A Study of Luspatercept (ACE-536) to Treat Anemia Due to Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes (MEDALIST)

• ClinicalTrials.gov Identifier: NCT02631070
• Recruitment Status: Completed
• First Posted: December 15, 2015
• Results First Posted: May 22, 2020
• Last Update Posted: December 17, 2021
• Sponsor: Celgene
• Collaborator: Acceleron Pharma Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.)
• Information provided by (Responsible Party): Celgene

Study Description

Brief Summary:

The study will be conducted in compliance with the International Council on Harmonisation (ICH) of Technical Requirements for Registration of Pharmaceuticals for Human Use/Good Clinical Practice (GCP) and applicable regulatory requirements.

This is a Phase 3, double-blind, randomized, placebo-controlled, multicenter study to determine the efficacy and safety of luspatercept (ACE-536) versus placebo in participants with anemia due to the Revised International Prognostic Scoring System (IPSS-R) very low, low, or intermediate MDS with ring sideroblasts who require red blood cell (RBC) transfusions.

Condition or disease	Intervention/treatment	Phase
Myelodysplastic Syndromes	Drug: Luspatercept; Other: Placebo	Phase 3

Detailed Description:

Anemia is considered to be one of the most prevalent cytopenias in patients who have myelodysplastic syndromes, an umbrella term used to describe disorders relating to the ineffective production of red blood cells, white blood cells, and/or platelets. Ranging in severity from mild (asymptomatic) to severe, anemia can result in patients requiring regular red blood cell (RBC) transfusions, which can lead to further complications from iron overload. The goal of this study is to assess the safety and efficacy of luspatercept versus placebo in anemic patients who are categorized as International Prognostic Scoring System-Revised (IPSS-R) very low, low, or intermediate risk Myelodysplastic syndrome (MDS), have ring sideroblasts present, and require constant RBC transfusions. The design of the study will allow a period of initial randomization of patients into either the luspatercept or placebo arm, followed by a double-blind treatment period, and then an MDS disease assessment visit. For those patients that are determined to be experiencing clinical benefit as judged from the study Investigator by this disease assessment visit, they will be permitted to enter the double-blind Extension Phase of the study. Once patients are discontinued from study treatment, they will enter a post treatment follow-up period.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 229 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Phase 3, Double-blind, Randomized Study to Compare the Efficacy and Safety of Luspatercept (ACE-536) Versus Placebo for the Treatment of Anemia Due to the IPSS-R Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes in Subjects With Ring Sideroblasts Who Require Red Blood Cell Transfusions.
• Actual Study Start Date: February 9, 2016
• Actual Primary Completion Date: June 18, 2019
• Actual Study Completion Date: November 26, 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: Experimental Arm - Luspatercept (ACE-536); Starting dose of 1.0 mg/kg subcutaneous injection every 3 weeks	Drug: Luspatercept; Other Name: ACE-536
Placebo Comparator: Control Arm: Placebo; Subcutaneous injection every 3 weeks	Other: Placebo

Outcome Measures

Primary Outcome Measures :

1. Percentage Of Participants Who Achieved Red Blood Cell Transfusion Independence (RBC-TI) ≥ 8 Weeks From Week 1 to Week 24 [ Time Frame: From Week 1 through Week 24 of study treatment ]
   RBC-TI response was defined as the absence of any Red Blood Cells (RBC) transfusion during any consecutive 56-day (8-week) period (ie, Days 1 to 56, Days 2 to 57, Days 3 to 58, etc.) during the first 24 weeks of study treatment. Participants had to have at least 56 days (≥ 8 weeks) of transfusion independence prior to (and including) the Week 24 cut-off date to qualify as a responder. Participants who failed to achieve RBC-TI at least 56 days prior to or on the cut-off date were counted as non-responders.

