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A Combination of Imatinib Mesylate and Pegylated Interferon α2a in Chronic-Phase Chronic Myeloid Leukemia (UMCC 2006-128)
This study is currently recruiting participants.
Verified by University of Michigan Cancer Center, December 2009
First Received: December 13, 2007   Last Updated: December 8, 2009   History of Changes
Sponsor: University of Michigan Cancer Center
Information provided by: University of Michigan Cancer Center
ClinicalTrials.gov Identifier: NCT00573378
  Purpose

Chronic myelogenous leukemia (CML) is a slow-growing cancer of the white blood cells. CML patients have bone marrow that makes too many white blood cells. CML is caused by a change in the genetic code of some of the cells in the bone marrow. In these cells, part of chromosome 9 moves to chromosome 22. This creates an abnormal chromosome called the Philadelphia chromosome. The Philadelphia chromosome makes an enzyme (called tyrosine kinase) that signals the body to make too many white blood cells. It is not known what causes the Philadelphia chromosome to appear

For most patients, a drug called Gleevec is the standard first treatment. (Gleevec is also known as imatinib mesylate.) Gleevec was approved by the U.S. Food and Drug Administration (FDA) in 2001. Gleevec blocks the tyrosine kinase enzyme so that the body stops (or slows down) making too many white blood cells. Although Gleevec has been effective in controlling the leukemia in most patients with CML, we know this therapy alone is not a cure. Gleevec does not kill the leukemic stem cells, which are a small population of cells that exist primarily in the bone marrow, and are responsible for ongoing disease. This study will evaluate whether the addition of a drug called pegylated interferon-α2a given with Gleevec will better target these leukemic stem cells, causing them to die. It is hoped that by killing the leukemia stem cells with Gleevec and interferon-α2a, patients may be able to eventually stop all of their CML therapy, and have their leukemia remain in a remission without having to receive treatment.

Pegylated interferon-α2a (Pegasys) is not approved by the United States Food and Drug Administration (FDA) for the treatment of chronic myeloid leukemia (CML), but interferon-α2a is approved for the treatment of CML and has been used extensively in the treatment of this disease. The pegylated form of interferon-α2a (Pegasys) has also been widely studied and shown to be an effective treatment for CML, but the manufacturer has never sought FDA approval for this indication.


Condition Intervention Phase
Chronic Myeloid Leukemia
Drug: PEG-IFN-a2a
Phase II

Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment
Official Title: A Combination of Imatinib Mesylate & Pegylated Interferon α2a in Chronic-Phase Chronic Myeloid Leukemia: A Phase II Pilot Study Targeting Both the Primitive and Differentiated CML Progenitor Populations

Resource links provided by NLM:


Further study details as provided by University of Michigan Cancer Center:

Primary Outcome Measures:
  • To investigate whether patients with chronic-phase chronic myeloid leukemia who have achieved a complete cytogenetic response (CCyR) on imatinib mesylate (IM) can then be treated with a combination of IM and interferon-α2a (PEG-IFN-a2a). [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • To determine whether the addition of PEG-IFN-02 a to IM improves upon the quality of the molecular remission seen with IM alone. [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 20
Study Start Date: October 2007
Estimated Study Completion Date: October 2010
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental Drug: PEG-IFN-a2a
Patients will receive pegylated interferon α-2a (Pegasys®) (PEG-IFN-α2a) 180 µg subcutaneously, once a week. Patients and/or caregivers identified by the patient will be taught how to perform subcutaneous injections of the PEG-IFN-α2a by trained nurses in the chemotherapy infusion center at the University of Michigan Comprehensive Cancer Center. Those patients who do not feel comfortable receiving the injections outside of the cancer center, or are deemed unreliable in administering injections per the training nurse, will return to the cancer center infusion room on a weekly basis to receive subsequent injections.

