Lenalidomide Safety/Efficacy in Myelodysplastic Syndromes (MDS) Associated With a Deletion (Del)(5q) Cytogenetic Abnormality
Condition: Myelodysplastic Syndromes
MeSH terms: Preleukemia; Myelodysplastic Syndromes; Chromosome Disorders; Syndrome; Chromosome Aberrations
Intervention: lenalidomide
Intervention description: 10 mg orally once daily for 21 days out of a 28-day cycle (syncopated); subsequently amended (Amendment 1, dated 27 August 2003) to employ a continuous dosage regimen in which 10 mg was taken once daily for 28 day cycles (continuous). Subjects who initially began a syncopated regimen and who did not experience a dose-limiting adverse event were allowed to switch to the continuous regimen.
Intervention MeSH terms: Lenalidomide
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 148.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: MDS; CC-5013; Revlimid; Celgene

Summary:

      This study is a multicenter, single-arm, open-label study of oral lenalidomide monotherapy
      administered to red blood cell (RBC) transfusion-dependent subjects with low- or
      intermediate-1-risk Myelodysplastic Syndromes (MDS) associated with a del (5q31-33)
      cytogenetic abnormality. Screening procedures will take place within 28 days of the first day
      of lenalidomide treatment. Subjects will receive lenalidomide in 28-day cycles for up to 6
      cycles, or until bone marrow disease progression or progression/relapse following erythroid
      hematologic improvement is documented. Study visits will occur every cycle (every 28 days)
      and laboratory monitoring to assess hematological parameters will occur every 14 days. Safety
      and efficacy assessments to be performed during the study are outlined in the Schedule of
      Study Assessments.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Must understand and voluntarily sign an informed consent form

          -  Age 18 years or older at the time of signing the informed consent

          -  Must be able to adhere to the study visit schedule and other protocol requirements.

          -  Diagnosis of low or intermediate-1-risk International Prognostic Scoring System (IPSS)
             Myelodysplastic Syndromes (MDS) without an abnormality of chromosome 5 involving a
             deletion between bands q31 and q33.

          -  Red blood cell (RBC) transfusion-dependent anemia defined as having received greater
             than or equal to 2 units of RBCs within 8 weeks of the first day of study drug
             treatment.

          -  Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1 or 2.

          -  Women of childbearing potential (WCBP) must have a negative serum or urine pregnancy
             test within 7 days of starting study drug.

          -  Sexually active WCBP must agree to use adequate contraceptive methods (oral,
             injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine
             device; barrier contraceptive with spermicide; or vasectomized partner) while on study
             drug.

          -  WCBP must agree to have pregnancy tests every 4 weeks while on study drug.

        Exclusion Criteria:

          -  Pregnant or lactating females

          -  Prior therapy with lenalidomide.

          -  An abnormality of chromosome 5 involving a deletion between bands q31 and q33.

          -  Lab Abnormality: Absolute neutrophil count (ANC) <500 cell/mm^3 (0.5*10^9/L)

          -  Lab Abnormality: Platelet count <50,000/mm^3 (50*10^9/L)

          -  Lab Abnormality: Serum creatinine >2.5 mg/dL (221 mmol/L)

          -  Lab Abnormality: Serum total bilirubin >2.0 mg/dL (34 mmol/L)

          -  Prior greater than or equal to grade 3 National Cancer Institute (NCI) Common Toxicity
             Criteria (CTC) allergic reaction/hypersensitivity to thalidomide.

          -  Clinically significant anemia due to factors such as iron, B12 or folate deficiencies,
             autoimmune or hereditary hemolysis or gastrointestinal bleeding

          -  If a marrow aspirate is not evaluable for storage iron, transferrin saturation must be
             > 20% and serum ferritin not less than 50 ng/mL

          -  Use of hematopoietic growth factors within 7 days of the first day of study drug
             treatment.

          -  Prior greater than or equal to grade 3 NCI CTC rash or any desquamation (blistering)
             while taking thalidomide.

          -  Chronic use (>2 weeks) of greater than physiologic doses of a corticosteroid agent
             (dose equivalent to >10 mg/day of prednisone) within 28 days of the first day of study
             drug treatment.

          -  Use of experimental or standard drugs (i.e. chemotherapeutic, immunosuppressive, and
             cytoprotective agents) for the treatment of MDS within 28 days of the first day of
             study drug treatment.

          -  Prior history of malignancy other than MDS (except basal cell or squamous cell
             carcinoma or carcinoma in situ of the cervix or breast) unless the subject has been
             free of disease for greater than or equal to 3 years.

          -  Use of any other experimental therapy within 28 days of the first day of study drug
             treatment.