AzTrials
AzTrials

Philadelphia Chromosome Positive (PH+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP)Phase 3ENESTPathNCT01743989

A Randomized Phase III Study to Assess the Effect of a Longer Duration of Consolidation Treatment With Nilotinib on TFR in CP CML.

A Phase 3 study testing Nilotinib in people with Philadelphia Chromosome Positive (PH+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP), run by Novartis Pharmaceuticals at 208 sites in 21 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study aimed to assess the optimal duration of nilotinib 300 mg twice daily (BID) consolidation treatment in patients with Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML), in order that patients remained in treatment-free remission (≥MR4.0) without molecular relapse 12 months after starting… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Nilotinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
620 participants
Where
208 sitesin 21 countries
Study dates
15 Apr 2013to 8 Jul 2020
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Confirmed diagnosis of chronic phase Ph+ CML
  • Previous first-line treatment with imatinib for a minimum of 2 years;
  • Patient in complete cytogenetic response;

Who cannot join

  • Previous achievement of MR4.0 at study entry;
  • Previous treatment with other target cells inhibitors other than imatinib;
  • Patients with any history of detectable atypical Leukemia transcripts or patients with detectable atypical leukemia transcripts at screening;
  • Previous anticancer agents for Chronic myeloid leukemia other than imatinib except for cytoreduction;
  • Severe and/or uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol;
  • History of other active malignancies within the 5 years prior to study entry with the exception of previous or concomitant basal cell skin cancer and previous carcinoma in situ treated curatively;
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  • Patients who have not recovered from prior surgery;
  • Treatment with other investigational agents within 4 weeks of Day 1;
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug
  • Other inclusion/exclusion criteria might apply.

Trial locations and contacts

208 sites in 21 countries.

