Bioequivalence Study of Azacitidine for Injection in Myelodysplastic Syndrome (MDS) Patients

Myelodysplastic Syndrome Clinical Trial

Official title:

A Multi-Center Relative Bioavailability Study of Azacitidine 75 mg/m2 Subcutaneous Injection In Myelodysplastic Syndrome Patients Under Fasting Conditions

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01152346
• Other study ID #: AZFAST101
• Status: Completed
• Phase: Phase 1
• First received: June 25, 2010
• Last updated: January 27, 2015
• Start date: April 2011
• Est. completion date: May 2013

Study information

• Verified date: January 2015
• Source: Bioniche Pharma USA LLC
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug AdministrationFrance: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to determine the bioavailability of Azacitidine for Injection relative to Vidaza® in MDS patients under fasting conditions. The data will be evaluated statistically to determine if the products meet bioequivalence criteria.

Description:

This study is an open label, multi-center randomized, single dose, two-treatment, two-period, two-sequence, two-way cross-over, relative bioavailability study of Azacitidine for Injection for suspension use manufactured for Bioniche Pharma USA LLC compared with Vidaza® manufactured by Celgene Corporation in MDS patients under fasting conditions. Patients who are on a stable 75 mg/m2 dose of Vidaza will be randomized to study drug sequence Azacitidine on C1D1/ Vidaza® on C2D1 or Vidaza® on C1D1 / Azacitidine on C2D1. Randomization will be in a 2:2 ratio. Thirty-six (36) patients will be enrolled to ensure 28 evaluable patients. Patients will not be blinded to their treatment assignment.

After randomization, fasted patients will receive 1 dose of assigned study drug (either Azacitidine for Injection or Vidaza®) subcutaneously at a dose of 75 mg/m2 on C1D1. On Days 2-7, they will receive their normal Vidaza® treatment. Following a 21 day rest period, patients will cross over to receive the alternate treatment on C2D1 followed by their normal Vidaza®) treatment on Cycle 2 Days 2-7. The Final Patient Visit will be conducted 7 days following the last dose of Vidaza®.

The total duration of the study for each patient will be up to 56 days including the Screening period and Post Study Visit.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 19
• Est. completion date: May 2013
• Est. primary completion date: December 2012
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Male or female patients with age >18 years.

• Patients with Myelodysplastic Syndrome (MDS) placed on Vidaza® according to the Marketing Authorization issued in the country in which the clinical study is being conducted (i.e., in the US, patients with any of the following French-American-British ( FAB) subtypes: Refractory Anemia (RA), Refractory Anemia with Ringed Sideroblasts (RARS), (if accompanied by neutropenia or thrombocytopenia or requiring transfusions), Refractory Anemia with Excess Blasts (RAEB), Refractory Anemia with Excess Blasts in Transformation (RAEB-T) and Chronic Myelomonocytic Leukemia (CMMoL); in France, subjects who are not eligible for hematopoietic stem cell transplantation: with intermediate -2 and high-risk myelodysplastic syndromes according to the International Prognostic Scoring System (IPSS) or chronic myelomonocytic leukemia (CMML) with 10-29% marrow blasts without myeloproliferative disorder) and who currently receive Vidaza at 75 mg/m2;

• Patient life expectancy > 6 months.

• Patients with performance status of 0 - 2 as per ECOG Scale.

• Patients with Total Bilirubin < 1.5 x ULN; ALT/AST < 2 x ULN, Serum Creatinine < 1.5 ULN, Serum Bicarbonate > 19 mEq/L.

• Patients who have signed the Informed Consent Form.

Exclusion Criteria:

• Patients with a history of alcoholism or drug addiction (during past 2 years)

• Patients with severe hepatic impairment, impaired renal function, and any condition which in the Investigator's opinion would be contraindicated or would interfere with absorption of the study drug.

• Patients whose clinical laboratory test values are outside the reference range may be re-tested at the discretion of the Investigator. If the clinical values are outside the range on re-testing, the patient will not be eligible to participate in the study unless the Investigator deems the result not to be significant.

• Patients with any other active malignancy within the past 5 years except for cervical cancer in situ, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin.

• Patients who have a history of allergic responses to the class of drug being tested.

• Patients with hypersensitivity to Mannitol.

• Patients should not have donated blood and/or plasma for at least thirty (30) days prior to the first dosing of the study drug. Patients should not have had any transfusion of blood products for at least 7 days prior.

• Patients who have taken any investigational drug within thirty (30) days prior to the first dosing of the study.

• Female patients who are pregnant, breast-feeding, or who are likely to become pregnant during the study. Female patients of child bearing potential will be instructed to either abstain from sexual intercourse or use an acceptable method of birth control during the course of the study and for 3 months afterward. Male patients or their female partners should also use an acceptable method of birth control.

• Any patient whom the Investigator believes will not be a good candidate for the study.

Study Design

Allocation: Randomized, Endpoint Classification: Bio-equivalence Study, Intervention Model: Crossover Assignment, Masking: Open Label

Related Conditions & MeSH terms

• Myelodysplastic Syndrome
• Myelodysplastic Syndromes
• Preleukemia
• Syndrome

Intervention

Drug:
• Azacitidine for Injection
75 mg/m2 sc injection on Day 1 of either cycle 1 or cycle 2 per randomization assignment
• Vidaza®
75 mg/m2 sc injection on Day 1 of either cycle 1 or cycle 2 per randomization assignment

Locations

Country	Name	City	State
France	Service d'hématologie clinique Hôpital Avicenne	Bobigny cedex
France	CHU de Brest- Hôpital Morvan	Brest
France	Centre Hospitalier Lyon Sud	Lyon
France	Hôpital Archet 1	Nice
France	Hôpital Haut-Lévêque	Pessac
France	CH Annecy	Pringy
France	CHU Purpan	Toulouse
France	Centre régional de cancérologie Henry-Kaplan Service d'Hématologie et thérapie cellulaire	Tours
France	Service d'hématologie et de médecine interne CHU de Nancy Hôpital de Brabois	Vandoeuvre
United States	Pacific Cancer Medical Center Inc.	Anaheim	California
United States	Wilshire Oncology Medical Group	Corona	California
United States	Holy Cross Hospital	Fort Lauderdale	Florida
United States	California Cancer Associates	Fresno	California

Sponsors (1)

Lead Sponsor	Collaborator
Bioniche Pharma USA LLC

Countries where clinical trial is conducted

United States,  France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Measurement of Azacitidine in Plasma Samples for Determination of Cmax, AUC0-t, and AUC0-Inf	Pharmacokinetic samples will be collected pre-dose and at 12 timepoints post-dose for determination of the level of azacitidine. The relative bioavailability of test to reference drug will be evaluated. If the Cmax, AUC0-t and AUC0-inf 90% confidence intervals for the geometric mean ratio all lie within 80-125% for Azacitidine then bioequivalence is concluded.	13 timepoints from pre-dose to 8 hours post dose	No
Secondary	Number of Participants with Adverse Events as a Measure of Safety and Tolerability	Safety will be assessed through monitoring of adverse events and laboratory measures.	Throughout study	Yes