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    Clinical Trial Results:
    An extension to a phase II study to determine the efficacy and the safety of STI571 in patients with chronic myeloid leukemia who are refractory to or intolerant of interferon-alpha

    Summary
    EudraCT number
    2005-001382-33
    Trial protocol
    IT  
    Global end of trial date
    29 Nov 2013

    Results information
    Results version number
    v3(current)
    This version publication date
    17 Oct 2021
    First version publication date
    11 May 2017
    Other versions
    v1 , v2
    Version creation reason
    • New data added to full data set
    • Changes to summary attachments
    full results attached

    Trial information

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    Trial identification
    Sponsor protocol code
    CSTI571A0110E2
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00171223
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111 ,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111 ,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Nov 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Nov 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The objective of the core study was to determine the rate of complete and major cytogenetic response to STTI571 as demonstrated by a decrease in the percentage of Philadelphia chromosome positive (Ph+) cells in the bone marrow, for patients with chronic myeloid leukemia who were hematologically or cytogenetically refractory to, or intolerant of, interferon-alpha. The objective of the extension phase was to decrease the frequency of bone marrow evaluations to once a year from once every 6 months for all patients who have achieved a complete cytogenetic response, to enable patients to continue to have access to study treatment, and to decrease data collection after month 48 of the extension phase to include only overall survival and serious adverse events.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    06 Dec 1999
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Switzerland: 8
    Country: Number of subjects enrolled
    United Kingdom: 28
    Country: Number of subjects enrolled
    United States: 342
    Country: Number of subjects enrolled
    France: 41
    Country: Number of subjects enrolled
    Germany: 68
    Country: Number of subjects enrolled
    Italy: 45
    Worldwide total number of subjects
    532
    EEA total number of subjects
    182
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    409
    From 65 to 84 years
    122
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Subjects were screened for eligibility over a period of one week.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    No

    Arm title
    Hematologic Failure
    Arm description
    Subjects failed to achieve a complete hematologic response, defined as lasting for at least 1 month despite 6 or more months of an interferon-alpha containing regimen, or had a rising WBC count (to a level 20 x 109/L) confirmed by two samples taken at least two weeks apart after achieving a complete hematological response while receiving an interferon- alpha containing regimen of at least 25 million international units (MIU) per week. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.
    Arm type
    Experimental

    Investigational medicinal product name
    STI571
    Investigational medicinal product code
    Other name
    imatinib mesylate, Gleevec/Glivec
    Pharmaceutical forms
    Capsule, Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects were administered 100 mg capsules for a total dose of 400 mg or 600 mg once daily or 800 mg twice daily (2 x 400 mg). Study drug was taken with 250 ml of water after breakfast and the evening meal (for the 800 mg/day dose). Subjects who demonstrated a complete hematologic response at 3 months, or who achieved a complete hematologic response but relapsed within 3 months of achieving the response (documented by two samples taken 2 weeks apart), or who did not demonstrate a complete or major cytogenetic response at 12 months, or who achieved only a partial cytogenetic response at 12 months, may have had the dose increased to a total of 800 mg daily. As per Amendment 1 to extension protocol #2, STI571 was re-supplied as tablets instead of capsules. Subjects continued to use capsules until the supply was finished and were then supplied with 100 and 400 mg tablets.

    Arm title
    Cytogenetic Failure
    Arm description
    Subjects' bone marrow (BM) cytogenetics showed >/= 65% Philadelphia chromosome positivity after one year of an interferon-alpha containing regimen or an increase in the Philadelphia chromosome positive BM cells by at least 30 percentage points (e.g., from 20% to 50%, or from 30% to 60%) confirmed by two samples at least 1 month apart, or an increase to >/= 65%. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.
    Arm type
    Experimental

