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Brief Title: Pevonedistat Plus Azacitidine Versus Single-Agent Azacitidine as First-Line Treatment for Participants With Higher-Risk Myelodysplastic Syndromes (HR MDS), Chronic Myelomonocytic Leukemia (CMML), or Low-Blast Acute Myelogenous Leukemia (AML)
Official Title: A Phase 3, Randomized, Controlled, Open-label, Clinical Study of Pevonedistat Plus Azacitidine Versus Single-Agent Azacitidine as First-Line Treatment for Patients With Higher-Risk Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia, or Low-Blast Acute Myelogenous Leukemia
Study ID: NCT03268954
Brief Summary: The purpose of this study is to determine whether the combination of pevonedistat and azacitidine improves event-free survival (EFS) when compared with single-agent azacitidine. (An event is defined as death or transformation to AML in participants with MDS or CMML, whichever occurs first, and is defined as death in participants with low-blast AML).
Detailed Description: The drug being tested in this study is called pevonedistat. Pevonedistat is being tested to treat people with higher-risk myelodysplastic syndromes (HR MDS), chronic myelomonocytic leukemia (CMML) and low-blast acute myelogenous leukemia (AML) as a combination treatment with azacitidine. This study will look at the overall survival, event-free survival and response to treatment in people who take pevonedistat and azacitidine when compared to people who take single-agent azacitidine. The study will enroll approximately 450 participants. Once enrolled, participants will be randomly assigned in 1:1 ratio (by chance, like flipping a coin) to one of the two treatment groups in 28-day treatment cycles: * Pevonedistat 20 mg/m\^2 and azacitidine 75 mg/m\^2 combination * Single-agent azacitidine 75 mg/m\^2 All participants will receive azacitidine via intravenous or subcutaneous route. Participants randomized to the combination arm will also receive pevonedistat intravenous infusion. This multi-center trial will be conducted Spain, Belgium, Brazil, Canada, Czech Republic, France, Germany, Israel, Italy, the United States, Australia, Greece, Japan, Mexico, Poland, Russia, Korea, Turkey, China and United Kingdom. The overall time to participate in this study is approximately 63 months. Participants will attend the end-of-treatment visit 30 days after the last dose of study drug or before the start of subsequent anti-neoplastic therapy if that occurs sooner. Participants with HR MDS or CMML will have EFS follow-up study visits every month if their disease has not transformed to AML and they have not started subsequent therapy. Participants with low-blast AML will have response follow-up study visits every month until they relapse from CR or meet the criteria for PD. All participants will enter OS follow-up (contacted every 3 months) when they have confirmed transformation to AML (for participants with HR MDS or CMML at enrollment) or experienced PD (for participants with low-blast AML at study enrollment).
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Southern Cancer Center - USOR, Daphne, Alabama, United States
Southern Cancer Center - USOR, Mobile, Alabama, United States
Southern Cancer Center - USOR, Mobile, Alabama, United States
Southern Cancer Center- USOR, Mobile, Alabama, United States
Southeastern Regional Medical Center - CTCA - PPDS, Goodyear, Arizona, United States
Arizona Oncology Associates (Orange HOPE) - USOR, Tucson, Arizona, United States
Arizona Oncology Associates (Rudasill HOPE) - USOR, Tucson, Arizona, United States
Arizona Oncology Associates (Wilmot HOPE) - USOR, Tucson, Arizona, United States
Compassionate Care Research Group Inc. at Compassionate Cancer Care Medical Group, Inc, Corona, California, United States
Compassionate Cancer Care Medical Group Inc, Fountain Valley, California, United States
