Safety and Efficacy of Imatinib Versus Interferon-α Plus Cytarabine in Patients With Newly Diagnosed Philadelphia Chromosome Positive Chronic Myelogenous Leukemia

August 7, 2013 updated by: Novartis Pharmaceuticals

A Phase III Study of STI571 Versus Interferon-α (IFN-α) Combined With Cytarabine (Ara-C) in Patients With Newly Diagnosed Previously Untreated Philadelphia Chromosome Positive (Ph+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)

The purpose of this study is to evaluate and compare the side effects and anti-leukemic benefits of imatinib with those of interferon and Ara-C for patients who have chronic myeloid leukemia (CML) in the chronic phase. Patients in this study will be randomized (1:1) to receive either interferon plus Ara-C or imatinib as initial treatment.

Study Overview

Study Type

Interventional

Enrollment (Actual)

1106

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Adelaide, Australia
        • Novartis Investigative Site
      • Brisbane, Australia
        • Novartis Investigative Site
      • Darlinghurst, Australia
        • Novartis Investigative Site
      • East Melbourne, Australia
        • Novartis Investigative Site
      • Nedlands, Australia
        • Novartis Investigative Site
      • Parkville, Australia
        • Novartis Investigative Site
      • Prahan, Australia
        • Novartis Investigative Site
      • South Brisbane, Australia
        • Novartis Investigative Site
      • St. Leonards, Australia
        • Novartis Investigative Site
      • Sydney, Australia, 2050
        • Novartis Investigative Site
      • Westmead, Australia
        • Novartis Investigative Site
      • Wien, Austria, 1090
        • Novartis Investigative Site
      • Bruxelles, Belgium, 1200
        • Novartis Investigative Site
      • Bruxelles, Belgium, 1000
        • Novartis Investigative Site
      • Godinne, Belgium
        • Novartis Investigative Site
      • Leuven, Belgium, 3000
        • Novartis Investigative Site
    • Alberta
      • Calgary, Alberta, Canada, T2N 4N2
        • Novartis Investigative Site
      • Edmonton, Alberta, Canada, T6G 1Z2
        • Novartis Investigative Site
    • British Columbia
      • Vancouver, British Columbia, Canada, V5Z 1M9
        • Novartis Investigative Site
    • Manitoba
      • Winnipeg, Manitoba, Canada, R3E 0V9
        • Novartis Investigative Site
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H 2Y9
        • Novartis Investigative Site
    • Ontario
      • Hamilton, Ontario, Canada, L8N 3Z5
        • Novartis Investigative Site
      • London, Ontario, Canada, N6A 4G5
        • Novartis Investigative Site
      • Ottawa, Ontario, Canada, K1H 8L6
        • Novartis Investigative Site
      • Toronto, Ontario, Canada, M5G 2M9
        • Novartis Investigative Site
    • Quebec
      • Montreal, Quebec, Canada, H1T 2M4
        • Novartis Investigative Site
      • Montreal, Quebec, Canada, H3A 1A1
        • Novartis Investigative Site
      • Arhus, Denmark, 8000
        • Novartis Investigative Site
      • Copenhagen, Denmark
        • Novartis Investigative Site
      • Herlev, Denmark, 2730
        • Novartis Investigative Site
      • Creteil, France, 94010
        • Novartis Investigative Site
      • Lille, France, 59037
        • Novartis Investigative Site
      • Lyon, France, 69437
        • Novartis Investigative Site
      • Marseille, France, 13273
        • Novartis Investigative Site
      • Nantes, France, 44035
        • Novartis Investigative Site
      • Paris, France, 75475
