['myelodysplastic syndromes']
['galunisertib', 'placebo']

        Inclusion Criteria:

          -  Confirmed diagnosis of MDS based on the World Health Organization (WHO) criteria

          -  Participants with 5q deletions are allowed only if they have failed or are intolerant
             of lenalidomide treatment

          -  Participants must have a Revised International Prognostic Scoring System (IPSS-R)
             category of very low-, low-, or intermediate-risk disease

          -  In the 8 weeks prior to registration, participants in phase 2 should have anemia with
             Hb ≤10.0 g/dL (based on the average of 2 baseline measurements and untransfused for at
             least 1 week) with or without red blood cell (RBC) transfusion dependence confirmed
             for a minimum of 8 weeks before enrollment

          -  For phase 3, participants should have anemia with RBC transfusion dependence confirmed
             within 8 weeks before enrollment

          -  Performance status ≤2 on the Eastern Cooperative Oncology Group (ECOG) scale

        Exclusion Criteria:

          -  No history of moderate or severe cardiac disease

          -  No prior history of acute myeloid leukemia (AML)
      