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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05883956
Registration number
NCT05883956
Ethics application status
Date submitted
25/04/2023
Date registered
1/06/2023
Titles & IDs
Public title
A Study Comparing Treatment Preference Between Oral Decitabine/Cedazuridine and Azacitidine in Myelodysplastic Syndrome, Low-Blast Acute Myeloid Leukemia, or Chronic Myelomonocytic Leukemia
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Scientific title
A Phase 3b, Randomized, Open-Label, Double Crossover Study Comparing Treatment Preference Between Oral Decitabine/Cedazuridine and Azacitidine in Adult Patients With IPSS R Intermediate Myelodysplastic Syndrome, Low Blast Acute Myeloid Leukemia, IPSS Intermediate-2 or High Risk Myelodysplastic Syndrome or Chronic Myelomonocytic Leukemia
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Secondary ID [1]
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393-419-00041
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Universal Trial Number (UTN)
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Trial acronym
PREFER-HMA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myelodysplastic Syndromes
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Leukemia, Myeloid, Acute
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Leukemia, Myelomonocytic, Chronic
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Patient Preference
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Blood
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Haematological diseases
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Blood
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Other blood disorders
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Subcutaneous azacitidine
Treatment: Drugs - Oral decitabine/cedazuridine
Active comparator: ABBA - Cycle 1: Oral decitabine/cedazuridine; Cycle 2: Subcutaneous azacitidine; Cycle 3: Subcutaneous azacitidine; Cycle 4: Oral decitabine/cedazuridine
Active comparator: BAAB - Cycle 1: Subcutaneous azacitidine; Cycle 2: Oral decitabine/cedazuridine; Cycle 3: Oral decitabine/cedazuridine; Cycle 4: Subcutaneous azacitidine
Treatment: Drugs: Subcutaneous azacitidine
Subcutaneous azacitidine, 75mg/m2, 7 days
Treatment: Drugs: Oral decitabine/cedazuridine
Oral decitabine 35mg/cedazuridine 100mg, once daily, 5 days
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Proportion of patients reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the patient treatment preference in myelodysplasia questionnaire (pTPMQ)
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Assessment method [1]
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Timepoint [1]
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Prior to initiation of Cycle 3 (each cycle is 28 days)
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Primary outcome [2]
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Proportion of patients reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the pTPMQ
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Assessment method [2]
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Timepoint [2]
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Prior to initiation of Cycle 5 (each cycle is 28 days)
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Secondary outcome [1]
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Proportion of carers reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the carer treatment preference in myelodysplasia questionnaire (cTPMQ)
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Assessment method [1]
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Timepoint [1]
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Prior to initiation of Cycle 3 (each cycle is 28 days)
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Secondary outcome [2]
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Proportion of carers reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the cTPMQ
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Assessment method [2]
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Timepoint [2]
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Prior to initiation of Cycle 5 (each cycle is 28 days)
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Secondary outcome [3]
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Proportion of clinicians reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the medical treatment preference in myelodysplasia questionnaire (mTPMQ)
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Assessment method [3]
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Timepoint [3]
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Prior to initiation of Cycle 4 (each cycle is 28 days)
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Secondary outcome [4]
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Proportion of clinicians reporting preference for oral decitabine/cedazuridine vs subcutaneous azacitidine on the mTPMQ
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Assessment method [4]
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Timepoint [4]
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End of Study (EOS) Day 28
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Secondary outcome [5]
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Proportion of clinicians choosing oral decitabine/cedazuridine vs subcutaneous azacitidine for continuation of treatment and reasons for the treatment choice based on the mTPMQ
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Assessment method [5]
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Timepoint [5]
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Cycle 5, Day 1 (each cycle is 28 days)
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Secondary outcome [6]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EQ-5D-5L in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [6]
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Timepoint [6]
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Cycle 1, Day 1 (each cycle is 28 days)
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Secondary outcome [7]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EORTC QLQ-C30 in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [7]
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Timepoint [7]
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Cycle 1, Day 1 (each cycle is 28 days)
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Secondary outcome [8]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EQ-5D-5L in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [8]
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Timepoint [8]
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Cycle 3, Day 5 (each cycle is 28 days)
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Secondary outcome [9]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EORTC QLQ-C30 in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [9]
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Timepoint [9]
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Cycle 3, Day 5 (each cycle is 28 days)
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Secondary outcome [10]
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Difference in quality of life between oral decitabine/cedazuridine and Subcutaneous azacitidine as assessed using the EQ-5D-5L in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [10]
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Timepoint [10]
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Cycle 4, Day 5 (each cycle is 28 days)
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Secondary outcome [11]
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Difference in quality of life between oral decitabine/cedazuridine and Subcutaneous azacitidine as assessed using the EORTC QLQ-C30 in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [11]
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Timepoint [11]
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Cycle 4, Day 5 (each cycle is 28 days)
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Secondary outcome [12]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EQ-5D-5L in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [12]
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Timepoint [12]
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Cycle 5, Day 5 (each cycle is 28 days)
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Secondary outcome [13]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EORTC QLQ-C30 in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [13]
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Timepoint [13]
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Cycle 5, Day 5 (each cycle is 28 days)
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Secondary outcome [14]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EQ-5D-5L in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [14]
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Timepoint [14]
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Cycle 6, Day 5 (each cycle is 28 days)
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Secondary outcome [15]
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Difference in quality of life between oral decitabine/cedazuridine and subcutaneous azacitidine as assessed using the EORTC QLQ-C30 in Myelodysplastic Syndrome, Chronic Myelomonocytic Leukemia and Low-Blast Acute Myeloid Leukemia patients
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Assessment method [15]
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Timepoint [15]
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Cycle 6, Day 5 (each cycle is 28 days)
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Secondary outcome [16]
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The difference in the incidence of treatment discontinuation and reasons for treatment discontinuation
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Assessment method [16]
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Timepoint [16]
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Baseline (pre-intervention) through to study completion (up to 6 cycles of treatment where each cycle is 28 days)
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Secondary outcome [17]
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Incidence and severity of adverse events upon study physician discretion.
