BosuPeg: Long-acting Low Dose Ropeginterferon for Chronic Myeloid Leukemia Treated With Bosutinib From Diagnosis

• Sponsor: St. Olavs Hospital (Other)
• Overall Status: Recruiting
• CT.gov ID: NCT03831776
• Collaborator: Haukeland University Hospital (Other), Oslo University Hospital (Other), University Hospital of North Norway (Other), Helse Stavanger HF (Other), Henri Mondor University Hospital (Other), Hôpital René Huguenin (Other), Hôpital Mignot, Versailles Paris (Other), Uppsala University Hospital (Other), Odense University Hospital (Other)
• Enrollment: 212
• Locations: 18
• Arms: 2
• Anticipated Duration (Months): 107.2
• Patients Per Site: 11.8
• Patients Per Site Per Month: 0.1

Study Details

Study Description

Brief Summary

To study the efficacy and safety of combination of Ro-Peg-interferon-α2b (RoPegIFN) with Bosutinib (BOS) in comparison to BOS monotherapy, as frontline therapy for newly diagnosed chronic myeloid leukemia patients, and to estimate efficacy of the addition of RoPegIFN to BOS in terms of deep molecular response with the aim of increasing the proportion of patients who may achieve treatment free remission. (NCMLSG study #NordCML012)

Condition or Disease	Intervention/Treatment	Phase
Chronic Myeloid Leukemia	Drug: Bosutinib; Drug: Ropeginterferon	Phase 2

Study Design

• Study Type: Interventional
• Anticipated Enrollment: 212 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Study of Efficacy and Safety of Long-acting Low Dose Ropeginterferon in Patients With Chronic Myeloid Leukemia Treated With Bosutinib From Diagnosis: a Randomized Prospective Trial
• Actual Study Start Date: Mar 25, 2019
• Anticipated Primary Completion Date: Mar 15, 2023
• Anticipated Study Completion Date: Mar 1, 2028

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Bosutinib-Ropeginterferon combination	Drug: Bosutinib; Bosutinib, provided by Pfizer, starting dose of 200mg QD and stepwise dose escalation (> 300 mg/d > 400 mg/d) during the first three months. A pharmacological study will be performed in the French cohort (BOSUSTEP Substudy). BOS residual plasma concentration (Cmin) will be checked after initiation, before each dose step in the French cohort, and at M3 also for Nordic patients in ancillary studies.; Drug: Ropeginterferon; Ro-Peg-Interferon α2b will be supplied by AOP Orphan to be administered by subcutaneous injections from prefilled injection pens. RoPegIFN will be given in an open-label fashion. Patients assigned to RoPegIFN will start with 50 μg injected subcutaneously every 14 days, in combination with Bosutinib.; Other Names: RoPegIFN
Active Comparator: Bosutinib monotherapy	Drug: Bosutinib; Bosutinib, provided by Pfizer, starting dose of 200mg QD and stepwise dose escalation (> 300 mg/d > 400 mg/d) during the first three months. A pharmacological study will be performed in the French cohort (BOSUSTEP Substudy). BOS residual plasma concentration (Cmin) will be checked after initiation, before each dose step in the French cohort, and at M3 also for Nordic patients in ancillary studies.

Outcome Measures

Primary Outcome Measures

1. Rate of molecular response 4 (MR4) [12 months]

   Molecular response 4 (MR4) is defined by either a positive BCR-ABL/ABL ratio ≤ 0.01% on the international scale (IS) or by undetectable BCR-ABL with the analysis of at least 10000 copies of ABL or 24000 copies of GUS (according to the ELN recommendations by N. Cross et al., Leukemia 2015)

Secondary Outcome Measures

1. Rate of molecular response MR2, MR3, MR4, MR4.5 from 1 month up to 24 months and every 6 months thereafter [2 years]

2. Cumulative incidence of molecular response MR3, MR4, MR4.5 [2 years]

3. Rate of complete cytogenetic response (CCyR) up to 12 months [12 months]

4. Rate of undetectable molecular response for patients who achieved molecular response MR4 and MR4.5 [2 years]

5. Time to and duration of CCyR, MR3, MR4, MR4.5 [2 years]

6. proportion of patients eligible for randomization after 3 months of Bosutinib [3 months]

7. rate and characteristics of severe adverse events (SAE) [2 years]

   type and grade according to the NCI CTCAE v4.03

8. Dose intensity of RoPegIFN and Bosutinib [2 years]

9. Cumulative incidence of discontinuation of the therapies, incl. reasons for discontinuation [2 years]

10. Quality of life assessment by QLQC30 questionnaire up to 6 years at key time point (Day 1, month 3, month 6, month 12, month 24, month 48, month 54, month 72) [6 years]

11. Quality of life assessment by CML24 questionnaire up to 6 years at key time point (Day 1, month 3, month 6, month 12, month 24, month 48, month 54, month 72) [6 years]

12. The proportion of patients achieving a durable deep molecular response and being eligible for treatment discontinuation at month 48 [4 years]

