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Study of Efficacy and Safety of MBG453 in Combination With Azacitidine in Subjects With Intermediate, High or Very High Risk Myelodysplastic Syndrome (MDS) as Per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2)

A Randomized, Double-blind, Placebo-controlled Phase III Multi-center Study of Azacitidine With or Without MBG453 for the Treatment of Patients With Intermediate, High or Very High Risk Myelodysplastic Syndrome (MDS) as Per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2)

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04266301
Acronym
STIMULUS-MDS2
Enrollment
530
Registered
2020-02-12
Start date
2020-06-08
Completion date
2024-10-02
Last updated
2026-01-13

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

Conditions

Myelodysplastic Syndromes, Leukemia, Myelomonocytic, Chronic

Keywords

MBG453, Phase III, TIM-3, azacitidine, myelodysplastic syndrome, MDS, chronic myelomonocytic leukemia, CMML-2, Sabatolimab, high or, very high risk myelodysplastic syndrome, Chronic Myelomonocytic Leukemia-2

Brief summary

This was a Phase III multi-center, randomized, two-arm parallel-group, double-blind, placebo-controlled study of MBG453 or placebo added to azacitidine in adult participants with intermediate, high or very high-risk myelodysplastic syndrome (MDS) as per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2) who are not eligible for intensive chemotherapy or hematopoietic stem cell transplantation (HSCT) according to medical judgment by the investigator. The purpose of the current study was to assess clinical effects of MBG453 in combination with azacytidine in adult participants with IPSS-R intermediate, high, very high risk MDS and CMML-2.

Detailed description

This was a Phase III multi-center, randomized, two-arm parallel-group, double-blind, placebo-controlled study of MBG453 or placebo added to azacitidine in adult participants with intermediate, high or very high-risk myelodysplastic syndrome (MDS) as per IPSS-R, or Chronic Myelomonocytic Leukemia-2 (CMML-2). The primary objective of this study was to compare overall survival (OS) in the MBG453 plus azacitidine arm versus placebo plus azacitidine arm where OS was the time from randomization until death due to any cause. Participants were randomized in a 1:1 ratio to treatment arms as follow: MBG453 800 mg IV Q4W plus azacitidine, Placebo IV Q4W plus azacitidine. The randomization was stratified into 4 groups: intermediate risk MDS, high risk MDS, very high risk MDS and CMML-2. All participants who discontinued both study treatments were to have entered a long-term post-treatment follow-up including response and PRO assessments, and/or survival follow-up for up to 5 years after the last participant was randomized. Participants were receiving treatment until they experienced progression of disease (including transformation to acute leukemia per WHO 2016 classification), experienced unacceptable toxicity or discontinued the study treatment for other reasons. Continuation of study treatment beyond progression (excluding transformation to acute leukemia: continuation in this case was not possible) could have been possible in selected participants.

Interventions

A dose of MBG453 800 mg was administered intravenously (IV) every 4 weeks (Q4W).

DRUGAzacitidine

A dose of Azacitidine 75 mg/m2 was administered IV or subcutaneously (SC) on Day 1-7, or Day 1-5, 8 and 9.

DRUGPlacebo

A dose of placebo 800 mg was administered intravenously every 4 weeks (Q4W).

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Intervention model description

Randomized, double-blind

Eligibility

Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No

Inclusion criteria

* Signed informed consent must be obtained prior to participation in the study * Age ≥ 18 years at the date of signing the informed consent form * Morphologically confirmed diagnosis of myelodysplastic syndrome (MDS) based on WHO 2016 classification (Arber et al 2016) by local investigator assessment with one of the following Prognostic Risk Categories, based on the revised International Prognostic Scoring System (IPSS-R): * Very high (\> 6 points) * High (\> 4.5 - ≤ 6 points) * Intermediate (\> 3 - ≤ 4.5 points) Or Morphologically confirmed diagnosis of Chronic Myelomonocytic Leukemia -2 based on WHO 2016 classification (Arber et al 2016, including persistent monocytosis) by local investigator assessment with WBC \< 13 x 109/L at time of initial diagnosis * Indication for azacitidine treatment according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions * Not eligible at time of screening for intensive chemotherapy according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions, including assessment of individual clinical factors such as age, comorbidities and performance status * Not eligible at time of screening for hematopoietic stem cell transplantation (HSCT) according to the investigator, based on local standard medical practice and institutional guidelines for treatment decisions, including assessment of individual clinical factors such as age, comorbidities, performance status, and donor availability * Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2

