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A Study of the Efficacy and Safety of Flumatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase.

Phase 4
Recruiting
Conditions
CML, Chronic Phase
Interventions
Registration Number
NCT05353205
Lead Sponsor
Jiangsu Hansoh Pharmaceutical Co., Ltd.
Brief Summary

It's a double-blind , randomized ,multi-center study. The purpose of this study is to explore the efficacy and safety of flumatinib 400mg once daily (QD) versus 600mg QD as the first line therapy in patients with chronic myleiod leukemia(CML) in chronic phase(CP).

Detailed Description

This is a dose-optimization study of flumatinib in adult patient with newly diagnosed CML-CP. The objective of this study is to compare the efficacy and safety of flumatinib 400mg QD with that of 600mg QD. Eligible patients are randomized in a 1:1 ratio to receive either fluamtinib 400mg QD or flumatinib 600mg QD. Randomization is stratified based on Sokal risk score (\<0.8,0.8\~1.2,\>1.2). Patients will discontinue study therapy due to treatment failure, disease progression or intolerance to study medication or due to investigator's or participant's decision. The primary efficacy endpoint is the rate of early molecular response , as measured by RQ-PCR at 3 months. Hematologic response, molecular response and cytogenetic response will be assessed at baseline and a certain frequency after treatment, until study completion.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  1. Signed informed consent form.
  2. Men or women aged more than or equal to (≥) 18 years, and less than (<) 75 years.
  3. ECOG performance status of 0-2.
  4. Patients with philadelphia chromosome positive chronic myeloid leukemia in chronic phase (Ph+ CML-CP) within 6 months of diagnosis.
  5. Adequate organ function.
  6. Men or women should be using adequate contraceptive measures throughout the study; Females should not be breastfeeding at the time of screening, during the study and until 6 months after completion of the study.
  7. Females must have evidence of non-childbearing potential.
Exclusion Criteria
  1. Known atypical CML or presence of additional chromosomal abnormalities.

  2. Known presence of the T315I mutation.

  3. Treatment with tyrosine kinase inhibitor(s) prior to randomization.

  4. Any treatment with anti-CML activity for longer than 2 weeks(exception of hydroxyurea or anagrelide) or hematopoietic stem cell transplantation prior to randomization .

  5. Prior treatment with splenectomy.

  6. Impaired cardiac function including any one of the following:

    1. Resting corrected QT interval (QTc) > 470 ms obtained from electrocardiogram (ECG), using the screening clinic's ECG machine and Fridericia's formula for QT interval correction (QTcF).
    2. Any clinically important abnormalities in rhythm, conduction, or morphology of the resting ECG.
    3. Any factors that increase the risk of QTc prolongation or risk of arrhythmic events,
    4. Left ventricular ejection fraction (LVEF) ≤ 50%.
    5. During screening period, ECG examination showed average heart rate <50 beats per minute.
    6. Myocardial infarction occurred within 12 months of randomization;
    7. Congestive heart failure occurred within 6 months of randomization;
    8. Uncontrollable angina.
  7. Stroke or transient ischemic attack within 6 months of randomization.

  8. Any severe or uncontrolled systemic diseases (i.e. uncontrolled hypertension or diabetes).

  9. Clinically severe gastrointestinal dysfunction that may affect drug intake, transport or absorption.

  10. The presence of active infectious diseases has been known prior to randomization

  11. History of significant congenital or acquired bleeding disorders unrelated to CML

  12. Inadequate other organ function.

  13. History of other malignancies.

  14. History of hypersensitivity to any active or inactive ingredient of flumatinib.

  15. Patients who are currently receiving treatment with any medications that have the potential to prolong the QT interval and the treatment cannot be either discontinued.

  16. Major surgery within 4 weeks of randomization.

  17. Any unresolved toxicities from prior therapy greater than Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 within 4 weeks of randomization.

  18. Any disease or condition that, in the opinion of the investigator, would compromise the safety of the patient or interfere with study assessments.

  19. Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions, and requirements.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Flumatinib (400mg)Flumatinib mesylate tablets (400mg)Flumatinib 400mg QD
Flumatinib (600mg)Flumatinib mesylate tablets (600mg)Flumatinib 600mg QD
Primary Outcome Measures
NameTimeMethod
Early molecular response(EMR) rate at 3 months3 months

Molecular response is assessed using BCR-ABL transcript levels and measured by realtime quantitative polymerase chain reaction(RQ-PCR). Early molecular response is defined as a ratio BCR-ABL/ABL ≤10% on the international scale (IS).

Secondary Outcome Measures
NameTimeMethod
MR4.0 rate at month 3,6,9 and 123, 6, 9 and 12 months

MR4.0 is defined as BCR-ABL/ABL ≤0.01% on the international scale.

Complete hematologic response(CHR) rate at month 1,2,3,4,5,6,9 and 121,2,3,4,5,6,9 and 12 months

Hematologic response will be assessed by complete blood count (CBC) and physical examination at each visit. CHR is defined as all of the following present:

1. white blood cell(WBC) count \<10×109/L

2. Platelet count \<450 ×109/L

3. Peripheral blood basophils \<5%

4. No blasts and no promyelocytes in peripheral blood

5. \< 5% myelocytes plus metamyelocytes in peripheral blood

6. No evidence of extramedullary disease, including no splenomegaly or hepatomegaly

Time to first MMRup to 36 months

Evaluate the time from the date of randomization to the date of first documented MMR during treatment.

Event-free survival (EFS)up to 36 months

EFS is defined as the time from the date of randomization to the earliest occurrence of the following events: death due to any cause ; loss of CHR ,loss of PCyR ;loss of CCyR ; discontinuation of study treatment due to AE or treatment failure ; progression to AP/BC

Duration of CCyRup to 36 months

Duration of CCyR is defined as the time from the date of first documented CCyR to the earliest date of loss of CCyR.

Major molecular response(MMR) rate at month 3,6,9 and 123, 6, 9 and 12 months

Major molecular response is defined as a ratio BCR-ABL/ABL ≤0.1% on the international scale as measured by RQ-PCR.

Time to first CCyRup to 36 months

Evaluate the time from the date of randomization to the date of first documented CCyR during treatment.

Progression-free survival (PFS)up to 36 months

PFS is defined as the time from the date of randomization to the earliest occurrence of progression to AP/BC or death from any cause.

MR4.5 rate at month 3,6,9 and 123, 6, 9 and 12 months

MR4.5 is defined as BCR-ABL/ABL ≤0.0032% on the international scale.

Complete cytogenetic response(CCyR)rate at month 3,6,9 and 123, 6, 9 and 12 months

Cytogenetic response (CyR) is based on the prevalence of Ph+ cells in metaphase from bone marrow (BM) sample . CCyR is defined as 0% Ph+ metaphases in the bone marrow.

Duration of MMRup to 36 months

Duration of MMR is defined as the time from the date of first documented MMR to the earliest date of loss of MMR.

Overall survival (OS)Frame:12 and 36 months

OS is defined as the time from the date of randomization to the date of death from any cause.

Pharmacokinetics (PK) of HS-10096:TmaxUp to approximately 36 months

Serum concentrations of HS-10096 will be collected and analyzed to evaluate the PK of HS-10096.Tmax is the time to reach maximum (peak) plasma drug concentration after dose administration (hr).

The incidence and severity of adverse events ((AE)up to 36 months

Assessed by number and severity of adverse events as recorded on the case report form NCI CTCAE v5.0.

Trial Locations

Locations (1)

Institute of Hematology and Oncology, Harbin The First Hospital

🇨🇳

Harbin, Hei Longjiang, China

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