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Comparing Imatinib Standard Dose With Imatinib High Dose Induction in Pretreated Chronic Myeloid Leukemia (CML) Patients in Chronic Phase

Primary Purpose

Chronic Myeloid Leukemia

Status
Unknown status
Phase
Phase 3
Locations
Austria
Study Type
Interventional
Intervention
Imatinib
Sponsored by
Central European Leukemia Study Group
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Myeloid Leukemia focused on measuring chronic myeloid leukemia, Ph+, bcr/abl+, imatinib

Eligibility Criteria

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

Inclusion Criteria: Patients > 18 years of age BCR-ABL positive CML patients in chronic phase, confirmed by karyotype (Ph+) or RT-PCR. Patients pretreated with any drug that is known to control the disease of CML in chronic phase except imatinib (Glivec®). Patients without a major cytogenetic response at study entry (> 35% Ph+ metaphases in bone marrow cytogenetic analysis performed < 3 months before study entry). Patients either intolerant to interferon-alpha (non-hematologic toxicity grade 3-4 for more than 2 weeks) or having received pretreatment for CML at least 12 months before study entry. World Health Organization (WHO) status 0-2 Adequate end organ function, defined as the following: total bilirubin < 1.5 x upper limit of normal (ULN) SGOT and SGPT < 2.5 x ULN creatinine < 1.5 x ULN absolute neutrophil count (ANC) > 1.5 x 10 ^ 9/L platelets > 100 x 10 ^ 9/L Female patients of childbearing potential must have negative pregnancy test within 7 days before initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of study drug. Written voluntary informed consent. Exclusion Criteria: Patients eligible for allogeneic bone marrow transplantation. Patients in accelerated phase or blast crisis. Known tuberculosis or other uncontrolled infection. Other primary tumor of a different histological origin than the study indication (unless the relapse-free interval is > 5 years, and with the exception of cervical carcinoma in situ [CIS], basal cell epithelioma, or squamous cell carcinoma of the skin). Major surgery within the last 14 days. Known to be HIV positive. Unstable medical disorder (except for indication) that excludes the patient in the opinion of the investigator. Patient has received any other investigational agents within 28 days of first day of study drug dosing. Patients with a WHO performance status score > 3 Patients with Grade III/IV cardiac problems as defined by the New York Heart Association criteria (i.e., congestive heart failure, myocardial infarction within 6 months of study). Female patients who are pregnant or breast-feeding. Refusal by female patients of childbearing age to use a safe contraceptive. Patients with known chronic liver disease (i.e., chronic active hepatitis, and cirrhosis). Patients with any significant history of non-compliance to medical regimens or an inability to grant reliable informed consent.

Sites / Locations

  • Medical University InnsbruckRecruiting

Outcomes

Primary Outcome Measures

To determine the efficacy regarding major cytogenetic response within 12 months after randomization

Secondary Outcome Measures

To determine the major cytogenetic response after 3 months versus 6-12 months after randomization
To determine the efficacy of the molecular response within 12 and 24 months after randomization
To determine the time to molecular progression within 24 months
To determine the dynamics of the molecular response within 3 and 6 months after randomization expressed as the slope decreases in BCR-ABL-transcripts
To determine tolerability

Full Information

First Posted
May 16, 2006
Last Updated
June 16, 2006
Sponsor
Central European Leukemia Study Group
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1. Study Identification

Unique Protocol Identification Number
NCT00327262
Brief Title
Comparing Imatinib Standard Dose With Imatinib High Dose Induction in Pretreated Chronic Myeloid Leukemia (CML) Patients in Chronic Phase
Official Title
Multicenter, Phase III Study Comparing Imatinib (STI571, Glivec®) Standard Dose (400 Mg/Day) With Imatinib High Dose Induction (800 Mg/Day) Followed by Standard Dose Maintenance (400 Mg/Day) in Pretreated CML Patients in Chronic Phase
Study Type
Interventional

2. Study Status

Record Verification Date
September 2005
Overall Recruitment Status
Unknown status
Study Start Date
January 2004 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
December 2008 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Central European Leukemia Study Group

