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

16. juni 2006 oppdatert av: Central European Leukemia Study Group

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

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.

Studieoversikt

Status

Ukjent

Intervensjon / Behandling

Detaljert beskrivelse

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).

Studietype

Intervensjonell

Registrering

240

Fase

  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Tyrol
      • Innsbruck, Tyrol, Østerrike, 6020
        • Rekruttering
        • Medical University Innsbruck
        • Ta kontakt med:
          • Guenther Gastl, MD
        • Ta kontakt med:
          • Dominic Fong, MD
        • Hovedetterforsker:
          • Guenther Gastl, MD

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. Patients > 18 years of age
  2. BCR-ABL positive CML patients in chronic phase, confirmed by karyotype (Ph+) or RT-PCR.
  3. Patients pretreated with any drug that is known to control the disease of CML in chronic phase except imatinib (Glivec®).
  4. Patients without a major cytogenetic response at study entry (> 35% Ph+ metaphases in bone marrow cytogenetic analysis performed < 3 months before study entry).
  5. 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.
  6. World Health Organization (WHO) status 0-2
  7. 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
  8. 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.
  9. Written voluntary informed consent.

Exclusion Criteria:

  1. Patients eligible for allogeneic bone marrow transplantation.
  2. Patients in accelerated phase or blast crisis.
  3. Known tuberculosis or other uncontrolled infection.
  4. 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).
  5. Major surgery within the last 14 days.
  6. Known to be HIV positive.
  7. Unstable medical disorder (except for indication) that excludes the patient in the opinion of the investigator.
  8. Patient has received any other investigational agents within 28 days of first day of study drug dosing.
  9. Patients with a WHO performance status score > 3
  10. 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).
  11. Female patients who are pregnant or breast-feeding.
  12. Refusal by female patients of childbearing age to use a safe contraceptive.
  13. Patients with known chronic liver disease (i.e., chronic active hepatitis, and cirrhosis).
  14. Patients with any significant history of non-compliance to medical regimens or an inability to grant reliable informed consent.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Hva måler studien?

Primære resultatmål

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

Sekundære resultatmål

Resultatmål
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studiestol: Guenther Gastl, MD, Medical University Innsbruck

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2004

Studiet fullført

1. desember 2008

Datoer for studieregistrering

Først innsendt

16. mai 2006

Først innsendt som oppfylte QC-kriteriene

16. mai 2006

Først lagt ut (Anslag)

18. mai 2006

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

20. juni 2006

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. juni 2006

Sist bekreftet

1. september 2005

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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