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Nilotinib in Treating Patients With Newly Diagnosed Chronic Phase Chronic Myelogenous Leukemia
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsored by: Irish Clinical Oncology Research Group
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00809211
  Purpose

RATIONALE: Nilotinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well nilotinib works in treating patients with newly diagnosed chronic phase chronic myelogenous leukemia.


Condition Intervention Phase
Leukemia
Drug: nilotinib
Procedure: cytogenetic analysis
Procedure: mutation analysis
Procedure: pharmacological study
Procedure: polymerase chain reaction
Phase II

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label
Official Title: A Phase II Multi-Center, Open-Label, Study of Nilotinib at a Dose of 300mg Twice Daily in Adult Patients With Newly Diagnosed Philadelphia Chromosome Positive (Ph+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Complete cytogenetic response rate at 6 months as assessed by metaphase analysis [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Molecular response rate at 3, 6, 9, 12, 18, and 24 months as assessed by quantitative PCR [ Designated as safety issue: No ]
  • Time to disease progression [ Designated as safety issue: No ]
  • Duration of event-free survival [ Designated as safety issue: No ]
  • Overall toxicity rate [ Designated as safety issue: Yes ]
  • Correlation of pharmacokinetic data with response rate and toxicity [ Designated as safety issue: No ]
  • Correlation of Bcr-Abl results using GeneXpert with Bcr-Abl results using international standardized quantitative PCR [ Designated as safety issue: No ]
  • Prevalence of Bcr-Abl mutations prior to and during treatment [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: October 2008
Estimated Primary Completion Date: March 2012 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To establish the complete cytogenetic response rate at 6 months in patients with newly diagnosed Philadelphia chromosome-positive chronic phase chronic myelogenous leukemia treated with nilotinib.

Secondary

  • To establish the complete cytogenetic response rate at 3, 9, 12, 18, and 24 months in these patients.
  • To establish the molecular response rate at 3, 6, 9, 12, 18, and 24 months in these patients.
  • To establish the safety of this drug in these patients.
  • To correlate pharmacokinetic data with response rate and toxicity.
  • To correlate Bcr-Abl results using GeneXpert with Bcr-Abl results using international standardized quantitative PCR.
  • To estimate the prevalence of Bcr-Abl mutations prior to and during treatment.

OUTLINE: This is a multicenter study.

Patients receive oral nilotinib twice daily on days 1-28. Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.

Peripheral blood and bone marrow samples are collected periodically for mutation analysis, Bcr-Abl analysis by quantitative PCR, metaphase cytogenetics, and pharmacokinetic analysis.

After completion of study therapy, patients are followed every 3 months for 2 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Cytogenetically confirmed chronic myelogenous leukemia (CML) by standard conventional cytogenetic analysis of bone marrow*

    • Newly diagnosed disease (within the past 6 months) NOTE: *FISH cannot be used
  • In chronic phase, as defined by the following:

    • Less than 15% blasts in peripheral blood and bone marrow
    • Less than 30% blasts plus promyelocytes in peripheral blood and bone marrow
    • Less than 20% basophils in peripheral blood
    • Platelet count ≥ 100,000/mm^3
    • No evidence of extramedullary leukemic involvement, except for hepatosplenomegaly
  • Philadelphia chromosome-positive disease as demonstrated by (9;22) translocation (presence of Bcr-Abl)

    • A review of ≥ 20 metaphases is required
  • No previously documented T315I mutations

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Total bilirubin < 1.5 times upper limit of normal (ULN)
  • AST and ALT < 2.5 times ULN
  • Estimated glomerular filtration rate ≥ 30 mL/min
  • Serum amylase and lipase ≤ 1.5 times ULN
  • Alkaline phosphatase ≤ 2.5 times ULN (unless related to CML)
  • Potassium ≥ lower limit of normal (LLN)
  • Magnesium ≥ LLN
  • Phosphorous ≥ LLN
  • Total calcium ≥ LLN (corrected for serum albumin)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No impaired cardiac function including, but not limited to, any of the following:

    • LVEF < 45% or < LLN by ECHO
    • Inability to determine the QT interval on ECG
    • Complete left bundle branch block
    • 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/min)
    • QTc > 450 msec on an average of 3 serial baseline ECGs (using the QTcF formula)
    • Clinically documented myocardial infraction within the past 12 months
    • Unstable angina within the past 12 months
    • Other clinically significant heart disease (e.g., congestive heart failure or uncontrolled hypertension)
  • No severe or uncontrolled medical condition (e.g., uncontrolled diabetes or active or uncontrolled infection)
  • No history of significant congenital or acquired bleeding disorder unrelated to CML
  • No history of non-compliance to medical regimens
  • No other primary malignancy unless it is neither currently clinically significant nor requiring active intervention
  • No impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the study drug (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection, or gastric bypass surgery)
  • No acute pancreatitis within the past year
  • No history of chronic pancreatitis
  • No acute or chronic liver, pancreatic, or severe renal disease considered unrelated to CML

PRIOR CONCURRENT THERAPY:

  • No prior therapy for CML other than hydroxyurea and/or anagrelide
  • Prior imatinib mesylate allowed provided it was administered for ≤ 14 days
  • More than 30 days since prior and no other concurrent investigational agents
  • More than 4 weeks since prior major surgery and recovered
  • No other concurrent anticancer agents, including chemotherapy and biologic agents
  • No concurrent strong CYP3A4 inhibitors (e.g., erythromycin, ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin, ritonavir, mibefradil)
  • No concurrent strong CYP3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, St. John's wort)
  • No concurrent medications that have the potential to prolong QT interval
  • No concurrent grapefruit, star fruit, Seville oranges, or their derivatives
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00809211

Locations
United States, Texas
M. D. Anderson Cancer Center at University of Texas Recruiting
Houston, Texas, United States, 77030-4009
Contact: Clinical Trials Office - M. D. Anderson Cancer Center at the U     713-792-3245        
Ireland
University College Hospital Recruiting
Galway, Ireland
Contact: Mike O'Dwyer, MD     353-91-524-222        
United Kingdom, Northern Ireland
Centre for Cancer Research and Cell Biology at Queen's University Belfast Recruiting
Belfast, Northern Ireland, United Kingdom, BT9 7BL
Contact: Mary F. McMullin, MD     44-28-9097-2960        
Sponsors and Collaborators
Irish Clinical Oncology Research Group
Investigators
Principal Investigator: Mike O'Dwyer, MD University College London Hospitals
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000629801, ICORG-08-02, EUDRACT-2008-004551-30, EU-20899
Study First Received: December 16, 2008
Last Updated: January 6, 2009
ClinicalTrials.gov Identifier: NCT00809211  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
Philadelphia chromosome positive chronic myelogenous leukemia
chronic phase chronic myelogenous leukemia

Study placed in the following topic categories:
Chromosomal abnormalities
Philadelphia Chromosome
Leukemia
Chronic myelogenous leukemia
Hematologic Diseases
Myeloproliferative Disorders
Chromosome Aberrations
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid, Chronic-Phase
Leukemia, Myeloid
Bone Marrow Diseases

Additional relevant MeSH terms:
Neoplasms
Pathologic Processes
Neoplasms by Histologic Type
Translocation, Genetic

ClinicalTrials.gov processed this record on January 14, 2009