Myeloproliferative Neoplasms Clinical Trial

Ponatinib in Participants With Resistant Chronic Phase Chronic Myeloid Leukemia (CP-CML) to Characterize the Efficacy and Safety of a Range of Doses

Summary

The purpose of this study is to characterize the efficacy of ponatinib administered in 3 starting doses (45 mg, 30 mg, and 15 mg daily) in participants with CP-leukemia-cml/" >CML who are resistant to prior tyrosine-kinase inhibitor (TKI) therapy or have T315I mutation, as measured by <=1 % Breakpoint Cluster Region-Abelson Transcript Level using International Scale (BCR-ABL1IS) at 12 months.

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Full Description

The drug being tested in this study is ponatinib. This study will characterize the safety and efficacy of ponatinib over a range of 3 starting doses.

The study will enroll 276 participants in 3 cohorts and each cohort will have 92 participants. All the participants will be randomized to receive once-daily oral administration of 1 of 3 starting doses of ponatinib:

Cohort A: 45 mg ponatinib tablet
Cohort B: 30 mg ponatinib tablet
Cohort C: 15 mg ponatinib tablet

The study is designed to consist of 2 periods: 24-cycle Main treatment period and optional treatment continuation period. Participants will be treated with their randomized dose of study drug in the Main Treatment Period until the occurrence of at least one of the following: absence of CHR by 3 months, absence of MCyR at 12 months, absence of <=1% BCR-ABL1IS at 12 months, loss of <=1% BCR-ABL1IS development of intolerance, or completion of all 24 cycles of treatment (whichever occurs first). Following completion of approximately 5 years or following early withdrawal, participants may enter into an optional treatment continuation period.

This multi-center trial will be conducted in the United States, United Kingdom, Republic of Korea, Spain, France, Taiwan, Australia, Canada, Italy, Chile, Japan, Germany, Argentina, Poland, Czech Republic, Denmark, Hong Kong, Portugal, Russia, Singapore, Switzerland, and Sweden. The overall time to participate in this study is approximately 96 months. Participants will make a final visit to the clinic approximately 30 days after the last dose of study treatment.

View Eligibility Criteria

Eligibility Criteria

Inclusion Criteria:

Have chronic phase-chronic myelogenous leukemia/chronic myeloid leukemia (CP-CML) and have received at least two prior tyrosine kinase inhibitor (TKI) therapies and have demonstrated resistance to treatment OR have documented history of presence of T315I mutation after receiving any number of prior TKI.

o] The diagnosis of chronic myeloid leukemia (CML) will be made using standard hematopathologic and cytogenetic criteria; CP-CML will be defined by all of the following: i <15% blasts in bone marrow ii <30% blasts plus promyelocytes in bone marrow iii <20% basophils in peripheral blood. iv >= 100*10^9/liter (L) platelets (>=100,000/mm^3). v No evidence of extramedullary disease except hepatosplenomegaly vi No prior diagnosis of AP-CML, and BP-CML o] Cytogenetic assessment at screening must demonstrate the BCR-ABL1 fusion by presence of the t(9;22) Philadelphia chromosome.

i Variant translocations are only allowed provided they meet inclusion criterion 1d.

o] Resistance to prior TKI therapy is defined as follows (participants must meet at least 1 criterion): i Three months after the initiation of prior TKI therapy: No cytogenetic response (>95% Ph+) or failure to achieve CHR or new mutation ii Six months after the initiation of prior TKI therapy: BCR-ABL1IS >10% and/or Ph+ >65% or new mutation iii Twelve months after the initiation of prior TKI therapy: BCR ABL1IS >10% and/or Ph+ >35% or new mutation iv At any time after the initiation of prior TKI therapy, the development of a new BCR-ABL1 kinase domain mutation(s) v At any time after the initiation of prior TKI therapy, the development of new clonal evolution vi At any time after the initiation of prior TKI therapy, the loss of CHR, or CCyR, or the confirmed loss of MMR in 2 consecutive tests, one of which has a BCR-ABL1IS transcript level of >=1% or new mutation o] >1% of BCR-ABL1IS as shown by real-time polymerase chain reaction

Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.

