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Study of Efficacy and Safety of Asciminib in Combination With Imatinib in Patients With Chronic Myeloid Leukemia in Chronic Phase (CML-CP)

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ClinicalTrials.gov Identifier: NCT03578367
Recruitment Status : Recruiting
First Posted : July 6, 2018
Last Update Posted : April 10, 2019
Sponsor:
Information provided by (Responsible Party):
Novartis ( Novartis Pharmaceuticals )

Brief Summary:
To evaluate efficacy, safety and pharmacokinetic profile of asciminib 40mg+imatinib or asciminib 60mg+imatinib versus continued imatinib and versus nilotinib in pre-treated patients with Chronic Myeloid Leukemia in chronic phase (CML-CP)

Condition or disease Intervention/treatment Phase
CML Chronic Myelogenous Leukemia Leukemia, Myeloid Chronic Hematologic Diseases Drug: Asciminib add-on Drug: Imatinib Drug: Nilotinib Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 120 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2, Multi-center, Open-label, Randomized Study of Oral Asciminib Added to Imatinib Versus Continued Imatinib Versus Switch to Nilotinib in Patients With CML-CP Who Have Been Previously Treated With Imatinib and Have Not Achieved Deep Molecular Response
Actual Study Start Date : November 22, 2018
Estimated Primary Completion Date : November 12, 2020
Estimated Study Completion Date : October 20, 2021


Arm Intervention/treatment
Experimental: Asciminib 60mg QD + Imatinib 400mg QD
Asciminib 60 mg taken once daily in combination with Imatinib 400 mg taken once daily
Drug: Asciminib add-on
Asciminib 60 mg or 40 mg taken orally once daily in addition to Imatinib 400 mg taken orally once daily
Other Name: ABL001 (asciminib), STI571 (imatinib)

Experimental: Asciminib 40mg QD + Imatinib 400mg QD
Asciminib 40 mg taken once daily in combination with Imatinib 400 mg taken once daily
Drug: Asciminib add-on
Asciminib 60 mg or 40 mg taken orally once daily in addition to Imatinib 400 mg taken orally once daily
Other Name: ABL001 (asciminib), STI571 (imatinib)

Active Comparator: Imatinib 400mg QD
Imatinib 400 mg taken once daily
Drug: Imatinib
Imatinib 400 mg taken orally once daily
Other Name: STI571, continuation treatment

Active Comparator: Nilotinib 300mg BID
Nilotinib 300 mg taken twice daily
Drug: Nilotinib
Nilotinib 300 mg taken orally twice daily (total daily dose of 600 mg)
Other Name: AMN107, switch to nilotinib treatment




Primary Outcome Measures :
  1. Molecular Response (MR)^4.5 rate between asciminib+imatinib and imatinib alone [ Time Frame: at 48 weeks ]
    Difference in the proportion of subjects with MR^4.5 (BCR-ABL1 (Fusion gene from breakpoint cluster region and Abelson genes) ratio of ≤ 0.0032%) at 48 weeks between asciminib+imatinib and imatinib alone


Secondary Outcome Measures :
  1. MR^4.5 rate at 48 weeks [ Time Frame: at 48 weeks ]
    Difference in the proportion of subjects with MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) at 48 weeks between asciminib+imatinib and nilotinib

  2. Rate of MR^4.5 at 96 weeks [ Time Frame: at 96 weeks ]
    Proportion of subjects with MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) at 96 weeks

  3. Rate of MR^4.5 by 48 and 96 weeks [ Time Frame: by 48 weeks and 96 weeks ]
    Best observed rate of MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) under randomized treatment up to the specific time point

  4. Sustained MR^4.5 from 48 weeks until 96 weeks [ Time Frame: from 48 weeks until 96 weeks ]
    Percentage of participants who are in MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) at both 48 and 96 weeks and who have no loss of MR^4.5 in between those two time points. This endpoint will be analyzed at 96 weeks.

  5. Time to MR^4.5 [ Time Frame: up to 96 weeks ]
    Time to MR^4.5 is the time from randomization to first MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) computed only for subjects who achieved MR^4.5

  6. Difference in rate of MR^4.5 at 48 weeks [ Time Frame: at 48 weeks ]
    Difference in the proportion of subjects with MR^4.5 (BCR-ABL1 ratio of ≤ 0.0032%) at 48 weeks between asciminib+imatinib and nilotinib

  7. Pharmacokinetic profile of asciminib and imatinib when administered in combination - Cmax [ Time Frame: up to Week 4 Day 28 ]
    The maximum (peak) observed drug concentration after dose administration

  8. Pharmacokinetic profile of asciminib and imatinib when administered in combination - Tmax [ Time Frame: up to Week 4 Day 28 ]
    The time to reach maximum (peak) drug concentration after dose administration

  9. Pharmacokinetic profile of asciminib and imatinib when administered in combination - Cmin [ Time Frame: up to 96 weeks ]
    Minimum drug concentration

  10. Pharmacokinetic profile of asciminib and imatinib when administered in combination - AUClast [ Time Frame: up to Week 4 Day 28 ]
    The AUC from time zero to the last measurable concentration sampling time (Tlast)

  11. Pharmacokinetic profile of asciminib and imatinib when administered in combination - AUCtau [ Time Frame: up to Week 4 Day 28 ]
    The AUC calculated to the end of a dosing interval (tau) at steady-state



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male or female patients ≥ 18 years of age with a confirmed diagnosis of Chronic Myeloid Leukemia in chronic phase (CML-CP).
  2. Minimum of two years (24 calendar months) treatment with imatinib first line for CML-CP (patients have to be on imatinib 400 mg QD at randomization and had no dose change in the past three months).
  3. BCR-ABL1 levels > 0.01% IS (International Scale) and ≤ 1% IS at the time of study entry as confirmed with a central assessment at screening; patients must not have achieved deep molecular response (MR4 IS) at any time during prior imatinib treatment.
  4. Patient must meet the following laboratory values before randomization:

    • Absolute Neutrophil Count ≥ 1.5 x 10E9/L
    • Platelets ≥ 75 x 10E9/L
    • Hemoglobin ≥ 9 g/dL
    • Serum creatinine < 1.5 mg/dL
    • Total bilirubin ≤ 1.5 x ULN (Upper Limit of Normal) except for patients with Gilbert's syndrome who may only be included with total bilirubin ≤ 3.0 x ULN
    • Aspartate transaminase (AST) ≤ 3.0 x ULN
    • Alanine transaminase (ALT) ≤ 3.0 x ULN
    • Alkaline phosphatase ≤ 2.5 x ULN
  5. Patients must have the following laboratory values ≥ Lower Limit of Normal or corrected to within normal limits with supplements prior to randomization: potassium, magnesium, phosphorus, total calcium (corrected for serum albumin).

Key Exclusion Criteria:

  1. Treatment failure according to European Leukemia Network (ELN) criteria 2013 during imatinib treatment.
  2. Known second chronic phase of CML after previous progression to Accelerated Phase (AP)/Blast Crisis (BC).
  3. Previous treatment with any tyrosine kinese inhibitors (TKIs) other than imatinib.
  4. History or current diagnosis of ECG abnormalities indicating significant risk or safety for subjects participating in the study such as:

    • History of myocardial infarction, angina pectoris, coronary artery bypass graft within 6 months prior to randomization
    • Concomitant clinically significant arrhythmias
    • Resting QTcF ≥ 450 msec (male) or ≥ 460 msec (female) prior to randomization
    • Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome, or any of the following:

      • Risk factors for Torsades de Pointes
      • Concomitant medications with a "known" risk of Torsades de Pointes
      • inability to determine the QTcF interval
  5. Severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol (e.g. uncontrolled diabetes, active or uncontrolled infection, uncontrolled clinically significant hyperlipidemia and high serum amylase)
  6. History of acute pancreatitis within 1 year prior to randomization or past medical history of chronic pancreatitis.
  7. History of other active malignancy within 3 years prior to randomization with the exception of basal cell skin cancer, indolent prostate cancer and carcinoma in situ treated curatively.

Other protocol defined inclusion/exclusion may apply.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03578367


Contacts
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Contact: Novartis Pharmaceuticals 1-888-669-6682 novartis.email@novartis.com
Contact: Novartis Pharmaceuticals +41613241111

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Sponsors and Collaborators
Novartis Pharmaceuticals
Investigators
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Study Director: Novartis Pharmaceuticals Novartis Pharmaceuticals

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Responsible Party: Novartis Pharmaceuticals
ClinicalTrials.gov Identifier: NCT03578367     History of Changes
Other Study ID Numbers: CABL001E2201
First Posted: July 6, 2018    Key Record Dates
Last Update Posted: April 10, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Plan Description:

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data is currently available according to the process described on www.clinicalstudydatarequest.com.


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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Novartis ( Novartis Pharmaceuticals ):
Asciminib
ABL001
CML
Chronic Myelogenous Leukemia
leukemia, myeloid chronic
Hematologic Diseases
Imatinib
Nilotinib
deep molecular response
DMR
Ph+ CML
chronic phase
cancer of the white blood cells
tyrosine kinase inhibitor
leukemia, myeloid
leukemia

Additional relevant MeSH terms:
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Leukemia
Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Hematologic Diseases
Neoplasms by Histologic Type
Neoplasms
Myeloproliferative Disorders
Bone Marrow Diseases
Imatinib Mesylate
Niacinamide
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Vitamin B Complex
Vitamins
Micronutrients
Nutrients
Growth Substances
Physiological Effects of Drugs