Secondary Outcome Measures :

1. Percentage of Participants Who Achieved Red Blood Cell Transfusion Independence (RBC-TI) ≥ 12 Weeks From Week 1 to Week 24 [ Time Frame: From Week 1 through Week 24 of study treatment ]
   RBC-TI Response was defined as the absence of any Red Blood Cells (RBC) transfusion during any consecutive 84-day (12-week) period (ie, Days 1 to 84, Days 2 to 85, Days 3 to 86, etc.) during the first 24 weeks of treatment.
2. Percentage of Participants Who Achieved Red Blood Cell Transfusion Independence (RBC-TI) ≥ 12 Weeks From Week 1 to Week 48 [ Time Frame: From Week 1 through Week 48 of study treatment ]
   RBC-TI Response was defined as the absence of any Red Blood Cells (RBC) transfusion during any consecutive 84-day (12-week) period (ie, Days 1 to 84, Days 2 to 85, Days 3 to 86, etc.) during the first 48 weeks of treatment.
3. Percentage of Participants Who Achieved Red Blood Cell Transfusion Independence (RBC-TI) ≥ 8 Weeks From Week 1 Through Week 48 [ Time Frame: From Week 1 through Week 48 of study treatment ]
   RBC-TI response was defined as the absence of any Red Blood Cells (RBC) transfusion during any consecutive 56-day (8-week) period (ie, Days 1 to 56, Days 2 to 57, Days 3 to 58, etc.) during Week 1 through Week 48. Participants had to have at least 56 days (≥ 8 weeks) of transfusion independence prior to (and including) the Week 48 cut-off date to qualify as a responder. Participants who failed to achieve RBC-TI at least 56 days prior to Week 48 were counted as non-responders.
4. Change From Baseline in RBC Units Transfused Over Fixed 16-Week Period [ Time Frame: At Baseline (16 weeks prior to first dose of study treatment) and Weeks 9 to 24 or Weeks 33 to 48 ]
   Mean change in total number of Red Blood Cells (RBC) units transfused over a fixed 16-week period (Week 9-24 or Week 33-48) from the total number of RBC units transfused in the 16 weeks immediately on or prior to first dose of study treatment.
5. Percentage of Participants Who Achieved a Modified Hematologic Erythroid Response (mHI-E) Over Any Consecutive 56-Day Period [ Time Frame: Week 1 through 24 or Week 1 Through Week 48 ]
   A modified HI-E response was defined as the percentage of participants meeting the modified HI-E per the International Working Group (IWG) sustained over 56-day consecutive period during the Treatment period. For participants with a baseline RBC transfusion burden of ≥ 4 units/8 weeks, a mHI-E was defined as a reduction in RBC transfusion of at least 4 units/8 weeks; for participants with baseline RBC transfusion burden of <4 units/8 weeks, mHI-E, was defined as a mean increase in hemoglobin of ≥ 1.5 g/dL for 8 weeks in the absence of RBC transfusions.
6. Percentage of Participants Who Achieved a Mean Hemoglobin (Hgb) Increase of at Least 1.0 g/dL Over Any Consecutive 56-Day Period in Absence of Red Blood Cells (RBC) Transfusions [ Time Frame: Week 1 though Week 24 and Week 1 through 48 ]
   A mean hgb increase of ≥ 1.0 g/dL was analyzed as the percentage of participants with a hgb increase ≥ 1.0 g/dL compared with baseline (after applying the 14/3 day rule) that was sustained over any consecutive 56-day (8-week) period in the absence of RBC transfusions during the treatment period. (Week 1 through Week 24 and Week 1 through Week 48).
7. Duration of Red Blood Cell Transfusion Independence (RBC-TI) - Week 1 Through Week 24 [ Time Frame: From start of study treatment to 16 weeks after last dose, up to approximately 93 weeks ]
   Duration of RBC-TI was defined as the longest duration of response for participants who achieved RBC-TI of ≥ 8 weeks during the treatment period Week 1 through Week 24. Participants who maintained RBC-TI through the end of the treatment period were censored at the date of IP discontinuation or death, whichever occurred first. Median was estimated from unstratified Kaplan Meier method.
8. Duration of Red Blood Cell Transfusion Independence (RBC-TI) - Week 1 Through Week 48 [ Time Frame: From start of study treatment to 16 weeks after last dose, up to approximately 93 weeks ]
   Duration of RBC-TI was defined as the longest duration of response for participants who achieved RBC-TI of ≥ 8 weeks during the treatment period Week 1 through Week 48. Participants who maintained RBC-TI through the end of the treatment period were censored at the date of IP discontinuation or death, whichever occurred first. Median was estimated from unstratified Kaplan Meier method.
9. Mean Change From Baseline in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Quality of Life Score [ Time Frame: Baseline and Cycle 3, Day 1 (C3 D1), C5 D1, C7 D1, Week 25, every other cycle during extension phase (C1 D1, C3 D1, C5 D1, etc. up to C59 D1) and end of treatment. Each cycle is composed of 21 days. ]

   The EORTC questionnaire is a validated health-related quality of life (HRQoL) measure applicable to participants with any cancer diagnosis. Version 3.0 of the questionnaire was used in the study.

