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Chronic Phase Philadelphia PositiveCML0912NCT01699217

Front-line Nilotinib Treatment of BCR-ABL+ Chronic Myeloid Leukaemia in Chronic Phase

An observational study of Chronic Phase Philadelphia Positive and BCR-ABL Positive, run by Gruppo Italiano Malattie EMatologiche dell'Adulto at 56 sites in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The GIMEMA CML Working Party promotes a multicentre, observational, prospective study of CML patients treated frontline with NIL. Patients will be followed for 5 years. This study will help the definition of guidelines for the treatment of CML patients in early CP. Read more about this study

Who is it for?
Ages 18 years and older
How many people
129 participants
Where
56 sitesItaly
Study dates
21 Jun 2013to 28 Dec 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Treatment decision is at the discretion of the investigator and must not be made on the basis of this observational study. Patients should have their treatment initiated in accordance with the summary of product characteristics.

Who may be able to join

  • Age: >=18 years;
  • Patients with chronic phase Ph+ and/or BCR-ABL+ CML, newly diagnosed (less than 6 months);
  • Prior treatment with Hydroxyurea or Anagrelide is allowed;
  • Prior treatment with IM for less than 30 days is allowed;
  • Signed written informed const according to ICH/EU/GCP and national local laws.

Who cannot join

  • Patients who are pregnant (negative pregnancy test is requested within 2 days before nilotinib start) or breast feeding, or adults of reproductive potential not employing an effective method of birth control.
  • Newly diagnosed Ph+ and/or BCR-ABL+ CML patients in advanced phases (accelerated or blastic phase).
  • Prior treatment with nilotinib, dasatinib, or other tyrosine-kinase inhibitors.

Trial locations and contacts

56 sites in 1 country.

56 sites in 1 country

Italy56 sites
  • S.O.C. di Ematologia - Azienda Ospedaliera - SS. Antonio e Biagio e Cesare Arrigo

    Alessandria

  • Azienda Ospedaliera Nuovo Ospedale "Torrette"

    Ancona

  • Dipartimento Area Medica - Presidio Ospedaliero "C. e G.Mazzoni"

    Ascoli Piceno

  • Ematologia con trapianto-Università degli Studi di Bari Aldo Moro

    Bari

  • Policlinico Sant'Orsola Malpighi

    Bologna

  • USD Trapianti di midollo per adulti - Cattedra di Ematologia - Università degli Studi di Brescia

    Brescia

  • Divisione di Ematologia Ospedale A. Perrino

    Brindisi

  • ASL N.8 - Ospedale "A. Businco" - Struttura Complessa di Ematologia e CTMO

    Cagliari

  • U.O.C. di Onco-Ematologia - Centro di Ricerca e Formazione ad Alta tecnologia nelle Scienze Biomediche

    Campobasso

  • US Dipartimentale - Centro per le malattie del sangue - Ospedale Civile - S.Giacomo

    Castelfranco Veneto

  • ezione di Ematologia C.T.M.O. Istituti Ospitalieri

    Cremona

  • Ospedale Santa Croce Divisione di Ematologia Cuneo

    Cuneo

  • Policlinico di Careggi, Università delgi studi di Firenze

    Florence

  • Struttura Complessa di Ematologia Ospedali Riuniti Foggia - Azienda Ospedaliero-Universitaria

    Foggia

  • Clinica Ematologica - DiMI - Università degli Studi di Genova

    Genova

  • IRCCS_AOU San Martino-IST-Ematologia 1-Monoblocco 11°piano- lato ponente

    Genova

  • SOC Ematologia e Centro Trasfusionale Ospedale di Ivrea - ASL TO4

    Ivrea

  • Divisione di Ematologia Ospedale "Santa Maria Goretti"

    Latina

  • Azienda Ospedaliera Universitaria - Policlinico G. Martino Dipartimento di Medicina Interna - U.O. Messina

    Messina

  • Divisione di Ematologia - Azienda Ospedaliera Ospedali Riuniti "Papardo Piemonte"

    Messina

  • U.O. Ematologia e Trapianto di MIdollo - Ist.Scientifico Ospedale San Raffaele

    Milan

  • UO Centro Trapianti di Midollo - IRCCS Ospedale Maggiore Policlinico

    Milan

  • Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli"

    Naples

  • Azienda Ospedaliera Universitaria - Università degli Studi di Napoli "Federico II" - Facoltà di Medicina e Chirurgia

    Naples

  • Ospedale San Gennaro - ASL Napoli 1

    Naples

  • Sez. di Ematologia Clinica Ospedale San Francesco

    Nuoro

  • Dip. di Scienze Cliniche e Biologiche - Ospedale S. Luigi Gonzaga-Medicina Interna 2 Prof. Giuseppe Saglio

    Orbassano

  • Università degli Studi di Padova - Ematologia ed Immunologia Clinica

    Padova

  • Divisione di Ematologia con trapianto di midollo - A.U. Policlinico "Paolo Giaccone"

