Condition Vasoregulation Function Endothelium in Patients With CML Getting TKI II Generation Bosutinib

Chronic Myeloid Leukaemia Clinical Trial

Official title:

Condition Vasoregulation Function Endothelium in Patients With Chronic Myeloid Leukemia (CML) Getting Tyrosine Kinase Inhibitor (TKI) II Generation Bosutinib

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05682924
• Other study ID #: 20221112
• Status: Recruiting
• Start date: October 1, 2022
• Est. completion date: May 15, 2023

Study information

• Verified date: December 2022
• Source: Samara State Medical University
• Contact: Igor Davydkin
• Phone: +78463741004
• Email: i.l.davydkin[@]samsmu.ru
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The study will study the state of the endothelium in patients with chronic myeloid leukemia during therapy with the II generation tyrosine kinase inhibitor bosutinib. Patients will be divided into groups receiving nilotinib 800mg/day, bosutinib 500mg/day, and imatinib 600mg/day. A comprehensive examination of patients will be carried out, including a clinical examination, a study of biochemical markers of endothelial damage and the functional state of the vascular wall. An algorithm will be developed for assessing the state of endothelial function in patients with ph-positive chronic myeloid leukemia in the chronic phase when using the second-generation tyrosine kinase inhibitor bosutinib.

Description:

Purpose: To assess the state of endothelial vasoregulatory function in patients with chronic myelogenous leukemia receiving the II generation tyrosine kinase inhibitor bosutinib as a second line of therapy based on a comprehensive assessment of biochemical markers of endothelial damage and the results of laser Doppler flowmetry. Description of the Protocol: At the first stage, study groups will be formed. The study groups will consist of 70 patients with ph-positive chronic myeloid leukemia in the chronic phase, aged 40 to 60 years, receiving nilotinib at a dose of 800 mg / day. (35 people) and bosutinib at a dose of 500 mg/day. (35 people) matched by sex and age. The control group will consist of 35 patients matched by gender and age with ph-positive chronic myeloid leukemia in the chronic phase, aged 40 to 60 years, receiving imatinib at a dose of 600 mg/day. (35 people). At the second stage, it is planned to conduct a comprehensive examination of patients, including a clinical examination, a study of biochemical markers of endothelial damage and the functional state of the vascular wall. At the third stage, the relationship between the results of laboratory methods for assessing endothelial function and dynamic parameters of microcirculation, determined by laser Doppler flowmetry in patients with ph-positive chronic myeloid leukemia in the chronic phase, receiving therapy with the II generation tyrosine kinase inhibitor bosutinib, will be analyzed. At the fourth stage, it is planned to develop an algorithm for assessing the state of endothelial function in patients with ph-positive chronic myelogenous leukemia in the chronic phase using the second generation tyrosine kinase inhibitor bosutinib. Scientific novelty 1. For the first time, an assessment of the state of endothelial function will be given on the basis of a comprehensive study using the Doppler flowmetry method and the determination of biochemical indicators of endothelial damage in patients with ph-positive chronic myeloid leukemia in the chronic phase while taking the II generation tyrosine kinase inhibitor bosutinib. 2. For the first time, an algorithm will be proposed for diagnosing the state of endothelial function in patients with ph-positive chronic myeloid leukemia in the chronic phase when using therapy with the II generation tyrosine kinase inhibitor bosutinib, based on the use of a multifactorial method of mathematical modeling. Practical significance Indicators will be determined that reflect the state of the vasoregulatory function of the endothelium in patients with ph-positive chronic myeloid leukemia in the chronic phase when using therapy with II generation tyrosine kinase inhibitors bosutinib. Taking into account the identified changes, an algorithm will be developed for assessing the state of endothelial function in patients with ph-positive chronic myeloid leukemia in the chronic phase when using the second-generation tyrosine kinase inhibitor bosutinib. Expected results Based on a comprehensive analysis of indicators of endothelial vasoregulatory function, including biochemical parameters and an assessment of the information content of the laser Doppler flowmetry method, an algorithm for assessing the state of endothelial function in patients with ph-positive chronic myeloid leukemia in the chronic phase against the background of taking the II generation tyrosine kinase inhibitor bosutinib will be developed.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 105
• Est. completion date: May 15, 2023
• Est. primary completion date: May 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years to 60 Years

Eligibility

Inclusion Criteria:

• patients with ph-positive chronic myeloid leukemia in the chronic phase before treatment and taking tyrosine kinase inhibitors of I and II generations (imatinib, nilotinib, bosutinib);
• availability of informed consent of the patient to participate in the study.

Exclusion Criteria:

• history of acute cerebrovascular accident;
• previous myocardial infarction in anamnesis;
• the presence of diabetes mellitus type I and II;
• the presence of chronic kidney disease C1-C5 stages;
• the presence of coronary heart disease with its clinical manifestations (II-IV functional class);
• the presence of hypertension III degree;
• the presence of atherosclerotic lesions of peripheral arteries according to the color duplex sonography data of the arteries of the upper and lower extremities;
• atrial fibrillation and flutter;
• the presence of other oncological diseases;
• inflammatory diseases in the acute stage;
• the presence of mutations, in which the appointment of tyrosine kinase inhibitors of the I or II generation is not indicated (resistance to tyrosine kinase inhibitors drugs)
• refusal of the patient from examination.

Related Conditions & MeSH terms

• Chronic Myeloid Leukaemia
• Leukemia
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive
• Leukemia, Myeloid

Intervention

Diagnostic Test:
• taking blood for the study of biochemical parameters and the study of microcirculation using the method of laser Doppler flowmetry
In the study, blood will be taken from patients with chronic myelogenous leukemia in the chronic phase to determine biochemical parameters (endothelin-1, homocysteine, VEGF (vascular endothelial growth factor)), as well as a study of microcirculation in these groups of patients using the method of laser Doppler flowmetry, to study the function of the endothelium.

Locations

Country	Name	City	State
Russian Federation	National Medical Research Centre for Hematology	Moscow
Russian Federation	Samara State Medical University	Samara

Sponsors (1)

Lead Sponsor	Collaborator
Samara State Medical University

Country where clinical trial is conducted

Russian Federation, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Evaluation of type of microcirculation.	Type of microcirculation (normal, hyperemic, spastic, congestive) according to the LAKK-OP apparatus	3 months
Secondary	Confirmation or exclusion of endothelial dysfunction.	Biochemical marker - Human Endothelin 1 (ET-1), fmol/ml	3 months
Secondary	Confirmation or exclusion of endothelial dysfunction.	Biochemical marker - Homocysteine, µmol/l	3 months
Secondary	Confirmation or exclusion of endothelial dysfunction.	Biochemical marker - VEGF (vascular endothelial growth factor), pg/ml	3 months