208 sites in 21 countries

Italy48 sites
  • Novartis Investigative Site

    Alessandria, AL, 15100

  • Novartis Investigative Site

    Ancona, AN, 60126

  • Novartis Investigative Site

    Avellino, AV, 83100

  • Novartis Investigative Site

    Bari, BA, 70124

  • Novartis Investigative Site

    Bologna, BO, 40138

  • Novartis Investigative Site

    Brescia, BS, 25123

  • Novartis Investigative Site

    Cagliari, CA, 09126

  • Novartis Investigative Site

    Catania, CT, 95100

  • Novartis Investigative Site

    Cona, FE, 44100

  • Novartis Investigative Site

    Cremona, CR, 26100

  • Novartis Investigative Site

    Florence, FI, 50134

  • Novartis Investigative Site

    Genova, GE, 16132

  • Novartis Investigative Site

    Lecce, LE, 73100

  • Novartis Investigative Site

    Livorno, LI, 57124

  • Novartis Investigative Site

    Messina, ME, 98125

  • Novartis Investigative Site

    Milan, MI, 20122

  • Novartis Investigative Site

    Milan, MI, 20132

  • Novartis Investigative Site

    Milan, MI, 20162

  • Novartis Investigative Site

    Mirano, VE, 30035

  • Novartis Investigative Site

    Modena, MO, 41124

  • Novartis Investigative Site

    Naples, 80131

  • Novartis Investigative Site

    Novara, 28100

  • Novartis Investigative Site

    Orbassano, TO, 10043

  • Novartis Investigative Site

    Padova, PD, 35128

  • Novartis Investigative Site

    Pagani, SA, 84016

  • Novartis Investigative Site

    Palermo, PA, 90127

  • Novartis Investigative Site

    Palermo, PA, 90146

  • Novartis Investigative Site

    Parma, PR, 43100

  • Novartis Investigative Site

    Pavia, PV, 27100

  • Novartis Investigative Site

    Perugia, 06129

  • Novartis Investigative Site

    Pescara, PE, 65124

  • Novartis Investigative Site

    Pisa, PI, 56126

  • Novartis Investigative Site

    Potenza, PZ, 85100

  • Novartis Investigative Site

    Reggio Calabria, RC, 89124

  • Novartis Investigative Site

    Reggio Emilia, RE, 42123

  • Novartis Investigative Site

    Roma, RM, 00133

  • Novartis Investigative Site

    Roma, RM, 00144

  • Novartis Investigative Site

    Roma, RM, 00161

  • Novartis Investigative Site

    Rome, Lazio, 00168

  • Novartis Investigative Site

    San Giovanni Rotondo, FG, 71013

  • Novartis Investigative Site

    Siena, SI, 53100

  • Novartis Investigative Site

    Taranto, TA, 74100

  • Novartis Investigative Site

    Torino, TO, 10126

  • Novartis Investigative Site

    Treviso, TV, 31100

  • Novartis Investigative Site

    Udine, UD, 33100

  • Novartis Investigative Site

    Venezia, VE, 30174

  • Novartis Investigative Site

    Verona, VR, 37126

  • Novartis Investigative Site

    Vicenza, VI, 36100

Other trials in Italy

Spain38 sites
  • Novartis Investigative Site

    A Coruña, Galicia, 15006

  • Novartis Investigative Site

    Alicante, Valencia, 03010

  • Novartis Investigative Site

    Alzira, Valencia, 46600

  • Novartis Investigative Site

    Badalona, Catalonia, 08916

  • Novartis Investigative Site

    Barcelona, Catalonia, 08003

  • Novartis Investigative Site

    Barcelona, Catalonia, 08035

  • Novartis Investigative Site

    Barcelona, Catalonia, 08036

  • Novartis Investigative Site

    Cáceres, Extremadura, 10003

  • Novartis Investigative Site

    Donostia / San Sebastian, Basque Country, 20080

  • Novartis Investigative Site

    Girona, Catalonia, 17007

  • Novartis Investigative Site

    Granada, Andalusia, 18014

  • Novartis Investigative Site

    Granollers, 08402

  • Novartis Investigative Site

    Jaén, Andalusia, 23007

  • Novartis Investigative Site

    L'Hospitalet de Llobregat, Catalonia, 08907

  • Novartis Investigative Site

    León, Castille and León, 24071

  • Novartis Investigative Site

    Madrid, 28006

  • Novartis Investigative Site

    Madrid, 28009

  • Novartis Investigative Site

    Madrid, 28031

  • Novartis Investigative Site

    Madrid, 28034

  • Novartis Investigative Site

    Madrid, 28040

  • Novartis Investigative Site

    Madrid, 28041

  • Novartis Investigative Site

    Madrid, 28046

  • Novartis Investigative Site

    Madrid, 28222

  • Novartis Investigative Site

    Málaga, Andalusia, 29010

  • Novartis Investigative Site

    Murcia, 30008

