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AnemiaPhase 2NCT01736683

Study of Sotatercept for the Treatment of Anemia in low-or Intermediate-1 Risk Myelodysplastic Syndromes (MDS) or Non-proliferative Chronic Myelomonocytic Leukemia (CMML)

A Phase 2 study testing Sotatercept in people with Anemia and Myelodysplastic Syndromes, run by Merck Sharp & Dohme LLC at 20 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this study is to determine a safe, tolerable and effective dose of sotatercept that results in the greatest frequency of improvement of anemia in patients diagnosed with low- or intermediate-1 risk myelodysplastic syndromes (MDS) or non-proliferative chronic myelomonocytic leukemia (CMML). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Sotatercept
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
20 sitesin 2 countries
Study dates
28 Nov 2012to 30 Apr 2018
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women ≥ 18 years of age
  • Documented diagnosis of myelodysplastic syndromes (MDS) or non-proliferative chronic myelomonocytic leukemia (CMML), white blood cells (WBC) ≤ 13,000 /mm^3, World Health Organization (WHO) that meets International Prognostic Scoring System (IPSS) criteria for low or intermediate-1 risk disease
  • Anemia, Hemoglobin (Hgb) ≤ 9.0 g/dL or ≥ 2 units of Red Blood Cells (RBCs) within 84 days
  • No response or loss of response to Erythropoiesis-Stimulating Agents (ESAs) or erythropoetin (EPO) > 500 mU/ml
  • Eastern Cooperative Group (ECOG) score ≤2.
  • Creatinine < 1.5 * Upper Limit of the Normal (ULN)
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  • Total bilirubin ≤3.0 mg/dL
  • Aspartate aminotransferase (AST)/Serum glutamic oxaloacetic transaminase (SGOT) \& Alanine Aminotransferase (ALT)/Serum Glutamic Pyruvic (SGPT) ≤3.0 * Upper Limit of Norma (ULN)
  • Free of metastatic malignancy (other than MDS) for ≥2 years
  • Highly effective methods of birth control for females and males

Who cannot join

  • Chromosome 5q deletion
  • Pregnant or breast feeding women and males who do not agree to use condom during the sexual contact with females of childbearing potential
  • Major surgery within 30 days
  • Incomplete recovery or incomplete healing of wounds from previous surgery
  • Heart failure ≥3 (New York Heart Association (NYHA))
  • Thromboembolic or myocardial infarction event within 6 months
Show all 15Show fewer
  • Concurrent anti-cancer cytotoxic chemotherapy
  • History of severe allergic or anaphylactic reaction or hypersensitivity to recombinant protein
  • Known positive for Human Immunovirus (HIV) or infectious Hepatitis type C or active infectious Hepatitis type B
  • Clinically significant anemia unrelated to MDS
  • Thrombocytopenia (<30,000/uL)
  • Uncontrolled hypertension
  • Treatment with another investigational drug or device within 28 days prior to Day 1
  • Prior exposure to sotatercept (ACE-011)
  • Any serious medical condition, lab abnormality or psychiatric illness

Trial locations and contacts

20 sites in 2 countries.

20 sites in 2 countries

United States13 sites
  • Johns Hopkins

    Baltimore, Maryland, 21231

  • Dana-Farber / Harvard Cancer Institute

    Boston, Massachusetts, 02215

  • The Cleveland Clinic Foundation Hematology and Medical Oncology Rm 35

    Cleveland, Ohio, 44195

  • Rocky Mountain Cancer Center-Midtown

    Denver, Colorado, 80218

  • Monter Cancer Center, North Shore LIJ Health Systems

    Lake Success, New York, 11042

  • Sarah Cannon Research Inst

    Nashville, Tennessee, 37203

  • Columbia University Medical Center/New York-Presbyterian Hospital

    New York, New York, 10032

  • Virginia Oncology Associates

    Norfolk, Virginia, 23502

  • Texas Oncology Round Rock Cancer Center - Round Rock

    Round Rock, Texas, 78681

  • University of Texas Health Science Center at San Antonio

    San Antonio, Texas, 78229

  • H. Lee Moffitt Cancer Center and Research Institute

    Tampa, Florida, 33612

  • Texas Oncology, P.A. - Tyler

    Tyler, Texas, 75702

  • Yakima Valley Memorial Hospital/ North Star Lodge

    Yakima, Washington, 98902

Other trials in United States

France7 sites
  • Centre Hospitalier Universitaire d'Avicennes

    Bobigny, 93009

  • Institute Paoli-Calmettes Service Haematology

    BP 156,, 13273

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

    Lille, 59037

  • CHRU Nantes

    Nantes, 44093

  • Hopital Cochin Hematologie

    Paris, 75679

  • Centre Henri Becquerel

    Rouen, 79038

  • CHU Purpan

    Toulouse, 31059

Other trials in France

About this study

Official title: An Open-label, Randomized, Phase 2, Parallel, Dose-Ranging, Multicenter Study of Sotatercept for the Treatment of Patients With Anemia and Low or Intermediate-1 Risk Myelodysplastic Syndromes or Non-proliferative Chronic Myelomonocytic Leukemia (CMML)

The primary objective of this study is to determine a safe, tolerable and effective dose of sotatercept that results in the greatest frequency of improvement of anemia in patients diagnosed with low- or intermediate-1 risk myelodysplastic syndromes (MDS) or non-proliferative chronic myelomonocytic leukemia (CMML).