Have adequate renal function as defined by the following criterion:

o] Serum creatinine <=1.5*ULN for institution o] Estimated creatinine clearance >=30 milliliter per minute (mL/min) (Cockcroft-Gault formula)

Have adequate hepatic function as defined by the following criteria:

o] Total serum bilirubin <=1.5*ULN, unless due to Gilbert's syndrome o] Alanine transaminase (ALT) <=2.5*ULN, or <=5*ULN if leukemic infiltration of the liver is present o] Aspartate transaminase (AST) <=2.5*ULN, or <=5*ULN if leukemic infiltration of the liver is present

Have normal pancreatic status as defined by the following criterion:

o] Serum lipase and amylase <=1.5*ULN

Have normal QT interval corrected (Frederica) (QTcF) interval on screening electrocardiogram (ECG) evaluation, defined as QTcF of <=450 milliseconds (ms) in males or <=470 ms in females.
Have a negative pregnancy test documented prior to enrollment (for females of childbearing potential).
Agree to use a highly effective form of contraception with sexual partners from randomization through at least 4 months after the end of treatment (for female and male participants who are fertile).
Provide written informed consent.
Be willing and able to comply with scheduled visits and study procedures.
Have recovered from toxicities related to prior anticancer therapy to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v 4.0 grade <=1.

Exclusion Criteria:

Have used any approved TKIs or investigational agents within 2 weeks or 6 half-lives of the agent, whichever is longer, prior to receiving study drug.
Received interferon, cytarabine, or immunotherapy within 14 days, or any other cytotoxic chemotherapy, radiotherapy, or investigational therapy within 28 days prior to receiving the first dose of ponatinib, or have not recovered (>grade 1 by NCI CTCAE, version 4.0) from AEs (except alopecia), due to agents previously administered.
Have undergone autologous or allogeneic stem cell transplant <60 days prior to receiving the first dose of ponatinib; have any evidence of ongoing graft-versus-host disease (GVHD) or GVHD requiring immunosuppressive therapy.
Are being considered for hematopoietic stem cell transplant (HSCT) within 6-12 months of enrollment (note: ponatinib is not to be used as a bridge to HSCT in this trial).
Are taking medications with a known risk of Torsades de Pointes.
Have previously been treated with ponatinib.
Have active CNS disease as evidenced by cytology or pathology; in the absence of clinical CNS disease, lumbar puncture is not required. History itself of CNS involvement is not exclusionary if CNS has been cleared with a documented negative lumbar puncture.

Have clinically significant, uncontrolled, or active cardiovascular disease, specifically including, but not restricted to:

o] Any history of myocardial infarction (MI), unstable angina, cerebrovascular accident, or Transient Ischemic Attack (TIA) o] Any history of peripheral vascular infarction, including visceral infarction o] Any revascularization procedure, including the placement of a stent o] Congestive heart failure (CHF) (New York Heart Association [NYHA] class III or IV) within 6 months prior to enrollment, or left ventricular ejection fraction (LVEF) less than lower limit of normal, per local institutional standards, within 6 months prior to enrollment o] History of clinically significant (as determined by the treating physician) atrial arrhythmia or any history of ventricular arrhythmia o] Venous thromboembolism, including deep venous thrombosis or pulmonary embolism, within 6 months prior to enrollment

Have uncontrolled hypertension (that is, >150 and >90 for systolic blood pressure (SBP) and diastolic blood pressure (DBP) respectively). Participants with hypertension should be under treatment at study entry to ensure blood pressure control. Those requiring 3 or more antihypertensive medications should be discussed with the medical monitor.
Have poorly controlled diabetes defined as HbA1c values of >7.5%. Participants with preexisting, well-controlled diabetes are not excluded.
Have a significant bleeding disorder unrelated to CML.
Have a history of alcohol abuse.
Have a history of either acute pancreatitis within 1 year of study enrollment or of chronic pancreatitis.
Have malabsorption syndrome or other gastrointestinal illness that could affect oral absorption of study drug.
Have a history of another malignancy, other than cervical cancer in situ or basal cell or squamous cell carcinoma of the skin; the exception is if participants have been disease-free for at least 5 years, and are deemed by the investigator to be at low risk for recurrence of that malignancy.
Are pregnant or lactating.
Have undergone major surgery (with the exception of minor surgical procedures, such as catheter placement or BM biopsy) within 14 days prior to first dose of ponatinib.
Have an active infection which requires intravenous antibiotics.
Have a known history of human immunodeficiency virus infection; testing is not required in the absence of prior documentation or known history.
Have any condition or illness that, in the opinion of the investigator, would compromise participant safety or interfere with the evaluation of the drug.
Have hypersensitivity to the ponatinib active substance or to any of its inactive ingredients.

