Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. If you need assistance understanding the eligibility criteria, please contact the study team.See eligibility criteria
- Men or women more than 18 years of age.
- Patients with high-risk Myelodysplastic Syndrome
- Performance status of greater or equal to 2 by the Eastern Cooperative Oncology Group (ECOG) scale.
- Subjects with high-risk MDS who are naïve to 5-Azacitidine or have previously received 5-AZA or decitabine as first-line cytotoxic therapy. Subjects with prior 5-Azacitidine therapy were evaluated to be either refractory or relapsed as determined by the Investigator, according to IWG response criteria.Subjects with relapsed or refractory disease may have only received prior 5-Azacitidine or decitabine.
- Hydroxyurea for patients with rapidly proliferative disease can be used up to 24 hours prior to therapy but not concomitantly with 5-Azacitidine.
- Adequate liver, pancreatic and renal function.
- Women of childbearing potential must have a negative serum pregnancy test at screening within 48 hours prior to the first dose
- Women of childbearing potential must agree to use 2 methods of adequate contraception
- Subjects with life-threatening toxicity or non tolerability to prior 5-Azacitidine therapy.
- Subjects with hypoplastic Myelodysplastic syndrome.
- Subjects with >30% bone marrow blast cells.
- Subjects with malignant hepatic tumors or secondary malignancy within 2 years
- Known diagnosis of human immunodeficiency virus or chronic active Hepatitis B or C.
- Uncontrolled hypertension
- Impaired cardiac function, uncontrolled cardiac arrhythmias despite medications,
- QT interval corrected for heart rate (QTcB) more than 480 msec
- Lack of recovery of prior adverse events to Grade ≤1 severity (National Cancer Institute Common Terminology Criteria for Adverse Events version 4) (except alopecia) due to therapy administered prior to the initiation of study drug dosing.
- Nursing or pregnant women.
- Known allergy to any of the formulation components of birinapant.
- Known or suspected hypersensitivity to 5-Azacitidine or mannitol.
- Any concurrent disease and/or medical condition that, in the opinion of the Investigator, would prevent the subject's participation.
- History of Bell's Palsy.