Trial Outcomes & Findings for Study of CC-5013 to Evaluate Safety, Pharmacokinetics and Effectiveness for Japanese Patients With Symptomatic Anemia Associated With Myelodysplastic Syndrome With a Del(5)(q31-33) Abnormality. (NCT NCT00812968)

NCT ID: NCT00812968

Last Updated: 2019-11-19

Results Overview

An AE that resulted in any of the following outcomes was defined as a serious adverse event (SAE): * Death; * Life-threatening event; * Any inpatient hospitalization or prolongation of existing hospitalization; * Persistent or significant disability or incapacity; * Congenital anomaly or birth defect; * Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 3.0) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

11 participants

Primary outcome timeframe

After the first study dose until 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).

Results posted on

2019-11-19

Participant Flow

Participant milestones

Participant milestones
Measure
Lenalidomide
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle. Treatment continued until disease progression or relapse following an erythroid improvement was documented, any of the criteria for treatment discontinuation was violated, or lenalidomide became commercially available for the treatment of MDS associated with a del (5q) cytogenetic abnormality, for up to 156 weeks (3 years).
Overall Study
STARTED
11
Overall Study
COMPLETED
0
Overall Study
NOT COMPLETED
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Lenalidomide
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle. Treatment continued until disease progression or relapse following an erythroid improvement was documented, any of the criteria for treatment discontinuation was violated, or lenalidomide became commercially available for the treatment of MDS associated with a del (5q) cytogenetic abnormality, for up to 156 weeks (3 years).
Overall Study
Relapse after erythroid response
6
Overall Study
Disease progression
1
Overall Study
No further treatment required
1
Overall Study
Study closed due to marketing approval
3

Baseline Characteristics

Study of CC-5013 to Evaluate Safety, Pharmacokinetics and Effectiveness for Japanese Patients With Symptomatic Anemia Associated With Myelodysplastic Syndrome With a Del(5)(q31-33) Abnormality.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Age, Continuous
71.8 years
STANDARD_DEVIATION 5.95 • n=39 Participants
Sex: Female, Male
Female
7 Participants
n=39 Participants
Sex: Female, Male
Male
4 Participants
n=39 Participants
Region of Enrollment
Japan
11 participants
n=39 Participants
Duration of MDS
2.0 years
STANDARD_DEVIATION 1.44 • n=39 Participants
International Prognostic Scoring System (IPSS) Score
Low risk
2 participants
n=39 Participants
International Prognostic Scoring System (IPSS) Score
Intermediate-1 risk
9 participants
n=39 Participants
International Prognostic Scoring System (IPSS) Score
Intermediate-2 risk
0 participants
n=39 Participants
International Prognostic Scoring System (IPSS) Score
High risk
0 participants
n=39 Participants
French-American-British (FAB) classification of MDS
Refractory anemia (RA)
9 participants
n=39 Participants
French-American-British (FAB) classification of MDS
Refractory anemia with ringed sideroblasts (RARS)
0 participants
n=39 Participants
French-American-British (FAB) classification of MDS
Refractory anemia with excess blasts (RAEB)
2 participants
n=39 Participants
French-American-British (FAB) classification of MDS
Chronic myelomonocytic leukemia (CMML)
0 participants
n=39 Participants
French-American-British (FAB) classification of MDS
RAEB in transformation (RAEB-t)
0 participants
n=39 Participants
World Health Organization Classification of MDS
Refractory anemia (RA)
0 participants
n=39 Participants
World Health Organization Classification of MDS
RA with ringed sideroblasts (RARS)
0 participants
n=39 Participants
World Health Organization Classification of MDS
Refractory anemia with excess blasts-1 (RAEB-1)
2 participants
n=39 Participants
World Health Organization Classification of MDS
Refractory anemia with excess blasts-2 (RAEB-2)
0 participants
n=39 Participants
World Health Organization Classification of MDS
Refractory cytopenia multilineage dysplasia (RCMD)
1 participants
n=39 Participants
World Health Organization Classification of MDS
RCMD and ringed sideroblasts (RCMD-RS)
0 participants
n=39 Participants
World Health Organization Classification of MDS
MDS, unclassified (MDS-U)
0 participants
n=39 Participants
World Health Organization Classification of MDS
MDS associated with isolated del(5q)
8 participants
n=39 Participants
Bone Marrow Cellularity
Aplastic (0%)
0 participants
n=39 Participants
Bone Marrow Cellularity
Hypocellular (> 0% to ≤ 30%)
3 participants
n=39 Participants
Bone Marrow Cellularity
Normocellular (> 30% to ≤ 60%)
5 participants
n=39 Participants
Bone Marrow Cellularity
Hypercellular (> 60% to ≤ 90%)
2 participants
n=39 Participants
Bone Marrow Cellularity
Packed (> 90% to ≤ 100%)
0 participants
n=39 Participants
Bone Marrow Cellularity
Missing
1 participants
n=39 Participants
Transfusion Dependency
Yes
5 participants
n=39 Participants
Transfusion Dependency
No
6 participants
n=39 Participants

