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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01736683
Other study ID # 7962-017
Secondary ID ACE-011-MDS-0012
Status Completed
Phase Phase 2
First received
Last updated
Start date November 28, 2012
Est. completion date April 30, 2018

Study information

Verified date October 2022
Source Merck Sharp & Dohme LLC
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The primary objective of this study is to determine a safe, tolerable and effective dose of sotatercept that results in the greatest frequency of improvement of anemia in patients diagnosed with low- or intermediate-1 risk myelodysplastic syndromes (MDS) or non-proliferative chronic myelomonocytic leukemia (CMML).


Recruitment information / eligibility

Status Completed
Enrollment 74
Est. completion date April 30, 2018
Est. primary completion date April 30, 2018
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Men and women = 18 years of age - Documented diagnosis of myelodysplastic syndromes (MDS) or non-proliferative chronic myelomonocytic leukemia (CMML), white blood cells (WBC) = 13,000 /mm^3, World Health Organization (WHO) that meets International Prognostic Scoring System (IPSS) criteria for low or intermediate-1 risk disease - Anemia, Hemoglobin (Hgb) = 9.0 g/dL or = 2 units of Red Blood Cells (RBCs) within 84 days - No response or loss of response to Erythropoiesis-Stimulating Agents (ESAs) or erythropoetin (EPO) > 500 mU/ml - Eastern Cooperative Group (ECOG) score =2. - Creatinine < 1.5 * Upper Limit of the Normal (ULN) - Total bilirubin =3.0 mg/dL - Aspartate aminotransferase (AST)/Serum glutamic oxaloacetic transaminase (SGOT) & Alanine Aminotransferase (ALT)/Serum Glutamic Pyruvic (SGPT) =3.0 * Upper Limit of Norma (ULN) - Free of metastatic malignancy (other than MDS) for =2 years - Highly effective methods of birth control for females and males Exclusion Criteria: - Chromosome 5q deletion - Pregnant or breast feeding women and males who do not agree to use condom during the sexual contact with females of childbearing potential - Major surgery within 30 days - Incomplete recovery or incomplete healing of wounds from previous surgery - Heart failure =3 (New York Heart Association (NYHA)) - Thromboembolic or myocardial infarction event within 6 months - Concurrent anti-cancer cytotoxic chemotherapy - History of severe allergic or anaphylactic reaction or hypersensitivity to recombinant protein - Known positive for Human Immunovirus (HIV) or infectious Hepatitis type C or active infectious Hepatitis type B - Clinically significant anemia unrelated to MDS - Thrombocytopenia (<30,000/uL) - Uncontrolled hypertension - Treatment with another investigational drug or device within 28 days prior to Day 1 - Prior exposure to sotatercept (ACE-011) - Any serious medical condition, lab abnormality or psychiatric illness

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Sotatercept
Sotatercept is supplied as a lyophilized powder that is reconstituted using Water for Injection (WFI) and administered as a subcutaneous injection (SC) injection by the study staff at the clinical site.

Locations

Country Name City State
France Centre Hospitalier Universitaire d'Avicennes Bobigny Cedex
France Institute Paoli-Calmettes Service Haematology Bp 156,
France CHRU de Lille-Hopital Claude Huriez Service des Maladies du Sang Lille
France CHRU Nantes Nantes
France Hopital Cochin Hematologie Paris Cedex 14
France Centre Henri Becquerel Rouen
France CHU Purpan Toulouse
United States Johns Hopkins Baltimore Maryland
United States Dana-Farber / Harvard Cancer Institute Boston Massachusetts
United States The Cleveland Clinic Foundation Hematology and Medical Oncology Rm 35 Cleveland Ohio
United States Rocky Mountain Cancer Center-Midtown Denver Colorado
United States Monter Cancer Center, North Shore LIJ Health Systems Lake Success New York
United States Sarah Cannon Research Inst Nashville Tennessee
United States Columbia University Medical Center/New York-Presbyterian Hospital New York New York
United States Virginia Oncology Associates Norfolk Virginia
United States Texas Oncology Round Rock Cancer Center - Round Rock Round Rock Texas
United States University of Texas Health Science Center at San Antonio San Antonio Texas
United States H. Lee Moffitt Cancer Center and Research Institute Tampa Florida
United States Texas Oncology, P.A. - Tyler Tyler Texas
United States Yakima Valley Memorial Hospital/ North Star Lodge Yakima Washington

Sponsors (1)

