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Polyethylene Glycol Interferon Alfa-2b (PEG Intron) Versus Interferon Alfa-2b (INTRON^® A) in the Treatment of Newly Diagnosed Chronic Myelogenous Leukemia (CML) (C98026)

Primary Purpose

Chronic Myelogenous Leukemia

Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Pegylated interferon alfa-2b
Interferon alfa-2b
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Myelogenous Leukemia

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Has chronic phase CML diagnosed within 3 months prior to study enrollment
  • Has chronic phase CML positive for Ph^1 as confirmed by cytogenetic studies, performed by a central laboratory
  • Has platelet count >/= 50,000/microl
  • Has hemoglobin >/= 9.0 g/dL
  • Has WBC count >/=2000/microl but </= 50,000/microl
  • Has adequate hepatic and renal function, as defined by the following parameters obtained within 14 days prior to initiation of study treatment

    • serum glutamic oxaloacetic transaminase (SGOT) <2 times upper limit of laboratory normal (ULN)
    • serum glutamic pyruvic transaminase SGPT <2 times upper ULN
    • serum bilirubin <2 times ULN
    • serum creatinine <2.0 mg/dL
  • Is fully recovered from any prior major surgery and must be at least 4 weeks postoperative
  • Has Eastern Cooperative Oncology Group Performance Status of 0-2
  • Has signed a written, voluntary informed consent before study entry, is willing to participate in this study, and is willing to complete all follow-up assessments

Exclusion Criteria:

  • Has accelerated phase CML as defined by any of the following criteria.

    • peripheral blood myeloblasts >/=15%
    • peripheral blood basophils >/= 20%
    • peripheral blood myeloblasts plus promyelocytes >/=30%
    • platelets <100,000/microl, unrelated to therapy
  • Has blastic phase CML (30% myeloblasts in peripheral blood or bone marrow)
  • Is a candidate for and is planning to receive allogeneic, syngeneic, or autologous bone marrow transplantation within the next 12 months
  • Has received prior treatment for their CML, except for hydroxyurea (collection of stem cells without using high dose chemotherapy for mobilization is acceptable)
  • Has severe cardiovascular disease (i. e., arrhythmias requiring chronic treatment, congestive heart failure [New York Heart Association (NYHA) Class III or IV], or symptomatic ischemic heart disease)
  • Has a history of a neuropsychiatric disorder requiring hospitalization
  • Has thyroid dysfunction not responsive to therapy
  • Has uncontrolled diabetes mellitus
  • Has a history of seropositivity for human immunodeficiency virus
  • Has active and/or uncontrolled infection, including active hepatitis
  • Has a medical condition requiring chronic systemic corticosteroids
  • Has a history of prior malignancies within the last 5 years, except for surgically cured non-melanoma skin cancer, or cervical carcinoma in situ
  • Has received any experimental therapy within 30 days prior to enrollment in this study
  • Is known to be actively abusing alcohol or drugs
  • Is pregnant, nursing, or of reproductive potential and is not practicing an effective means of contraception

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Pegylated interferon alfa-2b

    Interferon alfa-2b

    Arm Description

    Participants received pegylated interferon alfa-2b (PEG Intron) at a dose of 6.0 microg/kg, administered weekly by subcutaneous (SC) injection. Participants may have received hydroxyurea therapy as needed prior to randomization to reduce or keep the white blood cell (WBC) count ≤50,000/μl. Treatment was for a minimum of 6 months unless there was evidence of disease progression or unacceptable toxicity.

    Participants received interferon alfa-2b (Intron^® A), recombinant for injection, at a dose of 5 million international units (MIU)/m^2, administered daily by SC injection. Participants may have received hydroxyurea therapy as needed prior to randomization to reduce or keep the WBC count ≤50,000/μl. Treatment was for a minimum of 6 months unless there was evidence of disease progression or unacceptable toxicity.

