MedPath

Treating Patients With Chronic Myeloid Leukemia (CML) in Chronic Phase (CP) With Dasatinib

Completed
Conditions
Myeloid Leukemia, Chronic, Chronic-Phase
Registration Number
NCT02348957
Lead Sponsor
Onco Medical Consult GmbH
Brief Summary

CML requires ongoing treatment and assessment of treatment milestones in order to manage the disease properly. Dasatinib is approved for the treatment of newly diagnosed PH+ CP-CML and CML in chronic or accelerated phase or blast crisis in patients resistant or intolerant to prior therapies including Imatinib. Although Imatinib has demonstrated unprecedented efficacy in clinical trials, mostly in chronic phase CML, there is lack of published data on how CML is managed in real-life clinical practice settings. Therefore this non-interventional study is designed to collect real-life data on CML-treatment with Dasatinib in clinical routine with respect to first and second line treatment and/or switch setting (within 1st line or from 1st line TKI to 2nd line Dasatinib). Emphasis lies on health care provided in registered doctor's practices as here most of CML patients who are not involved in clinical trials are treated.

Detailed Description

The advent of Imatinib into the market in 2001 changed the treatment paradigm of CML. Seven-year follow-up from the IRIS trial revealed an estimated overall survival of 86% in newly diagnosed CML patients treated with Imatinib.

In June 2006, the U.S. Food and Drug Administration (FDA) granted accelerated approval for Dasatinib to treat adults with CP-CML with resistant disease or who were intolerant to prior therapy, including Imatinib. The FDA converted Dasatinib to a regular approval in May 2009, after confirmation of the treatment's safety and effectiveness. On October 28, 2010, FDA granted accelerated approval to Dasatinib for the treatment of newly diagnosed adult patients with CML-CP. Dasatinib entered thereby a marketplace with other TKIs including Nilotinib.

According to the summary of product characteristics brochure Dasatinib (Sprycel®) is indicated for the treatment of adult patients with:

* Newly diagnosed Ph+ CML In the chronic phase.

* Chronic, accelerated or blast phase CML with resistance or intolerance to prior therapy including Imatinib mesilate.

* Ph+ acute lymphoblastic leukaemia and lymoid blast CML with resistance or intolerance to prior therapy.

A phase III study (DASISION) of Dasatinib vs. Imatinib could proof that Dasatinib induced significantly higher and faster rates of complete cytogenetic response and major molecular response when compared to Imatinib. Since achieving complete cytogenetic response within 12 months has been associated with better long-term, progression-free survival, Dasatinib may improve the long-term outcomes among patients with newly diagnosed chronic-phase CML.

Nevertheless, further data are required to obtain additional information on the clinical benefits of Dasatinib.

CML requires ongoing treatment and assessment of treatment milestones in order to manage the disease properly. Dasatinib is approved for the treatment of newly diagnosed PH+ CP-CML and CML in chronic or accelerated phase or blast crisis in patients resistant or intolerant to prior therapies including Imatinib. Although Imatinib has demonstrated exceptional efficacy in clinical trials, mostly in chronic phase CML, there is lack of published data on how CML is managed in real-life clinical practice settings.

Therefore this non-interventional study is designed to collect real-life data on CML-treatment with Dasatinib in clinical routine with respect to first and second line treatment and/or switch setting (within 1st line or from 1st line TKI to 2nd line Dasatinib). Emphasis lies on health care provided in registered doctor's practices as here most of CML patients who are not involved in clinical trials are treated.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
223
Inclusion Criteria
  • Patients with newly diagnosed CP-CML and CML patients in chronic phase resistant or intolerant to prior therapies, including Imatinib. Any line treatment of chronic CML.
  • 18 years or older at time of diagnosis
  • Receiving treatment with Dasatinib according to the SmPC
  • Written informed consent obtained before any screening procedure and according to local guidelines
Exclusion Criteria

•Patients who are participating in a clinical trial for CML treatment will be excluded

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Distribution of Molecular remission status at study entry and after 12 months.12 Months

Patients included into this study are on a treatment with Dasatinib. Fraction of BCR-ABL positive cells is measured at study entry or was assessed at the timepoint of Dasatinib treatment begin and classified as \>MR3, MR3, MR4, and MR4.5 as an ordinal measure.

Molecular Fraction of BCR-ABL positive cells is reassessed after 12 months.

Secondary Outcome Measures
NameTimeMethod
Distribution of Molecular remission status at study entry and after 24 months.24 months

Patients included into this study are on a treatment with Dasatinib. Fraction of BCR-ABL positive cells is measured at study entry or was assessed at the time point of Dasatinib treatment begin and classified as \>MR3, MR3, MR4, and MR4.5 as an ordinal measure.

Molecular Fraction of BCR-ABL positive cells is reassessed after 24 months.

Hematologic response (HR) and complete blood count (if these parameters are routinely tested at the facility and are documented for the NIS)Up to 36 months

Complete blood count (if these parameters are routinely tested at the facility and are documented for the NIS

Patient Compliance/AdherenceAfter 3,6,12,24 months

Assessed at Baseline and analyzed over time after 3,6,12,24 months of observation.