4. Oversight

5. Study Description

Brief Summary
This study will investigate the efficacy and tolerability of a short (6 months) high dose therapy followed by a standard dose compared to a continuous treatment with a standard dose of imatinib (Glivec®) in pretreated Philadelphia chromosome- positive (Ph+)/BCR-ABL+ CML patients in chronic phase.
Detailed Description
Patients with CML not achieving or losing a major cytogenetic response on whatever palliative treatment for CML, are at high risk to progress to accelerated phase and blast crisis. A new promising treatment with Imatinib (Glivec®), a tyrosine-kinase inhibitor, has been introduced recently. High rates of hematologic and cytogenetic responses can be achieved with Imatinib (Glivec®) at > = 300 mg/day in chronic phase CML patients that are refractory, resistant or intolerant to interferon-alpha. However, about 10 - 20% of these high risk patients will lose their response to Imatinib (Glivec®) within 1-2 years. Therefore, improvement of the treatment is warranted. Since cytogenetic response rate is correlated to survival and the resistance to Imatinib (Glivec®) might be caused by mutations in the receptor, a more rapid decrease could lead to longer survival and/or less resistance development. In the initial 6 months of treatment, monotherapy with Imatinib (Glivec®) with a dose of 800 mg/day (high dose) should be more effective in the reduction of a high leukemic tumor burden, thereby allowing the residual normal progenitor and stem cells to expand. In addition, high dose Imatinib (Glivec®) should further improve the induction of a molecular response, as determined by quantitative reverse transcription polymerase chain reaction (RT-PCR), reducing the risk of relapse from residual malignant BCR-ABL positive cells. This study will investigate the efficacy and tolerability of a short (6 months) high dose therapy followed by a standard dose compared to a continuous treatment with a standard dose of Imatinib (Glivec®). In addition, the dynamics of the molecular and cytogenetic response will be investigated. Finally, the study will investigate the effect of this induction-maintenance concept on time-to-progression (TTP).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Myeloid Leukemia
Keywords
chronic myeloid leukemia, Ph+, bcr/abl+, imatinib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
240 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Imatinib
Primary Outcome Measure Information:
Title
To determine the efficacy regarding major cytogenetic response within 12 months after randomization
Secondary Outcome Measure Information:
Title
To determine the major cytogenetic response after 3 months versus 6-12 months after randomization
Title
To determine the efficacy of the molecular response within 12 and 24 months after randomization
Title
To determine the time to molecular progression within 24 months
Title
To determine the dynamics of the molecular response within 3 and 6 months after randomization expressed as the slope decreases in BCR-ABL-transcripts
Title
To determine tolerability

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients > 18 years of age BCR-ABL positive CML patients in chronic phase, confirmed by karyotype (Ph+) or RT-PCR. Patients pretreated with any drug that is known to control the disease of CML in chronic phase except imatinib (Glivec®). Patients without a major cytogenetic response at study entry (> 35% Ph+ metaphases in bone marrow cytogenetic analysis performed < 3 months before study entry). Patients either intolerant to interferon-alpha (non-hematologic toxicity grade 3-4 for more than 2 weeks) or having received pretreatment for CML at least 12 months before study entry. World Health Organization (WHO) status 0-2 Adequate end organ function, defined as the following: total bilirubin < 1.5 x upper limit of normal (ULN) SGOT and SGPT < 2.5 x ULN creatinine < 1.5 x ULN absolute neutrophil count (ANC) > 1.5 x 10 ^ 9/L platelets > 100 x 10 ^ 9/L Female patients of childbearing potential must have negative pregnancy test within 7 days before initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of study drug. Written voluntary informed consent. Exclusion Criteria: Patients eligible for allogeneic bone marrow transplantation. Patients in accelerated phase or blast crisis. Known tuberculosis or other uncontrolled infection. Other primary tumor of a different histological origin than the study indication (unless the relapse-free interval is > 5 years, and with the exception of cervical carcinoma in situ [CIS], basal cell epithelioma, or squamous cell carcinoma of the skin). Major surgery within the last 14 days. Known to be HIV positive. Unstable medical disorder (except for indication) that excludes the patient in the opinion of the investigator. Patient has received any other investigational agents within 28 days of first day of study drug dosing. Patients with a WHO performance status score > 3 Patients with Grade III/IV cardiac problems as defined by the New York Heart Association criteria (i.e., congestive heart failure, myocardial infarction within 6 months of study). Female patients who are pregnant or breast-feeding. Refusal by female patients of childbearing age to use a safe contraceptive. Patients with known chronic liver disease (i.e., chronic active hepatitis, and cirrhosis). Patients with any significant history of non-compliance to medical regimens or an inability to grant reliable informed consent.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Guenther Gastl, MD
Phone
++43 512 504 24003
Email
guenther.gastl@uibk.ac.at
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guenther Gastl, MD
Organizational Affiliation
Medical University Innsbruck
Official's Role
Study Chair
Facility Information:
Facility Name
Medical University Innsbruck
City
Innsbruck
State/Province
Tyrol
ZIP/Postal Code
6020
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guenther Gastl, MD
First Name & Middle Initial & Last Name & Degree
Dominic Fong, MD
First Name & Middle Initial & Last Name & Degree
Guenther Gastl, MD

12. IPD Sharing Statement

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Comparing Imatinib Standard Dose With Imatinib High Dose Induction in Pretreated Chronic Myeloid Leukemia (CML) Patients in Chronic Phase

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