Skip to content

Study of CC-5013 to Evaluate Safety, Pharmacokinetics and Effectiveness for Japanese Patients With Symptomatic Anemia Associated With Myelodysplastic Syndrome With a Del(5)(q31-33) Abnormality.

A Multicenter, Single-arm Study to Assess the Safety, Pharmacokinetics and Efficacy of Lenalidomide in Japanese Subjects With Low- or Intern=Mediate-1-risk Myelodysplastic Syndromes (MDS) Associated With a Deletion 5 (q31-33) Abnormality and Symptomatic Anemia

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00812968
Enrollment
11
Registered
2008-12-22
Start date
2007-09-01
Completion date
2010-09-01
Last updated
2019-11-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Myelodysplastic Syndromes

Keywords

Myelodysplastic Syndromes, Lenalidomide

Brief summary

The purpose of this clinical experience study is to determine whether CC-5013 is safe and effective (to include studying the process by which a drug is absorbed, distributed, metabolized, and eliminated by the body \[pharmacokinetics\]) in Japanese subjects with low- or intermediate-1-risk MDS (IPSS risk categories) associated with a deletion 5(q31-33) abnormality and symptomatic anemia.

Interventions

DRUGLenalidomide

Oral 10mg daily on Days 1-21 days every 28 days until disease progression/relapse or CC-5013 is permanently discontinued for any reason for up to 156 weeks (3 years).

Sponsors

Celgene
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Must understand and voluntarily sign an informed consent form. * Age ≥ 20 years at the time of signing the informed consent form. * Must be able to adhere to the study visit schedule and other protocol requirements. * Diagnosis of Myelodysplastic Syndrome (MDS) that meets International Prognostic Scoring System (IPSS) criteria for low- or intermediate-1-risk disease associated with a deletion 5(q31-33) abnormality * Symptomatic anemia secondary to MDS defined as:Untransfused Hb level \< 10.0 g/dL and a Functional Assessment of Cancer Therapy (FACT)-anemia subscale score of ≤ 74 or Transfusion dependent anemia

Exclusion criteria

* Pregnant or lactating females. * Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study. * Prior therapy with lenalidomide. * Patients with any of the following laboratory abnormalities within 14 days of starting study drug: Absolute Neutrophil Count (ANC) \< 750 cells/μL (0.75 x 10\^9/L) Platelet count \< 50,000/μL (50x10\^9/L) Serum creatinine \> 2.5 mg/dL Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) \> 3.0 x Upper Limit of Normal (ULN)

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Adverse Events (AE)After the first study dose until 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).An AE that resulted in any of the following outcomes was defined as a serious adverse event (SAE): * Death; * Life-threatening event; * Any inpatient hospitalization or prolongation of existing hospitalization; * Persistent or significant disability or incapacity; * Congenital anomaly or birth defect; * Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 3.0) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death.

