Trial Outcomes & Findings for Azacitidine and Pembrolizumab in Treating Patients With Myelodysplastic Syndrome (NCT NCT03094637)

NCT ID: NCT03094637

Last Updated: 2023-03-22

Results Overview

Will estimate the ORR for the experimental treatments, along with the 95% credible intervals. The association between ORR and patient's clinical characteristics will be examined by Wilcoxon's rank sum test or Fisher's exact test, as appropriate.

Recruitment status

UNKNOWN

Study phase

PHASE2

Target enrollment

40 participants

Primary outcome timeframe

Up to 2 years 4 months

Results posted on

2023-03-22

Participant Flow

Recruitment Period: November 2017 to March 2020

Participant milestones

Participant milestones
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) failureHMA Failure
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Overall Study
STARTED
17
20
Overall Study
COMPLETED
17
20
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Azacitidine and Pembrolizumab in Treating Patients With Myelodysplastic Syndrome

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Total
n=37 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
4 Participants
n=99 Participants
0 Participants
n=107 Participants
4 Participants
n=206 Participants
Age, Categorical
>=65 years
13 Participants
n=99 Participants
20 Participants
n=107 Participants
33 Participants
n=206 Participants
Age, Continuous
72 years
n=99 Participants
75 years
n=107 Participants
74 years
n=206 Participants
Sex: Female, Male
Female
7 Participants
n=99 Participants
5 Participants
n=107 Participants
12 Participants
n=206 Participants
Sex: Female, Male
Male
10 Participants
n=99 Participants
15 Participants
n=107 Participants
25 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
White
16 Participants
n=99 Participants
19 Participants
n=107 Participants
35 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Region of Enrollment
United States
17 participants
n=99 Participants
20 participants
n=107 Participants
37 participants
n=206 Participants

PRIMARY outcome

Timeframe: Up to 2 years 4 months

Will estimate the ORR for the experimental treatments, along with the 95% credible intervals. The association between ORR and patient's clinical characteristics will be examined by Wilcoxon's rank sum test or Fisher's exact test, as appropriate.

Outcome measures

Outcome measures
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Overall Response Rate (ORR) Defined as Complete Response + Partial Response + Hematological Improvement
13 Participants
5 Participants

PRIMARY outcome

Timeframe: Up to 4 years

Will be estimated using the method of Kaplan and Meier. Comparisons of time-to-event endpoints by important subgroups will be made using the log-rank tests.

Outcome measures

Outcome measures
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Event Free Survival
9.24 Months
Interval 3.98 to 31.23
5.39 Months
Interval 1.48 to 9.07

PRIMARY outcome

Timeframe: Up to 4 years

Will be estimated using the method of Kaplan and Meier. Comparisons of time-to-event endpoints by important subgroups will be made using the log-rank tests. Overall Survival will be presented by median survival, which is the time point at which the cumulative survival drops below 50%. If there is no median survival (not reached), it means the cumulative survival was more than 50%.

Outcome measures

Outcome measures
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 Participants
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Overall Survival
NA Months
Interval 1.0 to 32.0
Median survival for frontline patients cohort was not reached as the cumulative survival was greater than 50%.
5.79 Months
Interval 4.47 to 18.61