  • Novartis Investigative Site

    Palma de Mallorca, Balearic Islands, 07120

  • Novartis Investigative Site

    Pamplona, Navarre, 31008

  • Novartis Investigative Site

    Pontevedra, Galicia, 36071

  • Novartis Investigative Site

    Sabadell, Barcelona, 08208

  • Novartis Investigative Site

    Salamanca, Castille and León, 37007

  • Novartis Investigative Site

    Santa Cruz de Tenerife, 38009

  • Novartis Investigative Site

    Santiago de Compostela, Galicia, 15706

  • Novartis Investigative Site

    Seville, Andalusia, 41009

  • Novartis Investigative Site

    Seville, Andalusia, 41013

  • Novartis Investigative Site

    Tarragona, Catalonia, 43005

  • Novartis Investigative Site

    Valencia, Valencia, 46026

  • Novartis Investigative Site

    Valladolid, Castille and León, 47011

  • Novartis Investigative Site

    Zaragoza, 50009

Other trials in Spain

Germany33 sites
  • Novartis Investigative Site

    Augsburg, 86150

  • Novartis Investigative Site

    Bayreuth, 95445

  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Braunschweig, 38114

  • Novartis Investigative Site

    Bremen, 28177

  • Novartis Investigative Site

    Chemnitz, 09113

  • Novartis Investigative Site

    Cologne, 50671

  • Novartis Investigative Site

    Dresden, 01307

  • Novartis Investigative Site

    Eisenach, 99817

  • Novartis Investigative Site

    Frankfurt, 60596

  • Novartis Investigative Site

    Georgsmarienhütte, 49124

  • Novartis Investigative Site

    Halle, 06110

  • Novartis Investigative Site

    Hamm, 59063

  • Novartis Investigative Site

    Kiel, 24105

  • Novartis Investigative Site

    Leipzig, 04103

  • Novartis Investigative Site

    Lütten Klein, 18107

  • Novartis Investigative Site

    Magdeburg, 39104

  • Novartis Investigative Site

    Mannheim, Baden-Wurttemberg, 68305

  • Novartis Investigative Site

    Marburg, 35039

  • Novartis Investigative Site

    München, 81241

  • Novartis Investigative Site

    Münster, 48149

  • Novartis Investigative Site

    Nuremberg, 90449

  • Novartis Investigative Site

    Offenburg, 77654

  • Novartis Investigative Site

    Potsdam, 14467

  • Novartis Investigative Site

    Rostock, 18057

  • Novartis Investigative Site

    Rostock, 18059

  • Novartis Investigative Site

    Schorndorf, 73614

  • Novartis Investigative Site

    Schwäbisch Hall, 74523

  • Novartis Investigative Site

    Stuttgart, 70174

  • Novartis Investigative Site

    Velbert, 42551

  • Novartis Investigative Site

    Westerstede, 26655

  • Novartis Investigative Site

    Wiesbaden, 65191

  • Novartis Investigative Site

    Würzburg, 97080

Other trials in Germany

France28 sites
  • Novartis Investigative Site

    Angers, 49033

  • Novartis Investigative Site

    Bayonne, Bayonne Cedex, 64109

  • Novartis Investigative Site

    Bordeaux, 33000

  • Novartis Investigative Site

    Bordeaux, 33076

  • Novartis Investigative Site

    Caen, Cedex, 14033

  • Novartis Investigative Site

    Chalon-sur-Saône, 71321

  • Novartis Investigative Site

    Chambéry, 73011

  • Novartis Investigative Site

    Clermont-Ferrand, 63003

  • Novartis Investigative Site

    Corbeil-Essonnes, 91100

  • Novartis Investigative Site

    Dunkirk, 59240

  • Novartis Investigative Site

    Grenoble, 38043

  • Novartis Investigative Site

    La Roche-sur-Yon, 85925

  • Novartis Investigative Site

    Le Mans, Cedex 09, 72037

  • Novartis Investigative Site

    Lille, 59020

  • Novartis Investigative Site

    Lille, 59037

  • Novartis Investigative Site

    Lyon, 69373

  • Novartis Investigative Site

    Marseille, 13273

  • Novartis Investigative Site

    Metz, 57000

  • Novartis Investigative Site

    Metz, 57085

  • Novartis Investigative Site

    Mulhouse, 68070

  • Novartis Investigative Site

    Nice, 06202

  • Novartis Investigative Site

    Paris, Cedex 10, 75475

  • Novartis Investigative Site

    Paris, 75012

  • Novartis Investigative Site

    Perpignan, 66046

  • Novartis Investigative Site

    Pontoise, F-95300

  • Novartis Investigative Site

    Rouen, 76038

  • Novartis Investigative Site

    Saint-Priest-en-Jarez, 42271

  • Novartis Investigative Site

    Toulouse, 31059

