E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Anemia in Patients with Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes (MDS). |
La anemia en pacientes con síndromes mielodisplásicos (SMD) de riesgo muy bajo, bajo o intermedio |
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E.1.1.1 | Medical condition in easily understood language |
Myelodysplastic syndromes (MDS) are conditions that are observed when the blood-forming cells in the bone marrow become abnormal. |
Los síndromes mielodisplásicos (SMD) son afecciones que se observan cuando las células productoras de sangre en la médula ósea se vuelven anormales. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10028533 |
E.1.2 | Term | Myelodysplastic syndrome |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10002272 |
E.1.2 | Term | Anemia |
E.1.2 | System Organ Class | 100000004851 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Part 1: Dose Escalation • To evaluate the safety and tolerability of ascending doses of KER-050 in participants with very low, low, or intermediate risk MDS in order to determine the dose(s) that will be evaluated in Part 2 of the study. Part 2: Dose Confirmation • To confirm the safety and tolerability of the dose(s) selected in Part 1. |
Parte 1 de aumento gradual de la dosis: •Evaluar la seguridad y tolerabilidad del aumento escalonado de la dosis de KER-050 en participantes con SMD de riesgo muy bajo, bajo o intermedio para determinar las dosis que se evaluarán en la parte 2 del estudio.
Parte 2 de confirmación de la dosis: •Confirmar la seguridad y tolerabilidad de las dosis seleccionadas en la parte 1. |
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E.2.2 | Secondary objectives of the trial |
Secondary Objectives (Part 1 and Part 2) • To evaluate the PD effects of KER-050 on erythropoiesis in participants with very low, low, or intermediate risk MDS, separately for ring sideroblast (RS) positive and non-RS populations. • To evaluate the efficacy of KER-050 on anemia in participants with very low, low or intermediate risk MDS, separately for RS positive and non-RS populations. |
Objetivos secundarios (parte 1 y parte 2): •Evaluar los efectos farmacodinámicos (FD) de KER-050 en la eritropoyesis en participantes con SMD de riesgo muy bajo, bajo o intermedio, por separado para las poblaciones positivas para sideroblastos en anillo (SA) y sin sideroblastos en anillo (SSA).
•Evaluar la eficacia de KER-050 en la anemia en participantes con SMD de riesgo muy bajo, bajo o intermedio, por separado para las poblaciones positivas para SA y SSA. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. 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. 2. < 5% blasts in bone marrow. 3. Peripheral blood white blood cell (WBC) count < 13,000/µL. 4. Anemia defined as: a. In LTB participants (defined as having received < 4 units of RBCs within 8 weeks), mean hemoglobin concentration < 10.0 g/dL of two measurements (one performed within 1 day prior to Cycle 1 Day 1 and the other performed 7-28 days prior, not influenced by RBC transfusion within 7 days of measurement) OR b. In HTB participants (defined as requiring > or = 4 units of RBCs for hemoglobin < or = 9.0 g/dL within 8 weeks) 5. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 (if related to anemia. 6. Females of child-bearing potential and sexually active males must agree to use effective methods of contraception. |
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E.4 | Principal exclusion criteria |
1. 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. 2. Diagnosis of secondary MDS (ie, MDS that is known to have arisen as the result of chemical injury or treatment with chemotherapy and/or radiation for other diseases). 3. Vitamin B12 deficiency. 4. Prior treatment with azacitidine, decitabine, lenalidomide, luspatercept, or sotatercept. 5. Treatment within 28 days prior to Cycle 1 Day 1 with: a. Erythropoiesis stimulating agent (ESA) OR b. Granulocyte colony-stimulating factor (G-CSF) OR c. Granulocyte-macrophage colony-stimulating factor (GM-CSF) 6. Iron chelation therapy if initiated within 8 weeks prior to Cycle 1 Day 1. 7. Vitamin B12 therapy within 8 weeks prior to Cycle 1 Day 1. 8. Treatment with another investigational drug or device or approved therapy for investigational use < or = 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. 9. Platelet count > 450 x 10*9/L or < 30 x 10*9/L. 10. Transferrin saturation < 15%. 11. Ferritin < 50 µg/L. 12. Folate < 4.5 nmol/L (< 2.0 ng/mL). 13. Vitamin B12 < 148 pmol/L (< 200 pg/mL). 14. Estimated glomerular filtration rate (GFR) < 40 mL/min/1.73 m2 (as determined by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]. 15. Pregnant or lactating females. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary Endpoint: Safety and tolerability as determined by the incidence of adverse events (AEs) and serious AEs (SAEs). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. Maximum concentrations of KER-050 [Time Frame: Measured at multiple timepoints over the course of treatment from study day 1 to approximately 15 weeks] 2. Erythroid response in low-transfusion burden (LTB) and high-transfusion burden (HTB) participants. [Time Frame: Measured over the course of study, up to approximately 25 weeks from study day 1] a. 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). b. 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. 3. Modified 2006 International Working Group (IWG) Hematologic Improvement Erythroid (HI-E) response [Time Frame: Measured over the course of study, up to approximately 25 weeks from study day 1] a. In 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. b. 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. 4. Mean change from baseline in hemoglobin [Time Frame: Measured over the course of study, up to approximately 25 weeks from study day 1] 5. Time to erythroid response and modified 2006 IWG HI-E response [Time Frame: From treatment initiation to End of Study visit (approximately 25 weeks)] 6. Duration of erythroid response and modified 2006 IWG HI-E response [Time Frame: From treatment initiation to End of Study visit (approximately 25 weeks)] 7. Frequency of red blood cell (RBC) transfusions and rate of RBC transfusion independence ≥ 8 weeks [Time Frame: From treatment initiation to End of Study visit (approximately 25 weeks)] 8. Change from Baseline in RBC counts and reticulocytes [Time Frame: From treatment initiation to End of Study visit (approximately 25 weeks)] |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Timepoints indicated above. |
Puntos de tiempo indicados arriba. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability |
Tolerabilidad |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Dosis ascendente de 2ª parte |
2-part Ascending Dose |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Israel |
New Zealand |
Czechia |
France |
Germany |
Spain |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the study is defined as completion of the last participant completing the last visit or last procedure. |
El final del estudio se define como la finalización del último participante que completó la última visita o el último procedimiento. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 12 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 12 |