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Trial registered on ANZCTR
Registration number
ACTRN12610000641099
Ethics application status
Approved
Date submitted
5/08/2010
Date registered
6/08/2010
Date last updated
16/12/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Eltrombopag therapy for low platelets in patients on azacitidine treatment for myelodysplastic syndrome and acute myeloid leukaemia
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Scientific title
A single arm pilot study of azacitidine in myelodysplastic syndrome / acute myeloid leukaemia, with eltrombopag support for thrombocytopenia
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Secondary ID [1]
252382
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nil
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Universal Trial Number (UTN)
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Trial acronym
AZA-E
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myelodysplastic Syndromes (MDS)
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Low marrow blast count acute myeloid leukaemia (AML)
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Condition category
Condition code
Blood
258053
258053
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0
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Haematological diseases
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Cancer
258054
258054
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0
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Leukaemia - Acute leukaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Eltrombopag given orally every day for a 1-2 week pre-phase (50mg for a week, with a potential to go straight to combination therapy at 1 week or to maintain eltrombopag at the same dose as monotherapy for a second week in eligible patients, followed by azacitidine with or without eltrombopag. Individualised dose escalation of eltrombopag adapted according to response (dose range from 50-150mg in patients of East Asian extraction, 50-300mg in patients of predominantly non-East Asian extraction). Azacitidine administered by subcutaneous injection 75mg/m2 days 1-5, 8,9 per cycle for 6 cycles, for a total of 54 days treatment, with ongoing azacitidine offered those deriving clinical benefit.
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Intervention code [1]
256944
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Treatment: Drugs
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Grade III/IV non-haematological toxicity possibly, probably or definitely related to the combination of eltrombopag and azacitidine based on clinical assessments.
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Assessment method [1]
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Timepoint [1]
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At 6 cycles of therapy (approx 6 months)
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Secondary outcome [1]
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Secondary outcome 1:
To gather preliminary evidence of the clinical efficacy of eltrombopag to improve platelet counts in this setting, and the appropriate dose at which this may be achieved based on data obtained from clinical assessments, up to 4 bone marrow biopsies, and peripheral blood tests.
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Assessment method [1]
265078
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Timepoint [1]
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Time point: approximately 2.5 years after the last accrued patient completes study treatment
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Secondary outcome [2]
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To explore laboratory findings to correlate with the response of the combination of 5-azacitidine and eltrombopag in patients with MDS and low marrow blast count AML
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Assessment method [2]
265079
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Timepoint [2]
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Time point: approximately 2.5 years after last accrued patient completes study treatment
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Eligibility
Key inclusion criteria
Patients with low platelet count (<=150 x109/L) and in addition disease diagnosis of either MDS (by World Health Organization Criteria, those with refractory anemia with high blast counts and refractory anemia with ringed sideroblasts to also have at least one clinically significant cytopenia), nonproliferative Chronic Myelomonocytic Leukaemia (CMML) or low marrow blast count AML not suitable for induction chemotherapy; Eastern Cooperative Oncology Group (ECOG) 2 or less with life expectancy at least 3 months, adequate contraception and adequate renal and hepatic function; written informed consent
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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
Subjects with the diagnosis acute promyelocytic leukaemia; Prior treatment with 5-azacitidine or any other methyl-transferase inhibitor, eltrombopag, romiplostim, or other Trombopoietin T (TPO)-receptor agonist;AML or MDS requiring cytoreductive therapy (eg hydroxyurea, ara-c, thioguanine etc) in the month prior to study entry; known pro-thrombotic condition; history of Ischaemic neurological event (Transient Ischaemic Attack (TIA) or stroke) within the preceding 2 years;active or uncontrolled infections
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/11/2010
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Actual
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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
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Actual
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Sample size
Target
25
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
3120
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3002
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Victorian Cancer Agency
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Address [1]
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12 Victoria St. Carlton
Victoria, Australia, 3053
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Country [1]
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Australia
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Funding source category [2]
257396
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Commercial sector/Industry
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Name [2]
257396
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GlaxoSmithKline Pty Ltd
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Address [2]
257396
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1061 Mountain Highway
Boronia, Victoria, Australia, 3155
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Country [2]
257396
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Australia