   It is composed of 30 items that address 15 domains, including one global health status, functional domains, and symptom domains. Domain scores are transformed to a 0 to 100 scale, where higher scores on the global quality of life score indicate better function. As such, a positive change from Baseline score indicates an improvement in quality of life.

10. Percentage of Participants Who Achieved a Hematologic Improvement in Neutrophil Response (HI-N) Over Any Consecutive 56-day Period [ Time Frame: Week 1 through Week 24 or Week 1 Through Week 48 of study treatment ]
    Percentage of participants who achieved a hematologic improvement in neutrophil response (HI-N) per IWG criteria sustained over any consecutive 56-day (8-week) period, during the treatment period (Week 1 to Week 24 and Week 1 to Week 48) HI-N was defined as at least a 100% increase and an absolute increase > 0.5 X 10^9/L.
11. Percentage of Participants Who Achieved a Hematologic Improvement in Platelet Response (HI-P) Over Any Consecutive 56-day Period [ Time Frame: Week 1 through Week 24 or Week 1 Through Week 48 of study treatment ]

    Percentage of participants who achieved a hematologic improvement platelet response (HI-P) was defined as the percentage of participants meeting the HI-P criteria per the IWG sustained over any consecutive 56-day (8-week) period (Week 1 to Week 24 and Week 1 to Week 48) during the treatment period. HI - P reponse was defined as:

    • Absolute increase of ≥ 30 X 10^9/L in platelets for participants starting with > 20 X 10^9/L platelets
    • Increase in platelets from < 20 X 10^9/L to > 20 X 10^9/L and by at least 100%
12. Change From Baseline in Mean Serum Ferritin [ Time Frame: Baseline and Week 9 through Week 24 and Week 33 through Week 48 ]
    Mean change from baseline in mean serum ferritin was calculated as the difference of postbaseline mean serum ferritin (averaged over the specified timepoints) and baseline mean serum ferritin.
13. Change From Baseline in Mean Daily Dose of Iron Chelation Therapy (ICT) [ Time Frame: Baseline and Week 9 through Week 24 and Week 33 through Week 48 of study treatment ]
    Mean change from baseline in mean daily dose of ICT averaged over Week 9 to Week 24 or Week 33 to Week 48. For each participant, the mean change in daily dose of ICT was calculated as the difference of postbaseline mean daily dose and baseline mean daily dose.
14. Time to Red Blood Cell Transfusion Independence (RBC-TI) - Week 1 Through Week 24 [ Time Frame: From first dose to Week 24 of study treatment ]
    Time to RBC-TI was defined as the time between first dose date and the date of onset of RBC-TI first observed for participants who achieved RBC-TI of ≥ 8 weeks during Week 1 through Week 24
15. Time to Red Blood Cell Transfusion Independence (RBC-TI) - Week 1 Through Week 48 [ Time Frame: From first dose to Week 48 of study treatment ]
    Time to RBC-TI was defined as the time between first dose date and the date of onset of RBC-TI first observed for participants who achieved RBC-TI of ≥ 8 weeks during Week 1 through Week 48
16. Percentage of Participants Who Progressed to Acute Myeloid Leukemia (AML) [ Time Frame: From randomization to study completion (up to approximately 57 months) ]
    Percentage of participants progressing to AML throughout the course of the study
17. Time to Acute Myeloid Leukemia (AML) Progression [ Time Frame: From randomization to study completion (up to approximately 57 months) ]
    Time to AML progression was defined as the time between randomization date and the first diagnosis of AML as per World Health Organization (WHO) classification of ≥ 20% blasts in peripheral blood or bone marrow. Participants with a diagnosis of AML were considered to have had an event, participants who did not progress to AML at the time of analysis were censored at the last assessment date which did not indicate progression to AML.
18. Overall Survival [ Time Frame: From randomization to study completion (up to approximately 57 months) ]
    Overall Survival was defined as the time from the date of study drug randomization to death due to any cause. Overall survival was censored at the last date that the participant was known to be alive for participants who were alive at the time of analysis and for those who discontinued from the study or were lost to follow-up.
19. Number of Participants With Treatment Emergent Adverse Events (TEAEs) [ Time Frame: From date of first dose up to 42 days after the last dose (up to approximately 83 weeks) ]

