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The Protein Tyrosine Kinase Inhibitor Nilotinib as First-line Treatment of Ph+ Chronic Myeloid Leucemia (CML) in Early Chronic Phase: a Phase II Exploratory, Multicenter Study. GIMEMA Protocol CML 0307. EUDRACT 2007-000597-22.


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Chronic Myeloid Leukemia

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Trial Information

The Protein Tyrosine Kinase Inhibitor Nilotinib as First-line Treatment of Ph+ Chronic Myeloid Leucemia (CML) in Early Chronic Phase: a Phase II Exploratory, Multicenter Study. GIMEMA Protocol CML 0307. EUDRACT 2007-000597-22.


Study Phase:

Phase II, Prospective, multicentric, non randomized, open label

Objectives:

The primary objective of the trial is to investigate the cytogenetic and molecular effects
of the protein tyrosine kinase (PTK) inhibitor nilotinib in the treatment of early chronic
phase Ph+ CML.

The secondary objectives are:

To investigate in early CP Ph+ CML patients treated with nilotinib the clinical and the
hematologic effects, the effect on bcr/abl point mutations, the kinetic of the response, the
toxicity, the compliance to treatment and the dose density.

Study design:

This study is an open-label, multicenter, exploratory, Phase II study of nilotinib
administered orally twice daily for one year. For the patients who will benefit an extension
to 4 years is planned.

Visit Schedule and Assessments:

A visit with blood counts and differential and serum chemistry is due baseline, every 15
days for 3 months, hence every 30 days.

An ECG is due baseline, after 15 and 30 days, hence at 60, 90, 150, 240 and 360 days.

An echocardiogram is due baseline and at end-of-study (360 days) or early withdrawal.

A bone marrow aspirate is due baseline (cytology, cytogenetics and quantitative molecular
biology), after 3 and 6 months (cytology and cytogenetics) and after 12 months (cytology,
cytogenetics, quantitative molecular biology and mutational analysis).

A peripheral blood sample is due baseline, at 30, 60, 90, 180, 270 and 360 days for
quantitative molecular biology.

After the end of the study (i.e. after one year) clinical, cytogenetic and molecular data
are due every 6 months.

Biologic Monitoring:

Bone marrow and peripheral blood cells will be collected before, during and at the end of
the study, stored at the central lab in Bologna and used for molecular assays that are
listed in details in the protocol, with the exclusion of any test allowing the
identification of patients genotype. The samples are kept for a minimum of 10 years and can
be destroyed upon patient request. A specific consent form to the sample storage will be
submitted to the patients.


Inclusion Criteria:



- Patients with a cytologic and cytogenetic confirmed diagnosis of Ph+ CML.

- Age ≥ 18 years old

- Early CP (within 6 months from diagnosis)

- No prior treatment with any antileukemic drugs with the exception of Hydroxyurea (HU)
and Anagrelide.

- WHO performance status of ≤ 2

- Normal serum level of potassium, total calcium corrected for serum albumin, magnesium
and phosphorus, or correctable with supplements

- ALT and AST ≤ 2.5 x ULN or ≤ 5.0 x ULN if considered due to leukaemia.

- Alkaline phosphatase ≤ 2.5 x ULN unless considered due to leukemia.

- Serum bilirubin ≤ 1.5 x ULN

- Serum creatinine ≤ 1.5 x ULN

- Serum amylase ≤ 1.5 x ULN and serum lipase ≤ 1.5 x ULN.

- Written informed consent prior to any study procedures being performed.

Exclusion criteria:

- Impaired cardiac function, including LVEF < 45% as determined by MUGA scan or
echocardiogram, uncontrolled congestive heart failure, uncontrolled hypertension

- History of myocardial infarction within three months, or uncontrolled angina
pectoris.

- Significant electric heart abnormalities, including history or presence of
significant ventricular or atrial tachyarrhythmias, congenital long QT syndrome
and/or QTc > 450 msec on screening ECG (using the QTcF formula).

- Patients with ventricular pacemakers and clinically significant bradycardias.

- Patients with heart blocks.

- History of acute or chronic pancreatitis.

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

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

- Acute or chronic liver or renal disease considered unrelated to leukaemia

- Other concurrent severe and/or uncontrolled medical conditions (e.g., uncontrolled
diabetes, active or uncontrolled infection) that could cause unacceptable safety
risks or compromise compliance with the protocol

- Patients who are currently receiving treatment with any of the medications listed in
Appendix E and the treatment cannot be either discontinued or switched to a different
medication prior to starting study drug. The medications listed in Appendix E have
the potential to prolong QT, with the exception of HU and Anagrelide.

- Patients who have received any antileukemic agents and treatments, including HSCT,
with the exception of HU and Anagrelide.

- Patients who have received any investigational drug ≤ 4 weeks.

- 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. (Women of childbearing potential must
have a negative serum pregnancy test within 48 hrs prior to administration of
nilotinib). Post menopausal women must be amenorrheic for at least 12 months to be
considered of non-childbearing potential. Male and female patients 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.

- Treatment with any hematopoietic colony-stimulating growth factors (e.g. G-CSF,
GM-CSF) 1 week prior to starting study drug.

- Patients who have received immunotherapy 1 week prior to starting study drug or who
have not recovered from side effects of such therapy.

- Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not
mandatory).

- Patients with a history of another primary malignancy that is currently clinically
significant or currently requires active intervention.

- Patients unwilling or unable to comply with the protocol.

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Complete cytogenetic response (CCgR ) rate

Outcome Time Frame:

At 1 year

Safety Issue:

No

Principal Investigator

Michele BACCARANI

Investigator Role:

Principal Investigator

Investigator Affiliation:

Azienda Ospedaliera Universitaria -Policlincio S. Orsola-Malpighi

Authority:

Italy: The Italian Medicines Agency

Study ID:

CML0307

NCT ID:

NCT00481052

Start Date:

June 2007

Completion Date:

June 2013

Related Keywords:

  • Chronic Myeloid Leukemia
  • Adult
  • CML
  • Philadelphia positive
  • Nilotinib
  • early chronic phase
  • untreated or treated only with Hydroxyurea or Anagrelide
  • Chronic Myeloid Leukemia
  • Leukemia
  • Leukemia, Myeloid
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive

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