Other trials in France

Poland9 sites
  • Novartis Investigative Site

    Chorzów, 41-500

  • Novartis Investigative Site

    Gdansk, 80 952

  • Novartis Investigative Site

    Katowice, 40-027

  • Novartis Investigative Site

    Krakow, 30-510

  • Novartis Investigative Site

    Olsztyn, 10 561

  • Novartis Investigative Site

    Opole, 45-372

  • Novartis Investigative Site

    Torun, 87 100

  • Novartis Investigative Site

    Warsaw, 02 106

  • Novartis Investigative Site

    Warsaw, 02 776

Other trials in Poland

Romania7 sites
  • Novartis Investigative Site

    Bucharest, District 2, 022328

  • Novartis Investigative Site

    Bucharest, 030 171

  • Novartis Investigative Site

    Bucharest, 500098

  • Novartis Investigative Site

    Cluj-Napoca, 400124

  • Novartis Investigative Site

    Iași, 700483

  • Novartis Investigative Site

    Sibiu, 550245

  • Novartis Investigative Site

    Timișoara, 300 079

Other trials in Romania

Austria6 sites
  • Novartis Investigative Site

    Graz, 8036

  • Novartis Investigative Site

    Linz, Upper Austria, A 4020

  • Novartis Investigative Site

    Linz, 4010

  • Novartis Investigative Site

    Linz, A-4010

  • Novartis Investigative Site

    Rankweil, A-6830

  • Novartis Investigative Site

    Salzburg, 5020

Other trials in Austria

Bulgaria5 sites
  • Novartis Investigative Site

    Pleven, 5800

  • Novartis Investigative Site

    Plovdiv, 4002

  • Novartis Investigative Site

    Sofia, 1431

  • Novartis Investigative Site

    Sofia, 1756

  • Novartis Investigative Site

    Varna, 9000

Other trials in Bulgaria

Greece5 sites
  • Novartis Investigative Site

    Athens, GR, 115 27

  • Novartis Investigative Site

    Athens, 106 76

  • Novartis Investigative Site

    Athens, 115 27

  • Novartis Investigative Site

    Pátrai, 265 00

  • Novartis Investigative Site

    Thessaloniki, GR, 570 10

Other trials in Greece

Portugal5 sites
  • Novartis Investigative Site

    Lisbon, 1099 023

  • Novartis Investigative Site

    Lisbon, 1749-035

  • Novartis Investigative Site

    Porto, 4099-001

  • Novartis Investigative Site

    Porto, 4200 319

  • Novartis Investigative Site

    Porto, 4200-072

Other trials in Portugal

Serbia4 sites
  • Novartis Investigative Site

    Belgrade, 11000

  • Novartis Investigative Site

    Belgrade, 11070

  • Novartis Investigative Site

    Niš, 18000

  • Novartis Investigative Site

    Novi Sad

Other trials in Serbia

United Kingdom4 sites
  • Novartis Investigative Site

    East Yorkshire, HU16 5JQ

  • Novartis Investigative Site

    Edinburgh, EH4 2XU

  • Novartis Investigative Site

    London, EC1A 7BE

  • Novartis Investigative Site

    London, W12 0HS

Other trials in United Kingdom

Hungary3 sites
  • Novartis Investigative Site

    Budapest, 1097

  • Novartis Investigative Site

    Debrecen, 4032

  • Novartis Investigative Site

    Szeged, H 6725

Other trials in Hungary

Belgium2 sites
  • Novartis Investigative Site

    Brussels, 1070

  • Novartis Investigative Site

    Liège, 4000

Other trials in Belgium

Czechia2 sites
  • Novartis Investigative Site

    Brno-Bohunice, Czech Republic, 625 00

  • Novartis Investigative Site

    Hradec Králové, CZE, 500 05

Other trials in Czechia

Denmark2 sites
  • Novartis Investigative Site

    Holstebro, DK-7500

  • Novartis Investigative Site

    Roskilde, 4000

Other trials in Denmark

Norway2 sites
  • Novartis Investigative Site

    Bergen, NO-5021

  • Novartis Investigative Site

    Oslo, NO-0310

Other trials in Norway

Slovakia2 sites
  • Novartis Investigative Site

    Bratislava, 85107

  • Novartis Investigative Site

    Martin, 03601

Other trials in Slovakia

Finland1 site
  • Novartis Investigative Site

    HUS Helsinki, FIN-00029

Other trials in Finland

Slovenia1 site
  • Novartis Investigative Site

    Ljubljana, 1000

Other trials in Slovenia

Sweden1 site
  • Novartis Investigative Site

    Stockholm, SE-171 76

Other trials in Sweden

About this study

Official title: A Prospective, Randomized, Open Label, Two Arm Phase III Study to Evaluate Treatment Free Remission (TFR) Rate in Patients With Philadelphia-positive CML After Two Different Durations of Consolidation Treatment With Nilotinib 300mg BID.