Lead Sponsor Collaborator
Merck Sharp & Dohme LLC

Countries where clinical trial is conducted

United States,  France, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants With Erythroid Hematological Improvement (HI-E) Starting Before the Completion of Five Cycles of Treatment (Responder Rate) The responder rate includes non-transfusion dependent efficacy (NTDE) participants and transfusion dependent efficacy (TDE) participants. For non-transfusion dependence efficacy (NTDE) participants who required < 4 units of RBCs in the 8 weeks prior to start of therapy, HI-E was defined as an increase of >=1.5 g/dL hemoglobin sustained for 56 days over a period of >=8 weeks. For transfusion dependence efficacy (TDE) participants who required >=4 units of RBCs in the 8 weeks prior to start of therapy, HI-E was defined as a decrease of >= 4 units of RBCs transfused sustained for 56 days over a period of 8 weeks. Day 2 to Day 142
Secondary Time to Erythroid Hematological Improvement (HI-E) Response Time to first response = start date of first response (HI-E) - first dose date + 1 day. For NTDE participants (who required < 4 units of RBCs in the 8 weeks prior to start of therapy), HI-E was defined as an increase of >=1.5 g/dL hemoglobin sustained for 56 days over a period of >=8 weeks. For TDE participants (who required >=4 units of RBCs in the 8 weeks prior to start of therapy), HI-E was defined as a decrease of >= 4 units of RBCs transfused sustained for 56 days over a period of 8 weeks. Day 1 to Day 87
Secondary Duration of Erythroid Hematological Improvement (HI-E) The duration of HI-E response for participants who responded was (the last date of the consecutive hemoglobin [Hgb] measurements of the first >=56 day interval) - (the first date of the consecutive Hgb measurements of the first >=56 day interval) + 1 day. Day 1 to 183.7 weeks
Secondary Time to Progression to Acute Myeloid Leukemia (AML) for Participants Who Had Progression Progression to AML used criteria by the International Working Group (IWG) Response Criteria in Myelodysplasia (Cheson, 2006). Progression is considered if any of the following are met: - >=50% increase in blasts - >=50% decrement from maximum remission/response levels in granulocytes or platelets - Reduction in Hgb concentration by >=2 g/dL - Transfusion dependence This outcome was defined as a Kaplan-Meier estimate however few participants progressed so a Kaplan-Meier analysis could not be performed. Disclosed are time to progression values only for participants who did progress to AML. Day 1 to 183.7 weeks
Secondary Time to Progression to Events of Higher Risk Myelodysplastic Syndromes (MDS) Using the International Prognostic Scoring System (IPSS) For Participants Who Had Progression Progression to events of higher risk MDS used criteria from the International Prognostic Scoring System for MDS (IPSS) which assigns a prognostic score (0=good and increasing in risk by half-grades with the top score outlined below) for three prognostic variables: - Marrow blasts (score 0-2.0) - Karyotype (score 0-1.0) - Cytopenias: neutrophil, platelets, and Hg counts (score 0-0.5) The three individual scores are summed resulting in a full range of 0- 3.5 and placed into risk categories 0 = low risk 0.5-1.0 = intermediate-1 risk 1.5-2.0 = intermediate-2 risk >=2.5 = high risk This outcome was defined as a Kaplan-Meier estimate however few participants progressed so a Kaplan-Meier analysis could not be performed. Data reported represent event times (weeks) for participants who did progress to higher risk MDS categories. Day 1 to 257.3 weeks
Secondary Kaplan-Meier Estimates for Progression-free Survival Participants who had disease progression were considered to have events. Participants who died without acute myeloid leukemia (AML) were also considered to have events with the event date as the date of death. Those who did not have disease progression and who were lost to follow-up were censored at the last known disease progression assessment date. Participants without disease progression at the last follow-up contact were censored at the date of the last follow-up contact date. Disease Progression to AML used criteria by the International Working Group (IWG) Response Criteria in Myelodysplasia (Cheson, 2006). Progression is considered if any of the following are met: - >=50% increase in blasts - >=50% decrement from maximum remission/response levels in granulocytes or platelets - Reduction in hemoglobin (Hgb) concentration by >=2 g/dL - Transfusion dependence Day 1 to 257.3 weeks
Secondary Kaplan-Meier Estimates for Overall Survival (OS) OS was defined as the time between start of treatment and the death/censored date. Participants who died (regardless of the cause of death) were considered to have an event. Participants who were alive at the end of the study, and participants who were lost to follow-up, were censored at the last date when subjects were known to be alive. Day 1 to 257.3 weeks
Secondary Pharmacokinetic Parameters of Sotatercept: Serum Concentration at Various Study Timepoints Maximum observed serum concentration, obtained directly from the observed concentration versus time data. Cycle 1 Day 8 and !5 up to Cycle 2 Day 1
Secondary Participants With Treatment-Emergent Adverse Events (TEAE) An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a subject during the course of a study. Treatment-emergent adverse events (TEAEs) are defined as any AE occurring or worsening on or after the first treatment of the study medication and within 42 days after the last dose. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to the study drug and reported as 'Suspected' on the CRF. AEs with a missing relationship were treated as 'treatment-related' in data summaries. Day 1 up to 59.2 months
Secondary Dose Limiting Toxicities (DLTs) The following were DLTs if the investigator suspected they were treatment related: 1. Increase to >= 140 mmHg systolic blood pressure 2. Increase to >=90 mmHg diastolic blood pressure 3. Increase to >=140 systolic and increase > 20 mmHg compared to baseline systolic 4. Increase to >=90 mmHg diastolic and increase > 20 mmHg compared to baseline diastolic 5. Introduction of new anti-hypertension medication during treatment 6. Increase in dose of baseline anti-hypertension medication during treatment 7. >= Grade 2 (moderate severity or worse) hypertension as an adverse event Day 1 to 59.2 months
Secondary Number of Participants Who Achieved Red Blood Cell (RBC)-Transfusion Independence During the Erythroid Hematological Improvement (HI-E) Interval Number of participants who achieved RBC-independence was defined as participants who required no RBC-transfusions during a 56-day interval of erythroid hematological improvement (HI-E). NTDE = non-transfusion dependence efficacy participants who required < 4 units of RBCs in the 8 weeks prior to start of therapy TDE = transfusion dependence efficacy participants who required >=4 units of RBCs in the 8 weeks prior to start of therapy Day 2 to Day 142
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