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Phase II Randomized Study of BMS-354825 Versus Imatinib Mesylate in Patients With Imatinib Mesylate-Resistant Philadelphia Chromosome-Positive Chronic Phase Chronic Myelogenous Leukemia
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
BMS-354825 or Imatinib Mesylate in Treating Patients With Chronic Phase Chronic Myelogenous Leukemia That Did Not Respond to Previous Imatinib Mesylate
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
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Phase II | Treatment | Closed | 18 and over | UCLA-0501047-01 BMS-CA180017, EUDRACT-2004-004450-96, NCT00112775 |
Objectives Primary - Determine the 12-week major cytogenetic response (MCyR) rate in patients with imatinib mesylate-resistant Philadelphia chromosome-positive chronic phase chronic myelogenous leukemia treated with BMS-354825 vs imatinib mesylate.
Secondary - Determine the MCyR rate prior to crossover in patients treated with these drugs.
- Determine the durability of MCyR and time to MCyR prior to crossover in patients treated with these drugs.
- Determine the complete hematologic response (CHR) rate prior to crossover in patients treated with these drugs.
- Determine the durability of CHR and time to CHR prior to crossover in patients treated with these drugs.
- Determine the major molecular response rate prior to crossover, as determined by BCR-ABL transcripts in blood during treatment using quantitative reverse transcriptase polymerase chain reaction, in patients treated with these drugs.
- Determine post-crossover efficacy endpoints in patients treated with these drugs who crossover.
- Assess health-related quality of life prior to crossover in patients treated with these drugs.
- Determine the safety and tolerability of BMS-354825 in these patients.
- Determine the pharmacokinetics of BMS-354825 in these patients.
Entry Criteria Disease Characteristics:
Prior/Concurrent Therapy:
Biologic therapy - More than 14 days since prior interferon
Chemotherapy - More than 14 days since prior cytarabine
- Prior or concurrent hydroxyurea for elevated WBC (i.e., WBC > 50,000/mm3) allowed
Endocrine therapy Radiotherapy Surgery Other - More than 7 days since prior imatinib mesylate
- At least 7 days since prior and no concurrent low-dose aspirin (≤ 325 mg/day)
- At least 14 days since prior and no concurrent high-dose aspirin (> 325 mg/day)
- More than 14 days since prior targeted small molecule anticancer agents
- More than 28 days since prior investigational or antineoplastic agents except hydroxyurea or anagrelide
- At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent drugs that carry a risk of causing torsades de Pointes, including any of the following:
- Quinidine
- Procainamide
- Disopyramide
- Amiodarone
- Sotalol
- Ibutilide
- Dofetilide
- Erythromycin
- Clarithromycin
- Chlorpromazine
- Haloperidol
- Mesoridazine
- Thioridazine
- Pimozide
- Ziprasidone
- Cisapride
- Bepridil
- Droperidol
- Methadone
- Arsenic trioxide
- Chloroquine
- Domperidone
- Halofantrine
- Levomethadyl
- Pentamidine
- Sparfloxacin
- Lidoflazine
- At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent medication that directly inhibits platelet function (except anagrelide for thrombocytosis due to CML), including any of the following:
- Dipyridamole
- Epoprostenol
- Epitifibatide
- Clopidogrel
- Cilostazol
- Abciximab
- Ticlopidine
- At least 5 days or 5 half-lives (whichever is greater) since prior and no concurrent anticoagulants (e.g., warfarin, heparin, or low molecular weight heparin [e.g., danaparoid, dalteparin, tinzaparin, or enoxaparin])
- Concurrent prophylactic low-dose warfarin for prevention of catheter thrombosis and heparin-flush for IV lines allowed
- No prior BMS-354825
- No concurrent CYP3A4 inhibitors or inducers, including any of the following:
- Ketoconazole
- Ritonavir
- Rifampin
- Efavirenz
- No other concurrent therapy for CML
Patient Characteristics:
Age Performance status Life expectancy Hematopoietic - See Disease Characteristics
- No history of a significant bleeding disorder unrelated to CML, including any of the following:
- Congenital bleeding disorder (e.g., von Willebrand's disease)
- Acquired bleeding disorder diagnosed within the past year (e.g. acquired anti-factor VIII antibodies)