This study aimed to assess the optimal duration of nilotinib 300 mg twice daily (BID) consolidation treatment in patients with Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML), in order that patients remained in treatment-free remission (≥MR4.0) without molecular relapse 12 months after starting the Treatment-Free Remission (TFR) phase.

Read the detailed description

This was a prospective, randomized, open-label, multicenter Phase III study. The study design was made up of 3 phases:

  • Nilotinib induction phase: 12 months
  • Nilotinib consolidation phase: 12 or 24 months, depending on randomization
  • Nilotinib treatment-free remission (TFR) phase: 24 or 36 months, depending on randomization.

Subjects were enrolled into the study and were treated with nilotinib 300mg twice daily (BID) for 24 months, during the induction (12 months) and consolidation (12 months) phases. At the end of the first 24 months of treatment, participants achieving a sustained molecular response (defined as ≥ MR4.0, in 4 out of 5 real-time quantitative polymerase chain reaction (RQ-PCR) assessments, including the last assessment, in the last 12 months) were randomized on a 1:1 basis to either:

  1. suspend nilotinib treatment immediately and enter the TFR phase for 36 months (Nilotinib 24-month treatment arm), or
  2. continue nilotinib treatment for a further 12 months (post-randomization consolidation phase), then suspend treatment and enter the TFR phase for 24 months (Nilotinib 36-month treatment arm).

Participants not achieving a sustained molecular response at 24 months from treatment start were not eligible for randomization and were treated at the discretion of the investigator according to standard practice. Information on survival, stem cell transplantation, and status of the patient's disease was collected until death or until 5 years from study entry, whichever came first. Additionally, for Nilotinib 36-month treatment arm, participants who did not achieve a sustained molecular response at 36 months from treatment start, discontinued from the study and were treated according to standard practice and followed up until death or until 5 years from study entry, whichever came first.

Participants relapsing during the TFR phase entered the nilotinib re-treatment phase of the study, and were re-treated with the same dose of nilotinib as they were on before the TFR phase. These patients remained on study until the completion of the 5-year study period unless prematurely withdrawn and discontinued from the study for any reason specified in the Protocol.

Being tested
Nilotinib
Keywords
Adult, Chronic myelogenous leukemia (CML), Chronic myeloid leukemia (CML), Chronic myelocytic leukemia (CML), Acute Lymphoblastic Leukemia (ALL) Philadelphia chromosome positive, Acute Lymphoid Leukemia, Suboptimal molecular response
Medical subject headings
Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Precursor Cell Lymphoblastic Leukemia-Lymphoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NilotinibDrug

    Also called AMN107

    Participants received a daily oral nilotinib dose of 300 mg BID, given as two 150 mg capsules BID.

Study groups in NCT01743989
Study groupRoleWhat they receive
Nilotinib 24-month treatmentExperimentalParticipants were treated with nilotinib 300mg BID for 24 months and, thereafter, entered the 36-month TFR phase
Receives: Drug: Nilotinib
Nilotinib 36-month treatmentExperimentalParticipants were treated with nilotinib 300mg BID for 36 months and, thereafter, entered the 24-month TFR phase
Receives: Drug: Nilotinib
Not randomizedExperimentalParticipants were treated with nolotinib 300mg BID for 24 months, but did not achieve a sustained molecular response after 24 months of treatment.
Receives: Drug: Nilotinib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Who Remained in Treatment Free Remission (TFR) Without Molecular Relapse 12 Months After Entering the TFR Phase

    Number of participants who remained in TFR (≥molecular response (MR) 4.0) without molecular relapse 12 months after entering the TFR phase (without re-starting nilotinib therapy) divided by the number of participants who entered the TFR phase and multiplied by 100.

