STI571 ProspectIve RandomIzed Trial: SPIRIT

NCT ID: NCT00219739

Last Updated: 2020-04-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

789 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-09-30

Study Completion Date

2014-12-31

Brief Summary

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To test whether increasing the dose of imatinib or combining it with IFNalpha or ara-C increases the rate of molecular response (as measured by the decrease in BCR-ABL transcripts after 12 months of treatment) in patients with previously untreated CML in chronic phase.

To compare overall survival in a selected arm according to molecular response at 1 year from randomization with the reference arm.

Detailed Description

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Imatinib at 400 mg daily has emerged as the preferred therapy for newly diagnosed CML patients who do not undergo allogeneic stem cell transplant.

A phase III randomized study, comparing imatinib at 400 mg per day to interferon plus cytarabine in newly diagnosed chronic phase CML patients enrolled 1106 patients from June 2000 to January 2001. 553 patients were randomized to each treatment. For comparative purposes, at 6 months, 75% of patients randomized to imatinib obtained a major cytogenetic response with 51% complete responses. Despite these impressive results, only a minority of patients treated with imatinib in this study achieved a molecular remission. When analyzed by log reduction in Bcr-Abl transcript levels using quantitative RT-PCR, 39% of patients achieved a 3-log reduction in Bcr-Abl levels, but only 13% and 3% achieved a 4- and 5-log reduction, respectively.2 To improve upon these results, various groups have tried higher doses of imatinib, and combinations of imatinib with interferon alpha or cytarabine. Each of these studies has used cytogenetic responses as the major endpoint.

Each of these therapies has increased toxicity as compared to 400 mg of imatinib alone and the rates of molecular remissions have not been reported.

Thus the purpose of this study is to first determine whether higher doses of imatinib or combining Imatinib with interferon or Ara-C would result in higher rates of molecular responses and if so, in better survival.

Conditions

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Chronic Myeloid Leukemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Imatinib mesylate 400 mg

Group Type EXPERIMENTAL

Imatinib mesylate 400 mg

Intervention Type DRUG

Imatinib mesylate 600 mg

Intervention Type DRUG

Imatinib 400 mg + Peg-Interferon

Intervention Type DRUG

Imatinib mesylate 400 mg + Cytarabine

Intervention Type DRUG

Imatinib mesylate 600 mg

Group Type EXPERIMENTAL

Imatinib mesylate 400 mg

Intervention Type DRUG

Imatinib mesylate 600 mg

Intervention Type DRUG

Imatinib 400 mg + Peg-Interferon

Intervention Type DRUG

Imatinib mesylate 400 mg + Cytarabine

Intervention Type DRUG

Imatinib mesylate 400 mg +Peg interferon

Group Type EXPERIMENTAL

Imatinib mesylate 400 mg

Intervention Type DRUG

Imatinib mesylate 600 mg

Intervention Type DRUG

Imatinib 400 mg + Peg-Interferon

Intervention Type DRUG

Imatinib mesylate 400 mg + Cytarabine

Intervention Type DRUG

Imatinib mesylate 400 mg +Cytarabine

Group Type EXPERIMENTAL

Imatinib mesylate 400 mg

Intervention Type DRUG

Imatinib mesylate 600 mg

Intervention Type DRUG

Imatinib 400 mg + Peg-Interferon

Intervention Type DRUG

Imatinib mesylate 400 mg + Cytarabine

Intervention Type DRUG

Interventions

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Imatinib mesylate 400 mg

Intervention Type DRUG

Imatinib mesylate 600 mg

Intervention Type DRUG

Imatinib 400 mg + Peg-Interferon

Intervention Type DRUG

Imatinib mesylate 400 mg + Cytarabine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients over 18 years of age
* Patients with Bcr-Abl positive CML in chronic phase.
* Patients within 14 weeks of diagnosis and previously untreated for CML except for hydroxyurea and/or anagrelide.
* No evidence of extramedullary leukemic involvement, with the exception of hepatosplenomegaly
* ECOG performance score of 0-2
* acceptable hepatic, renal, and cardiac function
* Informed consent signed up

Exclusion Criteria

* Depressive syndrome not controlled
* Uncontrolled medical illnesses.
* Women with childbearing potential and male patients who are unwilling or unable to use an adequate method to avoid pregancy for the entire period of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, France

OTHER_GOV

Sponsor Role collaborator

Novartis

INDUSTRY

Sponsor Role collaborator

Roche Pharma AG

INDUSTRY

Sponsor Role collaborator

Poitiers University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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François GUILHOT, MD

Role: STUDY_CHAIR

Department of Oncology hematology and Cell therapy, University Hospital , 86021 Poitiers - FRANCE

Locations

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University Hospital

Poitiers, , France

Site Status

Countries

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France

References

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Bruzzoni-Giovanelli H, Gonzalez JR, Sigaux F, Villoutreix BO, Cayuela JM, Guilhot J, Preudhomme C, Guilhot F, Poyet JL, Rousselot P. Genetic polymorphisms associated with increased risk of developing chronic myelogenous leukemia. Oncotarget. 2015 Nov 3;6(34):36269-77. doi: 10.18632/oncotarget.5915.

Reference Type DERIVED
PMID: 26474455 (View on PubMed)

Delord M, Rousselot P, Cayuela JM, Sigaux F, Guilhot J, Preudhomme C, Guilhot F, Loiseau P, Raffoux E, Geromin D, Genin E, Calvo F, Bruzzoni-Giovanelli H. High imatinib dose overcomes insufficient response associated with ABCG2 haplotype in chronic myelogenous leukemia patients. Oncotarget. 2013 Oct;4(10):1582-91. doi: 10.18632/oncotarget.1050.

Reference Type DERIVED
PMID: 24123600 (View on PubMed)

Johnson-Ansah H, Guilhot J, Rousselot P, Rea D, Legros L, Rigal-Huguet F, Nicolini FE, Mahon FX, Preudhomme C, Guilhot F. Tolerability and efficacy of pegylated interferon-alpha-2a in combination with imatinib for patients with chronic-phase chronic myeloid leukemia. Cancer. 2013 Dec 15;119(24):4284-9. doi: 10.1002/cncr.28328. Epub 2013 Sep 16.

Reference Type DERIVED
PMID: 24105694 (View on PubMed)

Preudhomme C, Guilhot J, Nicolini FE, Guerci-Bresler A, Rigal-Huguet F, Maloisel F, Coiteux V, Gardembas M, Berthou C, Vekhoff A, Rea D, Jourdan E, Allard C, Delmer A, Rousselot P, Legros L, Berger M, Corm S, Etienne G, Roche-Lestienne C, Eclache V, Mahon FX, Guilhot F; SPIRIT Investigators; France Intergroupe des Leucemies Myeloides Chroniques (Fi-LMC). Imatinib plus peginterferon alfa-2a in chronic myeloid leukemia. N Engl J Med. 2010 Dec 23;363(26):2511-21. doi: 10.1056/NEJMoa1004095.

Reference Type DERIVED
PMID: 21175313 (View on PubMed)

Other Identifiers

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SPIRIT

Identifier Type: -

Identifier Source: org_study_id

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