Hepatic - Bilirubin ≤ 2.0 times upper limit of normal (ULN)
- ALT and AST ≤ 2.5 times ULN
Renal - Creatinine ≤ 1.5 times ULN
- Total serum or ionized calcium normal (supplementation allowed)
Cardiovascular - Heart rate ≥ 50 beats/minute by EKG
- No myocardial infarction within the past 6 months
- No uncontrolled angina within the past 3 months
- No congestive heart failure within the past 3 months
- No diagnosed or suspected congenital long QT syndrome
- No history of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, or torsades de Pointes)
- No prolonged QTc interval (i.e., > 450 msec) by EKG using Bazett's correction
- High Bazett's correction (i.e., > 450 msec) allowed provided Fridericia correction is ≤ 450 msec
- No history of second or third degree heart block
- No uncontrolled hypertension
- No other uncontrolled or significant cardiovascular disease
Other - Not pregnant
- No nursing during and for ≥ 3 months after study participation
- Negative pregnancy test
- Fertile patients must use effective contraception for ≥ 1 month before, during, and for ≥ 3 months after study participation
- Magnesium and potassium normal (supplementation allowed)
- No serious uncontrolled medical disorder or active infection that would preclude study participation
- No dementia or altered mental status that would preclude giving informed consent
- No significant bleeding from the gastrointestinal tract within the past 6 months
- No evidence of organ dysfunction or any clinically significant deviation from normal on physical examination, vital signs, EKG, or clinical laboratory determinations unrelated to CML that would preclude study participation
- No prisoners or patients who are involuntarily incarcerated for treatment of either a psychiatric or physical (e.g., infectious disease) illness
Expected Enrollment A minimum of 150 patients (100 in arm I and 50 in arm II) will be accrued for this study within 6-12 months. Outcomes Primary Outcome(s)Major cytogenic response (MCyR) rate at 12 weeks
Secondary Outcome(s)MCyR at any time Duration of MCyR Time to MCyR Complete hematologic response rate
Outline This is an open-label, multicenter, randomized, crossover study. Patients are stratified according to study site and cytogenetic response to prior imatinib mesylate (yes vs no). Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients receive oral BMS-354825 twice daily in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression or persistent intolerance to BMS-354825 cross over to arm II after a 2-day washout period. After crossover, patients receive oral imatinib mesylate twice daily in the absence of further disease progression or unacceptable toxicity.
- Arm II: Patients receive oral imatinib mesylate twice daily in the absence of disease progression or unacceptable toxicity. Patients experiencing disease progression, intolerance to imatinib mesylate, lack of major cytogenetic response at 12 weeks, or < 30% absolute reduction in Philadelphia chromosome-positive metaphases at 12 weeks cross over to arm I after a 1-week washout period. After crossover, patients receive oral BMS-354825 twice daily in the absence of further disease progression or unacceptable toxicity.
Quality of life is assessed at baseline, at day 29, every 4 weeks for 24 weeks, every 12 weeks for the remainder of study treatment, and then at the completion of study treatment. After the completion of study treatment, patients are followed for at least 30 days.
Trial Contact Information
Trial Lead Organizations Jonsson Comprehensive Cancer Center at UCLA | | | Ronald Paquette, MD, Principal investigator | | | |
Registry Information | | Official Title | | A Randomized Multi-Center Open Label Study of BMS-354825 vs Imatinib Mesylate (Gleevec®) 800 mg/d in Subjects With Chronic Phase Philadelphia Chromosome-Positive Chronic Myeloid Leukemia Who Have Disease That is Resistant to Iamtinib at a Dose of 400-600 mg/d | | Trial Start Date | | 2005-03-09 | | Registered in ClinicalTrials.gov | | NCT00112775 | | Date Submitted to PDQ | | 2005-04-06 | | Information Last Verified | | 2006-04-11 | | NCI Grant/Contract Number | | CA16042 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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