Studie zum Prüfpräparat MBG453 in Kombination mit der Standardtherapie Azacitidin bei Patienten mit myelodysplastischem Syndrom (MDS) oder chronischer myelomonozytischer Leukämie (CMML-2)

Drug: Sabatolimab;Drug: Azacitidine;Drug: Placebo

Gender: All
Maximum age: 100 Years
Minimum age: 18 Years
Inclusion Criteria:

- Signed informed consent must be obtained prior to participation in the study

- Age = 18 years at the date of signing the informed consent form

- Morphologically confirmed diagnosis of myelodysplastic syndrome (MDS) based on WHO
2016 classification (Arber et al 2016) by local investigator assessment with one of
the following Prognostic Risk Categories, based on the revised International
Prognostic Scoring System (IPSS-R):

- Very high (> 6 points)

- High (> 4.5 - = 6 points)

- Intermediate (> 3 - = 4.5 points) Or Morphologically confirmed diagnosis of
Chronic Myelomonocytic Leukemia -2 based on WHO 2016 classification (Arber et
al 2016, including persistent monocytosis) by local investigator assessment
with WBC < 13 x 109/L at time of initial diagnosis

- Indication for azacitidine treatment according to the investigator, based on local
standard medical practice and institutional guidelines for treatment decisions

- Not eligible at time of screening for intensive chemotherapy according to the
investigator, based on local standard medical practice and institutional guidelines
for treatment decisions, including assessment of individual clinical factors such as
age, comorbidities and performance status

- Not eligible at time of screening for hematopoietic stem cell transplantation (HSCT)
according to the investigator, based on local standard medical practice and
institutional guidelines for treatment decisions, including assessment of individual
clinical factors such as age, comorbidities, performance status, and donor
availability

- Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2

Exclusion Criteria:

- Prior exposure to TIM-3 directed therapy at any time. Prior therapy with immune
checkpoint inhibitors (e.g, anti-CTLA4, anti-PD-1, anti-PD-L1, or anti-PD-L2),
cancer vaccines is allowed except if the drug was administered within 4 months prior
to randomization

- Previous first-line treatment for intermediate, high, very high risk myelodysplastic
syndromes (based on IPSS-R) or CMML with any antineoplastic agents including for
example chemotherapy, lenalidomide and hypomethylating agents (HMAs) such as
decitibine and azacitidine. However, previous treatment with hydroxyurea or
leukopheresis to reduce WBC count is allowed prior to randomization.

- Investigational treatment received within 4 weeks or 5 half-lives of this
investigational treatment, whatever is longer, prior to randomization. In case of a
checkpoint inhibitor: a minimal interval of 4 months prior to randomization is
necessary to allow randomization.

- Subjects with Myelodysplastic syndrome (MDS) based on 2016 WHO classification (Arber
et al 2016) with revised International Prognostic Scoring System (IPSS-R) = 3

- Diagnosis of acute myeloid leukemia (AML) including acute promyelocytic leukemia and
extra-medullary acute myeloid leukemia, primary or secondary myelofibrosis based on
WHO 2016 classification (Arber et al 2016)

- Diagnosis of therapy related myeloid neoplasms based on WHO 2016 classification
(Arber et al 2016)

- History of organ or allogeneic hematopoietic stem cell transplant

Other protocol-defined Inclusion/Exclusion Criteria may apply.