Myelodysplastic Syndrome (MDS) is a group of disorders that gradually affect the ability of a person's bone marrow (semi-liquid tissue present in many bones like backbones) to produce normal blood cells. Some people with MDS have a risk of the disease progressing to acute myeloid leukemia (AML), and a risk of death from the disease itself. Symptoms of MDS include fatigue, shortness of breath, unusual paleness due to anemia (low red blood cell count), easy or unusual bruising, and red spots just beneath the skin caused by bleeding. The purpose of this study is to see how safe and effective venetoclax and azacitidine (AZA) combination are when compared to AZA and a placebo (contains no medicine), in participants with newly diagnosed higher-risk MDS. Venetoclax is an investigational drug being developed for the treatment of MDS. The study consists of two treatment arms - In one arm, participants will receive venetoclax and AZA. In another arm, participants will receive AZA and placebo. Adult participants with newly diagnosed higher-risk MDS will be enrolled. Around 500 participants will be enrolled in approximately 220 sites worldwide. Participants in one arm will receive oral doses of venetoclax tablet and intravenous (infusion in the vein) or subcutaneous (given under the skin) AZA solution. Participants in another arm will receive oral doses of placebo tablet and intravenous or subcutaneous AZA solution. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the course of the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood and bone marrow tests, checking for side effects, and completing questionnaires.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
531
Tablet: Oral
Subcutaneous (SC) or Intravenous (IV) injection
Tablet; Oral
Duplicate_Providence Medical Foundation /ID# 222633
Fullerton, California, United States
University of California, Los Angeles /ID# 221760
Los Angeles, California, United States
Torrance Memorial Physician Network Cancer Care /ID# 222702
Torrance, California, United States
PIH Health Whittier Hospital /ID# 222647
Whittier, California, United States
Rocky Mountain Cancer Centers - Boulder /ID# 223723
Boulder, Colorado, United States
Overall survival (OS)
OS is defined as the number of days from the date of randomization to the date of death of any cause, or last known date to be alive.
Time frame: Up To 5 Years
Modified Overall Response (mOR)
mOR \[complete remission (CR) + marrow complete remission (mCR) + partial response (PR)\] is defined as achieving a CR, mCR, or PR at any time point during the study per the modified International Working Group (IWG) 2006 criteria for myelodysplastic syndrome (MDS).
Time frame: Up To 5 Years
Percentage of Participants Achieving Overall Hematological Improvement (HI)
Overall HI is defined as achieving the response of HI-platelet or HI-neutrophil, or HI-erythroid at any time point during the study prior to post-treatment therapy per the modified IWG 2006 criteria for MDS.
Time frame: Up to 5 Years
Complete Remission (CR)
CR is defined as achieving a complete remission at any time point during the study per the modified International Working Group (IWG) 2006 criteria for myelodysplastic syndrome (MDS).
Time frame: Up To 36 Months
Percentage of Participants Achieving Transfusion Independence (TI) Who are Transfusion Dependent at Baseline
TI is when the participants who were transfusion dependent on red blood cell (RBC) and/or Platelet at baseline achieve transfusion independence post baseline. TI is a period of at least 56 days with no transfusion after the date of the first dose of study drug to the last dose of study drug + 30 days, or 1 day before the date of progressive disease/ relapse from CR or PR per the modified IWG 2006 criteria for MDS, or 1 day before the initiation of post-treatment therapy or 1 day before death, whichever is earliest.
Time frame: Up To 5 Years
Time to Deterioration in Physical Functioning as Measured by Physical Functioning Domain of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Scale
Time to deterioration in physical functioning, as measured by the EORTC QLQ-C30 physical functioning score is defined as the time from the date of randomization to the date of death of any cause, or the first time worsening of score from baseline \>= a pre-specified threshold. Participants rate items on a 4-point scale, with 1 as "not at all" and 4 as "very much."
Time frame: Up To 5 Years
Change in Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue Short Form (SF) 7a Scale Score
Fatigue will be assessed using the PROMIS Fatigue SF 7a Global Fatigue Score. PROMIS Fatigue SF 7a is a 7-item questionnaire that assesses the impact and experience of fatigue over the past 7 days. Participants rate items on a 5-point scale, with 1 as "never" an 5 as "always".
Time frame: Up To 5 Years
Overall Response (OR)
OR \[complete remission (CR) + partial response (PR)\] is defined as achieving a CR or PR at any time point during the study per the modified IWG 2006 criteria for MDS.
Time frame: Up To 5 Years
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Yale University School of Medicine /ID# 222764
New Haven, Connecticut, United States
Helen F. Graham Cancer Center & Research Institute /ID# 223731
Newark, Delaware, United States
Florida Cancer Specialists - Fort Myers /ID# 221319
Fort Myers, Florida, United States
Memorial Healthcare System /ID# 222703
Hollywood, Florida, United States
Florida Cancer Specialists - North /ID# 221318
St. Petersburg, Florida, United States
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