    Molecular relapse during TFR is defined as the loss of major molecular response (MMR), or the confirmed loss of MR4.0 (defined by 3 consecutive tests less than MR4.0 assessed at 3 consecutive visits during TFR phase). Participants dropping out early from the study during the TFR phase were considered as unsuccessful TFR.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    MR4.0 is defined as either detectable disease≤0.01% BCR-ABL or undetectable disease in cDNA with≥10,000 ABL transcripts

    Measured: 12 months after entering the TFR phase, which is after 36 months from study treatment start for Nilotinib 24-month treatment arm and after 48 months from study treatment start for Nilotinib 36-month treatment arm

Secondary outcomes (21)
  1. Cumulative Incidence of MMR During the Pre-randomization Induction/Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MMR during pre-randomization induction/consolidation phase divided by the number of participants without that response at baseline and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    Measured: From baseline up to 24 months after study treatment start

  2. Cumulative Incidence of MMR During the Post-randomization Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MMR during post-randomization consolidation phase divided by the number of participants without that response at baseline and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  3. Cumulative Incidence of MR4.0 During the Pre-randomization Induction/Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MR4.0 during the pre-randomization induction/consolidation phase divided by the number of participants without that response at baseline and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.0 is defined as either detectable disease ≤0.01% BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From baseline up to 24 months after study treatment start

  4. Cumulative Incidence of MR4.0 During the Post-randomization Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MR4.0 during the post-randomization consolidation phase divided by the number of participants without that response at baseline and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.0 is defined as either detectable disease ≤0.01% BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  5. Cumulative Incidence of MR4.5 During the Pre-randomization Induction/Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MR4.5 during the pre-randomization induction/consolidation phase divided by the number of participants without that response at baseline and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.5 is defined as either detectable disease ≤ 0.0032% BCR-ABL IS; or undetectable disease within cDNA with ≥ 32,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From baseline up to 24 months after study treatment start

  6. Cumulative Incidence of MR4.5 During the Post-randomization Consolidation Phase Among Participants Without That Response at Study Entry

    Number of participants who were in MR4.5 during the post-randomization consolidation phase divided by the number of participants without that response at baseline and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.5 is defined as either detectable disease ≤ 0.0032% BCR-ABL IS; or undetectable disease within cDNA with ≥ 32,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  7. Cumulative Incidence of MMR During the Pre-randomization Induction/Consolidation Phase

    Number of participants who were in MMR during the pre-randomization induction/consolidation phase divided by the number of enrolled participants and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    Measured: From baseline up to 24 months after study treatment start

  8. Cumulative Incidence of MMR During the Post-randomization Consolidation Phase

    Number of participants who were in MMR during the post-randomization consolidation phase divided by the number of enrolled participants and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  9. Cumulative Incidence of MR4.0 During the Pre-randomization Induction/Consolidation Phase

    Number of participants who were in MR4.0 during the pre-randomization induction/consolidation phase divided by the number of enrolled participants and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.0 is defined as either detectable disease ≤0.01% BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From baseline up to 24 months after study treatment start

  10. Cumulative Incidence of MR4.0 During the Post-randomization Consolidation Phase

    Number of participants who were in MR4.0 during the post-randomization consolidation phase divided by the number of enrolled participants and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.0 is defined as either detectable disease ≤0.01% BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  11. Cumulative Incidence of MR4.5 During the Pre-randomization Induction/Consolidation Phase

    Number of participants who were in MR4.5 during the pre-randomization induction/consolidation phase divided by the number of enrolled participants and multiplied by 100.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.5 is defined as either detectable disease ≤ 0.0032% BCR-ABL IS; or undetectable disease within cDNA with ≥ 32,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From baseline up to 24 months after study treatment start