Being tested
Sotatercept
Keywords
ACE-011, anemia, dose-ranging, intermediate-1 risk myelodysplastic syndromes, low risk myelodysplastic syndromes (MDS), multicenter, open-label, parallel, phase 2, randomized, Sotatercept, Non-proliferative chronic myelomonocytic leukemia (CMML), hemoglobin, transfusions
Medical subject headings
Anemia, Myelodysplastic Syndromes, Leukemia, Myelomonocytic, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SotaterceptDrug

    Also called ACE-011, ActRIIA-IgG1Fc

    Sotatercept is supplied as a lyophilized powder that is reconstituted using Water for Injection (WFI) and administered as a subcutaneous injection (SC) injection by the study staff at the clinical site.

Study groups in NCT01736683
Study groupRoleWhat they receive
Sotatercept 0.1 mg/kgExperimentalSotatercept 0.1 mg/kg
Receives: Drug: Sotatercept
Sotatercept 0.3 mg/kgExperimentalSotatercept 0.3 mg/kg
Receives: Drug: Sotatercept
Sotatercept 0.5 mg/kgExperimentalSotatercept 0.5 mg/kg
Receives: Drug: Sotatercept
Sotatercept 1.0 mg/kgExperimentalSotatercept 1.0 mg/kg
Receives: Drug: Sotatercept
Sotatercept 1.5 mg/kgExperimentalSotatercept 1.5 mg/kg
Receives: Drug: Sotatercept
Sotatercept 2.0 mg/kgExperimentalSotatercept 2.0 mg/kg
Receives: Drug: Sotatercept

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Erythroid Hematological Improvement (HI-E) Starting Before the Completion of Five Cycles of Treatment (Responder Rate)

    The responder rate includes non-transfusion dependent efficacy (NTDE) participants and transfusion dependent efficacy (TDE) participants. For non-transfusion dependence efficacy (NTDE) participants who required < 4 units of RBCs in the 8 weeks prior to start of therapy, HI-E was defined as an increase of >=1.5 g/dL hemoglobin sustained for 56 days over a period of >=8 weeks. For transfusion dependence efficacy (TDE) participants who required >=4 units of RBCs in the 8 weeks prior to start of therapy, HI-E was defined as a decrease of >= 4 units of RBCs transfused sustained for 56 days over a period of 8 weeks.

    Measured: Day 2 to Day 142

Secondary outcomes (10)
  1. Time to Erythroid Hematological Improvement (HI-E) Response

    Time to first response = start date of first response (HI-E) - first dose date + 1 day. For NTDE participants (who required < 4 units of RBCs in the 8 weeks prior to start of therapy), HI-E was defined as an increase of >=1.5 g/dL hemoglobin sustained for 56 days over a period of >=8 weeks. For TDE participants (who required >=4 units of RBCs in the 8 weeks prior to start of therapy), HI-E was defined as a decrease of >= 4 units of RBCs transfused sustained for 56 days over a period of 8 weeks.

    Measured: Day 1 to Day 87

  2. Duration of Erythroid Hematological Improvement (HI-E)

    The duration of HI-E response for participants who responded was (the last date of the consecutive hemoglobin [Hgb] measurements of the first >=56 day interval) - (the first date of the consecutive Hgb measurements of the first >=56 day interval) + 1 day.

    Measured: Day 1 to 183.7 weeks

  3. Time to Progression to Acute Myeloid Leukemia (AML) for Participants Who Had Progression

    Progression to AML used criteria by the International Working Group (IWG) Response Criteria in Myelodysplasia (Cheson, 2006). Progression is considered if any of the following are met: - >=50% increase in blasts - >=50% decrement from maximum remission/response levels in granulocytes or platelets - Reduction in Hgb concentration by >=2 g/dL - Transfusion dependence This outcome was defined as a Kaplan-Meier estimate however few participants progressed so a Kaplan-Meier analysis could not be performed. Disclosed are time to progression values only for participants who did progress to AML.

    Measured: Day 1 to 183.7 weeks

  4. Time to Progression to Events of Higher Risk Myelodysplastic Syndromes (MDS) Using the International Prognostic Scoring System (IPSS) For Participants Who Had Progression

    Progression to events of higher risk MDS used criteria from the International Prognostic Scoring System for MDS (IPSS) which assigns a prognostic score (0=good and increasing in risk by half-grades with the top score outlined below) for three prognostic variables: - Marrow blasts (score 0-2.0) - Karyotype (score 0-1.0) - Cytopenias: neutrophil, platelets, and Hg counts (score 0-0.5) The three individual scores are summed resulting in a full range of 0- 3.5 and placed into risk categories 0 = low risk 0.5-1.0 = intermediate-1 risk 1.5-2.0 = intermediate-2 risk >=2.5 = high risk This outcome was defined as a Kaplan-Meier estimate however few participants progressed so a Kaplan-Meier analysis could not be performed. Data reported represent event times (weeks) for participants who did progress to higher risk MDS categories.

