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A Study of Olverembatinib Combined With Inotuzumab Ozogamicin in the Treatment ph+ ALL With MRD Persistent Positive

Primary Purpose

Ph+ ALL, Bone Marrow Transplant, Minimal Residual Disease

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
the usage of Olverembatinib combined with Inotuzumab Ozogamicin
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ph+ ALL focused on measuring ph+ALL, HSCT, MRD persistent positive, Inotuzumab, tyrosine kinase inhibitor

Eligibility Criteria

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

Inclusion Criteria: Acute lymphoblastic leukemia with positive Ph chromosome or BCR / ABL fusion gene ; cD22 expression on the surface of leukemia cells ; hematological complete remission but with MRD persistent positive ( BCR-ABL1 level ≥ 10-4 ), after at least 3 times of intensive chemotherapy, in which classical chemotherapy combined with any first or second generation of tyrosine kinase inhibitors targeting BCR-ABL1. Be ≥ 18 years of age on the day of enrollment. Understand the study procedures, alternative treatment available, and risks involved with the study, and voluntarily agree to participate by giving written informed consent. Necessary to meet the criteria of important organ function : renal function and liver function are as follows : AST, ALT and ALP below the normal 2 times the upper limit, total bilirubin below the normal upper limit 1.5 times ; creatinine clearance rate greater than 50ML / min ; pancreatic function : serum amylase is not higher than the normal upper limit 1.5 times, serum lipase is not higher than the normal upper limit 1.5 times ; normal heart function : ejection fraction ( EF ) > 60 %, pulmonary artery systolic pressure ≤ 50mmHg. Has documented nefative results for human immunodeficiency virus antibody (HIV-Ab), hepatitis C virus antibody (HCV-Ab) , as well as undetectable HCV RNA, or undetectable HBV DNA. ECOG-PS 0-2. Informed consent must be signed before the start of the trial. Informed consent must be signed by the patient himself or his direct family members who are 18 years old and above ; considering the patient 's condition, if the patient 's signature is not conducive to the treatment of the disease, the informed consent is signed by the legal guardian or the patient 's immediate family. Exclusion Criteria: Diagnosed as mixed lineage leukemia. Documented as CNS leukemia or extramedullary infiltration. Patients with other malignant tumors ; the patients were assessed as having comorbidities that seriously endanger the patient 's life or affect the patient 's completion of the study. Used to use the third generation of TKIs, including Olverembatinib. Patients received any other kind of anti-leukemia antibody therapy two weeks before enrollment. Patients received radiotherapy or chemotherapy (except induction chemotherapy ) or any other research treatment within two weeks before enrollment, with the following exceptions :Designed to reduce circulating leukemia lymphocytes count or remission : Steroids, hydroxyurea or vincristine;Maintenance therapy : thiopurine, methotrexate, vincristine, thioguanine and / or tyrosine kinase inhibitors. Patients with severe allergies to InO components and excipients ( Grade ≥ 3 ). History of clinically significant liver disease, such as hepatic veno - occlusive disease ( VOD ) or sinusoidal obstruction syndrome ( SOS ) ; such as cirrhosis, decompensated liver disease, acute or chronic hepatitis. Active heart disease, defined as one or more of the following : with any history of heart or vascular disease ; have uncontrolled or symptomatic angina history ; myocardial infarction less than 6 months before enrollment ; a history of arrhythmia requiring drug treatment or severe clinical symptoms ; uncontrolled or symptomatic congestive heart failure ( > NYHA grade 2 ) ; ejection fraction is below the lower limit of the normal range. Cardiac ultrasound pulmonary artery systolic pressure > 50mmHg ; or pulmonary hypertension - related clinical symptoms. Severe cardiovascular disease, including myocardial infarction, unstable angina, severe arrhythmia, congestive heart failure, etc. during previous TKI treatment. A history of auto- or allo-HSCT. Dysfunction of blood coagulation. Positive serological response to known HIV or active hepatitis C virus. Patients with mental illness or other conditions that do not meet the requirements of research treatment and monitoring. Unable or unwilling to sign consent form. Pregnant or lactating women. Patients with other special conditions assessed as unqualified by the researchers.