Adverse Events

Treatment (Azacitidine, Pembrolizumab) in Untreated Patients

Serious events: 9 serious events
Other events: 15 other events
Deaths: 1 deaths

Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure

Serious events: 13 serious events
Other events: 14 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 participants at risk
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 participants at risk
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Investigations
Hyperbilirubinemia
5.9%
1/17 • Number of events 2 • Up to 4 years
0.00%
0/20 • Up to 4 years
Gastrointestinal disorders
Colitis
5.9%
1/17 • Number of events 1 • Up to 4 years
0.00%
0/20 • Up to 4 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
General disorders
Fatigue
0.00%
0/17 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Blood and lymphatic system disorders
Neutropenic Fever
5.9%
1/17 • Number of events 1 • Up to 4 years
10.0%
2/20 • Number of events 4 • Up to 4 years
General disorders
fever
5.9%
1/17 • Number of events 1 • Up to 4 years
0.00%
0/20 • Up to 4 years
Blood and lymphatic system disorders
anemia
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Hepatobiliary disorders
Hepatobiliary/Pancreas
5.9%
1/17 • Number of events 1 • Up to 4 years
0.00%
0/20 • Up to 4 years
Infections and infestations
Infection
23.5%
4/17 • Number of events 6 • Up to 4 years
55.0%
11/20 • Number of events 12 • Up to 4 years
Infections and infestations
Infection G 3 or 4 neutrophils
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Injury, poisoning and procedural complications
Intra-operative Injury
0.00%
0/17 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Blood and lymphatic system disorders
Leukocytes
0.00%
0/17 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Blood and lymphatic system disorders
Neutrophils
0.00%
0/17 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
General disorders
Pain
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Skin and subcutaneous tissue disorders
Pruritis/itching
0.00%
0/17 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Renal and urinary disorders
Renal/Genitourinary
5.9%
1/17 • Number of events 1 • Up to 4 years
0.00%
0/20 • Up to 4 years
Nervous system disorders
Syncope
5.9%
1/17 • Number of events 1 • Up to 4 years
0.00%
0/20 • Up to 4 years

Other adverse events

Other adverse events
Measure
Treatment (Azacitidine, Pembrolizumab) in Untreated Patients
n=17 participants at risk
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Treatment (Azacitidine, Pembrolizumab) Patients With Hypomethylating Agent (HMA) Failure
n=20 participants at risk
Patients receive azacitidine IV over 10-40 minutes or SC on days 1-7, and pembrolizumab IV over 30 minutes every 3 weeks. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Azacitidine: Given IV Pembrolizumab: Given IV
Gastrointestinal disorders
Nausea
17.6%
3/17 • Number of events 4 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Investigations
Alanine Aminotransferase
5.9%
1/17 • Number of events 1 • Up to 4 years
20.0%
4/20 • Number of events 4 • Up to 4 years
Gastrointestinal disorders
Anorexia
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Investigations
Asparatate Aminotransferase
0.00%
0/17 • Up to 4 years
20.0%
4/20 • Number of events 4 • Up to 4 years
Gastrointestinal disorders
Constipation
11.8%
2/17 • Number of events 2 • Up to 4 years
30.0%
6/20 • Number of events 6 • Up to 4 years
Skin and subcutaneous tissue disorders
Dermatology Skin/Other
11.8%
2/17 • Number of events 2 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Gastrointestinal disorders
Diarrhea
11.8%
2/17 • Number of events 2 • Up to 4 years
0.00%
0/20 • Up to 4 years
General disorders
Fever
0.00%
0/17 • Up to 4 years
10.0%
2/20 • Number of events 2 • Up to 4 years
Blood and lymphatic system disorders
anemia
11.8%
2/17 • Number of events 2 • Up to 4 years
0.00%
0/20 • Up to 4 years
Infections and infestations
Infection
17.6%
3/17 • Number of events 3 • Up to 4 years
5.0%
1/20 • Number of events 2 • Up to 4 years
General disorders
Injection Site Reaction
5.9%
1/17 • Number of events 1 • Up to 4 years
10.0%
2/20 • Number of events 2 • Up to 4 years
Investigations
Neutropenia
17.6%
3/17 • Number of events 3 • Up to 4 years
35.0%
7/20 • Number of events 7 • Up to 4 years
General disorders
Pain
35.3%
6/17 • Number of events 6 • Up to 4 years
15.0%
3/20 • Number of events 3 • Up to 4 years
Skin and subcutaneous tissue disorders
Pruritis/itching
5.9%
1/17 • Number of events 1 • Up to 4 years
5.0%
1/20 • Number of events 1 • Up to 4 years
Skin and subcutaneous tissue disorders
Rash/desquamation
17.6%
3/17 • Number of events 4 • Up to 4 years
10.0%
2/20 • Number of events 2 • Up to 4 years

Additional Information

Guillermo Garcia-Manero MD/Professor

The University of Texas MD Anderson Cancer Center

Phone: 713-745-3428

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place