Ponatinib vs Imatinib for Acute Lymphoblastic Leukemia

Recruiting in Palo Alto (17 mi)

+126 other locations

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 3

Waitlist Available

Sponsor: Takeda

No Placebo Group

Pivotal Trial (Near Approval)

Prior Safety Data

Trial Summary

What is the purpose of this trial?In this study, adults with newly-diagnosed Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) will receive first-line therapy of ponatinib or imatinib. The main aim of this study is to compare the number of participants on each treatment that show no signs of disease. Participants will take tablets of either ponatinib or imatinib at the same time each day combined with reduced-intensity chemotherapy for up to 20 months. Then, they will continue with single-agent therapy (ponatinib or imatinib) until they meet the discontinuation criteria from the study.

Eligibility Criteria

Adults newly diagnosed with Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who are in good enough health to perform daily activities with slight limitations (ECOG <=2). They can't join if they have HIV, hepatitis B or C, recent major surgery, certain heart diseases, other cancers within the last 5 years, severe nervous system conditions, or are taking specific drugs that affect liver enzymes or cause heart rhythm problems.

Inclusion Criteria

My leukemia is newly diagnosed and positive for Philadelphia chromosome or BCR-ABL1.

I can take care of myself but might not be able to do heavy physical work.

Exclusion Criteria

I have no history of major brain-related health issues like epilepsy, stroke, or dementia.

I have HIV or active hepatitis B or C.

Uncontrolled hypertriglyceridemia (triglycerides >450 milligram per deciliter [mg/dL])

+13 more

Participant Groups

The trial is testing Ponatinib against Imatinib in adults with Ph+ ALL. Participants will take one of these drugs as a pill every day along with less intense chemotherapy for up to 20 months and then continue just the pills unless they need to stop according to study rules.

2Treatment groups

Experimental Treatment

Active Control

Group I: Cohort A: Ponatinib 30 milligram (mg)Experimental Treatment6 Interventions

Ponatinib 30 mg, tablets, orally, once daily (QD), with vincristine 1.4 mg/m\^2 (max 2 mg) intravenous (IV), on Days 1 and 14 and dexamethasone 40 mg (\<60 years \[yrs\]) and 20 mg (≥60 yrs), orally, once on Days 1 to 4, Days 11 to 14 for up to 3 cycles (each cycle=28 days) in induction phase (reduced dose of ponatinib 15 mg upon achievement of MRD-negative CR at end of induction) followed by ponatinib last induction phase dose with cytarabine, 1000 mg/m\^2 as 2-hour IV infusion (\<60 yrs) and 250 mg/m\^2 (≥60 yrs) every 12 hours, IV on Days 1, 3, 5 of Cycles 2,4,6 and methotrexate, 1000 mg/m\^2 (\<60 yrs) and 250 mg/m\^2 (≥60 yrs), IV infusion, on Day 1 of cycles 1, 3, 5 in consolidation phase followed by ponatinib last consolidation phase dose with vincristine 1.4 mg/m\^2 (max 2 mg), IV, on Day 1 and prednisone 200 mg (\<60 yrs), 100 mg (≥60-69 yrs) and 50 mg(≥70 yrs) on Days 1 to 5 for up to 11 cycles in maintenance phase up to data cut-off date: 12 August 2022.

Group II: Cohort B: Imatinib 600 mgActive Control6 Interventions

Imatinib 600 mg, tablets, orally, QD, with vincristine 1.4 mg/m\^2 (max 2 mg), IV, on Days 1 and 14 and dexamethasone 40 mg (\<60 yrs) and 20 mg (≥60 yrs), orally, once on Days 1 to 4 and Days 11 to 14 in each 28-day cycle for up to 3 cycles in the induction phase followed by imatinib 600 mg, tablets, orally, QD, with cytarabine, 1000 mg/m\^2 every 12 hours as a 2-hour-IV infusion (\<60 yrs) and 250 mg/m\^2 every 12 hours (≥60 yrs), IV on Days 1, 3, and 5 of each 28-day even cycles (Cycles 2, 4, and 6), and methotrexate, 1000 mg/m\^2 (\<60 yrs) and 250 mg/m\^2 (≥60 yrs), IV infusion, on Day 1 of each 28-day odd cycles (Cycle 1, 3, and 5) in consolidation phase followed by imatinib 600 mg, tablets, orally, QD, along with vincristine 1.4 mg/m\^2 (max 2 mg), IV, on Day 1 and prednisone 200 mg (\<60 yrs), 100 mg (≥60-69 yrs) and 50 mg (≥70 yrs) on Days 1 through 5 in each 28-day cycle up to 11 cycles in maintenance phase up to data cut-off date: 12 August 2022.

Imatinib is already approved in European Union, United States, Canada, Japan, Switzerland for the following indications:

🇪🇺 Approved in European Union as Gleevec for: