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A Phase III Multi-center, Open-label, Randomized Study of Imatinib Versus Nilotinib in Adult Patients With Newly Diagnosed Philadelphia Chromosome Positive (Ph+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)


Phase 3
18 Years
N/A
Open (Enrolling)
Both
Myelogenous Leukemia, Chronic

Thank you

Trial Information

A Phase III Multi-center, Open-label, Randomized Study of Imatinib Versus Nilotinib in Adult Patients With Newly Diagnosed Philadelphia Chromosome Positive (Ph+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)

Inclusion Criteria


Inclusion criteria:

- ECOG 0, 1, or 2.

- Patients with CML-CP within 6 months of diagnosis (date of initial diagnosis is the
date of first cytogenetic analysis). Standard conventional cytogenetic analysis must
be done on bone marrow. (FISH cannot be used)

- Diagnosis of chronic myelogenous leukemia in chronic phase with cytogenetic
confirmation of Philadelphia chromosome of (9;22) translocations (presence of
BCR-ABL: a review of a minimum 20 metaphases is required.).

- Documented chronic phase CML will meet all the criteria defined by:

- < 15% blasts in peripheral blood and bone marrow

- < 30% blasts plus promyelocytes in peripheral blood and bone marrow

- < 20% basophils in the peripheral blood

- ≥ 100 x 109/L (≥ 100,000/mm3) platelets

- No evidence of extramedullary leukemic involvement, with the exception of
hepatosplenomegaly

- Adequate end organ function as defined by:

- Total bilirubin < 1.5 x ULN

- SGOT and SGPT < 2.5 x ULN

- Creatinine < 1.5 x ULN

- Serum amylase and lipase ≤ 1.5 x ULN

- Alkaline phosphatase ≤ 2.5 x ULN unless considered tumor related.

- Female patients of childbearing potential must have a negative serum pregnancy test
within 7 days before initiation of study drug.

- Patients must have the following laboratory values (≥ LLN (lower limit of normal) or
corrected to within normal limits with supplements prior to the first dose of study
medication.):

- Potassium ≥ LLN

- Magnesium ≥ LLN

- Phosphorus ≥ LLN

- Total calcium (corrected for serum albumin) ≥ LLN.

- Ability to provide written informed consent prior to any study related screening
procedures being performed.

Exclusion criteria:

- Patients who are considered to be Philadelphia chromosome negative because they do
not have a confirmed cytogenetic diagnosis of Philadelphia chromosome (9,22
translocation) positive CML.

- Previously documented T315I mutations.

- Treatment with tyrosine kinase inhibitor(s) prior to study entry is not allowed,
except in the following situation: in emergent cases where the patient requires
disease management while awaiting study start, commercial supplies of Gleevec/Glivec
at any dose may be prescribed to the patient but for no longer than 2 weeks in
duration.

- Any medical treatment for CML prior to study entry for longer than 2 weeks with the
exception of hydroxyurea and/or anagrelide

- Impaired cardiac function including any one of the following:

- LVEF < 45% or below the institutional lower limit of the normal range (whichever is
higher) as determined by locally read echocardiogram

- Inability to determine the QT interval on ECG

- Complete left bundle branch block

- Use of a ventricular-paced pacemaker

- Congenital long QT syndrome or a known family history of long QT syndrome.

- History of or presence of clinically significant ventricular or atrial
tachyarrhythmias

- Clinically significant resting bradycardia (<50 beats per minute)

- QTc > 450 msec on the average of three serial baseline ECG (using the QTcF formula)
as determined by central reading. If QTcF >450 msec and electrolytes are not within
normal ranges, electrolytes should be corrected and then the patient re-screened for
QTc

- History of clinically documented myocardial infarction

- History of unstable angina (during the last 12 months)

- Other clinically significant heart disease (e.g., congestive heart failure or
uncontrolled hypertension).

- Known cytopathologically confirmed CNS infiltration (in absence of suspicion of CNS
involvement, lumbar puncture not required).

