NCT02147873

Brief Summary

This is a randomized double blind placebo controlled study of azacitidine with or without birinapant in subjects with higher risk Myelodysplastic syndrome, secondary MDS or myelomonocytic leukemia (CMMoL) who are naïve, to azacitidine therapy. Pre-clinical and mechanistic studies support that azacitidine may modulate pathways that enable birinapant-mediated anti-tumor activity.

Trial Health

60
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
118

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Jun 2014

Geographic Reach
4 countries

76 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 13, 2014

Completed
15 days until next milestone

First Posted

Study publicly available on registry

May 28, 2014

Completed
4 days until next milestone

Study Start

First participant enrolled

June 1, 2014

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2016

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2016

Completed
Last Updated

October 20, 2016

Status Verified

October 1, 2016

Enrollment Period

1.6 years

First QC Date

May 13, 2014

Last Update Submit

October 18, 2016

Conditions

Keywords

MDSCMMLmyelodysplastic syndromechronic myelomonocytic leukemiaTL32711TL32711-0094azacitidinebirinapanthigher risknaivedouble blindplaceboplacebo controlledrandomized

Outcome Measures

Primary Outcomes (1)

  • Response Rate

    participants will be followed for until disease progression an expected average of 1 year

Secondary Outcomes (7)

  • Hematologic improvement

    participants will be followed for until disease progression an expected average of 1 year

  • Relapse free survival

    An expected average of 2 year post last study dose

  • Time to respond

    participants will be followed for until disease progression an expected average of 1 year

  • Change in transfusion requirements

    participants will be followed for until disease progression an expected average of 1 year

  • duration of response

    participants will be followed for until disease progression an expected average of 1 year

  • +2 more secondary outcomes

Other Outcomes (1)

  • exploratory translational biomarkers for antitumor effect

    30 days

Study Arms (2)

azacitidine with birinapant

ACTIVE COMPARATOR

Azacitidine 75 mg/m2 IV on days 1-5, 8 \& 9 OR days 1-7 and birinapant 13 mg/m2 IV twice a week (days 1 \& 4) for 3 out of 4 weeks

Drug: birinapantDrug: Azacitidine

Azacitidine and placebo

PLACEBO COMPARATOR

Azacitidine 75mg/m2 IV days 1-5, 8 \& 9 OR days 1-7 and placebo IV twice a week (days 1 \& 4) for 3 out of 4 weeks

Drug: AzacitidineDrug: Placebo

Interventions

Also known as: TL32711
azacitidine with birinapant
Azacitidine and placeboazacitidine with birinapant
Azacitidine and placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Morphologically confirmed diagnosis of MDS/CMMoL according to FAB or WHO classification, including RAEB-t and MDS/MPN
  • International prognostic score-revised (IPSS-R) of \>3.5 (Intermediate, High or Very High)
  • Previously untreated with hypomethylating agents for MDS/CMMoL
  • Performance status of 0, 1 or 2 by the ECOG scale
  • Adequate renal and liver function
  • Female subjects of childbearing potential must have a negative serum pregnancy test at screening within 96 hours prior to the first study dose.
  • Female subjects of childbearing potential and male subjects with partners of childbearing potential should ensure use of a highly effective method of birth control as defined by the investigator, for example, those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly during the study and for a period of 3 months following the last dose of any drug administered during the study.

You may not qualify if:

  • Relapsed or refractory to hypomethylating agents
  • Acute myeloid leukemia (AML), except those patients with RAEB-t who are not candidates for intensive AML therapy.
  • Participated in any interventional study within 4 weeks of randomization or 5 half lives (whichever is longer).
  • Received any hematopoietic growth factors within 14 days prior to screening.
  • Prior malignancy or secondary malignancy within the prior 2 years (except in situ cervical cancer, squamous cell carcinoma or basal cell carcinoma of the skin).
  • known diagnosis of human immunodeficiency virus or chronic active Hep B or C.
  • Uncontrolled hypertension
  • Impaired cardiac function, uncontrolled cardiac arrhythmias despite medications, or clinically significant cardiac disease
  • Lack of recovery of prior adverse events to Grade ≤1 severity (National Cancer Institute Common Terminology Criteria for Adverse Events version 4) (except alopecia) due to therapy administered prior to the initiation of study drug dosing.
  • Nursing or pregnant.
  • Known allergy or hypersensitivity to any of the formulation components
  • Any concurrent disease and/or medical condition that, in the opinion of the Investigator, would prevent the subject's participation.
  • History of cranial nerve palsy.
  • Being treated with anti-TNF therapies or has been treated with an anti-TNF therapy within 5 half-lives of randomization.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (76)