  12. Cumulative Incidence of MR4.5 During the Post-randomization Consolidation Phase

    Number of participants who were in MR4.5 during the post-randomization consolidation phase divided by the number of enrolled participants and multiplied by 100. Post-randomization consolidation phase corresponded to the 12-month additional treatment (after randomization) for Nilotinib 36-month treatment arm.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.5 is defined as either detectable disease ≤ 0.0032% BCR-ABL IS; or undetectable disease within cDNA with ≥ 32,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From randomization (month 24 after study treatment start) up to 36 months after study treatment start

  13. Percentage of Participants Who Were in MMR During TFR Phase

    Number of participants who were in MMR at selected timepoints divided by the number of participants in the TFR phase and multiplied by 100. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotinib 24-month treatment arm had a maximum of 36 months of TFR phase.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1% BCR-ABL.

    Measured: From Month 1 after entering TFR phase up to 24 months after entering TFR phase for Nilotinib 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

  14. Percentage of Participants Who Were in MR4.0 During the TFR Phase

    Number of participants who were in MR4.0 at selected timepoints divided by the number of participants in the TFR phase and multiplied by 100. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotinib 24-month treatment arm had a maximum of 36 months of TFR phase.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.0 is defined as either detectable disease ≤0.01% BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From Month 1 after entering TFR phase up to 24 months after entering TFR phase for Nilotininb 36-months treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-months treatment arm

  15. Percentage of Participants Who Were in MR4.5 During the TFR Phase

    Number of participants who were in MR4.5 at selected timepoints divided by the number of participants in the TFR phase and multiplied by 100. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotinib 24-month treatment arm had a maximum of 36 months of TFR phase.

    Confidence intervals were calculated based on the Exact Clopper-Pearson method. MR4.5 is defined as either detectable disease ≤ 0.0032% BCR-ABL IS; or undetectable disease within cDNA with ≥ 32,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From Month 1 after entering TFR phase up to 24 months after entering TFR phase for Nilotininb 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

  16. BCR-ABL Ratio (Expressed as a Percentage) During the Induction/Consolidation Phase

    BCR-ABL transcript ratio by international scale (IS) (expressed as a percentage) during the induction/consolidation phase. Participants randomized to Nilotinib 36-month treatment arm had 12-month additional consolidation phase (post-randomization).

    Measured: From baseline up to 24 months after study treatment start for Nilotinib 24-month treatment arm and Not randomized participants; and up to 36 months after study treatment start for Nilotinib 36-month treatment arm.

  17. BCR-ABL Ratio (Expressed as a Percentage) During the TFR Phase

    BCR-ABL/control gene (ABL) transcript ratio by international scale (IS) (expressed as a percentage) during the TFR phase. BCR-ABL is the fusion gene from breakpoint cluster region and Abelson genes.

    Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotinib 24-month treatment arm had a maximum of 36 months of TFR phase.

    Measured: From Month 1 after entering TFR phase up to 24 months after entering TFR phase for Nilotinib 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

  18. BCR-ABL Ratio (Expressed as a Percentage) During the Nilotinib Re-treatment Phase

    BCR-ABL/control gene (ABL) transcript ratio by international scale (IS) (expressed as a percentage) during the nilotinib re-treatment phase. BCR-ABL is the fusion gene from breakpoint cluster region and Abelson genes.

    Measured: From Day 1 after entering the re-treatment phase up to 24 months after entering re-treatment phase for Nilotinib 36-month treatment arm and 36 months after entering the re-treatment phase for Nilotinib 24-month treatment arm

  19. Progression-free Survival (PFS) During the TFR Phase of the Study.

    PFS is defined as the time from the date of start of the nilotinib TFR phase to the date of acelerated phase/blast crisis (AP/BC) or death, whichever came first. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotini 24-month treatment arm had a maximum of 36 months of TFR phase.

    Patients not known to have recurred or died on or before the cut-off date for PFS analysis were censored at the date of their last assessment (cytogenetic, hematology or extramedullary) for patients who were on study, and at the date of last contact for patients who were in follow-up.