Secondary

MeasureTime frameDescription
Time to Maximum Plasma Concentration (Tmax) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Time to maximum observed plasma concentration of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).
Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUCt) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Area under the plasma concentration-time curve from time zero to the last measurable concentration (AUCt) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).
Area Under the Plasma Concentration-time Curve Over the Dosing Interval (AUCτ) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.Area under the plasma concentration-time curve over the dosing interval (AUCτ) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).
Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC∞) of LenalidomideDay 1 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.Area under the plasma concentration-time curve from time zero to infinity (AUC∞) of lenalidomide after a single dose on Day 1.
Terminal Half-life (T1/2) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.The apparent terminal half-life is the time required for plasma concentration to decrease by 50% after pseudo-equilibrium of distribution has been reached, and calculated as the natural logarithm of 2 (0.693) / Apparent terminal rate constant (λz).
Apparent Volume of Distribution (VzF) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Apparent volume of distribution of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).
Apparent Total Plasma Clearance (CL/F) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Apparent total plasma clearance (CL/F) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).
Apparent Terminal Elimination Rate Constant of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Apparent terminal elimination rate constant of lenalidomide determined after a single dose on Day 1 and multiple doses (Day 4).
Number of Participants With a Erythroid ResponseResponse was assessed every 28 days through Week 156.Erythroid response was determined using the International Working Group (IWG) 2000 criteria, categorized as a major response or minor response. A major response in patients with transfusion-dependent anemia (receiving ≥ 4.5 units of red blood cell (RBC) transfusion during 56 consecutive days at Baseline) is defined as RBC transfusion independence accompanied by a ≥1.0 g/dL increase from Baseline in hemoglobin sustained for 56 days consecutively during the treatment period. In patients with transfusion-independent anemia with hemoglobin \< 10 g/dL at Baseline a major response is defined as a \> 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days. Minor response in patients with transfusion-dependent anemia defined as ≥ 50% decrease from Baseline in transfusion requirements sustained for consecutive 56 days, and in transfusion-independent patients as 1.0 to 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days.
Maximum Observed Plasma Concentration (Cmax) of LenalidomideDays 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.Maximum observed plasma concentration of lenalidomide after a single dose on Day and after multiple doses (Day 4).
Duration of Erythroid ResponseFrom the first dose of study drug through Week 156Duration of erythroid response was calculated as the time from the start of the first major or minor erythroid response to the end of the response. Similarly, duration of major erythroid response was calculated as the time from the start of the first major erythroid response to the end of the response. Response duration was censored at the last adequate assessment for patients who maintained response.
Change From Baseline in Hemoglobin ConcentrationBaseline and from Day1 until the maximum observed value (up to 155 weeks)Change in hemoglobin concentration from Baseline to the maximum observed value during the major erythroid response period for major erythroid responders.
Number of Participants With a Neutrophil ResponseResponse was assessed every 28 days through Week 156Neutrophil response was determined using the IWG (2000) criteria. A major response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase or a ≥ 500/mm\^3 increase, whichever is greater, sustained for consecutive 56 days during the treatment period. A minor response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase, but an absolute increase \< 500/mm\^3, sustained for consecutive 56 days during the treatment period.
Number of Participants With a Platelet ResponseResponse was assessed every 28 days through Week 156Platelet response was determined using the IWG (2000) criteria. Major response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 30,000/mm\^3 increase sustained for consecutive 56 days during the treatment period. In platelet-transfusion-dependent patients at Baseline a major response is defined as stabilization of platelet counts and platelet transfusion independence sustained for consecutive 56 days during the treatment period. Minor response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 50% increase in platelet count with an absolute increase \> 10,000/mm\^3 and \< 30,000/mm\^3 sustained for consecutive 56 days during the treatment period.
Number of Participants With a Cytogenetic ResponseResponse was assessed every 12 weeks through Week 156Cytogenetic (chromosome structure) abnormalities were assessed by a central cytogenetic reviewer based on prints and cytogenetic reports of the bone marrow sample from the central laboratory. Cytogenetic response was determined using the IWG (2000) criteria and categorized as either a major response or minor response. Twenty metaphases were analyzed for the determination of cytogenetic response. A major response was defined as no detectable cytogenetic abnormality, if an abnormality was present at Baseline, sustained for consecutive 56 days during the treatment period. A minor response was defined as ≥ 50% reduction from Baseline in abnormal metaphases sustained for consecutive 56 days during the treatment period.
Change From Baseline in Percentage of Bone Marrow ErythroblastsBaseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.
Percentage of Bone Marrow MyeloblastsBaseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.
Percentage of Bone Marrow PromyelocytesBaseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.
Time to Erythroid ResponseFrom the first dose of study drug through Week 156Time to erythroid response was calculated as the time from the first dose of study drug to the start of the first major or minor erythroid response. Similarly, time to major erythroid response was calculated as the time from the first dose of study drug to the start of the first major erythroid response.

