Oral AZA Study - Evaluating injectable versus oral azacitidine incorporation in mononuclear cells

The challenge

Myelodysplastic Syndrome (MDS) is a group of blood disorders where the bone marrow does not produce enough mature red blood cells, white blood cells and platelets. In a healthy person, the bone marrow makes blood stem cells (immature cells, also called ‘blasts’) that become mature blood cells over time. In people with MDS, this process is affected and immature blood cells in the bone marrow do not mature fully to become healthy blood cells. This causes a lack of healthy blood cells that can function properly. With fewer healthy blood cells, infection, anaemia, or easy bleeding may occur. MDS can progress to acute myeloid leukaemia in 25-30% of patients, and if untreated it can be rapidly fatal.

The project

The purpose of this study is to evaluate the standard treatment, azacitidine (Vidaza) given as an injection under the skin compared to the same medication (called CC-486) taken as a tablet by mouth. Vidaza is approved by the Australian Therapeutics Goods Administration (TGA) as standard treatment for MDS. CC-486 is an experimental treatment. This means it is not an approved treatment for MDS in Australia. CC-486 is being developed to increase convenience and make it easier for patients to continue their treatment. So far it has been given to over 870 patients in studies across the world. The treatment in the injection and the tablet is the same. Studies like this one are being done to ensure the tablet works in the same way as the standard injected treatment.

The method

Vidaza is given by subcutaneous injection (i.e. under the skin) over an hour for 7 days every 4 weeks for as long as it continues to work. All study participants will receive active treatment (there is no placebo), and all participants will receive the standard injection for six treatment cycles followed by the new tablet medication taken once daily for 21 days every 4 weeks. Blood and bone marrow samples will be taken to allow the researchers to compare the two ways of giving the medicine. Approximately 60 people will be enrolled in the study from hospitals in NSW.

The results

Accrual has commenced and results are anticipated in early 2018.

The impact

Researchers hope to better understand why some people with MDS respond to treatments more than others. This will provide the necessary data to support individualised alternatives to optimise future azacitidine therapy, including an oral tablet form.

Project funding