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Assessment method [17]
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Timepoint [17]
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Baseline (pre-intervention) through to study completion (up to 6 cycles of treatment where each cycle is 28 days)
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Eligibility
Key inclusion criteria
For Patients:
Patients are eligible to be included in the study only if all of the following criteria apply at any time starting from Screening up to Day 1 prior to study treatment administration:
* Patients must be 18 years of age or older.
* IPSS-R defined intermediate MDS, IPSS defined intermediate 2 or high-risk MDS, LB AML or CMML (with symptoms), as confirmed by recent full blood examination, bone marrow biopsy, and cytogenetic testing. NOTE: IPSS-R defined intermediate MDS patients are limited to less than 50% of enrolled patients.
* Life expectancy of at least 6 months.
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2 inclusive.
* Patient must be able to co-operate and complete tasks (including tasks such as electronic questionnaires on digital devices) over the following 4 months.
For Patients:
Patients are eligible to be included in the study only if all of the following criteria apply at any time starting from Screening up to Day 1 prior to study treatment administration:
* Patients must be 18 years of age or older.
* IPSS-R defined intermediate MDS, IPSS defined intermediate 2 or high-risk MDS, LB AML or CMML (with symptoms), as confirmed by recent full blood examination, bone marrow biopsy, and cytogenetic testing. NOTE: IPSS-R defined intermediate MDS patients are limited to less than 50% of enrolled patients.
* Life expectancy of at least 6 months.
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2 inclusive.
* Patient must be able to co-operate and complete tasks (including tasks such as electronic questionnaires on digital devices) over the following 4 months.
* Patient must be able to identify a carer to participate in completing the cTPMQ.
For Carers:
• Primary carer of a patient meeting all of the inclusion criteria (ie, a patient who meets criteria defined above).
For Clinicians:
• Clinician treating patients meeting all of the inclusion criteria (ie, treats patients who meet criteria defined above).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
For Patients:
Patients are excluded from the study if any of the following criteria apply:
* Patients with known hypersensitivity to the study treatments oral decitabine/cedazuridine or azacitidine.
* Patients with advanced malignant hepatic tumors.
* Patients with severe renal impairment (creatinine clearance <30 mL/min).
* Patients who have received hypomethylating agents (HMA) previously.
* Patients who are receiving lenalidomide or are receiving other therapies outside of standard of care (SOC).
* Receipt of any immunotherapy, any conventional or investigational systemic anti-cancer therapy within 5 half-lives of the drug, or within 4 weeks prior to the first dose of study treatment (whichever is longer).
* Any medical, psychological, social, or other condition which in the view of the Investigator is likely to interfere with the study, compliance, or put the patient at risk.
* Participants who are not fluent in English, or who cannot read or write in English will be excluded from the study.
For Carers:
Carers are excluded from the study if any of the following criteria apply:
* They are a carer of a patient who meets any of the exclusion criteria listed above.
* They are a relative of an employee of the investigational clinic or sponsor (e.g. Investigator, study coordinator)
For Clinicians:
• Clinicians will be excluded from participating in the study if they are a relative of an employee of the investigational clinic or sponsor (e.g. Investigator, Study Coordinator).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
20/12/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/05/2025
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Actual
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Sample size
Target
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Accrual to date
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Final
13
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
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Recruitment hospital [1]
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Calvary Mater Newcastle - Newcastle
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Recruitment hospital [2]
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Pindara Private Hospital - Benowa
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Recruitment hospital [3]
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Townsville Hospital - Townsville
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Recruitment hospital [4]
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Adelaide Oncology and Haematology - North Adelaide
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Recruitment hospital [5]
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Grampian Health (Ballarat Base Hospital) - Ballarat Central
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Recruitment hospital [6]
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Latrobe Regional Hospital - Traralgon
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Recruitment postcode(s) [1]
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- Newcastle
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Recruitment postcode(s) [2]
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- Benowa
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Recruitment postcode(s) [3]
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- Townsville
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Recruitment postcode(s) [4]
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- North Adelaide
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Recruitment postcode(s) [5]
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- Ballarat Central
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Recruitment postcode(s) [6]
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- Traralgon
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Christchurch
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Country [2]
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New Zealand
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State/province [2]
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Dunedin
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Country [3]
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New Zealand
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State/province [3]
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Grafton
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Country [4]
0
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New Zealand
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State/province [4]
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Hamilton
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Country [5]
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New Zealand
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State/province [5]
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Takapuna
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Otsuka Australia Pharmaceutical Pty Ltd
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
It is hypothesized that significantly more patients would prefer oral decitabine/cedazuridine to subcutaneous (SC) azacitidine (AZA) due to several factors, including improved treatment convenience, the reduced risk of nosocomial infections, and reduced treatment discomfort. However, this hypothesis has not been formally studied in a controlled setting. This study aims to address this evidence gap and evaluate patient, primary caregiver (carer), and clinician treatment preference between oral decitabine/cedazuridine and SC AZA in the treatment of adult patients with International Prognostic Scoring System-Revised (IPSS-R) intermediate, IPSS intermediate-2, or high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukemia (CMML), or low-blast (LB) acute myeloid leukemia (AML) and thereby lend further credibility to the clinical, economic, and patient value of oral decitabine/cedazuridine.
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Trial website
https://clinicaltrials.gov/study/NCT05883956
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Anoop Enjeti
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Address
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Calvary Mater Newcastle, Edith Street, Waratah, NSW 2298 Australia
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05883956