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Brief Title: Study in Patients With Chronic Leukemia
Official Title: Phase 2 Clinical Trial With Ponatinib as a Second Line Therapy for Patients With Chronic Myeloid Leukemia in Chronic Phase Resistant or Intolerant to Prior First Line Tyrosine Kinase Inhibitor Treatment
Study ID: NCT03807479
Brief Summary: This study will include patients suffering from chronic myeloid leukemia (CP-CML), who were treated with tyrosine kinase inhibitor (TKI, a substance that blocks the action of enzymes) in a previous therapy but which has not been effective. Patients will be treated with Ponatinib 30 mg in in this study. The aim of the study is to evaluate the safety and efficacy of Ponatinib as a second line treatment in patients failing or not tolerating first line therapy with any other approved TKIs. It is expected that Ponatinib, due to its efficacy, may be more effective as second line therapy than other approved TKIs and lead to improved overall survival. The effect will be determined by the molecular response rate (MMR) as the primary objective after 12 months of treatment. The safety of the drug will be evaluated on the basis if routine medical and laboratory examinations.
Detailed Description: Despite significant progress in the treatment of patients with chronic phase CML, there is still need to further optimize therapy to reach the goal of disease eradication for almost all patients. In case of imatinib failure, dasatinib and nilotinib are effective treatment options after an individualized treatment selection. Although MMR rates of around 30% after 2 years of therapy are a significant achievement, options that may improve response rates in depth are still desirable. Ponatinib is a third generation TKI with very high anti-clonal activity in all CML phases. Moreover, it also eradicates most of the known and problematic mutations and only very few (compound) mutations may induce ponatinib-resistance. Based on its favourable target spectrum, it is expected that Ponatinib may be more effective than 2nd line dasatinib or nilotinib in achieving early (i.e., at 6 months) cytogenetic and molecular responses in patients after inappropriate response to imatinib, and more effective as 2nd line treatment after failure of initial treatment with dasatinib or nilotinib than a cross-over between the 2nd generation TKIs. The basic hypothesis underlying therapeutic programs in CML is to be able to achieve meaningful and long-lasting suppression of the Philadelphia chromosome and breakpoint cluster region-abelson fusion gen (BCR-ABL). Complete cytogenetic responses have been associated with improved survival in CML, while major molecular responses are associated with improved event-free survival.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University Hospital, Halle (Saale), Saxony-Anhalt, Germany
University Hospital RWTH Aachen,Clinic for Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Department IV, Aachen, , Germany
Charité University Medicine Berlin - Medical Clinic, Department of Hematology, Oncology and Tumor Immunology, Berlin, , Germany
University Hospital Essen gGmbH, Westdeutsches Tumorzentrum; Internal Medicine (Tumor Research), Essen, , Germany
University Medicine Greifswald, Clinic and Policlinic - Internal Medicine C - Hematology and Oncology, Greifswald, , Germany
Asklepios Clinic St. Georg - Department of Oncology, Section Hematology, Hamburg, , Germany
University Hospital Mannheim GmbH, III. Medical Clinic for Hematology and Oncology, Mannheim, , Germany
Clinic for Hematologie, Marburg, , Germany
UKRUB University Hospital of Ruhr-University Bochum, Clinic for Hematology and Oncology, Minden, , Germany
University Hospital Ulm - Department for internal medicine III, Ulm, , Germany
Name: Philipp le Coutre, Prof.
Affiliation: Charité Berlin - Department of Hematology, Oncology and Tumor Immunology
Role: PRINCIPAL_INVESTIGATOR