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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03493646
Registration number
NCT03493646
Ethics application status
Date submitted
27/03/2018
Date registered
10/04/2018
Titles & IDs
Public title
Evaluating in Vivo AZA Incorporation in Mononuclear Cells Following Vidaza or CC486
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Scientific title
Evaluating in Vivo AZA Incorporation in Mononuclear Cells Following Vidaza or CC486
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Secondary ID [1]
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VZ-CL-MDSAML-PI-13085
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Secondary ID [2]
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2018-01-AZA
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Universal Trial Number (UTN)
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Trial acronym
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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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Acute Myeloid Leukemia
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Chronic Myelomonocytic Leukemia
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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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0
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Leukaemia - Chronic leukaemia
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Cancer
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0
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Children's - Leukaemia & Lymphoma
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Blood
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0
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Haematological diseases
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Blood
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Azacitidine
Treatment: Drugs - CC-486
Active comparator: Azacitidine - 6 cycles of azacitidine (28 day cycle)
Experimental: CC 486 - 6 cycles CC 486 (28 day cycle)
Treatment: Drugs: Azacitidine
75mg/m2 per day for 7 days of each 28 day cycle. Cycles 1-6
Treatment: Drugs: CC-486
100 mg BID for the first 21 days of each 28-day treatment cycle (cycles 7-8). The dose should be increased from cycle 9 onwards to 150mg BID for the first 21 days of each 28-day treatment cycle (cycles 9-12) in the absence of Grade 3 or 4 AE. If 2 or more cycles are tolerated at this dose, further increments are permitted for patients with Stable Disease or if clinically indicated in consultation with the coordinating investigator as per the study dose modification schedule.
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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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DNA incorporation of Vidaza® compared to CC-486
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Assessment method [1]
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DNA incorporation of Vidaza® compared to CC-486 as measured by the area under the curve (AUC) during the first 6 cycles compared to the area under the curve from cycles 7 to 12.
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Timepoint [1]
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At the end of cycle 6 (cycles 1-6 inclusive) compared with cycles 7-12 (cycles 7-12 inclusive). Each cycle is 28 days
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Secondary outcome [1]
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DNA incorporation in bone marrow mononuclear cells
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Assessment method [1]
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DNA incorporation in bone marrow mononuclear cells following Vidaza® compared to CC-486 as measured by the area under the curve (AUC) in cycle 6 compared to the AUC in cycle 7
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Timepoint [1]
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At the end of cycle 6 compared to cycle 7. Each cycle is 28 days
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Secondary outcome [2]
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DNA AZA derivative uptake
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Assessment method [2]
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DNA AZA derivative uptake (measured by AUC) between responders and non-responders who are classified as having AZA uptake
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Timepoint [2]
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end of Cycle 6 and 12
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Secondary outcome [3]
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Proportion of cells undergoing the cell cycle
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Assessment method [3]
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Proportion of cells undergoing the cell cycle for non-responders with AZA uptake vs non-responders without AZA uptake
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Timepoint [3]
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end of Cycle 6 and 12. Each cycle is 28 days
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Secondary outcome [4]
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Inflammatory markers, as measured by AUC, between responders and non-
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Assessment method [4]
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Inflammatory markers, as measured by AUC, between responders and non-responders who are classified as having AZA uptake
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Timepoint [4]
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end of Cycle 6 and 12. Each cycle is 28 days
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Eligibility
Key inclusion criteria
1. Male or female, = 18 years of age.
2. Documented diagnosis of
1. Myelodysplastic syndrome classified as intermediate-2 or high risk according to the IPSS, or
2. AML with 20-30% marrow blasts and multi-lineage dysplasia, according to WHO classification, or
3. CMML with 10-29% marrow blasts without myeloproliferative disorder according to WHO classification, or Confirmation will be from either the BMA performed at screening or a standard of care BMA if performed up to 6 weeks before cycle 1 day 1.
3. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
4. Females of childbearing potential (FCBP) may participate, providing they meet the following conditions:
1. Agree to use at least two effective contraceptive methods (oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; true abstinence; or vasectomized partner) throughout the study, and for 90 days following the last dose of investigational product (IP); and
2. Have a negative serum pregnancy test at screening
5. Male participants with a female partner of childbearing potential must agree to use at least two physician-approved contraceptive methods throughout the course of the study and should avoid fathering a child during the course of the study and for 90 days following the last dose of Investigational Product.
6. Understand and voluntarily sign an informed consent document prior to any study- related assessments or procedures conducted.
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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
1. Acute myeloid leukemia (AML) - = 30% blasts in bone marrow according to WHO classification. Participants known to have = 30% blasts are not eligible for inclusion in this study. Recognizing limitations of blast cell quantitation, this protocol will allow participants with pre-enrollment (screening/baseline) bone marrow blast counts up to 33% to be considered for inclusion subject to discussion with the Coordinating PI prior to enrollment.
2. Prior allogeneic or autologous stem cell transplant.
3. Prior exposure to a hypomethylating agent.
4. Use of any of the following within 28 days prior to cycle 1, day 1:
1. thrombopoiesis-stimulating agents ([TSAs]; eg, Romiplostim, Eltrombopag, Interleukin-11)
2. ESAs (Erythropoiesis stimulating agent) and other RBC hematopoietic growth factors (eg, interleukin-3)
3. Hydroxyurea
4. Any other investigational product from another clinical trial
5. Concurrent use of corticosteroids unless the participant is on a stable or decreasing dose for = 1 week prior to enrollment for medical conditions other than MDS.
6. History of inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis), celiac disease (ie, sprue), prior gastrectomy or upper bowel removal, or any other gastrointestinal disorder or defect that would interfere with the absorption, distribution, metabolism or excretion of the IP and/or predispose the participant to an increased risk of gastrointestinal toxicity.
7. Prior history of malignancies, other than MDS, unless the participant has been free of the disease for = 3 years. However, participants with the following history/concurrent conditions are allowed:
1. Basal or squamous cell carcinoma of the skin
2. Carcinoma in situ of the cervix
3. Carcinoma in situ of the breast
4. Incidental histologic finding of prostate cancer (T1a or T1b using the tumor, nodes, metastasis [TNM] clinical staging system)
8. Significant active cardiac disease within the previous 6 months, including:
1. New York Heart Association (NYHA) class IV congestive heart failure
2. Unstable angina or angina requiring surgical or medical intervention; and/or
3. Myocardial infarction
9. Active systemic infection including:
1. Ongoing signs/symptoms related to the infection without improvement despite appropriate anti-infectives
2. Active Hepatitis B infection
3. Subjects with Human Immunodeficiency Virus (HIV) or Hepatitis C infection will be considered individually by the coordinating principal investigator:
i) Those with HIV will generally be eligible if receiving antiretroviral therapy, HIV VL is suppressed <50 copies/mL and CD4=350 cells/mm3. ii) Those with HCV will generally be eligible if there is no evidence of clinical hepatic dysfunction or other systemic manifestations of HCV disease and the hepatic parameters below are met. Consideration should be given to curative HCV therapy prior to enrollment in consultation with HCV clinician, if possible.
10. Any of the following laboratory abnormalities:
1. Serum AST/SGOT or ALT/SGPT > 2.5 x ULN
2. Serum total bilirubin > 1.5 x ULN. Higher levels are acceptable if these can be attributed to active RBC precursor destruction within the bone marrow (ie, ineffective erythropoiesis).
3. Evidence of autoimmune hemolytic anemia manifested as a corrected reticulocyte count of > 2% with either a positive Direct Antiglobulin Test or over 50% of indirect bilirubin
4. Serum creatinine > 2.5 x ULN
5. Absolute white blood cell count = 20 x 109/L
11. Known or suspected hypersensitivity to azacitidine, mannitol, its constituents, or to any other humanized monoclonal antibody.