Exclusion criteria

* Prior exposure to TIM-3 directed therapy at any time. Prior therapy with immune checkpoint inhibitors (e.g, anti-CTLA4, anti-PD-1, anti-PD-L1, or anti-PD-L2), cancer vaccines is allowed except if the drug was administered within 4 months prior to randomization * Previous first-line treatment for intermediate, high, very high risk myelodysplastic syndromes (based on IPSS-R) or CMML with any antineoplastic agents including for example chemotherapy, lenalidomide and hypomethylating agents (HMAs) such as decitibine and azacitidine. However, previous treatment with hydroxyurea or leukopheresis to reduce WBC count is allowed prior to randomization. * Investigational treatment received within 4 weeks or 5 half-lives of this investigational treatment, whatever is longer, prior to randomization. In case of a checkpoint inhibitor: a minimal interval of 4 months prior to randomization is necessary to allow randomization. * Subjects with Myelodysplastic syndrome (MDS) based on 2016 WHO classification (Arber et al 2016) with revised International Prognostic Scoring System (IPSS-R) ≤ 3 * Diagnosis of acute myeloid leukemia (AML) including acute promyelocytic leukemia and extra-medullary acute myeloid leukemia, primary or secondary myelofibrosis based on WHO 2016 classification (Arber et al 2016) * Diagnosis of therapy related myeloid neoplasms based on WHO 2016 classification (Arber et al 2016) * History of organ or allogeneic hematopoietic stem cell transplant

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS) (Primary Efficacy Results)up to approx. 39 monthsOS is the time from randomization until death due to any cause.
Overall Survival (OS) (Final Efficacy Results)up to approx. 52 monthsOS is the time from randomization until death due to any cause.

