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A Phase 3 Study for the Efficacy and Safety of Radotinib in CP-CML Patients With Failure or Intolerance to Previous TKIs

Primary Purpose

Chronic Myeloid Leukemia, Chronic Phase, CML, Chronic Phase, CML, Refractory

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Radotinib HCl
Sponsored by
Il-Yang Pharm. Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Myeloid Leukemia, Chronic Phase

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients aged 18 years old
  2. Chronic Phase Ph+ Chronic Myeloid Leukemia patients who failed or intolerance the previous TKIs therapy including Imatinib Imatinib
  3. ECOG scale 0, 1 or 2
  4. Chronic phase is defined as all of the following conditions that subjects meet.

    • Blast in peripheral blood and bone marrow <15%
    • The sum of blast and promyelocyte in peripheral blood and bone marrow <30%
    • Basophil in peripheral blood <20%
    • Platelets count ≥50 × 10^9/L (≥ 50,000/mm3) (But, transient prior therapy related thrombocytopenia [< 50 × 109/L (< 50,000/mm3)] is acceptable
    • No evidence of involvement of extramedullary leukemia other than enlargements of liver and spleen
  5. Patients who have adequate organ functions as defined below:

    • Total bilirubin < 1.5 × upper limit of normal (ULN)
    • SGOT and SGPT < 2.5× ULN
    • Creatinine < 1.5 × ULN
    • Serum amylase and lipase ≤ 1.5 × ULN
    • Alkaline Phosphatase ≤ 2.5 × ULN (only if not related to the tumor)
  6. Women of childbearing potential should have a negative serum or urine pregnancy test within 14 days of the enrollment.
  7. Women of childbearing potential must be using an adequate method of contraception to avoid pregnancy throughout the study and for a period of at least 1 month (4 weeks) after the last dose of investigational product in such a manner that the risk of pregnancy is minimized.

Exclusion Criteria:

  1. Patients who have been diagonised accelerated phase and blast crisis CML in previous therapy if only once.
  2. Patients with CCyR at the time of screening
  3. Any below impaired cardiac function:

    • LVEF <45% or < lower bound of normal limit of study site (whichever higher), confirmed by echocardiogram at the site
    • Patients who cannot have QT intervals measured according to ECG
    • Complete left bundle branch block
    • Patients with cardiac pacemakers
    • Patients with congenital long QT syndrome or the family history of known long QT syndrome
    • History of, or presence of symptomatic ventricular or atrial tachyarrhythmias
    • Clinically significant resting bradycardia (< 50 bpm)
    • The mean QTcF >450msec following three consecutive ECG tests at baseline

      : Screening test will be performed again for QTcF after the adjustment of electrolyte if QTcF >450msec and the electrolyte is not within the normal range.

    • Medical history of clinically confirmed myocardial infarction
    • Medical history of unstable angina (within last 12 months)
    • Other clinically significant cardiac disease
  4. Patients with T315I point mutations
  5. Patients with central nervous system involvement as cytopathologically confirmed
  6. Severe or uncontrolled chronic disease
  7. Significant medical history of congenital or acquired bleeding disorders that are not related to leukemia
  8. Patients who previously received radiotherapy to at least 25% of the bodies with high portion of bone marrow
  9. Patients who received the major surgery within 4 weeks before the initiation of the IP administration or who failed to recover from the surgery that was performed before then.
  10. Patients who participated in other clinical study and are receiving any other IP.
  11. Patients who cannot give consent to the clinical study.
  12. Patients who have concurrently clinically significant primary malignancy
  13. Patients currently receiving treatment with a strong CYP3A4 inhibitors or strong CYP3A4 inducers or therapeutic Cumarin derivatives and that can neither stop the administration of these drugs before the start of the IP administration nor switch to other drugs.
  14. Patients who are currently receiving treatment with a medication that has the potential to prolong QT intervals and can neither stop the administration of the drugs before the start of the IP administration nor switch to other drugs. If subjects need to start such drug treatments during the study, they should contact the sponsor, IL-YANG PHARM. Co., Ltd.
  15. Gastrointestinal disorder or gastrointestinal disease that may result in a significant change in the absorption of the investigational product
  16. Medical history of acute or chronic pancreatitis within the past one year
  17. Acute or chronic liver, pancreas, or severe kidney disease that are not associated with the disease
  18. Patients known seropositive to human immunodeficiency virus (HIV), current acute or chronic hepatitis B (hepatitis B surface-antigen positive), hepatitis C, or cirrhosis. Inactive hepatitis B surface antigen (HBsAg) carriers, treated and stable hepatitis B (HBV DNA < 500 IU/mL or site specific local lab normal range lower limit assessed by investigator), and cured hepatitis C patients can be enrolled.
  19. Women patients that meet the following conditions should be excluded from the clinical study.