    Investigational medicinal product name
    STI571
    Investigational medicinal product code
    Other name
    imatinib mesylate, Gleevec/Glivec
    Pharmaceutical forms
    Capsule, Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects were administered 100 mg capsules for a total dose of 400 mg or 600 mg once daily or 800 mg twice daily (2 x 400 mg). Study drug was taken with 250 ml of water after breakfast and the evening meal (for the 800 mg/day dose). Subjects who demonstrated a complete hematologic response at 3 months, or who achieved a complete hematologic response but relapsed within 3 months of achieving the response (documented by two samples taken 2 weeks apart), or who did not demonstrate a complete or major cytogenetic response at 12 months, or who achieved only a partial cytogenetic response at 12 months, may have had the dose increased to a total of 800 mg daily. As per Amendment 1 to extension protocol #2, STI571 was re-supplied as tablets instead of capsules. Subjects continued to use capsules until the supply was finished and were then supplied with 100 and 400 mg tablets.

    Arm title
    Interferon-alpha Intolerance
    Arm description
    Subjects demonstrated intolerance to interferon-alpha therapy defined as a documented > Grade 3 non-hematologic toxicity persisting for more than 1 month after receiving an interferon-alpha containing regimen of at least 25 million international units (MIU)/week. Subjects must have been more than 6 months from time of diagnosis. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.
    Arm type
    Experimental

    Investigational medicinal product name
    STI571
    Investigational medicinal product code
    Other name
    imatinib mesylate, Gleevec/Glivec
    Pharmaceutical forms
    Capsule, Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects were administered a combination 100 mg capsules for a total dose of 400 mg or 600 mg once daily or 800 mg twice daily (2 x 400 mg). Study drug was taken with 250 ml of water after breakfast and the evening meal (for the 800 mg/day dose). Subjects who demonstrated a complete hematologic response at 3 months, or who achieved a complete hematologic response but relapsed within 3 months of achieving the response (documented by two samples taken 2 weeks apart), or who did not demonstrate a complete or major cytogenetic response at 12 months, or who achieved only a partial cytogenetic response at 12 months, may have had the dose increased to a total of 800 mg daily. As per Amendment 1 to extension protocol #2, STI571 was re-supplied as tablets instead of capsules. Subjects continued to use capsules until the supply was finished and were then supplied with 100 and 400 mg tablets.

    Number of subjects in period 1
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Started
    152
    188
    192
    Completed
    12
    47
    22
    Not completed
    140
    141
    170
         Adverse event, serious fatal
    6
    8
    9
         Subject withdrew consent
    12
    21
    15
         Adverse event, non-fatal
    6
    5
    19
         Protocol violation
    2
    2
    3
         Unsatisfactory therapeutic effect
    57
    43
    52
         Administrative problems
    4
    7
    6
         Abnormal laboratory values
    4
    2
    3
         No longer requires study drug (BMT)
    2
    4
    2
         Lost to follow-up
    5
    2
    3
         Abnormal procedure
    1
    -
    -
         Not specified; no data collected after cut-off
    41
    47
    58

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Hematologic Failure
    Reporting group description
    Subjects failed to achieve a complete hematologic response, defined as lasting for at least 1 month despite 6 or more months of an interferon-alpha containing regimen, or had a rising WBC count (to a level 20 x 109/L) confirmed by two samples taken at least two weeks apart after achieving a complete hematological response while receiving an interferon- alpha containing regimen of at least 25 million international units (MIU) per week. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Reporting group title
    Cytogenetic Failure
    Reporting group description
    Subjects' bone marrow (BM) cytogenetics showed >/= 65% Philadelphia chromosome positivity after one year of an interferon-alpha containing regimen or an increase in the Philadelphia chromosome positive BM cells by at least 30 percentage points (e.g., from 20% to 50%, or from 30% to 60%) confirmed by two samples at least 1 month apart, or an increase to >/= 65%. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Reporting group title
    Interferon-alpha Intolerance
    Reporting group description
    Subjects demonstrated intolerance to interferon-alpha therapy defined as a documented > Grade 3 non-hematologic toxicity persisting for more than 1 month after receiving an interferon-alpha containing regimen of at least 25 million international units (MIU)/week. Subjects must have been more than 6 months from time of diagnosis. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Reporting group values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance Total
    Number of subjects
    152 188 192 532
    Age categorical
    Units: Subjects
        < 50 years
    57 64 47 168
        >/= 50 to </= 60 years
    38 65 50 153
        >/= 60 to </= 70 years
    47 44 68 159
        >/= 70 years
    10 15 27 52
    Age continuous
    Units: years
        median (full range (min-max))
    55.5 (18 to 79) 53 (23 to 77) 59 (20 to 90) -
    Gender categorical
    Units: Subjects
        Female
    50 77 94 221
        Male
    102 111 98 311