Secondary

MeasureTime frameDescription
Key Secondary Endpoint 2: Red Blood Cell (RBC) Annualized Transfusion Free Rate for Transfusionup to approx. 52 monthsAnnualized transfusion free rate is defined as the average number of days in RBC transfusion-free intervals in a year (i.e., the total number of days in RBC transfusion-free intervals divided by the total days in the study multiplied by 365.25), where RBC transfusion-free intervals correspond to cumulative times of intervals with no evidence of RBC transfusion for at least 8 weeks at any point after randomization until death due to any cause.
Key Secondary Endpoint 3: Percentage of Participants With at Least 3 Point Confirmed Improvement From Baseline in FACIT-fatigue Scoresup to approx. 52 monthsFACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer participants. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. The responder is defined as having 3 points improvement from baseline confirmed by a second improvement of 3 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.
Key Secondary Endpoint 4: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Physical Functioning Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30)up to approx. 52 monthsEORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participants' responses to 5 questions about their physical functioning (Items 1-5) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. The responder is defined as having 10 points improvement from baseline confirmed by a second improvement of 10 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.
Key Secondary Endpoint 5: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Emotional Functioning Using EORTC-QLQ-C30up to approx. 52 monthsEORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participants' responses to 4 questions about their emotional functioning (Items 21-24) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. The responder is defined as having 10 points improvement from baseline confirmed by a second improvement of 10 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.
Percentage of Participants With Either CR, or mCR, or PR, or HI in Each Treatment Arm According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessmentup to approx. 52 monthsResponse rate of participants with complete remission (CR), or marrow remission (mCR), or partial remission (PR), or hematologic improvement (HI). CR: where the Bone marrow: ≤ 5% blasts with normal maturation of all cell lineages and Peripheral blood: where Hgb ≥ 10 g/dL AND Platelets ≥ 100\*109/L AND Neutrophils ≥ 1.0\*109/L AND Peripheral blasts 0%. mCR: Bone marrow: ≤ 5% blasts and blast count decrease by ≥ 50% compared to baseline; Peripheralblood/transfusion: Marrow CR may be achieved with or without improved blood counts or with or without transfusions PR: All CR criteria except bone marrow: ≥50% decrease from baseline in blasts in bone marrow AND blast count in bone marrow \>5%. HI: restoration or enhancement of the function of the body's blood cell-producing system that must last as least 8 weeks.
Percentage of Participants With Stable Disease (SD) According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessmentup to approx. 52 monthsResponse rate of participants with stable disease. SD is the failure to achieve at least partial response (PR), but no evidence of progression for \>8 weeks.
Progression Free Survival (PFS)up to approx. 52 monthsPFS is defined as the time from randomization to disease progression (including transformation to acute leukemia per WHO 2016), relapse from CR (IWG-MDS), or death. Disease progression: bone marrow blasts increase ≥ 50% over baseline, to \> 5% if initially \< 5%, \> 10% if 5%-\<10%, or \> 20% if 10%-\<20%. Includes a peripheral blood count decrease ≥ 50% from maximum remission/response levels: neutrophils \< 1.0x109/L, platelets \< 100x109/L, or hemoglobin drop ≥ 2 g/dL to \< 10 g/dL, becoming transfusion-dependent. Relapse from CR: baseline bone marrow blast % return, neutrophils decrease ≥ 50% to \< 1.0x109/L, platelets decrease ≥ 50% to \< 100x109/L, or hemoglobin drop ≥ 1.5 g/dL to \< 10 g/dL, becoming transfusion-dependent. Leukemia transformation: \> 20% blasts per WHO 2016 (Arber et al 2016).
Pharmacokinetics of MBG453 (Parameter AUC)0 hr (pre-dose) & 2 hrs (post-dose) of Cycle (C) 1 Day (D) 8 and 0 hr (pre-dose) & 2 hrs (post-dose) of C3D8AUCinf is the AUC from time zero to infinity (mass x time x volume-1).
Number of Participants Who Become Red Blood Cells (RBC) Transfusion Independent After Randomizationup to approx. 52 monthsImprovement in RBC transfusion independence as per International Working Group for MDS (IWG-MDS) criteria. RBC transfusion independence was defined as having received 0 units of RBC transfusions during at least 8 consecutive weeks after randomization. The number of participants was shown in only those with transfusion dependence at baseline (BL).
Number of Participants Who Become Platelets Transfusion Independent After Randomizationup to approx. 52 monthsImprovement in Platelets transfusion independence as per International Working Group for MDS (IWG-MDS) criteria. Platelets transfusion independence was defined as having received 0 units of Platelets transfusions during at least 8 consecutive weeks after randomization. The number of participants was shown in only those with transfusion dependence at baseline (BL).
Pharmacokinetics of MBG453 (Parameter Cmax)0 hr (pre-dose) & 2 hrs (post-dose) of Cycle (C) 1 Day (D) 8 and 0 hr (pre-dose) & 2 hrs (post-dose) of C3D8Cmax is the maximum (peak) observed drug concentration after single dose administration (mass x volume-1).
ADA Prevalence at Baseline and ADA-positive Participants On-treatmentBaseline, up to approx. 39 monthsAnti-drug Antibody (ADA) prevalence is the number of participants with at least one sample meeting the criteria at baseline. ADA-positive participants were calculated as the number of participants with at least one on-treatment ADA-positive sample divided by the number of participants with a determinant baseline IG sample and at least one determinant post-baseline IG sample.
Change From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeBaseline, every 3 cycles up to C48D1 (1 cycle = 28 days)The EQ-5D-5L comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression. For each of the 5 dimensions, subject's responses are scored on a 5-point scale (1=no problem to 5=extreme problems). Change from baseline is being presented for EQ Index score. Index score is defined as a weighted combination of the levels of the 5-dimention scales, ranging from 0 to 1 (perfect health), with higher scores indicating better health-related quality of life. The United States value set from Pickard et al 2019 was used.
Change From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeBaseline, every 3 cycles up to C48D1 (1 cycle = 28 days)The EQ-5D-5L VAS records the participant's self-rated health on a visual analogue scale numbered from 0 to 100, with 0 being the worst health you can imagine and 100 being the best health you can imagine. Change from baseline was presented.
Change From Baseline of Global Health Status/Quality of Life Scores Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC-QLQ-C30).Up to Cycle 12 Day 1 (C12D1) (1 cycle = 28 days)EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participant's responses to 2 questions (Items 29+30: How would you rate your overall health during the past week? and How would you rate your overall quality of life during the past week?) are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall outcome. Change from baseline to Cycle 12 Day 1 as presented.
Leukemia-free Survival (LFS)up to approx. 52 monthsLFS is defined as the time from randomization to ≥ 20% blasts in bone marrow/peripheral blood (per WHO 2016 classification) or diagnosis of extramedullary acute leukemia, or death due to any cause
Key Secondary Endpoint 1: Time to Definitive Deterioration of Fatigue Using Functional Assessment of Cancer Therapy (FACIT)-Fatigue Scoreup to approx. 52 monthsFACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer participants. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. Time to definitive deterioration of fatigue is defined as time from randomization to at least 3 points worsening from baseline in FACIT-fatigue scores with no subsequently observed improvement above this threshold, or death due to any cause, whichever occurred first.

Countries

Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Colombia, Czechia, Finland, France, Germany, Greece, India, Israel, Italy, Japan, Lebanon, Lithuania, Malaysia, Mexico, Netherlands, Oman, Portugal, Russia, Saudi Arabia, Singapore, South Korea, Spain, Switzerland, Taiwan, Thailand, Turkey (Türkiye), United Kingdom, United States

Participant flow

Recruitment details

This study randomized participants in 149 centers in 36 participating countries.