Study is for people with:

Myeloproliferative Neoplasms

Phase:

Phase 2

Estimated Enrollment:

283

Study ID:

NCT02467270

Recruitment Status:

Active, not recruiting

Sponsor:

Takeda

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There are 85 Locations for this study

See Locations Near You

Emory University Winship Cancer Institute
Atlanta Georgia, 30322, United States
Indiana Blood & Marrow Transplantation
Indianapolis Indiana, 46237, United States
University of Maryland Medical Center
Baltimore Maryland, 21201, United States
Michigan Medicine
Ann Arbor Michigan, 48109, United States
Barbara Ann Karmanos Cancer Institute
Detroit Michigan, 48201, United States
University of Minnesota Medical School
Minneapolis Minnesota, 55455, United States
University of Nebraska Medical Center
Omaha Nebraska, 68198, United States
Hackensack University Medical Center
Hackensack New Jersey, 07601, United States
Memorial Sloan-Kettering Cancer Center - New York
New York New York, 10065, United States
NewYork-Presbyterian Weill Cornell Medical Center
New York New York, 10065, United States
Duke University Medical Center
Durham North Carolina, 27710, United States
Cleveland Clinic Taussig Cancer Institute Main Campus
Cleveland Ohio, 44195, United States
Oregon Health and Science University
Portland Oregon, 97239, United States
Abramson Cancer Center
Philadelphia Pennsylvania, 19104, United States
MD Anderson Cancer Center
Houston Texas, 77030, United States
University of Utah Huntsman Cancer Institute
Salt Lake City Utah, 84112, United States
Fundaleu
Ciudad Autonoma de Buenos Aires Buenos Aires, C1114, Argentina
Hospital General de Agudo Jose Maria Ramos Mejia
Ciudad Autonoma de Buenos Aires Buenos Aires, C1221, Argentina
Hospital Italiano La Plata
La Plata Buenos Aires, B1900, Argentina
Royal North Shore Hospital
Saint Leonards New South Wales, 2065, Australia
Royal Adelaide Hospital
Adelaide South Australia, 5000, Australia
Princess Margaret Hospital - Toronto
Toronto Ontario, M5G 2, Canada
Jewish General Hospital
Montreal Quebec, H3T 1, Canada
Saskatchewan Cancer Agency
Regina Saskatchewan, S4T 7, Canada
Hospital del Salvador
Providencia Santiago, 75009, Chile
Centro de Investigaciones Clinicas Vina del Mar
Vina del Mar Valparaiso, 25403, Chile
Ustav Hematologie a Krevni Transfuze Praha
Prague Praha, 12820, Czechia
Fakultni Nemocnice Olomouc
Olomouc , 772 0, Czechia
Aarhus University Hospital
Aarhus C Aarhus, DK-80, Denmark
Centre de Lutte Contre le Cancer - Institut Bergonie
Bordeaux Aquitaine, 33076, France
Centre Hospitalier Universitaire de Nancy Hopital de Brabois
Vandoeuvre les Nancy Lorraine, 54511, France
Institut Universitaire du Cancer de Toulouse Oncopole
Toulouse Cedex 9 Midi-pyrenees, 31059, France
Centre Hospitalier Regional Universitaire de Lille
Lille cedex NORD Pas-de-calais, 59037, France
Center Hospitalier Universitaire d'Angers
Angers Cedex 9 PAYS DE LA Loire, 49933, France
Centre Hospitalier Universitaire de Nantes Hotel Dieu
Nantes Cedex 1 PAYS DE LA Loire, 44093, France
Centre Hospitalier Universitaire de Poitiers
Poitiers Cedex Poitou-charentes, 86021, France
Centre Hospitalier Universitaire de Nice Hopital l'Archet
Nice Cedex 3 Provence Alpes COTE D'azur, 06202, France
Universitaetsklinikum Heidelberg
Mannheim Baden-wuerttemberg, 68169, Germany
Universitatsklinikum Ulm
Ulm Baden-wuerttemberg, 89081, Germany
Universitatsmedizin Rostock
Rostock Mecklenburg-vorpommern, 18057, Germany
Uniklinik RWTH Aachen
Aachen Nordrhein-westfalen, 52074, Germany
Universitaetsklinikum Essen
Essen Nordrhein-westfalen, 45147, Germany