    End points

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    End points reporting groups
    Reporting group title
    Hematologic Failure
    Reporting group description
    Subjects failed to achieve a complete hematologic response, defined as lasting for at least 1 month despite 6 or more months of an interferon-alpha containing regimen, or had a rising WBC count (to a level 20 x 109/L) confirmed by two samples taken at least two weeks apart after achieving a complete hematological response while receiving an interferon- alpha containing regimen of at least 25 million international units (MIU) per week. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Reporting group title
    Cytogenetic Failure
    Reporting group description
    Subjects' bone marrow (BM) cytogenetics showed >/= 65% Philadelphia chromosome positivity after one year of an interferon-alpha containing regimen or an increase in the Philadelphia chromosome positive BM cells by at least 30 percentage points (e.g., from 20% to 50%, or from 30% to 60%) confirmed by two samples at least 1 month apart, or an increase to >/= 65%. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Reporting group title
    Interferon-alpha Intolerance
    Reporting group description
    Subjects demonstrated intolerance to interferon-alpha therapy defined as a documented > Grade 3 non-hematologic toxicity persisting for more than 1 month after receiving an interferon-alpha containing regimen of at least 25 million international units (MIU)/week. Subjects must have been more than 6 months from time of diagnosis. During the Core Phase of the study, subjects received STI571 daily for up to 12 months. Subjects completing 12 months of therapy were eligible to continue treatment in the Extension Phase of the study, and they continued STI571 for as long as the therapy was beneficial or until death, intolerable toxicity or the decision to discontinue by the investigator, whichever came first.

    Primary: Percent of Subjects With Cytogenetic Response to STI571

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    End point title
    Percent of Subjects With Cytogenetic Response to STI571 [1]
    End point description
    Response was evaluated from bone marrow aspirates and biopsy samples. Bone marrow (BM) cytogenetic studies were performed every 3 months during the core phase of the study, then twice yearly, then annually. Based on the percentage of Philadelphia chromosome positive (Ph+) cells = (positive cells/ examined cells)x100, at each BM assessment the cytogenetic response was classified as: Complete, 0% Ph+ cells; Partial, >0 – 35% Ph+ cells; Minor, >35 – 65% Ph+ cells; and Minimal, >65 – 95% Ph+ cells. Major cytogenetic response was defined as confirmed complete or partial response. This endpoint analyzed the Intent-to-Treat (ITT) population, defined as all subjects enrolled in the study.
    End point type
    Primary
    End point timeframe
    Up to 6 years after the start of treatment
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses have been reported for this primary end point
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    152
    188
    192
    Units: percent of subjects
    number (confidence interval 95%)
        Complete Response
    38.8 (31 to 47)
    52.7 (45.3 to 60)
    57.3 (50 to 64.4)
        Major Response
    48.7 (40.5 to 56.9)
    68.6 (61.5 to 75.2)
    67.2 (60.1 to 73.8)
    No statistical analyses for this end point

    Secondary: Percent of Subjects With Complete Hematologic Response to STI571

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    End point title
    Percent of Subjects With Complete Hematologic Response to STI571
    End point description
    Hematologic response was evaluated from hematology measurements in the peripheral blood. Complete hematological response was defined as normalization of peripheral blood counts (WBC and platelet count < ULN at the laboratory where the analysis was performed), with a normal WBC differential, and no immature granulocytes present, lasting for 4 weeks. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    12 months after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    143
    184
    176
    Units: percent of subjects
        number (confidence interval 95%)
    94.1 (89.1 to 97.3)
    97.9 (94.6 to 99.4)
    91.7 (86.8 to 95.2)
    No statistical analyses for this end point

