Clinical Trials /

Open-Label Study Evaluating Dasatinib Therapy Discontinuation in Patients With Chronic Phase Chronic Myeloid Leukemia With Stable Complete Molecular Response

NCT01850004

Description:

The study purpose is to test the hypothesis that Chronic Phase Chronic Myeloid Leukemia (CP-CML) patients with stable Complete Molecular Response (CMR) who discontinue Dasatinib treatment are able to maintain a sustained remission in the long-term, with undetectable or minimally detectable BCR-ABL residual disease.

Related Conditions:
  • Chronic Myeloid Leukemia
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Open-Label Study Evaluating Dasatinib Therapy Discontinuation in Patients With Chronic Phase Chronic Myeloid Leukemia With Stable Complete Molecular Response
  • Official Title: Open-Label Single Arm Phase 2 Study Evaluating Dasatinib Therapy Discontinuation In Patients With Chronic Phase Chronic Myeloid Leukemia (CP-CML) With Stable Complete Molecular Response (CMR) DASFREE

Clinical Trial IDs

  • ORG STUDY ID: CA180-406
  • SECONDARY ID: 2012-001421-27
  • NCT ID: NCT01850004

Conditions

  • Chronic Phase Chronic Myeloid Leukemia

Interventions

DrugSynonymsArms
DasatinibSprycelDasatinib

Purpose

The study purpose is to test the hypothesis that Chronic Phase Chronic Myeloid Leukemia (CP-CML) patients with stable Complete Molecular Response (CMR) who discontinue Dasatinib treatment are able to maintain a sustained remission in the long-term, with undetectable or minimally detectable BCR-ABL residual disease.

Detailed Description

      Primary Purpose: Protocol designed to evaluate remission of disease after treatment
      discontinuation. Treatment re-started if relapse occurs
    

Trial Arms

NameTypeDescriptionInterventions
DasatinibExperimentalDasatinib 50, 80, 100, 140, 180 mg tablets by mouth, once daily, up to 60 months
  • Dasatinib

Eligibility Criteria

        For more information regarding BMS clinical trial participation, please visit
        www.BMSStudyConnect.com

        Inclusion Criteria

          -  Signed Written Informed Consent

          -  Target Population

               1. Men and women diagnosed with CP-CML, on treatment with dasatinib for a minimum of
                  2 years at the time of enrollment and in dasatinib-induced complete molecular
                  remission ongoing for at least 1 year prior to study entry.

               2. Patients are eligible if they have been in stable dasatinib induced CMR for a
                  minimum of nine months, documented by at least three assessments, conducted 2 -
                  6.5 months apart, at a local lab.

               3. Subjects who have received dasatinib beyond first or second line treatment and
                  meet other enrollment criteria are eligible for the study provided prior
                  Tyrosine-kinase inhibitors (TKI) were discontinued due to intolerance or lack
                  efficacy, although only one instance of lack of efficacy to TKI is allowed.

               4. Eastern Co-Operative Group (ECOG) Performance Status (PS) of 0-1

          -  Age and Reproductive Status

               1. Men and women, ages ≥18

               2. Women of childbearing potential (WOCBP) must have a negative serum or urine
                  pregnancy test within 24 hours prior to the restart of study drug

               3. Women must not be breastfeeding

               4. WOCBP must agree to follow instructions for method(s) of contraception at the
                  restart of treatment with study drug (dasatinib) and for the duration treatment
                  plus 30 days (duration of ovulatory cycle) for a total of 30 days post-treatment
                  completion

               5. Men who are sexually active with WOCBP must agree to follow instructions for
                  method(s) of contraception for 90 days after study entry (withdrawal of
                  dasatinib), at restart of study drug (dasatinib) and for the duration of
                  treatment with study drug (dasatinib) plus 90 days (duration of sperm turnover)
                  for a total of 90 days post-treatment completion

        Exclusion Criteria:

          -  Target Disease Exceptions

               1. Patients who have not achieved a 1-log reduction in BCR-ABL transcript levels
                  compared with baseline as determined by local standards or > 10% IS
                  [International Standard]) documented at 3.0-6.5 months since the initial start of
                  dasatinib therapy.