PRIMARY outcome

Timeframe: After the first study dose until 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).

Population: Safety population: all patients who received at least 1 dose of study drug.

An AE that resulted in any of the following outcomes was defined as a serious adverse event (SAE): * Death; * Life-threatening event; * Any inpatient hospitalization or prolongation of existing hospitalization; * Persistent or significant disability or incapacity; * Congenital anomaly or birth defect; * Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 3.0) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Number of Participants With Adverse Events (AE)
Any adverse event (AE)
11 participants
Number of Participants With Adverse Events (AE)
AE related to study drug
11 participants
Number of Participants With Adverse Events (AE)
Grade 3 or 4 AE
11 participants
Number of Participants With Adverse Events (AE)
Grade 3 or 4 AE related to study drug
11 participants
Number of Participants With Adverse Events (AE)
Serious AE (SAE)
3 participants
Number of Participants With Adverse Events (AE)
SAE related to study drug
1 participants
Number of Participants With Adverse Events (AE)
AE leading to discontinuation of study drug
0 participants
Number of Participants With Adverse Events (AE)
Related AE leading to discontinuation
0 participants
Number of Participants With Adverse Events (AE)
AE leading to a dose reduction or interruption
10 participants
Number of Participants With Adverse Events (AE)
Related AE leading to dose reduction/interruption
9 participants
Number of Participants With Adverse Events (AE)
Deaths
0 participants

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: Pharmacokinetic (PK) population: all patients who adhered to the study treatment during the course of PK assessment (Days 1 to 5 of Cycle 1) and from whom blood and urine samples were collected.

Maximum observed plasma concentration of lenalidomide after a single dose on Day and after multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=6 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Maximum Observed Plasma Concentration (Cmax) of Lenalidomide
136 ng/mL
Geometric Coefficient of Variation 43.1
149 ng/mL
Geometric Coefficient of Variation 31.2

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population

Time to maximum observed plasma concentration of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=6 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Time to Maximum Plasma Concentration (Tmax) of Lenalidomide
2.52 hours
Interval 1.0 to 5.95
2.93 hours
Interval 1.0 to 4.0

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population

Area under the plasma concentration-time curve from time zero to the last measurable concentration (AUCt) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=6 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUCt) of Lenalidomide
718.4 ng*h/mL
Geometric Coefficient of Variation 41.2
803.5 ng*h/mL
Geometric Coefficient of Variation 46.9

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.

Population: PK population with available data

Area under the plasma concentration-time curve over the dosing interval (AUCτ) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Area Under the Plasma Concentration-time Curve Over the Dosing Interval (AUCτ) of Lenalidomide
866.5 ng*h/mL
Geometric Coefficient of Variation 44.1
877.9 ng*h/mL
Geometric Coefficient of Variation 43.0

SECONDARY outcome

Timeframe: Day 1 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.

