Lenalidomide and Decitabine in High Grade Myelodysplastic Syndromes - Full Text View

Sponsors and Collaborators:	Duke University Celgene Corporation
Information provided by:	Duke University
ClinicalTrials.gov Identifier:	NCT00828802

Purpose

The purpose of this study is to find out what dose of lenalidomide is safe to use in combination with decitabine when given in people with myelodysplastic syndrome.

Condition	Intervention	Phase
Myelodysplastic Syndromes	Drug: Lenalidomide, Decitabine	Phase I

Drug Information available for: 5-Aza-2'-deoxycytidine Lenalidomide CC 5013

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title:	A Phase I Study of Lenalidomide in Combination With Decitabine for Patients With High Grade Myelodysplastic Syndromes

Further study details as provided by Duke University:

Primary Outcome Measures:

Maximally tolerated dose (MTD)as defined by the protocol [ Time Frame: Cycle 1 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

response duration [ Time Frame: 5 years ] [ Designated as safety issue: No ]
effect on cytogenetic abnormalities [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	30
Study Start Date:	January 2009
Estimated Study Completion Date:	March 2013
Estimated Primary Completion Date:	March 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Cohort 1: Experimental Lenalidomide (5mg) and Decitabine	Drug: Lenalidomide, Decitabine Decitabine 20mg/m2 over one hour IV for 5 days, with cycles repeated every 28 days. Lenalidomide given orally on Days 1-21 followed by 7 days of rest at various dose escalated cohorts (5 mg, 10mg, 15mg, 20 mg, 25 mg)
Cohort 2: Experimental Lenalidomide (10 mg) and Decitabine	Drug: Lenalidomide, Decitabine Decitabine 20mg/m2 over one hour IV for 5 days, with cycles repeated every 28 days. Lenalidomide given orally on Days 1-21 followed by 7 days of rest at various dose escalated cohorts (5 mg, 10mg, 15mg, 20 mg, 25 mg)
Cohort 3: Experimental Lenalidomide (15 mg) and Decitabine	Drug: Lenalidomide, Decitabine Decitabine 20mg/m2 over one hour IV for 5 days, with cycles repeated every 28 days. Lenalidomide given orally on Days 1-21 followed by 7 days of rest at various dose escalated cohorts (5 mg, 10mg, 15mg, 20 mg, 25 mg)
Cohort 4: Experimental Lenalidomide (20 mg) and Decitabine	Drug: Lenalidomide, Decitabine Decitabine 20mg/m2 over one hour IV for 5 days, with cycles repeated every 28 days. Lenalidomide given orally on Days 1-21 followed by 7 days of rest at various dose escalated cohorts (5 mg, 10mg, 15mg, 20 mg, 25 mg)
Cohort 5: Experimental Lenalidomide (25 mg) and Decitabine	Drug: Lenalidomide, Decitabine Decitabine 20mg/m2 over one hour IV for 5 days, with cycles repeated every 28 days. Lenalidomide given orally on Days 1-21 followed by 7 days of rest at various dose escalated cohorts (5 mg, 10mg, 15mg, 20 mg, 25 mg)

Detailed Description:

Myelodysplastic syndrome (MDS) is a group of different kinds of stem cell abnormalities. It is characterized by low blood counts and abnormal blood cell formation. These abnormal blood cells can cause fatigue, shortness of breath, infection, and bleeding. There is significant risk of developing acute leukemia in this disorder.

The only known curative therapy is an allogeneic bone marrow transplant of which the vast majority of patients with this disorder are not candidates. Currently three drugs have been approved for the treatment of MDS: azacytidine, decitabine and lenalidomide for low grade patients with a chromosome 5q abnormality. Azacytidine and decitabine have been demonstrated to improve blood counts, improve the quality of life, and decrease the risk of progression to AML or death in a sizable minority of MDS patients. A recent study of MDS patients who had responded clinically to decitabine revealed that their bone marrow biopsies still showed stromal abnormalities such as increased angiogenesis. Lenalidomide acts at the level of the stromal - marrow cell interaction. It is hypothesized that the combination of decitabine with lenalidomide may show synergistic results.

Eligibility

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

Criteria

Inclusion Criteria:

Understand and voluntarily sign an informed consent form.
Age >/=18 years at the time of signing the informed consent form.
Able to adhere to the study visit schedule and other protocol requirements.
Myelodysplastic syndrome (documented by bone marrow biopsy) with IPSS score of Int-2 or High risk.
All previous MDS therapy, including radiation, hormonal therapy and surgery, must have been discontinued at least 28 days prior to treatment in this study.
ECOG performance status of </= 2 at study entry.
Laboratory test results within these ranges: Serum creatinine </= 2.5 mg/dL x ULN, Total bilirubin </= 2.5 mg/dL x ULN, AST (SGOT) and ALT (SGPT) </= 3 x ULN.
All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.
Females of childbearing potential must have a negative serum pregnancy test within 10-14 days prior to and again within 24 hours of prescribing lenalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. Must also agree to ongoing pregnancy testing.
Men must agree to use a latex condom during sexual contact even if they have had a successful vasectomy.
Disease free of prior malignancies for >/= 3 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, localized prostate cancer, or carcinoma "insitu" of the cervix or breast.

Exclusion Criteria:

Any serious medical condition, laboratory abnormality, or psychiatric
Pregnant or breast feeding females.
Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
Known hypersensitivity or reaction to thalidomide, lenalidomide or decitabine.
Any prior use of lenalidomide.
Concurrent use of other anti-cancer agents or anti-cancer treatments.
Known positive for HIV or active infectious hepatitis, type A, B or C.
History of thromboembolic event within past 6 months prior to enrollment.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00828802

Locations

United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710

Sponsors and Collaborators

Duke University

Celgene Corporation

Investigators

Principal Investigator:

Carlos de Castro, MD

Duke University

More Information

Duke Hematologic Malignancy Program This link exits the ClinicalTrials.gov site

Responsible Party:	Duke University Medical Center ( Carlos de Castro, MD/Principal investigator )
Study ID Numbers:	00010179
Study First Received:	January 22, 2009
Last Updated:	January 23, 2009
ClinicalTrials.gov Identifier:	NCT00828802
Health Authority:	United States: Institutional Review Board

Keywords provided by Duke University:

Myelodysplastic Syndromes
MDS

Study placed in the following topic categories:

Myelodysplastic syndromes
Preleukemia
Precancerous Conditions
Hematologic Diseases
Myelodysplasia

Myelodysplastic Syndromes
Lenalidomide
Decitabine
Bone Marrow Diseases

Additional relevant MeSH terms:

Antimetabolites
Neoplasms
Antimetabolites, Antineoplastic
Pathologic Processes
Disease
Molecular Mechanisms of Pharmacological Action

Antineoplastic Agents
Therapeutic Uses
Syndrome
Enzyme Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 30, 2009