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Phase II Study of PS341 (VELCADE) in Myelodysplastic Syndromes (MDS). EudraCT Number 2004-002935-23

Phase 2
18 Years
75 Years
Not Enrolling

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Trial Information

Phase II Study of PS341 (VELCADE) in Myelodysplastic Syndromes (MDS). EudraCT Number 2004-002935-23

The Myelodysplastic Syndromes (MDS) are an heterogeneous group of clonal disorders of the
hematopoietic stem cell characterized by ineffective hematopoiesis leading to peripheral
cytopenias, and variable risk of progression to more advanced disease and/or transformation
to acute myeloid leukemia (AML). The disease affects predominantly elderly individuals
(median age 69 years); the overall incidence is about 4 per 100,000 individuals but this
rises to > 30 per 100,000 in the over 70 year age population.

Therapy for MDS has included hematopoietic growth factors (in primis EPO, in combination or
not with granulocyte-colony stimulating factor- G-CSF or granulocyte-colony stimulating
factor-GM-CSF), differentiating agents, immunotherapy, low dose chemotherapy strategies,
AML-like induction regimens, traditional cytotoxic agents, and hematopoietic stem cell
transplantation (HSCT) strategies. With the exception of HSCT, which can result in long-term
survival in 23% to 50% of patients (Ref. 10) therapy for MDS has not consistently shown a
survival advantage, and also modest results have been obtained in an attempt to improve
anemia and/or the other cytopenias, and to decrease the number of red blood cell (RBC)
transfusions. Furthermore, MDS is primarily a disease of older patients who cannot tolerate
aggressive therapy and therefore cannot receive HSCT.

No therapy has thus been considered standard for MDS, and supportive therapy, including RBC
transfusions, platelet transfusions and antibiotic therapy has often been focus of care,
especially in the older patient population.

VELCADE™ (bortezomib) for injection is a small molecule proteasome inhibitor developed by
Millennium Pharmaceuticals, Inc., (MPI) as a novel agent to treat human malignancies.
VELCADE is currently approved by the US FDA for the treatment of multiple myeloma patients
who have received at least 2 prior therapies and have demonstrated disease progression on
the last therapy. VELCADE is a modified dipeptidyl boronic acid derived from leucine and
phenylalanine; its chemical name is N pyrazinecarbonyl L phenylalanine L leucine boronic
acid and has a molecular weight of 384.25 daltons.

Data from non clinical and clinical studies conducted to date support the development of
Velcade for the treatment of human malignancies.

Inclusion Criteria:

- Patients aged 18 -75 years.

- Patients with the following clinical diagnosis: RA(FAB) or RCMD (WHO), RARS (FAB) or

- IPSS intermediate-2 (score 1.5-2) or high (score 2.5-3) not previously treated
with chemotherapy (CT) and not eligible for intensive chemotherapy or allogeneic
stem cell transplantation (SCT), or

- IPSS intermediate-1(score 0.5-1) or low (score 0), EPO or immunosuppressive
(Cyclosporine, CSA; anti-tymocyte globulin, ATG) therapies resistant or not
eligible for these therapies, and transfusion dependent.

- Patients willing and able to comply with the protocol requirements.

- Patients given voluntary written informed consent to participate in the study, with
the understanding that consent may be withdrawn at any time without prejudice to
future medical care.

- Male and female patients willing to use acceptable methods for contraception, for the
duration of the study.

- Patients with WHO performance Status (PS) 0-2, and life expectancy > 3 months.

- Renal function tests ≤ 2 x upper limit of normal values.

- AST/GOT, ALT/GPT ≤ 2.5 x upper limit of normal values.

- Total bilirubine ≤ 1.5 x upper limit of normal value.

Exclusion Criteria:

- Patient has Grade 2 (as defined by the NCI Common Toxicity Criteria-CTC) peripheral
neuropathy within 14 days before enrollment.

- Patient has hypersensitivity to bortezomib, boron or mannitol.

- Patient has received prior treatment with bortezomib

- Patient is pregnant or nursing

- Patient has received other investigational drugs within 14 days before enrollment

- Patient has received prior chemotherapy

- Patient had a major surgery within 4 weeks before enrollment

- Patient had myocardial infarction within 6 months of enrollment or has class III-IV
heart failure, uncontrolled angina or arrhythmias

- Patient has been treated for previous malignancy within 5 years before enrollment

- Patient has uncontrolled hypertension or diabetes mellitus

- Patient is known to have HBV or HCV active hepatitis or is human immunodeficiency
virus (HIV)-positive

- Patient has systemic infections requiring treatment

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

to determine activity of Velcade in patients with MDS, intermediate-2 or high risk, and intermediate-1 or low risk unresponsive or not eligible for treatment with erythropoietin or immunosuppressive agents as assessed according to response criteria.

Principal Investigator


Investigator Role:

Principal Investigator

Investigator Affiliation:

Università degli Studi di Roma "La Sapienza", Dipartimento di Biotecnologie Cellulari ed Ematolgia


Italy: The Italian Medicines Agency

Study ID:




Start Date:

August 2006

Completion Date:

March 2008

Related Keywords:

  • MDS
  • MDS
  • Velcade
  • Myelodysplastic Syndromes
  • Preleukemia