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临床试验/KCT0000516
KCT0000516已完成未知

A Pivotal Phase 2 Trial of Ponatinib (AP24534) in Patients with Refractory Chronic Myeloid Leukemia and Ph+ Acute Lymphoblastic Leukemia

The Catholic University of Korea, Seoul St. Mary's Hospital0 个研究点目标入组 30 人开始时间: 待定最近更新:
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适应症

试验速览

阶段
未知
状态
已完成
入组人数
30
研究概览入排标准研究者记录与标识符相似试验

研究概览

简要总结

暂无简介。

研究设计

研究类型
Interventional Study

入排标准

年龄范围
18(Year) 至 o Limit（—）
性别
All

入选标准

  • •1. Patients must have CML in any phase (CP, AP, or BP of any phenotype) or Ph+ ALL
  • •2. Be previously treated with and resistant, or intolerant, to either dasatinib or nilotinib:
  • •2.1Resistance is defined for CML CP patients (CP at the time of initiation of dasatinib or nilotinib therapy) as follows. Patients must meet at least 1 criterion.
  • •a.Three months after the initiation of therapy: No cytogenetic response (>95% Ph+) or failure to achieve CHR.
  • •b.Six months after the initiation of therapy: Less than a minor cytogenetic response (>65% Ph+).
  • •c.Twelve months after the initiation of therapy: Less than a PCyR (>35% Ph+).
  • •d.At any time after the initiation of therapy, the development of new BCR-ABL kinase domain mutations in the absence of CCyR.
  • •e.At any time after the initiation of therapy, the development of new clonal evolution in the absence of CCyR.
  • •f.At any time after the initiation of therapy, the loss of any cytogenetic response [from complete (0%), partial (1% to 35%), minor (36% to 65%), or minimal (66% to 95%) to a response at least 1 grade worse], confirmed in at least 2 consecutive analyses separated by at least 4 weeks.
  • •g.At any time after the initiation of therapy, progression of disease (to AP or BP).
  • •2.2Resistance is defined for CML AP patients (AP at the time of initiation of dasatinib or nilotinib therapy) as follows. Patients must meet at least 1 criterion.
  • •a.Three months after the initiation of therapy: failure to achieve a MaHR.
  • •b.At any time after the initiation of therapy, the loss of a MaHR, confirmed in at least 2 consecutive analyses separated by at least 4 weeks.
  • •c.At any time after the initiation of therapy, the development of new BCR-ABL kinase domain mutations in the absence of a MaHR.
  • •2.3Resistance is defined for CML BP patients (BP at the time of initiation of dasatinib or nilotinib therapy) and Ph+ ALL patients as follows. Patients must meet at least 1 criterion.
  • •a.One month after the initiation of therapy: failure to achieve a MaHR.
  • •b.At any time after the initiation of therapy, the loss of a MaHR, confirmed in at least 2 consecutive analyses separated by at least 1 week.
  • •c.At any time after the initiation of therapy, the development of new BCR-ABL kinase domain mutations in the absence of a MaHR.
  • •2.4Intolerance to dasatinib or nilotinib is defined as:
  • •a.Non-hematologic intolerance: Patients with grade 3 or 4 toxicity while on therapy, or with persistent grade 2 toxicity, unresponsive to optimal management, including dose adjustments (unless dose reduction is not considered in the best interest of the patient if response is already suboptimal) in the absence of a CCyR for CP patients or MaHR for AP, BP or Ph+ ALL patients.
  • •b.Hematologic intolerance: Patients with grade 3 or 4 toxicity (absolute neutrophil count [ANC] or platelets) while on therapy that is recurrent after dose reduction to the lowest doses recommended by manufacturer (80 mg daily [QD] for dasatinib; 400 mg QD for nilotinib) in the absence of a CCyR for CP patients or MaHR for AP, BP or Ph+ ALL patients.
  • •3.Develop the T315I mutation after any TKI therapy.
  • •3.1Patients with T315I mutation after any TKI need not have been treated with dasatinib or nilotinib.
  • •3.2Patients with T315I in CP must have less than a CCyR (>0% Ph+).
  • •3.3Patients with T315I in AP, BP, or Ph+ ALL must have less than a MaHR.
  • •3.4Patients with any history of T315I mutation will be eligible for study participation. However, only those patients w

排除标准

  • •Patients are not eligible for participation in the study if they meet any of the following exclusion criteria:
  • •1.Received TKI therapy within 7 days prior to receiving the first dose of ponatinib, or have not recovered (> grade 1 by NCI CTCAE, v. 4.0) from AEs (except alopecia) due to agents previously administered.
  • •2.Received other therapies as follows:
  • •a. For CP and AP patients, received hydroxyurea or anagrelide within 24 hours prior to receiving the first dose of ponatinib, interferon, cytarabine, or immunotherapy within 14 days, or any other cytotoxic chemotherapy, radiotherapy, or investigational therapy within 28 days prior to receiving the first dose of ponatinib.
  • •b. For BP patients, received chemotherapy within 14 days prior to the first dose of ponatinib. Otherwise 2a applies.
  • •c. For Ph+ ALL patients, received corticosteroids within 24 hours before the first dose of ponatinib, or vincristine within 7 days prior to the first dose of ponatinib, or received other chemotherapy within 14 days prior to the first dose of ponatinib. Otherwise, 2a applies.
  • •d. All patients are excluded if they have not recovered (> grade 1 by NCI CTCAE, v. 4.0) from AEs (except alopecia) due to agents previously administered.
  • •3.Underwent autologous or allogeneic stem cell transplant < 60 days prior to receiving the first dose of ponatinib; any evidence of on-going graft versus-host disease (GVHD), or GVHD requiring immunosuppressive therapy.
  • •4.Take medications that are known to be associated with Torsades de Pointes. These prohibited medications are listed in Attachment B.
  • •5.Require concurrent treatment with immunosuppressive agents, other than corticosteroids prescribed for a short course of therapy.
  • •6.Have previously been treated with ponatinib.
  • •7.Patients with CML CP are excluded if they are in CCyR.
  • •8.Patients with CML AP, CML BP, or Ph+ ALL are excluded if they are in MaHR.
  • •9.Have active central nervous system (CNS) disease as evidenced by cytology or pathology. In the absence of clinical CNS disease, lumbar puncture is not required. History itself of CNS involvement is not exclusionary if CNS has been cleared with a documented negative lumbar puncture.
  • •10.Have significant or active cardiovascular disease, specifically including, but not restricted to:
  • •a.Myocardial infarction within 3 months prior to first dose of ponatinib,
  • •b.History of clinically significant atrial arrhythmia or any ventricular arrhythmia,
  • •c.Unstable angina within 3 months prior to first dose of ponatinib,
  • •d.Congestive heart failure within 3 months prior to first dose of ponatinib.
  • •11.Have a significant bleeding disorder unrelated to CML or Ph+ ALL.
  • •12.Have a history of pancreatitis or alcohol abuse.
  • •13.Have uncontrolled hypertriglyceridemia (triglycerides >450 mg/dL).
  • •14.Have malabsorption syndrome or other gastrointestinal illness that could affect absorption of orally administered ponatinib.
  • •15.Have been diagnosed with another primary malignancy within the past 3 years (except for non-melanoma skin cancer or cervical cancer in situ, or controlled prostate cancer, which are allowed within 3 years).
  • •16.Are pregnant or lactating. Women of childbearing potential must agree to effective contraception from the time of signing informed consent through the Follow-up Visit, approximately 30 days after last dose of ponatinib.
  • •17.Underwent major surgery (with the exception of minor surgical procedures, such as catheter placement or BM biopsy) within 14 days pri

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