Sites / Locations

  • Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment arm

Arm Description

patients enrolled treated with the combination of Olverembatinib and Inotuzumab to clear the persistent MRD.

Outcomes

Primary Outcome Measures

MRD clearance rate
The ratio of patients achieved MRD remission. The MRD remission was defined as the fusion gene BCR-ABL quantification in bone marrow samples was lower than the detection limit of RT-PCR ( < 0.01 %, the residual number of leukemia cells detected in our hospital was 0.0032 % ) ; at the same time, flow cytometry ( FACS ) was used to monitor the MRD of the cells, and the proportion of abnormal cells < 0.1 % was MRD-

Secondary Outcome Measures

One year OS after HSCT
For patients achived MRD remission, HSCT will be performed. The one year overall survival after HSCT will be the seconday outcom.
One year RFS after HSCT
For patients achived MRD remission, HSCT will be performed. The one year relaspe free survival after HSCT will be the seconday outcom.
One year NRM after HSCT
For patients achived MRD remission, HSCT will be performed. The one year non-relaspe mortality after HSCT will be the seconday outcom.

Full Information

First Posted
October 24, 2022
Last Updated
October 30, 2022
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05603156
Brief Title
A Study of Olverembatinib Combined With Inotuzumab Ozogamicin in the Treatment ph+ ALL With MRD Persistent Positive
Official Title
A Prospective, Single-arm, Multi-center Study of Olverembatinib Combined With Inotuzumab Ozogamicin in the Treatment ph+ ALL With MRD Persistent Positive
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 30, 2022 (Anticipated)
Primary Completion Date
July 31, 2024 (Anticipated)
Study Completion Date
July 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China