    Measured: Day 1 to 257.3 weeks

  5. Kaplan-Meier Estimates for Progression-free Survival

    Participants who had disease progression were considered to have events. Participants who died without acute myeloid leukemia (AML) were also considered to have events with the event date as the date of death. Those who did not have disease progression and who were lost to follow-up were censored at the last known disease progression assessment date. Participants without disease progression at the last follow-up contact were censored at the date of the last follow-up contact date. Disease Progression to AML used criteria by the International Working Group (IWG) Response Criteria in Myelodysplasia (Cheson, 2006). Progression is considered if any of the following are met: - >=50% increase in blasts - >=50% decrement from maximum remission/response levels in granulocytes or platelets - Reduction in hemoglobin (Hgb) concentration by >=2 g/dL - Transfusion dependence

    Measured: Day 1 to 257.3 weeks

  6. Kaplan-Meier Estimates for Overall Survival (OS)

    OS was defined as the time between start of treatment and the death/censored date. Participants who died (regardless of the cause of death) were considered to have an event. Participants who were alive at the end of the study, and participants who were lost to follow-up, were censored at the last date when subjects were known to be alive.

    Measured: Day 1 to 257.3 weeks

  7. Pharmacokinetic Parameters of Sotatercept: Serum Concentration at Various Study Timepoints

    Maximum observed serum concentration, obtained directly from the observed concentration versus time data.

    Measured: Cycle 1 Day 8 and !5 up to Cycle 2 Day 1

  8. Participants With Treatment-Emergent Adverse Events (TEAE)

    An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a subject during the course of a study. Treatment-emergent adverse events (TEAEs) are defined as any AE occurring or worsening on or after the first treatment of the study medication and within 42 days after the last dose. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to the study drug and reported as 'Suspected' on the CRF. AEs with a missing relationship were treated as 'treatment-related' in data summaries.

    Measured: Day 1 up to 59.2 months

  9. Dose Limiting Toxicities (DLTs)

    The following were DLTs if the investigator suspected they were treatment related: 1. Increase to >= 140 mmHg systolic blood pressure 2. Increase to >=90 mmHg diastolic blood pressure 3. Increase to >=140 systolic and increase > 20 mmHg compared to baseline systolic 4. Increase to >=90 mmHg diastolic and increase > 20 mmHg compared to baseline diastolic 5. Introduction of new anti-hypertension medication during treatment 6. Increase in dose of baseline anti-hypertension medication during treatment 7. >= Grade 2 (moderate severity or worse) hypertension as an adverse event

    Measured: Day 1 to 59.2 months

  10. Number of Participants Who Achieved Red Blood Cell (RBC)-Transfusion Independence During the Erythroid Hematological Improvement (HI-E) Interval

    Number of participants who achieved RBC-independence was defined as participants who required no RBC-transfusions during a 56-day interval of erythroid hematological improvement (HI-E). NTDE = non-transfusion dependence efficacy participants who required < 4 units of RBCs in the 8 weeks prior to start of therapy TDE = transfusion dependence efficacy participants who required >=4 units of RBCs in the 8 weeks prior to start of therapy

    Measured: Day 2 to Day 142

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Nov 2012 (estimated)
  2. Study start28 Nov 2012
  3. Primary completion30 Apr 2018
  4. Study completion30 Apr 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
74 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01736683
Sponsor's protocol ID
7962-017
Other IDs
ACE-011-MDS-001, 2012-002601-22
Status last verified
Oct 2022
First submitted
27 Nov 2012
Last updated
24 Oct 2022
Data monitoring committee
Yes
Individual data sharing
Yes: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Publications

  • Komrokji R, Garcia-Manero G, Ades L, Prebet T, Steensma DP, Jurcic JG, Sekeres MA, Berdeja J, Savona MR, Beyne-Rauzy O, Stamatoullas A, DeZern AE, Delaunay J, Borthakur G, Rifkin R, Boyd TE, Laadem A, Vo B, Zhang J, Puccio-Pick M, Attie KM, Fenaux P, List AF. Sotatercept with long-term extension for the treatment of anaemia in patients with lower-risk myelodysplastic syndromes: a phase 2, dose-ranging trial. Lancet Haematol. 2018 Feb;5(2):e63-e72. doi: 10.1016/S2352-3026(18)30002-4. Epub 2018 Jan 10.

    PubMed 29331635

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Sotatercept in people with Anemia and Myelodysplastic Syndromes, run by Merck Sharp & Dohme LLC at 20 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in United States, France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 Jun 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Erythroid Hematological Improvement (HI-E) Starting Before the Completion of Five Cycles of Treatment (Responder Rate) (time frame: Day 2 to Day 142). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01736683, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Oct 2022.

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