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NCT Number: NCT05440747

Treatment Free Remission (TFR) in CML Patients (CML-CP)Study

Improving the quality of life and achieving Treatment-Free Remission(TFR) is a long-term goal of treatment in CML-CP patients, and deep molecular response (DMR) is necessary to achieve TFR. Cording to the historical literature, it is reported that patients with CML-CP take MMR as the therapeutic target, and the acquisition rate of DMR under long-term TKI treatment is 50%. The 2-year success rate of TFR patients was 50%. Therefore, maybe only 25% of patients with CML can successfully stop the drug for a long time. It cannot meet the withdrawal needs of patients with long-term drug survival.

This study is to design a real-world observational registration study for optimal effect. On the premise of taking DMR as the target decision, through initial treatment intervention, improve the DMR rate, which will promote clinical practice, so as to improve the 2-year TFR rate of cml-cp patients. This study is a multicenter, observational, prospective registry to identify the optimal treatment for achieving TFR in CML patients. In this study, the investigators will assess the deep molecular response after 12 months of treatment and the 2-year treatment-free remission rate (TFR 2y) after drug discontinuation.

Eligible participants with CML-CP can be enrolled. The observation period of all participants is at least 60 months, of which the first 36 months is the shortest treatment period, and the last 24 months is the TFR observation period after TKIs (Imatinib/Flumatinib/Nilotinb/ Dasatinib) withdrawal. During the treatment phase, participants can receive TKIs ± IFN (or other treatments) as first-line/second-line treatment, and the treatment plan will be adjusted according to the molecular response. Patients should accept TKI treatment for at least 3 years or more, and MR4/MR4.5 should achieve at least 2 years before discontinuation.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 1) Aged >=14 years old male and female;
  • 2) Patients with Ph+ CML-CP should meet any of the following conditions;
  • Newly diagnosed Patients with CML-CP;
  • The CML-CP patients who treated with TKI (Imatinib, Nilotinib, Dasatinib and Flumatinib) are not achieved optimal (BCR-ABLIS>10% in 3 months, BCR-ABLIS>1% in 6 months, BCR-ABLIS>0.1% in 12 months or BCR-ABLIS>0.01% in 24 months )or intolerance to these TKIs; The definition of the confirmed diagnosis: Bone marrow cytogenetics Ph chromosome t(9;22) positive and/or BCR-ABL fusion gene positive by FISH, and/or BCR-ABL fusion gene positive(>10%) by Q-PCR ;
  • 3) Never received stem cell transplantation before enrollment;
  • 4) Female patients with fertility have a negative pregnancy test (within 7 days before enrollment).

All Patients with TFR requeirement should provid written informed consent before enrollment.

Exclusion criteria

  • T315I mutation is known;
  • Received stem cell transplantation before enrollment;
  • With other malignant tumors and need active intervention;
  • Those who are unable to follow the protocol steps or follow up on time;
  • Eastern Cooperative Oncology Group physical performance score (ECOG PS) >=3;
  • Other situations deemed unsuitable by the researcher.

Treatment and study plan

TFR(Treatment-Free Remission)

Other

Withdrawal TKIs(Tyrosine kinase inhibitors: Imatinib or Flumatinib or Nilotinb or Dasatinib)

Primary outcomes

  1. Deep molecular response(DMR) rate of 12 months

    Time frame: The 12th month

    DMR is defined by IS BCR-ABL/ABL achieve MR4.0(≤0.01%)

  2. Treatment-Free Remission(TFR) rate of 2 years

    Time frame: The second year

    The proportion of drug withdrawal

Secondary outcomes

  1. TFR rate

    Time frame: The 6months、12months

    TFR rate of 6/12months,Median duration of TFR

  2. DMR rate

    Time frame: The 24/36/48/60 months

    DMR rate of 24/36/48/60 months, Median duration of DMR, DMR is defined by IS BCR-ABL/ABL achieve MR4.0

  3. DMR persistence rate in 2 years

    Time frame: 2 years

    DMR is defined by IS BCR-ABL/ABL achieve MR4.0

  4. Disease progression rate , time to progression

    Time frame: The whole study, up to 7 years

    Time and proportion from diagnosis to disease progression to AP or BC

  5. Loss of Major Molecular Remission(MMR-loss IS BCR-ABL≥0.1%)

    Time frame: TFR phase in the study, up to 2 years

    Time and proportion from discontinuation to loss of MMR in TFR phase up to 2 years.

  6. Re-Major Molecular Remission

    Time frame: The TFR phase, up to 2 years

    Time and proportion from restarting therapy after MMR-lose to obtain MMR through TFR phase.

  7. Treatment-related safety

    Time frame: The whole study , up to 7 years

    Number of participants with treatment-related adverse events as assessed by CTCAE v5.0

  8. Patient Report Outcome(PRO)

    Time frame: Every 3 months in the whole enrollment period, up to 7 years

    EORTCQLQ-CML-24 survey every 3 months in the whole enrollment period

Other outcomes

  1. Clonal evolution in CML patients without optimal efficacy

    Time frame: After participants loss optimal efficacy in milestone,and once a years after that, up to 7 years

    Bone marrow karyotype analysis once a year in the patients without optimal efficacy in milestone through study completion

  2. Resistant mutation rate

    Time frame: The whole study, up to 7 years

    Molecular Mutation Examination(qPCR) once a year in patient without optimal efficacy through study completion.

Study contacts

Contact information is provided by the study sponsor or research team.

Jianyu Weng, PhD

CONTACT

[email protected]

+86-020-83827812

Lisi Huang

CONTACT

[email protected]

+86-020-83827812

Sponsors and collaborators

Lead sponsor

Guangdong Provincial People's Hospital

Other

Registry information

Official study title

A Multicenter, Observational Register Study of Treatment Free Remission in Patients With Chronic Myeloid Leukemia (CML-CP)

Important dates

Study start
2022
Primary completion
2024
Study completion
2031
First posted
Jul 1, 2022
Registry last updated
Jul 1, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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