Participants by arm

ArmCount
Sabatolimab (MBG453) + Azacitidine
Participants were randomized to sabatolimab plus Azacitidine
265
Placebo + Azacitidine
Participants were randomized to placebo plus Azacitidine
265
Total530

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event4143
Overall StudyDeath2635
Overall StudyGuardian Decision10
Overall StudyHematopoietic Stem-Cell Transplantation (HSCT) Planned2222
Overall StudyLost to Follow-up10
Overall StudyNew Therapy for Study Indication24
Overall StudyParticipant Decision2228
Overall StudyParticipants Not Treated11
Overall StudyPhysician Decision149
Overall StudyProgressive Disease11192
Overall StudyProtocol Deviation24
Overall StudyStudy Terminated by Sponsor2227

Baseline characteristics

CharacteristicSabatolimab (MBG453) + AzacitidinePlacebo + AzacitidineTotal
Age, Continuous70.2 Years
STANDARD_DEVIATION 11.46
69.1 Years
STANDARD_DEVIATION 11.23
69.6 Years
STANDARD_DEVIATION 11.35
ECOG performance status
ECOG performance status: 0
92 Participants101 Participants193 Participants
ECOG performance status
ECOG performance status: 1
161 Participants141 Participants302 Participants
ECOG performance status
ECOG performance status: 2
12 Participants23 Participants35 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
1 Participants2 Participants3 Participants
Race/Ethnicity, Customized
Asian
111 Participants124 Participants235 Participants
Race/Ethnicity, Customized
Black or African American
3 Participants4 Participants7 Participants
Race/Ethnicity, Customized
Unknown
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
White
150 Participants134 Participants284 Participants
Sex: Female, Male
Female
104 Participants79 Participants183 Participants
Sex: Female, Male
Male
161 Participants186 Participants347 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
161 / 265160 / 265
other
Total, other adverse events
256 / 263255 / 265
serious
Total, serious adverse events
174 / 263164 / 265

Outcome results

Primary

Overall Survival (OS) (Final Efficacy Results)

OS is the time from randomization until death due to any cause.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineOverall Survival (OS) (Final Efficacy Results)22.18 Months
Placebo + AzacitidineOverall Survival (OS) (Final Efficacy Results)18.83 Months
95% CI: [0.693, 1.076]
Primary

Overall Survival (OS) (Primary Efficacy Results)

OS is the time from randomization until death due to any cause.

Time frame: up to approx. 39 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineOverall Survival (OS) (Primary Efficacy Results)22.31 Months
Placebo + AzacitidineOverall Survival (OS) (Primary Efficacy Results)18.83 Months
p-value: 0.082595% CI: [0.671, 1.07]Log Rank
Secondary

ADA Prevalence at Baseline and ADA-positive Participants On-treatment

Anti-drug Antibody (ADA) prevalence is the number of participants with at least one sample meeting the criteria at baseline. ADA-positive participants were calculated as the number of participants with at least one on-treatment ADA-positive sample divided by the number of participants with a determinant baseline IG sample and at least one determinant post-baseline IG sample.

Time frame: Baseline, up to approx. 39 months

Population: Immunogenicity Incidence Set includes all participants in the Immunogenicity prevalence set with a non-missing baseline ADA sample and at least one non-missing post-baseline ADA sample.~The Immunogenicity prevalence set includes all participants in the Safety Set with a non-missing baseline ADA sample or at least one non-missing post-baseline ADA sample.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Sabatolimab (MBG453) + AzacitidineADA Prevalence at Baseline and ADA-positive Participants On-treatmentADA prevalence (i.e., ADA positive) at baseline24 Participants
Sabatolimab (MBG453) + AzacitidineADA Prevalence at Baseline and ADA-positive Participants On-treatmentADA-positive participants on-treatment34 Participants
Secondary

Change From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over Time

The EQ-5D-5L comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression. For each of the 5 dimensions, subject's responses are scored on a 5-point scale (1=no problem to 5=extreme problems). Change from baseline is being presented for EQ Index score. Index score is defined as a weighted combination of the levels of the 5-dimention scales, ranging from 0 to 1 (perfect health), with higher scores indicating better health-related quality of life. The United States value set from Pickard et al 2019 was used.

Time frame: Baseline, every 3 cycles up to C48D1 (1 cycle = 28 days)

Population: FAS population with non-missing baseline EQ-5D-5L assessments. For each post-baseline timepoint, FAS population with non-missing baseline and post-baseline EQ-5D-5L assessment. FAS comprised of all patients to whom study treatment had been assigned by randomization.