    Outcomes

    Primary Outcome Measures

    Number of Participants With Cytogenetic Responses to PEG Intron and INTRON A at 12 Months
    Cytogenetic response (CR) was defined by the degree of suppression of Philadelphia chromosome (Ph^1) achieved during study treatment. For all participants continuing treatment after study conclusion, cytogenetic assessments were conducted locally as per standard of care. Determination of CR at 12 months were based on cytogenetic analysis of bone marrow aspirate samples. The CR criteria were based on the percentage (%) of PH^1-positive cells during study treatment. Protocol-defined CR criteria were Complete Response (0%), Partial Response (1-34%), Minor Response (35-90%), or No Response (>90%). Data for the analysis population was based on the intent-to-treat principle. Participants who were treatment failures at 6 months were considered cytogenetic non-responders. Recording of CR was independent of hematologic responses.

    Secondary Outcome Measures

    Number of Participants With Cytogenetic Response (CR) to PEG Intron and Intron A at 6 Months
    Cytogenetic response (CR) at 6 months, as at 12 months, was defined by the degree of suppression of Philadelphia chromosome (Ph^1) achieved during study treatment. The determination of CR at 6 months was based on cytogenetic analysis of bone marrow aspirate samples. The CR criteria were based on the percentage (%) of PH^1-positive cells during study treatment. Protocol-defined CR criteria were Complete (0%), Partial (1-34%), Minor (35-90%), or No Response (>90%). Data for the analysis population was based on the intent-to-treat principle. Participants who were treatment failures at 6 months were considered cytogenetic non-responders. Recording of CR was independent of hematologic responses.
    Number of Participants With Hematologic Responses to PEG Intron and Intron A at 6 Months
    Hematologic response at 6 months was assessed, while the hematologic response was measured at 3, 6, 9 and 12 months during the first year of study treatment. To be considered a hematologic responder a participant must have met all of the following criteria for a minimum of 28 days: WBC count <10,000/μL; platelet count <450,000/L; normal differential count in peripheral blood (manual differential count); no palpable spleen. Participants achieving a complete hematologic response at 3 months had the cytogenetic response evaluated at 3 months as well. Participants who achieved a complete hematologic response by 6 months continued treatment for another 6 months. Participants who failed to achieve a complete hematologic response after 6 months of treatment were considered treatment failures, and further treatment for this group was at the discretion of the treating physician. Participants may have continued to receive their assigned study medication for an additional 6 months.
    Number of Participants With Overall Survival
    Participants were followed for survival; those who did not achieve a major cytogenetic response were discontinued from the study. For participants who completed 1 year of study treatment and continued to Year 2 and beyond, survival and disease progression every 3 months were assessed, and serious adverse events (SAEs) were reported. Participants were followed until resolution of any drug-related nonserious adverse event, and any SAE occurring while on the study or within 30 days of last dose of study drug. Participant death during survival follow-up was reported to the drug safety unit of the Sponsor. Each participant (whether discontinued or still on treatment) was followed every 3 months for survival and disease progression information. Overall survival was analyzed using the log-rank statistic, and the hazard ratio (HR) and 95% confidence interval (CI) for the HR were obtained using Cox's proportional hazards model.