        • Novartis Investigative Site
      • Pessac, France, 33604
        • Novartis Investigative Site
      • Poitiers, France
        • Novartis Investigative Site
      • Strasbourg, France, 67098
        • Novartis Investigative Site
      • Vandoeuvre-les-Nancy, France, 54511
        • Novartis Investigative Site
      • Berlin, Germany, 13353
        • Novartis Investigative Site
      • Dresden, Germany, 01307
        • Novartis Investigative Site
      • Dusseldorf, Germany, 40225
        • Novartis Investigative Site
      • Frankfurt, Germany, 60590
        • Novartis Investigative Site
      • Freiburg, Germany, 79106
        • Novartis Investigative Site
      • Hamburg, Germany, 20246
        • Novartis Investigative Site
      • Heidelberg, Germany, 69115
        • Novartis Investigative Site
      • Leipzig, Germany, 04103
        • Novartis Investigative Site
      • Mainz, Germany, 55101
        • Novartis Investigative Site
      • Mannheim, Germany, 68189
        • Novartis Investigative Site
      • Marburg, Germany, 35037
        • Novartis Investigative Site
      • Muenchen, Germany, 80804
        • Novartis Investigative Site
      • Munchen, Germany, 81675
        • Novartis Investigative Site
      • Regensburg, Germany, 93042
        • Novartis Investigative Site
      • Rostock, Germany, 18057
        • Novartis Investigative Site
      • Stuttgart, Germany, 70376
        • Novartis Investigative Site
      • Bari, Italy, 70124
        • Novartis Investigative Site
      • Bologna, Italy, 40138
        • Novartis Investigative Site
      • Firenze, Italy, 50134
        • Novartis Investigative Site
      • Genova, Italy, 16132
        • Novartis Investigative Site
      • Milano, Italy, 20162
        • Novartis Investigative Site
      • Napoli, Italy, 80131
        • Novartis Investigative Site
      • Orbassano, Italy, 10043
        • Novartis Investigative Site
      • Pavia, Italy, 27100
        • Novartis Investigative Site
      • Pescara, Italy, 65124
        • Novartis Investigative Site
      • Pisa, Italy, 56126
        • Novartis Investigative Site
      • Reggio Calabria, Italy, 89123
        • Novartis Investigative Site
      • Amsterdam, Netherlands, 1081HV
        • Novartis Investigative Site
      • Rotterdam, Netherlands
        • Novartis Investigative Site
      • Auckland, New Zealand
        • Novartis Investigative Site
      • Oslo, Norway, 27
        • Novartis Investigative Site
      • Tromso, Norway, 9038
        • Novartis Investigative Site
      • Barcelona, Spain, 8025
        • Novartis Investigative Site
      • Barcelona, Spain, 8036
        • Novartis Investigative Site
      • Barcelona, Spain, 8907
        • Novartis Investigative Site
      • Madrid, Spain, 28034
        • Novartis Investigative Site
      • Madrid, Spain, 28222
        • Novartis Investigative Site
      • Madrid, Spain, 46010
        • Novartis Investigative Site
      • Salamanca, Spain, 37007
        • Novartis Investigative Site
      • Valencia, Spain, 46010
        • Novartis Investigative Site
      • Goteborg, Sweden, 143 45
        • Novartis Investigative Site
      • Linkoping, Sweden, 581 85
        • Novartis Investigative Site
      • Lund, Sweden, 221 85
        • Novartis Investigative Site
      • Orebro, Sweden, 70 185
        • Novartis Investigative Site
      • Stockholm, Sweden, 141 86
        • Novartis Investigative Site
      • Stockholm, Sweden, 171 76
        • Novartis Investigative Site
      • Umea, Sweden, 901 85
