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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03817398
Registration number
NCT03817398
Ethics application status
Date submitted
2/01/2019
Date registered
25/01/2019
Date last updated
15/08/2024
Titles & IDs
Public title
Stopping Tyrosine Kinase Inhibitors in Affecting Treatment-Free Remission in Patients With Chronic Phase Chronic Myeloid Leukemia
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Scientific title
Stopping Tyrosine Kinase Inhibitors (TKI) to Assess Treatment-Free Remission (TFR) in Pediatric Chronic Myeloid Leukemia - Chronic Phase (CML-CP)
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Secondary ID [1]
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NCI-2018-03439
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Secondary ID [2]
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AAML18P1
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Phase Chronic Myeloid Leukemia, BCR-ABL1 Positive
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Biospecimen Collection
Other interventions - Drug Withdrawn
Other interventions - Quality-of-Life Assessment
Other interventions - Questionnaire Administration
Treatment: Drugs - Tyrosine Kinase Inhibitor
Experimental: Basic Science (stop taking TKI, biospecimen collection) - Patients stop taking TKI medication within 10 days after enrollment. Patients undergo peripheral blood collection to monitor loss of MMR every 4 weeks in year 1, every 6 weeks in year 2, and every 12 weeks in year 3. Patients who lose their molecular remission may restart TKI medication and are monitored every 4 weeks in year 1, every 6 weeks in year 2, and every 12 weeks in year 3.
Treatment: Surgery: Biospecimen Collection
Undergo blood collection
Other interventions: Drug Withdrawn
Stop taking TKI medication
Other interventions: Quality-of-Life Assessment
Ancillary studies
Other interventions: Questionnaire Administration
Ancillary studies
Treatment: Drugs: Tyrosine Kinase Inhibitor
Re-start TKI medication
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Intervention code [1]
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Treatment: Surgery
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Intervention code [2]
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Other interventions
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Intervention code [3]
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Treatment: Drugs
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Control group
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Outcomes
Primary outcome [1]
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Treatment-free remission (TFR)
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Assessment method [1]
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The Kaplan Meier method will be used to estimate 2-year TFR along with a 95% confidence interval.
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Timepoint [1]
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From date of TKI discontinuation to the date of the first event (molecular recurrence, hematologic relapse, cytogenetic relapse, re-initiation of TKI therapy, second malignant neoplasm, or death) or censoring, assessed up to 2 years
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Primary outcome [2]
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Major molecular remission (MMR/MR3)
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Assessment method [2]
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For patients re-initiating tyrosine kinase inhibitor (TKI) therapy, the cumulative incidence of major molecular remission will be calculated from the time of re-initiating TKI therapy treating deaths prior to achieving major molecular remission as competing events.
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Timepoint [2]
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Up to 1 year
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Secondary outcome [1]
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Clinical factors and laboratory correlates affecting persistence of MMR
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Assessment method [1]
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Clinical factors and laboratory correlates (e.g. duration and level of prior molecular remission, risk score, duration and type of TKI, disease scoring system and immune studies etc.) affecting persistence of MMR and re-initiation of treatment after stopping TKI will be assessed by Cox proportional hazard regression models.
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Timepoint [1]
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Up to 36 months
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Eligibility
Key inclusion criteria
* Patient must have been diagnosed with CML-CP at < 18 years of age.
* Patient must have histologic verification of CML-CP at original diagnosis
* Patient must be in molecular remission (MR) with a BCR-ABL1 level of =< 0.01% BCR-ABL1 as measured using the International Scale (IS) by RQ-PCR for >= 2 consecutive years at the time of enrollment
* Please note: The lab evaluating disease status and molecular response for this study must be College of American Pathology (CAP) and/or Clinical Laboratory Improvement Amendments (CLIA) certified (United States [US] only), sites in other countries must be certified by their accredited authorities. All labs must use the International Scale guidelines with a sensitivity of detection assay =< 0.01% BCR-ABL1 and be able to report results in =< 2 weeks
* Patient must have received any TKI for a minimum of 3 consecutive years at time of enrollment
* Patient agrees to discontinue TKI therapy
* REGULATORY REQUIREMENTS
* All patients and/or their parents or legal guardians must sign a written informed consent
* All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
* ELIGIBILITY FOR PATIENT-REPORTED OUTCOMES (PROs):
* Age >= 8 years at the time of enrollment
* Ability to understand English or Spanish
* Cognitive ability to complete instruments according to the primary team
* ELIGIBILITY FOR AAML18P1 NEUROCOGNITIVE STUDY:
* Patient must be 5 years or older at the time of enrollment
* English-, French- or Spanish-speaking
* No known history of neurodevelopmental disorder prior to diagnosis of CML (e.g., Down syndrome, Fragile X, William syndrome, mental retardation)
* No significant visual or motor impairment that would prevent computer use or recognition of visual test stimuli
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Minimum age
No limit
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Maximum age
25
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Known T3151 mutation
* Additional clonal chromosomal abnormalities in Philadelphia chromosome (Ph) positive (+) cells at any time prior to enrollment that include "major route" abnormalities (second Ph, trisomy 8, isochromosome 17q, trisomy 19), complex karyotype or abnormalities of 3q26.2
* History of accelerated phase or blast crisis CML
* Female patients who are pregnant
* Lactating females are not eligible unless they have agreed not to breastfeed their infants
* Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
8/11/2019
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Date of last participant enrolment
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Actual
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Date of last data collection
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30/06/2026
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Actual
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Sample size
Target
110
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
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Recruitment hospital [1]
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John Hunter Children's Hospital - Hunter Regional Mail Centre
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Recruitment hospital [2]
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The Children's Hospital at Westmead - Westmead
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Monash Medical Center-Clayton Campus - Clayton
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Royal Children's Hospital - Parkville
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Perth Children's Hospital - Perth
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2310 - Hunter Regional Mail Centre
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2145 - Westmead
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3168 - Clayton
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3052 - Parkville
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Recruitment postcode(s) [5]
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6009 - Perth
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Recruitment outside Australia
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United States of America
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Funding & Sponsors
Primary sponsor type
Other
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Name
Children's Oncology Group
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Address
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Name [1]
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National Cancer Institute (NCI)
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Summary
Brief summary
This phase II trial studies how stopping tyrosine kinase inhibitors will affect treatment-free remission in patients with chronic myeloid leukemia in chronic phase. When the level of disease is very low, it's called molecular remission. TKIs are a type of medication that help keep this level low. However, after being in molecular remission for a specific amount of time, it may not be necessary to take tyrosine kinase inhibitors. It is not yet known whether stopping tyrosine kinase inhibitors will help patients with chronic myeloid leukemia in chronic phase continue or re-achieve molecular remission.
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Trial website
https://clinicaltrials.gov/study/NCT03817398
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Sonali Chaudhury
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Address
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Children's Oncology Group
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03817398
Download to PDF