ClinicalTrials.gg
WithdrawnNCT03446638Updated Jun 11, 2019

iCare 2: Personalized Genomic Mutation Informed Treatment of Patients With Myelodysplastic Syndromes

An interventional study of FDA-approved drug or combination of drugs and FLAG induction in Myelodysplastic Syndromes, sponsored by University of Florida. Withdrawn at 1 site in United States. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2019-06-11.

Sponsored by University of Florida · Not applicable, Interventional, and Treatment

Why this study was withdrawn
administratively withdrawn
Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years to 99 Years
Sex
All
01

Study summary

This open-label, randomized, parallel group phase II study will investigate the efficacy of computational biology-informed treatment vs. standard of care treatment for patients with relapsed or refractory myelodysplastic syndromes (MDS).

Read the detailed description

It is hypothesized that personalized treatment informed by computational biology simulation technology will improve treatment outcomes for patients with relapsed or refractory MDS.

02

Conditions studied

  • Myelodysplastic Syndromes

Keywords

  • myelodysplastic syndromes
  • MDS
  • computational biology
  • relapsed
  • refractory
03

In context

Myelodysplastic Syndromes

1,997 studies on the registry are indexed under Myelodysplastic Syndromes; 324 are open to participants now.

Browse Myelodysplastic Syndromes studies →

Lead sponsor

University of Florida is the lead sponsor of 1,287 studies on the registry; 199 are open to participants now.

Of its 180 completed or terminated interventional studies of FDA-regulated products, 143 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Provide written
  • Must be at least 18 years of age
  • Diagnosis of MDS, as defined by World Health Organization (WHO) 2008, that has after any duration of time from last best response or is refractory to induction therapy (defined as 4 cycles of treatment with a hypomethylating agent, 2 cycles of lenalidomide, 1 cycle of low intensity chemotherapy, or 1 cycle of high intensity chemotherapy)
  • performance status of 0-2
  • Women of (i.e., women who are pre-menopausal or not surgically sterile) may participate, provided they meet the following conditions:

    1. Must agree to use physician-approved methods (e.g., abstinence, intrauterine device, oral contraceptive, double barrier device) throughout the study and for 3 months following the last dose of study treatment; and
    2. Must have a negative serum or urine pregnancy test within 7 days prior to beginning treatment on this trial
  • Males with female partners of child-bearing potential must agree to use physician approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study and should avoid conceiving children for 6 months following the last dose of study treatment.

Exclusion criteria

Exclusion Criteria:

  • Must not have acute myeloid leukemia (AML), as defined by WHO 2008
  • Pregnant and nursing subjects are excluded because the effects of study treatments on a fetus or nursing child are unknown
  • Must not have had treatment with any anti-cancer therapy ( or standard) within the previous 21 days prior to the first dose of study drug or less than full recovery (no worse than v4.0 grade 1) from the toxic effects of that treatment.
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Computational Biology-Informed Treatment

    Patients randomized to this arm will receive an FDA-approved drug or combination of drugs predicted to have a therapeutic effect based on their individual MDS disease genetic profile by a computational biology simulation software program. The specific drug or combination of drugs that a patient on this arm will receive will be decided jointly by a molecular oncology board comprised of physicians, pharmacists, and nurse coordinators and the treating physician. Patients will receive a minimum of 2 months and a maximum of 4 months of treatment with the selected drug or combination of drugs.

    Drug: FDA-approved drug or combination of drugs · Device: Computational biology simulations software

  • Active comparator
    Standard of Care Treatment

    Patients randomized to this arm will receive either one of three standard of care treatment regimens of the treating physician's choice (low-dose cytarabine, 7 + 3 induction, or FLAG induction) or supportive care alone. Patients will receive a minimum of 2 months and a maximum of 4 months of the selected treatment regimen or of supportive care alone.

    Drug: FLAG induction · Drug: 7 + 3 induction · Drug: Low-dose cytarabine · Other: Supportive care alone

Interventions

  • DrugFDA-approved drug or combination of drugs

    Patients assigned to this arm will receive an FDA-approved drug or combination of drugs. Dosing and treatment schedule will follow the package insert for the selected drug(s).