ArmMeasureGroupValue (MEAN)Dispersion
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C30D1-0.03 Scores on a scaleStandard Deviation 0.315
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C39D1-0.16 Scores on a scaleStandard Deviation 0.36
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C33D1-0.01 Scores on a scaleStandard Deviation 0.211
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C9D10.03 Scores on a scaleStandard Deviation 0.232
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C36D1-0.07 Scores on a scaleStandard Deviation 0.333
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C18D1-0.02 Scores on a scaleStandard Deviation 0.208
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C6D1-0.02 Scores on a scaleStandard Deviation 0.26
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C42D1-0.09 Scores on a scaleStandard Deviation 0.262
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C21D10.00 Scores on a scaleStandard Deviation 0.208
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C45D1-0.12 Scores on a scaleStandard Deviation 0.262
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at Cycle (C) 3 Day (D) 10.00 Scores on a scaleStandard Deviation 0.215
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C48D1-0.07 Scores on a scaleStandard Deviation 0
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C24D10.00 Scores on a scaleStandard Deviation 0.157
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeBaseline (BL)0.78 Scores on a scaleStandard Deviation 0.204
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C12D10.02 Scores on a scaleStandard Deviation 0.163
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C27D1-0.09 Scores on a scaleStandard Deviation 0.283
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C15D1-0.02 Scores on a scaleStandard Deviation 0.238
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C27D10.00 Scores on a scaleStandard Deviation 0.213
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at Cycle (C) 3 Day (D) 1-0.03 Scores on a scaleStandard Deviation 0.222
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C6D1-0.02 Scores on a scaleStandard Deviation 0.305
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C9D1-0.01 Scores on a scaleStandard Deviation 0.226
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C24D10.02 Scores on a scaleStandard Deviation 0.225
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C15D10.01 Scores on a scaleStandard Deviation 0.221
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C18D10.00 Scores on a scaleStandard Deviation 0.226
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C21D10.00 Scores on a scaleStandard Deviation 0.256
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeBaseline (BL)0.78 Scores on a scaleStandard Deviation 0.239
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C30D10.02 Scores on a scaleStandard Deviation 0.256
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C33D1-0.02 Scores on a scaleStandard Deviation 0.218
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C36D1-0.07 Scores on a scaleStandard Deviation 0.395
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C39D10.02 Scores on a scaleStandard Deviation 0.143
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C42D1-0.13 Scores on a scaleStandard Deviation 0.309
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C45D10.17 Scores on a scaleStandard Deviation 0.069
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C48D10.06 Scores on a scaleStandard Deviation 0.087
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQol) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Score Over TimeChange from BL at C12D1-0.05 Scores on a scaleStandard Deviation 0.261
Secondary

Change From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over Time

The EQ-5D-5L VAS records the participant's self-rated health on a visual analogue scale numbered from 0 to 100, with 0 being the worst health you can imagine and 100 being the best health you can imagine. Change from baseline was presented.

Time frame: Baseline, every 3 cycles up to C48D1 (1 cycle = 28 days)

Population: FAS population with non-missing baseline EQ-5D-5L assessments. For each post-baseline timepoint, FAS population with non-missing baseline and post-baseline EQ-5D-5L assessment. FAS comprised of all patients to whom study treatment had been assigned by randomization.

ArmMeasureGroupValue (MEAN)Dispersion
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C9D15.28 Scores on a scaleStandard Deviation 20.528
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C27D1-0.44 Scores on a scaleStandard Deviation 21.139
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at Cycle 3 Day 1 (C3D1)1.39 Scores on a scaleStandard Deviation 21.029
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C30D13.13 Scores on a scaleStandard Deviation 26.829
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C12D15.55 Scores on a scaleStandard Deviation 21.38
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C33D15.41 Scores on a scaleStandard Deviation 26.923
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeBaseline (BL)68.91 Scores on a scaleStandard Deviation 18.371
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C36D1-1.50 Scores on a scaleStandard Deviation 25.714
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C15D12.87 Scores on a scaleStandard Deviation 21.94
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C39D13.57 Scores on a scaleStandard Deviation 28.281
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C6D12.60 Scores on a scaleStandard Deviation 25.218
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C42D1-11.89 Scores on a scaleStandard Deviation 22.469
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C18D13.80 Scores on a scaleStandard Deviation 20.474
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C45D12.00 Scores on a scaleStandard Deviation 15.113
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C24D11.73 Scores on a scaleStandard Deviation 21.288
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C48D17.00 Scores on a scaleStandard Deviation 0
Sabatolimab (MBG453) + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C21D13.70 Scores on a scaleStandard Deviation 23.541
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C48D15.50 Scores on a scaleStandard Deviation 34.648
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C21D15.71 Scores on a scaleStandard Deviation 18.577
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeBaseline (BL)68.04 Scores on a scaleStandard Deviation 18.762
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at Cycle 3 Day 1 (C3D1)0.40 Scores on a scaleStandard Deviation 18.767
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C6D12.08 Scores on a scaleStandard Deviation 23.294
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C9D12.55 Scores on a scaleStandard Deviation 20.805
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C12D11.18 Scores on a scaleStandard Deviation 22.728
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C15D13.72 Scores on a scaleStandard Deviation 21.564
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C18D16.87 Scores on a scaleStandard Deviation 19.369
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C24D17.68 Scores on a scaleStandard Deviation 18.781
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C27D14.63 Scores on a scaleStandard Deviation 19.792
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C30D14.76 Scores on a scaleStandard Deviation 14.998
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C33D11.64 Scores on a scaleStandard Deviation 17.705
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C36D1-2.80 Scores on a scaleStandard Deviation 29.617
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C39D11.70 Scores on a scaleStandard Deviation 20.078
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C42D1-0.75 Scores on a scaleStandard Deviation 26.55
Placebo + AzacitidineChange From Baseline in the European Quality of Life (EuroQoL) - 5 Dimensions, 5 Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Over TimeChange from BL at C45D1-2.00 Scores on a scaleStandard Deviation 24.042
Secondary

Change From Baseline of Global Health Status/Quality of Life Scores Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC-QLQ-C30).

EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participant's responses to 2 questions (Items 29+30: How would you rate your overall health during the past week? and How would you rate your overall quality of life during the past week?) are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall outcome. Change from baseline to Cycle 12 Day 1 as presented.

Time frame: Up to Cycle 12 Day 1 (C12D1) (1 cycle = 28 days)

Population: FAS population with non-missing baseline (Cycle 1 Day 1) and Cycle 12 Day 1 EORTC-QLQ-C30 assessments. FAS comprised of all patients to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEAN)Dispersion
Sabatolimab (MBG453) + AzacitidineChange From Baseline of Global Health Status/Quality of Life Scores Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC-QLQ-C30).8.72 Scores on a scaleStandard Deviation 23.071
Placebo + AzacitidineChange From Baseline of Global Health Status/Quality of Life Scores Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC-QLQ-C30).8.20 Scores on a scaleStandard Deviation 19.932
Secondary

Key Secondary Endpoint 1: Time to Definitive Deterioration of Fatigue Using Functional Assessment of Cancer Therapy (FACIT)-Fatigue Score

FACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer participants. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. Time to definitive deterioration of fatigue is defined as time from randomization to at least 3 points worsening from baseline in FACIT-fatigue scores with no subsequently observed improvement above this threshold, or death due to any cause, whichever occurred first.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineKey Secondary Endpoint 1: Time to Definitive Deterioration of Fatigue Using Functional Assessment of Cancer Therapy (FACIT)-Fatigue Score13.37 Months
Placebo + AzacitidineKey Secondary Endpoint 1: Time to Definitive Deterioration of Fatigue Using Functional Assessment of Cancer Therapy (FACIT)-Fatigue Score11.76 Months
p-value: 0.213295% CI: [0.75, 1.13]Log Rank
Secondary

Key Secondary Endpoint 2: Red Blood Cell (RBC) Annualized Transfusion Free Rate for Transfusion

Annualized transfusion free rate is defined as the average number of days in RBC transfusion-free intervals in a year (i.e., the total number of days in RBC transfusion-free intervals divided by the total days in the study multiplied by 365.25), where RBC transfusion-free intervals correspond to cumulative times of intervals with no evidence of RBC transfusion for at least 8 weeks at any point after randomization until death due to any cause.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineKey Secondary Endpoint 2: Red Blood Cell (RBC) Annualized Transfusion Free Rate for Transfusion184.3 days per year
Placebo + AzacitidineKey Secondary Endpoint 2: Red Blood Cell (RBC) Annualized Transfusion Free Rate for Transfusion175.7 days per year
p-value: 0.4692negative binomial regression model
Secondary

Key Secondary Endpoint 3: Percentage of Participants With at Least 3 Point Confirmed Improvement From Baseline in FACIT-fatigue Scores

FACIT-Fatigue score is a 13-item questionnaire designed to assess fatigue in cancer participants. All items use a 5-point scale ranging from 0 to 4 (0=Not at All to 4=Very Much). The total score ranges from 0 to 52 with higher values representing better quality of life. The responder is defined as having 3 points improvement from baseline confirmed by a second improvement of 3 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (NUMBER)
Sabatolimab (MBG453) + AzacitidineKey Secondary Endpoint 3: Percentage of Participants With at Least 3 Point Confirmed Improvement From Baseline in FACIT-fatigue Scores39.6 Percentage of participants with response
Placebo + AzacitidineKey Secondary Endpoint 3: Percentage of Participants With at Least 3 Point Confirmed Improvement From Baseline in FACIT-fatigue Scores40.8 Percentage of participants with response
p-value: 0.486595% CI: [0.7, 1.4]Cochran-Mantel-Haenszel
Secondary

Key Secondary Endpoint 4: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Physical Functioning Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30)

EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participants' responses to 5 questions about their physical functioning (Items 1-5) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. The responder is defined as having 10 points improvement from baseline confirmed by a second improvement of 10 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (NUMBER)
Sabatolimab (MBG453) + AzacitidineKey Secondary Endpoint 4: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Physical Functioning Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30)30.2 Percentage of participants with response
Placebo + AzacitidineKey Secondary Endpoint 4: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Physical Functioning Using European Organization for Research and Treatment of Cancer's Core Quality of Life Questionnaire (EORTC QLQ-C30)22.6 Percentage of participants with response
p-value: 0.574395% CI: [1, 2.2]Cochran-Mantel-Haenszel
Secondary