Countries

Japan

Participant flow

Participants by arm

ArmCount
Lenalidomide
10 mg of lenalidomide was administered orally once daily on Days 1 to 21 of every 28-day cycle, for up to 156 weeks (3 years).
11
Total11

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDisease progression1
Overall StudyNo further treatment required1
Overall StudyRelapse after erythroid response6
Overall StudyStudy closed due to marketing approval3

Baseline characteristics

CharacteristicLenalidomide
Age, Continuous71.8 years
STANDARD_DEVIATION 5.95
Bone Marrow Cellularity
Aplastic (0%)
0 participants
Bone Marrow Cellularity
Hypercellular (> 60% to ≤ 90%)
2 participants
Bone Marrow Cellularity
Hypocellular (> 0% to ≤ 30%)
3 participants
Bone Marrow Cellularity
Missing
1 participants
Bone Marrow Cellularity
Normocellular (> 30% to ≤ 60%)
5 participants
Bone Marrow Cellularity
Packed (> 90% to ≤ 100%)
0 participants
Duration of MDS2.0 years
STANDARD_DEVIATION 1.44
French-American-British (FAB) classification of MDS
Chronic myelomonocytic leukemia (CMML)
0 participants
French-American-British (FAB) classification of MDS
RAEB in transformation (RAEB-t)
0 participants
French-American-British (FAB) classification of MDS
Refractory anemia (RA)
9 participants
French-American-British (FAB) classification of MDS
Refractory anemia with excess blasts (RAEB)
2 participants
French-American-British (FAB) classification of MDS
Refractory anemia with ringed sideroblasts (RARS)
0 participants
International Prognostic Scoring System (IPSS) Score
High risk
0 participants
International Prognostic Scoring System (IPSS) Score
Intermediate-1 risk
9 participants
International Prognostic Scoring System (IPSS) Score
Intermediate-2 risk
0 participants
International Prognostic Scoring System (IPSS) Score
Low risk
2 participants
Region of Enrollment
Japan
11 participants
Sex: Female, Male
Female
7 Participants
Sex: Female, Male
Male
4 Participants
Transfusion Dependency
No
6 participants
Transfusion Dependency
Yes
5 participants
World Health Organization Classification of MDS
MDS associated with isolated del(5q)
8 participants
World Health Organization Classification of MDS
MDS, unclassified (MDS-U)
0 participants
World Health Organization Classification of MDS
RA with ringed sideroblasts (RARS)
0 participants
World Health Organization Classification of MDS
RCMD and ringed sideroblasts (RCMD-RS)
0 participants
World Health Organization Classification of MDS
Refractory anemia (RA)
0 participants
World Health Organization Classification of MDS
Refractory anemia with excess blasts-1 (RAEB-1)
2 participants
World Health Organization Classification of MDS
Refractory anemia with excess blasts-2 (RAEB-2)
0 participants
World Health Organization Classification of MDS
Refractory cytopenia multilineage dysplasia (RCMD)
1 participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
11 / 11
serious
Total, serious adverse events
3 / 11

Outcome results

Primary

Number of Participants With Adverse Events (AE)

An AE that resulted in any of the following outcomes was defined as a serious adverse event (SAE): * Death; * Life-threatening event; * Any inpatient hospitalization or prolongation of existing hospitalization; * Persistent or significant disability or incapacity; * Congenital anomaly or birth defect; * Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 3.0) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death.

Time frame: After the first study dose until 28 days after completion of/discontinuation from the study (maximum time on study was 155 weeks).

Population: Safety population: all patients who received at least 1 dose of study drug.

ArmMeasureGroupValue (NUMBER)
LenalidomideNumber of Participants With Adverse Events (AE)Any adverse event (AE)11 participants
LenalidomideNumber of Participants With Adverse Events (AE)AE related to study drug11 participants
LenalidomideNumber of Participants With Adverse Events (AE)Grade 3 or 4 AE11 participants
LenalidomideNumber of Participants With Adverse Events (AE)Grade 3 or 4 AE related to study drug11 participants
LenalidomideNumber of Participants With Adverse Events (AE)Serious AE (SAE)3 participants
LenalidomideNumber of Participants With Adverse Events (AE)SAE related to study drug1 participants
LenalidomideNumber of Participants With Adverse Events (AE)AE leading to discontinuation of study drug0 participants
LenalidomideNumber of Participants With Adverse Events (AE)Related AE leading to discontinuation0 participants
LenalidomideNumber of Participants With Adverse Events (AE)AE leading to a dose reduction or interruption10 participants
LenalidomideNumber of Participants With Adverse Events (AE)Related AE leading to dose reduction/interruption9 participants
LenalidomideNumber of Participants With Adverse Events (AE)Deaths0 participants
Secondary