Population: PK population with available data

Area under the plasma concentration-time curve from time zero to infinity (AUC∞) of lenalidomide after a single dose on Day 1.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC∞) of Lenalidomide
878.0 ng*h/mL
Geometric Coefficient of Variation 45.1

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

The apparent terminal half-life is the time required for plasma concentration to decrease by 50% after pseudo-equilibrium of distribution has been reached, and calculated as the natural logarithm of 2 (0.693) / Apparent terminal rate constant (λz).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Terminal Half-life (T1/2) of Lenalidomide
3.26 hours
Geometric Coefficient of Variation 23.0
3.57 hours
Geometric Coefficient of Variation 29.6

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

Apparent volume of distribution of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Apparent Volume of Distribution (VzF) of Lenalidomide
53.6 liters
Geometric Coefficient of Variation 30.9
58.6 liters
Geometric Coefficient of Variation 25.8

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

Apparent total plasma clearance (CL/F) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Apparent Total Plasma Clearance (CL/F) of Lenalidomide
189.8 mL/minute
Geometric Coefficient of Variation 45.1
189.9 mL/minute
Geometric Coefficient of Variation 43.0

SECONDARY outcome

Timeframe: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

Apparent terminal elimination rate constant of lenalidomide determined after a single dose on Day 1 and multiple doses (Day 4).

Outcome measures

Outcome measures
Measure
Lenalidomide
n=5 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
n=5 Participants
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Apparent Terminal Elimination Rate Constant of Lenalidomide
0.213 1/h
Geometric Coefficient of Variation 23.0
0.194 1/h
Geometric Coefficient of Variation 39.0

SECONDARY outcome

Timeframe: Response was assessed every 28 days through Week 156.

Population: Efficacy population: all patients who had a diagnosis of low- or intermediate-1-risk MDS associated with anemia based on confirmation by the central reviewers and received at least 1 dose of study drug.

Erythroid response was determined using the International Working Group (IWG) 2000 criteria, categorized as a major response or minor response. A major response in patients with transfusion-dependent anemia (receiving ≥ 4.5 units of red blood cell (RBC) transfusion during 56 consecutive days at Baseline) is defined as RBC transfusion independence accompanied by a ≥1.0 g/dL increase from Baseline in hemoglobin sustained for 56 days consecutively during the treatment period. In patients with transfusion-independent anemia with hemoglobin \< 10 g/dL at Baseline a major response is defined as a \> 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days. Minor response in patients with transfusion-dependent anemia defined as ≥ 50% decrease from Baseline in transfusion requirements sustained for consecutive 56 days, and in transfusion-independent patients as 1.0 to 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Number of Participants With a Erythroid Response
Erythroid responders (major or minor)
11 participants
Number of Participants With a Erythroid Response
Major erythroid responders
11 participants

SECONDARY outcome

Timeframe: From the first dose of study drug through Week 156

Population: Efficacy population

Time to erythroid response was calculated as the time from the first dose of study drug to the start of the first major or minor erythroid response. Similarly, time to major erythroid response was calculated as the time from the first dose of study drug to the start of the first major erythroid response.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Time to Erythroid Response
Time to erythroid response (major or minor)
2.1 weeks
Interval 0.3 to 11.1
Time to Erythroid Response
Time to major erythroid response
6.3 weeks
Interval 3.1 to 31.1

SECONDARY outcome

Timeframe: From the first dose of study drug through Week 156

Population: Efficacy population with a erythroid response

Duration of erythroid response was calculated as the time from the start of the first major or minor erythroid response to the end of the response. Similarly, duration of major erythroid response was calculated as the time from the start of the first major erythroid response to the end of the response. Response duration was censored at the last adequate assessment for patients who maintained response.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Duration of Erythroid Response
Duration of erythroid response (major or minor)
76.6 weeks
Interval 8.9 to 152.0
Duration of Erythroid Response
Duration of major erythroid response
72.1 weeks
Interval 32.1 to 144.1

SECONDARY outcome

Timeframe: Baseline and from Day1 until the maximum observed value (up to 155 weeks)

Population: Efficacy population with a erythroid response

Change in hemoglobin concentration from Baseline to the maximum observed value during the major erythroid response period for major erythroid responders.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Change From Baseline in Hemoglobin Concentration
Baseline concentration
7.0 g/dL
Interval 4.7 to 9.1
Change From Baseline in Hemoglobin Concentration
Maximum concentration during study
13.1 g/dL
Interval 10.7 to 15.8
Change From Baseline in Hemoglobin Concentration
Change from Baseline to maximum value
6.0 g/dL
Interval 2.7 to 11.1

SECONDARY outcome

Timeframe: Response was assessed every 28 days through Week 156

Population: Efficacy population with Baseline neutrophil count \< 1,500/mm\^3.

