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    Clinical Trial Results:
    Randomized maintenance therapy with Azacitidine (Vidaza) in older patients (≥ 60 years of age) with acute myeloid leukemia (AML) and refractory anemia with excess of blasts (RAEB, RAEB-t). A phase III study.

    Summary
    EudraCT number
    2008-001290-15
    Trial protocol
    NL   BE  
    Global end of trial date
    31 Dec 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    26 Jan 2023
    First version publication date
    26 Jan 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HO97
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    HOVON
    Sponsor organisation address
    De Boelelaan 1117, Amsterdam, Netherlands,
    Public contact
    HOVON Data Center, HOVON, +31 (0)107041560, hdc@erasmusmc.nl
    Scientific contact
    HOVON Data Center, HOVON, +31 (0)107041560, hdc@erasmusmc.nl
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 Jul 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    12 Jul 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    31 Dec 2021
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To assess, in a randomized study the value of Azacitidine as post remission therapy (in comparison to observation) in elderly patients with AML, RAEB or RAEB-t with respect to the disease free survival.
    Protection of trial subjects
    Monitoring and insurance.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Jun 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 80
    Country: Number of subjects enrolled
    Belgium: 38
    Worldwide total number of subjects
    118
    EEA total number of subjects
    118
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    5
    From 65 to 84 years
    113
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    All subjects gave written informed consent and were screened according to the inclusion- and exclusion criteria

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A
    Arm description
    -
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    Arm B
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Azacitidine
    Investigational medicinal product code
    Other name
    Vidaza
    Pharmaceutical forms
    Powder and solution for solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    50 mg/m2, days 1,2,3,4,5 every 4 weeks until relapse for a maximum of 12 cycles.

    Number of subjects in period 1
    Arm A Arm B
    Started
    60
    58
    Completed
    23
    35
    Not completed
    37
    23
         Adverse reactions
    -
    3
         Other
    3
    6
         Lack of efficacy
    34
    14

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Reporting group values
    Overall trial Total
    Number of subjects
    118 118
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    5 5
        From 65-84 years
    113 113
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    69 (60 to 81) -
    Gender categorical
    Units: Subjects
        Female
    50 50
        Male
    68 68

    End points

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    End points reporting groups
    Reporting group title
    Arm A
    Reporting group description
    -

    Reporting group title
    Arm B
    Reporting group description
    -

    Primary: Primary Endpoint

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    End point title
    Primary Endpoint [1]
    End point description
    End point type
    Primary
    End point timeframe
    See publication.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: See attached chart/documents for results.
    End point values
    Arm A Arm B
    Number of subjects analysed
    60
    56
    Units: Whole
    60
    56
    Attachments
    Statistical data section from publication
    List of reported non-SAE's
    List of reported SAE's
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs of CTCAE grade 2 or higher have to be reported from the first study-related procedure until 30 days following the last protocol treatment or until the start of subsequent systemic therapy for the disease under study, if earlier.
    Adverse event reporting additional description
    Adverse events occurring after 30 days should also be reported if considered related to study drug. Grade 3 or 4 adverse events considered related to study drug must be followed until recovery or until 6 months after the last protocol treatment, whichever comes first.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    3
    Reporting groups
    Reporting group title
    Arm A
    Reporting group description
    -

