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    Clinical Trial Results:
    Phase III Trial Evaluating the Effectiveness of a Dose Adjustment of Imatinib Mesylate on the Molecular Response (MIM)

    Summary
    EudraCT number
    2008-007094-20
    Trial protocol
    FR  
    Global end of trial date
    01 Jan 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Jan 2022
    First version publication date
    20 Jan 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    IB 2009-07
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01827930
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Institut Bergonié
    Sponsor organisation address
    229 cours de l'Argonne, Bordeaux, France, 33076
    Public contact
    Regulatory Affairs Management Desk, Institut Bergonié, drci@bordeaux.unicancer.fr
    Scientific contact
    Regulatory Affairs Management Desk, Institut Bergonié, drci@bordeaux.unicancer.fr
    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
    01 Jan 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    01 Jan 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Jan 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    Phase III Trial to Evaluate the Effectiveness of a Dose Adjustment of Imatinib Mesylate on the Molecular Response in Patients With chronic myeloid leukemia (CML) in Chronic Phase Treated With IM 400 mg / Day for at Least Two Years, Complete Cytogenetic Response for at Least One Year
    Protection of trial subjects
    A supervisory committee is constitued to evaluate the benefit/risk ratio along the study period.
    Background therapy
    The Imatinib Mesylate at a dose of 400 mg / day is the standard treatment for patients with CML-CP. Recent studies show that the quality of response rate (complete cytogenetic response and major molecular response rate) is dependent on the residual plasma Imatinib.
    Evidence for comparator
    The Imatinib Mesylate at a dose of 400 mg / day is the standard treatment for patients with CML-CP. Recent studies show that the quality of response rate (complete cytogenetic response and major molecular response rate) is dependent on the residual plasma Imatinib. This study aims to evaluate the effectiveness of a strategy for dose adjustment of Imatinib Mesylate based on the measurement of the residual plasma imatinib in patients treated for at least 2 years Imatinib 400 mg / d in complete cytogenetic response for at least 1 year.
    Actual start date of recruitment
    14 Dec 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 68
    Worldwide total number of subjects
    68
    EEA total number of subjects
    68
    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)
    65
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Criteria Inclusion Criteria: Patients with CML-CP treated for at least two years by Imatinib Mesylate 400 mg / d, Patients in complete cytogenetic response for at least 1 year Patients with residual disease detectable by quantitative RT-PCR (RQ-PCR) ECOG ≤ 2, Age ≥ 18 years Signed informed consent, Membership of a social security system

    Period 1
    Period 1 title
    Baseline Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Randomized trial / Control Arm: Imatinib 400
    Arm description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)
    Arm type
    Active comparator

    Investigational medicinal product name
    Imatinib Mesylate
    Investigational medicinal product code
    Other name
    Glivec
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Drug: Imatinib Mesylate 600 MG Oral Tablet

    Arm title
    Randomized trial / Experimental Arm: Imatinib 600
    Arm description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)
    Arm type
    Experimental

    Investigational medicinal product name
    Imatinib Mesylate
    Investigational medicinal product code
    Other name
    Glivec
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Imatinib Mesylate 600 MG Oral Tablet:

    Arm title
    Parallel cohort: Imatinib 400
    Arm description
    Patients with IM concentration > 1000ng/mL are included in a parallel cohort and receive standard strategy (400 MG IM)
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 1
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400
    Started
    25
    24
    19
    Completed
    25
    24
    19

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Randomized trial / Control Arm: Imatinib 400
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Randomized trial / Experimental Arm: Imatinib 600
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Parallel cohort: Imatinib 400
    Reporting group description
    Patients with IM concentration > 1000ng/mL are included in a parallel cohort and receive standard strategy (400 MG IM)

    Reporting group values
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400 Total
    Number of subjects
    25 24 19 68
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    52.7 (25.1 to 79.1) 50.6 (27.2 to 72.0) 65.3 (34.3 to 80.4) -
    Gender categorical
    Units: Subjects
        Female
    6 4 6 16
        Male
    19 20 13 52

    End points

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    End points reporting groups
    Reporting group title
    Randomized trial / Control Arm: Imatinib 400
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Randomized trial / Experimental Arm: Imatinib 600
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Parallel cohort: Imatinib 400
    Reporting group description
    Patients with IM concentration > 1000ng/mL are included in a parallel cohort and receive standard strategy (400 MG IM)

    Primary: Percentage of Patients Presenting a Decline of the BCR-ABL Transcript Rate at 12 Months From Baseline

