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Pevonedistat

Phase 3

Myelodysplastic Syndrome | Small molecule | Oncology |Takeda Pharmaceutical Company Limited|Last Updated: Oct 29, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedCONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment454
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT03268954Pevonedistat Plus Azacitidine Versus Single-Agent Azacitidine as First-Line Treatment for Participants With Higher-Risk Myelodysplastic Syndromes (HR MDS), Chronic Myelomonocytic Leukemia (CMML), or Low-Blast Acute Myelogenous Leukemia (AML)PHASE3 COMPLETED 454Nov 28, 2017Oct 14, 2024Oct 29, 2025242 United States, Australia +18
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Study Endpoints
Primary Endpoints
Event-Free Survival (EFS)
From randomization until transformation to acute myeloid leukemia, or death due to any cause: up to approximately 42 months

EFS was defined as the time from randomization to the date of an EFS event. An EFS event was defined as death or transformation to acute myelogenous leukemia (AML) (World Health Organization \[WHO\] classification as a participant having greater than 20 % blasts in the blood or marrow and an increase of blast count by 50%), whichever event occurred first, in participants with myelodysplastic syndromes (MDS) or chronic myelomonocytic leukemias (CMML). An EFS event was defined as death in participants with low-blast AML.

Secondary Endpoints
Overall Survival (OS)
Up to approximately 6.9 years
Kaplan-Meier Estimates of Six-Month Survival Rate
Month 6
Kaplan-Meier Estimates of One-Year Survival Rate
Year 1
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Azacitidine 75 mg/m^2EXPERIMENTALParticipants were administered azacitidine 75 milligram per square meter (mg/m\^2) intravenous (IV) or subcutaneous (SC) injection on Days 1 to 5, Days 8 and 9, in 28-day treatment cycles until disease progression or unacceptable toxicity or up to a maximum of 63 cycles.
Pevonedistat 20 mg/m^2 + Azacitidine 75 mg/m^2EXPERIMENTALParticipants were administered azacitidine 75 mg/m\^2 IV or SC injection on Days 1 to 5, Days 8 and 9 and pevonedistat 20 mg/m\^2 IV infusion, on Days 1, 3, and 5 in 28-day treatment cycles until disease progression or unacceptable toxicity or up to a maximum of 63 cycles.
Interventions
NameTypeDescription
AzacitidineDRUGAzacitidine intravenous or subcutaneous formulation.
PevonedistatDRUGPevonedistat intravenous infusion.
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites242

Inclusion Criteria: 1. Has morphologically confirmed diagnosis of myelodysplastic syndromes (MDS) or CMML (i.e., with white blood cell \[WBC\] \<13,000/microliter \[mcL\]) or low-blast acute myelogenous leukemia (AML). 2. Has MDS or CMML and must also have one of the following Prognostic Risk Categ...

Countries:United StatesAustraliaBelgiumBrazilCanadaChinaCzechiaFranceGermanyGreeceIsraelItalyJapanMexicoPolandRussiaSouth KoreaSpainTurkey (Türkiye)United Kingdom
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Competitive Landscape -Myelodysplastic Syndromes 76 trials
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