    • Pregnancy
    • Breastfeeding
    • Pregnancy confirmed at screening pregnancy test
    • Women of childbearing potential who is unwilling to use an appropriate method of contraception during the study
  20. Men patients who are unwilling to use and appropriate method of contraception during the study
  21. Patients who have hypersensitivity to active ingredient or any of the excipients of this investigational product

Sites / Locations

  • Uijeongbu Eulji Medical Center, Eulji UniversityRecruiting
  • Territorial State Budgetary Institution
  • Federal State Budgetary Institution of ScienceRecruiting
  • Federal State Budgetary Institution
  • Hematology Centre based on City Clin. Hosp. n.a. S.P. BotkinRecruiting
  • Federal State Budgetary InstitutionRecruiting
  • Federal State Budgetary InstitutionRecruiting
  • Ankara University Medical FacultyRecruiting
  • Gazi University Medical FacultyRecruiting
  • Istanbul University Cerrahpasa - Cerrahpasa Medical FacultyRecruiting
  • Ege University Medical FacultyRecruiting
  • Mersin University Medical FacultyRecruiting
  • Ondokuz Mayis Univ. Med. Fac.Recruiting
  • CI Cherkasy Regional Oncological Dispensary of CRCRecruiting
  • CTPI Chernihiv Regional Oncological DispensaryRecruiting
  • CI Dnipropetrovsk CMCH #4 OF Dnipropetrovsk RCRecruiting
  • Institute of CR of SI NSC of Radiation Medicine of NAMSU H&T UnitRecruiting
  • SI Institute of Blood Pathology and Transfusion Medicine of AMSURecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Radotinib HCl

Arm Description

Enrolled subjects will continue to administer Radotinib 400mg twice daily (800mg/day) orally every 12 hours at regular dosing hours for 12 months. Dose modification is allowed if the subject cannot comply with the protocol-defined dosing schedule due to hematologic or non-hematologic toxicities and toxicities resolve within 28 days (within 42 days for hematologic toxicities). For radotinib, maximum 2 dose reductions will be allowed by stage to 600mg and to 400mg.

Outcomes

Primary Outcome Measures

Major Cytogenetic Response (MCyR)
MCyR is defined as 0~35% CCyR+PCyR based on ≥20 metaphase myelocytes. Chromosome test results from <20 metaphase myelocytes will be excluded from the analysis.

Secondary Outcome Measures

Cytogenetic Response (CCyR)
CCyR is defined as complete loss of Ph chromosome based on ≥20 metaphase myelocytes. Chromosome test results from <20 metaphase myelocytes will be excluded from the analysis.
Major molecular response
MMR is defined as a ≥3-log reduction in BCR-ABL1 transcript level from the standardized reference or BCR-ABL1/ABL % of ≤0.1% according to the international reference when the level of BCR-ABL1 gene was measured by RQ-PCR, a standardized quantitative genetic method.
Overall Survival(OS)
OS is defined as the duration from the first day of Radotinib administration to the day of death for certain causes.
Progression Free Survival (PFS)
PFS is defined as the duration from the first day of Radotinib administration to the earliest day of disease progression or death for certain causes.

Full Information

First Posted
February 12, 2018
Last Updated
October 12, 2023
Sponsor
Il-Yang Pharm. Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03459534
Brief Title
A Phase 3 Study for the Efficacy and Safety of Radotinib in CP-CML Patients With Failure or Intolerance to Previous TKIs
Official Title
A Phase 3 Multinational, Multi-center, Single-arm, Open-label Study for the Efficacy and Safety of Radotinib in Ph+ Chronic Phase Chronic Myeloid Leukemia Patients With Failure or Intolerance to Previous TKIs Therapy Including Imatinib
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 25, 2018 (Actual)
Primary Completion Date
January 29, 2025 (Anticipated)
Study Completion Date
April 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Il-Yang Pharm. Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In a multinational, multicenter, single-arm, open-label and Phase III Radotinib clinical study, chronic phase Ph+ chronic myeloid leukemia patients with failure or intolerance to previous TKIs therapy including Imatinib will be recruited. In this phase 3 study, 173 subjects are expected to be enrolled in a single arm with the administration of Radotinib 400mg twice daily, which includes 10% of dropout rate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Myeloid Leukemia, Chronic Phase, CML, Chronic Phase, CML, Refractory, CML - Philadelphia Chromosome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
173 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Radotinib HCl
Arm Type
Experimental
Arm Description
Enrolled subjects will continue to administer Radotinib 400mg twice daily (800mg/day) orally every 12 hours at regular dosing hours for 12 months. Dose modification is allowed if the subject cannot comply with the protocol-defined dosing schedule due to hematologic or non-hematologic toxicities and toxicities resolve within 28 days (within 42 days for hematologic toxicities). For radotinib, maximum 2 dose reductions will be allowed by stage to 600mg and to 400mg.
Intervention Type
Drug
Intervention Name(s)
Radotinib HCl
Other Intervention Name(s)
SUPECT
Intervention Description
Brand name/manufacturer: Supect Cap./IL-YANG PHARM. Co., Ltd. Active ingredient: radotinib HCl 106.8mg (100mg as radotinib) or HCl 213.6mg (200mg as radotinib) Appearance and formulation: hard capsule with a light blue cap and a body containing pale yellow powder Storage conditions: Store in an airtight light proof container at room temperature.
Primary Outcome Measure Information:
Title
Major Cytogenetic Response (MCyR)
Description
MCyR is defined as 0~35% CCyR+PCyR based on ≥20 metaphase myelocytes. Chromosome test results from <20 metaphase myelocytes will be excluded from the analysis.
Time Frame
at month 6
Secondary Outcome Measure Information:
Title
Cytogenetic Response (CCyR)
Description
CCyR is defined as complete loss of Ph chromosome based on ≥20 metaphase myelocytes. Chromosome test results from <20 metaphase myelocytes will be excluded from the analysis.
Time Frame
at month 12/24, by month 24
Title
Major molecular response
Description
MMR is defined as a ≥3-log reduction in BCR-ABL1 transcript level from the standardized reference or BCR-ABL1/ABL % of ≤0.1% according to the international reference when the level of BCR-ABL1 gene was measured by RQ-PCR, a standardized quantitative genetic method.
Time Frame
at month 12/24, by month 24
Title
Overall Survival(OS)
Description
OS is defined as the duration from the first day of Radotinib administration to the day of death for certain causes.
Time Frame
by month 24
Title
Progression Free Survival (PFS)
Description
PFS is defined as the duration from the first day of Radotinib administration to the earliest day of disease progression or death for certain causes.
Time Frame
by month 24
Other Pre-specified Outcome Measures:
Title
BCR-ABL1 point mutation
Description
Incidence rate of BCR-ABL1 point mutations that are newly found during the course of radotinib treatment
Time Frame
up to month 24
Title
correlation between the concentration of radotinib in blood and the response (efficacy and safety)
Description
To measure the concentration of radotinib in blood
Time Frame
up to month 24
Title
Incidence of Radotinib-Adverse Events
Description
Toxicities will be evaluated in all subjects treated with radotinib.
Time Frame
up to month 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients aged 18 years old Chronic Phase Ph+ Chronic Myeloid Leukemia patients who failed or intolerance the previous TKIs therapy including Imatinib Imatinib ECOG scale 0, 1 or 2 Chronic phase is defined as all of the following conditions that subjects meet. Blast in peripheral blood and bone marrow <15% The sum of blast and promyelocyte in peripheral blood and bone marrow <30% Basophil in peripheral blood <20% Platelets count ≥50 × 10^9/L (≥ 50,000/mm3) (But, transient prior therapy related thrombocytopenia [< 50 × 109/L (< 50,000/mm3)] is acceptable No evidence of involvement of extramedullary leukemia other than enlargements of liver and spleen Patients who have adequate organ functions as defined below: Total bilirubin < 1.5 × upper limit of normal (ULN) SGOT and SGPT < 2.5× ULN Creatinine < 1.5 × ULN Serum amylase and lipase ≤ 1.5 × ULN Alkaline Phosphatase ≤ 2.5 × ULN (only if not related to the tumor) Women of childbearing potential should have a negative serum or urine pregnancy test within 14 days of the enrollment. Women of childbearing potential must be using an adequate method of contraception to avoid pregnancy throughout the study and for a period of at least 1 month (4 weeks) after the last dose of investigational product in such a manner that the risk of pregnancy is minimized. Exclusion Criteria: Patients who have been diagonised accelerated phase and blast crisis CML in previous therapy if only once. Patients with CCyR at the time of screening Any below impaired cardiac function: LVEF <45% or < lower bound of normal limit of study site (whichever higher), confirmed by echocardiogram at the site Patients who cannot have QT intervals measured according to ECG Complete left bundle branch block Patients with cardiac