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    Clinical Trial Results:
    Phase II Study of Imatinib Mesylate for Philadelphia-Positive Acute Lymphocytic Leukemia

    Summary
    EudraCT number
    2017-001805-34
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    14 Feb 2007

    Results information
    Results version number
    v1(current)
    This version publication date
    26 Jul 2018
    First version publication date
    26 Jul 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CSTI571A1203
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    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
    14 Feb 2007
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Feb 2007
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To investigate the efficacy and safety of STI571 in patients diagnosed with Philadelphia chromosome positive acute lymphocytic leukemia.
    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
    07 May 2004
    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
    Japan: 8
    Worldwide total number of subjects
    8
    EEA total number of subjects
    0
    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)
    1
    Adults (18-64 years)
    5
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Treatment initiation day was expressed as Day 1 (the day before the treatment initiation as Day –1). Screening were performed between Day –7 and Day –1 (the day before the treatment initiation).

    Period 1
    Period 1 title
    Core phase
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    All subjects - Core phase
    Arm description
    600 mg oral once daily (400 mg oral twice daily if a daily dose is increased to 800 mg). Core phase (up to 12 weeks): a remission induction therapy with STI571 was conducted in this phase.
    Arm type
    Experimental

    Investigational medicinal product name
    STI571
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    STI571: 600 mg (oral once daily); a dose may be increased up to 800 mg (400 mg oral twice daily) in patients with an inadequate response

    Number of subjects in period 1
    All subjects - Core phase
    Started
    8
    Completed
    6
    Not completed
    2
         Inadequate response
    2
    Period 2
    Period 2 title
    Extension phase
    Is this the baseline period?
    No
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    All subjects - Extension phase
    Arm description
    600 mg oral once daily (400 mg oral twice daily if a daily dose is increased to 800 mg). Extension phase (until the study completion): treatment with STI571 continues in responders.
    Arm type
    Experimental

    Investigational medicinal product name
    STI571
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    STI571: 600 mg (oral once daily); a dose may be increased up to 800 mg (400 mg oral twice daily) in patients with an inadequate response

    Number of subjects in period 2
    All subjects - Extension phase
    Started
    6
    Completed
    1
    Not completed
    5
         Difficulty in making office visits
    2
         No need to treat with the investigational product
    2
         Inadequate response
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Core phase
    Reporting group description
    -

    Reporting group values
    Core phase Total
    Number of subjects
    8 8
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    1 1
        Adults (18-64 years)
    5 5
        From 65-84 years
    2 2
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    51.6 ( 16.7 ) -
    Gender categorical
    Units: Subjects
        Female
    5 5
        Male
    3 3

    End points

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    End points reporting groups
    Reporting group title
    All subjects - Core phase
    Reporting group description
    600 mg oral once daily (400 mg oral twice daily if a daily dose is increased to 800 mg). Core phase (up to 12 weeks): a remission induction therapy with STI571 was conducted in this phase.
    Reporting group title
    All subjects - Extension phase
    Reporting group description
    600 mg oral once daily (400 mg oral twice daily if a daily dose is increased to 800 mg). Extension phase (until the study completion): treatment with STI571 continues in responders.

    Subject analysis set title
    Core + Extension phases
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Al patients diagnosed with Philadelphia chromosome positive acute lymphocytic leukemia. Core phase (up to 12 weeks): a remission induction therapy with STI571 is to be conducted in this phase. Extension phase (until the study completion): treatment with STI571 continues in responders.

    Primary: Percentage of patients with Hematologic response (CHR + Marrow-CR)

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    End point title
    Percentage of patients with Hematologic response (CHR + Marrow-CR) [1]
    End point description
    Complete hematologic response (CHR): peripheral blasts = 0%, bone marrow blasts <5%, neutrophils ≥1500/mm^3, and platelets ≥100 000/mm^3 + Complete marrow response (Marrow-CR): peripheral blasts = 0% and bone marrow blasts <5%
    End point type
    Primary
    End point timeframe
    Antileukemic effect of STI571 monotherapy persisted for at least 4 weeks.
    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 endpoint.
    End point values
    All subjects - Core phase
    Number of subjects analysed
    8 [2]
    Units: Percentage of patients
    number (confidence interval 95%)
        All Response (n=8)
    100 (63.1 to 100.0)
        Sustained Response (n=5)
    62.5 (24.5 to 91.5)
    Notes
    [2] - full analysis set (FAS)
    No statistical analyses for this end point

