To study the efficacy and safety of combination of Ro-Peg-interferon-α2b (RoPegIFN) with Bosutinib (BOS) in comparison to BOS monotherapy, as frontline therapy for newly diagnosed chronic myeloid leukemia patients, and to estimate efficacy of the addition of RoPegIFN to BOS in terms of deep molecular response with the aim of increasing the proportion of patients who may achieve treatment free remission. (NCMLSG study #NordCML012)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
212
Bosutinib, provided by Pfizer, starting dose of 200mg QD and stepwise dose escalation (\> 300 mg/d \> 400 mg/d) during the first three months. A pharmacological study will be performed in the French cohort (BOSUSTEP Substudy). BOS residual plasma concentration (Cmin) will be checked after initiation, before each dose step in the French cohort, and at M3 also for Nordic patients in ancillary studies.
Ro-Peg-Interferon α2b will be supplied by AOP Orphan to be administered by subcutaneous injections from prefilled injection pens. RoPegIFN will be given in an open-label fashion. Patients assigned to RoPegIFN will start with 50 μg injected subcutaneously every 14 days, in combination with Bosutinib.
Aalborg university hospital
Aalborg, Denmark
Aarhus ...
Aarhus, Denmark
Copenhagen ...
Copenhagen, Denmark
Rate of molecular response 4 (MR4)
Molecular response 4 (MR4) is defined by either a positive BCR-ABL/ABL ratio ≤ 0.01% on the international scale (IS) or by undetectable BCR-ABL with the analysis of at least 10000 copies of ABL or 24000 copies of GUS (according to the ELN recommendations by N. Cross et al., Leukemia 2015)
Time frame: 12 months
Rate of molecular response MR2, MR3, MR4, MR4.5 from 1 month up to 24 months and every 6 months thereafter
Time frame: 2 years
Cumulative incidence of molecular response MR3, MR4, MR4.5
Time frame: 2 years
Rate of complete cytogenetic response (CCyR) up to 12 months
Time frame: 12 months
Rate of undetectable molecular response for patients who achieved molecular response MR4 and MR4.5
Time frame: 2 years
Time to and duration of CCyR, MR3, MR4, MR4.5
Time frame: 2 years
proportion of patients eligible for randomization after 3 months of Bosutinib
Time frame: 3 months
rate and characteristics of severe adverse events (SAE)
type and grade according to the NCI CTCAE v4.03
Time frame: 2 years
Dose intensity of RoPegIFN and Bosutinib
Time frame: 2 years
Cumulative incidence of discontinuation of the therapies, incl. reasons for discontinuation
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Odense Universitetshospital
Odense, Denmark
Comprehensive Cancer Center, Hematology
Helsinki, Finland
Haukeland Universitetssjukehus
Bergen, Norway
Oslo Universitetssykehus
Oslo, Norway
Stavanger Universitetssjukehus
Stavanger, Norway
Universitetssykehuset Nord Norge
Tromsø, Norway
St Olavs Hospital
Trondheim, Norway
...and 8 more locations
Time frame: 2 years
Quality of life assessment by QLQC30 questionnaire up to 6 years at key time point (Day 1, month 3, month 6, month 12, month 24, month 48, month 54, month 72)
Time frame: 6 years
Quality of life assessment by CML24 questionnaire up to 6 years at key time point (Day 1, month 3, month 6, month 12, month 24, month 48, month 54, month 72)
Time frame: 6 years
The proportion of patients achieving a durable deep molecular response and being eligible for treatment discontinuation at month 48
Sustained deep molecular response (MR) criteria will be defined according updated data and ELN guidelines before the first patient will achieve month 48 (at least a MR4 over a 12 months period and confirmed on the last centralized measurement at month 48
Time frame: 4 years