UC San Diego Moores Cancer Center, La Jolla, California, United States
Emad Ibrahim, MD, Inc, Redlands, California, United States
Compassionate Care Research Group Inc. at Compassionate Cancer Care Medical Group, Inc, Riverside, California, United States
Rocky Mountain Cancer Centers (Aurora) - USOR, Aurora, Colorado, United States
Rocky Mountain Cancer Centers (Boulder) - USOR, Boulder, Colorado, United States
Rocky Mountain Cancer Centers (Colorado Springs) - USOR, Colorado Springs, Colorado, United States
Quest Diagnostics, INC, Denver, Colorado, United States
Colorado Blood Cancer Institute - PPDS, Denver, Colorado, United States
Presbyterian Saint Lukes Medical Center Laboratory, Denver, Colorado, United States
Presbyterian/St. Luke's Medical Center, Denver, Colorado, United States
Rocky Mountain Cancer Centers (Williams) - USOR, Denver, Colorado, United States
Rocky Mountain Cancer Centers (Denver) - USOR, Denver, Colorado, United States
Kaiser Foundation Health Plan, Denver, Colorado, United States
Laboratory Corporation of America, Englewood, Colorado, United States
Rocky Mountain Cancer Centers (Lakewood) - USOR, Lakewood, Colorado, United States
Rocky Mountain Cancer Centers (Littleton) - USOR, Littleton, Colorado, United States
Rocky Mountain Cancer Centers (Lone Tree) - USOR, Lone Tree, Colorado, United States
Rocky Mountain Cancer Centers (Longmont) - USOR, Longmont, Colorado, United States
Rocky Mountain Cancer Centers (Parker) - USOR, Parker, Colorado, United States
Rocky Mountain Cancer Centers (Pueblo) - USOR, Pueblo, Colorado, United States
Rocky Mountain Cancer Centers (Thornton) - USOR, Thornton, Colorado, United States
Medstar Research Institute, Washington, District of Columbia, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Altamonte Springs, Florida, United States
SCRI Florida Cancer Specialists South, Bonita Springs, Florida, United States
SCRI Florida Cancer Specialists South, Bradenton, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Brandon, Florida, United States
SCRI Florida Cancer Specialists South, Cape Coral, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Clearwater, Florida, United States
SCRI Florida Cancer Specialists South, Fort Myers, Florida, United States
SCRI Florida Cancer Specialists South, Fort Myers, Florida, United States
SCRI Florida Cancer Specialists South, Fort Myers, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Gainesville, Florida, United States
Mayo Clinic Jacksonville - PPDS, Jacksonville, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Largo, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Lecanto, Florida, United States
University of Miami Miller School of Medicine, Miami, Florida, United States
Baptist Health System (N Kendall) - USOR, Miami, Florida, United States
SCRI Florida Cancer Specialists South, Naples, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, New Port Richey, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Ocala, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Orange City, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Orlando, Florida, United States
SCRI Florida Cancer Specialists South, Port Charlotte, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Saint Petersburg, Florida, United States
SCRI Florida Cancer Specialists South, Sarasota, Florida, United States
SCRI Florida Cancer Specialists South, Sarasota, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Spring Hill, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Tampa, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Tavares, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, The Villages, Florida, United States
SCRI Florida Cancer Specialists South, Venice, Florida, United States
SCRI Florida Cancer Specialists South, Venice, Florida, United States
Cleveland Clinic Florida, Weston, Florida, United States