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    End point title
    Percentage of Patients Presenting a Decline of the BCR-ABL Transcript Rate at 12 Months From Baseline
    End point description
    The BCR-ABL transcript rate was analysed by molecular biology by RQ-PCR at study entry, 3 months, 6 months, 9 months and 12 months. Treatment is considered effective at 12 months if: for patients with an inclusion transcript rate less than 0.1%: the transcript rate at 12 months is less or equal to 0.001% or undetectable. for patients with an inclusion transcript rate greater than 0.1% : the transcript rate at 12 months is less or equal to 0.1% or undetectable. If BCR-ABL transcript level was unavailable at M12, the treatment was considered ineffective.
    End point type
    Primary
    End point timeframe
    12 Months From Baseline
    End point values
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400
    Number of subjects analysed
    25
    24
    19
    Units: subjects
    8
    7
    2
    Statistical analysis title
    Statistical analysis for primary outcome
    Statistical analysis description
    The proportion of Patients Presenting a Decline of the BCR-ABL Transcript Rate at 12 Months From Baseline was estimated as the number of patients with a Decline of the BCR-ABL Transcript Rate at 12 Months From Baseline divided by the number of all patients. The 95% confidence interval is reported (binomial law)
    Comparison groups
    Randomized trial / Experimental Arm: Imatinib 600 v Randomized trial / Control Arm: Imatinib 400
    Number of subjects included in analysis
    49
    Analysis specification
    Pre-specified
    Analysis type
    other [1]
    P-value
    = 0.05 [2]
    Method
    t-test, 2-sided
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.14
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.34
         upper limit
    3.86
    Variability estimate
    Standard error of the mean
    Notes
    [1] - Rates are reported for each arm. no comparison was performed.
    [2] - not applicable.

    Secondary: Molecular Response at 12 Months

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    End point title
    Molecular Response at 12 Months
    End point description
    The molecular response is defined by the measurement of BCR-ABL transcript rate by quantitative RT-PCR (RQ-PCR) on peripheral venous blood according to international standards. It is defined as: - Major Molecular Response (MMR): BRC-ABL transcript rate ≤ 0.1% - Complete Molecular Response (CMR): transcript BCR-ABL undetectable and non quantifiable.
    End point type
    Secondary
    End point timeframe
    12 months from baseline
    End point values
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400
    Number of subjects analysed
    25
    24
    19
    Units: Subjects
    19
    20
    12
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    throughout the follow-up of the patient, up to 1 year
    Adverse event reporting additional description
    All adverse envent (related and unrelated to treatment) were reported. All serious adverse envent (related and unrelated to treatment) were reported.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    2
    Reporting groups
    Reporting group title
    Randomized trial / Control Arm: Imatinib 400
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Randomized trial / Experimental Arm: Imatinib 600
    Reporting group description
    Patients with IM concentration < 1000ng/mL are randomized between : (1) Experimental Arm : adapted strategy (up to 600 MG IM) (2) Control Arm : standard strategy (400 MG IM)

    Reporting group title
    Parallel cohort: Imatinib 400
    Reporting group description
    Patients with IM concentration > 1000ng/mL are included in a parallel cohort and receive standard strategy (400 MG IM)

