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Nilotinib as First-line Treatment of Ph+ CML in Early Chronic Phase (CML0307)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00481052
Recruitment Status : Completed
First Posted : June 1, 2007
Last Update Posted : October 8, 2020
Information provided by (Responsible Party):
Gruppo Italiano Malattie EMatologiche dell'Adulto

Brief Summary:
Treating Ph pos CML with Imatinib is very effective since the majority of the patients achieve a complete cytogenetic response and a major molecular response and are alive and progression-free after 5 years. However, the great majority of responding patients are not leukemia-free and may be at risk of progression, molecular, cytogenetic and clinical, at any time. In case of disease progression due to Imatinib failure, nilotinib has been found to be very effective, as expected from the preclinical profile of the drug, that is much more potent against BCR-ABL and inhibits nearly all the imatinib-resistant BCR-ABL mutants. For these reasons, nilotinib is going to be registered for the treatment of imatinib-resistant CMl patients. For the same reasons, nilotinib is expected to be more efficient than imatinib also front-line, based on the principle that we should aim at preventing the emergence of resistance better that at treating resistance once it has emerged. This expectation can be tested safely, because the "toxicity profile" of Nilotinib may be even more convenient than that of Imatinib, due to the lower frequency of edema and fluid retention.

Condition or disease Intervention/treatment Phase
Chronic Myeloid Leukemia Drug: Nilotinib Phase 2

Detailed Description:

Study Phase:

Phase II, Prospective, multicentric, non randomized, open label


The primary objective of the trial is to investigate the cytogenetic and molecular effects of the protein tyrosine kinase (PTK) inhibitor nilotinib in the treatment of early chronic phase Ph+ CML.

The secondary objectives are:

To investigate in early CP Ph+ CML patients treated with nilotinib the clinical and the hematologic effects, the effect on bcr/abl point mutations, the kinetic of the response, the toxicity, the compliance to treatment and the dose density.

Study design:

This study is an open-label, multicenter, exploratory, Phase II study of nilotinib administered orally twice daily for one year. For the patients who will benefit an extension to 4 years is planned.

Visit Schedule and Assessments:

A visit with blood counts and differential and serum chemistry is due baseline, every 15 days for 3 months, hence every 30 days.

An ECG is due baseline, after 15 and 30 days, hence at 60, 90, 150, 240 and 360 days.

An echocardiogram is due baseline and at end-of-study (360 days) or early withdrawal.

A bone marrow aspirate is due baseline (cytology, cytogenetics and quantitative molecular biology), after 3 and 6 months (cytology and cytogenetics) and after 12 months (cytology, cytogenetics, quantitative molecular biology and mutational analysis).

A peripheral blood sample is due baseline, at 30, 60, 90, 180, 270 and 360 days for quantitative molecular biology.

After the end of the study (i.e. after one year) clinical, cytogenetic and molecular data are due every 6 months.

Biologic Monitoring:

Bone marrow and peripheral blood cells will be collected before, during and at the end of the study, stored at the central lab in Bologna and used for molecular assays that are listed in details in the protocol, with the exclusion of any test allowing the identification of patients genotype. The samples are kept for a minimum of 10 years and can be destroyed upon patient request. A specific consent form to the sample storage will be submitted to the patients.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 74 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Protein Tyrosine Kinase Inhibitor Nilotinib as First-line Treatment of Ph+ Chronic Myeloid Leucemia (CML) in Early Chronic Phase: a Phase II Exploratory, Multicenter Study. GIMEMA Protocol CML 0307. EUDRACT 2007-000597-22.
Actual Study Start Date : June 23, 2007
Actual Primary Completion Date : April 30, 2018
Actual Study Completion Date : April 30, 2018

Primary Outcome Measures :
  1. Complete cytogenetic response (CCgR ) rate [ Time Frame: At 1 year ]