Key Secondary Endpoint 5: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Emotional Functioning Using EORTC-QLQ-C30

EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer participants. Participants' responses to 4 questions about their emotional functioning (Items 21-24) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A high score indicates a high / healthy level of functioning. The responder is defined as having 10 points improvement from baseline confirmed by a second improvement of 10 points at any time, regardless of preceding worsening. A participant who could not improve was considered as a non-responder.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (NUMBER)
Sabatolimab (MBG453) + AzacitidineKey Secondary Endpoint 5: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Emotional Functioning Using EORTC-QLQ-C3031.7 Percentage of participants
Placebo + AzacitidineKey Secondary Endpoint 5: Percentage of Participants With at Least 10 Point Confirmed Improvement From Baseline in Emotional Functioning Using EORTC-QLQ-C3028.3 Percentage of participants
p-value: 0.212695% CI: [0.8, 1.7]Cochran-Mantel-Haenszel
Secondary

Leukemia-free Survival (LFS)

LFS is defined as the time from randomization to ≥ 20% blasts in bone marrow/peripheral blood (per WHO 2016 classification) or diagnosis of extramedullary acute leukemia, or death due to any cause

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineLeukemia-free Survival (LFS)19.84 Months
Placebo + AzacitidineLeukemia-free Survival (LFS)13.73 Months
95% CI: [0.64, 1.038]
Secondary

Number of Participants Who Become Platelets Transfusion Independent After Randomization

Improvement in Platelets transfusion independence as per International Working Group for MDS (IWG-MDS) criteria. Platelets transfusion independence was defined as having received 0 units of Platelets transfusions during at least 8 consecutive weeks after randomization. The number of participants was shown in only those with transfusion dependence at baseline (BL).

Time frame: up to approx. 52 months

Population: Participants of the full analysis set (FAS) who were Platelets transfusion dependent at baseline.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Sabatolimab (MBG453) + AzacitidineNumber of Participants Who Become Platelets Transfusion Independent After Randomization11 Participants
Placebo + AzacitidineNumber of Participants Who Become Platelets Transfusion Independent After Randomization10 Participants
Secondary

Number of Participants Who Become Red Blood Cells (RBC) Transfusion Independent After Randomization

Improvement in RBC transfusion independence as per International Working Group for MDS (IWG-MDS) criteria. RBC transfusion independence was defined as having received 0 units of RBC transfusions during at least 8 consecutive weeks after randomization. The number of participants was shown in only those with transfusion dependence at baseline (BL).

Time frame: up to approx. 52 months

Population: Participants of the full analysis set (FAS) who were RBC transfusion dependent at baseline.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Sabatolimab (MBG453) + AzacitidineNumber of Participants Who Become Red Blood Cells (RBC) Transfusion Independent After Randomization50 Participants
Placebo + AzacitidineNumber of Participants Who Become Red Blood Cells (RBC) Transfusion Independent After Randomization53 Participants
Secondary

Percentage of Participants With Either CR, or mCR, or PR, or HI in Each Treatment Arm According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment

Response rate of participants with complete remission (CR), or marrow remission (mCR), or partial remission (PR), or hematologic improvement (HI). CR: where the Bone marrow: ≤ 5% blasts with normal maturation of all cell lineages and Peripheral blood: where Hgb ≥ 10 g/dL AND Platelets ≥ 100\*109/L AND Neutrophils ≥ 1.0\*109/L AND Peripheral blasts 0%. mCR: Bone marrow: ≤ 5% blasts and blast count decrease by ≥ 50% compared to baseline; Peripheralblood/transfusion: Marrow CR may be achieved with or without improved blood counts or with or without transfusions PR: All CR criteria except bone marrow: ≥50% decrease from baseline in blasts in bone marrow AND blast count in bone marrow \>5%. HI: restoration or enhancement of the function of the body's blood cell-producing system that must last as least 8 weeks.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (NUMBER)
Sabatolimab (MBG453) + AzacitidinePercentage of Participants With Either CR, or mCR, or PR, or HI in Each Treatment Arm According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment58.1 Percentage of participants
Placebo + AzacitidinePercentage of Participants With Either CR, or mCR, or PR, or HI in Each Treatment Arm According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment47.5 Percentage of participants
Secondary

Percentage of Participants With Stable Disease (SD) According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment

Response rate of participants with stable disease. SD is the failure to achieve at least partial response (PR), but no evidence of progression for \>8 weeks.