    Secondary: Percentage of patients with Cytogenetic response

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    End point title
    Percentage of patients with Cytogenetic response
    End point description
    Cytogenetic response (CGR): Complete CGR: At least 1 confirmed elimination of Philadelphia chromosome Major CGR: At least 1 confirmed suppression of Philadelphia chromosome to between 1% and 35%
    End point type
    Secondary
    End point timeframe
    Antileukemic effect of STI571 monotherapy persisted for at least 4 weeks.
    End point values
    Core + Extension phases
    Number of subjects analysed
    8 [3]
    Units: Percentage of patients
        number (confidence interval 95%)
    87.5 (47.3 to 99.7)
    Notes
    [3] - full analysis set (FAS); patients who reached the Cytogenetic response : n=7.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    7.0
    Reporting groups
    Reporting group title
    All subjects
    Reporting group description
    600 mg oral once daily (400 mg oral twice daily if a daily dose is increased to 800 mg). Core phase (up to 12 weeks): a remission induction therapy with STI571 was conducted in this phase. Extension phase (until the study completion): treatment with STI571 continues in responders.

    Serious adverse events
    All subjects
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 8 (50.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Puncture site hemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebral hemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin rash
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Sepsis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    All subjects
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    8 / 8 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumor lysis syndrome
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Vascular disorders
    Flushing
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Petechiae
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    General disorders and administration site conditions
    Malaise
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Oedema
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Pyrexia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Oedema peripheral
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Chest discomfort
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Chest pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Injection site reaction
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Puncture site haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pharyngolaryngeal pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pharynx discomfort
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pleural effusion
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rhinorrhoea
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Upper respiratory tract inflammation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Investigations
    Blood alkaline phosphatase increased
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Blood bilirubin increased
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Hemoglobin decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Lymphocyte count decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Weight increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Urinary occult blood positive
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood amylase increased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Blood creatinine increased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Blood pressure increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    PH urine abnormal
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Weight decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Laceration
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Thermal burn
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nerve injury
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nervous system disorders
    Burning sensation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Dysgeusia
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Headache
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Dizziness
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Hypothymia
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Dizziness postural
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Neutropenia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Thrombocytopenia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Leukopenia
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Myelosuppression
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Febrile neutropenia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Lymphadenopathy
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Eye disorders
    Conjunctival hemorrhage
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Conjunctival edema
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blepharitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Eyelid edema
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Lacrimation increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Photophobia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Retinal haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    8 / 8 (100.00%)
         occurrences all number
    8
    Vomiting
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Abdominal pain upper
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Constipation
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Diarrhoea
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Stomatitis
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Abdominal distension
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Cheilitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Haemorrhoids
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Abdominal pain
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Abdominal pain lower
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gingival bleeding
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gingivitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Faeces soft
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Oral discomfort
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Periodontitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Haemorrhoidal haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gastrointestinal mucosal disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hepatic function abnormal
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    7 / 8 (87.50%)
         occurrences all number
    7
    Face edema
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Eczema
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Alopecia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Dry skin
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Erythema
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Keloid scar
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rash vesicular
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Urticaria
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Renal and urinary disorders
    Glomerulonephritis chronic
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Cystitis haemorrhagic
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Cystitis-like symptom
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Muscular weakness
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Myalgia
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Osteonecrosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Infections and infestations
    Neutropenic infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Sepsis
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    4
    Nasopharyngitis
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Dental caries
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Infection
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Catheter related infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Herpes simplex
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Herpes virus infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Perianal abscess
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pharyngitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pneumonia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Escherichia infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Hypoalbuminemia
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Hypocalcaemia
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Hypokalaemia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    5
    Fluid retention
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    2
    Hypophosphatemia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Jun 2004
    Revision to clarify descriptions in inclusion and exclusion criteria and addition of on-site measurement methods to chromosome banding at screening were made.
    10 Sep 2004
    Changes in actions to be taken in case of occurrence of serious adverse events (SAE) were made in response to the revision of the clinical study standard operating procedures (SOP) of Novartis Pharma K.K.
    30 Nov 2004
    The study period was extended as treatment with the investigational product was likely to continue after April 2005.

    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.
    Data which would be needed to produce non-SAE and SAE tables by programming, does not exist. SAE and non-SAE tables in this document are the data of serious ADR and all AE respectively. For full, disclosure, all data available has been reported.
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