Clinical trial • Phase III • Haematology

IVOSIDENIB for Myelodysplastic syndrome | HMA-naive myelodysplastic syndrome

Phase III trial of IVOSIDENIB for Myelodysplastic syndrome | HMA-naive myelodysplastic syndrome.

Overview

Trial Therapeutic Area
Haematology
Trial Disease
Myelodysplastic syndrome | HMA-naive myelodysplastic syndrome
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
14-08-2024
First CTIS Authorization Date
02-12-2024

Trial design

Randomised, open-label, ivosidenib monotherapy: two 250 mg tablets, totaling 500 mg, administered orally once daily until disease relapse or progression, unacceptable toxicity, confirmed pregnancy, undergoing hsct, death, withdrawal of consent, lost to follow-up, or sponsor ending the study. | azacitidine monotherapy: azacitidine 75mg/m^2/day administered by subcutaneous (sc) or intravenous (iv) injection for 1 week (7 days) of each 4-week (28 day) treatment cycle until disease relapse or progression, unacceptable toxicity, confirmed pregnancy, undergoing hsct, death, withdrawal of consent, lost to follow-up, or sponsor ending the study.-controlled Phase III trial across 28 sites in France, Netherlands, Spain and others.

Randomised
Yes
Open Label
Yes
Comparator
Ivosidenib monotherapy: Two 250 mg tablets, totaling 500 mg, administered orally once daily until disease relapse or progression, unacceptable toxicity, confirmed pregnancy, undergoing HSCT, death, withdrawal of consent, lost to follow-up, or Sponsor ending the study. | Azacitidine monotherapy: Azacitidine 75mg/m^2/day administered by subcutaneous (SC) or intravenous (IV) injection for 1 week (7 days) of each 4-week (28 day) treatment cycle until disease relapse or progression, unacceptable toxicity, confirmed pregnancy, undergoing HSCT, death, withdrawal of consent, lost to follow-up, or Sponsor ending the study.
Target Sample Size
22

Eligibility

Recruits 22 Vulnerable population selected; no explicit details on consent or assent handling present in the provided content..

Vulnerable Population
Vulnerable population selected; no explicit details on consent or assent handling present in the provided content.

Inclusion criteria

  • {"criterion_text":"- Diagnosis of HMA naive IDH1 R132 mutated MDS defined according to World Health Organization (WHO) criteria (5th edition): - Moderate high, high and very high-risk MDS per IPSS-M score will be eligible regardless of blood counts and with blast counts 0-19%. - Low and moderate low-risk MDS per IPSS-M score must: o Have cytopenias related to MDS, defined as: <100 platelets/μL, or absolute neutrophil count (ANC) <1000/mm3, or Hgb <10g/dL AND o Have a blast count between 5-19% AND o Be eligible for HMA therapy (very low risk participants are to be excluded)."}
  • {"criterion_text":"- Locally or centrally confirmed IDH1 R132 C/G/H/L/S mutation."}

Exclusion criteria

  • {"criterion_text":"- Received prior anticancer/disease modifying treatment for MDS (including HMA’s, cytotoxic chemotherapy, investigational agents, bcl-2 inhibitor based-regimens, hematopoietic stem cell transplant (HSCT), IDH1 inhibitors). For LR-MDS patients, prior treatment with growth factors, luspatercept, lenalidomide, and imetelstat are allowed."}
  • {"criterion_text":"- > 20% blasts by morphology or immunohistochemistry on screening bone marrow aspirate."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Complete remission (CR) + Partial remission (PR) by 4 months as per IWG 2006 criteria.","definition_or_measurement_approach":"Complete remission (CR) + Partial remission (PR) by 4 months assessed per IWG 2006 criteria."}