    The outcome measure describes the number of participants who experienced different types of Treatment-emergent adverse events (TEAEs).

    TEAEs were defined as Adverse Events (AEs) that started on or after the day of the first dose and on or before 42 days after the last dose of IP.

    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 4.0) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death.

20. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Apparent Clearance (CL/F) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Apparent total plasma clearance was calculated as Dose/Area Under the Curve to infinity (ꝏ).
21. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Apparent Volume of Distribution of the Central Compartment (V1/F) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Apparent volume of distribution of luspatercept was calculated according to the equation Vz = (CL)/λ.
22. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Elimination Half-life (t1/2) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Terminal phase half-life was calculated according to the following equation: t1/2 = 0.693/λz.
23. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Time to Reach Maximum Concentration (Tmax) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Tmax was defined as the observed time to maximum plasma concentration of luspatercept.
24. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Maximum Concentration for the First Dose (Cmax) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Cmax was defined as the observed maximum plasma concentration, obtained directly from the observed concentration versus time.
25. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Maximum Concentration for the Starting Dose (Cmax) at Steady State [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Cmax was defined as the observed maximum plasma concentration, obtained directly from the observed concentration at a steady state.
26. Pharmacokinetic (PK) Parameters: Bayesian Estimate of Maximum Concentration for the Area Under the Curve at Steady State for Starting Dose (AUC^ss) [ Time Frame: Blood serum samples taken pre-dose at Cycle 1 Day 1 (C1, D1), C1 D8, C1 D15, C2 D1, C4 D1, C5 D8, C6 D1 and Week 25 visit, extension phase C4 D1 and Day 1 of every fourth treatment cycle thereafter. ]
    Area under the curve steady state was defined as the area under the plasma concentration-time curve for a steady state. calculated by the linear trapezoidal rule.
27. Participants With Pre-Existing and/or Treatment-Emergent Antidrug Antibodies (ADA) [ Time Frame: From randomization to 1 year post first dose ]
    Number of participants with positive ADA prior to taking study drug and/or during study. A participant was counted as "treatment-emergent" if there was a positive post-baseline sample while the baseline sample was ADA negative, or there was a positive post-baseline sample with a titer ≥ 4-fold of the baseline titer while the baseline sample was ADA positive. A participant was counted as "preexisting" if the baseline sample was ADA positive and the participant was not qualified for "treatment-emergent."

Eligibility Criteria

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

Criteria

Inclusion Criteria:

Subjects must satisfy the following criteria to be enrolled in the study:

1. Subject is ≥ 18 years of age the time of signing the informed consent form (ICF).
2. Documented diagnosis of MDS according to World Health Organization (WHO)/French American British (FAB) classification that meets IPSS R classification of very low, low, or intermediate risk disease, and:

Ring sideroblast ≥ 15% of erythroid precursors in bone marrow or ≥ 5% (but < 15%) if SF3B1 mutation is present.

• < 5% blasts in bone marrow
• Peripheral blood white blood cell (WBC) count < 13,000/µL 3. Requires red blood cell RBC transfusions 4. Eastern Cooperative Oncology Group (ECOG) score of 0, 1, or 2 5. Subjects who are refractory/intolerant/ineligible to prior erythropoietin-stimulating agents (ESA) treatment, defined as:
• Refractory to prior - erythropoietin stimulating agents treatment: documentation of non-response or response that is no longer maintained to prior ESA-containing regimen, either as single agent or combination (eg, with granulocyte colony stimulating factor (G-CSF); ESA regimen must have been either recombinant human erythropoietin (rHu EPO) ≥ 40,000 IU/wk for at least 8 doses or equivalent OR darbepoetin alpha ≥ 500 μg Q3W for at least 4 doses or equivalent
• Intolerant to prior ESA treatment: documentation of discontinuation of prior ESA-containing regimen, either as single agent or combination (eg, with G-CSF), at any time after introduction due to intolerance or an adverse event
• ESA ineligible: low chance of response to ESA base on endogenous serum erythropoietin level > 200 U/L for subjects not previously treated with ESAs

