Guadecitabine in Treating Patients With Higher-Risk Myelodysplastic Syndromes

NCT02131597 | Completed Phase 2 Results FDA Drug

• 2 other identifiers: 2013-0901NCI-2014-02377
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

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.

Conditions

High Risk Myelodysplastic Syndrome

Outcome Measures

Primary Outcomes (1)

• Number of Participants With a Complete Response (CR)

  Complete Response is Normalization of the peripheral blood and bone marrow with \</= 5% bone marrow blasts, a peripheral blood granulocyte count \>/= 1.0 x 10\^9/L, and a platelet count \>/= 100 x 10\^9/L. Hemoglobin \>/= 11 g/dL at any point while on treatment after the first cycle of therapy.

  At cycle 3 and cycle 6, cycles are up every 4 to 8 weeks. Up to 9 years, 8 months and 15 days.

Secondary Outcomes (2)

• Overall Survival

  Up to 9 years, 8 months and 15 days

• Time to Acute Myeloid Leukemia (AML) Transformation

  Up to 9 years, 8 months and 15 days

Study Arms (1)

Treatment (guadecitabine)

EXPERIMENTAL

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.

Drug: Guadecitabine

Interventions

Guadecitabine DRUG

Given SC

Also known as: DNMT inhibitor SGI-110, S110, SGI-110

Treatment (guadecitabine)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

M D Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Publications (1)

• Urrutia S, Bose P, Alvarado Y, Borthakur G, Ravandi F, Daver N, Pemmaraju N, Jabbour E, Takahashi K, Kadia T, DiNardo C, Kornblau S, Kanagal-Shamanna R, Huang X, Bodden K, Kantarjian H, Garcia-Manero G. Prospective performance of the IWG-2023 criteria and IPSS-M in a phase 2 trial of guadecitabine for higher-risk MDS or CMML. Blood Neoplasia. 2024 Mar 29;1(2):100008. doi: 10.1016/j.bneo.2024.100008. eCollection 2024 Jun.

  PMID: 40454402 DERIVED

Related Links

• MD Anderson Cancer Center

MeSH Terms

Interventions

guadecitabine

Results Point of Contact

• Title: Guillermo Garcia-Manero, MD/ Professor
• Organization: The University of Texas MD Anderson Cancer Center

ggarciam@mdanderson.org

713-745-3428

Study Officials

• Guillermo Garcia-Manero

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 2, 2014
• First Posted: May 6, 2014
• Study Start: November 10, 2014
• Primary Completion: July 25, 2024
• Study Completion: July 25, 2024
• Last Updated: July 17, 2025
• Results First Posted: July 17, 2025

Record last verified: 2025-06

Locations

US (1)