Secondary endpoints

  • {"endpoint_text":"- Overall Response (OR) rate per IWG 2023 criteria defined as CR (or CR equivalent) + PR + CRL + CRh + hematological improvement (HI).","definition_or_measurement_approach":"Defined as CR (or CR equivalent) + PR + CRL + CRh + hematological improvement (HI) per IWG 2023 criteria."}
  • {"endpoint_text":"- Event-free survival (EFS) defined as the date of randomization to the date of first documented confirmed relapse/progression/death, whichever occurs first.","definition_or_measurement_approach":"EFS measured from randomization to first documented confirmed relapse, progression, or death (whichever occurs first)."}
  • {"endpoint_text":"- Overall Survival (OS) defined as the time from randomization to the date of death due to any cause. Participants who are alive at the analysis cutoff date will be censored at the date they were last known to be alive.","definition_or_measurement_approach":"OS measured from randomization to date of death from any cause; surviving participants censored at last known alive date."}
  • {"endpoint_text":"- Duration of CR and PR among participants who achieve CR + PR per IWG 2006 criteria.","definition_or_measurement_approach":"Duration measured among participants achieving CR or PR per IWG 2006 criteria."}
  • {"endpoint_text":"- Time to CR and PR defined as time from the date of the randomization to the date of CR+PR, among participants who achieve CR+PR based on IWG 2006 Response Criteria.","definition_or_measurement_approach":"Time measured from randomization to date when CR or PR first observed per IWG 2006 Response Criteria."}
  • {"endpoint_text":"- Acute myeloid leukemia (AML) transformation rate","definition_or_measurement_approach":"Rate of transformation to AML as documented during follow-up."}
  • {"endpoint_text":"- Time to transfusion independence (TTTI) defined as time from date of randomization to date transfusion independence (TI) is first observed (Day 1 of a ≥ 56 days period without a transfusion), among participants who are baseline transfusion dependent and have achieved post-baseline TI. In the event a participant had more than one ≥ 56-day period, which met TI criteria, the earliest period will be used in analysis.","definition_or_measurement_approach":"TTTI measured from randomization to first day of a ≥56-day transfusion-free period among baseline transfusion-dependent participants who achieve TI; earliest qualifying period used if multiple."}
  • {"endpoint_text":"- Duration of transfusion independence (DOTI) among participants who have achieved post-baseline TI, DOTI will be calculated as the time from the date TI is first observed (Day 1 of a ≥ 56-day period without a transfusion) until the day before the participants had a subsequent transfusion.","definition_or_measurement_approach":"DOTI measured from first day of qualifying ≥56-day transfusion-free period until day before next transfusion."}
  • {"endpoint_text":"- Transfusion independence rate","definition_or_measurement_approach":"Proportion of participants achieving transfusion independence as defined in protocol (≥56 days without transfusion)."}
  • {"endpoint_text":"- Quality of Life in Myelodysplasia Scale (QUALMS) scores range from 0 to 100, with a higher score representing a better QOL.","definition_or_measurement_approach":"Measured by QUALMS; scores 0–100, higher indicates better quality of life."}
  • {"endpoint_text":"- Change from baseline in health economic outcomes measures based on EQ-5D-5L score. Health economic outcomes measures as assessed by the 5-level EuroQol five dimensions questionnaire (EQ-5D-5L) scores range from 5 to 25 with a higher number representing a worse health status.","definition_or_measurement_approach":"Measured by EQ-5D-5L; scores 5–25, higher worse health status; analysis is change from baseline."}
  • {"endpoint_text":"- Number of participants who proceed to hematopoietic stem cell transplantation (HSCT).","definition_or_measurement_approach":"Count of participants undergoing HSCT during study follow-up."}
  • {"endpoint_text":"- Ivosidenib plasma concentration and 2-HG plasma concentrations for participants receiving Ivosidenib monotherapy.","definition_or_measurement_approach":"Plasma concentrations of ivosidenib and 2-HG measured per PK/PD schedule for participants on ivosidenib monotherapy."}
  • {"endpoint_text":"- Number of participants achieving CR and PR by 6 months as per IWG 2006 criteria.","definition_or_measurement_approach":"Count of participants achieving CR or PR within 6 months assessed by IWG 2006 criteria."}
  • {"endpoint_text":"- Number of participants achieving CR and PR by 6 months as per IWG 2023 criteria.","definition_or_measurement_approach":"Count of participants achieving CR or PR within 6 months assessed by IWG 2023 criteria."}
  • {"endpoint_text":"- Number of participants achieving CR and PR by 4 months as per IWG 2023 criteria.","definition_or_measurement_approach":"Count of participants achieving CR or PR within 4 months assessed by IWG 2023 criteria."}
  • {"endpoint_text":"- Number of adverse events (AEs) and serious adverse events (SAEs).","definition_or_measurement_approach":"Counts of AEs and SAEs reported per standard definitions and reporting windows."}
  • {"endpoint_text":"- Health economic outcomes measures as assessed by the 5-level EuroQol five dimensions questionnaire (EQ-5D-5L) scores range from 5 to 25 with a higher number representing a worse health status.","definition_or_measurement_approach":"EQ-5D-5L scores (5–25) used as health economic outcomes; higher scores indicate worse health status; measured per protocol schedule."}