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (NUMBER)
Sabatolimab (MBG453) + AzacitidinePercentage of Participants With Stable Disease (SD) According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment20.0 Percentage of participants
Placebo + AzacitidinePercentage of Participants With Stable Disease (SD) According to International Working Group for MDS (IWG-MDS) as Per Investigator Assessment19.6 Percentage of participants
Secondary

Pharmacokinetics of MBG453 (Parameter AUC)

AUCinf is the AUC from time zero to infinity (mass x time x volume-1).

Time frame: 0 hr (pre-dose) & 2 hrs (post-dose) of Cycle (C) 1 Day (D) 8 and 0 hr (pre-dose) & 2 hrs (post-dose) of C3D8

Population: Pharmacokinetic Analysis Set (PAS) included all participants in the Safety Set, who had at least one evaluable PK concentration.~Safety Set included all participants who received at least one dose of any component of the study treatment, and they were analyzed according to the study treatment they received.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Sabatolimab (MBG453) + AzacitidinePharmacokinetics of MBG453 (Parameter AUC)Cycle 12670 day*ug/mlGeometric Coefficient of Variation 45.9
Sabatolimab (MBG453) + AzacitidinePharmacokinetics of MBG453 (Parameter AUC)Cycle 34930 day*ug/mlGeometric Coefficient of Variation 1.5
Secondary

Pharmacokinetics of MBG453 (Parameter Cmax)

Cmax is the maximum (peak) observed drug concentration after single dose administration (mass x volume-1).

Time frame: 0 hr (pre-dose) & 2 hrs (post-dose) of Cycle (C) 1 Day (D) 8 and 0 hr (pre-dose) & 2 hrs (post-dose) of C3D8

Population: Pharmacokinetic Analysis Set (PAS) included all participants in the Safety Set, who had at least one evaluable PK concentration.~Safety Set included all participants who received at least one dose of any component of the study treatment, and they were analyzed according to the study treatment they received.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Sabatolimab (MBG453) + AzacitidinePharmacokinetics of MBG453 (Parameter Cmax)Cycle 1232 ug/mlGeometric Coefficient of Variation 20.9
Sabatolimab (MBG453) + AzacitidinePharmacokinetics of MBG453 (Parameter Cmax)Cycle 3239 ug/mlGeometric Coefficient of Variation 39.5
Secondary

Progression Free Survival (PFS)

PFS is defined as the time from randomization to disease progression (including transformation to acute leukemia per WHO 2016), relapse from CR (IWG-MDS), or death. Disease progression: bone marrow blasts increase ≥ 50% over baseline, to \> 5% if initially \< 5%, \> 10% if 5%-\<10%, or \> 20% if 10%-\<20%. Includes a peripheral blood count decrease ≥ 50% from maximum remission/response levels: neutrophils \< 1.0x109/L, platelets \< 100x109/L, or hemoglobin drop ≥ 2 g/dL to \< 10 g/dL, becoming transfusion-dependent. Relapse from CR: baseline bone marrow blast % return, neutrophils decrease ≥ 50% to \< 1.0x109/L, platelets decrease ≥ 50% to \< 100x109/L, or hemoglobin drop ≥ 1.5 g/dL to \< 10 g/dL, becoming transfusion-dependent. Leukemia transformation: \> 20% blasts per WHO 2016 (Arber et al 2016).

Time frame: up to approx. 52 months

Population: FAS comprised of all participants to whom study treatment had been assigned by randomization.

ArmMeasureValue (MEDIAN)
Sabatolimab (MBG453) + AzacitidineProgression Free Survival (PFS)14.26 Months
Placebo + AzacitidineProgression Free Survival (PFS)10.12 Months
95% CI: [0.576, 0.875]
Post Hoc

All Collected Deaths

Deaths were collected from randomization until the end of the trial, approx. 52 months, including post-treatment survival follow up period.

Time frame: from randomization until end of trial, up to approx. 52 months

Population: Clinical database population: All randomized participants: participants who died before treatment, during treatment and post-treatment.

ArmMeasureGroupValue (NUMBER)
Sabatolimab (MBG453) + AzacitidineAll Collected DeathsPost-treatment deaths143 Participants
Sabatolimab (MBG453) + AzacitidineAll Collected DeathsPre-treatment deaths0 Participants
Sabatolimab (MBG453) + AzacitidineAll Collected DeathsAll deaths161 Participants
Sabatolimab (MBG453) + AzacitidineAll Collected DeathsOn-treatment deaths18 Participants
Placebo + AzacitidineAll Collected DeathsAll deaths160 Participants
Placebo + AzacitidineAll Collected DeathsOn-treatment deaths37 Participants
Placebo + AzacitidineAll Collected DeathsPre-treatment deaths1 Participants
Placebo + AzacitidineAll Collected DeathsPost-treatment deaths122 Participants

Source: ClinicalTrials.gov · Data processed: Feb 17, 2026