Apparent Terminal Elimination Rate Constant of Lenalidomide

Apparent terminal elimination rate constant of lenalidomide determined after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideApparent Terminal Elimination Rate Constant of Lenalidomide0.213 1/hGeometric Coefficient of Variation 23
Lenalidomide: Day 4Apparent Terminal Elimination Rate Constant of Lenalidomide0.194 1/hGeometric Coefficient of Variation 39
Secondary

Apparent Total Plasma Clearance (CL/F) of Lenalidomide

Apparent total plasma clearance (CL/F) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideApparent Total Plasma Clearance (CL/F) of Lenalidomide189.8 mL/minuteGeometric Coefficient of Variation 45.1
Lenalidomide: Day 4Apparent Total Plasma Clearance (CL/F) of Lenalidomide189.9 mL/minuteGeometric Coefficient of Variation 43
Secondary

Apparent Volume of Distribution (VzF) of Lenalidomide

Apparent volume of distribution of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideApparent Volume of Distribution (VzF) of Lenalidomide53.6 litersGeometric Coefficient of Variation 30.9
Lenalidomide: Day 4Apparent Volume of Distribution (VzF) of Lenalidomide58.6 litersGeometric Coefficient of Variation 25.8
Secondary

Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC∞) of Lenalidomide

Area under the plasma concentration-time curve from time zero to infinity (AUC∞) of lenalidomide after a single dose on Day 1.

Time frame: Day 1 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideArea Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC∞) of Lenalidomide878.0 ng*h/mLGeometric Coefficient of Variation 45.1
Secondary

Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUCt) of Lenalidomide

Area under the plasma concentration-time curve from time zero to the last measurable concentration (AUCt) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideArea Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUCt) of Lenalidomide718.4 ng*h/mLGeometric Coefficient of Variation 41.2
Lenalidomide: Day 4Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUCt) of Lenalidomide803.5 ng*h/mLGeometric Coefficient of Variation 46.9
Secondary

Area Under the Plasma Concentration-time Curve Over the Dosing Interval (AUCτ) of Lenalidomide

Area under the plasma concentration-time curve over the dosing interval (AUCτ) of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, 12 and 24 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideArea Under the Plasma Concentration-time Curve Over the Dosing Interval (AUCτ) of Lenalidomide866.5 ng*h/mLGeometric Coefficient of Variation 44.1
Lenalidomide: Day 4Area Under the Plasma Concentration-time Curve Over the Dosing Interval (AUCτ) of Lenalidomide877.9 ng*h/mLGeometric Coefficient of Variation 43
Secondary

Change From Baseline in Hemoglobin Concentration

Change in hemoglobin concentration from Baseline to the maximum observed value during the major erythroid response period for major erythroid responders.

Time frame: Baseline and from Day1 until the maximum observed value (up to 155 weeks)

Population: Efficacy population with a erythroid response

ArmMeasureGroupValue (MEDIAN)
LenalidomideChange From Baseline in Hemoglobin ConcentrationBaseline concentration7.0 g/dL
LenalidomideChange From Baseline in Hemoglobin ConcentrationMaximum concentration during study13.1 g/dL
LenalidomideChange From Baseline in Hemoglobin ConcentrationChange from Baseline to maximum value6.0 g/dL
Secondary

Change From Baseline in Percentage of Bone Marrow Erythroblasts

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Time frame: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens.

ArmMeasureGroupValue (MEDIAN)
LenalidomideChange From Baseline in Percentage of Bone Marrow ErythroblastsChange from Baseline at the end of Cycle 336.5 Percentage of Bone Marrow Erythroblasts
LenalidomideChange From Baseline in Percentage of Bone Marrow ErythroblastsChange from Baseline at the end of Cycle 621.5 Percentage of Bone Marrow Erythroblasts
Secondary

Duration of Erythroid Response

Duration of erythroid response was calculated as the time from the start of the first major or minor erythroid response to the end of the response. Similarly, duration of major erythroid response was calculated as the time from the start of the first major erythroid response to the end of the response. Response duration was censored at the last adequate assessment for patients who maintained response.

