A randomized, open-label assessor blinded, multi-center, controlled phase III Trial to evaluate the efficacy of AOP2014 administered bi-weekly subcutaneously (s.c.) in preventing molecular relapse (loss of MMR) in CML patients, who discontinue ABL tyrosine kinase inhibitor therapy (TKI) in deep molecular remission of MR4 or better (MR4.5, or MR5).
Four hypotheses are tested in hierarchical order. To avoid inflation of type 1 error (false rejection of a null hypothesis), further confirmatory testing has to be stopped as soon as a null hypothesis could not be rejected. All four hypotheses are tested at significance level 0.05. Null hypothesis 1 is the primary endpoint and investigates molecular relapse-free survival as a time-to-event variable; the two arms are compared with the log-rank test. Null hypotheses 2, 3, and 4 deal with probabilities of molecular relapse-free survival 7, 13, and 25 months after randomization, respectively; arms A and B are compared with the uncorrected chi-square test.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
214
AOP2014 as pre-filled auto-injection pen for subcutaneous injection, containing 250 µg AOP2014 / 0.5 ml. The solution also contains inactive ingredients (sodium chloride, polysorbate 80, benzyl alcohol, sodium acetate, and acetic acid). The solution is colorless to light yellow.
For patients randomized into this treatment arm stopp their standard treatment and will just be under observation.
mRFS
The primary efficacy endpoint is molecular relapse free survival (mRFS). Relapse is defined as loss of major molecular remission, MMR, which is any increase of the BCR-ABL ratio to \> 0.1% according to the international scale (IS). Time to relapse is defined as the time from randomization to relapse the BCR-ABL ratio to \> 0.1% according to the international scale (IS). Time to relapse is defined as the time from randomization to relapse.
Time frame: Randomization until time of relapse
mRFS 7
The primary efficacy endpoint is molecular relapse free survival, RFS 7 months after
Time frame: 7 months after randomization
mRFS 13
The relapse free survival, RFS 13 months after randomization
Time frame: 13 months after randomization
mRFS 25
The relapse free survival, RFS 25 months after randomization
Time frame: 25 months after randomization
Number of participants with treatment-related adverse events as assessed by CTCAE v4.03
Adverse events, serious adverse events (AEs, SAEs)• Safety, tolerability and toxicity based on incidences of adverse events, serious adverse events
Time frame: Day 0 - Month 15 (Arm B) or Month 16 (additional safety visit one month after last application for Arm A)
Quality of life measured by EORTC QLQ-C30
The QoL assessment in this study is planned to gain information on the QoL of CML patients under stopping conditions. The data will be compared between the treatment groups and to QoL of normal population.
Time frame: Day 0 - Month 25
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Institut Bergonié
Bordeaux, France
Centre Léon Bérard
Lyon, France
CHRU de Nancy - Hôpitaux de Brabois
Vandœuvre-lès-Nancy, France
03 Universitätsklinikum Aachen, Hämatologie/Onkologie
Aachen, Germany
18 Studienzentrum Aschaffenburg
Aschaffenburg, Germany
06 Universitätsmedizin Berlin Charite- Campus Virchow Klinikum, Klinik für Hämatologie und Onkologie
Berlin, Germany
19 Universitätsklinikum Bonn, Medizinische Klinik und Poliklinik III
Bonn, Germany
16 Klinikum Bremen Mitte, Medizinische Klinik I
Bremen, Germany
22 BAG / Onkologische Gemeinschaftspraxis
Dresden, Germany
05 Universitätsklinikum Düsseldorf, Klinik für Hämatologie, Onkologie und Klinische Immunologie
Düsseldorf, Germany
...and 16 more locations
Quality of life measured by EORTC-QLQ-CML24
The QoL assessment in this study is planned to gain information on the QoL of CML patients under stopping conditions. The data will be compared between the treatment groups and to QoL of normal population. Furthermore, results of the CML24 module should be shared with the EORTC group to complete the validation of this questionnaire
Time frame: Day 0 - Month 25
OS (overall survival)
Overall survival (OS), defined as the time between the date of randomization and the date of death from any cause.
Time frame: Day 0 - Month 25 (plus annual post study follow up Months 36,48,60)
Kinetics of BCR-ABL transcript level over time after TKI stop
Kinetics of BCR-ABL transcript level over time after TKI stop
Time frame: Day 0 - Month 25 (plus annual post study follow up Months 36,48,60)
For Germany: Detection of blood parameters 95 CD86+pDC as mRFS predictor
For Germany: To explore the value of 95 CD86+pDC / 105 lymphocytes at baseline in predicting risk of molecular relapse (loss of MMR)
Time frame: Day 0 - Month 25 (plus annual post study follow up Months 36,48,60)
For Germany: Explore immunological and genetic biomarkers and identify predictors
For Germany: Explore immunological and genetic biomarkers to study biology of TFR, and identify predictors IFN response (e.g. mRNA sequencing of whole blood or leukocyte subpopulations, PD-L1-, PD1-, CD62L- measurements by FACS on peripheral blood subsets, T-cell activation and exhaustion marker measurements, PR1-CTL assessment and cytokines). Evaluation of cytokines/chemokines (i.e., IL-6, IFN-α, IL 10, and others).
Time frame: Day 0 - Month 25 (plus annual post study follow up Months 36,48,60)
For Germany: Evaluation of cytokines/chemokines
For Germany: Evaluation of cytokines/chemokines (i.e., IL-6, IFN-α, IL 10, and others)
Time frame: Day 0 - Month 25 (plus annual post study follow up Months 36,48,60)