Recruitment

Planned Sample Size
22
Recruitment Window Months
47
Consent Approach
Informed consent obtained using subject information sheets and informed consent forms (SIS and ICF). Documents available in multiple languages including French, Spanish, Italian, German, Dutch and English. Consent to be provided by adult participants. No explicit details on assent procedures for minors provided in the available content.

Geography

Total Number Of Sites
28
Total Number Of Participants
26

France

Earliest CTIS Part Ii Submission Date
26-09-2024
Latest Decision Or Authorization Date
27-04-2026
Processing Time Days
578
Number Of Sites
6
Number Of Participants
5

Sites

Site Name
CHRU De Nancy
Department Name
Service d'hématologie clinique
Principal Investigator Name
Maud D'AVENI-PINEY
Principal Investigator Email
m.daveni-piney@chru-nancy.fr
Contact Person Name
Maud D'AVENI-PINEY
Contact Person Email
m.daveni-piney@chru-nancy.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service d’hématologie sénior
Principal Investigator Name
Marie SEBERT
Principal Investigator Email
marie.sebert@aphp.fr
Contact Person Name
Marie SEBERT
Contact Person Email
marie.sebert@aphp.fr
Site Name
Centre Hospitalier Universitaire De Nice
Department Name
Service d’hématologie clinique
Principal Investigator Name
Thomas CLUZEAU
Principal Investigator Email
cluzeau.t@chu-nice.fr
Contact Person Name
Thomas CLUZEAU
Contact Person Email
cluzeau.t@chu-nice.fr
Site Name
Centre Hospitalier Universitaire De Nantes
Department Name
Service hématologie clinique
Principal Investigator Name
Alice GARNIER
Principal Investigator Email
alice.garnier@chu-nantes.fr
Contact Person Name
Alice GARNIER
Contact Person Email
alice.garnier@chu-nantes.fr
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Service de médecine interne et immunopathologie
Principal Investigator Name
Thibault COMONT
Principal Investigator Email
comont.thibault@iuct-oncopole.fr
Contact Person Name
Thibault COMONT
Site Name
Centre Hospitalier Universitaire De Bordeaux
Department Name
Service d'hématologie clinique et thérapie cellulaire
Principal Investigator Name
Sophie DIMICOLI-SALAZAR
Principal Investigator Email
sophie.dimicoli-salazar@chu-bordeaux.fr
Contact Person Name
Sophie DIMICOLI-SALAZAR

Netherlands

Earliest CTIS Part Ii Submission Date
08-11-2024
Latest Decision Or Authorization Date
28-04-2026
Processing Time Days
536
Number Of Sites
2
Number Of Participants
2

Sites

Site Name
Amsterdam UMC Stichting
Department Name
Hematology
Principal Investigator Name
Canan Alhan
Principal Investigator Email
hematology@amsterdamumc.nl
Contact Person Name
Canan Alhan
Contact Person Email
hematology@amsterdamumc.nl
Site Name
Universitair Medisch Centrum Groningen
Department Name
Hematology
Principal Investigator Name
Gerwin Huls
Principal Investigator Email
g.huls@umcg.nl
Contact Person Name
Gerwin Huls
Contact Person Email
g.huls@umcg.nl

Spain

Earliest CTIS Part Ii Submission Date
07-11-2024
Latest Decision Or Authorization Date
30-04-2026
Processing Time Days
539
Number Of Sites
7
Number Of Participants
6