Florida Cancer Specialists - NORTH - SCRI - PPDS, Winter Park, Florida, United States
Winship Cancer Institute, Emory University, Atlanta, Georgia, United States
Saint Alphonsus Regional Medical Center, Boise, Idaho, United States
Saint Alphonsus Caldwell Cancer Care Center, Caldwell, Idaho, United States
Saint Alphonsus Medical Center, Nampa, Idaho, United States
Rush University Medical Center, Chicago, Illinois, United States
Menorah Medical Center, Overland Park, Kansas, United States
Centerpoint Medical Center, Independence, Missouri, United States
HCA Midwest Health - SCRI - PPDS, Kansas City, Missouri, United States
Research Medical Center, Kansas City, Missouri, United States
Nebraska Cancer Specialists, Omaha, Nebraska, United States
New Jersey Hematology Oncology Associates LLC, Brick, New Jersey, United States
John Theurer Cancer Center, Hackensack, New Jersey, United States
New Jersey Hematology and Oncology, Toms River, New Jersey, United States
Weill Cornell Medical Center - Monitoring Location, New York, New York, United States
Weill Cornell Medical Center, New York, New York, United States
Strong Memorial Hospital, Rochester, New York, United States
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Oncology Hematology Care, Inc., Cincinnati, Ohio, United States
Oncology Hematology Care, Inc., Cincinnati, Ohio, United States
Oncology Hematology Care Inc - USOR, Cincinnati, Ohio, United States
Oncology Hematology Care Inc - USOR, Cincinnati, Ohio, United States
Fairview Hospital, Cleveland, Ohio, United States
The Cleveland Clinic Foundation, Cleveland, Ohio, United States
Oncology Hematology Care, Inc - Fairfield, Fairfield, Ohio, United States
Hillcrest Hospital Cancer Care Center, Mayfield, Ohio, United States
St. Luke's Hospital, Bethlehem, Pennsylvania, United States
St. Luke's University Health Network, Easton, Pennsylvania, United States
Greenville Health System, Easley, South Carolina, United States
Greenville Health System, Greenville, South Carolina, United States
Greenville Health System Cancer Institute, Greenville, South Carolina, United States
Greenville Health System, Greer, South Carolina, United States
Greenville Health System, Seneca, South Carolina, United States
Greenville Health System, Spartanburg, South Carolina, United States
Tennessee Oncology - DICKSON - SCRI - PPDS, Dickson, Tennessee, United States
Tennessee Oncology - FRANKLIN - SCRI - PPDS, Franklin, Tennessee, United States
Tennessee Oncology - GALLATIN - SCRI - PPDS, Gallatin, Tennessee, United States
Tennessee Oncology - SUMMIT - SCRI - PPDS, Hermitage, Tennessee, United States
Tennessee Oncology - LEBANON - SCRI - PPDS, Lebanon, Tennessee, United States
Tennessee Oncology - MURFREESBORO - SCRI - PPDS, Murfreesboro, Tennessee, United States
Sarah Cannon Center for Blood Centers - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncolgy - BAPTIST - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncology NASH - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncology - ST THOMAS WEST - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncology SKYLINE - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncology - SOUTHERN HILLS - SCRI - PPDS, Nashville, Tennessee, United States
Tennessee Oncology - SHELBYVILLE - SCRI - PPDS, Shelbyville, Tennessee, United States
Tennessee Oncology - SMYRNA - SCRI - PPDS, Smyrna, Tennessee, United States
Texas Oncology (West 38) - USOR, Austin, Texas, United States
Texas Oncology (Balcones) - USOR, Austin, Texas, United States
Texas Oncology (James Casey) - USOR, Austin, Texas, United States
Texas Oncology (Medical City) - USOR, Dallas, Texas, United States
Baylor Sammons Cancer Center, Dallas, Texas, United States
University of Texas Southwestern Medical Center, Dallas, Texas, United States
Texas Oncology (Tyler) - USOR, Longview, Texas, United States
Texas Oncology (E Common) - USOR, New Braunfels, Texas, United States
