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Study of Efficacy and Safety of CML-CP Patients Treated With Asciminib Versus Best Available Therapy, Previously Treated With 2 or More Tyrosine Kinase Inhibitors

Primary Purpose

Leukemia, Chronic Myelogenous

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
asciminib
best available treatment
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia, Chronic Myelogenous focused on measuring Chronic Myelogenous Leukemia in chronic phase, Chronic Myelogenous Leukemia, CML-CP, Chronic, Chronic Phase, ABL001, asciminib, prior treatment with 2 or more tyrosine kinase inhibitors (TKIs), major molecular response, MMR, Chinese patients, phase ll, open label, best available therapy, BAT

Eligibility Criteria

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

Inclusion Criteria:

Diagnosed as CML-CP:

  1. Participants must meet all of the following laboratory values at the screening visit:

    < 15% blasts in peripheral blood and bone marrow < 30% blasts plus promyelocytes in peripheral blood and bone marrow < 20% basophils in the peripheral blood

    • 50 x 10^9/ L (≥ 50,000/mm3) platelets Transient prior therapy related thrombocytopenia (< 50,000/mm3 for ≤ 30 days prior to screening) is acceptable No evidence of extramedullary leukemic involvement, with the exception of hepatosplenomegaly
  2. Prior treatment with a minimum of 2 prior ATP-competitive TKIs.
  3. Failure (adapted from the 2013 European Leukemia Net (ELN) Guidelines) or intolerance to the most recent TKI therapy at the time of screening.
  4. Evidence of typical BCR-ABL1 transcript [e14a2 and/or e13a2] at the time of screening which are amenable to standardized RQ-PCR quantification

Exclusion Criteria:

  1. Known presence of the T315I mutation at any time prior to study entry
  2. Known second chronic phase of CML after previous progression to AP/BC
  3. Previous treatment with a hematopoietic stem cell transplantation
  4. Participants planning to undergo allogeneic hematopoietic stem cell transplantation
  5. Cardiac or cardiac repolarization abnormality, including any of the following:

    History within 6 months prior to starting study treatment of myocardial infarction, angina pectoris, coronary artery bypass graft Clinically significant cardiac arrhythmias , complete left bundle branch block, high-grade AV block QTcF at screening ≥450 msec (male participants), ≥460 msec (female participants)

    Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome, or any of the following:

    Risk factors for Torsades de Pointes including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure, or history of clinically significant/symptomatic bradycardia Concomitant medication(s) with a "Known risk of Torsades de Pointes" that cannot be discontinued or replaced 7 days prior to starting study drug by safe alternative medication.

    Inability to determine the QTcF interval

  6. History of acute pancreatitis within 1 year of study entry or past medical history of chronic pancreatitis

Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

asciminb arm

best available treatment arm

Arm Description

Patients will receive asciminib (40 mg BID continuous)

Patients will receive best available therapy chosen by investigator

Outcomes

Primary Outcome Measures

Major molecular response rate of asciminib
Evaluate the major molecular response rate at 24 weeks in asciminib arm

Secondary Outcome Measures

Cytogenetic response (CyR) rate
Evaluate the cytogenetic response rate (Complete, Partial, Major, Minor, Minimal, no response) at and by all scheduled data collection time points including 24, 48 and 96 weeks for both asciminib arm and best available treatment arm.
Major molecular response rate of best available treatment arm
Evaluate the major molecular response rate at week 24 of best available treatment arm, and compare with asciminib arm
Major molecular response rate of both asciminib arm and BAT armn time points
Evaluate the major molecular response rate, collected at all scheduled data collection time point (except week 24)
major molecular response rate by all scheduled data collection time points
Evaluate the major molecular rate by all scheduled data collection time points including 24, 48 and 96 weeks by treatment group
Time to major molecular response rate
Evaluate the time from the date of the first dose of study drug to the date of the first documented MMR by treatment group
Duration of major molecular response
First document major molecular response to loss of MMR up to 96 weeks after last participant receive the first dose
Overall survival
To evaluate the time from the date of randomization to the date of death (including the survival follow-up period)
Progression free survival
Evaluate the time from the date of randomization to the earliest occurrence of documented disease progression to AP/BC or the date of death from any cause (including progressions and deaths observed during the survival follow-up period)
Pharmacokinetics (PK) parameter of asciminib: Cmax
Characterize PK of asciminib in the Chinese CML-CP population. Cmax is the maximum (peak) observed plasma drug concentration after dose administration (ng/mL).
PK parameter of asciminib: Tmax
Characterize PK of asciminib in the Chinese CML-CP population. Tmax is the time to reach maximum (peak) plasma drug concentration after dose administration (hr).
PK parameter of asciminib: Ctrough
Characterize PK of asciminib in the Chinese CML-CP population. Trough plasma concentrations (Ctrough)
PK parameter of asciminib: AUCtau
Characterize PK of asciminib in the Chinese CML-CP population. The partial area under the plasma concentration-time curve from dose time to tau (ng*hr/mL). For a bid regimen, Tau=12h.
PK parameter of asciminib: AUClast
Characterize PK of asciminib in the Chinese CML-CP population. AUClast is the The AUC from the time of dosing to the time of the last measurable plasma concentration (Tlast) (ng*hr/mL)