Palo Verde Hematology Oncology

Glendale, Arizona, 85304, United States

Location

Arizona Center for Cancer Care

Glendale, Arizona, 85306, United States

Location

Mayo Clinic

Scottsdale, Arizona, 85259, United States

Location

Arizona Oncology Associates

Tucson, Arizona, 85704, United States

Location

Ronald Reagan UCLA Medical Center

Los Angeles, California, 90095, United States

Location

North County Oncology

Oceanside, California, 92056, United States

Location

Desert Hematology Oncology Medical Group

Rancho Mirage, California, 92270, United States

Location

Stanford Hospital and Clinics

Stanford, California, 94305, United States

Location

Wellness Oncology & Hematology

West Hills, California, 91307, United States

Location

Colorado Blood Cancer Institute

Denver, Colorado, 80218, United States

Location

Cancer Specialists of North Florida

Jacksonville, Florida, 32207, United States

Location

Mayo Clinic Jacksonville

Jacksonville, Florida, 32224, United States

Location

Hematology Oncology Associates of the Treasure Coast

Port Saint Lucie, Florida, 34952, United States

Location

H. Lee Moffitt Cancer Center & Research Institute

Tampa, Florida, 33612, United States

Location

Bond Clinic PA

Winter Haven, Florida, 33880, United States

Location

Loyola University Medical Center

Maywood, Illinois, 60153, United States

Location

Simmons Cancer Institute at Southern Illinois University

Springfield, Illinois, 62794, United States

Location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Location

University of Louisville Hospital/James Graham Brown Cancer Center

Louisville, Kentucky, 40202, United States

Location

Tulane Medical Center

New Orleans, Louisiana, 70112, United States

Location

University of Maryland, Greenebaum Cancer Center

Baltimore, Maryland, 21201, United States

Location

University of Massachusetts Worcester

Worcester, Massachusetts, 01655, United States

Location

St. Joseph Mercy Hospital

Ann Arbor, Michigan, 48106, United States

Location

New Jersey Hematology Oncology Associates

Brick, New Jersey, 08724, United States

Location

Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

Location

University of New Mexico Cancer Center

Albuquerque, New Mexico, 87106, United States

Location

North Shore Hematology Oncology Associates

East Setauket, New York, 11733, United States

Location

Monter Cancer Center

Lake Success, New York, 11042, United States

Location

Columbia University Medical Center

New York, New York, 10032, United States

Location

Weill Cornell Medical College - New York-Presbyterian Hospital

New York, New York, 10065, United States

Location

Montefiore Medical Center

The Bronx, New York, 10461, United States

Location

Duke University Medical Center

Durham, North Carolina, 27710, United States

Location

Gabrail Cancer Center Research

Canton, Ohio, 44718, United States

Location

Oncology Hematology Care, Inc.

Cincinnati, Ohio, 45242, United States

Location

Oregon Health and Sciences University

Portland, Oregon, 97239, United States

Location

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, 17033, United States

Location

Medical University of South Carolina, Hollings Cancer Center

Charleston, South Carolina, 29425, United States

Location

Carolina Blood and Cancer Care Associates, P.A.