pacemakers Patients with congenital long QT syndrome or the family history of known long QT syndrome History of, or presence of symptomatic ventricular or atrial tachyarrhythmias Clinically significant resting bradycardia (< 50 bpm) The mean QTcF >450msec following three consecutive ECG tests at baseline : Screening test will be performed again for QTcF after the adjustment of electrolyte if QTcF >450msec and the electrolyte is not within the normal range. Medical history of clinically confirmed myocardial infarction Medical history of unstable angina (within last 12 months) Other clinically significant cardiac disease Patients with T315I point mutations Patients with central nervous system involvement as cytopathologically confirmed Severe or uncontrolled chronic disease Significant medical history of congenital or acquired bleeding disorders that are not related to leukemia Patients who previously received radiotherapy to at least 25% of the bodies with high portion of bone marrow Patients who received the major surgery within 4 weeks before the initiation of the IP administration or who failed to recover from the surgery that was performed before then. Patients who participated in other clinical study and are receiving any other IP. Patients who cannot give consent to the clinical study. Patients who have concurrently clinically significant primary malignancy Patients currently receiving treatment with a strong CYP3A4 inhibitors or strong CYP3A4 inducers or therapeutic Cumarin derivatives and that can neither stop the administration of these drugs before the start of the IP administration nor switch to other drugs. Patients who are currently receiving treatment with a medication that has the potential to prolong QT intervals and can neither stop the administration of the drugs before the start of the IP administration nor switch to other drugs. If subjects need to start such drug treatments during the study, they should contact the sponsor, IL-YANG PHARM. Co., Ltd. Gastrointestinal disorder or gastrointestinal disease that may result in a significant change in the absorption of the investigational product Medical history of acute or chronic pancreatitis within the past one year Acute or chronic liver, pancreas, or severe kidney disease that are not associated with the disease Patients known seropositive to human immunodeficiency virus (HIV), current acute or chronic hepatitis B (hepatitis B surface-antigen positive), hepatitis C, or cirrhosis. Inactive hepatitis B surface antigen (HBsAg) carriers, treated and stable hepatitis B (HBV DNA < 500 IU/mL or site specific local lab normal range lower limit assessed by investigator), and cured hepatitis C patients can be enrolled. Women patients that meet the following conditions should be excluded from the clinical study. Pregnancy Breastfeeding Pregnancy confirmed at screening pregnancy test Women of childbearing potential who is unwilling to use an appropriate method of contraception during the study Men patients who are unwilling to use and appropriate method of contraception during the study Patients who have hypersensitivity to active ingredient or any of the excipients of this investigational product
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Na Yun Kim
Phone
+82.70.7165.7316
Email
nykim@ilyang.co.kr
First Name & Middle Initial & Last Name or Official Title & Degree
Kang Hi An
Phone
+82.70.7165.7322
Email
khan@ilyang.co.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dong Wook Kim
Organizational Affiliation
the Catholic University of Korea's St. Mary's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Uijeongbu Eulji Medical Center, Eulji University
City
Uijeongbu-si
State/Province
Gyeonggi-do
ZIP/Postal Code
11749
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dong-Wook Kim, MD
First Name & Middle Initial & Last Name & Degree
Dong-Wook Kim
Facility Name
Territorial State Budgetary Institution
City
Barnaul
ZIP/Postal Code
656024
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
Federal State Budgetary Institution of Science
City
Kirov
ZIP/Postal Code
610027
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Federal State Budgetary Institution
City
Moscow
ZIP/Postal Code
125167
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
Hematology Centre based on City Clin. Hosp. n.a. S.P. Botkin
City
Moscow
ZIP/Postal Code
300186883
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Federal State Budgetary Institution
City
Saint-Petersburg
ZIP/Postal Code
191024
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Federal State Budgetary Institution
City
Saint-Petersburg
ZIP/Postal Code
197341
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Ankara University Medical Faculty
City
Ankara
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Gazi University Medical Faculty
City
Ankara
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Istanbul University Cerrahpasa - Cerrahpasa Medical Faculty
City
Istanbul
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Ege University Medical Faculty
City
Izmir
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Mersin University Medical Faculty
City
Mersin
Country
Turkey
Individual Site Status
Recruiting
Facility Name
Ondokuz Mayis Univ. Med. Fac.
City
Samsun
Country
Turkey
Individual Site Status
Recruiting
Facility Name
CI Cherkasy Regional Oncological Dispensary of CRC
City
Cherkassy
Country
Ukraine
Individual Site Status
Recruiting
Facility Name
CTPI Chernihiv Regional Oncological Dispensary
City
Chernihiv
Country
Ukraine
Individual Site Status
Recruiting
Facility Name
CI Dnipropetrovsk CMCH #4 OF Dnipropetrovsk RC
City
Dnipro
Country
Ukraine
Individual Site Status
Recruiting
Facility Name
Institute of CR of SI NSC of Radiation Medicine of NAMSU H&T Unit
City
Kyiv
Country
Ukraine
Individual Site Status
Recruiting
Facility Name
SI Institute of Blood Pathology and Transfusion Medicine of AMSU
City
Lviv
Country
Ukraine
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 3 Study for the Efficacy and Safety of Radotinib in CP-CML Patients With Failure or Intolerance to Previous TKIs

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