Subgroup analysis concerning the time to progressionUp to 36 months

Common influencing factors like age, sex or previous therapy patterns are analyzed, whether they have an influence on time to progression

Subgroup analyses of participants with Adverse Events as a Measure of Safety and TolerabilityTime after 3,6,12,24 months

Common influencing factors like age, sex, comorbidities or previous therapy patterns are analyzed, whether they have an influence on safety and toxicity

Best possible responseUp to 36 months

Defined as the best response at any time after the start of the treatment. Reported will be distributions for each response (progression, stable disease, remission for at least one class of MR)

Time to Molecular remissionup to 36 months

Patients reach this event, when a change from a higher amount of BCR-ABL positive patients to a lower amount of BCR-ABL positive patients occurs

Time molecular progressionUp to 36 months

Patients start the observation period at study entry and reach this event, when a change to a higher BCR-ABL remission status is reached.

Cytogenetic profile at start of Dasatinib treatment, type of BCR-ABL transcript (if these parameters are routinely tested at the facility and are documented for the NIS).Up to 36 months

Cytogenetic response according to conventional cytogenetics (evaluation of at least 20 metaphase chromosomes) and hyper metaphase FISH (if applicable)

Patients' SatisfactionAfter 3,6,12,24 months

Assessed at Baseline and analyzed over time after 3,6,12,24 months of observation.

Quality of LifeTime after 3,6,12,24 months

Assessed at Baseline and analyzed over time after 3,6,12,24 months of observation.

Subgroup analysis concerning the quality of life and patient complianceTime after 3,6,12,24 months

Common influencing factors like age, sex, comorbidities or previous therapy patterns are analyzed, whether they have an influence on quality of life and patient compliance

Number of Participants with Adverse Events as a Measure of Safety and TolerabilityTime after 3,6,12,24 months

Assessed at Baseline and analyzed over time after 3,6,12,24 months of observation.

Subgroup analysis concerning the primary study objective12 months

Common influencing factors like prognostic scores or previous therapy patterns are analyzed, whether they have an influence on the primary study aim.

Subgroup analysis concerning the time to remissionUp to 36 months

Common influencing factors like prognostic scores or previous therapy patterns are analyzed, whether they have an influence on time to remission

Trial Locations

Locations (62)

Gemeinschaftspraxis Drs. Georg Jacobs, Prof Heiner Daus und PD Dr. Schmits

🇩🇪

Saarbrücken, Saarland, Germany

Onkologische Gemeinschaftspraxis

🇩🇪

Bamberg, Bayern, Germany

Hämatologie Onkologie Palliativmedizin Tagesklinik Landshut

🇩🇪

Landshut, Bayern, Germany

Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus

🇩🇪

Frankfurt am Main, Hessen, Germany

Gemeinschaftspraxis für Hämatologie und Onkologie

🇩🇪

Westerstede, Germany

Ambulantes Therapiezentrum

🇩🇪

Offenburg, Baden-Württemberg, Germany

Diakonie-Klinikum Schwäbisch Hall GmbH, Klinik für Innere Medizin III

🇩🇪

Schwäbisch Hall, Baden-Württemberg, Germany

Praxis für Hämatologie und internistische Onkologie

🇩🇪

Heidenheim, Baden-Württemberg, Germany

Klinikum Bayreuth Klinik für Hämatologie und Onkologie

🇩🇪

Bayreuth, Bayern, Germany

Intern. Gemeinschaftspraxis

🇩🇪

Güstrow, Mecklenburg-Vorpommern, Germany

Klinikum Aschaffenburg Hämato-Onkologische Schwerpunktpraxis

🇩🇪

Aschaffenburg, Bayern, Germany

Praxisklinik für integrative Onkologie

🇩🇪

Altötting, Bayern, Germany

MVZ für Blut- und Krebserkrankungen Potsdam

🇩🇪

Potsdam, Brandenburg, Germany

Gemeinschaftspraxis für Hämatologie/Onkologie

🇩🇪

Rostock, Mecklenburg-Vorpommern, Germany

Schwerpunktpraxis für Hämatologie und Onkologie

🇩🇪

Bayreuth, Bayern, Germany

Fachärztliche Gemeinschaftspraxis

🇩🇪

Weiden, Bayern, Germany

Praxisklinik für Hämatologie und Onkologie Koblenz/ Institut für Versorgungsforschung in der Onkologie GbR

