Safety And Efficacy Of Tyrosine Kinase Inhibitor Cessation For Chronic Myeloid Leukemia Patients With Stable Molecular Response In A Real World Population

Description

This is a single-arm, phase II study to evaluate safety and efficacy of tyrosine kinase inhibitor (TKI) cessation for chronic myeloid leukemia (CML) patients with stable molecular response in a real world population.Transitioning from busulfan, hydroxyurea, IFN-α to tyrosine kinase inhibitors (TKIs) has dramatically altered the natural history of CML. Patients with CML appropriately managed with TKIs are able to benefit from near normal life expectancy. Given the age-adjusted incidence of 1.6 per 100,000 people combined with a reduced annual mortality of less than 2% to 3% per year, it is expected the prevalence in the US to increase from approximately 70,000 in 2010 to a projected 144,000 in 2030. Thus, advancing our knowledge regarding clinical management is critical in order to care for this expanding population. However the morbidity associated with prolonged TKI exposure remains a substantial burden on this patient population. In addition to a relatively benign side effect profil

Trial Eligibility

Inclusion Criteria 1. Patients who are 18 years or older 2. Patients have a diagnosis of Philadelphia chromosome- or BCR-ABL1-positive CML (as determined by cytogenetics, FISH, or PCR). 3. Prior evidence of a quantifiable BCR-ABL1 transcript by RT-PCR 4. Patients who have been taking TKI for \> 36 months. 5. Patients must have a history of stable molecular response, defined as MR4.5 for ≥24 months, as documented by ≥3 separate tests performed at least three months apart. 6. Patient must have a current status of complete molecular remission (CMR), defined as MR4.5 (per section 5.1), within 30 days of signing consent. 7. ECOG performance status \< 2 8. Patients must have normal marrow function within 30 days of registration, as defined: * Absolute Neutrophil Count (ANC) ≥ 1.5 x 10E9/L * Hemoglobin ≥ 9.0 g/dL * Platelets ≥ 100 x 10E9/L 9. Patients must not have any signs of extramedullary leukemia 10. Patients must have a life expectancy of more than 12 months in the absence of any intervention 11. All participants must be informed of the investigational nature of this study and must sign and give written informed consent 12. Contraception requirements will be as per routine clinical practice. Exclusion Criteria 1. Patients who are unable or unwilling to give their consent to participate to the study. 2. Previous or planned allogeneic stem cell transplantation 3. Patients who have pathologies or treatments that are able to enhance the potential relapse risk after stopping Imatinib. 4. Patient has received an investigational agent within last 2 years 5. Atypical BCR-ABL transcript not quantifiable by standard RQ-PCR. 6. Patient cannot have had a known interruption of TKI therapy of greater than 14 consecutive days or for a total of 6 weeks in the six months prior to registration. 7. Another primary malignant disease, except those that do not currently require treatment (adequately treated conditions, such as excised skin cancer or cervical intra-epithelial neoplasia would not be considered exclusion criteria. If in doubt, please refer to the Principal Investigator). 8. Any medical condition that, in the opinion of the investigator, would exclude the patient from participating in this study. 9. Active liver disease (e.g., chronic active hepatitis, cirrhosis). 10. Known diagnosis of human immunodeficiency virus (HIV) infection.

Study Info

Interventions

Locations Recruiting

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