Time frame: From the first dose of study drug through Week 156

Population: Efficacy population with a erythroid response

ArmMeasureGroupValue (MEDIAN)
LenalidomideDuration of Erythroid ResponseDuration of erythroid response (major or minor)76.6 weeks
LenalidomideDuration of Erythroid ResponseDuration of major erythroid response72.1 weeks
Secondary

Maximum Observed Plasma Concentration (Cmax) of Lenalidomide

Maximum observed plasma concentration of lenalidomide after a single dose on Day and after multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: Pharmacokinetic (PK) population: all patients who adhered to the study treatment during the course of PK assessment (Days 1 to 5 of Cycle 1) and from whom blood and urine samples were collected.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideMaximum Observed Plasma Concentration (Cmax) of Lenalidomide136 ng/mLGeometric Coefficient of Variation 43.1
Lenalidomide: Day 4Maximum Observed Plasma Concentration (Cmax) of Lenalidomide149 ng/mLGeometric Coefficient of Variation 31.2
Secondary

Number of Participants With a Cytogenetic Response

Cytogenetic (chromosome structure) abnormalities were assessed by a central cytogenetic reviewer based on prints and cytogenetic reports of the bone marrow sample from the central laboratory. Cytogenetic response was determined using the IWG (2000) criteria and categorized as either a major response or minor response. Twenty metaphases were analyzed for the determination of cytogenetic response. A major response was defined as no detectable cytogenetic abnormality, if an abnormality was present at Baseline, sustained for consecutive 56 days during the treatment period. A minor response was defined as ≥ 50% reduction from Baseline in abnormal metaphases sustained for consecutive 56 days during the treatment period.

Time frame: Response was assessed every 12 weeks through Week 156

Population: Efficacy population

ArmMeasureGroupValue (NUMBER)
LenalidomideNumber of Participants With a Cytogenetic ResponseMajor response1 participants
LenalidomideNumber of Participants With a Cytogenetic ResponseMinor response5 participants
Secondary

Number of Participants With a Erythroid Response

Erythroid response was determined using the International Working Group (IWG) 2000 criteria, categorized as a major response or minor response. A major response in patients with transfusion-dependent anemia (receiving ≥ 4.5 units of red blood cell (RBC) transfusion during 56 consecutive days at Baseline) is defined as RBC transfusion independence accompanied by a ≥1.0 g/dL increase from Baseline in hemoglobin sustained for 56 days consecutively during the treatment period. In patients with transfusion-independent anemia with hemoglobin \< 10 g/dL at Baseline a major response is defined as a \> 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days. Minor response in patients with transfusion-dependent anemia defined as ≥ 50% decrease from Baseline in transfusion requirements sustained for consecutive 56 days, and in transfusion-independent patients as 1.0 to 2.0 g/dL increase from Baseline in hemoglobin sustained for consecutive 56 days.

Time frame: Response was assessed every 28 days through Week 156.

Population: Efficacy population: all patients who had a diagnosis of low- or intermediate-1-risk MDS associated with anemia based on confirmation by the central reviewers and received at least 1 dose of study drug.

ArmMeasureGroupValue (NUMBER)
LenalidomideNumber of Participants With a Erythroid ResponseErythroid responders (major or minor)11 participants
LenalidomideNumber of Participants With a Erythroid ResponseMajor erythroid responders11 participants
Secondary

Number of Participants With a Neutrophil Response

Neutrophil response was determined using the IWG (2000) criteria. A major response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase or a ≥ 500/mm\^3 increase, whichever is greater, sustained for consecutive 56 days during the treatment period. A minor response for participants with a Baseline neutrophil count \< 1,500/mm\^3 is defined as a ≥ 100% increase, but an absolute increase \< 500/mm\^3, sustained for consecutive 56 days during the treatment period.

Time frame: Response was assessed every 28 days through Week 156

Population: Efficacy population with Baseline neutrophil count \< 1,500/mm\^3.

