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The goal of this clinical research study is to find out if treatment with a combination of dasatinib plus ropeginterferon can help to control CML-CP. The safety of this combination will also be studied.
Full description
Primary Objective:
To assess the rate of molecular response 4.5 (4.5 log-reduction of BCR::ABL1 transcripts or level ≤ 0.0032% IS) by 12 months of therapy
Secondary Objectives:
To assess the rate of complete cytogenetic response (BCR::ABL1 transcripts ≤ 1% IS) by 12 months of therapy
To assess the rate of major molecular response (BCR::ABL1 transcripts ≤ 0.1% IS) by 12 months of therapy
To estimate the proportion of patients achieving MR4.5 at 6, 18, 24, and 36 months of therapy
To estimate the rate of sustained deep molecular response (DMR; BCR::ABL1 transcripts ≤ 0.01% IS) for 2 years and longer
To evaluate the safety of the combination
To assess event-free survival and overall survival for 10 years after the last patient is enrolled
Enrollment
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Volunteers
Inclusion criteria
Adult patients age ≥18 years.
Patients must have a diagnosis of Ph-positive or BCR::ABL1 positive CML in chronic phase.
Patients who received prior hydroxyurea, 1 to 2 doses of cytarabine, and/or an FDA approved TKI for <30 days are eligible.
Patients with additional chromosomal abnormalities at diagnosis (early disease) and no other criteria for accelerated phase will be eligible for this study.
ECOG performance status ≤2.
Patients must have adequate end organ function, defined as the following: total bilirubin
≤1.5x ULN (unless secondary to Gilbert's disease, in which case should be ≤2.5x ULN), SGPT or SGOT ≤3x ULN, creatinine clearance ≥30mL/min calculated using modified Cockcroft-Gault.
Ability to understand and the willingness to sign a written informed consent document.
Dasatinib is known to be teratogenic. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. (Refer to Pregnancy Assessment Policy MD Anderson Institutional Policy # CLN1114). This includes all female patients, between the onset of menses (as early as 8 years of age) and 55 years unless the patient presents with an applicable exclusionary factor which may be one of the following:
Approved methods of birth control are as follows: Hormonal contraception (i.e. birth control pills, injection, implant, transdermal patch, vaginal ring), Intrauterine device (IUD), Tubal Ligation or hysterectomy, Subject/Partner post vasectomy, Implantable or injectable contraceptives, and condoms plus spermicide. Not engaging in sexual activity for the total duration of the trial and the drug washout period is an acceptable practice; however periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.
Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class II or better.
Exclusion criteria
Patients who have received more than 30 days of prior FDA approved TKI or more than 2 doses of cytarabine.
Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > Grade 1) with the exception of alopecia.
Patients who are receiving any other investigational agents.
History of allergic reactions attributed to compounds of similar chemical or biologic composition to dasatinib, ropeginterferon, or other agents used in study.
NYHA cardiac class III-IV heart disease.
Active autoimmune disease at screening.
History or presence of clinically relevant depression
Patients with active, uncontrolled psychiatric disorders including psychosis, major depression, and bipolar disorders.
Patients with cognitive impairment or psychiatric illness/social situations that would limit compliance with study requirements.
Evidence of other clinically significant uncontrolled condition(s) including, but not limited to:
Any contraindications or hypersensitivity to dasatinib or IFN-α and/or its excipients
Patients in accelerated (except as noted in inclusion criteria 4.1) or blast phase are excluded.
Pregnant women are excluded from this study because dasatinib is an agent with potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with dasatinib, breastfeeding should be discontinued if the mother is treated with dasatinib. These potential risks may also apply to other agents used in this study.
Primary purpose
Allocation
Interventional model
Masking
40 participants in 1 patient group
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Central trial contact
Fadi Haddad, MD
Data sourced from clinicaltrials.gov
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