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Philadelphia Chromosome Positive CML Patients Without Optimal Response or Tolerance to Bcr-Abl TKI

Primary Purpose

Leukemia, Leukemia, Myeloid, Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Radotinib
Sponsored by
Il-Yang Pharm. Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring Radotinib, CML-CP, AP

Eligibility Criteria

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

Inclusion Criteria:

Phase I

  1. Age ≥ 18 years old
  2. Ph+ CML patients who are resistant at chronic, accelerate, and acute phase, or suboptimal responsive, or intolerant to imatinib or resistant or intolerant to at least one second-generation targeted anticancer agent while being resistant, suboptimal responsive, or intolerant to imatinib simultaneously.
  3. WHO Performance status of ≤2
  4. Patients must have the following laboratory values With normal liver and renal function
  5. Patients who have received interferon, other anti cancer drug or radiotherapy > 1 week prior to starting study drug.

Phase II

  1. Age ≥ 18 years old
  2. Ph+ CML patients in chronic or accelerated phase who are resistant or intolerant to Imatinib mesylate
  3. WHO Performance status of ≤2
  4. Patients must have the following laboratory values With normal liver and renal function
  5. Patients who have received interferon, other anti cancer drug or radiotherapy > 1 week prior to starting study drug.

Exclusion Criteria:

Phase I

  1. CNS infiltration
  2. Impaired cardiac function, including any one of the followings.

    • LVEF <45% as determined by MUGA scan or echocardiogram
    • Clinically significant resting bradycardia
  3. Severe GI disease that may cause drug absorption problem of study drug
  4. Use of therapeutic Warfarin
  5. Acute or chronic liver or renal disease
  6. Other concurrent severe and/or uncontrolled medical conditions
  7. Treatment with any hematopoietic colony-stimulating growth factors ≤1 week prior to starting study drug.
  8. Patients who are currently receiving treatment with medications have the potential to prolong the QT interval
  9. Patients who have received Imatinib, interferon, other anti cancer drug or chemotherapy ≤ 1 week
  10. Patients who have received Nilotinib and Dasatinib ≤4 weeks prior to starting study drug.
  11. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  12. Patients who are pregnant or breast-feeding or adults of reproductive potential not employing an effective method of birth control.
  13. Patients not to agree using birth control during the study and for up 3 months following study completion.

15. HIV infection

Phase II

  1. Blast phase CML
  2. CNS infiltration
  3. Impaired cardiac function, including any one of the following

    • LVEF< 45% as determined by MUGA scan or echocardiogram
    • Use of Cardiac pacemaker
    • ST depression > 1mm in 2 or more leads and/or T wave inversions in 2 or more contiguous leads
    • Congenital long QT syndrome
    • History of, or presence of significant ventricular or atrial tachyarrhythmias
    • Clinically significant resting bradycardia
    • QTcF> 480 msec on screening ECG
    • Right bundle branch block + left anterior hemiblock, Bifascicular block
    • Angina pectoris
  4. Severe GI disease that may cause drug absorption problem of study
  5. Use of therapeutic Warfarin
  6. Acute or chronic liver or renal disease
  7. Other concurrent severe and/or uncontrolled medical conditions
  8. Treatment with any hematopoietic colony-stimulating growth factors ≤1 week prior to starting study drug.
  9. Patients who are currently receiving treatment with medications have the potential to prolong the QT interval
  10. Patients who have received Imatinib, interferon, other anti cancer drug or chemotherapy ≤ 1 week
  11. Patients who have received wide field radiotherapy ≤4 weeks prior to starting study drug.
  12. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  13. Patients who are pregnant or breast-feeding or adults of reproductive potential not employing an effective method of birth control

Sites / Locations

  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Local institution
  • Seoul St. Mary's hospital
  • Local institution
  • Local institution

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Radotinib

Arm Description

Phase 1 : 200mg/kg or 1200mg/m^2 Phase 2 : 400mg Bid

Outcomes

Primary Outcome Measures

To investigate the Maximum Tolerated Dose(Phase 1)
Radotinib will be given orally twice daily. Dose will be increased until it reaches MTD or the blood concentration of Radotinib stops rising
Rate of Complete hematologic response(CHR)(Phase 2)
Main parameters for response assessment in the chronic and accelerated phases include Major Hematologic Responses (MR; No Evidence of Leukemia or NEL + Complete Hematologic Response or CHR) lasting for 4 weeks and at least one major cytogenetic response (MCyR)

Secondary Outcome Measures

To investigate the Dose Limiting Toxicity(Phase 1)
The initial cohort will include 3 subjects who will receive 100mg Radotinib daily. If DLT is observed in one of the 3 subjects, the same dose will be given to 3 more subjects to evaluate safety.
Rate of complete Cytogenetic Response(CCyR)(Phase 2)
Cytogenetic response rate will be calculated as the percentage of Ph+ bone marrow metaphases as follows at least 20 bone marrow metaphases should be analyzed.
Adverse events(Phase 1& Phase 2)
All adverse events recorded during the study will be itemized and summarized. Severity, relation to the study medication, and seriousness will be summarized for each adverse event.
Progression-free survival or PFS
It is defined as the duration from the first day of administration to the earliest day of disease progression or death for certain causes. In subjects who have shown response, disease progression is defined as loss of MCyR.

