ALT) =< 2.5 x ULN Alkaline phosphatase =< 2.5 x ULN Provide signed written informed consent Capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent Female patients of childbearing potential must have a negative pregnancy test within 2 weeks prior to entering this study Women who are able to become pregnant and men who can father a child must use birth control while on study and for at least 8 weeks after your last dose of study drug(s); acceptable birth control includes a condom or a diaphragm with spermicidal jelly; and birth control methods that are taken by mouth, injected, or implanted; if you are already using birth control, you must check with the study staff to make sure that it is considered one of the acceptable forms to use in this study Exclusion Criteria: Current concomitant chemotherapy, radiation therapy, or immunotherapy other than as specified in the protocol Use of investigational agents within 30 days or any anticancer therapy within 2 weeks prior to entering this study with the exception of hydroxyurea; the patient must have recovered from all acute toxicities from any previous therapy Have any other severe concurrent disease, or have a history of serious organ dysfunction or disease involving the heart, kidney, liver, or other organ system that may place the patient at undue risk to undergo treatment Patients with a systemic fungal, bacterial, viral, or other infection not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment) Pregnant or lactating patients Any significant concurrent disease, illness, or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow up, or interpretation of study results Any concurrent malignancy Exceptions Patients with treated non-melanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia, regardless of the disease-free duration, are eligible for this study if definitive treatment for the condition has been completed Patients with organ-confined prostate cancer with no evidence of recurrent or progressive disease based on prostate-specific antigen (PSA) values are also eligible for this study if hormonal therapy has been initiated or a radical prostatectomy has been performed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guillermo Garcia-Manero
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
MD Anderson Cancer Center Website

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Guadecitabine in Treating Patients With Higher-Risk Myelodysplastic Syndromes

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