This study is an open-label, multicentric, phase IIIb study of NILOTINIB administered orally twice daily for 24 months and indefinitely if it is in the interest of the patient. The primary objective of the trial is to evaluate the efficacy of nilotinib, 300 mg twice daily with dose increase to 400 mg twice daily in case of suboptimal response or failure (excluding patients who will fail for progression to ABP), in a population of patients with Ph-positive, BCR-ABL positive CML in early CP.
This study is an open-label, multicentric, phase IIIb study of NILOTINIB administered orally at the dose of 300 mg twice daily (total daily dose 600 mg daily) for 24 months (study core), and indefinitely if it is in the interest of the patient (the drug will be given free-of-charge after 24 months to all those patients achieving the CMR4 at 24 months and in absence of safety concerns). Nilotinib dose is increased to 400 mg BID in case of suboptimal response or failure (with the exception of patients who will fail for progression to ABP: in case of progression to ABP, the patient will not be treated with study drug and the choice of the treatment will be up to the physician). Study duration is estimated in 6 years, 1 year of estimated enrollment, 2 years therapy duration. Thereafter, information on course and survival is due for other 3 years. The main data analysis will be performed when all patients will complete 24 months of treatment (or discontinued earlier). Safety and tolerability profile will be assessed by collecting hematologic and non-hematologic adverse events, laboratory examinations and ECG data. The molecular response will be assessed using the GIMEMA standardized molecular laboratories (Labnet network).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
109
Administered orally at the dose of 300 mg twice daily (total daily dose 600 mg daily) for 24 months (study core), and indefinitely if it is in the interest of the patient (the drug will be given free-of-charge after 24 months to all those patients achieving the CMR4 at 24 months and in absence of safety concerns). Nilotinib dose is increased to 400 mg BID in case of suboptimal response or failure (with the exception of patients who will fail for progression to ABP: in case of progression to ABP, the patient will not be treated with study drug and the choise of the treatment will be up to the physician).
Complete molecular response
To assess the complete molecular response (CMR4) rate at 24 months of treatment. For the purpose of this protocol, CMR is defined as a negative results of quantitative RT-PCR for BCR-ABL transcripts in a peripheral blood sample of at least 10 ml with a minimum sensitivity of 1:10,000, that corresponds to at least a 4-log reduction (hence, CMR4)
Time frame: At 24 months of treatment
Toxicity
Number of toxic events
Time frame: At three years from study entry
Compliance
Number of fully compliant patients and number of patients who do not comply with treatment
Time frame: At 3 years from study entry
The complete cytogenetic response (CCgR) rate
Time frame: At 3, 6, 12, 18 and 24 months from study entry
The rate and the degree of molecular response
Time frame: At 3, 6, 12, 18 and 24 months from study entry
The time to CCgR, the time to MMR and the time to CMR
Time frame: baseline
Overall Survival (OS)
From the date of the first nilotinib dose to death
Time frame: At three years from study entry
Progression Free Survival (PFS)
From the date of the first nilotinib dose to progression to AP or BP or death
Time frame: At three years from study entry
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Azienda Ospedaliera Nuovo Ospedale "Torrette"
Ancona, Italy
S.G. Moscati Hospital
Avellino, Italy
Azienda Ospedaliera Di Bologna Policlinico S. Orsola - Malpighi
Bologna, Italy
USD Trapianti di midollo per adulti - Cattedra di Ematologia - Università degli Studi di Brescia
Brescia, Italy
Università di Catania - Cattedra di Ematologia - Ospedale "Ferrarotto"
Catania, Italy
Azienda Ospedaliera Pugliese Ciaccio - Presidio Ospedaliero A.Pugliese - Unità Operativa di Ematologia
Catanzaro, Italy
Sezione di Ematologia e Fisiopatologia delle Emostasi - Azienda Ospedaliera - Arcispedale S. Anna
Ferrara, Italy
Struttura Complessa di Ematologia Ospedali Riuniti Foggia - Azienda Ospedaliero-Universitaria
Foggia, Italy
Clinica Ematologica - DiMI - Università degli Studi di Genova
Genova, Italy
Divisione Ematologia 1 - Azienda Ospedaliera Universitaria "San Martino"
Genova, Italy
...and 24 more locations
Failure Free Survival (FFS)
From the date of the first nilotinib dose to failure\* or progression or death
Time frame: At three years from study entry
Event Free Survival (EFS)
From the date of the first nilotinib to any event. Including treatment discontinuation for adverse events, failure, progression to AP or BP, or death, whichever comes first.
Time frame: At three years from study entry
Patient-reported quality of life (QoL)
Time frame: At baseline and then at 3, 6, 12, 18 and 24 months