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CompletedNCT03588078Updated Sep 21, 2026

Study of the Safety and Efficacy of APR-246 in Combination With Azacitidine

A Phase 1/2 interventional study of APR-246 and Azacitidine in Myelodysplastic Syndrome With Gene Mutation, Acute Myeloid Leukemia With Gene Mutations and Myeloproliferative Neoplasm, sponsored by Groupe Francophone des Myelodysplasies. Completed at 7 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by Groupe Francophone des Myelodysplasies · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was May 2020, 6 years 6 months ago, and no results have been posted to the registry.
Phase
Phase 1/2
Study type
Interventional
Enrollment
53
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The main purpose of this study is to determine the safe and efficacy of APR-246 in combination with azacitidine as well as to see complete remission of this patients

Read the detailed description

Patients will be treated for a total of 6 cycles.For patients responding or who have stable disease following cycle 6, treatment may continue until one of the following criteria applies:

  • Inter-current illness that prevent further administration of treatment
  • Unacceptable adverse event(s)
  • Participant decides to withdraw from the study,
  • general or specific changes in the participant's condition render the participant unacceptable for further treatment in the judgment of the investigator.
  • Evidence of disease progression by international working Group (IWG) 2006 criteria.
  • participants who wish not to continue treatment at time of disease assessment at end of cycle 6 will complete their end of treatment visit upon completion of cycle 6
02

Conditions studied

  • Myelodysplastic Syndrome With Gene Mutation
  • Acute Myeloid Leukemia With Gene Mutations
  • Myeloproliferative Neoplasm
  • Chronic Myelomonocytic Leukemia

Keywords

  • Azacitidine
03

In context

Myeloproliferative Disorders

667 studies on the registry are indexed under Myeloproliferative Disorders; 110 are open to participants now.

This study's enrollment of 53 is above the median of 47 across 462 interventional studies indexed under Myeloproliferative Disorders.

Browse Myeloproliferative Disorders studies →

Lead sponsor

Groupe Francophone des Myelodysplasies is the lead sponsor of 44 studies on the registry; 5 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
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

  1. Patient has signed the (ICF) and is able to comply with protocol requirements.
  2. Patient has adequate organ function as defined by the following laboratory values:

    1. Serum creatinine ≤ 2 x (ULN)
    2. Total serum \< 1.5 x ULN or total bilirubin ≤ 3.0 x ULN with direct bilirubin within normal range in patients with well documented Gilbert's Syndrome or hemolysis or who required regular blood transfusions
    3. (ALT) and aspartate aminotransferase (AST) \< 2.5 x ULN
  3. Age ≥18 years at the time of signing the informed consent form
  4. Documented diagnosis of myelodysplastic syndrome (MDS), MDS/ myeloproliferative neoplasm (MPN), chronic myelomonocytic leukemia (CMML) by World Health organization (WHO) criteria or non-proliferative AML (ie with WBC \< 20 G/l)
  5. Documentation of a TP53 gene mutation by next-generation sequencing (NGS) based on central or local evaluation.
  6. Revised International Prognostic Scoring System (IPSS-R) criteria for Intermediate, High-risk or Very High-risk.
  7. An (ECOG) performance status score of 0, 1, or 2 is required.
  8. If of , negative pre-treatment urine or serum pregnancy test.
  9. If of childbearing potential (males and females), willing to use an effective form of such as latex condom, hormonal birth control, intrauterine device or double barrier method during chemotherapy treatment and for at least six months thereafter.

Exclusion criteria

Exclusion Criteria:

  1. Patient has a known history of or active or active infection (testing not mandatory).
  2. Patient has any of the following cardiac abnormalities (as determined by treating MD):