Full Information

First Posted
April 20, 2012
Last Updated
August 27, 2018
Sponsor
Il-Yang Pharm. Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01602952
Brief Title
Philadelphia Chromosome Positive CML Patients Without Optimal Response or Tolerance to Bcr-Abl TKI
Official Title
A Phase I/II Multicenter Study of IY5511HCl in Philadelphia Chromosome Positive Chronic Myeloid Leukemia Patients Without Optimal Response or Tolerance to Bcr-Abl Tyrosine Kinase Inhibitors (Imatinib and/ or Dasatinib, Nilotinib)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
October 2012 (Actual)
Study Completion Date
July 13, 2018 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Phase I/II multicenter study of IY5511HCl in Philadelphia chromosome positive chronic myeloid leukemia patients without optimal response or tolerance to Bcr-Abl tyrosine kinase inhibitors (Imatinib and/ or Dasatinib, Nilotinib) In this study, The efficacy and safety of CML patients who are resistant or intolerable to imatinib in the Chronic and Accelerated phases. Phase 1 1. To investigate the Maximum Tolerated Dose (MTD) and the Dose Limiting Toxicity (DLT) of oral Radotinib HCl bid (twice daily) in the Philadelphia chromosome-positive CML subjects who are resistant, suboptimal responsive, or intolerant to imatinib OR resistant or intolerant to at least one second-generation targeted anticancer agent while being resistant, suboptimal responsive, or intolerant to imatinib simultaneously. Phase 2 To investigate safety of oral Radotinib HCl in CML patients who are resistant or intolerable to imatinib in the chronic and accelerated phases. To evaluate hematologic and cytogenetic efficacy of oral Radotinib HCl in CML patients who are resistant or intolerable to imatinib in the chronic and accelerated phases.
Detailed Description
This study is a multi-center, open-label, Phase 1/2 clinical trial of Radotinib HCl, a targeted anticancer agent that inhibits the Bcr-Abl oncoprotein. It is aimed at determining the optimal therapeutic dose and confirming safety and efficacy of Radotinib HCl. Phase 1 study began at St. Mary's hospital in Korea and Phase 2 study is ongoing at 9 Korean sites and about 7 sites in China, India and Thailand will take part in Phase 2. After determination of a safe and proper therapeutic dose in Phase 1, Phase 2 began continuously to evaluate efficacy in chronic and accelerated phases. Before the start of the Phase 2 trial, interim or final reports for the Phase 1 trial were reviewed by the Korean Food and Drug Administration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Leukemia, Myeloid, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Philadelphia Chromosome, Hematologic Diseases
Keywords
Radotinib, CML-CP, AP

