A Study to Investigate Tolerability and Efficacy of Asciminib (Oral) Versus Nilotinib (Oral) in Adult Participants (≥18 Years of Age) With Newly Diagnosed Philadelphia Chromosome Positive Chronic Myelogenous Leukemia in Chronic Phase (Ph+ CML-CP)

A Phase IIIb, Multi-center, Open-label, Randomized Study of Tolerability and Efficacy of Oral Asciminib Versus Nilotinib in Patients With Newly Diagnosed Philadelphia Chromosome Positive Chronic Myelogenous Leukemia in Chronic Phase.

ClinicalTrials.gov Identifier: NCT05456191

Novartis Reference Number: CABL001J12302

Last Update: Mar 31, 2023

See if you pre-qualify

All compounds are either investigational or being studied for (a) new use(s). Efficacy and safety have not been established. There is no guarantee that they will become commercially available for the use(s) under investigation. 

Study Description

The study is designed to compare the tolerability of asciminib versus nilotinib for the treatment of newly diagnosed, previously untreated patients with Positive Chronic Myelogenous Leukemia in Chronic Phase (Ph+ CML-CP).

Condition 
Philadelphia Chromosome-Positive Chronic Myeloid Leukemia
Phase 
Phase 3
Overall status 
Recruiting
Start date 
Nov 21, 2022
Completion date 
Mar 15, 2027
Gender 
All
Age(s)
18 Years and older (Adult, Older Adult)

Interventions

Drug
Asciminib
Asciminib 80 mg QD administered under fasting conditions.
Drug
Nilotinib
Nilotinib 300 mg BID administered under fasting conditions.

Eligibility Criteria

Inclusion Criteria:

Patients with CML-CP within 3 months of diagnosis.

Diagnosis of CML-CP (ELN 2020 criteria) with cytogenetic confirmation of the Philadelphia chromosome

Documented chronic phase CML will meet all the below criteria Baccarani et al 2013:

< 15% blasts in peripheral blood and bone marrow,
< 30% blasts plus promyelocytes in peripheral blood and bone marrow,
< 20% basophils in the peripheral blood,
PLT count ≥ 100 x 10^9/L (≥ 100,000/mm3), except treatment induced thrombocytopenia
No evidence of extramedullary leukemic involvement, with the exception of hepatosplenomegaly.
Evidence of typical BCR::ABL1 transcript [e14a2 and/or e13a2] which is amenable to standardized RQ-PCR quantification by the central laboratory assessment.
ECOG performance status of 0 or 1.

Adequate end organ function as defined by:

Total bilirubin (TBL) < 3 x ULN; patients with Gilbert's syndrome may only be included if TBL ≤ 3.0 x ULN or direct bilirubin ≤ 1.5 x ULN,
CrCl ≥ 30 mL/min as calculated using Cockcroft-Gault formula, Serum lipase ≤ 1.5 x ULN. For serum lipase > ULN - ≤ 1.5 x ULN, value must be considered not clinically significant and not associated with risk factors for acute pancreatitis.

Patients must have the following laboratory values within normal limits or corrected to within normal limits with supplements prior to randomization:

Potassium (potassium increase of up to 6.0 mmol/L is acceptable if associated with CrCl* ≥ 90 mL/min),
Total calcium (corrected for serum albumin); (calcium increase of up to 12.5 mg/dl or 3.1 mmol/L is acceptable if associated with CrCl* ≥ 90 mL/min),
Magnesium (magnesium increase of up to 3.0 mg/dL or 1.23 mmol/L if associated with CrCl* ≥ 90 mL/min),

For patients with mild to moderate renal impairment (CrCl* ≥ 30 mL/min and <90 mL/min) - potassium, total calcium (corrected for serum albumin) and magnesium should be within normal limits or corrected to within normal limits with supplements prior to randomization.

CrCl as calculated using Cockcroft-Gault formula.

Exclusion Criteria:

Previous treatment of CML with any other anticancer agents including chemotherapy and/or biologic agents or prior stem cell transplant, with the exception of hydroxyurea and/or anagrelide.
Known cytopathologically confirmed CNS infiltration (in absence of suspicion of CNS involvement, lumbar puncture not required).

