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Study of Oral Dasatinib in Subjects With Myelodysplastic Syndrome (MDS) and Excess Marrow Blasts
This study is currently recruiting participants.
Verified by H. Lee Moffitt Cancer Center and Research Institute, February 2008
Sponsors and Collaborators: H. Lee Moffitt Cancer Center and Research Institute
Bristol-Myers Squibb
Information provided by: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier: NCT00624585
  Purpose

The main purpose of this study is to learn how patients with myelodysplastic syndrome (MDS) respond to the study drug dasatinib. The study drug, dasatinib, has been approved by the U.S. Food and Drug Administration (FDA) for treatment of leukemia, but has not been approved for the treatment of other kinds of cancer. The use of dasatinib in this study is considered experimental.


Condition Intervention Phase
Myelodysplastic Syndromes
Drug: Dasatinib
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Dasatinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: A Pilot Study of Oral Dasatinib in Subjects With MDS and Excess Marrow Blasts

Further study details as provided by H. Lee Moffitt Cancer Center and Research Institute:

Primary Outcome Measures:
  • Complete remission (CR) and partial remission (PR) (modified IWG); IWG = International MDS Working Group [ Time Frame: At 8 weeks and 16 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Hematologic improvement in platelets, RBC, neutrophils according to modified IWG Criteria; Cytogenetic response (modified IWG); Change in percentage of blasts in bone marrow and peripheral blood; Src-Tyr416 phosphorylation in medullary myeloblasts. [ Time Frame: At 8 weeks and 16 weeks ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 26
Study Start Date: February 2008
Estimated Study Completion Date: February 2010
Estimated Primary Completion Date: February 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental Drug: Dasatinib

DOSE ESCALATION OF DASATINIB AFTER 8 WEEKS IF ELIGIBLE

  • Dose Level and Dose of dasatinib:

    1. Starting dose (1-8 weeks)= 100 mg po daily
    2. +1 (<8 weeks if no PR and well tolerated) = 150 mg po daily

DOSE MODIFICATION OF DASATINIB

  • Dose Level and Dose of dasatinib:

    1. Starting dose = 100 mg po daily
    2. -1 = 70 mg po daily
    3. -2 = 50 mg po daily

OR

  • Dose Level and Dose of dasatinib:

    1. Starting dose = 150 mg po daily
    2. -1 = 120 mg po daily
    3. -2 = 90 mg po daily
    4. -3 = 50 mg po daily

Detailed Description:

Study Core Period:

The first 16 weeks after the initial dose of dasatinib is called the Study Core Period. Patients who are eligible and chose to participate in this study should expect to take 100 mg of dasatinib daily for 8 weeks. If the study doctor believes that they have not achieved a partial response after 8 weeks of treatment, the dose may be increased to 150 mg per day. The study doctor may lower the dosage of dasatinib if the 100 mg treatment is too strong. If the lower dose of dasatinib is still too strong, the study doctor may decide to take the patient off of the study. The patient will continue to receive supportive care as needed during the duration of the trial as well as after completion of the trial.

During the Study Core Period, participants will have a study visit every 4 weeks. Complete Blood Counts (CBC) will be obtained every 2 weeks for study purposes and disease monitoring. Bone marrow aspiration and biopsy will be obtained at screening, and at 8 weeks and 16 weeks of treatment for response assessment. Additional bone marrow aspirations and biopsies may be obtained at any other time, to evaluate the disease process, at the doctor's judgment. A bone marrow aspirate and biopsy must be done at the time of study discontinuation.

Study Extension Period:

The time after the first 16 weeks of treatment is called the study extension period. If the patient is responding to the treatment, does not experience disease progression or any severe adverse events, the patient may continue dasatinib treatment for up to 48 weeks. If patients continue after 48 weeks, they will be asked to enroll in a separate extension study for future follow up.

During the Study Extension Period, participants will have a study visit every 4 weeks. Complete Blood Counts (CBC) will be obtained every 2 or 4 weeks for study purposes and disease monitoring. Bone marrow aspiration and biopsy will be obtained every 16 weeks. A bone marrow aspirate and biopsy must be done at the time of study discontinuation.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Documented diagnosis of MDS or MPS/MPD with blast percentage > 10% in bone marrow, MDS/AML with <30% blasts:

    • MDS [all WHO types] with blast percentage > 10% in bone marrow
    • CMML with blast percentage > 10% in bone marrow
    • Myelodysplastic / Myeloproliferative (MDS/MPD) syndromes with blast percentage > 10% in bone marrow
    • AML with Multilineage Dysplasia (MDS/AML) with <30% blasts and declined standard induction chemotherapy or deemed unfit for standard induction chemotherapy
  • Performance Status (ECOG) 0 to 2
  • Previous therapy with Azacitidine or Decitabine with last dose at least 2 months prior to first dose of dasatinib okay. Must be at least 4 weeks out from any previous investigational therapy.
  • Adequate Organ Function