Full Information

First Posted
March 10, 2021
Last Updated
October 17, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04795427
Brief Title
Study of Efficacy and Safety of CML-CP Patients Treated With Asciminib Versus Best Available Therapy, Previously Treated With 2 or More Tyrosine Kinase Inhibitors
Official Title
A Randomized, Open-label, Multi-center, Phase II Study of Asciminib Versus Best Available Therapy in Chinese Patients With Chronic Myelogenous Leukemia in Chronic Phase (CML-CP), Previously Treated With 2 or More Tyrosine Kinase Inhibitors
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 6, 2021 (Actual)
Primary Completion Date
May 29, 2023 (Actual)
Study Completion Date
December 9, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this Chinese bridging study is to evaluate the efficacy, safety, tolerability and pharmacokinetics of asciminib versus best available therapy in Chinese patients with Chronic Myelogenous Leukemia in chronic phase, previously treated with 2 or more tyrosine kinase inhibitors to support related indication registration in China. The primary objective of the study is to evaluate the Major Molecular Response (MMR) rate of asciminib treatment at 24 weeks.
Detailed Description
The purpose of this Chinese bridging study is to evaluate the efficacy, safety, tolerability and pharmacokinetics (PK) of asciminib versus best available therapy (BAT) in Chinese patients with Chronic Myelogenous Leukemia in chronic phase (CML-CP), previously treated with 2 or more tyrosine kinase inhibitors (TKIs) to support related indication registration in China. This study will enroll the participants 1) who failed their most recent TKI therapy by meeting the definition of treatment failure as per the 2013 European Leukemia Net (ELN) guidelines, or 2) who were intolerant to the most recent TKI therapy and must have BCR-ABL1 ratio > 0.1% IS at screening. Eligible participants will be randomized into asciminib arm or the BAT arm on a 2:1 ratio, to receive asciminib treatment (continuous 40 mg BID) or BAT from Day 1 until the end of study treatment period defined as 96 weeks after the last participant receives the first dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Chronic Myelogenous
Keywords
Chronic Myelogenous Leukemia in chronic phase, Chronic Myelogenous Leukemia, CML-CP, Chronic, Chronic Phase, ABL001, asciminib, prior treatment with 2 or more tyrosine kinase inhibitors (TKIs), major molecular response, MMR, Chinese patients, phase ll, open label, best available therapy, BAT

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
asciminb arm
Arm Type
Experimental
Arm Description
Patients will receive asciminib (40 mg BID continuous)
Arm Title
best available treatment arm
Arm Type
Experimental
Arm Description
Patients will receive best available therapy chosen by investigator
Intervention Type
Drug
Intervention Name(s)
asciminib
Other Intervention Name(s)
ABL001
Intervention Description
Asciminib comes in 20 mg and 40 mg tablets and is taken orally twice daily
Intervention Type
Other
Intervention Name(s)
best available treatment
Intervention Description
Best available treatment will be based on investigator's choice identified prior to randomization. Dose and frequency will depend on label and institutional guidelines for various BAT
Primary Outcome Measure Information:
Title
Major molecular response rate of asciminib
Description
Evaluate the major molecular response rate at 24 weeks in asciminib arm
Time Frame
week 24
Secondary Outcome Measure Information:
Title
Cytogenetic response (CyR) rate
Description
Evaluate the cytogenetic response rate (Complete, Partial, Major, Minor, Minimal, no response) at and by all scheduled data collection time points including 24, 48 and 96 weeks for both asciminib arm and best available treatment arm.
Time Frame
24, 48, 96 weeks
Title
Major molecular response rate of best available treatment arm
Description
Evaluate the major molecular response rate at week 24 of best available treatment arm, and compare with asciminib arm
Time Frame
week 24
Title
Major molecular response rate of both asciminib arm and BAT armn time points
Description
Evaluate the major molecular response rate, collected at all scheduled data collection time point (except week 24)
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment, except week 24
Title
major molecular response rate by all scheduled data collection time points
Description
Evaluate the major molecular rate by all scheduled data collection time points including 24, 48 and 96 weeks by treatment group
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment
Title
Time to major molecular response rate
Description
Evaluate the time from the date of the first dose of study drug to the date of the first documented MMR by treatment group
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment
Title
Duration of major molecular response
Description
First document major molecular response to loss of MMR up to 96 weeks after last participant receive the first dose
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment
Title
Overall survival
Description
To evaluate the time from the date of randomization to the date of death (including the survival follow-up period)
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment, plus 30 days for safety follow up
Title
Progression free survival
Description
Evaluate the time from the date of randomization to the earliest occurrence of documented disease progression to AP/BC or the date of death from any cause (including progressions and deaths observed during the survival follow-up period)
Time Frame
Up to all participants received at least 96 weeks of randomized study treatment, plus 30 days for safety follow up
Title
Pharmacokinetics (PK) parameter of asciminib: Cmax
Description
Characterize PK of asciminib in the Chinese CML-CP population. Cmax is the maximum (peak) observed plasma drug concentration after dose administration (ng/mL).
Time Frame
week 2 day 1, week 4, week 12, week 24 and week 96
Title
PK parameter of asciminib: Tmax
Description
Characterize PK of asciminib in the Chinese CML-CP population. Tmax is the time to reach maximum (peak) plasma drug concentration after dose administration (hr).
Time Frame
week 2 day 1, week 4, week 12, week 24 and week 96
Title
PK parameter of asciminib: Ctrough
Description
Characterize PK of asciminib in the Chinese CML-CP population. Trough plasma concentrations (Ctrough)
Time Frame
week 2 day 1, week 4, week 12, week 24 and week 96
Title
PK parameter of asciminib: AUCtau
Description
Characterize PK of asciminib in the Chinese CML-CP population. The partial area under the plasma concentration-time curve from dose time to tau (ng*hr/mL). For a bid regimen, Tau=12h.
Time Frame
week 2 day 1, week 4, week 12, week 24 and week 96
Title
PK parameter of asciminib: AUClast
Description
Characterize PK of asciminib in the Chinese CML-CP population. AUClast is the The AUC from the time of dosing to the time of the last measurable plasma concentration (Tlast) (ng*hr/mL)
Time Frame
week 2 day 1, week 4, week 12, week 24 and week 96