               2. Patients who have previously undergone hematopoietic stem cell transplantation
                  (SCT) or who are scheduled for SCT

               3. Previous diagnosis of CML accelerated phase or blast crisis

          -  Medical History and Concurrent Diseases

               1. Prior or concurrent malignancy, except the following:

                    -  Curatively treated basal cell or squamous cell skin cancer

                    -  Cervical carcinoma in situ

                    -  Adequately treated Stage I or II cancer from which the subject is currently
                       in complete remission

                    -  Any other cancer from which the subject has been disease free for 3 years

               2. A serious uncontrolled medical disorder or active infection that would impair the
                  ability of the subject to receive protocol therapy in case re-initiation of
                  dasatinib is needed.

               3. Uncontrolled or significant cardiovascular disease

               4. Subjects with prior history of pericardial effusion or pleural effusion that
                  required thoracentesis are excluded. Subjects with prior history of pericardial
                  or pleural effusion that was clinically manageable and a maintained CMR for ≥ 1
                  year on a stable dose of dasatinib are allowed.

               5. History of significant bleeding disorder unrelated to CML

          -  Allergies and Adverse Drug Reaction

             a. Subjects with known hypersensitivity to excipients of Dasatinib tablets

          -  Sex and Reproductive Status

               1. Patients who are pregnant or breastfeeding or likely to become pregnant

               2. Men whose partner is unwilling or unable to avoid pregnancy

          -  Other Exclusion Criteria

               1. Patients with a history of non-compliance to CML treatment and monitoring
                  requirements

               2. Prisoners or subjects who are involuntarily incarcerated

          -  Additional Criteria for Patients Eligible to Restart Dasatinib

               -  Any patient who has lost MMR and is eligible for re-starting dasatinib therapy
                  must not have developed a condition that precludes dasatinib use.

        Other protocol defined inclusion/exclusion criteria could apply
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Major Molecular Response (MMR) Rate
Time Frame:At 12 months after Dasatinib discontinuation (assessed up to approximately June 4, 2018)
Safety Issue:
Description:Major Molecular Response (MMR) rate at 12 months is the percentage of participants who maintain MMR (BCR-ABL transcripts < 0.1% on the International Scale [IS]) at 12 months after Dasatinib discontinuation without restarting Dasatinib

Secondary Outcome Measures

Measure:Event-free Survival (EFS) Rate After Dasatinib Discontinuation
Time Frame:At 12 months
Safety Issue:
Description:EFS was defined as the time from the date of dasatinib treatment discontinuation to the date of loss of MMR.
Measure:Relapse-free Survival (RFS) After Dasatinib Discontinuation
Time Frame:At 6,12,18, 24 months and every 6 months thereafter up to 5 years
Safety Issue:
Description:Relapse is defined as any of the following events while a subject is on study: the loss of MMR, loss of Complete Cytogenetic Response (CCyR), loss of Complete Hematologic Response (CHR) or progression to advanced/blastic phase. RFS is defined as the time from Dasatinib treatment discontinuation to the date of relapse. Subjects who did not relapse were censored on the date of their last molecular assessment.
Measure:Progression Free Survival (PFS) Rate
Time Frame:From Dasatinib treatment discontinuation up to 5 years
Safety Issue:
Description:Progression is defined as Transformation to Accelerated Phase or Blast Crisis (AP/BC) Accelerated Phase (AP) Blasts in PB or BM 15-29%; Blast + promyelocytes >= 30% with blasts < 30% or ACA in Ph+ cells (clonal progression), or basophils in blood >= 20%,or platelets < 100 x 109 /L unrelated to therapy Blastic Phase or Crisis (BP/BC) Blasts in PB or BM >= 30%, or extramedullary blast cell involvement (with the exception of spleen and liver)

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Bristol-Myers Squibb

Last Updated

November 2, 2018