Study title
Ruxolitinib for Chronic Myeloid Leukemia (CML) with Minimal Residual Disease (MRD)
Scientific title
Phase I-II Study of Ruxolitinib (INCB18424) for Patients With Chronic Myeloid Leukemia (CML) With Minimal Residual Disease While on Therapy With Tyrosine Kinase Inhibitors
(ClinicalTrials.gov NCT01751425)
Indication and most important inclusion criteria
Potential study participants must be 18 years or older and have Philadelphia chromosome (Ph)-positive or BCR/ABL-positive CML. They have been receiving imatinib (once the maximum tolerated dose (MTD) has been established, patients receiving dasatinib or nilotinib also eligible) for at least 18 months with no increase in their dose for the last 6 months.
Patients with some response to tyrosine kinase inhibitor (TKI) but persistent minimal residual disease are eligible. In the phase 1 portion of the study only patients receiving imatinib who have at least a complete hematologic response are eligible. Once MTD is determined, patients with nilotinib or dasatinib are also eligible. For the phase 2 portion of the study only patients with complete cytogenetic response are eligible provided they have detectable disease.
Short description of intervention
This study consists of two parts. The goal of the first part is to find the highest tolerable dose of ruxolitinib that can be given with a tyrosine kinase inhibitor that patients are already taking as part of their standard treatment. The goal of the second part of this study is to learn if this drug combination can help to control CML in patients in whom, despite a good response to therapy, the disease is still detectable at low levels (this is called "minimal residual disease"). Researchers believe that eliminating all detectable evidence of disease may decrease the chances that the leukemia will ever come back. The safety of the drug combination will also be studied in both parts.
Type of study
Therapy optimization trial
Current status
Active, not recruiting
Study sponsor
M.D. Anderson Cancer Center
In collaboration with
Incyte Corporation
Scientific lead / contact
Jorge Cortes, MD
Principal investigator
Jorge Cortes, MD
Additional information
Study description in the US register ClinicalTrials.gov, a service of the U. S. National Institutes of Health
Study centers / principal investigators
United States
UT MD Anderson Cancer Center
Houston, Texas, 77030
Jorge Cortes, MD
Complete Cytogenetic Response
Absence of cells with the Philadelphia Chromosome in the bone marrow, usually detected by cytogenetics or FISH diagnostics
Complete Hematologic Response
The blood cell count has returned to normal, and tests don’t show any immature white blood cells. Also, the spleen has returned to a normal size if it was enlarged.
Minimal residual disease
A type of deep remission in CML where BCR-ABL is however still detectable by PCR
Chronic Myeloid Leukemia
also called: Chronic Myelogeneous Leukemia
A chronic disease of the blood and bone marrow that results from a transformation of a stem cell.
Philadelphia chromosome
A certain change in chromosomes (on chromosome 22) found in 95% of patients who have CML. The Philadelphia chromosome results from a mutation that involves the fusion of parts of chromosome 9 and chromosome 22 (the bcr-abl fusion gene)
Inclusion criteria
Inlusion criteria define which subjects may participate in a clinical study. Study subjects must fulfill all inclusion criteria (e.g. with regard to sex, age, previous diseases). This ensures a uniform composition of the study population and minimizes the risk of influences that distort the study results.
Chromosome
A chromosome is a structure of DNA that carries the genetic makeup in the nucleus of the cell. Chromosomes contain giant chain molecules of DNA, coiled and folded as aggregates with specific proteins. Chromosomes ensure that during cell division the hereditary information is evenly distributed to the daughter cells. Normal human body cells have 46 chromosomes. Cancer cells can have a different number and/or structure of chromosomes.
Indication
In medicine, a reason to use a certain diagnostic test, therapeutic procedure or medication. The opposite of indication is contraindication.
Dasatinib
Trade name: Sprycel, development name: BMS-354825, inhibits BCR-ABL and SRC tyrosine kinases. Authorized for marketing in the EU since 2006 for the treatment of CML and Ph+ALL.
Other names: BMS-354825|BMS354825|Sprycel
Nilotinib
Trade name: Tasigna, development name: AMN107, inhibits BCR-ABL tyrosine kinase. Authorized for marketing in the EU since 2007 for the treatment of CML and Ph+ALL.
Other names: |AMN107|Tasigna
Imatinib
Imatinib, trade name Glivec/Gleevec, development name STI-571, a first-generation BCR-ABL tyrosine kinase inhibition. Authorized for marketing since 2002 for the treatment of CML and Ph-positive ALL.
Other names: Gleevec|Glivec
Chronic
Long-lasting, slowly developping
Gene
A unit of information present as DNA; a gene usually contains the blueprint for a protein.
CML
Chronic Myeloid Leukemia, also called Chronic Myelogenous Leukemia
A chronic disease of the blood and bone marrow that results from a transformation of a stem cell.
CHR
Abbreviation for Complete Hematologic Response. The blood cell count has returned to normal, and tests don’t show any immature white blood cells. Also, the spleen has returned to a normal size if it was enlarged.