Texas Oncology (Round Rock) - USOR, Round Rock, Texas, United States
Texas Oncology - San Antonio Medical Center - USOR, San Antonio, Texas, United States
Texas Oncology (Tyler) - USOR, Tyler, Texas, United States
Oncology and Hematology Associates of Southwest Virginia (Blacksburg) - USOR, Blacksburg, Virginia, United States
University of Virginia, Charlottesville, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia (Low Moor) - USOR, Low Moor, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia (Roanoke) - USOR, Roanoke, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia Inc, Salem, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia, Wytheville, Virginia, United States
Icon Cancer Care Wesley, Auchenflower, Queensland, Australia
Icon Cancer Care Chermside, Chermside, Queensland, Australia
Icon Cancer Care South Brisbane, South Brisbane, Queensland, Australia
Icon Cancer Care, South Brisbane, Queensland, Australia
Icon Cancer Care Southport, Southport, Queensland, Australia
Royal Hobart Hospital, Hobart, Tasmania, Australia
Liverpool Hospital, Liverpool, , Australia
Algemeen Ziekenhuis Klina, Brasschaat, Antwerpen, Belgium
CHU UCL Namur asbl - Site Godinne, Yvoir, Namur, Belgium
AZ Sint-Jan AV, Brugge, West-Vlaanderen, Belgium
Cliniques Universitaires Saint-Luc, Bruxelles, , Belgium
UZ Leuven, Leuven, , Belgium
Liga Paranaense de Combate Ao Cancer - Hospital Erasto Gaertner, Curitiba, Parana, Brazil
Liga Norte Riograndense Contra O Cancer, Natal, Rio Grande Do Norte, Brazil
Centro de Pesquisas Oncologicas, Florianopolis, Santa Catarina, Brazil
Hospital de Clinicas de Porto Alegre (HCPA) - PPDS, Porto Alegre, , Brazil
Universidade Federal do Rio de Janeiro - UFRJ, Rio De Janeiro, , Brazil
Hospital Santa Marcelina, Sao Paulo, , Brazil
Hospital Santa Marcelina, Sao Paulo, , Brazil
Tom Baker Cancer Centre, Calgary, Alberta, Canada
University of Alberta, Edmonton, Alberta, Canada
Kaye Edmonton Clinic, Edmonton, Alberta, Canada
Saint John Regional Hospital, Saint John, New Brunswick, Canada
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Princess Margaret Hospital, Toronto, Ontario, Canada
Princess Margaret Hospital, Toronto, Ontario, Canada
Xuanwu Hospital Capital Medical University, Beijing, Beijing, China
Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences, Tianjin, Tianjin, China
Fakultni nemocnice Hradec Kralove, Hradec Kralove, Kralovehradeck Kraj, Czechia
Vseobecna Fakultni Nemocnice V Praze, Prague, , Czechia
Fakultni nemocnice Kralovske Vinohrady, Praha, , Czechia
Hopital Cote de Nacre, Caen, Calvados, France
CHU Angers, Angers, Maine-et-Loire, France
Centre Hospitalier Le Mans, Le Mans, , France
Hopital Saint Louis, Paris, , France
Hopital Saint Louis, Paris, , France
Universitatsklinikum Tubingen, Tubingen, Baden-Wurttemberg, Germany
Universitatsklinikum Leipzig, Leipzig, Sachsen, Germany
Universitatsklinikum Carl Gustav Carus an der TU Dresden, Dresden, , Germany
Marien Hospital Akademisches Lehrkrankenhaus, Dusseldorf, , Germany
Laiko General Hospital of Athens, Athens, Attiki, Greece
Athens General Hospital 'G Gennimatas', Athens, Attiki, Greece
Attikon University General Hospital, Athens, Attiki, Greece
University Hospital of Alexandroupolis, Alexandroupolis, , Greece
Laiko General Hospital of Athens, Athens, , Greece
University General Hospital of Ioannina, Ioannina, , Greece
University General Hospital of Larissa, Larissa, , Greece
University General Hospital of Patras, Patras, , Greece
Georgios Papanikolaou General Hospital of Thessaloniki, Thessaloniki, , Greece
Edith Wolfson Medical Center, Holon, , Israel
Shaare Zedek Medical Center, Jerusalem, , Israel
Hadassah Medical Center PPDS -, Jerusalem, , Israel
Galilee Medical Center, Nahariya, , Israel
ZIV Medical Center, Safed, , Israel
Tel Aviv Sourasky Medical Center PPDS, Tel Aviv, , Israel