    • Total bilirubin < 2.0 times institutional Upper Limit of Normal (ULN)
    • Hepatic enzymes (AST, ALT) ≤ 2.5 times institutional ULN
    • Serum Na, K+, Mg2+, Phosphate and Ca2+≥ Lower Limit of Normal (LLN) [low electrolyte levels must be repleted to all for entry]
    • Serum Creatinine < 1.5 times ULN
    • PT, PTT Grade 0-1
  • Able to take oral medication (Dasatinib must be swallowed whole. Tablets can be dissolved in juice and then put down an NG/G tube or drank as a solution)
  • Women of childbearing potential must have Negative serum or urine pregnancy test within 72 hours prior to start of study drug
  • Persons of reproductive potential must agree to use adequate birth control throughout treatment and at least 4 weeks after study drug is stopped
  • Signed written informed consent

Exclusion Criteria:

  • WBC >50,000 off hydroxyurea for >72 hours
  • Malignancy [other than the one treated in this study] requiring radiotherapy or systemic treatment within past 3 years
  • Chemotherapy or any agent with activity in MDS or AML concurrent with the study.
  • Chemotherapy for MDS or AML prior to enrollment not allowed other than Azacitidine or Decitabine >2 months prior to first dose
  • Concurrent medical condition which may increase the risk of toxicity, including:

    • Pleural or pericardial effusion
    • Serious medical condition, unstable medical co-morbidity, psychiatric illness that will prevent subject from signing informed consent form or place them at unacceptable risk if they participate
  • Cardiac Symptoms, including:

    • Uncontrolled angina, congestive heart failure or MI (within 6 mos.)
    • Diagnosed congenital long QT syndrome
    • History of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes)
    • Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec)
  • Hypokalemia or hypomagnesemia if cannot be corrected
  • History of significant bleeding disorder unrelated to cancer, including:

    • Congenital bleeding disorders
    • Acquired bleeding disorder within 1 year
    • Ongoing or recent (≤ 3 months) significant gastrointestinal bleeding
  • Concomitant Medications, consider the following prohibitions:

    • Drugs generally accepted to have risk of causing Torsades de Pointes(Must discontinue drug 7 days prior to starting dasatinib)
    • Concomitant use of H2 blockers or proton pump inhibitors with dasatinib not recommended. Use of antacids should be considered in place of H2 blockers or proton pump inhibitors in patients receiving dasatinib therapy.
    • On-going requirement for treatment with platelet function inhibitor or anti-coagulation.
    • Must discontinue St. Johns Wort while receiving dasatinib therapy
    • Must agree that IV bisphosphonates be withheld for first 8 weeks of Dasatinib therapy due to risk of hypocalcemia.
    • May not be receiving any prohibited CYP3A4 inhibitors
  • Women:

    • Positive pregnancy test at baseline
    • Pregnant or breastfeeding
  • Prisoners or subjects who are compulsorily detained for treatment of either psychiatric or physical (e.g., infectious) illness
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00624585

Contacts
Contact: Alan List, M.D. 813-745-6086 alan.list@moffitt.org
Contact: Enrique Santana 813-745-2071 enrique.santana@moffitt.org

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute Recruiting
Tampa, Florida, United States, 33612
Contact: Alan List, M.D.     813-745-6086     alan.list@moffitt.org    
Contact: Enrique Santana     813-745-2071     enrique.santana@moffitt.org    
Principal Investigator: Alan List, M.D.            
Sub-Investigator: Jeffrey Lancet, M.D.            
Sub-Investigator: Javier Pinilla, M.D., PhD.            
Sub-Investigator: Lubomir Sokol, M.D., PhD.            
Sub-Investigator: Eduardo Sotomayor, M.D.            
Sub-Investigator: Kenneth Zuckerman, M.D.            
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Bristol-Myers Squibb
Investigators
Principal Investigator: Alan List, M.D. H. Lee Moffitt Cancer Center and Research Institute
  More Information

Moffitt Cancer Center Clinical Trials website  This link exits the ClinicalTrials.gov site

Responsible Party: H. Lee Moffitt Cancer Center and Research Institute ( Alan List, M.D. )
Study ID Numbers: MCC-15276, USFIRB#106266d, CA180-106
Study First Received: February 15, 2008
Last Updated: March 18, 2008
ClinicalTrials.gov Identifier: NCT00624585  
Health Authority: United States: Institutional Review Board

Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
MDS
MDS/MPD
MDS/AML
CMML
Excess Marrow Blasts

Study placed in the following topic categories:
Myelodysplastic syndromes
Preleukemia
Precancerous Conditions
Hematologic Diseases
Dasatinib
Myelodysplasia
Myelodysplastic Syndromes
Bone Marrow Diseases

Additional relevant MeSH terms:
Neoplasms
Pathologic Processes
Disease
Molecular Mechanisms of Pharmacological Action
Syndrome
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009