Neutrophil response was determined using the IWG (2000) criteria. A major response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase or a ≥ 500/mm\^3 increase, whichever is greater, sustained for consecutive 56 days during the treatment period. A minor response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase, but an absolute increase \< 500/mm\^3, sustained for consecutive 56 days during the treatment period.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=6 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Number of Participants With a Neutrophil Response
Minor response
0 participants
Number of Participants With a Neutrophil Response
Major response
1 participants

SECONDARY outcome

Timeframe: Response was assessed every 28 days through Week 156

Population: Efficacy population with a Baseline platelet count of \< 100,000/mm\^3 or who were platelet-transfusion dependent at Baseline. There were no patients with platelet count of \< 100,000/mm3 or who were platelet-transfusion dependent at Baseline, and thus platelet response was not evaluated.

Platelet response was determined using the IWG (2000) criteria. Major response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 30,000/mm\^3 increase sustained for consecutive 56 days during the treatment period. In platelet-transfusion-dependent patients at Baseline a major response is defined as stabilization of platelet counts and platelet transfusion independence sustained for consecutive 56 days during the treatment period. Minor response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 50% increase in platelet count with an absolute increase \> 10,000/mm\^3 and \< 30,000/mm\^3 sustained for consecutive 56 days during the treatment period.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Response was assessed every 12 weeks through Week 156

Population: Efficacy population

Cytogenetic (chromosome structure) abnormalities were assessed by a central cytogenetic reviewer based on prints and cytogenetic reports of the bone marrow sample from the central laboratory. Cytogenetic response was determined using the IWG (2000) criteria and categorized as either a major response or minor response. Twenty metaphases were analyzed for the determination of cytogenetic response. A major response was defined as no detectable cytogenetic abnormality, if an abnormality was present at Baseline, sustained for consecutive 56 days during the treatment period. A minor response was defined as ≥ 50% reduction from Baseline in abnormal metaphases sustained for consecutive 56 days during the treatment period.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Number of Participants With a Cytogenetic Response
Major response
1 participants
Number of Participants With a Cytogenetic Response
Minor response
5 participants

SECONDARY outcome

Timeframe: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens.

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=10 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Change From Baseline in Percentage of Bone Marrow Erythroblasts
Change from Baseline at the end of Cycle 3
36.5 Percentage of Bone Marrow Erythroblasts
Interval -12.0 to 51.0
Change From Baseline in Percentage of Bone Marrow Erythroblasts
Change from Baseline at the end of Cycle 6
21.5 Percentage of Bone Marrow Erythroblasts
Interval -5.0 to 56.0

SECONDARY outcome

Timeframe: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens at each time point (indicated by "N").

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Percentage of Bone Marrow Myeloblasts
Baseline (N=11)
3.77 Percentage of myeloblasts
Interval 1.2 to 8.4
Percentage of Bone Marrow Myeloblasts
End of Cycle 3 (N=10)
1.47 Percentage of myeloblasts
Interval 0.01 to 4.55
Percentage of Bone Marrow Myeloblasts
End of Cycle 6 (N=10)
1.79 Percentage of myeloblasts
Interval 0.01 to 4.0

SECONDARY outcome

Timeframe: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens at each time point (indicated by "N").

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Outcome measures

Outcome measures
Measure
Lenalidomide
n=11 Participants
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Lenalidomide: Day 4
Analysis of PK parameters on Day 4, after participants had received 10 mg of lenalidomide administered orally once daily for 4 days.
Percentage of Bone Marrow Promyelocytes
Baseline (N=11)
5 Percentage of promyelocytes
Interval 0.0 to 13.0
Percentage of Bone Marrow Promyelocytes
End of Cycle 3 (N=10)
5 Percentage of promyelocytes
Interval 1.0 to 12.0
Percentage of Bone Marrow Promyelocytes
End of Cycle 6 (N=10)
5 Percentage of promyelocytes
Interval 1.0 to 12.0

Adverse Events

Lenalidomide

Serious events: 3 serious events
Other events: 11 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Lenalidomide
n=11 participants at risk
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Gastrointestinal disorders
Gastric Ulcer
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Hepatobiliary disorders
Cholelithiasis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Herpes Zoster
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Influenza
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Spinal Compression Fracture
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Liver Function Test Abnormal
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Anorexia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).