    Secondary: Duration of Complete Hematologic Response to STI571

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    End point title
    Duration of Complete Hematologic Response to STI571
    End point description
    Duration of hematologic response was defined as the time from the first documentation of the complete hematologic response (as defined above) to the date the loss of complete hematologic response is documented. Loss of complete hematological response was defined as a rising WBC count (increased to a level above the upper limit of normal (ULN) at the laboratory where the analysis was performed confirmed by two samples obtained one month apart). The mean survival time and its standard error were underestimated because the largest observation was censored and the estimation was restricted to the largest event time. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    12 months after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    143
    184
    176
    Units: months
        arithmetic mean (standard error)
    19.3672 ( 0.6383 )
    23.9389 ( 0.506 )
    24.6818 ( 0.6507 )
    No statistical analyses for this end point

    Secondary: Time to Complete Hematologic Response to STI571

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    End point title
    Time to Complete Hematologic Response to STI571
    End point description
    Complete hematological response was defined as normalization of peripheral blood counts (WBC and platelet count < ULN at the laboratory where the analysis was performed), with a normal WBC differential, and no immature granulocytes present, lasting for 4 weeks. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    12 months after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    143
    184
    176
    Units: months
        median (inter-quartile range (Q1-Q3))
    1.64 (0.6 to 2.8)
    0.72 (0.3 to 2.8)
    0.72 (0.3 to 2.8)
    No statistical analyses for this end point

    Secondary: Number of Subjects With Common Toxicity Criteria Grade 3 or 4 Cancer-related Sypmptoms

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    End point title
    Number of Subjects With Common Toxicity Criteria Grade 3 or 4 Cancer-related Sypmptoms
    End point description
    National Cancer Institute (NCI)/ National Institute of Health (NIH) provides a grading (severity) scale for each AE term, the Common Toxicity Criteria (CTC). Grade 3 refers to severe AE and Grade 4 refers to life-threatening or disabling AE. Values reported are the sum of 3, 6, and 9 months. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    3, 6, and 9 months after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    152
    188
    192
    Units: subjects
        Abdominal discomfort Grade 3
    0
    0
    0
        Abdominal discomfort Grade 4
    0
    0
    0
        Anorexia Grade 3
    0
    0
    0
        Anorexia Grade 4
    0
    0
    0
        Arthralgia Grade 3
    0
    0
    1
        Arthralgia Grade 4
    0
    0
    0
        Bone pain Grade 3
    0
    1
    0
        Bone pain Grade 4
    0
    0
    0
        Fatigue Grade 3
    1
    0
    0
        Fatigue Grade 4
    0
    0
    0
        Fever Grade 3
    0
    0
    0
        Fever Grade 4
    0
    0
    0
        Night sweats Grade 3
    0
    0
    0
        Night sweats Grade 4
    0
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Subjects With Grade 3 or 4 Eastern Cooperative Oncology Group Performance Status

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    End point title
    Number of Subjects With Grade 3 or 4 Eastern Cooperative Oncology Group Performance Status
    End point description
    The Eastern Cooperative Oncology Group (ECOG) performance status was recorded at baseline and every 3 months during the core study. The ECOG Performance Scale has 5 grades. 0 = Fully active, able to carry out all pre-disease activities; 1 = Restricted in strenuous activity but ambulatory and able to carry out work of light or sedentary nature; 2 = Ambulatory and capable of all self-care but unable to carry out work activities. Active about 50% of waking hours; 3 = Capable of limited self-care, confined to bed/chair more than 50% of waking hours; 4 = Completely disabled; cannot carry on self-care. Totally confined to bed/chair. Values reported are the sum of 3, 6, and 9 months. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    3, 6, and 9 months after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    152
    188
    192
    Units: subjects
        Grade 3
    1
    0
    0
        Grade 4
    0
    0
    0
    No statistical analyses for this end point

    Secondary: Percent of Subjects With Accelerated Phase Disease or Blast Crisis at 72 Months