  • DrugFLAG induction

    Patients will receive 30 mg/m2 per day intravenously of fludarabine for 5 days and 2000 mg/m2 per day intravenously of cytarabine for 5 days. 5 mg/kg per day of granulocyte colony stimulating factor (G-CSF) may be given subcutaneously beginning on Day 1 of each treatment until absolute granulocyte count \> 500/ microliter for 3 days.

  • Drug7 + 3 induction

    Patients will receive 100-200 mg/m2 per day intravenously of cytarabine for 7 days, plus either 45-60 mg/m2 per day intravenously of daunorubicin or 9-12 mg/m2 per day intravenously of idarubicin for 3 days.

  • Patients will receive 20 mg/m2 per day subcutaneously of cytarabine for 10 days every 28 days.

  • OtherSupportive care alone

    Patients will receive one or more of the following: blood product transfusions, antibiotics, granulocyte colony-stimulating factor (G-CSF), erythropoietic stimulating factors, and iron chelation.

  • DeviceComputational biology simulations software

    Genetic testing results for each patient randomized to this arm will be used by a computational biology simulations software program to generate a personalized map of dysregulated metabolic pathways contributing to the patient's disease. This map will then be used to digitally screen for potentially therapeutic FDA-approved drugs or drug combinations to target the dysregulated metabolic pathways.

06

What researchers measure

Primary outcomes

  1. Difference in overall response, as measured by International Working Group (IWG) 2006 criteria for response in MDS

    Difference in overall response (number of patients who achieve complete response, partial response, stable disease, or hematologic improvement per IWG 2006 criteria) between patients treated with computational biology-informed therapy vs. those treated with standard of care regimens

    Time frame: 4 months

Secondary outcomes

  1. Difference in safety and feasibility, as measured by CTCAE v4.0 criteria

    Difference in safety and feasibility, as measured by CTCAE v4.0 criteria, between patients treated with computational biology-informed treatment and those who receive a standard of care regimen

    Time frame: 5 months

  2. Difference in time to death between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 3 years

  3. Difference in time to progression to acute myeloid leukemia (AML), as measured by IWG 2006 criteria for response in MDS, between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 4 months

  4. Difference in time to disease relapse, as measured by IWG 2006 criteria for response in MDS, between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 4 months

  5. Difference in time to best response, as measured by IWG 2006 criteria for response in MDS, between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 4 months

  6. Difference in change in myeloblast percentage between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 4 months

  7. Difference in blood transfusion rate between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 7 months

Other outcomes

  1. Differences in mutant allele frequencies between patients treated with computational biology-informed therapy and those treated with standard of care regimens

    Time frame: 4 months

  2. Laboratory correlations between computational model and actual intracellular pathway activation status

    Time frame: 4 months

  3. Clinical correlations between pharmacogenotypes and drug efficacy (as measured by IWG 2006 criteria for response in MDS)

    Time frame: 4 months

  4. Clinical correlations between pharmacogenotypes and drug-related adverse events (as measured by CTCAE v4.0 criteria)

    Time frame: 5 months

07

Study locations

1 site
  • University of Florida
    Gainesville, Florida 32608, United States
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for May 2019; primary completion for Aug 2021, 27 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 20, 2018
First posted
Feb 27, 2018
StartEst.
May 2019
Primary completionEst.
Aug 2021
CompletionEst.
Sep 2022
Last update
Jun 11, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 11, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03446638
Collaborators
Gateway for Cancer Research, Cellworks Group Inc.
Responsible party
Sponsor
First posted
Feb 27, 2018
Start date
May 2019 (estimated)
Primary completion
Aug 2021 (estimated)
Completion
Sep 2022 (estimated)
Last update
Jun 11, 2019

Study contacts

Christopher Cogle, MD
principal investigator · University of Florida

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Jun 2019. You cannot join it, but the record below documents what was studied.

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