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A Multicenter, Randomized, Open-label, Parallel-group, Phase 3 Trial of Subcutaneous Azacitidine Plus Best Supportive Care Versus Conventional Care Regimens Plus Best Supportive Care for the Treatment of Myelodysplastic Syndromes (MDS)

0 criterios cumplidosConsulta de un vistazo cómo tu perfil cumple con cada criterio de elegibilidad.
Qué se está evaluando

Azacitidine

+ Physician Choice
Medicamento
Otro
Quiénes están siendo reclutados

Enfermedad
+6

+ Enfermedades de la Médula Ósea
+ Enfermedades Hematológicas
A partir de 18 años
Ver todos los criterios de elegibilidad
Cómo está diseñado el estudio

Otro tipo de estudio

Fase 3
Intervencional
Inicio del estudio: noviembre de 2003
Ver detalles del protocolo

Resumen

Patrocinador PrincipalCelgene
Última actualización: 14 de enero de 2026
Extraido de una base de datos validada por el gobierno.Reclamar como socio
Fecha de inicio: 1 de noviembre de 2003Fecha en la que se inscribió al primer participante.

Comparison/Control Interventions offered the physician three options: * Best supportive care (BSC) alone, * Low-dose cytarabine subcutaneously for 14 days every 28 to 42 days, or * Standard chemotherapy administered for induction as a continuous intravenous infusion of cytarabine over 7 days plus an anthracycline (daunorubicin, idarubicin, or mitoxantrone) on Days 1, 2, and 3; and, for those eligible, 1 or 2 consolidation cycles administered as continuous intravenous infusions of cytarabine for 3 to 7 days with the same anthracycline that was used at induction on Days 1 and 2 (each cycle between 28 to 70 days from the start of the previous cycle). All three options included best supportive care. Neither the experimental group (azacitidine) nor any of the comparison/control options allowed use of erythropoietin. Duration of Intervention: Patients will be treated until death, withdrawal, unacceptable toxicity or conclusion of the study.

Título OficialA Multicenter, Randomized, Open-label, Parallel-group, Phase 3 Trial of Subcutaneous Azacitidine Plus Best Supportive Care Versus Conventional Care Regimens Plus Best Supportive Care for the Treatment of Myelodysplastic Syndromes (MDS) 
NCT00071799
Patrocinador PrincipalCelgene
Última actualización: 14 de enero de 2026
Extraido de una base de datos validada por el gobierno.Reclamar como socio

Protocolo

Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.
Detalles del Diseño
Se reclutarán 358 pacientesNúmero total de participantes que el ensayo clínico espera reclutar.
Otro Tipo de Estudio
Algunos estudios exploran temas que no encajan en una categoría específica. Pueden incluir investigaciones innovadoras, nuevas tecnologías o áreas emergentes en el ámbito de la salud.

Cómo se asignan los participantes a diferentes grupos/brazos
En este estudio clínico, los participantes se colocan en grupos de forma aleatoria, como si se lanzara una moneda. Esto garantiza que el estudio sea justo e imparcial, lo que hace que los resultados sean más confiables. Al asignar a los participantes al azar, los investigadores pueden comparar mejor los tratamientos sin influencias externas.

Otras formas de asignar participantes
Asignación no aleatoria: Los participantes se asignan en función de factores específicos, como su condición médica o la decisión de un médico.
Ninguna (ensayo de un solo brazo): Si el estudio tiene un solo grupo, todos los participantes reciben el mismo tratamiento y no se necesita asignación.

Cómo se administran los tratamientos a los participantes
Los participantes se dividen en diferentes grupos, y cada uno recibe un tratamiento específico al mismo tiempo. Esto ayuda a los investigadores a comparar la eficacia de los distintos tratamientos entre sí.

Otras formas de asignar tratamientos
Asignación a un solo grupo: Todos reciben el mismo tratamiento.
Asignación cruzada: Los participantes cambian de tratamiento durante el estudio.
Asignación factorial: Los participantes reciben diferentes combinaciones de tratamientos.
Asignación secuencial: Los participantes reciben tratamientos uno tras otro en un orden específico, posiblemente según su respuesta individual.
Otra asignación: La asignación de tratamientos no sigue un diseño estándar o predefinido.

Cómo se controla la efectividad del tratamiento
En un estudio no controlado con placebo, ningún participante recibe una sustancia inerte (placebo) para comparar los resultados. En su lugar, todos los participantes reciben el tratamiento experimental o una alternativa activa (a menudo el tratamiento estándar). Este método permite comparar los efectos del tratamiento experimental con los de otra intervención activa, en lugar de un placebo.

Otras opciones
Controlado con placebo: Se utiliza un placebo para comparar los efectos del tratamiento experimental con los de una sustancia inerte, aislando así el efecto real del tratamiento.

Cómo se mantiene la confidencialidad de las intervenciones asignadas a los participantes
Todos los involucrados en el estudio saben qué tratamiento se está administrando. Esto se utiliza cuando no es posible o necesario ocultar los detalles del tratamiento a los participantes o investigadores.

