Chronic Myelogenous LeukemiaPhase 3NCT04948333
Asciminib Treatment Optimization in ≥ 3rd Line CML-CP
A Phase 3 study testing ABL001 40mg BID, ABL001 80mg QD and ABL001 200mg QD in people with Chronic Myelogenous Leukemia, run by Novartis Pharmaceuticals at 48 sites in 16 countries.
Trial summary
The purpose of the study is to optimize the treatment of asciminib in patients with chronic myelogenous leukemia in chronic phase (CML-CP) previously treated with 2 or more Tyrosine Kinase Inhibitors (TKIs). Read more about this study
- Who is it for?
- Ages 18 to 99 years
- Conditions the study is for
- Chronic Myelogenous Leukemia
- What is being tested?
- ABL001 40mg BID, ABL001 80mg QD and ABL001 200mg QD
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 199 participants
- Where
- 48 sitesin 16 countries
- Study dates
- 13 Oct 2021to 25 Feb 2026
- Phase
- Phase 3
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 to 99 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent must be obtained prior to participation in the study
- Male or female patients with a diagnosis of CML-CP ≥ 18 years of age
- Treatment with a minimum of 2 or more prior TKIs (i.e. imatinib, nilotinib, dasatinib, bosutinib, radotinib or ponatinib)
- Warning or failure (adapted from the 2020 ELN Recommendations) or intolerance to the most recent TKI therapy at the time of screening
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2
- Adequate end organ function (as per central laboratory tests)
Who cannot join
- Known presence of the BCR::ABL1 T315I mutation at any time prior to study entry
- Known second chronic phase of CML after previous progression to AP/BC
- Previous treatment with a hematopoietic stem-cell transplantation
- Patient planning to undergo allogeneic hematopoietic stem cell transplantation
- Uncontrolled cardiac repolarization abnormality
- 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
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- History of acute pancreatitis within 1 year of study entry or past medical history of chronic pancreatitis
- Testing for Hepatitis B surface antigen (HbsAg) and Hepatitis B core antibody (HBcAb / anti HBc) will be performed at screening. Patients with active Hepatitis B Virus (HBV) infection (hepatitis B surface antigen [HbsAg] positive) will be excluded
- Other Inclusion/Exclusion criteria may apply.
Trial locations and contacts
48 sites in 16 countries.
48 sites in 16 countries
Germany6 sites
Novartis Investigative Site
Berlin, 13353
Novartis Investigative Site
Frankfurt am Main, Hesse, 60590
Novartis Investigative Site
Jena, Thuringia, 07740
Novartis Investigative Site
Kiel, 24116
Novartis Investigative Site
Mannheim, Baden-Wurttemberg, 68305
Novartis Investigative Site
München, 80377
France5 sites
Novartis Investigative Site
Bordeaux, 33076
Novartis Investigative Site
Lyon, 69373
Novartis Investigative Site
Montpellier, 34295
Novartis Investigative Site
Nantes, 44093
Novartis Investigative Site
Paris, 75475
Spain5 sites
Novartis Investigative Site
Barcelona, 08035
Novartis Investigative Site
Bilbao, Bizkaia, 48013
Novartis Investigative Site
Madrid, 28041
Novartis Investigative Site
Santa Cruz, Santa Cruz De Tenerife, 38009
Novartis Investigative Site
Santiago Compostela, A Coruna, 15706
Malaysia4 sites
Novartis Investigative Site
George Town, Pulau Pinang, 10450
Novartis Investigative Site
Johor Bahru, 80100
Novartis Investigative Site
Kota Kinabalu, Sabah, 88586
Novartis Investigative Site
Kuala Selangor, 68000
United Kingdom4 sites
Novartis Investigative Site
Cambridge, CB2 0QQ
Novartis Investigative Site
Leeds, West Yorkshire, LS9 7TF
Novartis Investigative Site
London, SE1 9RT
Novartis Investigative Site
London, W12 0HS
Austria3 sites
Novartis Investigative Site
Graz, 8036
Novartis Investigative Site
Linz, 4010
Novartis Investigative Site
Vienna, 1140
Italy3 sites
Novartis Investigative Site
Monza, MB, 20900
Novartis Investigative Site
Roma, RM, 00161
Novartis Investigative Site
Verona, VR, 37134
South Korea3 sites
Novartis Investigative Site
Seoul, Korea, 03080
Novartis Investigative Site
Seoul, 06351
Novartis Investigative Site
Taegu, 41944
Argentina2 sites
Novartis Investigative Site
Buenos Aires, C1114AAN
Novartis Investigative Site
CABA, Buenos Aires, C1221ADC
Brazil2 sites
Novartis Investigative Site
Rio de Janeiro, Rio de Janeiro, 20211-030
Novartis Investigative Site
São Paulo, 01227-200
Canada2 sites
Novartis Investigative Site
Toronto, Ontario, M5G 2M9
Novartis Investigative Site
Vancouver, British Columbia, V5Z 1M9
Greece2 sites
Novartis Investigative Site
Athens, 115 27
Novartis Investigative Site
Thessaloniki, 570 10
Poland2 sites
Novartis Investigative Site
Katowice, 40-519
Novartis Investigative Site
Warsaw, 00-791
Singapore2 sites
Novartis Investigative Site
Singapore, 119074
Novartis Investigative Site
Singapore, 169608
Vietnam2 sites
Novartis Investigative Site
Hanoi, 100000
Novartis Investigative Site
Ho Chi Minh City, 70000
About this study
Official title: A Phase 3b, Multi-center, Open-label, Treatment Optimization Study of Oral Asciminib in Patients With Chronic Myelogenous Leukemia in Chronic Phase (CML-CP) Previously Treated With 2 or More Tyrosine Kinase Inhibitors
The purpose of the study is to optimize the treatment of asciminib in patients with chronic myelogenous leukemia in chronic phase (CML-CP) previously treated with 2 or more Tyrosine Kinase Inhibitors (TKIs).