    Palermo

  • La Maddalena Casa di Cura di Alta Specialità Dipartimento Oncologico di III Livello

    Palermo

  • Ospedali Riuniti "Villa Sofia-Cervello"

    Palermo

  • Cattedra di Ematologia CTMO Università degli Studi di Parma

    Parma

  • Div. di Ematologia di Muraglia - CTMO Ospedale San Salvatore

    Pesaro

  • U.O. Ematologia Clinica - Azienda USL di Pescara

    Pescara

  • Unità Operativa Ematologia e Centro Trapianti - Dipartimento di Oncologia ed Ematologia - AUSL Ospedale di Piacenza

    Piacenza

  • Università di Pisa - Azienda Ospedaliera Pisana - Dipartimento di Oncologia, dei Trapianti e delle nuove Tecnologie in Medicina - Divisione di Ematologia

    Pisa

  • Dipartimento Oncologico - Ospedale S.Maria delle Croci

    Ravenna

  • Dipartimento Emato-Oncologia A.O."Bianchi-Melacrino-Morelli"

    Reggio Calabria

  • Unità Operativa Complessa di Ematologia - Arcispedale S. Maria Nuova

    Reggio Emilia

  • Ospedale "Infermi"

    Rimini

  • U.O. di Ematologia - Centro Oncologico Basilicata

    Rionero in Vulture

  • Az. Ospedaliera "Sant' Andrea"-Università la Sapienza Seconda Facoltà di Medicina e Chirurgia

    Roma

  • Complesso Ospedaliero S. Giovanni Addolorata

    Roma

  • Pronto Soccorso e Accettazione Ematologica - Dipartimento Biotecnologie Cellulari ed Ematologia - Università degli Studi di Roma "Sapienza"

    Roma

  • Segreteria di Ematologia - S.C. di Ematologia e Trapianti - I.F.O. Istituto Nazionale Tumori Regina Elena

    Roma

  • U.O.C. Ematologia - Ospedale S.Eugenio

    Roma

  • Università Cattolica del Sacro Cuore - Policlinico A. Gemelli

    Roma

  • Azienda Sanitaria Locale Viterbo - Polo Ospedaliero Centrale - Ospedale Di Ronciglione - U.O. di Ematologia

    Ronciglione

  • Istituto di Ematologia - IRCCS Ospedale Casa Sollievo della Sofferenza

    San Giovanni Rotondo

  • U.O.C. Ematologia e Trapianti - A.O. Senese - Policlinico " Le Scotte"

    Siena

  • SS.C. di Oncoematologia - Dipartimento di Medicina Clinica e Sperimentale - Azienda Ospedaliera - S. Maria Di Terni

    Terni

  • Dipartimento di Oncologia ed Ematologia S.C. Ematologia 2 A.O. Città della Salute e della Scienza di Torino San Giovanni Battista

    Torino

  • Sezione di Ematologia - Med.II Div. Presidio Ospedaliero S. Chiara di Trento

    Trento

  • Azienda U.L.S.S.9 - U.O. di Ematologia

    Treviso

  • Clinica Ematologica - Policlinico Universitario

    Udine

  • Università degli Studi di Verona - A. O. - Istituti Ospitalieri di Verona- Div. di Ematologia - Policlinico G.B. Rossi

    Verona

Other trials in Italy

About this study

Official title: Front-line Nilotinib Treatment of BCR-ABL+ Chronic Myeloid Leukaemia in Chronic Phase. An Observational Multicentre Study of the GIMEMA CML WP.

The GIMEMA CML Working Party promotes a multicentre, observational, prospective study of CML patients treated frontline with NIL. Patients will be followed for 5 years. This study will help the definition of guidelines for the treatment of CML patients in early CP.