Azienda Ospedaliero Universitaria Di Bologna - Policlinico S Orsola Malpighi, Bologna, Emilia-Romagna, Italy
ASST degli Spedali Civili di Brescia - Spedali Civili di Brescia - INCIPIT - PIN, Brescia, Lombardia, Italy
Azienda Ospedaliera Universitaria Careggi, Firenze, , Italy
IRCCS Centro Di Riferimento Oncologico Della Basilicata, Rionero in Vulture, , Italy
Istituto Clinico Humanitas, Rozzano, , Italy
Azienda Ospedaliero Universitaria San Giovanni Battista Di Torino, Torino, , Italy
Japan Mutual Aid Association of Public School Teachers Chugoku Central Hospital, Fukuyama, Hirosima, Japan
Hokkaido University Hospital, Sapporo, Hokkaido, Japan
Fukushima Medical University Hospital, Fukushima-shi, Hukusima, Japan
Kobe City Medical Center General Hospital, Kobe-City, Hyogo, Japan
University Hospital, Kyoto Prefectural University of Medicine, Kyoto-shi, Kyoto, Japan
Kindai University Hospital, Osakasayama, Osaka, Japan
Saitama Medical Center, Kawagoe, Saitama, Japan
Juntendo University Hospital, Bunkyo, Tokyo, Japan
NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
Kyushu University Hospital, Fukuoka-city, , Japan
Dokkyo Medical University Hospital, Mibu, , Japan
Nagasaki University Hospital, Nagasaki, , Japan
Osaka Metropolitan University Hospital, Osaka, , Japan
Yokohama City University Hospital, Yokohama-shi, , Japan
University of Fukui Hospital, Yoshida-gun, , Japan
Pusan National University Hospital, Busan, , Korea, Republic of
Kyungpook National University Hospital, Daegu, , Korea, Republic of
Chonnam National University Hwasun Hospital, Jeongnam, , Korea, Republic of
Asan Medical Center - PPDS, Seoul, , Korea, Republic of
Samsung Medical Center - PPDS, Seoul, , Korea, Republic of
The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, , Korea, Republic of
Hematologica Alta Especialidad S.C., Huixquilucan, , Mexico
Capital Humano para Investigacion Clinica SC, Mexico, , Mexico
Instytut Hematologii i Transfuzjologii, Warszawa, Mazowieckie, Poland
Uniwersyteckie Centrum Kliniczne, Klinika Hematologii I Transplantologii, Budynek Centrum Medycyny N, Gdansk, Pomorskie, Poland
Uniwersyteckie Centrum Kliniczne, Gdansk, Pomorskie, Poland
Swietokrzyskie Centrum Onkologii, Kielce, Swietokrzyskie, Poland
Centrum Onkologii Ziemi Lubelskiej, Lublin, , Poland
Zaklad Diagnostyki Obrazowej SOR, Opole, , Poland
Szpital Wojewodzki w Opolu, Opole, , Poland
City Clinical Hospital # 40, Moscow, , Russian Federation
North-West Federal Medical Research Center n.a. V.A. Almazov, Saint Petersburg, , Russian Federation
Russian Research Institute of Hematology and Blood Transfusion, St. Petersburg, , Russian Federation
ICO lHospitalet Hospital Duran i Reynals, LHospitalet de Llobregat, Barcelona, Spain
Complejo Asistencial Universitario de Leon, Leon, Castilla Y Leon, Spain
Hospital Universitario Vall d'Hebron - PPDS, Barcelona, , Spain
Hospital Universitario de La Princesa, Madrid, , Spain
Hospital General Universitario Gregorio Maranon, Madrid, , Spain
Hospital Universitario Ramon y Cajal, Madrid, , Spain
Hospital Universitario La Paz - PPDS, Madrid, , Spain
Complejo Asistencial Universitario de Salamanca - H. Clinico, Salamanca, , Spain
Hospital Clinico Universitario de Valencia, Valencia, , Spain
Hospital Universitari i Politecnic La Fe de Valencia, Valencia, , Spain
Gazi University Medical Faculty Gazi Hospital, Ankara, , Turkey
Ege University Medical Faculty, Izmir, , Turkey
Mersin University Medical Faculty, Mersin, , Turkey
Ondokuz Mayis Universitesi Tip Fakultesi Hastanesi, Samsun, , Turkey
Namik Kemal University, Tekirdag, , Turkey
Karadeniz Technical University Faculty of Medicine, Trabzon, , Turkey
Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom
Maidstone Hospital, Maidstone, Kent, United Kingdom
St Bartholomew's Hospital, London, , United Kingdom
Singleton Hospital - PPDS, Swansea, , United Kingdom
Name: Medical Director
Affiliation: Takeda
Role: STUDY_DIRECTOR