Read the detailed description
This study consists of a screening period of up to 28 days, a treatment period of 144 weeks and a post-treatment safety follow-up period of 4 weeks.
Patients will receive asciminib as study treatment continuously for up to 144 weeks or until disease progression, treatment failure or intolerance to treatment. At treatment initiation, asciminib will be provided to all trial patients at a total daily dose of 80 mg. All patients will be randomly assigned 1:1 to 2 groups with 80 mg given either as 40 mg b.i.d. or 80 mg q.d., using IRT to avoid any selection bias.
In patients not achieving Major Molecular Responses (MMR) at 48 weeks or losing the response after the week 48 assessment up to week 108, asciminib dose may be escalated to 200 mg q.d. if in the investigator's opinion the patient may benefit from the escalation. In addition, there must not be any grade 3 or 4 toxicity while on therapy, or persistent grade 2 toxicity, possibly related to asciminib and unresponsive to optimal management.
The trial will enroll a total of approximately 186 patients:
- 156 patients with CML-CP not in MMR at baseline who were treated with two or more TKIs and who were either resistant (ELN 2020 warning or failure) or intolerant to the last treatment will be enrolled. For this population, the primary endpoint for MMR at 48 weeks will be assessed.
- Up to 30 additional patients intolerant only to their last TKI treatment and in MMR at baseline will also be enrolled. This patient population will not be part of primary endpoint analysis; however, all assessments will be done as with the 156 patients from the population of the primary endpoint analysis.
- Conditions
- Chronic Myelogenous Leukemia
- Being tested
- ABL001 40mg BID, ABL001 80mg QD, ABL001 200mg QD
- Keywords
- ABL001, Phase 3, tyrosine kinase inhibitor, Chronic myelogenous leukemia (CML), chronic myeloid leukemia (CML), chronic myelocytic leukemia (CML), chronic granulocytic leukemia (CGL), cancer of the white blood cells, clonal bone marrow stem cell disorder, proliferation of mature granulocytes, Treatment optimization, Asciminib, European Leukemia Network (ELN) Recommendations 2020, Major Molecular Response (MMR) rate at 48 weeks
- Medical subject headings
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ABL001 40mg BIDDrug
Also called asciminib
One tablet of 40 mg will be taken orally twice a day (BID)
ABL001 80mg QDDrug
Also called asciminib
Two tablets of 40 mg will be taken orally once a day (QD)
ABL001 200mg QDDrug
Also called asciminib
Five tablets of 40 mg will be taken orally once a day (QD)
| Study group | Role | What they receive |
|---|---|---|
| ABL001 | Experimental | Participants will be treated with 80 mg of ABL001 (40 mg BID or 80mg QD). In patients not achieving MMR at 48 weeks or losing the response after the week 48 assessment up to week 108, asciminib dose may be escalated to 200 mg q.d. if in the investigator's opinion the patient may benefit from the escalation. Receives: Drug: ABL001 40mg BID; Drug: ABL001 80mg QD; Drug: ABL001 200mg QD |
What is being measured
The primary outcome is the main question the study is designed to answer.