12. Pregnant or breast-feeding females.
13. Clinical evidence of central nervous system (CNS) or pulmonary leukostasis, disseminated intravascular coagulation, or CNS leukemia.
14. Any condition not already outlined above which, in the opinion of the clinical investigator, would place the subject at risk if they participated or would jeopardise adherence or follow up or confound the ability to interpret study data.
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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
Other
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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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
18/05/2018
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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
21/09/2021
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Sample size
Target
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Calvary Mater Newcastle - Newcastle
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Recruitment hospital [2]
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Nepean Hospital - Penrith
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Recruitment hospital [3]
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Prince of Wales Hospital - Sydney
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Recruitment hospital [4]
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Royal North Shore Hospital - Sydney
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Recruitment hospital [5]
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Blacktown Hospital - Sydney
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Recruitment hospital [6]
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Liverpool Hospital - Sydney
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Recruitment hospital [7]
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Gosford and Wyong Hospitals - Sydney
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Recruitment hospital [8]
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St George Hospital - Sydney
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Recruitment hospital [9]
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Royal Prince Alfred Hospital - Sydney
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Recruitment hospital [10]
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St Vincent's hospital - Sydney
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Recruitment hospital [11]
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Wollongong Hospital - Wollongong
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Recruitment postcode(s) [1]
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2298 - Newcastle
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Recruitment postcode(s) [2]
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2750 - Penrith
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Recruitment postcode(s) [3]
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2031 - Sydney
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Recruitment postcode(s) [4]
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2065 - Sydney
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Recruitment postcode(s) [5]
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2148 - Sydney
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Recruitment postcode(s) [6]
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2170 - Sydney
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Recruitment postcode(s) [7]
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219 - Sydney
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Recruitment postcode(s) [8]
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2217 - Sydney
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Recruitment postcode(s) [9]
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- Sydney
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Recruitment postcode(s) [10]
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2500 - Wollongong
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Kirby Institute
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Celgene
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Myelodysplastic Syndrome (MDS) is a group of blood disorders where the bone marrow does not produce enough mature red blood cells, white blood cells and platelets. In a healthy person, the bone marrow makes blood stem cells (immature cells, also called 'blasts') that become mature blood cells over time. In people with MDS, this process is affected and immature blood cells in the bone marrow do not mature fully to become healthy blood cells. This causes a lack of healthy blood cells that can function properly. With fewer healthy blood cells, infection, anaemia, or easy bleeding may occur. MDS can progress to acute myeloid leukaemia in 25-30% of patients, and if untreated it can be rapidly fatal. The purpose of this study is to evaluate the standard treatment, azacitidine (Vidaza) given as an injection under the skin compared to the same medication (called CC-486) taken as a tablet by mouth. Vidaza is approved by the Australian Therapeutics Goods Administration (TGA) as standard treatment for MDS. CC-486 is an experimental treatment. This means it is not an approved treatment for MDS in Australia. CC-486 is being developed to increase convenience and make it easier for patients to continue their treatment. So far it has been given to over 870 patients in studies across the world. The treatment in the injection and the tablet is the same. Studies like this one are being done to ensure the tablet works in the same way as the standard injected treatment. Vidaza is given by subcutaneous injection (ie under the skin) over an hour for 7 days every 4 weeks for as long as it continues to work. All study participants will receive active treatment (there is no placebo), and all participants will receive the standard injection for six treatment cycles followed by the new tablet medication taken once daily for 21 days every 4 weeks. This allows the researchers to compare the two ways of giving the medicine.
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Trial website
https://clinicaltrials.gov/study/NCT03493646
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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John Pimanda, MD
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Address
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University of New South Wales
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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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)?
Undecided
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No/undecided IPD sharing reason/comment
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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/NCT03493646