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A Study of KER-050 to Treat Anemia Due to Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes

PHASE2RECRUITING

The purpose of this study is to evaluate the effects of KER-050 on anemia in patients with very low, low or intermediate risk MDS.

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Study details:

KER-050 is a therapeutic protein designed to increase red blood cell and platelet production by inhibiting the signaling of a subset of the transforming growth factor beta (TGF-ß) family of proteins to promote hematopoiesis. It is being developed for the treatment of low blood cell counts, or cytopenias including anemia and thrombocytopenia in patients with Myelodysplastic Syndrome (MDS) and Myelofibrosis (MF).

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

  • Diagnosis of MDS according to World Health Organization (WHO)/French American British (FAB) classification that meets Revised International Prognostic Scoring System (IPSS-R) classification of very low, low, or intermediate risk disease.
  • < 5% blasts in bone marrow.
  • Peripheral blood white blood cell count <13,000/µL.
  • Anemia defined as: In non-transfused participants, having received no red blood cell (RBC) transfusions within 8 weeks Hgb concentration ≤ 10.0 g/dL OR In LTB participants, having received 1 to 3 units RBCs for Hgb ≤ 9.0 g/dL within 8 weeks OR In HTB participants, having received ≥ 4 units of RBCs for Hgb ≤ 9.0 g/dL within 8 weeks
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 (if related to anemia.
  • Females of child-bearing potential and sexually active males must agree to use effective methods of contraception.
  • Exclusion criteria

  • Any active infection requiring parenteral antibiotic therapy within 28 days prior to Cycle 1 Day 1 or oral antibiotics within 14 days of Cycle 1 Day 1.
  • Diagnosis of secondary MDS (i.e., MDS known to have arisen as the result of chemical injury or treatment with chemotherapy and/or radiation for other diseases).
  • Vitamin B12 deficiency.
  • Prior treatment with azacitidine, decitabine, lenalidomide, luspatercept, or sotatercept.
  • Treatment within 28 days prior to Cycle 1 Day 1 with: Erythropoiesis stimulating agent (ESA) OR Granulocyte colony-stimulating factor (G-CSF) OR Granulocyte-macrophage colony-stimulating factor (GM-CSF)
  • Iron chelation therapy if initiated within 8 weeks prior to Cycle 1 Day 1.
  • Vitamin B12 therapy within 8 weeks prior to Cycle 1 Day 1.
  • Treatment with another investigational drug or device or approved therapy for investigational use ≤ 28 days prior to Cycle 1 Day 1, or if the half-life of the previous product is known, within 5 times the half-life prior to Cycle 1 Day 1, whichever is longer.
  • Platelet count > 450 x 10*9/L or < 30 x 10*9/L.
  • Transferrin saturation < 15%.
  • Ferritin < 50 µg/L.
  • Folate < 4.5 nmol/L (< 2.0 ng/mL).
  • Vitamin B12 < 148 pmol/L (< 200 pg/mL).
  • Estimated glomerular filtration rate (GFR) < 40 mL/min/1.73 m2 (as determined by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI].
  • Pregnant or lactating females
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: All

    Things to know

    Study dates

    Study start: 2020-08-19

    Primary completion: 2025-06-30

    Study completion finish: 2025-11-30

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE2

    trial

    Trial ID

    NCT04419649

    Intervention or treatment

    DRUG: KER-050

    Conditions

    • Myelodysplastic Syndromes
    • Cytopenia

    Find a site

    Closest Location:

    The Tweed Hospital

    Research sites nearby

    Select from list below to view details:

    • The Tweed Hospital

      Tweed Heads, New South Wales, Australia

    • Westmead Hospital

      Westmead, New South Wales, Australia

    • Townsville University Hospital

      Douglas, Queensland, Australia

    • Royal Adelaide Hospital

      Adelaide, South Australia, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: KER-050 Cohort 1
    • Escalating doses of KER-050 administered subcutaneously every 4 weeks for up to 4 cycles. Participants have the option to continue to receive KER-050 once 4 cycles have been completed for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.
    EXPERIMENTAL: KER-050 Cohort 2
    • Escalating doses of KER-050 administered subcutaneously every 4 weeks for up to 4 cycles. Participants have the option to continue to receive KER-050 once 4 cycles have been completed for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.
    EXPERIMENTAL: KER-050 Cohort 3
    • Escalating doses of KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.
    EXPERIMENTAL: KER-050 Cohort 4
    • Escalating doses of KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.
    EXPERIMENTAL: KER-050 Cohort 5
    • Escalating doses of KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.
    EXPERIMENTAL: KER-050 Dose Confirmation Cohort
    • Participants to receive KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles.
    DRUG: KER-050
    • KER-050 administered subcutaneously every 4 weeks for up to 24 cycles. Eligible participants may be able to continue to receive subcutaneously administered KER-050 after completing 24 cycles in a Long-Term Extension.

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    Incidence of adverse events (AEs) and serious adverse events (SAEs).Type, frequency, severity of AEs and relationship of AEs to KER-050From treatment initiation to end of study, approximately 2 years

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    Maximum concentrations of KER-050Pharmacokinetics of KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Erythroid response in low-transfusion burden (LTB) and high-transfusion burden (HTB) participants.In LTB participants, the proportion of participants who have a hemoglobin increase of ≥ 1.5 g/dL from Baseline for ≥ 14 days (in the absence of RBC transfusions). In HTB participants, the proportion of participants having a reduction of ≥ 50% or ≥ 4 RBC units transfused compared to pretreatment over an 8-week period.Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Incidence of progression to higher risk MDS or AML per World Health Organization 2016 criteriaChange in baseline laboratory assessments prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Incidence of progression to higher risk MDS or AML per World Health Organization 2016 criteriaChange in baseline bone marrow assessments prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Modified 2006 International Working Group (IWG) Hematologic Improvement Erythroid (HI-E) responseIn LTB participants, the proportion of participants with an increase of ≥ 1.5 g/dL from pretreatment hemoglobin during any 8-week period on study compared to Baseline. In HTB participants, the proportion of participants having a reduction by ≥ 4 units of RBCs transfused (for a hemoglobin ≤ 9.0 g/dL) during any 8-week period on study, compared with the 8-week period prior to study Cycle 1 Day 1.Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Mean change from baseline in hemoglobinChange in baseline hemoglobin prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Time to erythroid response and modified 2006 IWG HI-E responseTime to erythroid response prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Duration of erythroid response and modified 2006 IWG HI-E responseDuration of erythroid response prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Frequency of red blood cell (RBC) transfusions and rate of RBC transfusion independence ≥ 8 weeksFrequency and rate of RBC transfusions prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years
    Change from Baseline in RBC counts and reticulocytesChange in baseline RBC counts and reticulocytes prior to treatment with KER-050 and after treatment with KER-050Measured at multiple timepoints over the course of study from study day 1 to end of study, approximately 2 years

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    References

    Clinical Trials Gov: A Study of KER-050 to Treat Anemia Due to Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes

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