Major Molecular Response (MMR) Rate at Week 48 for All Patients With no Evidence of MMR at Baseline
Major Molecular Response (MMR) is defined as a significant reduction in the level of BCR::ABL1 transcripts, which are the genetic markers of chronic myeloid leukemia (CML). Specifically, MMR is achieved when there is a ≥ 3.0 log reduction in BCR::ABL1 transcripts compared to a standardized baseline, which corresponds to a BCR::ABL1/ABL1 ratio of ≤ 0.1% on the international scale (IS).
The Major Molecular Response (MMR) rate at Week 48 for all patients with no evidence of MMR at baseline refers to the percentage of patients who achieve MMR after 48 weeks of treatment, despite not having MMR at the start.
Measured: Week 48
Secondary outcomes (20)
MMR Rate at Week 12, 24, 36, 72, 96 and 144 for Patients With no MMR at Baseline
The Major Molecular Response (MMR) rate at alternative time points (weeks 12, 24, 36, 72, 96 and 144) for all patients with no evidence of MMR at baseline refers to the percentage of patients who achieve MMR after those respective weeks of treatment, despite not having MMR at the start. MMR itself is defined as achieving a BCR::ABL1 ratio of ≤ 0.1%.
Measured: Week 12, 24, 36, 72, 96 and 144
Major Molecular Response (MMR) Rate at Week 48 for Patients With MMR at Baseline
The Major Molecular Response (MMR) rate at Week 48 for patients with MMR at baseline refers to the percentage of patients who maintain or achieve MMR after 48 weeks of treatment. MMR itself is defined as achieving a BCR::ABL1 ratio of ≤ 0.1%.
Measured: Week 48.
Time to MMR for Subjects Without MMR at Baseline
Time to MMR defined as the time from the date of randomization to the date of the first documented MMR. MMR itself is defined as achieving a BCR::ABL1 ratio of ≤ 0.1%.
Measured: From the date of enrollment to the date of first documented MMR, assessed up to 144 weeks
Rate of BCR::ABL1 ≤ 10% for Subjects Without MMR at Baseline
The rate of BCR::ABL1 ≤ 10% refers to the percentage of patients who achieve a BCR::ABL1 level of 10% or lower within the first 48 weeks of treatment.
Measured: Week 12, 24, 36 and 48
Rate of BCR::ABL1 ≤ 1% for Subjects Without MMR at Baseline
The rate of BCR::ABL1 ≤ 1% refers to the percentage of patients who achieve a BCR::ABL1 level of 1% or lower within the first 48 weeks of treatment.
Measured: Week 12, 24, 36 and 48.
Deep Molecular Responses (MR4) Rate for Subjects Without MMR at Baseline
Deep molecular responses (MR4) is defined as a ≥ 4 log reduction in BCR::ABL1 transcripts compared to the standardized baseline, equivalent to 0.01% BCR::ABL1/ABL1 by the international scale (IS).
Measured: Week 12, 24, 36, 48, 72, 96 and 144.
Deep Molecular Responses (MR4.5) Rate for Subjects Without MMR at Baseline
Deep molecular responses (MR4.5) is defined as a ≥ 4.5 log reduction in BCR::ABL1 transcripts compared to the standardized baseline, equivalent to 0.0032% BCR::ABL1/ABL1 by the international scale (IS).
Measured: Week 12, 24, 36, 48, 72, 96 and 144.
Rate of Complete Cytogenetic Response (CCyR) for Subjects Without MMR at Baseline
Cytogenetic Response is assessed based on the percentage of Philadelphia chromosome-positive (Ph+) metaphases in the bone marrow, with a review of at least 20 metaphases required.
Complete Cytogenetic Response (CCyR) is defined as 0% Ph+ metaphases in the bone marrow.
Measured: Week 48 and end of treatment (up to 144 weeks)
Occurrence of High-risk Additional Chromosomal Abnormalities (ACA) for Subjects Without MMR at Baseline
High-risk additional chromosomal abnormalities (ACAs) are specific chromosomal abnormalities that are considered to increase the risk in Philadelphia chromosome-positive (Ph+) cells.
Measured: Up to 144 weeks
Cumulative Molecular Response Rate of BCR::ABL1 ≤ 10% for Subjects Without MMR at Baseline
The cumulative molecular response rate refers to the proportion of subjects achieving a BCR::ABL1 level of ≤ 10% on the international scale (IS) over a specified period.
Measured: From enrollment to end of treatment up to 144 weeks.
Cumulative Molecular Response Rate of BCR::ABL1 ≤1% for Subjects Without MMR at Baseline
The cumulative molecular response rate refers to the proportion of subjects achieving a BCR::ABL1 level of ≤ 1% on the international scale (IS) over a specified period.
Measured: From enrollment to end of treatment up to 144 weeks.
