Status:

ACTIVE_NOT_RECRUITING

Ponatinib in Adult Ph+ ALL Patients With MRD Positivity or Hematological Relapse

Lead Sponsor:

Gruppo Italiano Malattie EMatologiche dell'Adulto

Conditions:

Philadelphia-Positive ALL

Acute Lymphoblastic Leukemia, in Relapse

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

This is a phase II interventional trial to evaluate if the use of ponatinib, with or without chemotherapy, can induce a molecular remission in MRD-positive patients, in patients in hematologic and ext...

Detailed Description

This is a phase II interventional multicenter study for adult patients with Ph+ALL who: * Are MRD+ (i.e. BCR-ABL1/ABL1 \>0.01) (or loose their molecular response) after whichever kind of previous tre...

Eligibility Criteria

Inclusion

  • Ph+ ALL patients with evidence of MRD disease or in hematologic and extra-hematologic relapse/refractoriness after any previous treatment, will be considered eligible to enter the study.
  • Age ≥18 years old with no upper age limit.
  • Adequate hepatic function as defined by the following criteria:
  • total serum bilirubin ≤1.5 x upper limit of normal (ULN), unless due to Gilbert's syndrome
  • alanine aminotransferase (ALT) ≤2.5 × ULN
  • aspartate aminotransferase (AST) ≤2.5 × ULN.
  • Adequate pancreatic function as defined by the following criterion:
  • \- serum lipase and amylase ≤1.5 × ULN.
  • For females of childbearing potential, a negative pregnancy test must be documented prior to enrollment.
  • Female and male patients who are fertile must agree to use an effective form of contraception with their sexual partners from enrollment through 4 months after the end of treatment.
  • Signed written informed consent according to ICH/EU/GCP and national local laws.

Exclusion

  • WHO performance status ≤ 50% (Karnofsky) or ≥ 3 (ECOG).
  • Uncontrolled active HBV or HCV hepatitis, or AST/ALT ≥ 2.5 x ULN and bilirubine ≥ 1.5 x ULN not due to the disease.
  • History of acute pancreatitis within 1 year of study or history of chronic pancreatitis.
  • History of alcohol abuse.
  • Ongoing or active uncontrolled infections.
  • Uncontrolled hypertriglyceridemia (triglycerides \>450 mg/dL).
  • Clinically significant, uncontrolled or active cardiovascular disease, specifically including, but not restricted to:
  • any history of myocardial infarction, stroke, or revascularization
  • unstable angina or transient ischemic attack within 6 months prior to enrollment
  • congestive heart failure within 6 months prior to enrollment, or left ventricular ejection fraction (LVEF) less than lower limit of normal per local institutional standards within 6 months prior to enrollment
  • history of clinically significant (as determined by the treating physician) atrial arrhythmia
  • any history of ventricular arrhythmia
  • any history of venous thromboembolism including deep venous thrombosis or pulmonary embolism
  • uncontrolled hypertension (diastolic blood pressure \>90 mm Hg; systolic \>140 mm Hg). Patients with hypertension should be under treatment on study entry to effect blood pressure control.
  • Taking medications that are known to be associated with Torsades de Pointes.
  • Taking any medications or herbal supplements that are known to be strong inhibitors of CYP3A4 within at least 14 days before the first dose of ponatinib.
  • Creatinine level \>2.5mg/dl or glomerular filtration rate (GFR) \<20 ml/min or proteinuria \>3.5 g/day.
  • Patients who are currently receiving treatment with any of the medications listed in Appendix E if the medications cannot be either discontinued or switched to a different medication prior to starting study drug. The medications listed in Appendix E have the potential to prolong QT.

Key Trial Info

Start Date :

May 4 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

November 1 2024

Estimated Enrollment :

67 Patients enrolled

Trial Details

Trial ID

NCT04475731

Start Date

May 4 2021

End Date

November 1 2024

Last Update

October 22 2024

Active Locations (22)

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Page 1 of 6 (22 locations)

1

Aou Ospedali Riuniti "Umberto I - G.M. Lancisi - G. Salesi"- Ancona - Sod Clinica Ematologica

Ancona, Italy

2

Area Vasta N. 5 Ascoli Piceno - S. Benedetto Del Tronto, Presidio Ospedaliero Av5 Osp. Gen. Prov.Le "C.G.Mazzoni" - Uoc Ematologia

Ascoli Piceno, Italy

3

Ao Di Rilievo Nazionale E Di Alta Specialità "San Giuseppe Moscati" - Avellino - Uoc Ematologia Con Unità Di Trapianto

Avellino, Italy

4

Aou Consorziale Policlinico - Bari - Uo Ematologia Con Trapianto

Bari, Italy