Table 1.

RCTs with HMA combination therapy as initial therapy for MDS

TrialDesignDiseaseInvestigational agentStudy armsPatientsPrimary endpointAnticipated study completion date
STIMULUS MDS1 Phase 2 double-blind Intermediate- to very high-risk MDS MBG 433: anti-TIM-3 antibody ICPI MBG 453 + HMA 60 CR and PFS 14-Aug-23 
PBO + HMA 60 
PANTHER Phase 3 open label Intermediate- to very high-risk MDS Pevonedistat: selective NEDD8 inhibitor induces DNA repair Pevonedistat + aza 227 EFS 31-Mar-23 
Aza 227 
A18-15331 Phase 3 open label Intermediate- to very high-risk MDS APR-246: stabilizes mutated p53 APR-246 + aza 77 CR 1-Nov-20 
Aza 77 
HOVON 156 AML Phase 3 open label AML + MDS-EB2 FLT-3+ Mido and Gilt: FLT-3 inhibitor IC + midostaurin 384 EFS 1-May-23 
IC + gilteritinib 384 
VERONA Phase 3 double-blind Intermediate- to very high-risk MDS Venetoclax: BCL-2 inhibitor Venetoclax + aza 250 CR and OS 26-Jan-25 
PBO + aza 250 
ENHANCE Phase 3 double-blind Intermediate- to very high-risk MDS Magrolimab: anti-CD47 antibody; ICPI Magrolimab + aza 90 CR 1-Jul-25 
PBO + aza 90 
 Multiphase trial 1-3 MDS, AML, CMML, MDS-MPN ASTX030: ced/aza deaminase inhibitor Sequencing trial subcutaneous aza vs ced/aza 245 PK 1-Apr-23 
LEAP Phase 2/3 open label MDS-EB2, AML Midostaurin: FLT3 inhibitor nivolumab: ICPI Midostaurin + aza 16,70 OS 1-Aug-23 
Nivolumab + aza 
Dec + LDAC 
Aza 
HO-155 Phase 2 open label MDS-EB, AML Mido: FLT3 inhibitor Midostaurin + dec 70 CR 1-Mar-26 
Dec 70 
Cusatuzumab combination Phase 2 open label Intermediate- to very high-risk MDS, CMML Cusatuzumab: anti-CD 70 antibody Cusatuzumab + aza 75 ORR 18-Jul-22 
Aza 75 
 Phase 3 Intermediate- to very high-risk MDS Rigosertib: Ras kinase inhibitor Rigosertib + aza Unknown ORR Unknown 
Aza Unknown 
TrialDesignDiseaseInvestigational agentStudy armsPatientsPrimary endpointAnticipated study completion date
STIMULUS MDS1 Phase 2 double-blind Intermediate- to very high-risk MDS MBG 433: anti-TIM-3 antibody ICPI MBG 453 + HMA 60 CR and PFS 14-Aug-23 
PBO + HMA 60 
PANTHER Phase 3 open label Intermediate- to very high-risk MDS Pevonedistat: selective NEDD8 inhibitor induces DNA repair Pevonedistat + aza 227 EFS 31-Mar-23 
Aza 227 
A18-15331 Phase 3 open label Intermediate- to very high-risk MDS APR-246: stabilizes mutated p53 APR-246 + aza 77 CR 1-Nov-20 
Aza 77 
HOVON 156 AML Phase 3 open label AML + MDS-EB2 FLT-3+ Mido and Gilt: FLT-3 inhibitor IC + midostaurin 384 EFS 1-May-23 
IC + gilteritinib 384 
VERONA Phase 3 double-blind Intermediate- to very high-risk MDS Venetoclax: BCL-2 inhibitor Venetoclax + aza 250 CR and OS 26-Jan-25 
PBO + aza 250 
ENHANCE Phase 3 double-blind Intermediate- to very high-risk MDS Magrolimab: anti-CD47 antibody; ICPI Magrolimab + aza 90 CR 1-Jul-25 
PBO + aza 90 
 Multiphase trial 1-3 MDS, AML, CMML, MDS-MPN ASTX030: ced/aza deaminase inhibitor Sequencing trial subcutaneous aza vs ced/aza 245 PK 1-Apr-23 
LEAP Phase 2/3 open label MDS-EB2, AML Midostaurin: FLT3 inhibitor nivolumab: ICPI Midostaurin + aza 16,70 OS 1-Aug-23 
Nivolumab + aza 
Dec + LDAC 
Aza 
HO-155 Phase 2 open label MDS-EB, AML Mido: FLT3 inhibitor Midostaurin + dec 70 CR 1-Mar-26 
Dec 70 
Cusatuzumab combination Phase 2 open label Intermediate- to very high-risk MDS, CMML Cusatuzumab: anti-CD 70 antibody Cusatuzumab + aza 75 ORR 18-Jul-22 
Aza 75 
 Phase 3 Intermediate- to very high-risk MDS Rigosertib: Ras kinase inhibitor Rigosertib + aza Unknown ORR Unknown 
Aza Unknown 

CR, complete remission; EFS, event-free survival; Gilt, gilteritinib; IC, induction chemotherapy; ICPI, immune checkpoint inhibitor; LDAC, low-dose ara-c; Mido, midostaurin; MPN, myeloproliferative neoplasm; ORR, overall response rate; PBO, placebo; PFS, progression-free survival; PK, pharmacokinetics.

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