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosed as CML-CP: Participants must meet all of the following laboratory values at the screening visit: < 15% blasts in peripheral blood and bone marrow < 30% blasts plus promyelocytes in peripheral blood and bone marrow < 20% basophils in the peripheral blood 50 x 10^9/ L (≥ 50,000/mm3) platelets Transient prior therapy related thrombocytopenia (< 50,000/mm3 for ≤ 30 days prior to screening) is acceptable No evidence of extramedullary leukemic involvement, with the exception of hepatosplenomegaly Prior treatment with a minimum of 2 prior ATP-competitive TKIs. Failure (adapted from the 2013 European Leukemia Net (ELN) Guidelines) or intolerance to the most recent TKI therapy at the time of screening. Evidence of typical BCR-ABL1 transcript [e14a2 and/or e13a2] at the time of screening which are amenable to standardized RQ-PCR quantification Exclusion Criteria: Known presence of the T315I mutation at any time prior to study entry Known second chronic phase of CML after previous progression to AP/BC Previous treatment with a hematopoietic stem cell transplantation Participants planning to undergo allogeneic hematopoietic stem cell transplantation Cardiac or cardiac repolarization abnormality, including any of the following: History within 6 months prior to starting study treatment of myocardial infarction, angina pectoris, coronary artery bypass graft Clinically significant cardiac arrhythmias , complete left bundle branch block, high-grade AV block QTcF at screening ≥450 msec (male participants), ≥460 msec (female participants) Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome, or any of the following: Risk factors for Torsades de Pointes including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure, or history of clinically significant/symptomatic bradycardia Concomitant medication(s) with a "Known risk of Torsades de Pointes" that cannot be discontinued or replaced 7 days prior to starting study drug by safe alternative medication. Inability to determine the QTcF interval History of acute pancreatitis within 1 year of study entry or past medical history of chronic pancreatitis Other protocol-defined inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Chongqing City
State/Province
Chongqing
ZIP/Postal Code
404100
Country
China
Facility Name
Novartis Investigative Site
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510515
Country
China
Facility Name
Novartis Investigative Site
City
Shenzhen
State/Province
Guangdong
ZIP/Postal Code
518037
Country
China
Facility Name
Novartis Investigative Site
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450008
Country
China
Facility Name
Novartis Investigative Site
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450052
Country
China
Facility Name
Novartis Investigative Site
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Facility Name
Novartis Investigative Site
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Facility Name
Novartis Investigative Site
City
Nantong
State/Province
Jiangsu
ZIP/Postal Code
226000
Country
China
Facility Name
Novartis Investigative Site
City
Suzhou
State/Province
Jiangsu
ZIP/Postal Code
215006
Country
China
Facility Name
Novartis Investigative Site
City
Nanchang
State/Province
Jiangxi
ZIP/Postal Code
330006
Country
China
Facility Name
Novartis Investigative Site
City
Chang Chun
State/Province
Jilin
ZIP/Postal Code
130021
Country
China
Facility Name
Novartis Investigative Site
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China
Facility Name
Novartis Investigative Site
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Facility Name
Novartis Investigative Site
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Facility Name
Novartis Investigative Site
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325000
Country
China
Facility Name
Novartis Investigative Site
City
Beijing
ZIP/Postal Code
100044
Country
China
Facility Name
Novartis Investigative Site
City
Beijing
ZIP/Postal Code
100730
Country
China
Facility Name
Novartis Investigative Site
City
Shanghai
ZIP/Postal Code
200025
Country
China
Facility Name
Novartis Investigative Site
City
Shenyang
ZIP/Postal Code
110004
Country
China
Facility Name
Novartis Investigative Site
City
Xian
ZIP/Postal Code
710004
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Learn more about this trial

Study of Efficacy and Safety of CML-CP Patients Treated With Asciminib Versus Best Available Therapy, Previously Treated With 2 or More Tyrosine Kinase Inhibitors

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