Impaired cardiac function or cardiac repolarization abnormality including but not limited to any one of the following:

History of myocardial infarction (MI), angina pectoris, coronary artery bypass graft (CABG) within 6 months prior to starting study treatment.
Clinically significant cardiac arrhythmias (e.g., ventricular tachycardia), complete left bundle branch block, high-grade AV block (e.g., bifascicular block, Mobitz type II and third degree AV block).
QTcF ≥ 450 ms (male patients), ≥460 ms (female patients) on the average of three serial baseline ECG (using the QTcF formula). If QTcF ≥ 450 ms and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient re-screened for QTcF.
Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome, or any of the following:
Risk factors for Torsades de Pointes (TdP) including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure, or history of clinically significant/symptomatic bradycardia.
Concomitant medication(s) with a "Known risk of Torsades de Pointes" per www.crediblemeds.org that cannot be discontinued or replaced 7 days prior to starting study drug by safe alternative medication.
Inability to determine the QTcF interval.
Severe and/or uncontrolled concurrent medical disease that in the opinion of the Investigator could cause unacceptable safety risks or compromise compliance with the protocol (e.g. uncontrolled diabetes, active or uncontrolled infection; uncontrolled arterial or pulmonary hypertension, uncontrolled clinically significant hyperlipidemia).
History of significant congenital or acquired bleeding disorder unrelated to cancer.
Major surgery within 4 weeks prior to study entry or patients who have not recovered from prior surgery.
History of other active malignancy within 3 years prior to study entry with the exception of previous or concomitant basal cell skin cancer and previous carcinoma in situ treated curatively.
History of acute pancreatitis within 1 year prior to randomization or medical history of chronic pancreatitis.
History of chronic liver disease leading to severe hepatic impairment, or ongoing acute liver disease.
Known history of chronic Hepatitis B (HBV), or chronic Hepatitis C (HCV) infection. Testing for Hepatitis B surface antigen (HBs Ag) and Hepatitis B core antibody (HBc Ab/anti HBc) will be performed at screening. If anti-HBc is positive, HBV-DNA evaluation will be carried out at screening. A patient having positive HBV-DNA will not be enrolled in the study. Also, a patient with positive HBsAg will not be enrolled in the study. HCV Ab testing will also be performed at screening. For details on the criteria see Appendix 4.
History of Human Immunodeficiency Virus (HIV) unless well-controlled on a stable dose of anti-retroviral therapy at the time of screening.

Other protocol-defined Inclusion/exclusion criteria will apply.

