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A randomized, double-blind, placebo-controlled Phase II multi-center study of intravenous MBG453 added to hypomethylating agents in adult subjects with intermediate, high or very high risk myelodysplastic syndrome (MDS) as per IPSS-R criteria.

A Phase II efficacy and safety study of MBG453 in combination with hypomethylating agents in subjects with IPSS-R intermediate, high or very high-risk myelodysplastic syndrome (MDS).

Hirano Takamitsu

Novartis Pharma. K.K.

Toranomon Hills Mori Tower 23-1, Toranomon 1-chome Minato-ku, Tokyo 105-6333, Japan

rinshoshiken.toroku2@novartis.com

Hirano Takamitsu

Novartis Pharma. K.K.

Toranomon Hills Mori Tower 23-1, Toranomon 1-chome Minato-ku, Tokyo 105-6333, Japan

+81-120-003-293

rinshoshiken.toroku2@novartis.com

completed

Aug. 07, 2019

Interventional

Randomized, Double blinded, Placebo controlled, parallel-group assignment

treatment purpose

2

1. Signed informed consent must be obtained prior to participation in the study.
2. Age => 18 years at the date of signing the informed consent form (ICF)
3. Morphologically confirmed diagnosis of a myelodysplastic syndrome (MDS) based on 2016 WHO classification (Arber et al 2016) by investigator assessment with one of the following Prognostic Risk Categories, based on the International Prognostic Scoring System (IPSSR):
-Very high (> 6 points)
-High (> 4.5-6 points)
-Intermediate (> 3-4.5 points): a subject determined to be in the Intermediate Prognostic Risk Category is only allowable in the setting of => 5% bone marrow blast
4. Not eligible at the time of screening for intensive chemotherapy according to the investigator, based on local standard medical practice and institutional guidelines for treatment decision
5. Not eligible at the time of screening, for allogeneic stem-cell transplantation (HSCT) according to the investigator, based on local medical practice and institutional guidelines for treatment decisions
6. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2

1. Prior exposure to TIM-3 directed therapy at any time. Prior therapy with immune check point inhibitors (e.g. anti-CTLA4, anti-PD-1, anti-PD-L1, or anti-PD-L2), cancer vaccines are allowed except if the drug was administered within 4 months prior to randomization.
2. Previous first-line treatment for intermediate, high or very high risk myelodysplastic syndromes (based on IPSS-R) with chemotherapy or any other antineoplastic agents including lenalidomide and hypomethylating agent (HMAs) such as decitabine or azacitidine.
3. History of severe hypersensitivity reactions to any ingredient of the study treatment (azacitidine, decitabine or MGB453) or their excipients, or to monoclonal antibodies (mAbs).
4. Currently using or used within 14 days prior to randomization of systemic, steroid therapy (> 10 mg/day prednisone or equivalent) or any immunosuppressive therapy. Topical, inhaled, nasal, ophthalmic steroids are allowed. Replacement therapy, steroids given in the context of a transfusion are allowed and not considered a form of
systemic treatment.
5. Investigational treatment for MDS received within 4 weeks prior to randomization. In case of a checkpoint inhibitor: 4 months minimum prior to randomization interval is necessary to allow enrollment.
6. Active autoimmune disease requiring systemic therapy (e.g.corticosteroids).
7. Live vaccine administered within 30 Days prior to randomization.

Both

MDS

Active agent arm: MBG453 400 mg Q2W i.v. plus Aza 75 mg/m2 i.v. or s.c.
Pracebo arm: Placebo 400 mg Q2W i.v. plus Aza 75 mg/m2 i.v. or s.c.

Efficacy
-To determine if MBG453 combined with standard HMA therapy improves complete remission in subjects with intermediate, high, or very high risk MDS.
-To determine if MBG453 combined with standard HMA therapy improves PFS in subjects with intermediate, high or very high risk MDS.

June. 26, 2019