Exclusion Criteria:

The presence of any of the following will exclude a subject from enrollment:

1. Prior therapy with disease modifying agents for underlying MDS disease.
2. Previously treated with either luspatercept (ACE-536) or sotatercept (ACE-011)
3. MDS associated with del 5q cytogenetic abnormality
4. Secondary MDS, ie, MDS that is known to have arisen as the result of chemical injury or treatment with chemotherapy and/or radiation for other diseases.

5. Known clinically significant anemia due to iron, vitamin B12, or folate deficiencies, or autoimmune or hereditary hemolytic anemia, or gastrointestinal bleeding

   - iron deficiency to be determined by serum ferritin less than or equal to 15 ug/L and additional testing if clinically indicated (eg, calculated transferrin saturation [iron/total iron binding capacity less than or equal to 20%] or bone marrow aspirate stain for iron).

6. Prior allogeneic or autologous stem cell transplant
7. Known history of diagnosis of acute myeloid leukemia (AML)

8. Use of any of the following within 5 weeks prior to randomization:

   • anticancer cytotoxic chemotherapeutic agent or treatment
   • corticosteroid, except for subjects on a stable or decreasing dose for ≥ 1 week prior to randomization for medical conditions other than MDS
   • iron-chelating agents, except for subjects on a stable or decreasing dose for at least 8 weeks prior to randomization
   • other RBC hematopoietic growth factors (eg, Interleukin-3)
   • investigational drug or device, or approved therapy for investigational use. If the half-life of the previous investigational product is known, use within 5 times the half-life prior to randomization or within 5 weeks, whichever is longer is excluded.

9. Prior history of malignancies, other than MDS, unless the subject has been free of the disease (including completion of any active or adjuvant treatment for prior malignancy) for ≥ 5 years. However, subjects with the following history/concurrent conditions are allowed:

   • Basal or squamous cell carcinoma of the skin
   • Carcinoma in situ of the cervix
   • Carcinoma in situ of the breast
   • Incidental histologic finding of prostate cancer (T1a or T1b using the tumor, nodes, metastasis [TNM] clinical staging system)
10. Major surgery within 8 weeks prior to randomization. Subjects must have completely recovered from any previous surgery prior to randomization

