This study, is a Phase I/II clinical trial in three parts: Phase I Dose Escalation, Phase II, Part 1 RPTD Cohort, and Phase II, Part 2 Expansion. The first two parts have been completed. The Phase II, Part 2 Expansion will assess if treatment with rigosertib in combination with azacitidine, has measurable effects in patients with myelodysplastic syndrome (MDS). Safety of patients is an objective throughout all parts of the study.
This will be a Phase I/II open-label, single-arm, dose-escalating, multicenter study, in three parts: Phase I Dose Escalation, Phase II, Part 1 RPTD Cohort, and Phase II, Part 2 Expansion, in which patients with myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), or chronic myelomonocytic leukemia (CMML) will receive subcutaneous (SC) or intravenous (IV) azacitidine per approved label in combination with oral rigosertib. The first two parts of the study have been completed. The Phase II Part 2 Expansion will enroll up to 40 patients, randomized 1:1 into 2 cohorts of up to 20 patients each, to receive 1120 mg of rigosertib over 24 hours: either 560 mg in the morning and 560 mg in the afternoon, or 840 mg in the morning and 280 mg in the afternoon. The afternoon dose in both cohorts must be administered at 3 PM (±1 hr) at least 2 hr after lunch. In the Phase II, Part 2 Expansion patients with RAEB t/non-proliferative AML will be eligible, however patients with CMML will not.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Oral rigosertib will be administered twice a day in fasting conditions for weeks 1, 2, and 3 of a 4-week cycle.
Starting on Day 1 of second week (Day 8) of the cycle, azacitidine will be administered by subcutaneous injection or intravenous infusion at the labeled daily dose of 75 mg/m2, for 7 days.
Banner MD Anderson Cancer Center
Gilbert, Arizona, United States
City of Hope
Duarte, California, United States
Desert Hematology Oncology Medical Group, Inc.
Rancho Mirage, California, United States
Dose escalation part of study: Number of patients in whom Dose a Limiting Toxicity (DLT) are observed
Dose Limiting Toxicity is defined as Grade 3 or greater non-hematological toxicity or stomatitis and/or esophagitis/dysphagitis lasting longer than 3 days.
Time frame: 28 days
Dose escalation part of study: Number of patients in whom adverse events are observed
Adverse events will be coded using the most recent version of the Medical Dictionary for Regulatory Activities (MedDRA) and summarized by system organ class (SOC), preferred term (PT), and worst Common Terminology Criteria for Adverse Events (CTCAE) Version 4 grade per patient.
Time frame: Up to 48 weeks
In Phase 2 of study: Number of patients in whom adverse events are observed
Adverse events will be coded using the most recent version of the Medical Dictionary for Regulatory Activities (MedDRA) and summarized by system organ class (SOC), preferred term (PT), and worst Common Terminology Criteria for Adverse Events (CTCAE) Version 4 grade per patient.
Time frame: Up to 48 weeks
In Phase 2 of study: Area Under the Curve (AUC)
The following time points will be used to collect samples to determine the AUC on Day 1 and 15: Pre-dose the first dose of the day and at 0.5, 1.0, 1.5, 2.0, 4.0, 6.0, and 8.0 hour post dose the first dose of the day.
Time frame: Day 1 and Day 15
In Phase 2 of the study: Cmax
The following time points will be used to collect samples to determine the Cmax on Day 1 and 15: Pre-dose the first dose of the day and at 0.5, 1.0, 1.5, 2.0, 4.0, 6.0, and 8.0 hour post dose the first dose of the day.
Time frame: Days 1 and 15.
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Rush University Medical Center
Chicago, Illinois, United States
Cancer Center of Kansas
Wichita, Kansas, United States
Saint Louis University
St Louis, Missouri, United States
Roswell Park Cancer Institute
Buffalo, New York, United States
Mount Sinai Medical Center
New York, New York, United States
White Plains Hospital Center for Cancer Care
White Plains, New York, United States
Carolina Blood and Cancer Care Associates
Rock Hill, South Carolina, United States
...and 3 more locations
Number of patients with complete or partial response
Complete remission (CR) or partial remission (PR) or bone marrow CR according to 2006 International Working Group criteria.
Time frame: Up to 48 weeks
Number of patients in whom improvements in absolute neutrophil count, platelet count, and erythroid responses are observed
Hematologic Improvement according to 2006 International Working Group criteria.
Time frame: Up to 48 weeks.