    Full Information

    First Posted
    May 24, 2018
    Last Updated
    July 12, 2019
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03547154
    Brief Title
    Polyethylene Glycol Interferon Alfa-2b (PEG Intron) Versus Interferon Alfa-2b (INTRON^® A) in the Treatment of Newly Diagnosed Chronic Myelogenous Leukemia (CML) (C98026)
    Official Title
    A RANDOMIZED PHASE 2/3 TRIAL OF SCH 54031 PEG12000 INTERFERON ALFA-2b (PEG INTRON, SCH 54031) VS. INTRON A (SCH 30500) IN SUBJECTS WITH NEWLY DIAGNOSED CML (PROTOCOL NOS. C/I98-026)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2019
    Overall Recruitment Status
    Terminated
    Study Start Date
    October 22, 1998 (Actual)
    Primary Completion Date
    February 20, 2001 (Actual)
    Study Completion Date
    February 20, 2001 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The primary purpose of this study is to compare the efficacy of polyethylene glycol (PEG; pegylated) interferon alfa-2b (PEG Intron, C98026) versus interferon alfa-2b (Intron® A) in the treatment of participants with newly diagnosed CML.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Chronic Myelogenous Leukemia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2, Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    344 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Pegylated interferon alfa-2b
    Arm Type
    Experimental
    Arm Description
    Participants received pegylated interferon alfa-2b (PEG Intron) at a dose of 6.0 microg/kg, administered weekly by subcutaneous (SC) injection. Participants may have received hydroxyurea therapy as needed prior to randomization to reduce or keep the white blood cell (WBC) count ≤50,000/μl. Treatment was for a minimum of 6 months unless there was evidence of disease progression or unacceptable toxicity.
    Arm Title
    Interferon alfa-2b
    Arm Type
    Active Comparator
    Arm Description
    Participants received interferon alfa-2b (Intron^® A), recombinant for injection, at a dose of 5 million international units (MIU)/m^2, administered daily by SC injection. Participants may have received hydroxyurea therapy as needed prior to randomization to reduce or keep the WBC count ≤50,000/μl. Treatment was for a minimum of 6 months unless there was evidence of disease progression or unacceptable toxicity.
    Intervention Type
    Biological
    Intervention Name(s)
    Pegylated interferon alfa-2b
    Other Intervention Name(s)
    PEG Intron
    Intervention Description
    Weekly SC injection of pegylated interferon alfa-2b, 6.0 microg/kg
    Intervention Type
    Biological
    Intervention Name(s)
    Interferon alfa-2b
    Other Intervention Name(s)
    INTRON^® A
    Intervention Description
    Daily SC injection of interferon alfa-2b, 5 MIU/m^2
    Primary Outcome Measure Information:
    Title
    Number of Participants With Cytogenetic Responses to PEG Intron and INTRON A at 12 Months
    Description
    Cytogenetic response (CR) was defined by the degree of suppression of Philadelphia chromosome (Ph^1) achieved during study treatment. For all participants continuing treatment after study conclusion, cytogenetic assessments were conducted locally as per standard of care. Determination of CR at 12 months were based on cytogenetic analysis of bone marrow aspirate samples. The CR criteria were based on the percentage (%) of PH^1-positive cells during study treatment. Protocol-defined CR criteria were Complete Response (0%), Partial Response (1-34%), Minor Response (35-90%), or No Response (>90%). Data for the analysis population was based on the intent-to-treat principle. Participants who were treatment failures at 6 months were considered cytogenetic non-responders. Recording of CR was independent of hematologic responses.
    Time Frame
    Up to 12 months
    Secondary Outcome Measure Information:
    Title
    Number of Participants With Cytogenetic Response (CR) to PEG Intron and Intron A at 6 Months
    Description
    Cytogenetic response (CR) at 6 months, as at 12 months, was defined by the degree of suppression of Philadelphia chromosome (Ph^1) achieved during study treatment. The determination of CR at 6 months was based on cytogenetic analysis of bone marrow aspirate samples. The CR criteria were based on the percentage (%) of PH^1-positive cells during study treatment. Protocol-defined CR criteria were Complete (0%), Partial (1-34%), Minor (35-90%), or No Response (>90%). Data for the analysis population was based on the intent-to-treat principle. Participants who were treatment failures at 6 months were considered cytogenetic non-responders. Recording of CR was independent of hematologic responses.
    Time Frame
    6 months
    Title
    Number of Participants With Hematologic Responses to PEG Intron and Intron A at 6 Months
    Description
    Hematologic response at 6 months was assessed, while the hematologic response was measured at 3, 6, 9 and 12 months during the first year of study treatment. To be considered a hematologic responder a participant must have met all of the following criteria for a minimum of 28 days: WBC count <10,000/μL; platelet count <450,000/L; normal differential count in peripheral blood (manual differential count); no palpable spleen. Participants achieving a complete hematologic response at 3 months had the cytogenetic response evaluated at 3 months as well. Participants who achieved a complete hematologic response by 6 months continued treatment for another 6 months. Participants who failed to achieve a complete hematologic response after 6 months of treatment were considered treatment failures, and further treatment for this group was at the discretion of the treating physician. Participants may have continued to receive their assigned study medication for an additional 6 months.
    Time Frame
    6 months
    Title
    Number of Participants With Overall Survival
    Description
    Participants were followed for survival; those who did not achieve a major cytogenetic response were discontinued from the study. For participants who completed 1 year of study treatment and continued to Year 2 and beyond, survival and disease progression every 3 months were assessed, and serious adverse events (SAEs) were reported. Participants were followed until resolution of any drug-related nonserious adverse event, and any SAE occurring while on the study or within 30 days of last dose of study drug. Participant death during survival follow-up was reported to the drug safety unit of the Sponsor. Each participant (whether discontinued or still on treatment) was followed every 3 months for survival and disease progression information. Overall survival was analyzed using the log-rank statistic, and the hazard ratio (HR) and 95% confidence interval (CI) for the HR were obtained using Cox's proportional hazards model.
    Time Frame
    Up to 2 years (24 months), and beyond

