This study aims at evaluating the efficacy of treatment with ponatinib in patients with chronic myeloid leukemia who are in a chronic phase and who previously received treatment with imatinib but resulted to be resistant to it.
Phase 2, single-arm, multicentre, open label. No interim analysis is planned, but a monitoring committee will evaluate the data every 6 months. Ponatinib is given orally 30 mg daily, with dose adjustment to 15 mg daily once a BCR-ABL1 level smaller or equal to 0.1% (MMR) has been achieved and confirmed in the next test, 4 weeks apart. A return to prior, 30 mg, dose is due in case of return of BCR-ABL1 transcripts level to \> 1%. Dose adjustments for toxicity are detailed in the protocol. Treatment time will be 52 weeks, during which study drug will be provided free-of-charge by ARIAD Pharmaceuticals, upon approval of the protocol. Treatment is discontinued at any time in case of failure or treatment-related SAEs. After one year of treatment, upon request of the local investigator and upon confirmation of the Treatment Advisory Committee (TAC, see section 23), ARIAD Pharmaceutics, Inc. will continue to provide ponatinib for the study patients who will benefit from treatment continuation, for at least 2 years, until the drug will be approved with that indication.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
14
Ponatinib is given orally 30 mg daily, with dose adjustment to 15 mg daily once a BCR-ABL1 level minor or equal to 0.1% (MMR) has been achieved and confirmed in the next test, 4 weeks apart. A return to prior, 30 mg, dose is due in case of return of BCR-ABL1 transcripts level to \> 1%. Dose adjustments for toxicity are detailed in the protocol.
Number of patients with major cytogenetic response
Cytogenetic response (CyR) is defined based on the percentage of Ph pos metaphases, as evaluated by chromosome banding analysis (CBA) of at least 20 marrow cell metaphases: 1. Major Cytogenetic Response if Ph pos metaphases \< 35% 2. Complete (CCyR) if Ph pos metaphases 0 or FISH BCR-ABL1 nuclei minor or equal to 1% 3. Partial (PCyR) if Ph pos metaphases 1-34% 4. Minor (mCyR) if Ph pos metaphases 35-65% 5. Minimal or none (min/none CyR) if Ph pos metaphases \> 65% If marrow cell metaphases cannot be obtained or analysed, interphase fluorescence-in-situ-hybridization (FISH) can be used, but only to distinguish a CCyR (minor or equal to 1% positive nuclei out of at least 200 nuclei) from a non CCyR. FISH data cannot be used to classify a response as minimal, minor, or partial.
Time frame: After 52 weeks of ponatinib treatment start
Number of Cardiovascular Adverse Events (AEs)
Time frame: After three years from ponatinib treatment start
Number of blood hypertension AEs
Time frame: After three years from ponatinib treatment start
Number of pancreatitis AEs
Time frame: After three years from ponatinib treatment start
Number of patients achieving Complete Cytogenetic Response (CCyR)
Time frame: After 52 weeks of ponatinib treatment start
Number of patients achieving major molecular response
Time frame: After 52 weeks of ponatinib treatment start
Number of patients with failure-free survival
Time frame: At 36 months from ponatinib treatment start
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Aos Ss. Antonio E Biagio E C. Arrigo - Soc Ematologia
Alessandria, Italy
Azienda Ospedaliero - Universitaria Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi
Ancona, Italy
Azienda Ospedaliera Di Bologna Policlinico S. Orsola - Malpighi
Bologna, Italy
Asst Degli Spedali Civili Di Brescia - Uo Ematologia
Brescia, Italy
Ao Brotzu, Presidio Ospedaliero A. Businco - Sc Ematologia E Ctmo
Cagliari, Italy
Ctc U.O Di Ematologia Con Trapianto Di Midollo Osseo
Catania, Italy
Università di Catania - Cattedra di Ematologia - Ospedale "Ferrarotto"
Catania, Italy
Ao Di Catanzaro "Pugliese-Ciaccio", Presidio Ospedaliero "Ciaccio - de Lellis" - Ematologia
Catanzaro, Italy
Aou Arcispedale Sant'Anna - Cona (Fe) - Uoc Ematologia E Fisiopatologia Della Coagulazione
Cona, Italy
Aso S. Croce E Carle - Cuneo - Sc Ematologia
Cuneo, Italy
...and 27 more locations
Number of patients with progression-free survival
Time frame: At 36 months from ponatinib treatment start
Number of patients in overal survival
Time frame: At 36 months from ponatinib treatment start
Number of patients in event-free survival
Time frame: At 36 months from ponatinib treatment start
Quality of Life patterns over time with the EORTC QLQ-C30 and the EORTC QLQ-CML24 questionnaires
Time frame: At baseline and at at weeks 4, 12, 24, 36 and 52