Otras formas de enmascarar la información
Simple ciego: Los participantes no saben qué tratamiento están recibiendo, pero los investigadores sí.
Doble ciego: Ni los participantes ni los investigadores saben qué tratamiento se está administrando.
Triple ciego: Participantes, investigadores y evaluadores de resultados no saben qué tratamiento se está administrando.
Cuádruple ciego: Participantes, investigadores, evaluadores de resultados y personal de atención no saben qué tratamiento se está administrando.

Elegibilidad

Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.
Condiciones
Criterios
Cualquier sexoSexo biológico de los participantes elegibles para inscribirse.
A partir de 18 añosRango de edades de los participantes que pueden unirse al estudio.
Voluntarios sanos no permitidosIndica si personas sanas, sin la condición que se estudia, pueden participar.
Condiciones
Patología
Enfermedad
Enfermedades de la Médula Ósea
Enfermedades Hematológicas
Síndromes Mielodisplásicos
Neoplasias
Procesos Patológicos
Condiciones Precancerosas
Preleucemia
Síndrome
Criterios

Inclusion Criteria: * Have a diagnosis of refractory anemia with excess blasts or refractory anemia with excess blasts in transformation according to the French-American-British classification system for myelodysplastic syndromes (MDS) and a relatively high risk of acute myeloid leukemia (AML) transformation, with an International Prognostic Scoring System score of INT-2 or High. * Be 18 years of age or older * Have a life expectancy of at least 3 months * Be unlikely to proceed to bone marrow or stem cell transplantation therapy following remission * Have serum bilirubin levels less than or equal to 1.5 times the upper limit of normal range for the laboratory * Have serum glutamic-oxaloacetic transaminase (aspartate aminotransferase) or serum glutamic-pyruvic transaminase (alanine aminotransferase) levels less than or equal to 2 times the upper limit of normal (unless these are considered to be related to transfusion-induced secondary hemosiderosis) * Have serum creatinine levels less than or equal to 1.5 times the upper limit of normal Exclusion Criteria: * Secondary myelodysplastic syndromes (MDS) * Prior treatment with azacitidine; * Prior history of acute myeloid leukemia (AML); * Malignant disease diagnosed within prior 12 months; * Metastatic disease; * Hepatic tumors; * Radiation, chemotherapy, cytotoxic therapy for non-MDS conditions within prior 12 months; * Prior transplantation or cytotoxic therapy to treat MDS; * Serious medical illness likely to limit survival to 12 months or less; * Treatment with erythropoietin or myeloid growth factors during prior 21 days or androgenic hormones during prior 13 days; * Active HIV, viral hepatitis type B or C; * Treatment with investigational drugs during prior 30 days; * Within the 28-day screening period, documented red cell folate deficiency, as evidenced by red blood cell folate (not serum folate) or vitamin B12 deficiency

Plan de Estudio

Conoce todos los tratamientos administrados en este estudio, su descripción detallada y en qué consisten.
Grupos de Tratamiento
Objetivos del Estudio
2 grupos de intervención 

están designados en este estudio

0% de probabilidad 

de ser asignado al grupo placebo

Grupos de Tratamiento
Grupo I
Experimental
Study Drug plus best supportive care. Treatment with erythropoietin was not permitted

Azacitidine was injected subcutaneously (SC) at an initial dose of 75mg/m\^2/day for 7 days. The 7-day dosing was repeated every 28 days with dose adjustment based on predefined hematology and renal laboratory results. Number of cycles: Azacitidine treatment was to be continued until the end of the study unless treatment was discontinued due to unacceptable toxicity, relapse after complete or partial response, transformation to AML or disease progression.
Grupo II
Comparador Activo
Physician choice of low dose cytarabine (plus best supportive care), standard chemotherapy (plus best supportive care) or best supportive care (only). Treatment with erythropoietin was not permitted

Physician Choice was one of three options: * Best supportive care (BSC) alone, * Low-dose cytarabine subcutaneously for 14 days every 28 to 42 days, or * Standard chemotherapy administered for induction as a continuous intravenous infusion of cytarabine over 7 days plus an anthracycline (daunorubicin, idarubicin, or mitoxantrone) on Days 1, 2, and 3; and, for those eligible, 1 or 2 consolidation cycles administered as continuous intravenous infusions of cytarabine for 3 to 7 days with the same anthracycline that was used at induction on Days 1 and 2 (each cycle between 28 to 70 days from the start of the previous cycle). All three options included best supportive care
Objetivos del Estudio
Objetivos Primarios

Kaplan-Meier estimates for the median months until death from any cause within the intent-to-treat population. Patients surviving at the end of the follow-up period were censored at the date of last contact. If a patient withdrew consent to follow-up or was lost to follow-up, the patient was censored as of the last date of contact.