🇩🇪

Koblenz, Rheinland-Pfalz, Germany

MVZ Arnsberg

🇩🇪

Arnsberg, Nordrhein-Westfalen, Germany

Vinzenz Pallotti Hospital GmbH

🇩🇪

Bergisch Gladbach, Nordrhein-Westfalen, Germany

Gemeinschaftspraxis für Hämatologie und Onkologie / Ambulante Tumortherapie

🇩🇪

Köln, Nordrhein-Westfalen, Germany

Schwerpunktpraxis

🇩🇪

Neustadt am Rübenberge, Niedersachsen, Germany

Onkologisches Ambulanzzentrum Hannover

🇩🇪

Hannover, Niedersachsen, Germany

Praxisklinik Hämatologie/Onkologie Herne

🇩🇪

Herne, Nordrhein-Westfalen, Germany

Praxis für Hämatologie, Onkologie und Palliativmed

🇩🇪

Mönchengladbach, Nordrhein-Westfalen, Germany

Klinikum Idar-Oberstein GmbH Medizinische Klinik I

🇩🇪

Idar-Oberstein, Rheinland-Pfalz, Germany

CaritasKlinikum Saarbrücken St. Theresia Akademisches Lehrkrankenhaus der Universität des Saarlandes

🇩🇪

Saarbrücken, Saarland, Germany

IDGGQ, Institut für med. Dokumentation GbR

🇩🇪

Kaiserslautern, Rheinland-Pfalz, Germany

Krebsheilkunde Lichtenberg

🇩🇪

Berlin, Germany

Onkologie Hof - Medizinisches Versorgungszentrum GmbH

🇩🇪

Hof, Germany

Onkologische Schwerpunktpraxis Trier St. Anna / Brüderkrankenhaus

🇩🇪

Trier, Germany

Hämatologische Praxisgemeinschaft München

🇩🇪

München, Germany

Onkologische Schwerpunktpraxis

🇩🇪

Hanau, Hessen, Germany

Facharztpraxis für Hämatologie und Onkologie, München

🇩🇪

München, Bayern, Germany

Hämatologisch-onkologische Gemeinschaftspraxis Nordhorn

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Nordhorn, Niedersachen, Germany

Praxis für Hämatologie und Onkologie am Isartor

🇩🇪

München, Bayern, Germany

Schwerpunktpraxis und Tagesklinik dür Hämatologie und Onkologie/OncoPRO GbR

🇩🇪

Regensburg, Bayern, Germany

Onkologische Schwerpunktpraxis und Tagesklinik

🇩🇪

Bad Soden am Taunus, Hessen, Germany

Praxis für Hämatologie und Onkologie

🇩🇪

Hamm, Nordrhein-Westfalen, Germany

Onkologische Schwerpunktpraxis Mülheim an der Ruhr und Oberhausen

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Mülheim an der Ruhr, Nordrhein-Westfalen, Germany

Medizinisches Versorgungszentrum (MVZ) an der St. Marien-Hospital Düren gGmbH

🇩🇪

Düren, Nordrhein-Westfalen, Germany

Onkologische Schwerpunktpraxis Hildesheim

🇩🇪

Hildesheim, Niedersachsen, Germany

Klinikum Lippe Onkologie und Hämatologie

🇩🇪

Lemgo, Nordrhein-Westfalen, Germany

Onkologische Praxis Remscheid

🇩🇪

Remscheid, Nordrhein-Westfalen, Germany

Onkologische Praxis Bautzen

🇩🇪

Bautzen, Sachsen, Germany

Hämato-onkologische Praxis

🇩🇪

Halberstadt, Sachsen-Anhalt, Germany

Internistische Praxis & Tagesklinik

🇩🇪

Neustadt, Sachsen, Germany

Ambulante Onkologie Ostsachsen

🇩🇪

Zittau, Sachsen, Germany

OVZ Friedrichshain Hämatologie, Onkologie und Palliativmedizin

🇩🇪

Berlin, Germany

Praxis für Innere Medizin Ärztehaus Berlin-Pankow

🇩🇪

Berlin, Germany

Onkologische Schwerpunktpraxis Augsburg

🇩🇪

Augsburg, Germany

Onkologie Duisburg Nord

🇩🇪

Duisburg, Germany

Onkologie Lerchenfeld

🇩🇪

Hamburg, Germany

MOP-Studiengesellschaft

🇩🇪

München, Bayern, Germany

Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie Charité - Universitätsmedizin Berlin

🇩🇪

Berlin, Germany

Gemeinschaftspraxis Drs. Klausmann

🇩🇪

Aschaffenburg, Bayern, Germany

Dres. Klaus Maria Josten und Ortwin Klein

🇩🇪

Wiesbaden, Hessen, Germany

Gemeinschaftspraxis Dres med. Dirk Meyer & Andreas Ammon und Michael Metz

🇩🇪

Göttingen, Hessen, Germany

Onkologische Kooperation Harz

🇩🇪

Goslar, Niedersachsen, Germany

Onko.Logix GmbH & Co. KG

🇩🇪

Gelsenkirchen, Nordrhein-Westfalen, Germany

Gemeinschaftspraxis

🇩🇪

Eisenach, Thüringen, Germany

Klinikum Chemnitz gGmbH Klinik für Innere Medizin III

🇩🇪

Chemnitz, Sachsen, Germany

Schwerpunktpraxis für Hämatologie und Internistische Onkologie, Gastroenterologie

🇩🇪

Singen, Germany

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