Sites

Site Name
Vall D Hebron Institute Of Oncology
Department Name
Hematology
Principal Investigator Name
David Valcarcel Ferreiras
Principal Investigator Email
dvalcarcel@vhio.net
Contact Person Name
David Valcarcel Ferreiras
Contact Person Email
dvalcarcel@vhio.net
Site Name
Clinica Universidad De Navarra
Department Name
Hematology
Principal Investigator Name
Ana Alonso
Principal Investigator Email
aalfonso@unav.es
Contact Person Name
Ana Alonso
Contact Person Email
aalfonso@unav.es
Site Name
Hospital Universitario De Salamanca
Department Name
Hematology
Principal Investigator Name
María Diez Campelo
Principal Investigator Email
mdiezcampelo@usal.es
Contact Person Name
María Diez Campelo
Contact Person Email
mdiezcampelo@usal.es
Site Name
Hospital Universitario Virgen De La Macarena
Department Name
Hematology
Principal Investigator Name
Ildefonso Espigado Tocino
Principal Investigator Email
espigado@us.es
Contact Person Name
Ildefonso Espigado Tocino
Contact Person Email
espigado@us.es
Site Name
Institut Catala D'oncologia
Department Name
Hematology
Principal Investigator Name
Blanca Xicoy Cirici
Principal Investigator Email
bxicoy@iconcologia.net
Contact Person Name
Blanca Xicoy Cirici
Contact Person Email
bxicoy@iconcologia.net
Site Name
Hospital Universitario Y Politecnico La Fe
Department Name
Hematology
Principal Investigator Name
Evelyn Acuña Cruz
Principal Investigator Email
evelyn_acuna@islafe.es
Contact Person Name
Evelyn Acuña Cruz
Contact Person Email
evelyn_acuna@islafe.es
Site Name
Clinica Universidad De Navarra
Department Name
Hematology
Principal Investigator Name
Ana Alonso
Principal Investigator Email
aalfonso@unav.es
Contact Person Name
Ana Alonso
Contact Person Email
aalfonso@unav.es

Germany

Earliest CTIS Part Ii Submission Date
27-11-2024
Latest Decision Or Authorization Date
30-04-2026
Processing Time Days
519
Number Of Sites
6
Number Of Participants
5

Sites

Site Name
Universitaet Leipzig
Department Name
Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und Intektiologie
Principal Investigator Name
Dominic Brauer
Principal Investigator Email
Dominic.Brauer@medizin.uni-leipzig.de
Contact Person Name
Dominic Brauer
Site Name
Technische Universitaet Dresden
Department Name
Medizinische Fakultät Carl Gustav Carus, Medizinische Klinik und Poliklinik I
Principal Investigator Name
Katja Sockel
Principal Investigator Email
Katja.Sockel@ukdd.de
Contact Person Name
Katja Sockel
Contact Person Email
Katja.Sockel@ukdd.de
Site Name
Klinikum rechts der Isar der TU Muenchen AöR
Department Name
Medizinische Klinik - Hämatologie und Internistische Onkologie
Principal Investigator Name
Katharina Götze
Principal Investigator Email
katharina.goetze@mri.tum.de
Contact Person Name
Katharina Götze
Contact Person Email
katharina.goetze@mri.tum.de
Site Name
Universitaetsmedizin Goettingen
Department Name
Klinik für Hämatologie und Medizinische Onkologie
Principal Investigator Name
Hannes Treiber
Principal Investigator Email
sz-umg.sponsor-qm@med.uni-goettingen.de
Contact Person Name
Hannes Treiber
Site Name
Marien Hospital Duesseldorf GmbH
Department Name
Klinik für Onkologie, Hämatologie und Palliativmedizin
Principal Investigator Name
Aristoteles Giagounidis
Principal Investigator Email
aristoteles.giagounidis@vkkd-kliniken.de
Contact Person Name
Aristoteles Giagounidis
Site Name
Medizinische Hochschule Hannover
Department Name
Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation
Principal Investigator Name
Felicitas Thol
Principal Investigator Email
Thol.Felicitas@mh-hannover.de
Contact Person Name
Felicitas Thol
Contact Person Email
Thol.Felicitas@mh-hannover.de

Italy

Earliest CTIS Part Ii Submission Date
05-11-2024
Latest Decision Or Authorization Date
30-04-2026
Processing Time Days
541
Number Of Sites
7
Number Of Participants
8

Sites

Site Name
Humanitas Mirasole S.p.A.
Department Name
Sezione Leucemie e Mielodisplasie
Principal Investigator Name
Matteo Giovanni Della Porta
Principal Investigator Email
matteo.della_porta@hunimed.eu
Contact Person Name
Matteo Giovanni Della Porta
Contact Person Email
matteo.della_porta@hunimed.eu
Site Name
Careggi University Hospital
Department Name
SOD Ematologia
Principal Investigator Name
Valeria Santini
Principal Investigator Email
valeria.santini@unifi.it
Contact Person Name
Valeria Santini
Contact Person Email
valeria.santini@unifi.it
Site Name
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
Department Name
Dipartimento di Oncologia
Principal Investigator Name
Chiara Frairia
Principal Investigator Email
cfrairia@cittadellasalute.to.it
Contact Person Name
Chiara Frairia
Site Name
Fondazione IRCCS Policlinico San Matteo
Department Name
Dipartimento di Oncologia
Principal Investigator Name
Luca Malcovati
Principal Investigator Email
l.malcovati@smatteo.pv.it
Contact Person Name
Luca Malcovati
Contact Person Email
l.malcovati@smatteo.pv.it
Site Name
Azienda Ospedaliero Universitaria Delle Marche
Department Name
SOD Clinica Ematologica
Principal Investigator Name
Antonella Poloni
Principal Investigator Email
a.poloni@staff.univpm.it
Contact Person Name
Antonella Poloni
Contact Person Email
a.poloni@staff.univpm.it
Site Name
Azienda Ospedaliero-Universitaria Di Bologna IRCCS Istituto Di Ricerca E Di Cura A Carattere Scientifico
Department Name
U.O. di Ematologia
Principal Investigator Name
Stefania Paolini
Principal Investigator Email
stefania.paolini@unibo.it
Contact Person Name
Stefania Paolini
Contact Person Email
stefania.paolini@unibo.it
Site Name
Universita' Degli Studi Di Roma Tor Vergata
Department Name
Dipartimento di Biomedicina e Prevenzione
Principal Investigator Name
Maria Teresa Voso
Principal Investigator Email
voso@med.uniroma2.it
Contact Person Name
Maria Teresa Voso
Contact Person Email
voso@med.uniroma2.it

Sponsor

Primary sponsor

Full Name
Institut De Recherches Internationales Servier IRIS
Organisation Type
Pharmaceutical company
Country Of Registered Address
France

Third parties

  • {"country":"United States","full_name":"Azenta US Inc.","duties_or_roles":"Long Term Storage / Biobank","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"PPD Global Central Labs","duties_or_roles":"Central Lab / Logistic platform","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Kayentis","duties_or_roles":"eCOA","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Cenetron Diagnostics Ltd.","duties_or_roles":"IDH1 mutation assessment","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Tempus AI Inc.","duties_or_roles":"IPSS-M calculation","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Hematogenix Laboratory Services Limited","duties_or_roles":"MRD by flow cytometry","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Ppd Inc.","duties_or_roles":"PK/PD, 2-HG and study drug in plasma","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Scout Clinical","duties_or_roles":"Patient payment & reimbursement services","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"United States","full_name":"Hematogenix Laboratory Services LLC","duties_or_roles":"Molecular analysis, including NGS for IPSS-M","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United Kingdom","full_name":"Iqvia Biotech Limited","duties_or_roles":"Support functions (role code 1)","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
AG-120/S95031 250mg film-coated tablet
Active Substance
IVOSIDENIB
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
Investigational product (no marketing authorisation listed in provided data)
Starting Dose
500 mg orally once daily (two 250 mg tablets)
Dose Levels
500 mg once daily
Frequency
Once daily
Maximum Dose
500 mg daily
Investigational Product Name
Vidaza 25 mg/ml powder for suspension for injection
Active Substance
AZACITIDINE
Modality
Small molecule
Routes Of Administration
INTRAVENOUS (IV) OR SUBCUTANEOUS (SC)
Route
SC or IV
Authorisation Status
Authorised medicine (marketing authorisation EU/1/08/488/001)
Starting Dose
75 mg/m^2/day administered by SC or IV for 7 days of each 28-day cycle
Dose Levels
75 mg/m^2/day for 7 days per 28-day cycle
Frequency
Daily for 7 days of each 28-day cycle
Maximum Dose
75 mg/m^2 per day

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