- Severe or uncontrolled medical conditions (i.e. uncontrolled diabetes, active or
uncontrolled infection).

- History of significant congenital or acquired bleeding disorder unrelated to cancer.

- Previous radiotherapy to ≥ 25% of the bone marrow.

- Major surgery within 4 weeks prior to Day 1 of study or who have not recovered from
prior surgery.

- Treatment with other investigational agents (defined as not used in accordance with
the approved indication) within 30 days of Day 1.

- History of non-compliance to medical regimens or inability to grant consent.

- Use of therapeutic coumarin derivatives (i.e., warfarin, acenocoumarol,
phenprocoumon)

- Patients with another primary malignancy except if the other primary malignancy is
neither currently clinically significant or requiring active intervention

- Patients actively receiving therapy with strong CYP3A4 inhibitors (e.g.,
erythromycin, ketoconazole, itraconazole, voriconazole, clarithromycin,
telithromycin, ritonavir, mibefradil) and the treatment cannot be either discontinued
or switched to a different medication prior to starting study drug. See link for
complete list of these medications: http://medicine.iupui.edu/flockhart/table.htm.
Novartis must be contacted if a patient needs to be started on any of these drugs
during study treatment.

- Patients actively receiving therapy with strong CYP3A4 inducers (e.g., dexamethasone,
phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbitol, St. John's
Wort) and the treatment cannot be either discontinued or switched to a different
medication prior to starting study drug. See link for complete list of these
medications: http://medicine.iupui.edu/flockhart/table.htm. Novartis must be
contacted if a patient needs to be started on any of these drugs during study
treatment.

- Impairment of gastrointestinal (GI) function or GI disease that may significantly
alter the absorption of study drug (e.g., ulcerative disease, uncontrolled nausea,
vomiting, diarrhea, malabsorption syndrome, small bowel resection, or gastric bypass
surgery)

- History of acute pancreatitis within 1 year of study entry or past medical history of
chronic pancreatitis.

- Acute or chronic liver, pancreatic or severe renal disease considered unrelated to
disease.

- Patients who are currently receiving treatment with any medications that have the
potential to prolong the QT interval and the treatment cannot be either discontinued
or switched to a different medication prior to starting study drug (Please see
http://www.torsades.org/medical-pros/drug-lists/printable-drug-list.cfm for a
comprehensive list of agents that prolong the QT interval)

- Patients who are: (a) pregnant, (b) breast feeding, (c) of childbearing potential
without a negative pregnancy test prior to baseline and (d) female of childbearing
potential unwilling to use contraceptive precautions throughout the trial
(post-menopausal women must be amenorrheic for at least 12 months to be considered of
non-childbearing potential)

Other protocol-defined inclusion/exclusion criteria may apply

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Molecular Response Rate (MMR) at 12 Months

Outcome Description:

Rate of MMR is defined as <= 0.1% BCR-ABL/ABL ratio by international scale (IS), measured by real-time quantitative polymerase chain reaction (RQ-PCR) which corresponds to a ≥ 3 log reduction of BCR-ABL transcript from standardized baseline. BCR-ABL = fusion gene from BCR (breakpoint cluster region gene/BCR gene product) and ABL (Abelson protooncogene)

Outcome Time Frame:

Baseline, 12 months

Safety Issue:

No

Principal Investigator

Novartis Pharmaceuticals

Investigator Role:

Study Director

Investigator Affiliation:

Novartis Pharmaceuticals

Authority:

United States: Food and Drug Administration

Study ID:

CAMN107A2303

NCT ID:

NCT00471497

Start Date:

July 2007

Completion Date:

October 2018

Related Keywords:

  • Myelogenous Leukemia, Chronic
  • leukemia
  • bone marrow
  • leukemia symptoms
  • cml
  • complete blood count
  • lymphocyte
  • blood cancer
  • leukocytes
  • chronic leukemia
  • bone marrow biopsy
  • leukemia research
  • leukemia cells
  • bone marrow disease
  • chronic myeloid leukemia
  • blood cancer symptoms
  • white blood cell diseases
  • chronic myelogenous leukemia
  • leukemia treatment
  • leukemia facts
  • leucemia
  • facts about leukemia
  • myelogenous leukemia
  • newly diagnosed CML
  • Philadelphia chromosome positive
  • Ph+
  • chronic phase
  • CML-CP
  • Leukemia
  • Leukemia, Myeloid
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive
  • Philadelphia Chromosome
  • Chronic Disease

Name

Location

Tyler Cancer Center Tyler, Texas  75702
Utah Cancer Specialists Salt Lake City, Utah  84106
Kansas City Cancer Center KCCC Business Office Overland Park, Kansas  66210
Kaiser Permanente - California Southern Dept of Kaiser South 9 San Diego, California  
Kaiser Permanente - California Southern Dept of Kaiser South 3 San Diego, California  
Kaiser Permanente - California Southern San Diego Zion Avenue San Diego, California  
Kaiser Permanente - California Northern Kaiser Med Vallejo, California  
Kaiser Permanente - California Northern Vallejo Med Center/Med Offices Vallejo, California  
Rocky Mountain Cancer Centers RMCC - Colorado Springs Greenwood Village, Colorado  
Florida Cancer Specialists Dept. FloridaCancerSpecialists Fort Myers, Florida  33901
Advanced Medical Specialties Research Dept. Miami, Florida  33176
Florida Cancer Institute Flordia Cancer Affilates New Port Richey, Florida  34655
Cancer Centers of Florida PA Cancer Centers of FL Ocoee, Florida  *see dep*
University of Chicago Medical Center Section of Hematology/Oncology Chicago, Illinois  60546
Indiana Blood and Marrow Institute Dept. of Indiana Blood&Marrow Beach Grove, Indiana  46107
University of Iowa Hospitals and Clinics Dept.of U of Iowa Hosp&Clinics Iowa City, Iowa  52242
LSU HEALTH SCIENCES CENTER/ LSU SCHOOL OF MEDICINE Feist-Weiller Cancer Center New Orleans, Louisiana  70115
Michigan State University / Breslin Cancer Center Breslin Cancer Center Lansing, Michigan  
Missouri Cancer Associates Dept. of Boone Hospital Center Columbia, Missouri  65201
Hematology Oncology Consultants, Inc. Deptof Hem. Onc.Consunsultants St. Louis, Missouri  63136
Hackensack University Medical Center Department of Research Hackensack, New Jersey  07601
Memorial Sloan Kettering Cancer Center Clinical Trials Office New York, New York  10021
UNC/Lineberg Comprehensive Cancer Center UNC Lineberger Cancer Center Chapel Hill, North Carolina  27514
Cancer Centers of North Carolina Cancer Centers of NC-Raleigh Raleigh, North Carolina  27609
Wake Forest University Baptist Medical Center Dept. of Industry Research Winston-Salem, North Carolina  27157
University of Cincinnati / Barrett Cancer Center Dept.of Internal Med. Cincinnati, Ohio  45219
Cleveland Clinic Foundation CCF Cleveland, Ohio  44195
Northwest Cancer Specialists Vancouver Location Portland, Oregon  97210
Cancer Centers of the Carolinas CC of C -Eastside Greenville, South Carolina  29605
Chattanooga Oncology and Hematology Assoicates, PC Memorial Plaza Chattanooga, Tennessee  37404
Tennessee Oncology Dept. of Centennial Medical Nashville, Tennessee  37203
Texas Cancer Center ( Medical City Dallas Hospital) Dallas, Texas  75230
Cancer Care Centers of South Texas / HOAST CCC of So.TX- Medical Center San Antonio, Texas  78229
University of California at Los Angeles Dept. of Hematology Clinic Los Angeles, California  90095