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Evaluating Low-dose Deferasirox (DFX) in Patients With Low-risk MDS Resistant or Relapsing After ESA Agents (LODEFI)

Primary Purpose

Myelodysplasia

Status
Recruiting
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Deferasirox
Sponsored by
University Hospital, Grenoble
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplasia focused on measuring efficacy, safety

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with MDS according to WHO 2008 criteria (refractory anemia with multilineage dysplasia, RA (refractory anemia), refractory anemia with ringed sideroblasts (RARS) including CMML-1 (chronic myelomonocytic leukemia) type 1 with <10% blasts)
  2. low risk (IPSS-R very low, low and intermediate)
  3. in primary or secondary failure after erythropoiesis stimulating agents (ESAs), (either epoetins (≥60,000 units / week), or darbepoetin (≥250 μg / week), administered for at least 12 weeks, as defined by the IWG criteria 2006 (no erythroid response at 12 weeks, or more than 15g / l decrease in Hb after response to ESAs) PS: Patients with low transfusion of less than (<) 4RBP assessed over 4 months (RBP administered for patients with Hb ≤ 9g / dl) will be accepted)
  4. age ≥ 18 years
  5. ECOG ≤2
  6. informed consent dated and signed
  7. affiliated to a social security scheme
  8. Women and men of childbearing potential must have effective contraception throughout the duration of the study and up to 4 days after the last administration of deferasirox

Exclusion Criteria:

  1. Transfusion dependent patient (≥) 2 red blood cells (RBP) per 2-month period evaluated over 4 months between M-4 and M0
  2. Patients with high-risk MDS (based on IPSS-R) and patients with other hematologic and non-haematological malignancies who should not benefit from chelation therapy due to rapid progression of their disease
  3. Ferritin <200 ng / ml
  4. Iron overload: ferritin> 1000 ng / ml
  5. Creatinine clearance according to MDRD ≤60 ml / min
  6. 5q- deletion to karyotype
  7. Patient eligible for allograft
  8. Patient participating in another interventional clinical study or exclusion period from another study
  9. History of cancer treated or untreated for less than 5 years, whether or not there are signs of relapse or metastases, with the exception of basocellular cancers.
  10. Persons referred to in Articles L1121-5 to L1121-8 of the CSP: pregnant woman, parturient, mother who is breastfeeding, person deprived of liberty by judicial or administrative decision, person subject to a legal protection measure, can not not be included in clinical trials.

Sites / Locations

  • CHU de GRENOBLE ALPESRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Deferasirox

Arm Description

efficacy of 3.5mg/kg/day

Outcomes

Primary Outcome Measures

Percentage of patients without transfusion-dependence at 12 months.
Percentage of patients without transfusion-dependence at 12 months.

Secondary Outcome Measures

Full Information

First Posted
December 22, 2017
Last Updated
May 19, 2022
Sponsor
University Hospital, Grenoble
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT03387475
Brief Title
Evaluating Low-dose Deferasirox (DFX) in Patients With Low-risk MDS Resistant or Relapsing After ESA Agents
Acronym
LODEFI
Official Title
Phase II Trial Evaluating Low-dose Deferasirox (DFX) in Patients With Low-risk (MDS) Myelodysplastic Syndrome Resistant or Relapsing After ESA Agents (LODEFI)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Recruiting
Study Start Date
February 20, 2018 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Grenoble
Collaborators
Novartis

4. Oversight

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

5. Study Description

Brief Summary
Patients with low-risk MDS verifying the eligibility criteria may be included in the study.
Detailed Description
Patients will receive the number of DFX tablets (Exjade, cp film-coated, 90mg or 360mg), in relation to their body weight to be closer to 3.5mg / kg / d for 12 months. At one month and six months of treatment, the residual plasma levels of DFX will be measured in patients (sent to the Bordeaux laboratory of Biochemistry, Pr Molimard) to allow the dosage to be adjusted (plasma objective of 3 μM). At inclusion (J1) and at 6 months of treatment, a dosage of NTBI and hepcidine will be performed. If patients become transfusion-dependent (≥) 2 packed red cells (RBP) per 2-month period evaluated over 6 months, they will stop low-dose DFX and go out of protocol to receive DFX at 20mg / kg (according to EMEA authorization) for iron chelation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplasia
Keywords
efficacy, safety

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Deferasirox
Arm Type
Experimental
Arm Description
efficacy of 3.5mg/kg/day
Intervention Type
Drug
Intervention Name(s)
Deferasirox
Other Intervention Name(s)
exjade
Intervention Description
iron chelation
Primary Outcome Measure Information:
Title
Percentage of patients without transfusion-dependence at 12 months.
Description
Percentage of patients without transfusion-dependence at 12 months.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with MDS according to WHO 2008 criteria (refractory anemia with multilineage dysplasia, RA (refractory anemia), refractory anemia with ringed sideroblasts (RARS) including CMML-1 (chronic myelomonocytic leukemia) type 1 with <10% blasts) low risk (IPSS-R very low, low and intermediate) in primary or secondary failure after erythropoiesis stimulating agents (ESAs), (either epoetins (≥60,000 units / week), or darbepoetin (≥250 μg / week), administered for at least 12 weeks, as defined by the IWG criteria 2006 (no erythroid response at 12 weeks, or more than 15g / l decrease in Hb after response to ESAs) PS: Patients with low transfusion of less than (<) 4RBP assessed over 4 months (RBP administered for patients with Hb ≤ 9g / dl) will be accepted) age ≥ 18 years ECOG ≤2 informed consent dated and signed affiliated to a social security scheme Women and men of childbearing potential must have effective contraception throughout the duration of the study and up to 4 days after the last administration of deferasirox Exclusion Criteria: Transfusion dependent patient (≥) 2 red blood cells (RBP) per 2-month period evaluated over 4 months between M-4 and M0 Patients with high-risk MDS (based on IPSS-R) and patients with other hematologic and non-haematological malignancies who should not benefit from chelation therapy due to rapid progression of their disease Ferritin <200 ng / ml Iron overload: ferritin> 1000 ng / ml Creatinine clearance according to MDRD ≤60 ml / min 5q- deletion to karyotype Patient eligible for allograft Patient participating in another interventional clinical study or exclusion period from another study History of cancer treated or untreated for less than 5 years, whether or not there are signs of relapse or metastases, with the exception of basocellular cancers. Persons referred to in Articles L1121-5 to L1121-8 of the CSP: pregnant woman, parturient, mother who is breastfeeding, person deprived of liberty by judicial or administrative decision, person subject to a legal protection measure, can not not be included in clinical trials.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sophie Park
Phone
0476762777
Email
Spark@chu-grenoble.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Valérie Rolland
Phone
0476765096
Email
VRolland-neyret@chu-grenoble.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sophie Park
Organizational Affiliation
University Hospital, Grenoble
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU de GRENOBLE ALPES
City
Grenoble
ZIP/Postal Code
38043
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sophie PARK
Phone
04 76 76 27 77
Email
SPark@chu-grenoble.fr

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
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Evaluating Low-dose Deferasirox (DFX) in Patients With Low-risk MDS Resistant or Relapsing After ESA Agents

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