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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04266301
Registration number
NCT04266301
Ethics application status
Date submitted
21/01/2020
Date registered
12/02/2020
Titles & IDs
Public title
Study of Efficacy and Safety of MBG453 in Combination With Azacitidine in Subjects With Intermediate, High or Very High Risk Myelodysplastic Syndrome (MDS) as Per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2)
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Scientific title
A Randomized, Double-blind, Placebo-controlled Phase III Multi-center Study of Azacitidine With or Without MBG453 for the Treatment of Patients With Intermediate, High or Very High Risk Myelodysplastic Syndrome (MDS) as Per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2)
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Secondary ID [1]
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2019-002089-11
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Secondary ID [2]
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CMBG453B12301
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Universal Trial Number (UTN)
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Trial acronym
STIMULUS-MDS2
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myelodysplastic Syndromes
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Leukemia, Myelomonocytic, Chronic
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Blood
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Haematological diseases
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Blood
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Other blood disorders
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Sabatolimab
Treatment: Drugs - Azacitidine
Treatment: Drugs - Placebo
Experimental: MBG453 (Sabatolimab) + Azacitidine - Participants will receive MBG453 plus Azacitidine
Placebo comparator: Placebo + Azacitidine - Participants will receive Placebo plus Azacitidine
Treatment: Drugs: Sabatolimab
A dose of MBG453 800 mg will be administered intravenously (IV) every 4 weeks (Q4W).
Treatment: Drugs: Azacitidine
A dose of Azacitidine 75 mg/m2 will be administered IV or subcutaneously (SC) on Day 1-7, or Day 1-5, 8 and 9.
Treatment: Drugs: Placebo
A dose of Placebo 800 mg will be administered intravenously every 4 weeks (Q4W).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Overall Survival
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Assessment method [1]
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Time from randomization until death due to any cause
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Timepoint [1]
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Up to 5 years after last patient randomized
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Secondary outcome [1]
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Key secondary endpoint 1: Time to definitive deterioration of fatigue using Functional Assessment of Cancer Therapy (FACIT)-Fatigue score
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Assessment method [1]
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FACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer patients. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. Time from randomization to at least 3 points worsening from baseline will be presented.
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Timepoint [1]
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Up to 5 years after last patient randomized
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Secondary outcome [2]
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Key secondary endpoint 2: Red Blood Cell transfusion-free intervals
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Assessment method [2]
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Cumulative times of intervals with no evidence of Red Blood Cell (RBC) transfusion for at least 8 weeks after randomization
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Timepoint [2]
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Up to 5 years after last patient randomized
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Secondary outcome [3]
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Key secondary endpoint: Percent of subjects with at least 3 point confirmed improvement from baseline in FACIT-fatigue scoresscore
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Assessment method [3]
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FACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer patients. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. Percentage of subjects with at least 3 point confirmed improvement from baseline will be presented.
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Timepoint [3]
0
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Up to 5 years after last patient randomized
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Secondary outcome [4]
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Key secondary endpoint 4: Percent of subjects with at least 10 point confirmed improvement from baseline in physical functioning using European Or ganization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30)
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Assessment method [4]
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EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Subject's responses to 5 questions about their physical functioning (Items 1-5) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. Percentage of subjects with at least 10 point confirmed improvement from baseline in physical functioning will be presented.
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Timepoint [4]
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Up to 5 years after last patient randomized
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Secondary outcome [5]
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Key secondary endpoint 5: Percent of subjects with at least 10 point confirmed improvement from baseline in emotional functioning using EORTC-QLQ-C30
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Assessment method [5]
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EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Subject's responses to 4 questions about their emotional functioning (Items 21-24) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. Percentage of subjects with at least 10 point confirmed improvement from baseline in emotional functioning will be presented.
