A Phase III, Prospective Randomised Comparison of Imatinib (STI571, Glivec/Gleevec) 400mg Daily Versus Dasatinib 100mg in Patients With Newly-diagnosed Chronic Phase Chronic Myeloid Leukaemia
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 814
- 试验地点
- 1
- 主要终点
- 5-year event free survival
研究概览
简要总结
Imatinib 400mg daily is the current NICE-approved standard treatment for newly diagnosed Chronic Myeloid Leukaemia (CML). 5 yr follow up of CML patients treated in this way indicates an 89% probability of progression-free survival. Imatinib is not tolerated or effective in some patients however, and a proportion of patients become resistant to the drug. SPIRIT 2 study aims to establish whether a new drug, dasatinib, is superior to imatinib in terms of event free survival and therefore will be an effective first-line therapy for newly-diagnosed CML patients. This study will also provide crucial long-term survival, quality of life and health economic data to assist health care providers and managers to determine the most cost-effective drug therapy for CML.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male or female patients 18 years or over.
- •Patients must have all of the following:
- •be enrolled within 3 months of initial diagnosis of CML-CP (date of initial diagnosis is the date of first cytogenetic analysis)
- •cytogenetic confirmation of the Philadelphia chromosome or variants of (9;22) translocations
- •patients may have secondary chromosomal abnormalities in addition to the Philadelphia chromosome.
- •< 15% blasts in peripheral blood and bone marrow;
- •< 30% blasts plus promyelocytes in peripheral blood and bone marrow;
- •< 20% basophils in peripheral blood,
- •100 x 109/L platelets or greater
- •no evidence of extramedullary leukaemic involvement, with the exception of the hepatosplenomegaly.
- •Written voluntary informed consent.
排除标准
- •Patients with Ph-negative, BCR-ABL-positive, disease are NOT eligible for the study.
- •Any prior treatment for CML with: any tyrosine kinase inhibitor (eg imatinib, dasatinib); busulphan; interferon-alpha; homoharringtonine; cytosine arabinoside; any other investigational agents (hydroxycarbamide and anagrelide are the only drugs permitted). NB patients will be ineligible for the study if they have received ANY prior therapy with interferon-alpha or imatinib. NO exceptions.
- •Patients who received prior chemotherapy, including regimens used in peripheral blood progenitor cells (PBPCs) mobilisation for haematopoietic progenitor-cell transplantation. (It is allowable to collect unmobilised PBPCs at diagnosis.)
- •Patient who have had any form of prior haemopoietic stem cell transplant, either autograft or allograft.
- •Patients with an ECOG Performance Status Score of 2 or less.
- •Patients with serum bilirubin, SGOT/AST, SGPT/ALT, or creatinine concentrations > 2.0 x the institutional upper limit of the normal range (IULN).
- •Patients with International normalized ratio (INR) or partial thromboplastin time (PTT) > 1.5 x IULN, with the exception of patients on treatment with oral anticoagulants.
- •Patients with uncontrolled medical disease such as diabetes mellitus, thyroid dysfunction, neuropsychiatric disorders, infection, angina, or Grade 3/4 cardiac problems as defined by the New York Heart Association Criteria.
- •Patients with known positivity for human immunodeficiency virus (HIV); baseline testing for HIV is not required.
- •Patients who have undergone major surgery within 4 weeks of Study Day 1, or who have not recovered from prior major surgery.
- •Patients who are:
- •pregnant,
- •breast feeding,
- •of childbearing potential without a negative pregnancy test prior to Study Day 1, and
- •male or female of childbearing potential unwilling to use barrier contraceptive precautions throughout the trial (postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential).
- •Patients with a history of another malignancy either currently or within the past five years, with the exception of basal cell skin carcinoma or cervical carcinoma in situ.
- •Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable.
研究组 & 干预措施
Arm A - Imatinib
Imatinib 400mg daily
干预措施: Imatinib (Drug)
Arm B - Dasatinib
Dasatinib 100mg daily
干预措施: Dasatinib (Drug)
结局指标
主要结局
5-year event free survival
时间窗: ongoing throughout study (5 years)
To compare 5-year event free survival between the 2 treatment arms. The study aim is to show superiority of the dasatinib arm over the imatinib 400mg arm.
次要结局
未报告次要终点