    Sustained deep molecular response (MR) criteria will be defined according updated data and ELN guidelines before the first patient will achieve month 48 (at least a MR4 over a 12 months period and confirmed on the last centralized measurement at month 48

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 75 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Signed written informed consent form (ICF) before any procedure related to the study

• Newly diagnosed (≤ 3 months) BCR-ABL positive chronic myeloid leukemia (CML) in chronic phase

• Major BCR-ABL transcripts (p210 b2a2(e13a2) and/or b3a2 (e14a2)

• Not previously treated for CML except with hydroxyurea or anagrelide

• ECOG Performance Status (ECOG PS) ≤ 2

• Adequate organ function: Total bilirubin < 1,5 times the institutional Upper Limit of Normal (ULN); Hepatic enzymes ASAT and ALAT < 2 times the institutional ULN; Serum Creatinine < 1.5 time the institutional ULN; Lipase < 1.5 time the institutional ULN

• Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study.

• WOCBP must have a negative serum or urine pregnancy test at screening.

• Free subject, without guardianship nor subordination

• Health insurance coverage

Exclusion Criteria:

• Patients with BCR-ABL transcript other than M-BCR-ABL

• Patients previously treated with tyrosine kinase inhibitors (TKIs).

• Inability to freely provide consent through judiciary or administrative condition.

• Ongoing participation to another clinical investigational study.

• Medical history and concurrent diseases: a) Hypersensitivity to any of the excipients of BOS or RoPegIFN, b) Prior treatment with Interferon-α, contraindication to interferon-α, c) Autoimmune disorder, concomitant immunosuppressive treatment or corticosteroids, d) Pre-existing thyroid disease unless controlled with conventional treatment, auto-immune thyroiditis, e) Chronic liver disease, f) Prior or ongoing severe psychiatric disease, g) HIV positivity, chronic hepatitis B or C, h) Uncontrolled or severe cardiac (NYHA Class III or IV) or pulmonary disease, echocardiography with LVF < 45% or LLN, peak velocity of tricuspid regurgitant flow > 2,8 m/s, pulmonary arterial hypertension (PAH), QTc>450 ms (by Barrets correction)

• Other malignant disease during the last 5 years prior to the inclusion except non-melanoma skin carcinoma or carcinoma in situ of the cervix,

• History of significant bleeding disorder unrelated to CML or diagnosed congenital bleeding disorder,

• Subjects with an uncontrolled undercurrent illness or any concurrent condition that, in the investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol.

• Prohibited treatments and/or therapies: strong inhibitors/inducers of the CYP 3A4,

• History / any condition for poor compliance to medical treatment.

• Women who are pregnant or breastfeeding are not eligible for this study

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Aalborg university hospital	Aalborg		Denmark
2	Aarhus ...	Aarhus		Denmark
3	Copenhagen ...	Copenhagen		Denmark
4	Odense Universitetshospital	Odense		Denmark
5	Comprehensive Cancer Center, Hematology	Helsinki		Finland
6	Haukeland Universitetssjukehus	Bergen		Norway
7	Oslo Universitetssykehus	Oslo		Norway
8	Stavanger Universitetssjukehus	Stavanger		Norway
9	Universitetssykehuset Nord Norge	Tromsø		Norway
10	St Olavs Hospital	Trondheim		Norway
11	Göteborg ....	Göteborg		Sweden
12	Universitetssjukhuset Linköping	Linköping		Sweden
13	Skåne University Hospital	Lund		Sweden
14	Karolinska Universitetssjukhus	Stockholm		Sweden
15	Sundsvall ...	Sundsvall		Sweden
16	Norrlands Universitetssjukhus	Umeå		Sweden
17	University Hospital	Uppsala		Sweden
18	Universitetssjukhuset Örebro	Örebro		Sweden

Sponsors and Collaborators

• St. Olavs Hospital
• Haukeland University Hospital
• Oslo University Hospital
• University Hospital of North Norway
• Helse Stavanger HF
• Henri Mondor University Hospital
• Hôpital René Huguenin
• Hôpital Mignot, Versailles Paris
• Uppsala University Hospital
• Odense University Hospital

Investigators

• Study Director: Tom Christian Martinsen, md phd, St Olavs Hospital, Clinical of Internal Medicine
• Principal Investigator: Henrik Hjorth-Hansen, md phd, St. Olavs Hospital
• Principal Investigator: Lydia Roy, md phd, Centre Hospitalo-Universitaire Henri Mondor, Service d'Hematologie Clinique

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: St. Olavs Hospital
• ClinicalTrials.gov Identifier: NCT03831776
• Other Study ID Numbers: BosuPeg TRIAL; 2018-001044-54
• First Posted: Feb 6, 2019
• Last Update Posted: Apr 5, 2022
• Last Verified: Apr 1, 2022

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No
• Keywords provided by St. Olavs Hospital: Bosupeg; Ropeginterferon
• Additional relevant MeSH terms: Leukemia; Leukemia, Myeloid; Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Study Results

No Results Posted as of Apr 5, 2022