AzTrials
AzTrials

Myelodysplastic SyndromesPhase 3NCT01928537

Efficacy and Safety of IV Rigosertib in MDS Patients With Excess Blasts Progressing After Azacitidine or Decitabine

A Phase 3 study testing rigosertib sodium in people with Myelodysplastic Syndromes and Refractory Anemia With Excess Blasts, run by Traws Pharma, Inc. at 35 sites in 8 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study will examine the effect intravenously administered rigosertib has on the relationship between bone marrow blasts response and overall survival in myelodysplastic syndromes (MDS) patients who have 5-30% bone marrow blasts and who progressed on or after treatment with azacitidine or decitabine. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
rigosertib sodium
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
67 participants
Where
35 sitesin 8 countries
Study dates
Aug 2013to 29 Jun 2017
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of MDS confirmed within 6 weeks prior to Screening according to WHO criteria or French-American-British (FAB) classification.
  • MDS classified as follows, according to WHO criteria and FAB classification:
  • RAEB-1 (5% to 9% BM blasts)
  • RAEB-2 (10% to 19% BM blasts)
  • CMML (10% to 20% BM blasts) and white blood cells (WBC) < 13,000/μL
  • RAEB-t (20% to 30% BM blasts), meeting the following criteria: WBC < 25,000/μL at study entry; or, Stable White Blood Cell (WBC) at least 4 weeks prior to Screening and not requiring intervention for WBC control with hydroxyurea, chemotherapy, or leukopheresis.
Show all 19Show fewer
  • At least one cytopenia (Absolute Neutrophil Count (ANC) < 1800/μL or Platelet (PLT) count < 100,000/μL or hemoglobin (Hgb) < 10 g/dL).
  • Progression (according to 2006 IWG criteria) at any time after initiation of subcutaneous or intravenous azacitidine or decitabine treatment per labeling during the past 2 years, defined as follows:
  • For patients with ˂ 5% BMBL, ≥ 50% increase in BMBL to ˃ 5% BMBL
  • For patients with 5-10% BMBL, ≥ 50% increase in BMBL to ˃ 10% BMBL
  • For patients with 10-20% BMBL, ≥ 50% increase in BMBL to ˃ 20% BMBL
  • For patients with 20-30% BMBL, ≥ 50% increase in BMBL to ˃ 30% BMBL
  • Any of the following: ≥ 50% decrease from maximum remission/response levels in granulocytes or PLT; Decrease in Hgb concentration by ≥ 2 g/dL; or, Transfusion dependence, defined as administration of at least 4 RBC units in the past 8 weeks before Screening (patients must have Hgb values ˂ 9 g/dL prior to transfusion to be considered), in the absence of another explanation.
  • Has failed to respond to, relapsed following, not eligible, or opted not to participate in bone marrow transplantation.
  • Off all other treatments for MDS for at least 4 weeks, except for azacitidine or decitabine. Filgrastim (G-CSF) and erythropoietin are allowed before and during the study as clinically indicated.
  • No medical need for induction chemotherapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2.
  • Willing to adhere to the prohibitions and restrictions specified in this protocol.
  • Patient must signed an informed consent form.

Who cannot join

  • Previous participation in a clinical study of IV or oral rigosertib.
  • Anemia due to factors other than MDS (including hemolysis or gastrointestinal [GI] bleeding) unless stabilized for 1 week after RBC transfusion.
  • Any active malignancy within the past year, except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix or breast.
  • Uncontrolled intercurrent illness including.
  • Active infection not adequately responding to appropriate therapy.
  • Total bilirubin ≥ 1.5 mg/dL not related to hemolysis or Gilbert's disease.
Show all 19Show fewer
  • ALT/AST ≥ 2.5 x upper limit of normal (ULN).
  • Serum creatinine ≥ 2.0 mg/dL.
  • Ascites requiring active medical management including paracentesis, or hyponatremia (defined as serum sodium value of <130 mEq/L).
  • Female patients who are pregnant or lactating.
  • Patients who are unwilling to follow strict contraception requirements.
  • Female patients with reproductive potential who do not have a negative urine beta-human chorionic gonadotropin (βHCG) pregnancy test at Screening.
  • Major surgery without full recovery or major surgery within 3 weeks of Baseline/Cycle 1 Day 1 visit.
  • Uncontrolled hypertension (defined as a systolic pressure ≥160 mmHg and/or a diastolic pressure ≥ 110 mmHg).
  • New onset seizures (within 3 months prior to Baseline) or poorly controlled seizures.
  • Any other concurrent investigational agent or chemotherapy, radiotherapy, or immunotherapy.
  • Prior treatment with low-dose cytarabine during the past 2 years.
  • Investigational therapy within 4 weeks of Baseline/Day 1 visit.
  • Psychiatric illness or social situation that would limit the patient's ability to tolerate and/or comply with study requirements.

Trial locations and contacts

35 sites in 8 countries.