Secondary Outcome Measures :
  1. The complete and the partial cytogenetic response rate [ Time Frame: At 6 months ]
  2. The major molecular response (MMR) rate [ Time Frame: At 1 year ]
  3. The kinetics of haematologic, cytogenetic and molecular response to AMN107 [ Time Frame: At 1 year ]
  4. The development of bcr-abl mutation during the treatment with AMN107 (number and type) [ Time Frame: At 1 year ]
  5. The safety and tolerability of nilotinib treatment at the dose of 300 mg b.i.d [ Time Frame: At 1 year ]
  6. To describe any SAE [ Time Frame: At 1 year ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients with a cytologic and cytogenetic confirmed diagnosis of Ph+ CML.
  • Age ≥ 18 years old
  • Early CP (within 6 months from diagnosis)
  • No prior treatment with any antileukemic drugs with the exception of Hydroxyurea (HU) and Anagrelide.
  • WHO performance status of ≤ 2
  • Normal serum level of potassium, total calcium corrected for serum albumin, magnesium and phosphorus, or correctable with supplements
  • ALT and AST ≤ 2.5 x ULN or ≤ 5.0 x ULN if considered due to leukaemia.
  • Alkaline phosphatase ≤ 2.5 x ULN unless considered due to leukemia.
  • Serum bilirubin ≤ 1.5 x ULN
  • Serum creatinine ≤ 1.5 x ULN
  • Serum amylase ≤ 1.5 x ULN and serum lipase ≤ 1.5 x ULN.
  • Written informed consent prior to any study procedures being performed.

Exclusion criteria:

  • Impaired cardiac function, including LVEF < 45% as determined by MUGA scan or echocardiogram, uncontrolled congestive heart failure, uncontrolled hypertension
  • History of myocardial infarction within three months, or uncontrolled angina pectoris.
  • Significant electric heart abnormalities, including history or presence of significant ventricular or atrial tachyarrhythmias, congenital long QT syndrome and/or QTc > 450 msec on screening ECG (using the QTcF formula).
  • Patients with ventricular pacemakers and clinically significant bradycardias.
  • Patients with heart blocks.
  • History of acute or chronic pancreatitis.
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of nilotinib (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection)
  • Use of therapeutic coumarin derivates (i.e. warfarin, acenocoumarol, phenprocoumon).
  • Acute or chronic liver or renal disease considered unrelated to leukaemia
  • Other concurrent severe and/or uncontrolled medical conditions (e.g., uncontrolled diabetes, active or uncontrolled infection) that could cause unacceptable safety risks or compromise compliance with the protocol
  • Patients who are currently receiving treatment with any of the medications listed in Appendix E and the treatment cannot be either discontinued or switched to a different medication prior to starting study drug. The medications listed in Appendix E have the potential to prolong QT, with the exception of HU and Anagrelide.
  • Patients who have received any antileukemic agents and treatments, including HSCT, with the exception of HU and Anagrelide.
  • Patients who have received any investigational drug ≤ 4 weeks.
  • Patients who have undergone major surgery ≤ 2 weeks prior to starting study drug or who have not recovered from side effects of such therapy.
  • Patients who are pregnant or breast feeding, or adults of reproductive potential not employing an effective method of birth control. (Women of childbearing potential must have a negative serum pregnancy test within 48 hrs prior to administration of nilotinib). Post menopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Male and female patients must agree to employ an effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of study drug.
  • Treatment with any hematopoietic colony-stimulating growth factors (e.g. G-CSF, GM-CSF) 1 week prior to starting study drug.
  • Patients who have received immunotherapy 1 week prior to starting study drug or who have not recovered from side effects of such therapy.
  • Known diagnosis of human immunodeficiency virus (HIV) infection (HIV testing is not mandatory).
  • Patients with a history of another primary malignancy that is currently clinically significant or currently requires active intervention.
  • Patients unwilling or unable to comply with the protocol.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00481052

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Sponsors and Collaborators
Gruppo Italiano Malattie EMatologiche dell'Adulto
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Principal Investigator: Michele BACCARANI Azienda Ospedaliera Universitaria -Policlincio S. Orsola-Malpighi

Publications automatically indexed to this study by Identifier (NCT Number):

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Responsible Party: Gruppo Italiano Malattie EMatologiche dell'Adulto Identifier: NCT00481052    
Other Study ID Numbers: CML0307
First Posted: June 1, 2007    Key Record Dates
Last Update Posted: October 8, 2020
Last Verified: October 2020
Keywords provided by Gruppo Italiano Malattie EMatologiche dell'Adulto:
Philadelphia positive
early chronic phase
untreated or treated only with Hydroxyurea or Anagrelide
Chronic Myeloid Leukemia
Additional relevant MeSH terms:
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Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Neoplasms by Histologic Type
Myeloproliferative Disorders
Bone Marrow Diseases
Hematologic Diseases