    Measured: From the start of the TFR phase to progression to AP/BC or death up to 24 months after entering TFR phase for Nilotininb 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

  20. Treatment -Free Survival (TFS) During the TFR Phase of the Study

    TFS is defined as the time from the start of the TFR phase to the date of the earliest of the following: loss of MMR, confirmed loss of MR4.0,re-start of nilotinib treatment, progression to AP/BC, or death from any cause. Patients not known to have had any of the events on or before the cut-off date were censored at the earlier of the date of their last assessment for patients who were still on study and the date of last contact for patients who were in follow-up. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotinib 24-month treatment arm had a maximum of 36 months of TFR phase. MMR is defined as ≥3.0 log reduction in BCR-ABL transcripts compared to the standardized baseline or ≤0.1%BCR-ABL.

    MR4.0 is defined as either detectable disease ≤0.01%BCR-ABL IS or undetectable disease in cDNA with ≥10,000 ABL transcripts (numbers of ABL transcripts in the same volume of cDNA used to test for BCR-ABL)

    Measured: From the start of the TFR phase to the date of occurrence of treatment-free survival event, up to 24 months after entering TFR phase for Nilotinib 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

  21. Overall Survival (OS) Rate During the TFR Phase of the Study.

    OS is defined as the time from start of the TFR phase to the time of death due to any cause. Participants randomized in Nilotinib 36-month treatment arm had a maximum of 24 months of TFR phase, whereas participants randomized in Nilotini 24-month treatment arm had a maximum of 36 months of TFR phase.

    For participants without any event on or before the cut-off date, survival time will be censored at the date of their last assessment for patients who are still on study, and at the date of last contact for patients who are in follow-up.

    Measured: From the start of the TFR phase to death due to any cause, assessed up to 24 months after entering TFR phase for Nilotinib 36-month treatment arm and up to 36 months after entering TFR phase for Nilotinib 24-month treatment arm

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Dec 2012 (estimated)
  2. Study start15 Apr 2013
  3. Primary completion8 Jul 2020
  4. Study completion8 Jul 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
All participants received 24 months of study treatment. After 24 months of treatment, eligible participants (i.e. those deemed to have achieved sustained molecular response) were randomized to one of the two study arms on a continued open-label basis. Participants not achieving sustained molecular response after 24 months of treatment were not randomized but remained in the study until the 5-year study period was completed (Not randomized arm).
Masking
None (open label)
Enrolment
620 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01743989
Sponsor's protocol ID
CAMN107AIC05
Other IDs
2012-005124-15
Acronym
ENESTPath
Status last verified
Jun 2021
First submitted
4 Dec 2012
Last updated
15 Jul 2021
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Borghi L, Rosti G, Maggi A, Breccia M, Di Bona E, Iurlo A, La Barba G, Sportoletti P, Albano F, Galimberti S, Rivellini F, Cambrin GR, Capodanno I, Cuneo A, Bonifacio M, Sica S, Arcaini L, Capochiani E, Minotto C, Ciceri F, Crugnola M, Di Caprio L, Supekar S, Elena C, Baccarani M, Vegni E. Perspectives and Emotional Experiences of Patients With Chronic Myeloid Leukemia During ENESTPath Clinical Trial and Treatment-Free Remission: Rationale and Protocol of the Italian Substudy. Front Oncol. 2021 May 26;11:638689. doi: 10.3389/fonc.2021.638689. eCollection 2021.

    PubMed 34123791

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Nilotinib in people with Philadelphia Chromosome Positive (PH+) Chronic Myelogenous Leukemia in Chronic Phase (CML-CP), run by Novartis Pharmaceuticals at 208 sites in 21 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 208 sites in Italy, Spain, Germany, France, Poland and 16 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Who Remained in Treatment Free Remission (TFR) Without Molecular Relapse 12 Months After Entering the TFR Phase (time frame: 12 months after entering the TFR phase, which is after 36 months from study treatment start for Nilotinib 24-month treatment arm and after 48 months from study treatment start for Nilotinib 36-month treatment arm). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01743989, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2021; AzTrials last refreshed its copy on 26 Oct 2026.

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