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Safety, Pharmacokinetics, and Pharmacodynamics of Oral Azacitidine in Subjects With Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia and Acute Myelogenous Leukemia

Phase 1
Completed
Conditions
Myelodysplastic Syndromes (MDS)
Chronic Myelomonocytic Leukemia (CMML)
Acute Myelogenous Leukemia (AML)
Interventions
Registration Number
NCT00528983
Lead Sponsor
Celgene
Brief Summary

The purpose of this study is to determine whether a tablet form of azacitidine that taken by mouth is safe. This Phase I study will also look at different doses and different treatment schedules in order to better understand the effects (positive and negative) of oral azacitidine on the body and on the disease MDS, AML and CMML.

Detailed Description

Optional Extension Phase (OEP) to the AZA PH US 2007 CL 005 study which allows subjects who continue to receive oral azacitidine and have stable disease or are demonstrating clinical benefit as assessed by the Investigator, and have consented to participate, may enter the OEP of this study (at their current doses) at the start of their next cycle.

Subjects who are entering the OEP should be discontinued from Part 1 or Part 2 protocol prescribed therapy in the AZA PH US 2007 CL 005 study.

Subjects may continue to receive oral azacitidine in the OEP until they meet the criteria for study discontinuation or oral azacitidine becomes commercially available. Subjects discontinuing from the OEP will have an OEP discontinuation visit 28 days after the last dose of study drug or at study withdrawal.

Primary Objective of OEP is to evaluate long term safety of oral azacitidine.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
133
Inclusion Criteria
  • 18 years or older.
  • Diagnosis of low or Int-1 risk MDS
  • Low platelet count, and/or low hemoglobin, and/or RBC transfusion-dependent and/or platelet transfusion-dependent
  • ECOG Performance status 0-2
  • Standard safety inclusion for serum creatinine, AST, ALT, bilirubin.
  • Serum bicarbonate greater than or equal to 20 mEq/L.
  • Use of acceptable birth control.
  • Signed, written informed consent.
Exclusion Criteria
  • Diagnosis of acute PML.
  • Previous or concurrent malignancy.
  • Prior treatment with azacitidine or other demethylating agents.
  • Treatment with any anticancer therapy or investigational drugs within 21 days.
  • Hypersensitivity to azacitidine or mannitol.
  • Presence of GI disease.
  • Active, uncontrolled infection.
  • Known Human Immunodeficiency Virus (HIV) or Hepatitis C, or known active viral Hepatitis B.
  • Breastfeeding or Pregnant females;
  • Presence of serious illness, medical condition, or other medical history which would be likely to interfere with a subject's participation in the study or with the interpretation of the results.
  • Current congestive heart failure (NY Heart Association Class III-IV), unstable angina or angina requiring surgical or medical intervention within 6 months, myocardial infarct within 6 months, or uncontrolled cardiac arrhythmia.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Subcutaneous (SC) Azacitidine and Oral AzacitidineOral AzacitidineCycle 1 subjects receive SC Azacitidine for first 7 days of 28 day cycle. For Cycle 2 and beyond subjects receive Oral Azacitidine (experimental) for first 7 days of 28 day cycle.
Oral AzacitidineOral AzacitidineSubjects receive Oral Azacitidine (experimental) QD or BID for the first 14 or 21 days of 28 day cycle.
Subcutaneous (SC) Azacitidine and Oral AzacitidineSubcutaneous (SC) AzacitidineCycle 1 subjects receive SC Azacitidine for first 7 days of 28 day cycle. For Cycle 2 and beyond subjects receive Oral Azacitidine (experimental) for first 7 days of 28 day cycle.
Primary Outcome Measures
NameTimeMethod
Maximum-tolerated dose60 months
Pharmacodynamic blood and bone marrow samples will be collected and evaluated.60 months
Safety evaluation as measured by monitoring AEs, dose limiting toxicities, scheduled lab assessments, vital sign measurements, ECGs, & physical exams for study duration. Adverse changes in physical signs/symptoms will be graded according to CTC AE V.3.0.60 months
Secondary Outcome Measures
NameTimeMethod
Efficacy assessed by evidence of response (MDS subjects) and/or hematologic improvement (MDS subjects) examined using IWG criteria.60 months
Biologically active dose based on safety, PK and PD data.60 months

Trial Locations

Locations (18)

Institute for Translational Oncology Research IRB

🇺🇸

Greenville, North Carolina, United States

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

Central Indiana Cancer Centers

🇺🇸

Indianapolis, Indiana, United States

Kansas University Medical Center

🇺🇸

Westwood, Kansas, United States

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

New York Oncology Hematology P.C.

🇺🇸

Albany, New York, United States

Gabrail Cancer Center

🇺🇸

Canton, Ohio, United States

Virginia Oncology Associates

🇺🇸

Norfolk, Virginia, United States

Yakima Valley Memorial Hospital/ North Star Lodge

🇺🇸

Yakima, Washington, United States

HOAST

🇺🇸

San Antonio, Texas, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Kansas City VA Medical Center University of Kansas Medical Center

🇺🇸

Kansas City, Missouri, United States

Texas Oncology Cancer Care

🇺🇸

Austin, Texas, United States

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