35 sites in 8 countries

United States14 sites
  • Greenbaum Cancer Center University of Maryland

    Baltimore, Maryland, 21201

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • University of Chicago Medicine

    Chicago, Illinois, 60637

  • University of Texas Southwestern Medical Center-Parkland Hospital

    Dallas, Texas, 75235

  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75390

  • MD Anderson Cancer Center

    Houston, Texas, 77030

  • Mount Sinai Medical Center

    New York, New York, 10029

  • Columbia University Medical Center

    New York, New York, 10032

  • New York Presbyterian Hospital-Weill Cornell Medical College

    New York, New York, 10065

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Stanford University Cancer Center

    Stanford, California, 94305

  • Montefiore Medical Center

    The Bronx, New York, 10461

  • University of Kansas Cancer Center and Medical Pavilion

    Westwood, Kansas, 66205

Other trials in United States

Germany6 sites
  • Universitätsklinikum Köln Klinik I für Innere Medizin

    Cologne, 50973

  • University Hospital Carl Guslav Carus

    Dresden, 01062

  • Marien Hospital, Onkologie

    Düsseldorf, 40479

  • Universitätsklinikum Frankfurt, Goethe Universität

    Frankfurt am Main, Hesse, 60590

  • Universitätsmedizin Göttingen

    Göttingen, 37075

  • Technische Universität München, III. Medizinische Klinik

    München, 81675

Other trials in Germany

Australia4 sites
  • Royal Adelaide Hospital

    Adelaide, South Australia, 5000

  • Monash Health, Monash Medical Centre

    Clayton, Victoria, 3168

  • Peter MacCallum Cancer Center

    East Melbourne, Victoria, 3002

  • Royal Melbourne Hospital

    Parkville, Victoria, 3050

Other trials in Australia

Italy3 sites
  • Azienda Ospedaliero-Universitaria Careggi

    Florence, 50134

  • AOU Maggiore della Carità, SCUD Ematologia

    Novara, 28100

  • Policlinico Umberto 1, Universita "Sapienza"

    Rome, 00161

Other trials in Italy

Sweden3 sites
  • Sahlgrenska University Hospital

    Gothenberg, Västra Götalandsregionen, 41345

  • Skåne University Hospital,

    Lund, Skåne County, SE-221 85

  • Karolinska University Hospital, Huddinge

    Stockholm, SE-141 86

Other trials in Sweden

Denmark2 sites
  • Aarhus University Hospital

    Aarhus, Jylland, DK-8000

  • Rigshospitalet, Department of Hematology

    Copenhagen, Capital Region, DK-2100

Other trials in Denmark

France2 sites
  • Institute Paoli Calmettes

    Marseille, 13009

  • Hôpital Saint-Louis, Service d'Hématologie

    Paris, IDF, 75475

Other trials in France

Spain1 site
  • Hospital Universitário de Salamanca

    Salamanca, 37007

Other trials in Spain

About this study

Official title: Phase IIIB, Open-label, Multi-Center Study of the Efficacy and Safety of Rigosertib Administered as 72-hour Continuous Intravenous Infusions in Patients With Myelodysplastic Syndrome With Excess Blasts Progressing On or After Azacitidine or Decitabine

This study will examine the effect intravenously administered rigosertib has on the relationship between bone marrow blasts response and overall survival in myelodysplastic syndromes (MDS) patients who have 5-30% bone marrow blasts and who progressed on or after treatment with azacitidine or decitabine.

Being tested
rigosertib sodium
Keywords
International Working Group, azacitidine, decitabine
Medical subject headings
Myelodysplastic Syndromes, Anemia, Refractory, with Excess of Blasts, Leukemia, Myelomonocytic, Chronic, Cytopenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • rigosertib sodiumDrug

    Also called ON 01910.Na, SyB L-1101

Study groups in NCT01928537
Study groupRoleWhat they receive
rigosertib sodiumExperimentalRigosertib sodium will be administered as a 72-hr continuous intravenous infusion consisting of 3 consecutive doses of 1800 mg over 24 hours on Days 1, 2, and 3 of a 14-day cycle for the first 8 cycles and then on Days 1, 2, and 3 of a 28-day cycle for the following cycles.
Receives: Drug: rigosertib sodium

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Relationship of bone marrow blast response and overall survival.

    Bone marrow blast response is defined as bone marrow (BM) complete response, ≥ 50% BM blast decrease from pretreatment value, or stable BM response (no progression) according to the International Working Group (IWG) 2006 criteria and overall survival. Overall survival is defined as the time from first study treatment to death from any cause. All patients will be followed until death and/or progression, even if they have discontinued treatment for whatever cause. Survival time of patients lost to follow-up will be censored at the time they were last known to be alive.

    Measured: Up to 2 years.

Secondary outcomes (9)
  1. Number of patients with overall hematologic response.

    Overall hematologic response (complete remission [CR], partial remission [PR], bone marrow complete response [BMCR], and stable disease [SD]) is defined according to 2006 International Working Group (IWG) response criteria.