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Timepoint [5]
0
0
Up to 5 years after last patient randomized
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Secondary outcome [6]
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Percentage of subjects with either CR, or mCR, or PR, or HI in each treatment arm according to International Working Group for MDS (IWG-MDS) as per investigator assessment
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Assessment method [6]
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Response rate of subjects with complete remission (CR), or marrow remission (mCR), or partial remission (PR), or hematologic improvement (HI)
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Timepoint [6]
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Up to 5 years after last patient randomized
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Secondary outcome [7]
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Percentage of subjects with SD in each treatment arm according to International Working Group for MDS (IWG-MDS) as per investigator assessment
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Assessment method [7]
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Response rate of subjects with stable disease (SD)
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Timepoint [7]
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Up to 5 years after last patient randomized
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Secondary outcome [8]
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Progression Free Survival (PFS)
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Assessment method [8]
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Time from randomization to disease progression (including transformation to acute leukemia per WHO 2016 classification), relapse from CR according to International Working Group for MDS (IWG-MDS), or death due to any cause, whichever occurs first, as per investigator assessment
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Timepoint [8]
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Up to 5 years after last patient randomized
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Secondary outcome [9]
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Leukemia-free survival
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Assessment method [9]
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Time from randomization to = 20% blasts in bone marrow/peripheral blood (per WHO 2016 classification) or diagnosis of extramedullary acute leukemia, or death due to any cause
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Timepoint [9]
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Up to 5 years after last patient randomized
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Secondary outcome [10]
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Number of transfusion dependent subjects at baseline who become Red Blood Cells/platelets transfusion independent after randomization
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Assessment method [10]
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Improvement in RBC/Platelets transfusion independence as per International Working Group for MDS (IWG-MDS) criteria
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Timepoint [10]
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Up to 5 years after last patient randomized as per IWG-MDS criteria
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Secondary outcome [11]
0
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Percentage of transfusion dependent subjects at baseline who become Red Blood Cells/platelets transfusion independent after randomization
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Assessment method [11]
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Improvement in RBC/Platelets transfusion Independence as per International Working Group for MDS (IWG-MDS) criteria
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Timepoint [11]
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Up to 5 years after last patient randomized
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Secondary outcome [12]
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Pharmacokinetics of MBG453 (parameter Cmax)
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Assessment method [12]
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Maximum (peak) MBG453 concentration \[Cmax\]
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Timepoint [12]
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At Day 8 of each cycle (1 cycle = 28 days) until cycle 9, at day 8 of cycle 12 and every 6 cycles thereafter up to 150 day after end of study drug
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Secondary outcome [13]
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Pharmacokinetics of MBG453 (parameter AUC)
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Assessment method [13]
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Area Under the Curve \[AUC\]
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Timepoint [13]
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At Day 8 of each cycle (1 cycle = 28 days) until cycle 9, at day 8 of cycle 12 and every 6 cycles thereafter up to 150 day after end of study drug
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Secondary outcome [14]
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Anti-drug Antibody (ADA) prevalence at baseline and ADA incidence on-treatment
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Assessment method [14]
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Immunogenicity of MBG453
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Timepoint [14]
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At Day 8 of each cycle (1 cycle = 28 days) until cycle 9, at day 8 of cycle 12 and every 6 cycles thereafter up to 150 day after end of study drug
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Secondary outcome [15]
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Change from baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) score over time
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Assessment method [15]
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The EQ-5D-5L comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression. For each of the 5 dimensions, subject's responses are scored on a 5-point scale (1=no problem to 5=extreme problems). Change from baseline will be presented.
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Timepoint [15]
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Up to 5 years after last patient randomized
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Secondary outcome [16]
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Change from baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale over time
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Assessment method [16]
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The EQ-5D-5L VAS records the subject's self-rated health on a visual analogue scale numbered from 0 to 100, with 0 being "the worst health you can imagine" and 100 being "the best health you can imagine". Change from baseline will be presented.
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Timepoint [16]
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Up to 5 years after last patient randomized
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Secondary outcome [17]
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Change from baseline to C12D1 of Global Health Status/Quality of Life scores using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC-QLQ-C30)
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Assessment method [17]
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EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Subject's responses to 2 questions (Items 29+30: "How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall outcome. Change from baseline to Cycle 12 Day 1 will be presented.