    1. symptomatic congestive heart failure
    2. myocardial infarction ≤ 6 months prior to enrollment
    3. unstable angina pectoris
    4. serious uncontrolled cardiac arrhythmia
    5. ≥ 470 msec (≥ 500 msec in the presence of RBBB) calculated from a mean of 3 readings using Fridericia's correction (QTcF = QT/RR0.33)
    6. bradycardia (\<40 bpm)
    7. known (LVEF) \< the institution lower limit of normal as assessed by ECHO
    8. pericardial disease
    9. electrocardiographic evidence of acute ischemia
    10. familial history of long QT syndrome
  3. Concomitant or previous malignancies with less than a 1-year disease free interval at the time of signing consent. Patients with adequately resected basal or squamous cell carcinoma of the skin, or adequately resected carcinoma in situ (e.g. cervix) may enroll irrespective of the time of diagnosis.
  4. Prior exposure to azacitidine, decitabine or hypomethylating agent
  5. Use of cytotoxic chemotherapeutic agents, or experimental agents (agents that are not commercially available) for the treatment of MDS, MDS/MPN, CMML or AML within 14 days of the first day of study drug treatment.
  6. No concurrent use of erythroid stimulating agents, Granulocyte-colony stimulating Factor (G-CSF), Granulocyte Macrophage-colony stimulating factor (GM-CSF) is allowed during study except in cases of febrile neutropenia where G-CSF can be used for short term. Growth factors must be stopped 14 days prior to study.
  7. Patients with history of stem cell transplantation.
  8. Pregnant women are excluded from this study because APR-246 has not been studied in pregnant subjects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with APR-246, breastfeeding should be discontinued if the mother is treated with APR-246.
Terms in these criteria, in plain language(17)

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.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

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.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
53 participants (actual)

Study arms

  • Experimental
    combination of APR246 and azacitidine

    Following completion of the Dose Finding Phase, we will conduct a dose expansion, whereby patients will be treated with APR-246 administered at the maximum tolerated dose (MTD) with azacitidine on a 28 day cycle utilizing the same dosing as in Phase 1b

    Drug: APR-246 · Drug: Azacitidine

Interventions

  • Azacitidine at maximum tolerated dose. APR246 at the Dose limited Toxicity (DLT) dose

    Also known as: PRIMA-1MET, Methylated analogue to PRIMA-1

  • azacitidine is administered subcutaneously (SC) or via IV at 75 mg/m2

    Also known as: Mylosar, Vidaza

06

What researchers measure

Primary outcomes

  1. Overall Survival

    overall survival at complete remission

    Time frame: 8 months

Secondary outcomes

  1. Duration of response

    Time frame: minimum 24 months it is defined as the time between achieving response and progression of disease

07

Study locations

7 sites
  • Bruno Quesnel
    Lille, 59037, France
  • Dr Pierre Peterlin and Pr Patrice Chevalier
    Nantes, 44093, France
  • Hôpital Archet 1
    Nice, 06200, France
  • Hôpital Saint Louis - Hématologie Séniors
    Paris, 75010, France
  • Hôpital Cochin/Service d'Hématologie
    Paris, 75679, France
  • Aspasia Stamatoullas
    Rouen, 76038, France
  • Odile Beyne Rosy
    Toulouse, 31059, France
08

References and documents

Publications

  • Cluzeau T, Sebert M, Rahme R, Cuzzubbo S, Lehmann-Che J, Madelaine I, Peterlin P, Beve B, Attalah H, Chermat F, Miekoutima E, Rauzy OB, Recher C, Stamatoullas A, Willems L, Raffoux E, Berthon C, Quesnel B, Loschi M, Carpentier AF, Sallman DA, Komrokji R, Walter-Petrich A, Chevret S, Ades L, Fenaux P. Eprenetapopt Plus Azacitidine in TP53-Mutated Myelodysplastic Syndromes and Acute Myeloid Leukemia: A Phase II Study by the Groupe Francophone des Myelodysplasies (GFM). J Clin Oncol. 2021 May 10;39(14):1575-1583. doi: 10.1200/JCO.20.02342. Epub 2021 Feb 18. PubMed 33600210 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03588078
Lead sponsor
Groupe Francophone des Myelodysplasies
Collaborators
Aprea Therapeutics
Responsible party
Sponsor
First posted
Jul 17, 2018
Start date
Sep 15, 2018
Primary completion
May 1, 2020
Completion
May 15, 2021
Last update
Sep 21, 2026

Study contacts

Pierre Fenaux
principal investigator · service Hématologie Séniors Hôpital Saint Louis

Oversight

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

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This study is completed, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Eprenetapopt

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