Kaplan-Meier estimates for the median months until death from any cause within the intent-to-treat population. Patients surviving at the end of the follow-up period were censored at the date of last contact. If a patient withdrew consent to follow-up or was lost to follow-up, the patient was censored as of the last date of contact. Subgroups that were analyzed are age, gender, French-American-British (FAB) classification, World Health Organization (WHO) classification and International Prognostic Scoring System (IPSS) classification.

Count of participants who died during the study
Objetivos Secundarios

The time to transformation to AML or death from any cause (whichever occurred first) was defined as the number of days from the date of randomization until the date of documented AML transformation or death from any cause. Patients who did not transform to AML or die were censored at the date of last follow-up.

The time to transformation to AML was defined as the number of days from the date of randomization until the date of documented AML transformation, defined as a bone marrow blast count ≥ 30% independent of baseline bone marrow count. Patients who did not transform to AML were censored at the date of last follow-up or date of death.

Summary of dependence and independence from red blood cell (RBC) transfusion at baseline and during treatment, for patients who were dependent at baseline. A patient was considered transfusion independent at baseline if the patient had no transfusions during the 56 days prior to randomization. During study, a patient was considered transfusion independent during the on-treatment period if the patient had no transfusions during any 56 consecutive days or more. Otherwise, the patient was considered transfusion dependent.

Summary of dependence and independence from red blood cell (RBC) transfusion at baseline and during treatment, for patients who were independent at baseline. A patient was considered transfusion independent at baseline if the patient had no transfusions during the 56 days prior to randomization. During study, a patient was considered transfusion independent during the on-treatment period if the patient had no transfusions during any 56 consecutive days or more. Otherwise, the patient was considered transfusion dependent.

Summary of dependence and independence from platelet transfusion at baseline and during treatment for patients who were dependent at baseline. A patient was considered transfusion independent at baseline if the patient had no transfusions during the 56 days prior to randomization. During study, a patient was considered transfusion independent during the on-treatment period if the patient had no transfusions during any 56 consecutive days or more. Otherwise, the patient was considered transfusion dependent.

Summary of dependence and independence from platelet transfusion at baseline and during treatment for patients who were independent at baseline. A patient was considered transfusion independent at baseline if the patient had no transfusions during the 56 days prior to randomization. During study, a patient was considered transfusion independent during the on-treatment period if the patient had no transfusions during any 56 consecutive days or more. Otherwise, the patient was considered transfusion dependent.

Investigator determined responses followed IWG criteria for * complete remission(CR): repeat bone marrow show \<5% myeloblasts, and peripheral blood evaluations lasting \>=2 months of hemoglobin(\>110 g/L), neutrophils(\>=1.5x10\^9/L), platelets(\>=100x10\^9/L), blasts (0%) and no dysplasia * partial remission(PR) is the same as CR for peripheral blood: bone marrow shows blasts decrease by \>=50% or a less advanced FAB classification from pretreatment * stable disease(SD) is a failure to achieve at least a partial remission, but with no evidence of progression for at least 2 months.

IWG 2000 Criteria: Pretreatment=hemoglobin \<100g/L or RBC transfusion-dependent, platelet count \<100x10\^9/L or platelet transfusion dependent, absolute neutrophil count \<1.5x10\^9/L. Erythroid response: Major-\>20g/L increase or transfusion independent. Minor- 10-20g/L increase or \>=50% decrease in transfusion requirements. Platelet response: Major-absolute increase of \>=30x10\^9/L or platelet transfusion independence. Minor-\>=50% increase. Neutrophil response: Major-\>=100% increase or an absolute increase of \>0.5x10\^9/L. Minor-\>=100% increase and absolute increase of \<0.5x10\^9/L.

The time to disease progression, relapse after complete or partial remission (CR, PR), or death from any cause was defined as the time from the date of randomization until the first date of documented disease progression, relapse after CR or PR, or death from any cause.

The duration of improvement was defined as the time from the date of hematologic improvement until the date of first documented progression or relapse after hematologic improvement or death from any cause.

The on-treatment adverse event rate of infection requiring IV antibiotics, antifungals, or antivirals per patient-years. The on-treatment period was considered the period from the date of randomization to the last treatment study visit.

Patient counts for a variety of subsets of adverse experiences for the core study period (day 1 to 42 months). The individual options for Conventional Care Regimens (Best Supportive Care Only, Low-Dose Cytarabine, and Standard Chemotherapy) are presented as separate treatments.

Centros del Estudio

Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.
Este estudio tiene 108 ubicaciones
Suspendido
Universita Degli Studi Di SassariSassari, ItalyVer ubicación
Suspendido
National Centre of Hematology and Transfusiology, SofiaSofia, Bulgaria
Suspendido
Multiprofile Hospital for Active Treatment (MHAT), "St. Marina" Clinic of HematologyVarna, Bulgaria
Suspendido
University Multiprofile Hospital for Active Treatment "Sveta Marina"Varna, Bulgaria
Completado108 Centros de Estudio