Read the detailed description

The primary objective of the study is to describe the stability of molecular response with NIL as frontline therapy in newly diagnosed, unselected, CP CML patients, in an independent, investigator-initiated observational study. Imatinib mesylate (IM), a protein tyrosine kinase inhibitor (TKI) targeting BCR-ABL, has become in the last decade the standard of care for Chronic Myeloid Leukaemia (CML) in chronic phase (CP)1,2. Nilotinib (NIL) is a second generation TKI, effective in IM-resistant and IM-intolerant patients, which demonstrated superior efficacy to IM in early CP BCR-ABL+ CML patients3. Currently, the most important target of the treatment of CML with TKIs is the major molecular response (MMR), defined as a ≥ 3 log reduction in BCR-ABL/ABL transcript level, marker of better long-term outcome. With imatinib therapy, achieving a MMR correlates with an improved probability of a durable cytogenetic remission30. Results from IRIS suggest that a MMR after 12 months of imatinib therapy may be a marker of stable response. Further on, the IRIS study showed that patients with a MMR after 12 months of therapy had a significantly better probability of disease-free survival compared with those in complete cytogenetic remission, but not in MMR31. Moreover, obtaining an undetectable BCR-ABL transcript level is extremely relevant in order to consider TKIs discontinuation. This condition is known as "Complete Molecular Response" (CMR) and is further defined according to the sensitivity achieved (for the definition see the "Criteria of evaluation" section). As far as treatment discontinuation, two experiences have been published so far, aimed at evaluating the persistence of the CMR after imatinib discontinuation. The first was a pilot study32 where 12 patients were included. These 12 patients discontinued imatinib after at least 2 years of CMR (median duration of negativity, 32 months). Six patients displayed a molecular relapse with a detectable BCR-ABL transcript at 1, 1, 2, 3, 4, and 5 months. Imatinib was then reintroduced and led to a novel molecular response. Six other patients (50%) still have an undetectable level of BCR-ABL transcript after a median follow-up of 18 months (range, 9-24 months). The results of this pilot trial have been confirmed and extended in a second trial, the STIM trial33: 100 patients were enrolled, median follow-up 17 months, 69 patients with at least 12 months follow-up: 42 (61%) of these 69 patients relapsed (40 before 6 months, one patient at month 7, and one at month 19). At 12 months, the probability of persistent CMR for these 69 patients was 41% (95% CI 29-52). All patients who relapsed responded to reintroduction of imatinib. An increase of the CMR rate could possibly translate in a higher proportion of patients candidate to stopping anti-CML treatment, with higher probability of remaining disease-free in the long term. The advantages of this possible future scenario could be: first, the possibility of treatment discontinuation at least in patients with chronic clinical adverse events; second, a potential reduction of the costs of TKI treatment (after the introduction of TKI, the costs of CML treatment is increasing year by year, with the increasing prevalence of CML patients). Standardized molecular monitoring has become widely available in Europe through the efforts of EUTOS cooperation19 and now allows for the generation of comparable data on the residual disease using recalculation on the international scale despite these data being analyzed in many different laboratories. These advances in the standardization of molecular responses and the improvement of targeted therapy have allowed for comparable response assessment across Italian Centres and early treatment optimization of patients.

In summary, 1) monitoring of molecular response and of deep and sustained molecular response, provides a straightforward opportunity to assess patients' response and possible prognosis in the use of targeted therapy. 2) Most data on second generation TKIs are from company-sponsored studies generally implemented in selected referral centres. 3) The detailed description of the kinetic of the molecular response and, particularly, the rate of stable MR4, potentially related in turn with a subsequent treatment discontinuation, within the frame of a long-term post-marketing surveillance observational trial offered to all eligible patients followed at a nation-wide, independent multicentre group is the core distinctive feature of this observational trial.

Keywords
Chronic Myeloid Leukaemia, Philadelphia positive, BCR-ABL positive
Medical subject headings
Leukemia, Myelogenous, Chronic, BCR-ABL Positive

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The rate of confirmed MR4

    Measured: At 24 months from study entry

Secondary outcomes (10)
  1. The rate of MMR

    Measured: At 24, 36, 48, and 60 months from study entry.

  2. The rate of MR4

    Measured: At 24, 36, 48, and 60 months from study entry.

  3. The rate of MR4.5

    Measured: At 24, 36, 48, and 60 months from study entry.

  4. The rate of confirmed MR4

    Measured: At 36, 48, and 60 months from study entry.

  5. The rate of stable MR4

    (at least three PCR results with MR4 within the last year [± 2 months] and no results > 0.01% during the same period).

    Measured: At 24, 36, 48, and 60 months from study entry

  6. The rate of stable MR4.5

    (at least three PCR results with MR4.5 within the last year [± 2 months] and no results > 0.0032% during the same period)

    Measured: At 24, 36, 48, and 60 months from study entry

  7. The rate of confirmed loss of MMR (MR3)

    Measured: At 60 months from study entry

  8. The rate of confirmed loss of MMR

    Measured: At one year from study entry

  9. The rate of Complete Cytogenetic Response

    Measured: At one year.

  10. The cumulative rate of permanent NIL discontinuation

    (for failure [defined according to ELN recommendations 2009], intolerance, and death for any reason; not for patients in ≥ MR4 entering clinical trials exploring nilotinib discontinuation)

    Measured: At 5 years from study entry

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Oct 2012 (estimated)
  2. Study start21 Jun 2013
  3. Primary completion16 Dec 2017
  4. Study completion28 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
129 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01699217
Sponsor's protocol ID
CML0912
Acronym
CML0912
Status last verified
Apr 2025
First submitted
1 Oct 2012
Last updated
18 Apr 2025
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Phase Philadelphia Positive and BCR-ABL Positive, run by Gruppo Italiano Malattie EMatologiche dell'Adulto at 56 sites in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 56 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The rate of confirmed MR4 (time frame: At 24 months from study entry). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Apr 2025.

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