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria Has chronic phase CML diagnosed within 3 months prior to study enrollment Has chronic phase CML positive for Ph^1 as confirmed by cytogenetic studies, performed by a central laboratory Has platelet count >/= 50,000/microl Has hemoglobin >/= 9.0 g/dL Has WBC count >/=2000/microl but </= 50,000/microl Has adequate hepatic and renal function, as defined by the following parameters obtained within 14 days prior to initiation of study treatment serum glutamic oxaloacetic transaminase (SGOT) <2 times upper limit of laboratory normal (ULN) serum glutamic pyruvic transaminase SGPT <2 times upper ULN serum bilirubin <2 times ULN serum creatinine <2.0 mg/dL Is fully recovered from any prior major surgery and must be at least 4 weeks postoperative Has Eastern Cooperative Oncology Group Performance Status of 0-2 Has signed a written, voluntary informed consent before study entry, is willing to participate in this study, and is willing to complete all follow-up assessments Exclusion Criteria: Has accelerated phase CML as defined by any of the following criteria. peripheral blood myeloblasts >/=15% peripheral blood basophils >/= 20% peripheral blood myeloblasts plus promyelocytes >/=30% platelets <100,000/microl, unrelated to therapy Has blastic phase CML (30% myeloblasts in peripheral blood or bone marrow) Is a candidate for and is planning to receive allogeneic, syngeneic, or autologous bone marrow transplantation within the next 12 months Has received prior treatment for their CML, except for hydroxyurea (collection of stem cells without using high dose chemotherapy for mobilization is acceptable) Has severe cardiovascular disease (i. e., arrhythmias requiring chronic treatment, congestive heart failure [New York Heart Association (NYHA) Class III or IV], or symptomatic ischemic heart disease) Has a history of a neuropsychiatric disorder requiring hospitalization Has thyroid dysfunction not responsive to therapy Has uncontrolled diabetes mellitus Has a history of seropositivity for human immunodeficiency virus Has active and/or uncontrolled infection, including active hepatitis Has a medical condition requiring chronic systemic corticosteroids Has a history of prior malignancies within the last 5 years, except for surgically cured non-melanoma skin cancer, or cervical carcinoma in situ Has received any experimental therapy within 30 days prior to enrollment in this study Is known to be actively abusing alcohol or drugs Is pregnant, nursing, or of reproductive potential and is not practicing an effective means of contraception
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Polyethylene Glycol Interferon Alfa-2b (PEG Intron) Versus Interferon Alfa-2b (INTRON^® A) in the Treatment of Newly Diagnosed Chronic Myelogenous Leukemia (CML) (C98026)

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