    Reporting group title
    Arm B
    Reporting group description
    -

    Serious adverse events
    Arm A Arm B
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 60 (6.67%)
    14 / 55 (25.45%)
         number of deaths (all causes)
    45
    41
         number of deaths resulting from adverse events
    Investigations
    Investigations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Vascular disorders
    Vascular disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    3 / 55 (5.45%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Blood and lymphatic system disorders
    Blood and lymphatic disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    General disorders and administration site conditions
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Infections and infestations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    3 / 55 (5.45%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    2 / 55 (3.64%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Arm A Arm B
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 60 (48.33%)
    39 / 55 (70.91%)
    Vascular disorders
    Vascular
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    1 / 55 (1.82%)
         occurrences all number
    2
    1
    Surgical and medical procedures
    Surgery/intra-operative injury
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Coagulation
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences all number
    0
    1
    Constitutional symptoms
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    3 / 60 (5.00%)
    9 / 55 (16.36%)
         occurrences all number
    3
    11
    Death
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences all number
    0
    1
    Immune system disorders
    Allergy/immunology
    Additional description: All combined, see non-SAE chart for details.
         subjects affected / exposed
    0 / 60 (0.00%)
    3 / 55 (5.45%)
         occurrences all number
    0
    3
    Reproductive system and breast disorders
    Sexual/reproductive function
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    0 / 55 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary/upper respiratory
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    5 / 60 (8.33%)
    6 / 55 (10.91%)
         occurrences all number
    5
    8
    Cardiac disorders
    Cardiac arrythmia
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences all number
    0
    2
    Cardiac general
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    2 / 55 (3.64%)
         occurrences all number
    1
    2
    Nervous system disorders
    Neurology
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    4 / 55 (7.27%)
         occurrences all number
    3
    4
    Blood and lymphatic system disorders
    Blood/bone marrow
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    10 / 55 (18.18%)
         occurrences all number
    2
    21
    Hemorrhage/bleeding
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    1 / 55 (1.82%)
         occurrences all number
    1
    1
    Lymphatics
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    2 / 55 (3.64%)
         occurrences all number
    0
    2
    Ear and labyrinth disorders
    Auditory/ear
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    2 / 55 (3.64%)
         occurrences all number
    1
    3
    Eye disorders
    Ocular/visual
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    1 / 55 (1.82%)
         occurrences all number
    1
    1
    Gastrointestinal disorders
    Gastrointestinal
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    12 / 55 (21.82%)
         occurrences all number
    2
    22
    Pain
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    6 / 60 (10.00%)
    5 / 55 (9.09%)
         occurrences all number
    6
    8
    Hepatobiliary disorders
    Hepatobiliary/pancreas
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    3 / 55 (5.45%)
         occurrences all number
    3
    3
    Skin and subcutaneous tissue disorders
    Dermatology/skin
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    5 / 60 (8.33%)
    8 / 55 (14.55%)
         occurrences all number
    7
    14
    Renal and urinary disorders
    Renal/genitourinary
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    1 / 60 (1.67%)
    3 / 55 (5.45%)
         occurrences all number
    1
    3
    Endocrine disorders
    Endocrine
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 55 (1.82%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Musculoskeletal/soft tissue
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    3 / 60 (5.00%)
    4 / 55 (7.27%)
         occurrences all number
    3
    4
    Infections and infestations
    Infection
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    11 / 60 (18.33%)
    11 / 55 (20.00%)
         occurrences all number
    14
    19
    Metabolism and nutrition disorders
    Metabolic/laboratory
    Additional description: All combined, see non-SAE chart for details
         subjects affected / exposed
    2 / 60 (3.33%)
    4 / 55 (7.27%)
         occurrences all number
    2
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    20 Dec 2011
    Page 1: Statistician Y. van Norden changed into Prof. Dr. Ir. C.A.G. van Montfort and Mw. Dr. Ir. D. Chitu Page 7, §3: End of recruitment I 2012 changed into IV 2013 Page 8, §4: Cytological and Immunophenotype Review M.B. van ‘t Veer changed into M. Jongen-Lavrencic Page 8, §4: Statistician Y. van Norden changed into Prof. Dr. Ir. C.A.G. van Montfort and Mw. Dr. Ir. D. Chitu Page 17(18), §11: Required investigations at entry X-thorax removed from table Page 17(18), §11.1: Evaluations prior to start treatment Chest X-ray removed Page 20(22), §13.2: hematological toxicities, abnormal laboratory values that have been recorded as being not clinically significant and progression of the disease under study and a pre-existing condition that does not increase in severity should be reported on the baseline concomitant diseases form added to adverse events that should not be reported Page 22(24), §13.3: Description of SUSAR evaluation and SUSAR reporting adjusted to the current procedure, agreement of reporting of SAE to EC added
    29 Oct 2012
    Page 8, §4: Principal Investigator, G. Huls, University Medical Center, Groningen changed into University Medical Center St. Radboud, Nijmegen Page 8, §4: Writing Committee, G. Huls, University Medical Center, Groningen changed into University Medical Center St. Radboud, Nijmegen

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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