Clinical trial NCT00118287: Azacitidine and Etanercept in Treating Patients With Myelodysplastic Syndromes
Official title: Therapy of Myelodysplastic Syndrome (MDS) With Azacitidine Given in Combination With Etanercept: A Phase I/II Study.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
PHASE2
Conditions: de Novo Myelodysplastic Syndromes
Previously Treated Myelodysplastic Syndromes
Secondary Myelodysplastic Syndromes
Lead sponsor: Fred Hutchinson Cancer Center
Sponsor class: OTHER
Collaborators: name: National Cancer Institute (NCI)
First posted: 2005-07-11
Enrollment: 32
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This phase I/II trial studies how well giving azacitidine together with etanercept works in treating patients with myelodysplastic syndromes (MDS). Drugs used in chemotherapy, such as azacitidine, works in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemoprotective drugs, such as etanercept, may protect normal cells from the side effects of chemotherapy

Detailed description: PRIMARY OBJECTIVES:

I. Determine the frequency of hematologic responses in patients with MDS to 5-aza (azacitidine) plus etanercept.

II. Determine the efficacy of 5-aza combined with etanercept in patients with low or intermediate (int)-1 risk who fail to respond to anti-thymocyte globulin (ATG) plus etanercept and for the purpose of this trial are considered as having progressive or "more advanced" disease.

III. Correlate results of ex vivo/in vitro studies on phenotypic, cytogenetic and functional disease characteristics with in vivo treatment responses, to identify parameters that are associated with a high probability of response.

OUTLINE:

Patients receive etanercept subcutaneously (SC) twice weekly during weeks 1 and 2 and azacitidine SC or intravenously (IV) over 10-40 minutes on days 1-7. Treatment repeats every 28 days for at least 3 courses. Treatment continues in the absence of disease progression or unacceptable toxicity.

Eligibility criteria: Inclusion Criteria:

* Int-2 or high risk MDS patients
* Patients with low-risk or int-1 risk MDS by International Prognostic Scoring System (IPSS) criteria with:

  * Single or multilineage cytopenia (absolute neutrophil count \[ANC\] \< 1500/μL, hemoglobin \[Hgb\],10g/dL, or platelet count \< 100,000/μL); or
  * Transfusion requirement of at least 2 units of packed red blood cells over an 8 week period
* Serum creatinine =\< 1.5x ULN (upper limit of normal)
* Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2x ULN
* Performance status =\< 2 (Eastern Cooperative Oncology Group \[ECOG\] scale, 0-5)

Exclusion Criteria:

* Patients who have previously received hematopoietic stem cell transplants, specifically for MDS
* Patients with a diagnosis of acute myeloid leukemia (AML) by World Health Organization (WHO) criteria (i.e \>= 20% blasts) at time of enrollment
* Women of child bearing potential who are currently pregnant, lactating or who are not willing to use contraception during the entire duration of the study
* Men who are unwilling to use contraception while receiving 5-aza
* Patients with severe disease other than MDS which is expected to prevent compliance with the present protocol
* Patients with severe infections (pneumonia, septicemia, etc) within the 2 weeks prior to the anticipated start of protocol treatment
* Patients who are currently receiving or within the preceding 2 weeks have received cytotoxic therapy, hemopoietic growth factors, immunomodulatory therapy, or other experimental therapy for the treatment of MDS
* Current evidence of uncontrolled cardiac arrhythmia or congestive heart failure
* Platelet count =\< 10,000/mcl
* Absolute neutrophil count =\< 250/mcl
* Prior treatment with 5-aza
* Known or suspected hypersensitivity to azacitidine or mannitol

Primary outcomes:
measure: Frequency of Hematologic Responses, as Defined by International Working Group (IWG) Criteria
timeFrame: Up to 2 years
Secondary outcomes:
Other outcomes:
Locations:
city: Seattle
country: United States
facility: Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
state: Washington
Study officials:
affiliation: Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
name: Bart Scott
role: PRINCIPAL_INVESTIGATOR
References: