Birinapant With 5-azacitidine in MDS Subjects Who Are Naïve, Have Relapsed or Are Refractory to 5-azacitidine Therapy

  • Study type:

    Interventional What is this?

    Describes the nature of a clinical study. Types include:

    • Observational study — observes people and measures outcomes without affecting results.
    • Interventional study (clinical trial) — studies new tests, treatments, drugs, surgical procedures or devices.
    • Medical records research — uses historical information collected from medical records of large groups of people to study how diseases progress and which treatments and surgeries work best.
  • Study phase:

    I/II What is this?

    During the early phases (phases 1 and 2), researchers assess safety, side effects, optimal dosages and risks/benefits. In the later phase (phase 3), researchers study whether the treatment works better than the current standard therapy. They also compare the safety of the new treatment with that of current treatments. Phase 3 trials include large numbers of people to make sure that the result is valid. There are also less common very early (phase 0) and later (phase 4) phases. Phase 0 trials are small trials that help researchers decide if a new agent should be tested in a phase 1 trial. Phase 4 trials look at long-term safety and effectiveness, after a new treatment has been approved and is on the market.

Study IDs

  • Site IRB:

    • Scottsdale/Phoenix, Arizona: 13-002910
    • Jacksonville, Florida: 13-002910
  • NCT ID:

  • Sponsor Protocol Number:


About this study

This is a dose escalation followed by dose expansion study of TL32711 in combination with 5-Azacitidine in subjects with Myelodysplastic syndrome who are naïve, have relapsed or have failed prior 5-azacitidine therapy. Pre-clinical and mechanistic studies support that 5-Azacitidine may modulate pathways that enable birinapant-mediated anti-tumor activity.

Participation eligibility

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

Inclusion 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

Exclusion Criteria:

  • 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.

Participating Mayo Clinic locations

Study statuses change often. Please contact us for help.

Mayo Clinic Location Status Contact

Scottsdale/Phoenix, Ariz.

Mayo Clinic principal investigator

Raoul Tibes, M.D., Ph.D.

Closed for enrollment

Cancer Center Clinical Trials Referral Office


Jacksonville, Fla.

Mayo Clinic principal investigator

Raoul Tibes, M.D., Ph.D.

Closed for enrollment

Cancer Center Clinical Trials Referral Office