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    End point title
    Percent of Subjects With Accelerated Phase Disease or Blast Crisis at 72 Months
    End point description
    The time to accelerated or blast crisis is defined as the time from the first dose of STI571 to the first documentation of accelerated phase, or blast crisis. Accelerated phase is defined as the percentage of blasts in blood or bone marrow > 15% but < 30%, or percentage of blasts plus promyelocytes in the peripheral blood or bone marrow 30%, or peripheral basophils > 20%, or thrombocytopenia < 100 x 109/L unrelated to therapy. Blast crisis is defined as •> 30% blasts in peripheral blood or bone marrow. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    6 years after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    152
    188
    192
    Units: percent of subjects
        number (confidence interval 95%)
    49.8 (40.8 to 58.7)
    68.4 (61.2 to 75.6)
    62.1 (54.5 to 69.7)
    No statistical analyses for this end point

    Secondary: Kaplan-Meier Estimates of Overall Survival

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    End point title
    Kaplan-Meier Estimates of Overall Survival
    End point description
    Overall survival was defined as the time from the first dose of STI571 to the death of the subject. To evaluate overall survival, all subjects were followed after the last dose of study drug every three to sixs months until death or for a period of up to a total of five years, inclusive from the date the patient commenced the extension protocol. If a patient is not known to have died, survival will be censored at the time of last contact. This endpoint analyzed the ITT population, defined as all subjects enrolled in the study.
    End point type
    Secondary
    End point timeframe
    Up to 13 years after the start of treatment
    End point values
    Hematologic Failure Cytogenetic Failure Interferon-alpha Intolerance
    Number of subjects analysed
    152
    188
    192
    Units: percent of subjects
    number (confidence interval 95%)
        12 months
    94.7 (89.8 to 97.3)
    98.9 (95.8 to 99.7)
    97.4 (93.9 to 98.9)
        24 months
    88.1 (81.8 to 92.3)
    93.6 (89 to 96.3)
    89.5 (84.3 to 93.1)
        36 months
    84 (77.1 to 89)
    91.5 (86.5 to 94.7)
    83.8 (77.7 to 88.3)
        48 months
    78.4 (70.9 to 84.2)
    87.1 (81.4 to 91.2)
    76.3 (69.6 to 81.7)
        60 months
    73.3 (65.2 to 79.7)
    83.8 (77.6 to 88.4)
    73.6 (66.7 to 79.3)
        72 months
    70.1 (61.9 to 76.9)
    79.7 (73.1 to 84.9)
    71.4 (64.3 to 77.3)
        84 months
    68.5 (60 to 75.5)
    79.7 (73.1 to 84.9)
    67.2 (59.9 to 73.5)
        96 months
    66.5 (57.9 to 73.8)
    79.1 (72.3 to 84.3)
    65.9 (58.6 to 72.3)
        108 months
    63.3 (54.3 to 71)
    78.4 (71.6 to 83.7)
    65.3 (57.9 to 71.7)
        120 months
    61 (51.8 to 69)
    77 (70 to 82.5)
    63.8 (56.3 to 70.4)
        132 months
    59.7 (50.4 to 67.9)
    75.4 (68.2 to 81.2)
    62.3 (54.6 to 69)
        144 months
    57 (47.2 to 65.5)
    73.8 (66.4 to 79.8)
    60.8 (53 to 67.6)
        156 months
    55.5 (45.6 to 64.3)
    70.1 (62.1 to 76.7)
    60.8 (53 to 67.6)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    Safety information provided in the final CSR is based on SAEs reported in the safety (ARGUS) database. All AEs reported in the clinical database had been included in the CSR based on 31-Jul-2002 data cut-off. August 1, 2002 to November 29, 2013
    Adverse event reporting additional description
    Information about all serious adverse events was collected on the SAE form and recorded in the safety database only. To ensure patient safety each serious adverse event also had to be reported to Novartis within 24 hours of learning its occurrence.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    STI571 all doses
    Reporting group description
    As dosage administration was not captured after the 31-Jul-06 data cut-off, no analyses could be performed for this final CSR.