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Timepoint [17]
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Up to cycle 12 day 1 (C12D1)(1 cycle = 28 days)
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Eligibility
Key inclusion criteria
* Signed informed consent must be obtained prior to participation in the study
* Age = 18 years at the date of signing the informed consent form
* Morphologically confirmed diagnosis of myelodysplastic syndrome (MDS) based on WHO 2016 classification (Arber et al 2016) by local investigator assessment with one of the following Prognostic Risk Categories, based on the revised International Prognostic Scoring System (IPSS-R):
* Very high (> 6 points)
* High (> 4.5 - = 6 points)
* Intermediate (> 3 - = 4.5 points) Or Morphologically confirmed diagnosis of Chronic Myelomonocytic Leukemia -2 based on WHO 2016 classification (Arber et al 2016, including persistent monocytosis) by local investigator assessment with WBC < 13 x 109/L at time of initial diagnosis
* Indication for azacitidine treatment according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions
* Not eligible at time of screening for intensive chemotherapy according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions, including assessment of individual clinical factors such as age, comorbidities and performance status
* Not eligible at time of screening for hematopoietic stem cell transplantation (HSCT) according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions, including assessment of individual clinical factors such as age, comorbidities, performance status, and donor availability
* Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Prior exposure to TIM-3 directed therapy at any time. Prior therapy with immune checkpoint inhibitors (e.g, anti-CTLA4, anti-PD-1, anti-PD-L1, or anti-PD-L2), cancer vaccines is allowed except if the drug was administered within 4 months prior to randomization
* Previous first-line treatment for intermediate, high, very high risk myelodysplastic syndromes (based on IPSS-R) or CMML with any antineoplastic agents including for example chemotherapy, lenalidomide and hypomethylating agents (HMAs) such as decitibine and azacitidine. However, previous treatment with hydroxyurea or leukopheresis to reduce WBC count is allowed prior to randomization.
* Investigational treatment received within 4 weeks or 5 half-lives of this investigational treatment, whatever is longer, prior to randomization. In case of a checkpoint inhibitor: a minimal interval of 4 months prior to randomization is necessary to allow randomization.
* Subjects with Myelodysplastic syndrome (MDS) based on 2016 WHO classification (Arber et al 2016) with revised International Prognostic Scoring System (IPSS-R) = 3
* Diagnosis of acute myeloid leukemia (AML) including acute promyelocytic leukemia and extra-medullary acute myeloid leukemia, primary or secondary myelofibrosis based on WHO 2016 classification (Arber et al 2016)
* Diagnosis of therapy related myeloid neoplasms based on WHO 2016 classification (Arber et al 2016)
* History of organ or allogeneic hematopoietic stem cell transplant
Other protocol-defined Inclusion/Exclusion Criteria may apply.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
8/06/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
3/10/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
530
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Recruitment in Australia
Recruitment state(s)
QLD,VIC,WA
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Recruitment hospital [1]
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Novartis Investigative Site - Woolloongabba
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Recruitment hospital [2]
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Novartis Investigative Site - Clayton
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Novartis Investigative Site - Perth
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Recruitment postcode(s) [1]
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4102 - Woolloongabba
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Recruitment postcode(s) [2]
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3168 - Clayton
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Recruitment postcode(s) [3]
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6000 - Perth
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Recruitment outside Australia
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United States of America
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Arizona
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California
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Argentina
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Buenos Aires
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Austria
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Graz
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Austria
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Innsbruck
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Linz
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Brasschaat
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Roeselare
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SC
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SP
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BO
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CT
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GE
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RC
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RM
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Fukuoka
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Japan
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Japan
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Kanagawa
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Japan
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Miyagi
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Japan
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Nagasaki
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Japan
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Osaka
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Tokyo
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Japan
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Yamagata
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Seoul
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Beirut
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Distrito Federal
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Mexico
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Groningen
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Oman
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Muscat
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Portugal
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Lisboa
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Portugal
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Porto
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Russian Federation
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Russian Federation
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St Petersburg
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Riyadh
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Asturias
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Catalunya
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Comunidad Valenciana
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Madrid
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Valencia
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Bern
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Taoyuan
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Hat Yai
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THA
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Thailand
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Bangkok
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Thailand
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Turkey
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Ankara
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Edirne
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Istanbul
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Samsun
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United Kingdom
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Hants
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United Kingdom
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Edinburgh
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United Kingdom
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Manchester
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United Kingdom
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Nottingham
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Novartis Pharmaceuticals
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Ethics approval
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Summary
Brief summary
This is a Phase III multi-center, randomized, two-arm parallel-group, double-blind, placebo-controlled study of MBG453 or placebo added to azacitidine in adult subjects with intermediate, high or very high-risk myelodysplastic syndrome (MDS) as per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2) who are not eligible for intensive chemotherapy or hematopoietic stem cell transplantation (HSCT) according to medical judgment by the investigator. The purpose of the current study is to assess clinical effects of MBG453 in combination with azacitidine in adult subjects with IPSS-R intermediate, high, very high risk MDS and CMML-2.
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Trial website
https://clinicaltrials.gov/study/NCT04266301
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Public notes
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Contacts
Principal investigator
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Novartis Pharmaceuticals
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Novartis Pharmaceuticals
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04266301