Other adverse events

Other adverse events
Measure
Lenalidomide
n=11 participants at risk
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
Blood and lymphatic system disorders
Neutropenia
100.0%
11/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Thrombocytopenia
100.0%
11/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Leukopenia
90.9%
10/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Lymphopenia
72.7%
8/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Eosinophilia
45.5%
5/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Basophilia
36.4%
4/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Leukocytosis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Lymphadenitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Blood and lymphatic system disorders
Lymphocytosis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Constipation
90.9%
10/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Diarrhoea
36.4%
4/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Abdominal Pain
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Dental Caries
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Enteritis
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Gastritis
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Abdominal Discomfort
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Abdominal Pain Upper
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Dyspepsia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Gingivitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Haemorrhoidal Haemorrhage
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Lip Dry
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Oesophagitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Periodontitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Toothache
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Gastrointestinal disorders
Vomiting
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Nasopharyngitis
72.7%
8/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Bronchitis
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Gastroenteritis
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Rhinitis
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Urinary Tract Infection
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Acute Tonsillitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Cystitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Lymphadenitis Bacterial
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Oral Herpes
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Pharyngitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Pneumonia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Infections and infestations
Vulvitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Rash
72.7%
8/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Pruritus
45.5%
5/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Dermatitis Contact
36.4%
4/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Eczema
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Acute Febrile Neutrophilic Dermatosis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Dry Skin
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Erythema
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Skin and subcutaneous tissue disorders
Erythema Multiforme
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Alanine Aminotransferase Increased
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Creatinine Increased
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Fibrin Degradation Products Increased
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Aspartate Aminotransferase Increased
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Bilirubin Increased
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Phosphorus Decreased
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Uric Acid Increased
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Fibrin D Dimer Increased
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Alkaline Phosphatase Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Lactate Dehydrogenase Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Potassium Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Pressure Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Urea Decreased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Blood Urea Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
International Normalised Ratio Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Mean Cell Volume Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Investigations
Protein Total Increased
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Back Pain
36.4%
4/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Muscle Spasms
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Arthralgia
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Bone Pain
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Musculoskeletal Chest Pain
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Myalgia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Myalgia Intercostal
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Osteoarthritis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Osteoporosis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Periarthritis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Musculoskeletal and connective tissue disorders
Spinal Osteoarthritis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Spinal Compression Fracture
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Contusion
27.3%
3/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Excoriation
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Fracture
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Injury, poisoning and procedural complications
Tooth Fracture
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Face Oedema
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Injection Site Erythema
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Non-cardiac Chest Pain
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Oedema
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Oedema Peripheral
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Pain
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
General disorders
Pyrexia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Dehydration
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Hypoalbuminaemia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Hypokalaemia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Hypophosphataemia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Iron Deficiency
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Metabolism and nutrition disorders
Vitamin B12 Deficiency
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Vascular disorders
Hypertension
36.4%
4/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Eye disorders
Blepharitis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Eye disorders
Conjunctival Haemorrhage
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Eye disorders
Eye Discharge
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Eye disorders
Vision Blurred
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Eye disorders
Vitreous Detachment
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Respiratory, thoracic and mediastinal disorders
Epistaxis
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Respiratory, thoracic and mediastinal disorders
Rhinorrhoea
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Respiratory, thoracic and mediastinal disorders
Upper Respiratory Tract Inflammation
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Endocrine disorders
Hypothyroidism
18.2%
2/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Nervous system disorders
Cervicobrachial Syndrome
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Nervous system disorders
Headache
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Psychiatric disorders
Insomnia
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Psychiatric disorders
Tension
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Ear and labyrinth disorders
Ear Discomfort
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Hepatobiliary disorders
Hepatic Function Abnormal
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).
Renal and urinary disorders
Dysuria
9.1%
1/11 • From the first dose of study drug through 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).

Additional Information

Associate Director, Clinical Trials Disclosure

Celgene Corporation

Phone: 1-888-260-1599

Results disclosure agreements

  • Principal investigator is a sponsor employee Disclosure agreements vary; the Investigators shall not disclose any material/information disclosed by the Sponsor (Celgene KK) with the clinical trial or information obtained by conducting the clinical trial to third parties without Sponsor's prior written approval.
  • Publication restrictions are in place

Restriction type: OTHER