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
85 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Radotinib
Arm Type
Experimental
Arm Description
Phase 1 : 200mg/kg or 1200mg/m^2 Phase 2 : 400mg Bid
Intervention Type
Drug
Intervention Name(s)
Radotinib
Other Intervention Name(s)
IY5511HCl
Intervention Description
50mg, 100mg or 200mg Capsule BID
Primary Outcome Measure Information:
Title
To investigate the Maximum Tolerated Dose(Phase 1)
Description
Radotinib will be given orally twice daily. Dose will be increased until it reaches MTD or the blood concentration of Radotinib stops rising
Time Frame
12 month
Title
Rate of Complete hematologic response(CHR)(Phase 2)
Description
Main parameters for response assessment in the chronic and accelerated phases include Major Hematologic Responses (MR; No Evidence of Leukemia or NEL + Complete Hematologic Response or CHR) lasting for 4 weeks and at least one major cytogenetic response (MCyR)
Time Frame
12 months
Secondary Outcome Measure Information:
Title
To investigate the Dose Limiting Toxicity(Phase 1)
Description
The initial cohort will include 3 subjects who will receive 100mg Radotinib daily. If DLT is observed in one of the 3 subjects, the same dose will be given to 3 more subjects to evaluate safety.
Time Frame
12 months
Title
Rate of complete Cytogenetic Response(CCyR)(Phase 2)
Description
Cytogenetic response rate will be calculated as the percentage of Ph+ bone marrow metaphases as follows at least 20 bone marrow metaphases should be analyzed.
Time Frame
12 months
Title
Adverse events(Phase 1& Phase 2)
Description
All adverse events recorded during the study will be itemized and summarized. Severity, relation to the study medication, and seriousness will be summarized for each adverse event.
Time Frame
12 months
Title
Progression-free survival or PFS
Description
It is defined as the duration from the first day of administration to the earliest day of disease progression or death for certain causes. In subjects who have shown response, disease progression is defined as loss of MCyR.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Phase I Age ≥ 18 years old Ph+ CML patients who are resistant at chronic, accelerate, and acute phase, or suboptimal responsive, or intolerant to imatinib or resistant or intolerant to at least one second-generation targeted anticancer agent while being resistant, suboptimal responsive, or intolerant to imatinib simultaneously. WHO Performance status of ≤2 Patients must have the following laboratory values With normal liver and renal function Patients who have received interferon, other anti cancer drug or radiotherapy > 1 week prior to starting study drug. Phase II Age ≥ 18 years old Ph+ CML patients in chronic or accelerated phase who are resistant or intolerant to Imatinib mesylate WHO Performance status of ≤2 Patients must have the following laboratory values With normal liver and renal function Patients who have received interferon, other anti cancer drug or radiotherapy > 1 week prior to starting study drug. Exclusion Criteria: Phase I CNS infiltration Impaired cardiac function, including any one of the followings. LVEF <45% as determined by MUGA scan or echocardiogram Clinically significant resting bradycardia Severe GI disease that may cause drug absorption problem of study drug Use of therapeutic Warfarin Acute or chronic liver or renal disease Other concurrent severe and/or uncontrolled medical conditions Treatment with any hematopoietic colony-stimulating growth factors ≤1 week prior to starting study drug. Patients who are currently receiving treatment with medications have the potential to prolong the QT interval Patients who have received Imatinib, interferon, other anti cancer drug or chemotherapy ≤ 1 week Patients who have received Nilotinib and Dasatinib ≤4 weeks prior to starting study drug. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy Patients who are pregnant or breast-feeding or adults of reproductive potential not employing an effective method of birth control. Patients not to agree using birth control during the study and for up 3 months following study completion. 15. HIV infection Phase II Blast phase CML CNS infiltration Impaired cardiac function, including any one of the following LVEF< 45% as determined by MUGA scan or echocardiogram Use of Cardiac pacemaker ST depression > 1mm in 2 or more leads and/or T wave inversions in 2 or more contiguous leads Congenital long QT syndrome History of, or presence of significant ventricular or atrial tachyarrhythmias Clinically significant resting bradycardia QTcF> 480 msec on screening ECG Right bundle branch block + left anterior hemiblock, Bifascicular block Angina pectoris Severe GI disease that may cause drug absorption problem of study Use of therapeutic Warfarin Acute or chronic liver or renal disease Other concurrent severe and/or uncontrolled medical conditions Treatment with any hematopoietic colony-stimulating growth factors ≤1 week prior to starting study drug. Patients who are currently receiving treatment with medications have the potential to prolong the QT interval Patients who have received Imatinib, interferon, other anti cancer drug or chemotherapy ≤ 1 week Patients who have received wide field radiotherapy ≤4 weeks prior to starting study drug. Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy Patients who are pregnant or breast-feeding or adults of reproductive potential not employing an effective method of birth control
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
IL-yang Pharm
Organizational Affiliation
IL-YANG Pharmaceutical.Co.,Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Local institution
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
741-234
Country
India
Facility Name
Local institution
City
Mumbai
State/Province
Mazagaon
ZIP/Postal Code
512-364
Country
India
Facility Name
Local institution
City
Daegu
State/Province
Buk-gu
ZIP/Postal Code
511-230
Country
Korea, Republic of
Facility Name
Local institution
City
Jeonju
State/Province
Deokjin-gu
ZIP/Postal Code
212-789
Country
Korea, Republic of
Facility Name
Local institution
City
Ulsan
State/Province
Dong-gu
ZIP/Postal Code
411-978
Country
Korea, Republic of
Facility Name
Local institution
City
Anyang-si
State/Province
Dongan-gu
ZIP/Postal Code
751-231
Country
Korea, Republic of
Facility Name
Local institution
City
Hwasun
State/Province
Hwasun-eup
ZIP/Postal Code
322-511
Country
Korea, Republic of
Facility Name
Local institution
City
Seoul
State/Province
Jongro-ku
ZIP/Postal Code
231-855
Country
Korea, Republic of
Facility Name
Local institution
City
Busan
State/Province
Seo-gu
ZIP/Postal Code
400-321
Country
Korea, Republic of
Facility Name
Seoul St. Mary's hospital
City
Seoul
State/Province
Seocho-gu
Country
Korea, Republic of
Facility Name
Local institution
City
Suwon
State/Province
Yeongtong-gu
ZIP/Postal Code
781-512
Country
Korea, Republic of
Facility Name
Local institution
City
Bangkok
State/Province
Phyathai
ZIP/Postal Code
215-714
Country
Thailand

12. IPD Sharing Statement

Citations:
PubMed Identifier
24705186
Citation
Kim SH, Menon H, Jootar S, Saikia T, Kwak JY, Sohn SK, Park JS, Jeong SH, Kim HJ, Kim YK, Oh SJ, Kim H, Zang DY, Chung JS, Shin HJ, Do YR, Kim JA, Kim DY, Choi CW, Park S, Park HL, Lee GY, Cho DJ, Shin JS, Kim DW. Efficacy and safety of radotinib in chronic phase chronic myeloid leukemia patients with resistance or intolerance to BCR-ABL1 tyrosine kinase inhibitors. Haematologica. 2014 Jul;99(7):1191-6. doi: 10.3324/haematol.2013.096776. Epub 2014 Apr 4.
Results Reference
derived

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Philadelphia Chromosome Positive CML Patients Without Optimal Response or Tolerance to Bcr-Abl TKI

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