Cumulative Molecular Response Rate of MMR for Subjects Without MMR at Baseline
The cumulative molecular response rate refers to the proportion of subjects achieving MMR, defined as a BCR::ABL1 ratio of ≤ 0.1% on the international scale (IS), over a specified period.
Measured: From enrollment to end of treatment up to 144 weeks.
Cumulative Molecular Response Rate of MR4 for Subjects Without MMR at Baseline
The cumulative molecular response rate refers to the proportion of subjects achieving MR4, defined as a ≥ 4 log reduction in BCR::ABL1 transcripts compared to the standardized baseline, equivalent to 0.01% BCR::ABL1/ABL1 by the international scale (IS), over a specified period.
Measured: From enrollment to end of treatment up to 144 weeks.
Cumulative Molecular Response Rate of MR4.5 for Subjects Without MMR at Baseline
The cumulative molecular response rate refers to the proportion of subjects achieving MR4.5, defined as a ≥ 4.5 log reduction in BCR::ABL1 transcripts compared to the standardized baseline, equivalent to 0.0032% BCR::ABL1/ABL1 by the international scale (IS), over a specified period.
Measured: From enrollment to end of treatment up to 144 weeks.
Duration of MMR
Duration of MMR is defined as the time from the date of first documented MMR to the earliest date of loss of MMR, progression to accelerated phase (AP) or blast crisis (BC), or CML-related death. The duration of MMR is analyzed for the subjects in FAS who achieved MMR at any time.
Measured: From the date of the first documented molecular response at MMR level to the date of first documented loss of the response level or death due to any cause, whichever occurs first, assessed up to 144 weeks.
Duration of MR4 Without Loss of MMR
Duration of MR4 without loss of MMR refers to the period during which a patient maintains a deep molecular response (MR4) without experiencing a loss of Major Molecular Response (MMR).
Measured: From the date of first documented MR4 without loss of MMR to the date of first documented loss of the response level or death due to any cause, whichever occurs first, assessed up to 144 weeks.
Progression-Free Survival (PFS) for Subjects Without MMR at Baseline
Progression-Free Survival (PFS) is defined as the time from the date of randomization to the earliest occurrence of documented disease progression to AP/BC or the date of death from any cause, assessed up to approximately 144 weeks. The time will be censored at the date of last study assessment (PCR, cytogenetic, hematologic or extramedullary) or last post-treatment follow-up for subjects without event. PFS (in months) is calculated as: (date of disease progression/death or censoring date - date of randomization +1)/30.4375.
Measured: Up to 144 weeks.
Overall Survival (OS) for Subjects Without MMR at Baseline
Overall Survival (OS) is defined as the time from treatment assignment to death due to any cause during study, assessed up to 144 weeks. Subjects who are alive at the time of the analysis data cutoff date will be censored at the date of last contact before the cut-off date. OS (in months) is calculated as: (date of death or censoring date - date of randomization + 1)/30.4375.
Measured: Up to 144 weeks.
Time to Treatment Failure (TTF) for Subjects Without MMR at Baseline
Time from treatment assignment to treatment failure is defined as BCR-ABL1>10%, assessed up to 144 weeks. For subjects who have not reached treatment failure, their TTFs will be censored at the time of last study assessment (PCR, cytogenetic, hematologic or extramedullary) before the cut-off date. TTF (in months) is calculated as: (date of treatment failure or censoring date - date of randomization + 1)/30.4375.
Measured: Up to 144 weeks.
Change in Symptom Burden and Interference From Baseline Over Time According to the MDASI-CML PRO Instrument
The MD Anderson Symptom Inventory - Chronic Myeloid Leukemia (MDASI-CML) is a 26 item self-administered questionnaire for adult CML patients. Twenty of the items measure the severity of disease-related symptoms (symptom burden) and are scored from 0 (not present) to 10 (as bad as you can imagine) and 6 items that measure symptom interference with daily life (interference) scored from 0 (did not interfere) to 10 (interfered completely). For symptom burden, total scores range from 0 to 200 and for interference range from 0 to 60, with higher scores indicates high impact on severity of chronic myeloid leukemia-related symptoms and on impact of these symptoms on daily functioning for the patient.
Measured: Week 4, 12, 24, 48, 72, 96, 120 and at end of treatment (up to 144 weeks).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Jul 2021
- Study start13 Oct 2021
- Primary completion12 Mar 2024
- Study completion25 Feb 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Chronic Myelogenous LeukemiaStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 199 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04948333
- Sponsor's protocol ID
- CABL001A2302
- Other IDs
- 2024-511381-36-00
- Status last verified
- Mar 2026
- First submitted
- 28 Jun 2021
- Last updated
- 18 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- 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