        • Novartis Investigative Site
      • Uppsala, Sweden, 751 85
        • Novartis Investigative Site
      • Basel, Switzerland, 4031
        • Novartis Investigative Site
      • Bern, Switzerland, 3010
        • Novartis Investigative Site
      • St. Gallen, Switzerland, 9007
        • Novartis Investigative Site
      • Birmingham, United Kingdom, B9 5SS
        • Novartis Investigative Site
      • Cambridge, United Kingdom, CB2 2XY
        • Novartis Investigative Site
      • Cardiff, United Kingdom, CF14 4XN
        • Novartis Investigative Site
      • Leeds, United Kingdom, LS1 3EX
        • Novartis Investigative Site
      • Liverpool, United Kingdom, L7 8XP
        • Novartis Investigative Site
      • London, United Kingdom, EC1A 7BE
        • Novartis Investigative Site
      • London, United Kingdom, SE5 9RS
        • Novartis Investigative Site
      • Manchester, United Kingdom, M13 9WL
        • Novartis Investigative Site
      • Nottingham, United Kingdom, NG5 1PB
        • Novartis Investigative Site
      • Plymouth, United Kingdom
        • Novartis Investigative Site
    • Alabama
      • Birmingham, Alabama, United States, 35294
        • Novartis Investigative Site
      • Montgomery, Alabama, United States, 36106
        • Novartis Investigative Site
    • Arizona
      • Tucson, Arizona, United States, 85724
        • Novartis Investigative Site
    • California
      • Berkeley, California, United States, 94704
        • Novartis Investigative Site
      • Campbell, California, United States, 95008
        • Novartis Investigative Site
      • Duarte, California, United States, 91010
        • Novartis Investigative Site
      • La Jolla, California, United States, 92093-0960
        • Novartis Investigative Site
    • Colorado
      • Denver, Colorado, United States, 80218
        • Novartis Investigative Site
    • Florida
      • Miami, Florida, United States, 33176-2197
        • Novartis Investigative Site
      • Orlando, Florida, United States, 32804
        • Novartis Investigative Site
    • Georgia
      • Atlanta, Georgia, United States, 30342
        • Novartis Investigative Site
    • Hawaii
      • Honolulu, Hawaii, United States, 96813
        • Novartis Investigative Site
    • Illinois
      • Chicago, Illinois, United States, 60612
        • Novartis Investigative Site
      • Chicago, Illinois, United States, 60611
        • Novartis Investigative Site
      • Chicago, Illinois, United States, 60637
        • Novartis Investigative Site
      • Decatur, Illinois, United States, 62526
        • Novartis Investigative Site
    • Indiana
      • Beech Grove, Indiana, United States, 46107
        • Novartis Investigative Site
    • Kansas
      • Witchita, Kansas, United States, 67214
        • Novartis Investigative Site
    • Kentucky
      • Louisville, Kentucky, United States, 40202
        • Novartis Investigative Site
    • Louisiana
      • New Orleans, Louisiana, United States, 70112
        • Novartis Investigative Site
    • Maryland
      • Baltimore, Maryland, United States, 21201
        • Novartis Investigative Site
    • Massachusetts
      • Boston, Massachusetts, United States, 02115
        • Novartis Investigative Site
      • Worcester, Massachusetts, United States, 01665
        • Novartis Investigative Site
    • Michigan
      • Ann Arbor, Michigan, United States, 48109
        • Novartis Investigative Site
      • Detroit, Michigan, United States, 48202-2689
        • Novartis Investigative Site
      • East Lansing, Michigan, United States, 48910