    Serious adverse events
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 25 (16.00%)
    3 / 24 (12.50%)
    0 / 19 (0.00%)
         number of deaths (all causes)
    1
    0
    0
         number of deaths resulting from adverse events
    1
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Gastrointestinal - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Renal/Genitourinary - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fracture
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac General - Other (Specify, __)
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac ischemia/infarction
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal/Soft Tissue - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary/Upper Respiratory - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Infections and infestations
    Infection - Other
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Randomized trial / Control Arm: Imatinib 400 Randomized trial / Experimental Arm: Imatinib 600 Parallel cohort: Imatinib 400
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    12 / 25 (48.00%)
    24 / 24 (100.00%)
    15 / 19 (78.95%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    2 / 25 (8.00%)
    1 / 24 (4.17%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    1
    Carotid
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    General disorders and administration site conditions
    Fatigue (asthenia, lethargy, malaise)
         subjects affected / exposed
    3 / 25 (12.00%)
    9 / 24 (37.50%)
    2 / 19 (10.53%)
         occurrences all number
    4
    10
    2
    Edema:head and neck
         subjects affected / exposed
    0 / 25 (0.00%)
    3 / 24 (12.50%)
    1 / 19 (5.26%)
         occurrences all number
    0
    6
    1
    Edema:limb
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    1
    0
    1
    Lymphatics - Other
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Immune system disorders
    Allergic reaction/hypersensitivity (including drug fever)
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    1
    Respiratory, thoracic and mediastinal disorders
    Allergic rhinitis (including sneezing, nasal stuffiness, postnasal drip)
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    2
    Nose
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    1
    Cough
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    2 / 19 (10.53%)
         occurrences all number
    0
    1
    2
    Dyspnea (shortness of breath)
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    1
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Depression
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 24 (8.33%)
    1 / 19 (5.26%)
         occurrences all number
    0
    2
    1
    Investigations
    Leukocytes (total WBC)
         subjects affected / exposed
    1 / 25 (4.00%)
    3 / 24 (12.50%)
    1 / 19 (5.26%)
         occurrences all number
    3
    3
    2
    Lymphopenia
         subjects affected / exposed
    1 / 25 (4.00%)
    1 / 24 (4.17%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    1
    Neutrophils/granulocytes (ANC/AGC)
         subjects affected / exposed
    1 / 25 (4.00%)
    4 / 24 (16.67%)
    1 / 19 (5.26%)
         occurrences all number
    2
    4
    1
    Cardiac disorders
    Cardiac General - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    1
    0
    1
    Nervous system disorders
    Head/headache
         subjects affected / exposed
    1 / 25 (4.00%)
    1 / 24 (4.17%)
    2 / 19 (10.53%)
         occurrences all number
    1
    1
    2
    Blood and lymphatic system disorders
    Hemoglobin
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 24 (8.33%)
    2 / 19 (10.53%)
         occurrences all number
    0
    2
    2
    Eye disorders
    Cataract
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Ocular/Visual - Other
         subjects affected / exposed
    2 / 25 (8.00%)
    2 / 24 (8.33%)
    2 / 19 (10.53%)
         occurrences all number
    2
    2
    2
    Watery eye (epiphora, tearing) † 1 [3]
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Gastrointestinal disorders
    Diarrhea
         subjects affected / exposed
    0 / 25 (0.00%)
    6 / 24 (25.00%)
    4 / 19 (21.05%)
         occurrences all number
    0
    7
    4
    Dry mouth/salivary gland (xerostomia)
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Gastrointestinal - Other
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 24 (8.33%)
    1 / 19 (5.26%)
         occurrences all number
    0
    7
    1
    Stomach
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 24 (8.33%)
    1 / 19 (5.26%)
         occurrences all number
    0
    2
    1
    Skin and subcutaneous tissue disorders
    Dermatology/Skin - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    3 / 24 (12.50%)
    1 / 19 (5.26%)
         occurrences all number
    1
    4
    1
    Induration/fibrosis (skin and subcutaneous tissue)
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Pruritus/itching
         subjects affected / exposed
    0 / 25 (0.00%)
    2 / 24 (8.33%)
    1 / 19 (5.26%)
         occurrences all number
    0
    2
    1
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    0 / 25 (0.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    Renal/Genitourinary - Other
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal/Soft Tissue - Other
         subjects affected / exposed
    3 / 25 (12.00%)
    9 / 24 (37.50%)
    2 / 19 (10.53%)
         occurrences all number
    4
    12
    2
    Joint
         subjects affected / exposed
    0 / 25 (0.00%)
    1 / 24 (4.17%)
    2 / 19 (10.53%)
         occurrences all number
    0
    1
    2
    Infections and infestations
    Infection - Other
         subjects affected / exposed
    2 / 25 (8.00%)
    6 / 24 (25.00%)
    4 / 19 (21.05%)
         occurrences all number
    2
    8
    5
    Metabolism and nutrition disorders
    Phosphate, serum-low (hypophosphatemia)
         subjects affected / exposed
    1 / 25 (4.00%)
    2 / 24 (8.33%)
    1 / 19 (5.26%)
         occurrences all number
    1
    2
    1
    Triglyceride, serum-high (hypertriglyceridemia)
         subjects affected / exposed
    1 / 25 (4.00%)
    0 / 24 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    2
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    02 Oct 2009
    Protocol V2.1 dated 22-sep-2009
    18 Jun 2012
    Protocol V3 dated 02-jan-2012
    16 May 2014
    Protocol V4 dated 28-feb-2014
    30 Aug 2016
    Protocol V6 dated 06-jul-2016

    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
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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