Rock Hill, South Carolina, 29732, United States

Location

Tennessee Oncology

Chattanooga, Tennessee, 37404, United States

Location

Tennessee Oncology

Nashville, Tennessee, 37203, United States

Location

The University of Texas MD Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Tyler Hematology Oncology PA

Tyler, Texas, 75701, United States

Location

Utah Cancer Specialists

Salt Lake City, Utah, 84106, United States

Location

University of Utah, Huntsman Cancer Hospital

Salt Lake City, Utah, 84112, United States

Location

Virginia Commonwealth University Massey Cancer Center

Richmond, Virginia, 23298, United States

Location

Seattle Cancer Care Alliance

Seattle, Washington, 98109, United States

Location

Royal Prince Alfred Hospital

Camperdown, New South Wales, 2050, Australia

Location

Westmead Hospital

Westmead, New South Wales, 2145, Australia

Location

Metro South Health, Princess Alexandra Hospital

Woolloongabba, Queensland, 4102, Australia

Location

Royal Adelaide Hospital

Adelaide, South Australia, 5000, Australia

Location

Royal Hobart Hospital

Hobart, Tasmania, 7000, Australia

Location

Austin Health

Heidelberg, Victoria, 3084, Australia

Location

Cabrini Hospital

Malvern, Victoria, 3144, Australia

Location

The Alfred

Melbourne, Victoria, 3004, Australia

Location

Border Medical Oncology

Wodonga, Victoria, 3690, Australia

Location

Perth Blood Institute

Nedlands, Western Australia, 6009, Australia

Location

Klinikum der Ludwig-Maximilians-Universitat Munchen

Munich, Bavaria, 81377, Germany

Location

Klinikum Rechts der Isar, Technischen Universitat Munchen

München, Bavaria, 81675, Germany

Location

University Hospital of Cologne

Cologne, North Rhine-Westphalia, 50937, Germany

Location

Marien Hospital Dusseldorf

Düsseldorf, North Rhine-Westphalia, 40479, Germany

Location

University Hospital Halle

Halle, Saxony-Anhalt, 06120, Germany

Location

Universitatsklinikum Essen

Essen, 45147, Germany

Location

Medizinische Hochschule Hannover

Hanover, 30625, Germany

Location

Medizinische Universitatsklinik Heidelberg

Heidelberg, 69120, Germany

Location

Universitatsklinikum Wurzburg

Würzburg, 97080, Germany

Location

Hospital Germans Trias I Pujol

Badalona, Badalona, 08916, Spain

Location

Hospital University Reina Sofia

Córdoba, Cordoba, 14004, Spain

Location

Hospital Universitario Severo Ochoa

Leganés, Madrid, 28911, Spain

Location

Hospital Universitario Gregorio Maranon

Madrid, Madrid, 28007, Spain

Location

MD Anderson Cancer Center

Madrid, Madrid, 28033, Spain

Location

Hospital Clinico Universitario Virgen de la Arrixaca

El Palmar, Murcia, 30120, Spain

Location

Clinica Universidad de Navarra

Pamplona, Navarre, 31008, Spain

Location

Hospital Universitario de Canarias

San Cristóbal de La Laguna, S/C Tenerife, 38320, Spain

Location

Hospital Universitario de Salamanca

Salamanca, Salamanca, 37007, Spain

Location

Complejo Hospitalario Virgen de la Salud

Toledo, Toledo, 45004, Spain

Location

Hospital Clinico Universitario de Valencia

Valencia, Valencia, 46010, Spain

Location

MeSH Terms

Conditions

Myelodysplastic SyndromesLeukemia, Myelomonocytic, Chronic

Interventions

birinapantAzacitidine

Condition Hierarchy (Ancestors)

Bone Marrow DiseasesHematologic DiseasesHemic and Lymphatic DiseasesLeukemia, MyeloidLeukemiaNeoplasms by Histologic TypeNeoplasmsMyelodysplastic-Myeloproliferative DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Aza CompoundsOrganic ChemicalsCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsNucleosidesNucleic Acids, Nucleotides, and NucleosidesRibonucleosides

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 13, 2014

First Posted

May 28, 2014

Study Start

June 1, 2014

Primary Completion

January 1, 2016

Study Completion

June 1, 2016

Last Updated

October 20, 2016

Record last verified: 2016-10

Locations