    Measured: Up to 2 years after study enrollment.

  2. Number of patients with hematological improvement.

    Hematological improvement (erythroid response, platelet response and neutrophil response) is defined according to 2006 International Working Group (IWG) response criteria.

    Measured: Up to 2 years after study enrollment.

  3. Number of patients with cytogenetic response.

    Cytogenetic response is defined according to 2006 International Working Group (IWG) response criteria.

    Measured: Up to 2 years after study enrollment.

  4. Progression-free survival.

    Progression-free survival is defined as time from date of first dose until date when progression is documented. Progression is defined according to 2006 International Working Group (IWG) response criteria.

    Measured: Up to 2 years after study enrollment.

  5. Number of patients who transition to Acute Myeloid Leukemia (AML)

    Participants who progress to Acute Myeloid Leukemia (AML) during the study. AML is defined as an increase of at least 50% bone marrow blasts, and more than 20% bone marrow blasts for Refractory Anemia with Excess Blasts types 1 and 2 (RAEB-1 and RAEB-2) and Chronic Myelomonocytic Leukemia (CMML) patients and as an increase of at least 50% bone marrow blasts for Refractory Anemia with Excess Blasts in Transformation (RAEB-t) patients.

    Measured: Up to 2 years after study enrollment.

  6. Quality of Life Questionnaire

    Change from baseline in responses in the European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire [QLQ]-C30 version 3. Questionnaire will be administered at baseline and at 4 week intervals.

    Measured: Up to 2 years after study enrollment.

  7. Infections.

    Incidence of infections requiring treatment with intravenous antimicrobials and of bleeding episodes.

    Measured: Up to 2 years after study enrollment.

  8. Concentration of rigosertib in plasma.

    Concentration of rigosertib in plasma will be measured by a validated High Performance Liquid Chromatography (HPLC) method.

    Measured: Week 1 and week 3.

  9. Safety.

    Counts of patients who have adverse events (AEs). Adverse events will be grouped by system organ class (SOC) and preferred term (PT) using the most recent version of the Medical Dictionary for Regulatory Activities (MedDRA), and will be summarized by worst grade according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0.

    Measured: Study enrollment until 30 days after patient's last dose of rigosertib up to 2 years.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Aug 2013 (estimated)
  2. Study startAug 2013
  3. Primary completion29 Jun 2017
  4. Study completion29 Jun 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01928537
Sponsor's protocol ID
Onconova 04-24
Other IDs
2013-001124-19
Status last verified
Jul 2018
First submitted
21 Aug 2013
Last updated
30 Jun 2020
Results posted
No
Data monitoring committee
Yes

Publications

  • Olnes MJ, Shenoy A, Weinstein B, Pfannes L, Loeliger K, Tucker Z, Tian X, Kwak M, Wilhelm F, Yong AS, Maric I, Maniar M, Scheinberg P, Groopman J, Young NS, Sloand EM. Directed therapy for patients with myelodysplastic syndromes (MDS) by suppression of cyclin D1 with ON 01910.Na. Leuk Res. 2012 Aug;36(8):982-9. doi: 10.1016/j.leukres.2012.04.002. Epub 2012 Apr 21.

    PubMed 22524974
  • Seetharam M, Fan AC, Tran M, Xu L, Renschler JP, Felsher DW, Sridhar K, Wilhelm F, Greenberg PL. Treatment of higher risk myelodysplastic syndrome patients unresponsive to hypomethylating agents with ON 01910.Na. Leuk Res. 2012 Jan;36(1):98-103. doi: 10.1016/j.leukres.2011.08.022. Epub 2011 Sep 14.

    PubMed 21924492
  • Silverman LR, Greenberg P, Raza A, Olnes MJ, Holland JF, Reddy P, Maniar M, Wilhelm F. Clinical activity and safety of the dual pathway inhibitor rigosertib for higher risk myelodysplastic syndromes following DNA methyltransferase inhibitor therapy. Hematol Oncol. 2015 Jun;33(2):57-66. doi: 10.1002/hon.2137. Epub 2014 Apr 29.

    PubMed 24777753
  • Al-Kali A. Relationship of bone marrow blast (BMBL) response to overall survival (OS) in a multicenter study of rigosertib (Rigo) in patients (pts) with myelodysplastic syndrome (MDS) with excess blasts progressing on or after treatment with a hypomethylating agent (HMA). Journal of Clinical Oncology 2017 35:15_suppl, 7056-7056 ASCO 2017

  • Garcia-Manero G, Fenaux P. Comprehensive Analysis of Safety: Rigosertib in 557 Patients with Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML). Blood Dec 2016, 128 (22) 2011; ASH 2016.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing rigosertib sodium in people with Myelodysplastic Syndromes and Refractory Anemia With Excess Blasts, run by Traws Pharma, Inc. at 35 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 35 sites in United States, Germany, Australia, Italy, Sweden and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Relationship of bone marrow blast response and overall survival. (time frame: Up to 2 years.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01928537, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jun 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in