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: Other non-serious adverse events were not collected during the extension phase within the clinical database.
    Serious adverse events
    STI571 all doses
    Total subjects affected by serious adverse events
         subjects affected / exposed
    13 / 532 (2.44%)
         number of deaths (all causes)
    2
         number of deaths resulting from adverse events
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Sarcoma
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate Adenocarcinoma
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Hip fracture
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    fall
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Generalised oedema
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Anal fistula
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Inflammatory bowel disease
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal pain
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumonia
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Pollakiuria
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Mental disorder
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Sepsis
         subjects affected / exposed
    1 / 532 (0.19%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    STI571 all doses
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 532 (0.00%)

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    16 Dec 1999
    In addition to minor clarifications to the protocol, the purpose of this amendment was: - To clarify the definition of the interferon refractory patient population. - To include patients with a documented hematologic resistance to an interferonalpha containing regimen. - To revise the statistical analysis for the inclusion of patients with a documented hematologic resistance to an interferon-alpha containing regimen. - To add two additional timepoints to the full pharmacokinetic profile to sampling to more accurately evalute the profile of STI571. - To expand the time for the screening bone marrow from within one week of study start to within one month.
    12 Sep 2000
    The purpose of this amendment was: - To clarify dose interruptions/reductions for Grade 3-4 hematologic toxicity (as outlined in letter to investigators dated 24 April 2000). - To revise the guidelines for oral administration of STI571 relative to breakfast. Preliminary study of the effect of food on the bioavailability of STI571 indicate that when administered with food STI571 had a minimal impact on the bioavailability, which did not achieve statistical significance (refer to the Investigator´s Brochure, dated June 2000). STI571 may be administered before, during or after meals. - To clarify Visit Schedule (Extension Phase) specifically for bone marrow exams. In the Extension Phase bone marrows are due every 12 weeks, therefore, the first bone marrow should be done on Week 61, not Week 55. - To update patient informed consent to include changes to administration of STI571 and evolving STI571 safety profile (refer to the Investigator´s Brochure, dated June 2000).
    13 Mar 2008
    Changes to the protocol are listed below: - Follow up study visits will be decreased from every six months to every year (±3 months) at which time a yearly supply of study drug will be dispensed. - For discontinued patients, survival information data collection will be decreased from every six months to every year (±3 months) until death, or for a period of up to a total of five years, inclusive from the date the patient commenced the extension protocol, whichever is longer. - The addition of a new section to include protocol deviation language that states that under no circumstances are protocol deviations allowed. - Patients will be discontinued if they do not adhere to the study requirements. - Study drug will only be shipped directly to the investigational sites only. - Study drug STI571 tablets will be used instead of capsules. - Bone marrow evaluations are no longer required.
    17 Aug 2012
    Changes to the protocol, and the sections affected, are detailed below: Section 1, Introduction - Addition of statement to reflect that the study will be closed following the final visit of patients. Patients that are currently benefiting from the study medication can enroll in the roll-over protocol (CSTI571A2406) and receive the same dose of imatinib. Section 3.3.1, Dispensing of Drug - Addition of statement to reflect that study treatment will not be dispensed to the patients at their final visit. On-going patients that are currently benefiting from the treatment with imatinib as determined by the investigator, will continue to have access to imatinib in the roll-over protocol (CSTI571A2406). Section 3.4.1, Visit Schedule - The evaluation schedule is updated to reflect that once the roll-over protocol is approved at the study site patients will have their final visit. No study treatment will be dispensed to the patient at this final visit. Patients will need to sign an informed consent (amendment 2) as part of their final visit on the parent study informing them about these changes. Section 3.4.2.2, Overall Survival - Addition of statement for patients that have discontinued the study treatment no further follow-up visits are to be conducted. Section 5, Data Management - Addition of statement to reflect that the investigator must enter the information for patients who have discontinued the study drug as well as for those patients who will enroll in the roll-over protocol. For those patients given the opportunity to enroll in the roll-over protocol the Comments CRF is to document “Patient to enroll in Study CSTI571A2406” or similar wording

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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