This study will assess the pharmacokinetics of nilotinib in Ph+ CML pediatric patients that are newly diagnosed or resistant or intolerant to imatinib or dasatinib or refractory or relapsed Ph+ ALL compared to the adult populations. It will also evaluate safety and activity of nilotinib as secondary objectives.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Nilotinib capsules were delivered in bottles with dose strengths of 50mg, 150mg and 200mg. Patients were administered nilotinib 230 mg/m2 (per BSA) bid, orally, rounded to the nearest 50 mg (max single dose 400 mg) for 28 days (1 cycle) for up to 12 cycles prior to protocol amendment 3 and up to 24 cycles post amendment 3. Capsules were to be swallowed whole with water. Apple sauce (puréed apple) may have been used as a vehicle for dosing where capsules were not able to be swallowed whole with water.
Novartis Investigative Site
Bordeaux, Aquitaine, France
Novartis Investigative Site
Lille, France
Novartis Investigative Site
Paris, France
Summary of Nilotinib Non-compartmental PK Parameters: Cmax
The full PK profiles of nilotinib in pediatric patients were assessed using serial sampling following a single 230 mg/m2 dose on Cycle 1 Day 1.
Time frame: Cycle 1 Day 1
Summary of Nilotinib Non-compartmental PK Parameters: Tmax
The full PK profiles of nilotinib in pediatric patients were assessed using serial sampling following a single 230 mg/m2 dose on Cycle 1 Day 1.
Time frame: Cycle 1 Day 1
Summary of Nilotinib Non-compartmental PK Parameters: AUClast (Last = 24h)
The full PK profiles of nilotinib in pediatric patients were assessed using serial sampling following a single 230 mg/m2 dose on Cycle 1 Day 1.
Time frame: Cycle 1 Day 1
Summary of Nilotinib Non-compartmental PK Parameters: AUC0-12h
The full PK profiles of nilotinib in pediatric patients were assessed using serial sampling following a single 230 mg/m2 dose on Cycle 1 Day 1.
Time frame: Cycle 1 Day 1
Summary of Nilotinib Steady-state PK Parameters: AUCss
The steady-state PK profiles of nilotinib in pediatric patients were estimated using trough sampling following multiple 230 mg/m2 bid doses
Time frame: Cycle 1 Day 8 - Cycle 1 Day 28
Summary of Nilotinib Steady-state PK Parameters: CLF (Body Surface Area (BSA) Adjusted)
The steady-state PK profiles of nilotinib in pediatric patients were estimated using trough sampling following multiple 230 mg/m2 bid doses
Time frame: Cycle 1 Day 8 - Cycle 1 day 28
Summary of Nilotinib Steady-state PK Parameters: Cmin
The full PK profiles of nilotinib in pediatric patients were assessed using serial sampling following a single 230 mg/m2 dose.
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Novartis Investigative Site
Poitiers, France
Novartis Investigative Site
Monza, MB, Italy
Novartis Investigative Site
Padua, PD, Italy
Novartis Investigative Site
Roma, RM, Italy
Novartis Investigative Site
Amsterdam, Netherlands
Novartis Investigative Site
Rotterdam, Netherlands
Novartis Investigative Site
West Midlands, Birmingham, United Kingdom
...and 2 more locations
Time frame: Cycle 1 Day 8 - Cycle 1 Day 28
Number of Ph+ CML Participants With Confirmed Complete Hematologic Response (CHR)
A confirmed complete hematological response (CHR) is defined when all of the following criteria are achieved at two consecutive assessments, at least 4 weeks apart: white blood cell (WBC) count \< 10 × 109/L; platelet \< 450 × 109/L; basophils \< 5%; no blasts and promyelocytes in peripheral blood (PB); myelocytes + metamyelocytes \< 5% in PB; and no extramedullary involvement. The information used for hematological assessment was to be obtained from the laboratory and extramedullary data, all merged by patient and date.
Time frame: minimum of 12 cycles (28 days per cycle)
Number of Ph+ CML Participants With Cytogenic Response
Cytogenetic response was initially assessed as the percentage of Ph+ metaphases in the bone marrow (BM) and performed within 21 days prior to study entry. A major cytogenetic response (0% to 35% Ph+ metaphases test positive for the Philadelphia chromosome) combines both complete cytogenetic (CCyR) and partial cytogenetic response (PCyR). CCyR implies 0% Ph+ metaphases in the BM, PCyR is \> 0% to 35%, minor cytogenetic response (mCyR) is \> 35% to 65%, minimal response is \> 65% to 95% and no response is \> 95% Ph+ metaphases in the BM.
Time frame: minimum of 12 cycles (28 days per cycle)
Number of Ph+ CML Participants With Major Molecular Response (MMR)
The bcr-abl gene fusion encodes for a BCR-ABL fusion protein. Depending on the precise location of the fusion, the molecular weight of this protein can range from 185 to 210 kDa. Consequently BCR-ABL is referred to as p185 or p210 transcript. For the patients expressing the major BCR-ABL transcript p210, molecular response was defined and reported as the percent ratio of BCR-ABL transcripts/control gene transcripts converted to a reference standard according to the International Scale (IS). A major molecular response (MMR) is defined as a BCR-ABL/control gene ratio ≤ 0.1% (equal to a 3 log reduction in BCR-ABL transcripts) on the IS. In this study, the control gene was abl.
Time frame: minimum of 12 cycles (28 days per cycle)
Efficacy Endpoints for Ph+ ALL Patients
Best Response in Ph+ ALL patients was defined as either Complete Remission (CR) with platelet recovery, Complete Remission (CR) with incomplete platelet recovery, Partial Remission (PR) or Stable disease. Stable disease was defined is defined as failure to qualify for either CR, PR, or progressive disease.
Time frame: minimum of 12 cycles (28 days per cycle)