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Funding source category [3]
257397
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Commercial sector/Industry
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Name [3]
257397
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Celgene Pty Ltd
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Address [3]
257397
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Celgene Australia Melbourne Level 7, 607 St Kilda Rd. Melbourne, Victoria 3004
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Country [3]
257397
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Australia
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Primary sponsor type
Hospital
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Name
Peter Mac Callum Cancer Centre
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Address
St Andrews Place, East Melbourne Victoria, 3002
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Country
Australia
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Secondary sponsor category [1]
256642
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None
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Name [1]
256642
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Address [1]
256642
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Country [1]
256642
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Secondary sponsor category [2]
256643
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None
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Name [2]
256643
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Address [2]
256643
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Country [2]
256643
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Other collaborator category [1]
251423
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Other Collaborative groups
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Name [1]
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Victorian Epigenetic Group
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Address [1]
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Dr Melita Kenealy (coordinator)
Peter MacCallum Cancer Centre
St Andrews Pl. East Melbourne
Victoria 3002
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Country [1]
251423
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
259418
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Peter MacCallum Cancer Centre Ethics Committee
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Ethics committee address [1]
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St Andrews Pl, East Melbourne Victoria
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Ethics committee country [1]
259418
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Australia
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Date submitted for ethics approval [1]
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06/08/2010
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Approval date [1]
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13/12/2010
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Ethics approval number [1]
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10/78
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Summary
Brief summary
Myelodysplastic Syndrome (MDS) is a disease of the bone marrow characterized by anemia, neutropenia, and thrombocytopenia (low red blood cell, white blood cell, and platelet counts). MDS patients with thrombocytopenia who fail standard therapies require regular platelet transfusions which are expensive and inconvenient, and are a risk for further serious bleeding complications. The new treatment of MDS using azacitidine has shown to increase the survival rate of MDS patients including to improve platelet production over time. However, in the early cycles of treatment with azacitidine, the low platelet counts tend to exacerbate before they provide any clinical benefit. Eltrombopag is a drug designed to activate the thrombopoietin receptor. Eltrombopag has been able to increase platelet counts in healthy volunteers and in patients with chronic Immune Thrombocytopenia Purpura (ITP), a disease where patients destroy their own platelets very rapidly and thus develop thrombocytopenia. Eltrombopag is administered orally and is Therapeutic Goods Administration (TGA) approved for the treatment of thrombocytopenia in patients with chronic ITP who failed to respond to standard treatment. This study is a single arm pilot study to evaluate the safety and tolerability of Eltrombopag in the treatment of low platelet counts in adult subjects with MDS treated using azacitidine This study also incorporates a correlative laboratory component designed to determined the mechanism of action of 5-azacitidine +/- Eltrombopag and to determine a baseline profile which may predict those most responsive. These studies will incorporate gene methylation and expression, and immunoprofiling.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
31477
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Address
31477
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Country
31477
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Phone
31477
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Fax
31477
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Email
31477
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Contact person for public queries
Name
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Dr Kirsten Herbert
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Address
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c/o Department of Haematology and Medical Oncology, Peter Mac Callum Cancer Centre
Locked Bag 1
A’Beckett Street. Melbourne VIC 8006
Country: Australia
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Country
14724
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Australia
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Phone
14724
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+61 3 9656 1701
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
5652
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Dr Kirsten Herbert
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Address
5652
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c/o Department of Haematology and Medical Oncology, Peter Mac Callum Cancer Centre
Locked Bag 1
A’Beckett Street. Melbourne VIC 8006
Country: Australia
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Country
5652
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Australia
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Phone
5652
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+61 3 9656 1701
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Fax
5652
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Email
5652
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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