Study Locations

Bulgaria
Novartis Investigative Site
Recruiting
Pleven, 5800
-
Bulgaria
Novartis Investigative Site
Recruiting
Plovdiv, 4002
-
Bulgaria
Novartis Investigative Site
Recruiting
Sofia, 1413
-
Bulgaria
Novartis Investigative Site
Recruiting
Sofia, 1431
-
Bulgaria
Novartis Investigative Site
Recruiting
Sofia, 1797
-
Bulgaria
Novartis Investigative Site
Recruiting
Varna, 9010
-
Bulgaria
Czech Republic
Novartis Investigative Site
Recruiting
Brno Bohunice, 625 00
Czech Republic
Czech Republic
Novartis Investigative Site
Recruiting
Praha 2, 128 20
Czech Republic
Czech Republic
Novartis Investigative Site
Recruiting
Plzen-Bory, 30599
-
Czech Republic
Novartis Investigative Site
Recruiting
Praha 10, 100 34
-
Czech Republic
France
Novartis Investigative Site
Recruiting
Bordeaux, 33076
-
France
Novartis Investigative Site
Recruiting
Caen Cedex, 14033
-
France
Novartis Investigative Site
Recruiting
Clermont Ferrand, 63003
-
France
Novartis Investigative Site
Recruiting
Lille Cedex, 59037
-
France
Novartis Investigative Site
Recruiting
Lyon, 69373
-
France
Novartis Investigative Site
Recruiting
Marseille, 13273
-
France
Novartis Investigative Site
Recruiting
Nantes Cedex 1, 44093
-
France
Novartis Investigative Site
Recruiting
Nice Cedex, 06202
-
France
Novartis Investigative Site
Recruiting
Paris Cedex 10, 75475
-
France
Novartis Investigative Site
Recruiting
Poitiers, 86000
-
France
Novartis Investigative Site
Recruiting
Strasbourg, 67200
-
France
Novartis Investigative Site
Recruiting
Toulouse, 31059
-
France
Novartis Investigative Site
Recruiting
Vandoeuvre les Nancy cedex, 54511
-
France
Germany
Novartis Investigative Site
Recruiting
Mannheim, 68305
Baden-Wuerttemberg
Germany
Novartis Investigative Site
Recruiting
Muenchen, 81241
Bayern
Germany
Novartis Investigative Site
Recruiting
Velbert, 42551
North Rhine-Westphalia
Germany
Novartis Investigative Site
Recruiting
Aachen, 52074
-
Germany
Novartis Investigative Site
Recruiting
Bad Saarow, 15526
-
Germany
Novartis Investigative Site
Recruiting
Bayreuth, 95445
-
Germany
Novartis Investigative Site
Recruiting
Berlin, 13353
-
Germany
Novartis Investigative Site
Recruiting
Bonn, 53105
-
Germany
Novartis Investigative Site
Recruiting
Bremen, 28177
-
Germany
Novartis Investigative Site
Recruiting
Chemnitz, 09113
-
Germany
Novartis Investigative Site
Recruiting
Essen, 45147
-
Germany
Novartis Investigative Site
Recruiting
Freiburg, 79106
-
Germany
Novartis Investigative Site
Recruiting
Halle S, 06120
-
Germany
Novartis Investigative Site
Recruiting
Hamburg, 20246
-
Germany
Novartis Investigative Site
Recruiting
Hannover, 30161
-
Germany
Novartis Investigative Site
Recruiting
Heidelberg, 69120
-
Germany
Novartis Investigative Site
Recruiting
Jena, 07740
-
Germany
Novartis Investigative Site
Recruiting
Leipzig, 04103
-
Germany
Novartis Investigative Site
Recruiting
Magdeburg, 39104
-
Germany
Novartis Investigative Site
Recruiting
Paderborn, 33098
-
Germany
Novartis Investigative Site
Recruiting
Regensburg, 93049
-
Germany
Novartis Investigative Site
Recruiting
Tübingen, 72076
-
Germany
Novartis Investigative Site
Recruiting
Ulm, 89081
-
Germany
Greece
Novartis Investigative Site
Recruiting
Ioannina, 455 00
GR
Greece
Novartis Investigative Site
Recruiting
Larissa, 411 10
GR
Greece
Novartis Investigative Site
Recruiting
Thessaloniki, 570 10
GR
Greece
Novartis Investigative Site
Recruiting
Athens, 115 27
-
Greece
Novartis Investigative Site
Recruiting
Patras, 265 00
-
Greece
Hungary
Novartis Investigative Site
Recruiting
Budapest, 1085
-
Hungary
Novartis Investigative Site
Recruiting
Budapest, 1097
-
Hungary
Novartis Investigative Site
Recruiting
Eger, 3300
-
Hungary
Jordan
Novartis Investigative Site
Recruiting
Amman, 11941
-
Jordan
Korea, Republic of
Novartis Investigative Site
Recruiting
Bundang Gu, 13620
Gyeonggi Do
Korea, Republic of
Romania
Novartis Investigative Site
Recruiting
Bucharest, 022328
District 2
Romania
Novartis Investigative Site
Recruiting
Bucharest, 030 171
-
Romania
Novartis Investigative Site
Recruiting
Cluj-Napoca, 400124
-
Romania
Novartis Investigative Site
Recruiting
Craiova, 200136
-
Romania
Novartis Investigative Site
Recruiting
Sibiu, 550245
-
Romania
Novartis Investigative Site
Recruiting
Timisoara, 300079
-
Romania
Singapore
Novartis Investigative Site
Recruiting
Singapore, 119228
-
Singapore
Novartis Investigative Site
Recruiting
Singapore, 169608
-
Singapore
Novartis Investigative Site
Recruiting
Singapore, S308433
-
Singapore
Slovakia
Novartis Investigative Site
Recruiting
Kosice, 040 66
Slovak Republic
Slovakia
Novartis Investigative Site
Recruiting
Bratislava, 85107
-
Slovakia

Contacts

Name: 
Novartis Pharmaceuticals
Phone: 
Name: 
Novartis Pharmaceuticals
Phone: 

Have a question?

Call 1-888-669-6682 or email [email protected]