RATIONALE: Nilotinib and imatinib mesylate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying how well giving nilotinib together with imatinib mesylate works in treating patients with early chronic phase chronic myelogenous leukemia.
OBJECTIVES: Primary * To assess the complete cytogenetic response rate at 12 months in patients with Philadelphia chromosome- and BCR-ABL-positive early chronic phase chronic myelogenous leukemia treated with nilotinib and imatinib mesylate. Secondary * To assess the complete cytogenetic response rate at 6 and 24 months in these patients. * To assess the major and complete molecular response rate at 6, 12, and 24 months in these patients. * To assess the frequency and the types of BCR-ABL kinase domain mutations at 24 months during and for 3 years after study treatment. * To assess the rate of failures and the time to failure at 12, 24, and 60 months in these patients. * To assess compliance, toxicity, and adverse events in these patients. * To understand the relationship between response, gene expression profile, biomarkers, and drug plasma concentrations in these patients. OUTLINE: This is a multicenter study. Patients receive oral nilotinib twice daily in months 1-3, 7-9, 13-15, and 19-21 and oral imatinib mesylate once daily in months 4-6, 10-12, 16-18, and 22-24. Treatment continues for 24 months in the absence of disease progression or unacceptable toxicity. Patients may be eligible to continue oral nilotinib and oral imatinib mesylate for up to another 36 months if it is in the interest of the patient. Blood samples and bone marrow biopsies are collected periodically for cytogenetic response by chromosome banding analysis and FISH analysis; real-time quantitative PCR mutational analysis and single nucleotide polymorphism analysis of BCR-ABL transcripts; and gene expression profiling and correlative biomarker studies. After completion of study therapy, patients are followed every 6 months for 3 years and then every 12 months for 5 years.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
129
Complete cytogenetic response rate
Time frame: At 12 months from study entry
Complete cytogenetic response
Time frame: At at 6 and 24 months from study entry
Major and complete molecular response rate
Time frame: At at 6, 12 and 24 months from study entry
Development of BCR-ABL kinase domain mutations (number, timing, and type)
Time frame: At at 24 months during and for 3 years after study treatment
Rate of failures and the time to failure
Time frame: At 12, 24, and 60 months from study entry
Safety and tolerability
Time frame: At 24 months from study entry
Frequency and type of adverse events (AE) and severe AE
Time frame: At 24 months from study entry
Relationship between response, the gene expression profile, the biomarkers of leukemic cells, and plasma concentrations of nilotinib and imatinib mesylate
Time frame: At 24 months from study entry
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