Contacts and Locations

Locations

United States, California

Stanford Cancer Center

Stanford, California, United States, 94305

United States, Connecticut

Yale University School of Medicine

New Haven, Connecticut, United States, 06510

United States, Florida

H Lee Moffitt Cancer Center and Research Institute

Tampa, Florida, United States, 33612

United States, Georgia

Emory University Hospital

Atlanta, Georgia, United States, 30322

United States, Louisiana

Ochsner Medical Institutions

New Orleans, Louisiana, United States, 70123

United States, Maryland

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

Baltimore, Maryland, United States, 21287

United States, Michigan

Karmanos Cancer Institute

Detroit, Michigan, United States, 48201

United States, New York

Montefiore Medical Center Albert Einstein Cancer Center

Bronx, New York, United States, 10467

Columbia-Presbyterian Medical Center

New York, New York, United States, 10032

United States, Ohio

Gabrail Cancer Center

Canton, Ohio, United States, 44718

Cleveland Clinic Taussig Cancer Institute

Cleveland, Ohio, United States, 44195-0001

United States, Tennessee

Vanderbilt University Medical Center

Nashville, Tennessee, United States, 37232

United States, Texas

MD Anderson Cancer Center

Houston, Texas, United States, 77030

Belgium

Algemeen Ziekenhuis Klina

Brasschaat, Belgium, 2930

AZ Sint-Jan AV Brugge

Brugge, Belgium, 8000

UZ Brussels

Brussel, Belgium, 1090

Grand Hopital de Charleroi

Charleroi, Belgium, 6000

UZ Gent

Gent, Belgium, 9000

UZ Leuven

Leuven, Belgium, 3000

Cliniques Universitaires UCL de Mont-Godine

Yvoir, Belgium, 5530

Canada, Alberta

Tom Baker Cancer Center

Calgary, Alberta, Canada, T2N 4N2

Canada, Ontario

Juravinski Cancer Centre

Hamilton, Ontario, Canada, L8V 1C3

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada, M4N 3M5

Princess Margaret Hospital

Toronto, Ontario, Canada, M5G 2M9

France

CHU d'Angers

Angers, France, 49033

CHU Hotel

Grenoble Cedex 09, France, 38043

CHRU de Lille-Hopital Claude Huriez Service des Maladies du Sang

Lille, France, 59037

Institut Paoli Calmettes

Marseille cedex, France, 13273

CHU de Nice Archet I

Nice, France, 06202

Hopital Saint Louis

Paris, France, 75010

Hopital Haut Leveque

Pessac Cedex, France, 33604

Centre hospitalier Lyon Sud Hematologie

Pierre-Bénite cedex, France, 69495

Hopital civil

Strasbourg, France, 67091

Institut Universitaire du Cancer de Toulouse - Oncopole

Toulouse Cedex 9, France, 31059

Hopital Bretonneau

Tours, France, 37044

Germany

Universitatsklinikum Bonn

Bonn, Germany, 53105

Universitatsklinikum Carl Gustav Carus an der TU Dresden

Dresden, Germany, 01307

Marien Hospital

Dusseldorf, Germany, 40479

Universitätsklinikum Düsseldorf

Düsseldorf, Germany, 40225

Medizinische Hochschule Hannover

Hannover, Germany, 30625

Klinikum rechts der Isar der Technischen Universität München

München, Germany, 81675

Italy

Azienda Ospedaliera Santi Antonio Biagio E Cesare Arrigo

Allessandria, Italy, 15100

Azienda Ospedaliero Universitaria Di Bologna Policlinico Sorsola Malpighi

Bologna, Italy, 40138

Azienda Ospedaliera Universitaria Careggi

Firenze, Italy, 50121

Azienda Sanitaria Locale Lecce

Lecce, Italy, 73100

Fondazione IRCCS Policlinico San Matteo

Pavia, Italy, 27100

Azienda Ospedaliera Bianchi Melacrino Morelli

Reggio, Calabria, Italy, 89100

Fondazione Policlinico Universitario A Gemelli

Roma, Italy, 00168

Fondazione PTV Policlinico Tor Vergata

Roma, Italy, 00168

Netherlands

VU Medisch Centrum

Amsterdam, Netherlands, 1081 HV

Universitair Medisch Centrum Groningen

Groningen, Netherlands, 9713 GZ

Spaarne Ziekenhuis

Hoofddorp, Netherlands, 2135

Spain

Hospital Universitario Cruces

Barakaldo, Spain, 48903

Hospital Universitario Vall D hebron

Barcelona, Spain, 08035

Instituto Catalan de Oncologia-Hospital Duran i Reynals

Barcelona, Spain, 08908

Hospital General Universitario Gregorio Marañon

Madrid, Spain, 28007

