This is a prospective, open label, single arm, multi-centre phase II trial aiming to evaluate the safety and efficacy of Enasidenib (investigational product) as prophylactic consolidation in patients with IDH2-mutated MDS, CMML and AML in remission after allo-SCT.
This is a prospective, open label, single arm, multi-centre phase II trial aiming to evaluate the safety and efficacy of Enasidenib (investigational product) as prophylactic consolidation in patients with IDH2-mutated MDS, CMML and AML in remission after allo-SCT. Study Design: * interventional * prospective, open-label, single arm, multicenter phase-II trial * total patients sample size: 50 patients * number of trial sites: 11 all located in Germany and members of the EBMT Patients with AML, MDS and CMML, in whom an IDH2 mutation has been detected at diagnosis prior allo-SCT, are eligible for consolidation therapy, if they are in complete hematological remission after first allo-SCT. IDH2 mutation might be absent at this time (CRMRDnegative), or might be detectable at submicroscopical levels (CRMRDpositive) given the high sensitivity of detection methods nowadays available. Remission will be evaluated within a screening period between day +25 and day +35. Evaluation of remission will be performed locally with IDH2 mutation analysis performed at an experienced local laboratory of the respective center. The report about IDH2 mutation testing at diagnosis has to be sent to the principle investigator for review at screening to include the patient; a BM sample will be stored for central retesting, which will be performed in batch during the course of the study. Having a documented hematological CR, patients will enter the treatment phase within 30 days after this BM evaluation (latest time point day +65) and start treatment with Enasidenib. They are envisaged to receive Enasidenib (100 mg per day, day 1-28) for up to 12 cycles (=12 months). Patients will go off protocol prematurely in case of relapse, intolerability of study treatment and in case of withdrawal of consent. In those patients who relapse during study treatment subsequent therapy for relapse will be performed according to the choice of the individual treating physician. Patients who finish study as planned or prematurely will be regularly followed for one year, lost to follow up, death or withdrawal of consent.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
Participants receive up to 12 cycles of Enasidenib.
University Hospital Duesseldorf Dept. of Hematology, Oncology and Clinical Immunology
Düsseldorf, North Rhine-Westphalia, Germany
Uniklinik RWTH Aachen Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation (Med. Klinik IV)
Aachen, Germany
Type, incidence and severity of adverse events specifying seriousness and expectedness (AE, SAE, SUSAR)
Number of participants with Adverse Events as assessed by CTCAE v5.0
Time frame: through study completion, an average of 2 years
Number of participants who maintain remission (molecular/hematological) after allo-SCT
Number of participants who maintain Remission (molecular/hematological) as a measure of efficacy
Time frame: through study completion, an average of 2 years
Overall Survival
Days from start of Treatment and from date of allo-SCT until death or last follow up as a measure of efficacy
Time frame: through study completion, an average of 2 years
Relapse-free Survival
Days from evaluation of remission at screening and from date of allo-SCT until relapse, death, or last follow up as a measure of efficacy
Time frame: through study completion, an average of 2 years
Non-relapse mortality
Days from evaluation of remission at screening and from date of allo-SCT until death without relapse or last follow up as a measure of efficacy
Time frame: through study completion, an average of 2 years
Relapse incidence
number of participants that relapse during the study as a measure of efficacy
Time frame: through study completion, an average of 2 years
Numbers of Participants Meeting Criteria of Treatment Failure
Number of participants who require any cellular or pharmacological intervention due to pending or frank relapse (defined as treatment-failure) as a measure of efficacy
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TREATMENT
Masking
NONE
Enrollment
50
Universitätsklinikum Köln Klinik I für Innere Medizin
Cologne, Germany
Universitätsklinikum Carl Gustav Carus Medizinische Klinik und Poliklinik I
Dresden, Germany
Universitätsklinikum Essen Klinik für Hämatologie und Stammzelltransplantation
Essen, Germany
Universitätsklinikum Frankfurt Med. Klinik II
Frankfurt, Germany
Universitätsklinikum Hamburg-Eppendorf Interdisziplinäre Klinik für Stammzelltransplantation
Hamburg, Germany
Universitätsklinikum Heidelberg Innere Medizin V: Hämatologie, Onkologie und Rheumatologie
Heidelberg, Germany
Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik I, Hämatologie und Zelltherapie
Leipzig, Germany
Klinikum rechts der Isar der TU München Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie
München, Germany
...and 1 more locations
Time frame: through study completion, an average of 2 years
Correlation of cytogenetics/molecular alterations and relapse-free survival
Comparison of relapse-free survival between different cytogenetics/molecular subtypes as a measure of efficacy using time to event curves and log-rank test
Time frame: through study completion, an average of 2 years
Incidence, course and severity of aGvHD and cGvHD
Incidence, course and severity of aGvHD and cGvHD as a measure of safety
Time frame: through study completion, an average of 2 years
Number of hospitalizations
Number of hospitalizations per participant as a measure of safety
Time frame: through treatment completion, an average of 1 year
Number of participants who require dose reductions for toxicity reasons
Number of participants who require dose reductions for toxicity reasons as a measure of safety
Time frame: through treatment completion, an average of 1 year
Number of participants who have to stop consolidation therapy due to toxicity (Consolidation Arm)
Number of participants who have to stop consolidation therapy due to toxicity as a measure of safety (Consolidation Arm)
Time frame: through treatment completion, an average of 1 year
Number of participants who can receive all 12 cycles of consolidation therapy(Consolidation Arm)
Number of participants who can receive all 12 cycles of consolidation therapy as a measure of Safety (Consolidation Arm)
Time frame: through treatment completion, an average of 1 year
Number of screened participants that can start consolidation therapy within the envisaged time frame (Consolidation Arm)
Number of screened participants that can start consolidation therapy within the envisaged time Frame as a measure of safety (Consolidation Arm)
Time frame: up to 65 days