        • Novartis Investigative Site
    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • Novartis Investigative Site
    • Missouri
      • St. Louis, Missouri, United States, 63110
        • Novartis Investigative Site
    • Montana
      • Billings, Montana, United States, 59101
        • Novartis Investigative Site
    • Nebraska
      • Omaha, Nebraska, United States, 68198-7681
        • Novartis Investigative Site
    • New Jersey
      • Hackensack, New Jersey, United States, 07601
        • Novartis Investigative Site
    • New Mexico
      • Alburquerque, New Mexico, United States, 87109
        • Novartis Investigative Site
      • Alburquerque, New Mexico, United States, 87131
        • Novartis Investigative Site
      • Farmington, New Mexico, United States, 87131
        • Novartis Investigative Site
    • New York
      • Buffalo, New York, United States, 14263
        • Novartis Investigative Site
      • New York, New York, United States, 10029
        • Novartis Investigative Site
      • New York, New York, United States, 10021
        • Novartis Investigative Site
      • New York, New York, United States, 10017
        • Novartis Investigative Site
      • Syracuse, New York, United States, 13210
        • Novartis Investigative Site
    • North Carolina
      • Chapel Hill, North Carolina, United States, 27599
        • Novartis Investigative Site
      • Charlotte, North Carolina, United States, 28203
        • Novartis Investigative Site
      • Durham, North Carolina, United States, 27710
        • Novartis Investigative Site
      • Winston-Salem, North Carolina, United States, 27157
        • Novartis Investigative Site
    • Ohio
      • Cleveland, Ohio, United States, 44195
        • Novartis Investigative Site
      • Columbus, Ohio, United States, 43210
        • Novartis Investigative Site
      • Columbus, Ohio, United States, 43215
        • Novartis Investigative Site
      • Dayton, Ohio, United States, 45429
        • Novartis Investigative Site
    • Oklahoma
      • Tulsa, Oklahoma, United States, 74136
        • Novartis Investigative Site
    • Oregon
      • Portland, Oregon, United States, 97239
        • Novartis Investigative Site
    • Pennsylvania
      • Pittsburg, Pennsylvania, United States, 15224
        • Novartis Investigative Site
      • Pittsburg, Pennsylvania, United States, 15232
        • Novartis Investigative Site
    • Rhode Island
      • Providence, Rhode Island, United States, 02903
        • Novartis Investigative Site
    • South Carolina
      • Spartanburg, South Carolina, United States, 29303
        • Novartis Investigative Site
    • Tennessee
      • Memphis, Tennessee, United States, 38119
        • Novartis Investigative Site
      • Nashville, Tennessee, United States, 37203
        • Novartis Investigative Site
      • Nashville, Tennessee, United States, 37205
        • Novartis Investigative Site
    • Texas
      • Dallas, Texas, United States, 75246
        • Novartis Investigative Site
      • Dallas, Texas, United States, 75235-9179
        • Novartis Investigative Site
      • Houston, Texas, United States, 77030
        • Novartis Investigative Site
    • Utah
      • Salt Lake City, Utah, United States, 84112
        • Novartis Investigative Site
    • Washington
      • Seattle, Washington, United States, 98109-1024
        • Novartis Investigative Site
    • Wisconsin
      • Milwaukee, Wisconsin, United States, 53215
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion criteria:

  • Must have signed consent for Amendment 5
  • Must have completed visit 62 of the core IRIS trial or be in follow-up
  • Must be on STI571 treatment
  • If on IFN treatment, must be willing to cross over to STI571 treatment

Exclusion criteria:

  • Patients who have discontinued from the study and are in follow-up
  • Patients who are on IFN treatment and do not want to cross over to STI571 treatment
  • Patients who have not consented to amendment 5
  • Patients who did not complete the amendment 5 protocol

Additional protocol-defined inclusion/exclusion criteria may apply

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: imatinib (STI571)
In the first-line treatment period participants received imatinib 400 mg orally once daily in the morning. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10^9/liter. If protocol specific criteria applied, participants were eligible to crossover to receive interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m^2/day. After the maximum tolerated dose of IFN-a was achieved, participants also received cytarabine (ARA-C) 20 mg/m^2/day (max 40 mg) SC injection for 10 days every month. Maximum study duration was 11.5 years.
imatinib supplied as 100 mg and 400 mg tablets or 100 mg capsules.
Other Names:
  • Glivec®
  • STI571
  • Gleevec®
interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m^2/day.
Other Names:
  • Roferon®-A
  • Intron®-A
cytarabine 20 mg/m^2/day (max 40 mg) SC for 10 days every month.
Active Comparator: IFN-a+Ara-C
In the first-line treatment period participants received interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m^2/day. After the maximum tolerated dose of IFN-a was achieved, participants also received cytarabine (ARA-C) 20 mg/m^2/day (max 40 mg) SC injections for 10 days every month. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10^9/liter. If protocol specific criteria applied, participants were eligible to crossover to the second-line treatment period to receive imatinib (STI571). IFN treatment was discontinued with protocol amendment 6. Maximum study duration was 8 years.
imatinib supplied as 100 mg and 400 mg tablets or 100 mg capsules.
Other Names:
  • Glivec®
  • STI571
  • Gleevec®
interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m^2/day.
Other Names:
  • Roferon®-A
  • Intron®-A
cytarabine 20 mg/m^2/day (max 40 mg) SC for 10 days every month.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)
Time Frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Overall survival was defined as the time between date of randomization and death due to any cause. The time was censored at last examination date for patients who were still being treated and at date of last contact for patients who discontinued treatment. Kaplan-Meier estimates of the percentage of participants at each time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
12,24,36,48,60,72,84,96,108,120,132 and 144 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)
Time Frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months

Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment:

  • progression to Accelerated Phase (AP) or Blast Crisis (BC)
  • loss of Complete Hematological Response (CHR)
  • loss of Major Cytogenetic Response (MCyR) confirmed
  • loss of Major Cytogenetic Response (MCyR) unconfirmed
  • increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC)
  • death (due to any cause when reported as primary reason for discontinuation of treatment).

Kaplan Meier estimates of the percentage of participants with Event Free Survival at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

12,24,36,48,60,72,84,96,108,120,132 and 144 months
Percentage of Participants With Event Free Survival Events (All Randomized Participants)
Time Frame: 144 months

Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment:

  • progression to Accelerated Phase (AP) or Blast Crisis (BC)
  • loss of Complete Hematological Response (CHR)
  • loss of Major Cytogenic Response (MCyR) confirmed
  • loss of Major Cytogenic Response (MCyR) unconfirmed
  • increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC)
  • death (due to any cause when reported as primary reason for discontinuation of treatment).

The percentage of participants with Event Free Survival events in each category was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.

144 months
Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)
Time Frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Time to progression to AP/BC is defined as the time between randomization and either of the following events on treatment: death (due to CML when reported as primary reason for discontinuation of treatment) or progression to Accelerated Phase or Blast Crisis and is censored at last examination date for patients without event. No data after discontinuation of study treatment was included. The Kaplan Meier estimates of the percentage of participants with survival without progression to AP/BC at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
12,24,36,48,60,72,84,96,108,120,132 and 144 months
Percentage of Participants With Best Cytogenetic Response (First-line Treatment)
Time Frame: 144 months

Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Philadelphia chromosome positive (Ph+) metaphases) and amount of blasts and promyelocytes in bone marrow to establish cytogenetic response.

Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= > 0 and ≤ 35 % of Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.

144 months
Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)
Time Frame: 144 months

Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Ph chromosome (Ph+) containing metaphases) and the amount of blasts and promyelocytes in bone marrow to establish cytogenetic response.

Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= > 0 and ≤ 35 % Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.

144 months
Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)
Time Frame: 144 months
A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant
144 months
Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)
Time Frame: 144 months
A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant
144 months
Percentage of Participants With Major Molecular Response (First-line Treatment)
Time Frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
12,24,36,48,60,72,84,96,108,120,132 and 144 months
Percentage of Participants With Major Molecular Response (Second-line Treatment)
Time Frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
12,24,36,48,60,72,84,96,108,120,132 and 144 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2000

Primary Completion (Actual)

March 1, 2012

Study Completion (Actual)

March 1, 2012

Study Registration Dates

First Submitted

June 2, 2006

First Submitted That Met QC Criteria

June 2, 2006

First Posted (Estimate)

June 6, 2006

Study Record Updates

Last Update Posted (Estimate)

October 14, 2013

Last Update Submitted That Met QC Criteria

August 7, 2013

Last Verified

August 1, 2013

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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