Table 2 List of trials assessing the use of immunotherapy in high-risk myelodysplastic syndrome
Drug | Mechanism of action and target | Combination | NCT | Patient population | Trial design | Outcomes | Status | Reference |
|---|---|---|---|---|---|---|---|---|
Ipilimumab | Anti-CTLA4 monoclonal antibody | Monotherapy | NCT01822509 | N = 28 with hematologic malignancies N = 2 with MDS | Phase I | 1 patient with MDS transformed to AML | Completed | [80] |
Monotherapy | NCT01757639 | N = 29 HR-MDS Failed HMA therapy | Phase I | mOS: 9.8 m | Completed | [79] | ||
Ipilimumab or Nivolumab | Anti-CTLA4 or PD-1 monoclonal antibody | With or without azacitidine | NCT02530463 | MDS Treatment naïve: N = 41 HMA failure: N = 35 | Phase II | ORR/CR: Nivo + AZA: 75%/50%; Ipi + Aza: 71%/38%; Nivo: 13%/0%; Ipi: 35%/15% | Ongoing | [81] |
Pembrolizumab | Anti-PD-1 monoclonal antibody | Entinostat | NCT02936752 | MDS, after HMA failure | Phase Ib | No results yet | Ongoing | [108] |
Durvalumab | Anti-PD-L1 monoclonal antibody | Arm A: azacitidine Arm B azacitidine with durvalumab | NCT02775903 | Untreated HR-MDS population N = 84 | FUSION-AML-001 | ORR: 67% arm A vs. 47.6% arm B; p = 0.18 mOS: 11.6 m (A) vs. 16.7 m (B); p = 0.74 | Completed | [83] |
Lenalidomide | Immunomodulatory drug | 15Â mg or 50Â mg | NCT00867308 | R/R HR-MDS and AML with MRC | Phase II | ORR: 11% mOS: 114Â days | Terminated | [86] |
Sabatolimab (MBG453) | Anti-TIM-3 monoclonal antibody | Azacitidine or decitabine | NCT03066648 | Newly diagnosed HR and very HR-MDS N = 53 | Phase Ib | ORR: 56.9% CR: 19.6% 12-m PFS: 51.9% mDoR: 16.1 m | Ongoing | [97] |
Placebo or HMA | NCT03946670 | Patients with MDS, intermediate, HR, very HR Not eligible to transplant or intensive chemotherapy | Phase II STIMULUS-MDS1 | No results yet | Ongoing | [98] | ||
NCT04266301 | Patients with MDS, intermediate, HR, very HR or CMML-2 Not eligible to transplant or intensive chemotherapy | Phase III STIMULUS-MDS2 | No results yet | Ongoing | [98] | |||
Azacitidine and venetoclax | NCT04812548 | HR or very HR-MDS Not eligible for intensive chemotherapy or transplant | Phase II STIMULUS-MDS3 | No results yet | Ongoing | [109] | ||
CC-90002 | Anti-CD47 | monotherapy | NCT02641002 | R/R AML (N = 24) and HR-MDS (N = 4) | Phase I CC-90002-AML-001 | Patients with MDS, N = 4: SD in 2 patients 82% of the patients TD | Terminated | [100] |
Magrolimab | Anti-CD47 | Placebo or azacitidine | NCT04313881 | Previously untreated HR-MDS | Phase III ENHANCE | No results yet | Ongoing | [105] |