Myelodysplastic Syndrome Clinical Trial
Official title:
A Randomized Phase I Study to Assess the Pharmacokinetics, Tolerability, Efficacy and Pharmacodynamics of Three Dosing Schedules of Oral Rigosertib in Transfusion-dependent, Low, Intermediate 1, or Intermediate-2 Myelodysplastic Syndrome Patients Based on the International Prognostic Scoring System
This study will compare the dosing regimen of oral rigosertib, which has been used in other studies of lower risk Myelodysplastic Syndrome (MDS), with 2 new dosing regimens to determine if one of the new regimens gives improved results as measured by disease status, side effects, and analyses of blood and urine samples.
This will be a Phase I, randomized, 3-treatment arm, single-center study in
transfusion-dependent Myelodysplastic Syndrome (MDS) patients classified as Low- or
Intermediate-1 (Int-1) or Intermediate-2 (Int-2) risk by the International Prognostic Scoring
System (IPSS). Initially, 18 patients (6 per treatment arm) will be randomized in a 1:1:1
ratio to 1 of 3 oral rigosertib dosing regimens, each of which is a cycle consisting of 14
consecutive days of dosing followed by 7 days off drug.
Treatment with erythropoiesis-stimulating agent (ESA) is prohibited for the first 15 weeks (5
cycles). After 15 weeks of dosing (5 cycles), ESA treatment will be initiated if the patient
still needs red blood cell (RBC) transfusions and if the pre-transfusion hemoglobin (Hgb)
value is ≤ 9 g/dL, unless the clinical judgment of the Investigator determines ESA
administration to a patient with a Hgb level > 9 g/dL is warranted.
All study participants will be allowed, as medically justified, access to RBC and platelet
(PLT) transfusions, and to filgrastim. Rigosertib dosing adjustment policies are described.
After all 18 patients have completed 3 cycles, a risk/benefit analysis will be completed
assessing the distribution of adverse events (AEs) and serious adverse events (SAEs) and the
number of transfusions among the 3 treatment arms. This analysis will select 1 of the 3
dosing regimens as having the best risk/benefit profile and an additional 12 to 18 patients
will be enrolled at this dosing regimen. Eligibility criteria may be modified by protocol
amendments to enroll patients with different characteristics. All patients will be treated
for 48 weeks or until 2006 International Working Group (IWG) progression criteria are met,
unacceptable toxicity is observed, intercurrent illness or a change in the patient's
condition prevents further administration of study drug treatment, or until death from any
cause occurs, whichever comes first. Patients who have continued hematologic response at 48
weeks may continue to be treated in the study beyond 48 weeks until 2006 IWG progression
criteria are met or until death from any cause, whichever comes first.
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