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

2006年6月16日 更新者: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.

研究概览

地位

未知

详细说明

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).

研究类型

介入性

注册

240

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Tyrol
      • Innsbruck、Tyrol、奥地利、6020
        • 招聘中
        • Medical University Innsbruck
        • 接触:
          • Guenther Gastl, MD
        • 接触:
          • Dominic Fong, MD
        • 首席研究员:
          • Guenther Gastl, MD

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

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.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

研究衡量的是什么?

主要结果指标

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

次要结果测量

结果测量
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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:Guenther Gastl, MD、Medical University Innsbruck

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2004年1月1日

研究完成

2008年12月1日

研究注册日期

首次提交

2006年5月16日

首先提交符合 QC 标准的

2006年5月16日

首次发布 (估计)

2006年5月18日

研究记录更新

最后更新发布 (估计)

2006年6月20日

上次提交的符合 QC 标准的更新

2006年6月16日

最后验证

2005年9月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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