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Brief Title: Safety and Efficacy of Pegylated IFN-alpha 2B Added to Dasatinib in Newly Diagnosed Chronic Phase Myeloid Leukemia
Official Title: A Safety and Efficacy Study of Adding Low Dose Pegylated IFN-alpha 2B to Standard Dose Dasatinib in Patients With Newly Diagnosed Chronic Phase Myeloid Leukemia
Study ID: NCT01725204
Brief Summary: Patients with newly diagnosed CML have excellent outcomes with tyrosine kinase inhibitors (TKI). However, a few patients will be cured with TKIs alone, and thus need continued life-long treatment. Some patients achieve complete molecular remission (CMR), and this rate is higher with second generation TKIs compared with imatinib. Some experience with drug discontinuation in CMR has been derived from a few small studies, most notably the French STIM study. Approximately 40 % of patients with a minimum of two years in MR4.5 (4.5 log reduction in molecular response) can stop imatinib without relapse, indicating possible cure. To increase the non-relapse rate is of major importance. To achieve a permanent "cure" without stem cell transplantation is presently the most relevant goal of clinical studies in CML. The investigators hypothesize that to significantly increase cure rates in CML, therapy should eradicate leukemic stem cells and/or induce or restore anti-CML immunity. Second generation TKIs may have a more profound effect on the stem cell pool as compared to imatinib. This is assessed in our current randomized study with a reduction in leukemic stem cell burden as the primary endpoint (NordCML006). Interferon-alpha (IFN) has a prominent immunomodulatory and antiproliferative mode of action, and has also activity in stem cells. Pegylated IFN in combination with imatinib results in improved therapy responses as compared to imatinib monotherapy. This advantage may translate into higher cure rates. Dasatinib has a unique dual mechanism of action: it is the most potent of available TKIs and induces immunological effects that are different from those of IFN. Both of these drugs may have immunological adverse-effects when used as a monotherapy. However, immunological adverse-effects may also be markers of anti-leukemia efficacy. A combination of dasatinib and pegylated IFN (PegIFN) may have additive or synergistic effects and should be tested in a clinical study.
Detailed Description:
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Helsinki University Central Hospital, Helsinki, , Finland
Bergen University Central Hospital, Bergen, , Norway
Rikshospitalet, Oslo, , Norway
Stavanger University Hospital, Stavanger, , Norway
University Hospital of Northern Norway, Tromsø, , Norway
St Olavs Hospital - Trondheim University Hospital, Trondheim, , Norway
Linköping University Hospital, Linköping, , Sweden
Sunderby Sjukhus, Luleå, , Sweden
Lund University Hospital, Lund, , Sweden
Karolinska University Hospital, Stockholm, , Sweden
Sundsvall County Hospital, Sundsvall, , Sweden
Umeå University Hospital, Umeå, , Sweden
Uppsala University Hospital, Uppsala, , Sweden
Örebro University Hospital, Örebro, , Sweden
Name: Henrik Hjorth-Hansen, MD PhD
Affiliation: Norwegian University of Science and Technology
Role: STUDY_CHAIR