Actively Recruiting

Phase 1
Phase 2
Age: 18Years - 75Years
All Genders
NCT04742634

Pre-emptive Therapy With DEC-C to Improve Outcomes in MDS Patients With Measurable Residual Disease Post Allogeneic Hematopoietic Cell Transplant

Led by Washington University School of Medicine · Updated on 2026-03-23

209

Participants Needed

1

Research Sites

602 weeks

Total Duration

On this page

Sponsors

W

Washington University School of Medicine

Lead Sponsor

T

Taiho Oncology, Inc.

Collaborating Sponsor

AI-Summary

What this Trial Is About

The investigators hypothesize that early measurable residual disease (MRD)-guided pre-emptive therapy with decitabine + cedazaridine (DEC-C) will decrease the risk of progression in post-transplant myelodysplastic syndromes (MDS) patients with persistent mutations (molecular MRD). To detect molecular MRD, the investigators will perform ultra-deep, error-corrected panel-based sequencing (MyeloSeq-HD) at Day 30 in post-transplant MDS patients. The investigators will treat patients with detectable molecular MRD with DEC-C to determine if pre-emptive, MRD-guided therapy with DEC-C decreases relapse rates and improves progression-free survival.

CONDITIONS

Official Title

Pre-emptive Therapy With DEC-C to Improve Outcomes in MDS Patients With Measurable Residual Disease Post Allogeneic Hematopoietic Cell Transplant

Who Can Participate

Age: 18Years - 75Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Diagnosis of myelodysplastic syndromes (MDS) based on WHO 2016 classification
  • Received an allogeneic hematopoietic cell transplant
  • Age between 18 and 75 years
  • Completed gene panel testing prior to transplant with at least one somatic mutation detected
  • Willing to comply with treatment assignment based on MRD test results
  • Not currently receiving investigational agents
  • Ability to understand and sign informed consent
  • For DEC-C intervention arm: detectable somatic variants at Day 30 post-transplant with variant allele frequency  0.2%, Days 42-100 post-transplant, bone marrow myeloblasts = 5%, ANC  1.0 x 10^9/L, platelets  50 x 10^9/L
  • Controlled GVHD = Grade 2
  • ECOG performance status = 2
  • Adequate liver and kidney function (bilirubin  1.5 x IULN, AST/ALT  3.0 x IULN, creatinine clearance  30 mL/min)
  • Women and men must agree to use contraception during and for 6 months after study participation
  • For observation arm: bone marrow myeloblasts = 5% or not eligible for intervention arm
Not Eligible

You will not qualify if you...

  • Currently receiving other investigational agents
  • History of allergic reactions to compounds similar to DEC-C or study agents
  • Taking drugs metabolized by cytidine deaminase concurrently
  • Uncontrolled illness including active infection, symptomatic heart failure, unstable angina, or arrhythmia
  • Pregnant or breastfeeding
  • Women of childbearing potential must have negative pregnancy test within 10 days before starting DEC-C
  • Active GVHD grade 3 or higher

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 1 location

1

Washington University School of Medicine

St Louis, Missouri, United States, 63110

Actively Recruiting

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Research Team

M

Meagan Jacoby, M.D., Ph.D.

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NON_RANDOMIZED

Model

SEQUENTIAL

Primary Purpose

TREATMENT

Number of Arms

4

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