4. Oversight

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

5. Study Description

Brief Summary
Hematopoietic stem cell transplantation (HSCT) is the effective and even the only cure treatment option for ph+ acute lymphocyte leukemia (ph+ALL). However, the outcome has been insufficient and relapse remains the major cause of treatment failure and poor survival, especially for patients with persistent minimal residual disease (MRD). It is believed that clearance of MRD pre-HSCT could significantly reduce the incidence of relapse post-HSCT. Olverembatinib has been documented as a promising third generation of TKIs. Meanwhile, Inotuzumab ozogamicin (InO) , an antibody-drug conjugate approved in the US and the European Union, has been applied in relapsed/refractory acute lymphoblastic leukemia (R/R ALL) and achieved good treatment outcome. This prospective, single arm and multicenter study is to investigate the efficacy and safety of combination of Olverembatinib and Ino for MRD clearance before bridging to HSCT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ph+ ALL, Bone Marrow Transplant, Minimal Residual Disease
Keywords
ph+ALL, HSCT, MRD persistent positive, Inotuzumab, tyrosine kinase inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
46 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
treatment arm
Arm Type
Experimental
Arm Description
patients enrolled treated with the combination of Olverembatinib and Inotuzumab to clear the persistent MRD.
Intervention Type
Drug
Intervention Name(s)
the usage of Olverembatinib combined with Inotuzumab Ozogamicin
Intervention Description
patients in this arm will accept a 28 days treatment regimen: Olverembatinib 40mg QOD (d1 to d28 )and Inotuzumab Ozogamicin 1.2mg/m2 (divided into 2 days, d1 and d8, 0.6mg/m2, respectively).
Primary Outcome Measure Information:
Title
MRD clearance rate
Description
The ratio of patients achieved MRD remission. The MRD remission was defined as the fusion gene BCR-ABL quantification in bone marrow samples was lower than the detection limit of RT-PCR ( < 0.01 %, the residual number of leukemia cells detected in our hospital was 0.0032 % ) ; at the same time, flow cytometry ( FACS ) was used to monitor the MRD of the cells, and the proportion of abnormal cells < 0.1 % was MRD-
Time Frame
2 weeks after the treatment with Olverembatinib and Inotuzumab Ozogamicin
Secondary Outcome Measure Information:
Title
One year OS after HSCT
Description
For patients achived MRD remission, HSCT will be performed. The one year overall survival after HSCT will be the seconday outcom.
Time Frame
One year after HSCT
Title
One year RFS after HSCT
Description
For patients achived MRD remission, HSCT will be performed. The one year relaspe free survival after HSCT will be the seconday outcom.
Time Frame
One year after HSCT
Title
One year NRM after HSCT
Description
For patients achived MRD remission, HSCT will be performed. The one year non-relaspe mortality after HSCT will be the seconday outcom.
Time Frame
One year after HSCT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Acute lymphoblastic leukemia with positive Ph chromosome or BCR / ABL fusion gene ; cD22 expression on the surface of leukemia cells ; hematological complete remission but with MRD persistent positive ( BCR-ABL1 level ≥ 10-4 ), after at least 3 times of intensive chemotherapy, in which classical chemotherapy combined with any first or second generation of tyrosine kinase inhibitors targeting BCR-ABL1. Be ≥ 18 years of age on the day of enrollment. Understand the study procedures, alternative treatment available, and risks involved with the study, and voluntarily agree to participate by giving written informed consent. Necessary to meet the criteria of important organ function : renal function and liver function are as follows : AST, ALT and ALP below the normal 2 times the upper limit, total bilirubin below the normal upper limit 1.5 times ; creatinine clearance rate greater than 50ML / min ; pancreatic function : serum amylase is not higher than the normal upper limit 1.5 times, serum lipase is not higher than the normal upper limit 1.5 times ; normal heart function : ejection fraction ( EF ) > 60 %, pulmonary artery systolic pressure ≤ 50mmHg. Has documented nefative results for human immunodeficiency virus antibody (HIV-Ab), hepatitis C virus antibody (HCV-Ab) , as well as undetectable HCV RNA, or undetectable HBV DNA. ECOG-PS 0-2. Informed consent must be signed before the start of the trial. Informed consent must be signed by the patient himself or his direct family members who are 18 years old and above ; considering the patient 's condition, if the patient 's signature is not conducive to the treatment of the disease, the informed consent is signed by the legal guardian or the patient 's immediate family. Exclusion Criteria: Diagnosed as mixed lineage leukemia. Documented as CNS leukemia or extramedullary infiltration. Patients with other malignant tumors ; the patients were assessed as having comorbidities that seriously endanger the patient 's life or affect the patient 's completion of the study. Used to use the third generation of TKIs, including Olverembatinib. Patients received any other kind of anti-leukemia antibody therapy two weeks before enrollment. Patients received radiotherapy or chemotherapy (except induction chemotherapy ) or any other research treatment within two weeks before enrollment, with the following exceptions :Designed to reduce circulating leukemia lymphocytes count or remission : Steroids, hydroxyurea or vincristine;Maintenance therapy : thiopurine, methotrexate, vincristine, thioguanine and / or tyrosine kinase inhibitors. Patients with severe allergies to InO components and excipients ( Grade ≥ 3 ). History of clinically significant liver disease, such as hepatic veno - occlusive disease ( VOD ) or sinusoidal obstruction syndrome ( SOS ) ; such as cirrhosis, decompensated liver disease, acute or chronic hepatitis. Active heart disease, defined as one or more of the following : with any history of heart or vascular disease ; have uncontrolled or symptomatic angina history ; myocardial infarction less than 6 months before enrollment ; a history of arrhythmia requiring drug treatment or severe clinical symptoms ; uncontrolled or symptomatic congestive heart failure ( > NYHA grade 2 ) ; ejection fraction is below the lower limit of the normal range. Cardiac ultrasound pulmonary artery systolic pressure > 50mmHg ; or pulmonary hypertension - related clinical symptoms. Severe cardiovascular disease, including myocardial infarction, unstable angina, severe arrhythmia, congestive heart failure, etc. during previous TKI treatment. A history of auto- or allo-HSCT. Dysfunction of blood coagulation. Positive serological response to known HIV or active hepatitis C virus. Patients with mental illness or other conditions that do not meet the requirements of research treatment and monitoring. Unable or unwilling to sign consent form. Pregnant or lactating women. Patients with other special conditions assessed as unqualified by the researchers.
Facility Information:
Facility Name
Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300041
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of Olverembatinib Combined With Inotuzumab Ozogamicin in the Treatment ph+ ALL With MRD Persistent Positive

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