The purpose of the present study is to determine the rate of successful treatment-free remission (TFR) within the first 52 weeks following cessation of ponatinib treatment in patients who achieved MR4. Eligible patients had been previously treated with TKI and when patients achieved an optimal molecular response, TKI treatment was discontinued. After loss of response, patients were treated again with a TKI treatment and have documented MR4 for one year at the time of switch to ponatinib to study entry. MR4 is defined as BCR-ABL transcript level ≤ 0.01% IS or undetectable BCR-ABL levels with sample sensitivity of at least 4 log.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
80
Patients will receive ponatinib 15 mg/day for 104 weeks orally. Ponatinib will be self-administered by the patient on a daily schedule. Acetyl salicylic acid (ASA) (100 mg) will be used such auxiliary medicinal product in order to prevent vascular occlusive events related with ponatinib.
Patients will receive acetylsalicylic acid 100 mg/day for 104 weeks orally.
Institut Català D'Oncologia L'Hospitalet (ICO)
L'Hospitalet de Llobregat, Barcelona, Spain
Hospital General Universitario Gregorio Marañón
Madrid, Madrid, Spain
Hospital Ramón y Cajal
Madrid, Madrid, Spain
Hospital Universitario y Politécnico La Fe
Valencia, Valencia, Spain
Hospital Clínico Universitario de Valencia
Valencia, Valencia, Spain
Institut Català d´oncologia Badalona (ICO)
Badalona, Spain
Hospital Universitario de Gran Canaria Dr. Negrín
Las Palmas de Gran Canaria, Spain
Hospital Universitario 12 de Octubre
Madrid, Spain
Hospital Universitario La Paz
Madrid, Spain
Complejo Hospitalario Regional de Málaga
Málaga, Spain
...and 3 more locations
Proportion of patients with a maintained MMR within 52 weeks following ponatinib Treatment-Free Remission (TFR)
This variable is defined as the number of patients who have a maintained MMR and have not restarted TKI therapy in the first 52 weeks after starting ponatinib TFR phase divided by the number of patients who entered ponatinib TFR phase.
Time frame: 52 weeks
Evaluate the toxicity and safety profile of 15 mg/24h dose treatment of ponatinib combined with ASA.
The number and percentage of patients with treatment-emergent adverse events (new or worsening from baseline) will be summarized by system organ class (SOC) and/or preferred term (PT), severity (based on CTCAE grades), type of adverse event and relation to study treatment.
Time frame: 104 weeks
Evaluate thromboembolic events for study period.
The number and percentage of patients with thromboembolic events will be summarized by preferred term, severity (based on CTCAE grades), type of adverse event, relation to study treatment by the phases or subsets previously described.
Time frame: 104 weeks
Evaluate hemorrhagic events for study period.
The number and percentage of patients with hemorrhagic events will be summarized by preferred term, severity (based on CTCAE grades), type of adverse event, relation to study treatment by the phases or subsets previously described.
Time frame: 104 weeks
Evaluate hemolytic events for study period.
The number and percentage of patients with hemolytic events will be summarized by preferred term, severity (based on CTCAE grades), type of adverse event, relation to study treatment by the phases or subsets previously described.
Time frame: 104 weeks
Evaluate gastrointestinal events for study period.
The number and percentage of patients with gastrointestinal events will be summarized by preferred term, severity (based on CTCAE grades), type of adverse event, relation to study treatment by the phases or subsets previously described.
Time frame: 104 weeks
Evaluate the proportion of patients still in MR4 (BCR-ABL ≤ 0.01%) within 52 weeks following ponatinib therapy cessation.
Number of patients still in MR4 and have not restarted TKI therapy in the first 52 weeks after starting ponatinib TFR phase divided by the number of patients who entered ponatinib TFR phase.
Time frame: 52 weeks
Evaluate the proportion of patients still in MMR within 24 weeks following ponatinib therapy cessation.
The number of patients who still have a MMR and have not restarted TKI therapy in the first 24 weeks after starting ponatinib TFR phase divided by the number of patients who entered ponatinib TFR phase.
Time frame: 24 weeks
To estimate progression-free survival (PFS)
Time from start ponatinib treatment to the occurrence of progression to AP/BC, loss of MMR or death from any cause, the earliest of these events.
Time frame: 4 years
Treatment-free survival (TFS)
time from ponatinib cessation to the occurrence of loss of MMR, restart of TKI treatment, progression of AP/BC, or death from any cause, the earliest of these events.
Time frame: 104 weeks
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