Hospital Universitario Central de Asturias

Oviedo, Spain, 33011

Hospital Universitario de Salamanca

Salamanca, Spain, 37007

Hospital Universitario Virgen del Rocio

Seville, Spain, 41013

Hospital Universitario La Fe

Valencia, Spain, 46026

Sweden

Sahlgrenska Universitetssjukhus

Göteborg, Sweden, SE-41685

Skanes Universitetssjukhus Lund

Lund, Sweden, 222 41

Karolinska University Hospital

Stockholm, Sweden, SE-17176

Akademiska Sjukhuset

Uppsala, Sweden, 75185

Turkey

Cukurova University Medical Faculty Balcali Hospital

Adana, Turkey, 01330

Ankara University Medical Faculty Cebeci Hospital

Ankara, Turkey, 06590

Istanbul University Cerrahpasa Medical Faculty Hospital

Istanbul, Turkey, 34098

Ege Universitesi Tip Fakultesi Hastanesi

Izmir, Turkey, 35100

United Kingdom

Aberdeen Royal Infirmary

Aberdeen, United Kingdom, AB25 2ZN

John Radcliffe Hospital

Headington, United Kingdom, OX3 9DU

St James University Hospital

Leeds, United Kingdom, LS1 3EX

Guys Hospital

London, United Kingdom, SE1 9RT

Kings College Hospital

London, United Kingdom, SE5 9RS

Kings Mill Hospital

Sutton in Ashfield, United Kingdom, NG17 4SL

Sponsors and Collaborators

Celgene

Acceleron Pharma Inc. (a wholly owned subsidiary of Merck Sharp and Dohme, a subsidiary of Merck & Co., Inc.)

Investigators

• Study Director: Rodrigo Ito, MD; Celgene

  Study Documents (Full-Text)

Documents provided by Celgene:

Study Protocol  [PDF] May 9, 2017

Statistical Analysis Plan  [PDF] May 31, 2018

More Information

Publications of Results:

Fenaux P, Platzbecker U, Mufti GJ, Garcia-Manero G, Buckstein R, Santini V, Diez-Campelo M, Finelli C, Cazzola M, Ilhan O, Sekeres MA, Falantes JF, Arrizabalaga B, Salvi F, Giai V, Vyas P, Bowen D, Selleslag D, DeZern AE, Jurcic JG, Germing U, Gotze KS, Quesnel B, Beyne-Rauzy O, Cluzeau T, Voso MT, Mazure D, Vellenga E, Greenberg PL, Hellstrom-Lindberg E, Zeidan AM, Ades L, Verma A, Savona MR, Laadem A, Benzohra A, Zhang J, Rampersad A, Dunshee DR, Linde PG, Sherman ML, Komrokji RS, List AF. Luspatercept in Patients with Lower-Risk Myelodysplastic Syndromes. N Engl J Med. 2020 Jan 9;382(2):140-151. doi: 10.1056/NEJMoa1908892.

Komrokji RS. Luspatercept in Myelodysplastic Syndromes: Who and When? Hematol Oncol Clin North Am. 2020 Apr;34(2):393-400. doi: 10.1016/j.hoc.2019.10.004. Epub 2020 Jan 21.

Fenaux P, Kiladjian JJ, Platzbecker U. Luspatercept for the treatment of anemia in myelodysplastic syndromes and primary myelofibrosis. Blood. 2019 Feb 21;133(8):790-794. doi: 10.1182/blood-2018-11-876888. Epub 2019 Jan 2.

Other Publications:

Porter J. Beyond transfusion therapy: new therapies in thalassemia including drugs, alternate donor transplant, and gene therapy. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):361-370. doi: 10.1182/asheducation-2018.1.361.

Piga A, Perrotta S, Gamberini MR, Voskaridou E, Melpignano A, Filosa A, Caruso V, Pietrangelo A, Longo F, Tartaglione I, Borgna-Pignatti C, Zhang X, Laadem A, Sherman ML, Attie KM. Luspatercept improves hemoglobin levels and blood transfusion requirements in a study of patients with beta-thalassemia. Blood. 2019 Mar 21;133(12):1279-1289. doi: 10.1182/blood-2018-10-879247. Epub 2019 Jan 7.

• Responsible Party: Celgene
• ClinicalTrials.gov Identifier: NCT02631070
• Other Study ID Numbers: ACE-536-MDS-001; 2015-003454-41 ( EudraCT Number )
• First Posted: December 15, 2015
• Results First Posted: May 22, 2020
• Last Update Posted: December 17, 2021
• Last Verified: November 2021

Keywords provided by Celgene:

Luspatercept; Transfusion dependent; Lower risk; Low risk; Myelodysplastic Syndromes; ESA refractory; ESA intolerant; ESA ineligible; ACE-536; Anemia; Ring Sideroblasts; Require Red Blood Cell Transfusions; MEDALIST; MDS; IPSS-R very low/IPSS-R low/IPSS-R intermediate

Additional relevant MeSH terms:

Preleukemia; Anemia; Myelodysplastic Syndromes; Syndrome; Disease; Pathologic Processes; Hematologic Diseases; Bone Marrow Diseases; Precancerous Conditions; Neoplasms; Luspatercept; Hematinics