Universitatsklinikum Jena
Jena Thuringen, 07747, Germany
Charite Universitatsmedizin Berlin
Berlin , 13353, Germany
Universitatsklinikum Hamburg-Eppendorf
Hamburg , 20246, Germany
Queen Mary Hospital
Hong Kong , 852, Hong Kong
Azienda Ospedaliera San Gerardo di Monza
Monza Monza E Brianza, 20090, Italy
Azienda Ospedaliera Ospedali Riuniti Marche Nord
Pesaro Pesaro E Urbino, 61100, Italy
Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele
Catania , 95124, Italy
Azienda Ospedaliera Universitaria San Martino
Genova , 16132, Italy
Azienda Sanitaria Locale di Pescara Ospedale Civile Dello Spirito Santo
Pescara , 65124, Italy
Sapienza Universita Di Roma
Roma , 00161, Italy
AOUI - Ospedale Policlinico "Giambattista Rossi" di Borgo Roma
Verona , 37134, Italy
The Catholic University of Korea, Seoul St. Mary's Hospital
Seoul , 6591, Korea, Republic of
Samodzielny Publiczny Szpital Kliniczny Nr 1 we Wroclawiu
Wroclaw Dolnoslaskie, 50-36, Poland
Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Lodzi
Lodz Lodzkie, 93-51, Poland
Malopolskie Centrum Medyczne
Krakow Malopolskie, 30-51, Poland
Instytut Hematologii i Transfuzjologii
Warszawa Mazowieckie, 02-77, Poland
Uniwersyteckie Centrum Kliniczne
Gdansk Pomorskie, 80-95, Poland
Instituto Portugues de Oncologia de Lisboa Francisco Gentil
Lisboa , 1090-, Portugal
Centro Hospitalar Sao Joao
Porto , 4200-, Portugal
Rostov State Medical University
Rostov-na-Donu Rostov, 34402, Russian Federation
Chelyabinsk Regional Clinical Hospital
Chelyabinsk , 45407, Russian Federation
Kemerovo Regional Clinical Hospital
Kemerovo , 65006, Russian Federation
GBUZ Moscow Clinical Scientific Center DZM
Moscow , 11112, Russian Federation
Russian Academy of Medical Science
Moscow , 12516, Russian Federation
FGU Russian Scientific Research Institute of Hematology and Transfusiology
Saint Petersburg , 19102, Russian Federation
Almazov Federal North-West Medical Research Centre of Department of Health of Russian Federation
Saint Petersburg , 19734, Russian Federation
Samara State Medical University
Samara , 44309, Russian Federation
Saratov State Medical University
Saratov , 35501, Russian Federation
Singapore General Hospital
Singapore , 16985, Singapore
Hospital Regional Universitario Carlos Haya
Malaga Andalucia, 29010, Spain
Hospital Universitario de Gran Canaria Doctor Nergrin
Las Palmas de Gran Canaria LAS Palmas, 35010, Spain
Hospital Clinic i Provincial de Barcelona
Barcelona , 08036, Spain
Hospital Universitario de La Princesa
Madrid , 28006, Spain
Hospital Universitario Ramon Y Cajal
Madrid , 28034, Spain
Hospital Clinico Universitario de Valencia
Valencia , 46010, Spain
Akademiska Sjukhuset
Uppsala , 751 8, Sweden
University Hospital Zurich
Zurich , 8091, Switzerland
National Taiwan University Hospital
Taipei , 100, Taiwan
Royal Liverpool University Hospital NHS Trust
Liverpool England, L7 8X, United Kingdom
King's College Hospital NHS Foundation Trust
London England, SE5 9, United Kingdom
Imperial College Healthcare NHS Trust
London England, W12 0, United Kingdom
Nottingham City Hospital NHS Trust
Nottingham England, NG5 1, United Kingdom
Churchill Hospital
Oxford England, OX3 7, United Kingdom
Beatson West of Scotland Cancer Centre
Glasgow Scotland, G12 0, United Kingdom

How clear is this clinincal trial information?

Study is for people with:

Myeloproliferative Neoplasms

Phase:

Phase 2

Estimated Enrollment:

283

Study ID:

NCT02467270

Recruitment Status:

Active, not recruiting

Sponsor:


Takeda

How clear is this clinincal trial information?

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