  Eligibility

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

Inclusion Criteria:

  • diagnosis of Philadelphia chromosome positive (Ph+) chronic myeloid leukemia in chronic phase by having met all of the following criteria at the time of their initial diagnosis:

    • Cytogenetic confirmation of Philadelphia chromosome or variants of (9;22) translocations. may have secondary chromosomal abnormalities in addition to the Philadelphia chromosome.
    • Peripheral blood or bone marrow blast count < 10%.
    • Peripheral blood basophil count < 20%.
    • Platelet count ≥ 100,000 x 10^9/L.
  • eighteen years of age or older
  • must be actively receiving treatment for their CML with imatinib mesylate.
  • must be on imatinib mesylate for a minimum of 2 years, and be on a stable dose for at least one consecutive year leading up to enrollment.
  • must have an ongoing complete hematologic response (CHR) on imatinib mesylate, defined as follows:

    • WBC ≤ 10 x 10^9/L.
    • Platelet count < 450,000 x 10^9/L.
    • No blasts or promyelocytes in peripheral blood.
    • No evidence of disease-related symptoms and extramedullary disease, including the liver and spleen.
  • must have a complete cytogenetic response (CCyR) on imatinib mesylate for a minimum of 1 year leading up to enrollment. Complete cytogenetic response is defined as 0% Ph+ cells in metaphase, in the bone marrow and/or a negative peripheral blood FISH analysis for the BCR-ABL gene fusion, and an ongoing CCyR must be confirmed by bone marrow aspirate cytogenetics and/or peripheral blood FISH for BCR-ABL within 4 weeks of starting treatment.
  • may have a negative quantitative RT-PCR (QPCR) for BCR-ABL at the time time of enrollment, but if QPCR is positive, patients cannot have greater than 0.5% BCR-ABL/ABL transcript, present in 2 consecutive QPCR analyses, performed at least 3 months apart, in the 6 to 12 months leading up to enrollment.
  • must have an ECOG performance status of 0-2.
  • must be informed of the investigational nature of this study and standard alternative therapy. Must sign and give written informed consent in accordance with institutional and federal guidelines.

Exclusion Criteria:patients who:

  • have had prior progression of their CML to accelerated phase or blast crisis.
  • have previously undergone hematopoietic stem cell transplantation.
  • have previously been treated with interferon-α.
  • with an absolute neutrophil count (ANC) < 1500/mm3 and/or a platelet count < 100,000/mm3.
  • with serum bilirubin, SGOT[AST], SGPT[ALT], or serum creatinine > 1.5 x the upper limit of normal (ULN).
  • with an INR or PTT > 1.5 x ULN, with the exception of patients on treatment with oral anticoagulants.
  • with uncontrolled medical diseases such as diabetes mellitus, neuropsychiatric disorders, infection, angina, severe hypertension, pulmonary disease (chronic obstructive pulmonary disease [COPD] with hypoxemia), major organ malfunction (liver, kidney) or class III or IV cardiac disease as defined by the New York Heart Association Criteria.
  • are:

    1. pregnant
    2. breast feeding
    3. of childbearing potential without a negative pregnancy test prior to Study Day 1, and
    4. male or female of childbearing potential unwilling to use barrier contraceptive precautions throughout the trial (postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential).
  • with a history of another active malignancy within the last five years, which required treatment with chemotherapy, hormonal therapy, or radiation therapy. Exceptions to this rule include basal cell and squamous cell skin carcinomas or cervical carcinoma in situ.
  • with a history of non-compliance to medical regimens or who are considered potentially unreliable.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00573378

Contacts
Contact: Lisa Kujawski, MD 734-764-8100 kuj@umich.edu
Contact: Cancer Answer Line 1-800-865-1125

Locations
United States, Michigan
Universtiy of Michigan Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Lisa Kujawski, MD     734-764-8100     kuj@umich.edu    
Principal Investigator: Lisa Kujawski, MD            
Sponsors and Collaborators
University of Michigan Cancer Center
Investigators
Principal Investigator: Lisa Kujawski, M.D. University of Michigan
  More Information

No publications provided

Responsible Party: Universtiy of Michigan ( Dr. Lisa Kujawski, MD )
Study ID Numbers: UMCC 2006.128
Study First Received: December 13, 2007
Last Updated: December 8, 2009
ClinicalTrials.gov Identifier: NCT00573378     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Michigan Cancer Center:
CML

Additional relevant MeSH terms:
Anti-Infective Agents
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Hematologic Diseases
Antineoplastic Agents
Interferons
Myeloproliferative Disorders
Enzyme Inhibitors
Leukemia, Myeloid
Leukemia, Myeloid, Chronic-Phase
Protein Kinase Inhibitors
Antiviral Agents
Pharmacologic Actions
Imatinib
Leukemia
Neoplasms
Therapeutic Uses
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Bone Marrow Diseases

ClinicalTrials.gov processed this record on February 08, 2010