ArmMeasureGroupValue (NUMBER)
LenalidomideNumber of Participants With a Neutrophil ResponseMinor response0 participants
LenalidomideNumber of Participants With a Neutrophil ResponseMajor response1 participants
Secondary

Number of Participants With a Platelet Response

Platelet response was determined using the IWG (2000) criteria. Major response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 30,000/mm\^3 increase sustained for consecutive 56 days during the treatment period. In platelet-transfusion-dependent patients at Baseline a major response is defined as stabilization of platelet counts and platelet transfusion independence sustained for consecutive 56 days during the treatment period. Minor response in patients with Baseline platelet count \< 100,000/mm\^3 is defined as a ≥ 50% increase in platelet count with an absolute increase \> 10,000/mm\^3 and \< 30,000/mm\^3 sustained for consecutive 56 days during the treatment period.

Time frame: Response was assessed every 28 days through Week 156

Population: Efficacy population with a Baseline platelet count of \< 100,000/mm\^3 or who were platelet-transfusion dependent at Baseline. There were no patients with platelet count of \< 100,000/mm3 or who were platelet-transfusion dependent at Baseline, and thus platelet response was not evaluated.

Secondary

Percentage of Bone Marrow Myeloblasts

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Time frame: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens at each time point (indicated by N).

ArmMeasureGroupValue (MEDIAN)
LenalidomidePercentage of Bone Marrow MyeloblastsBaseline (N=11)3.77 Percentage of myeloblasts
LenalidomidePercentage of Bone Marrow MyeloblastsEnd of Cycle 3 (N=10)1.47 Percentage of myeloblasts
LenalidomidePercentage of Bone Marrow MyeloblastsEnd of Cycle 6 (N=10)1.79 Percentage of myeloblasts
Secondary

Percentage of Bone Marrow Promyelocytes

Bone marrow morphology was assessed by the central hematologic reviewers based on the locally-prepared bone marrow smear slide and clot section.

Time frame: Baseline, at the end of Cycle 3 (Day 85) and Cycle 6 (Day 169).

Population: Efficacy population with available bone marrow specimens at each time point (indicated by N).

ArmMeasureGroupValue (MEDIAN)
LenalidomidePercentage of Bone Marrow PromyelocytesEnd of Cycle 3 (N=10)5 Percentage of promyelocytes
LenalidomidePercentage of Bone Marrow PromyelocytesBaseline (N=11)5 Percentage of promyelocytes
LenalidomidePercentage of Bone Marrow PromyelocytesEnd of Cycle 6 (N=10)5 Percentage of promyelocytes
Secondary

Terminal Half-life (T1/2) of Lenalidomide

The apparent terminal half-life is the time required for plasma concentration to decrease by 50% after pseudo-equilibrium of distribution has been reached, and calculated as the natural logarithm of 2 (0.693) / Apparent terminal rate constant (λz).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population with available data

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
LenalidomideTerminal Half-life (T1/2) of Lenalidomide3.26 hoursGeometric Coefficient of Variation 23
Lenalidomide: Day 4Terminal Half-life (T1/2) of Lenalidomide3.57 hoursGeometric Coefficient of Variation 29.6
Secondary

Time to Erythroid Response

Time to erythroid response was calculated as the time from the first dose of study drug to the start of the first major or minor erythroid response. Similarly, time to major erythroid response was calculated as the time from the first dose of study drug to the start of the first major erythroid response.

Time frame: From the first dose of study drug through Week 156

Population: Efficacy population

ArmMeasureGroupValue (MEDIAN)
LenalidomideTime to Erythroid ResponseTime to erythroid response (major or minor)2.1 weeks
LenalidomideTime to Erythroid ResponseTime to major erythroid response6.3 weeks
Secondary

Time to Maximum Plasma Concentration (Tmax) of Lenalidomide

Time to maximum observed plasma concentration of lenalidomide after a single dose on Day 1 and multiple doses (Day 4).

Time frame: Days 1 and 4 at predose and 0.5, 1, 1.5, 2, 3, 4, 6, 9, and 12 hours post-dose.

Population: PK population

ArmMeasureValue (MEDIAN)
LenalidomideTime to Maximum Plasma Concentration (Tmax) of Lenalidomide2.52 hours
Lenalidomide: Day 4Time to Maximum Plasma Concentration (Tmax) of Lenalidomide2.93 hours

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026