Working… Menu

Combination of 5-azacitidine and Lenalidomide in Myelodysplastic Syndromes (MDS) or Acute Myelogenous Leukemia (AML) Myelodysplastic Syndromes (AZALE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00923234
Recruitment Status : Terminated (The primary objective has already been answered with the number of recruited patients.)
First Posted : June 18, 2009
Last Update Posted : December 18, 2013
Celgene Corporation
Information provided by (Responsible Party):
Technische Universität Dresden

Brief Summary:
The hypothesis of this study is that 5-aza and lenalidomide act synergistically in MDS and AML patients with chromosomal abnormalities involving monosomy 5 or del5q. Therefore, this phase I study will investigate the maximum tolerated dose (MTD) of lenalidomide in combination with a fixed dose of 5-aza in this patient population.

Condition or disease Intervention/treatment Phase
Myelodysplastic Syndromes Acute Myelogenous Leukemia Drug: Azacitidine Drug: Lenalidomide Phase 1

Detailed Description:
Cytogenetics are the main predictors of outcome in patients with AML. In fact, a monosomy 5 or del (5q) as single aberration are poor prognostic markers. Overall, the complete response rate for conventionally treated patients with newly-diagnosed AML with chromosome 5 abnormalities is about 31% to 37 % and all patients rapidly relapse if not rescued by allogeneic HSCT. The situation is almost similar in patients with high-risk MDS.Vidaza® has been shown in clinical trials to achieve remission rates in about 29% (CR+PR) of the patients while a total of 49% achieve improvement of blood counts.Revlimid® is also able to achieve complete remissions in advanced MDS and even overt leukemia with or without chromosome 5 abnormalities. Nevertheless, response rates are lower compared to low-risk MDS (IPSS Low/INT-1). Therefore, Revlimid® seems to be too weak as a single agent, but a promising compound for a combination therapy.

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of a Combination of 5-azacitidine Followed by Lenalidomide in High-risk MDS or Relapsed/Refractory AML Patients With Cytogenetic Abnormalities Including -5 or Del(5q)
Study Start Date : June 2009
Actual Primary Completion Date : July 2012
Actual Study Completion Date : July 2012

Arm Intervention/treatment
Experimental: Azacitidine and Lenalidomide
Azacitidine 75 mg/m² SC days 1-5 every 28 days for a maximum of 8 cycles and Lenalidomide 10 - 25 mg PO days 6-19 every 28 days for a maximum of 8 cycles
Drug: Azacitidine
75 mg/m² SC days 1-5 every 28 days for a maximum of 8 cycles
Other Name: Vidaza

Drug: Lenalidomide
10 - 25 mg PO days 6-19 every 28 days for a maximum of 8 cycles
Other Name: Revlimid

Primary Outcome Measures :
  1. Maximum tolerated dose (MTD) of Revlimid® (lenalidomide)in combination with Vidaza®(5-azacitidine) [ Time Frame: during first cycle of therapy ]

Secondary Outcome Measures :
  1. Clinical and cytogenetic response [ Time Frame: during therapy ]
  2. Safety (type, frequency, severity, and relationship of adverse events to study treatment) [ Time Frame: during therapy ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Understand and voluntarily sign an informed consent form.
  • Age >=18 years at the time of signing the informed consent form.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Relapsed or refractory AML (>30% blasts, FAB classification)with karyotype abnormalities involving monosomy 5 or del(5q) or MDS and t-MDS INT-2 or HIGH according to IPSS classification with karyotype abnormalities involving monosomy 5 or del(5q) either previously treated or untreated
  • Not eligible for an immediate allogeneic HSCT (due to donor unavailability)
  • All previous MDS or AML specific therapy with exception of corticosteroids not exceeding doses of 10mg/day prednisone must have been discontinued at least 1 week prior to study enrollment.
  • Non-hematological toxicity (except alopecia) resulting from previous treatment must be resolved to WHO CTC Grade ≤ 2.
  • ECOG performance status of < 3 at study entry.
  • Laboratory test results within these ranges:Serum creatinine <= 2.0 mg/dL, Total bilirubin <= 3 x ULN, AST (SGOT) and ALT (SGPT) <= 3 x ULN
  • Females of childbearing potential must agree to use a reliable form of contraception or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or breast feeding females. (Lactating females must agree not to breast feed while on study).
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Known hypersensitivity to thalidomide, lenalidomide, 5-azacitidine or mannitol.
  • Myocardial infarction within 6 months before study entry, New York Heart Association Class III or IV heart failure, uncontrolled angina or severe uncontrolled ventricular arrhythmias.
  • The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  • Uncontrolled lung disease.
  • Known positive for HIV or acute infectious hepatitis, type A, B or C.
  • Participation in another clinical study in the 4 weeks prior to enrollment or during this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00923234

Layout table for location information
Medizinische Klinik und Poliklinik I, Uniklinik
Dresden, Germany
Universitätsklinikum Düsseldorf, Klinik für Hämatologie/Onkologie/klinische Immunologie
Düsseldorf, Germany, 40225
Klinikum der J.W. Goethe-Universität, Medizinische Klink II
Frankfurt, Germany, 60590
Technische Universität München, Klinikum Rechts der Isar
München, Germany, 81675
Sponsors and Collaborators
Technische Universität Dresden
Celgene Corporation
Layout table for investigator information
Principal Investigator: Uwe Platzbecker, MD Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
Layout table for additonal information
Responsible Party: Technische Universität Dresden Identifier: NCT00923234    
Other Study ID Numbers: TUD-AZALE1-037
First Posted: June 18, 2009    Key Record Dates
Last Update Posted: December 18, 2013
Last Verified: December 2013
Keywords provided by Technische Universität Dresden:
monosomy 5
Additional relevant MeSH terms:
Layout table for MeSH terms
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Myelodysplastic Syndromes
Pathologic Processes
Neoplasms by Histologic Type
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Immunologic Factors
Physiological Effects of Drugs
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors