Description:
REGIME is comparing two treatments, with Darbepoetin Alpha (DA) and Filgrastim (Granulocyte
Colony Stimulating Factor, G-CSF), to the standard treatment for Myelodysplastic Syndrome
(MDS).
After giving Informed Consent patients will undergo a number of tests to confirm eligibility.
Once eligibility is confirmed patients will be randomly assigned to one of the three
treatments group: A: Darbepoetin Alpha (DA), B: Darbepoetin Alpha and Filgrastim (DA+G-CSF),
C: Blood transfusion only. Patients will be required to attend the clinic once a month for 24
weeks. After 24 weeks if a patient has reacted favorably to the treatment they may continue
on the treatment regime up to 52 weeks. After week 24 all patients will be required to attend
the clinic twice more, at week 36 and 52.
Patients will be followed for a further 5 years to record loss of response, transformation to
Acute Myeloid Leukaemia and/or Refractory Anemia with Excess Blasts and death.
Title
- Brief Title: Comparison Study of Standard Care Against Combination of Growth Factors Agents for Low-risk Myelodysplastic Syndromes
- Official Title: REGIME: A Randomised Controlled Trial of Prolonged Treatment With Darbepoetin Alpha, With or Without Recombinant Human Granulocyte Colony Stimulating Factor, Versus Best Supportive Care in Patients With Low-risk Myelodysplastic Syndromes (MDS).
Clinical Trial IDs
- ORG STUDY ID:
MDS201001
- SECONDARY ID:
2009-017462-23
- SECONDARY ID:
CRUK/08/009
- NCT ID:
NCT01196715
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Darbepoetin alpha | Aranesp | Darbepoetin Alfa |
Filgrastim | Neupogen | G-CSF |
Purpose
REGIME is comparing two treatments, with Darbepoetin Alpha (DA) and Filgrastim (Granulocyte
Colony Stimulating Factor, G-CSF), to the standard treatment for Myelodysplastic Syndrome
(MDS).
After giving Informed Consent patients will undergo a number of tests to confirm eligibility.
Once eligibility is confirmed patients will be randomly assigned to one of the three
treatments group: A: Darbepoetin Alpha (DA), B: Darbepoetin Alpha and Filgrastim (DA+G-CSF),
C: Blood transfusion only. Patients will be required to attend the clinic once a month for 24
weeks. After 24 weeks if a patient has reacted favorably to the treatment they may continue
on the treatment regime up to 52 weeks. After week 24 all patients will be required to attend
the clinic twice more, at week 36 and 52.
Patients will be followed for a further 5 years to record loss of response, transformation to
Acute Myeloid Leukaemia and/or Refractory Anemia with Excess Blasts and death.
Trial Arms
Name | Type | Description | Interventions |
---|
Darbepoetin Alfa | Active Comparator | | |
G-CSF | Active Comparator | | |
Best Supportive Care | Active Comparator | Red cell transfusion support to achieve a predicted post-transfusion haemoglobin of 11.0 to 12.0 g/dl at a quantity and frequency such that the minimum haemoglobin is never below 8.0 g/dl | |
Eligibility Criteria
Inclusion Criteria:
1. Males and females aged over 18 years, (no upper age limit)
2. ECOG performance status 0-2
3. Life expectancy more than 6 months
4. A confirmed diagnosis of MDS - WHO type:
- refractory anaemia (RA)
- hypoplastic RA ineligible for/or failed immunosuppressive therapy (ALG,
cyclosporine)
- refractory anaemia with ring sideroblasts (RARS)
- refractory cytopenia with multilineage dysplasia
- myelodysplastic syndrome unclassifiable
5. IPSS low or Int-1, but with BM blasts less than 5%
6. A haemoglobin concentration of less than 10g/dl and/or red cell transfusion dependence
7. Able to understand the implications of participation in the Trial and give written
informed consent.
Exclusion Criteria:
1. MDS with bone marrow blasts greater or equal than 5%
2. Myelodysplastic syndrome associated with del(5q)(q31-33) syndrome
3. Chronic myelomonocytic leukaemia (monocytes greater than1.0x109/l)
4. Therapy-related MDS
5. Splenomegaly, with spleen greater or equal than 5 cm from left costal margin
6. Platelets less than 30x109/l
7. Uncorrected haematinic deficiency. Patient deplete to iron, B12 and folate according
to local lab ranges
8. Women who are pregnant or lactating.
9. Females of childbearing potential and all males must be willing to use an effective
method of contraception (hormonal or barrier method of birth control; abstinence) for
the duration of the study and for up to 3 months after the last dose of study
medication. Note: Subjects are not considered of child bearing potential if they are
surgically sterile (they have undergone a hysterectomy, bilateral tubal ligation, or
bilateral oophorectomy) or they are postmenopausal
10. Females of childbearing potential must have a negative pregnancy test prior to
starting the study.
11. Uncontrolled hypertension, previous venous thromboembolism, or uncontrolled cardiac or
pulmonary disease
12. Previous serious adverse events to the study medications or its components
13. Patients who have had previous therapy with ESAs ± G-CSF within 4 weeks of study entry
14. Patients currently receiving experimental therapy, e.g. with thalidomide, or who are
participating in another CTIMP.
15. Medical or psychiatric illness, which makes the patient unsuitable or unable to give
informed consent.
16. Patients with malignancy requiring active treatment (except hormonal therapy).
17. Patients with a history of seizures
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Quality of Life |
Time Frame: | weeks 0 |
Safety Issue: | |
Description: | To compare the Quality of Life of low risk Myelodysplastic Syndrome (MDS) patients randomised to receive prolonged treatment with DA alone, DA with G-CSF or best supportive care alone |
Secondary Outcome Measures
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | every week |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 4 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 8 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 12 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 16 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 20 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 24 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 36 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Measure: | Utility of prognostic factor and predictive factor assessment |
Time Frame: | week 52 |
Safety Issue: | |
Description: | To assess the utility of prognostic factor and predictive factor assessment, in particular against the predictive model proposed by Hellstrom-Lindberg. |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | Barts & The London NHS Trust |
Trial Keywords
- Quality of Life
- Erythroid response
- disease progression
- survival
- Overall erythroid response at 24 weeks
- Quality of life at 24 weeks
- Quality of life at 12, 36 and 52 weeks
- Overall erythroid response at 12 and 52 weeks
- Incidence of disease progression
- Overall Survival
Last Updated
March 15, 2012