Efficacy and Safety of Generic Imatinib (Carcemia®) Compared to Glivec® in Real-Life Management of Chronic Phase of Chronic Myeloid Leukemia

Chronic Myeloid Leukemia Clinical Trial

— CARCML  

Official title:

Efficacy and Safety of Generic Imatinib (Carcemia®) Compared to Glivec® in Real-Life Management of Chronic Phase of Chronic Myeloid Leukemia; a Multicenter, Observational Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05282108
• Other study ID #: HIK-CAR-2021-04
• Status: Recruiting
• Start date: July 20, 2022
• Est. completion date: August 2024

Study information

• Verified date: September 2023
• Source: Hikma Pharmaceuticals LLC
• Contact: Ruba A Jaber
• Phone: 009625805430
• Email: rjaber[@]Hikma.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The purpose of this study is to evaluate Efficacy and Safety of Generic Imatinib (Carcemia®) Compared to Glivec® in Real-Life Management of Chronic Phase of Chronic Myeloid Leukemia

Description:

This is an observational, prospective, cohort study design, where no visits or intervention(s) additional to the daily practice will be performed. In the study site, two cohorts will be identified among eligible patients, followed up, and assessed for a total of 12 months.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 240
• Est. completion date: August 2024
• Est. primary completion date: August 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Age =18 years

2. Newly diagnosed patients with Ph+ CML in CP, with or without the presence of other cytogenetic abnormalities at the time of diagnosis

3. Treatment naïve patients with confirmed diagnosis within 3 months of study enrolment

4. Levels of liver aminotransferases and serum bilirubin = 2 times the upper limit of the normal range, and serum creatinine =1.5 times the upper limit of the normal range

5. Written informed consent

Exclusion Criteria:

1. CML in accelerated phase (AP) at enrolment except patients in AP with the presence of other cytogenetic abnormalities at the time of diagnosis 2. CML in BP at enrolment 3. Patients who meet any of the contraindications to the administration of the study drug according to the approved Summary of Product Characteristics.

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Related Conditions & MeSH terms

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

Intervention

Drug:
• Carcemia
Generic Imatinib
• Glivec
Imatinib

Locations

Country	Name	City	State
Egypt	Nasser Institute	Cairo
Egypt	National Cancer Institute (NCI)	Cairo

Sponsors (1)

Lead Sponsor	Collaborator
Hikma Pharmaceuticals LLC

Country where clinical trial is conducted

Egypt, 

References & Publications (14)

Abou Dalle I, Kantarjian H, Burger J, Estrov Z, Ohanian M, Verstovsek S, Ravandi F, Borthakur G, Garcia-Manero G, Jabbour E, Cortes J. Efficacy and safety of generic imatinib after switching from original imatinib in patients treated for chronic myeloid leukemia in the United States. Cancer Med. 2019 Nov;8(15):6559-6565. doi: 10.1002/cam4.2545. Epub 2019 Sep 10. — View Citation

Awidi A, Abbasi S, Alrabi K, Kheirallah KA. Generic Imatinib Therapy Among Jordanians: An Observational Assessment of Efficacy and Safety in Routine Clinical Practice. Clin Lymphoma Myeloma Leuk. 2017 Dec;17(12):e55-e61. doi: 10.1016/j.clml.2017.08.001. Epub 2017 Aug 5. — View Citation

Baccarani M, Cortes J, Pane F, Niederwieser D, Saglio G, Apperley J, Cervantes F, Deininger M, Gratwohl A, Guilhot F, Hochhaus A, Horowitz M, Hughes T, Kantarjian H, Larson R, Radich J, Simonsson B, Silver RT, Goldman J, Hehlmann R; European LeukemiaNet. Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet. J Clin Oncol. 2009 Dec 10;27(35):6041-51. doi: 10.1200/JCO.2009.25.0779. Epub 2009 Nov 2. — View Citation

Baccarani M, Deininger MW, Rosti G, Hochhaus A, Soverini S, Apperley JF, Cervantes F, Clark RE, Cortes JE, Guilhot F, Hjorth-Hansen H, Hughes TP, Kantarjian HM, Kim DW, Larson RA, Lipton JH, Mahon FX, Martinelli G, Mayer J, Muller MC, Niederwieser D, Pane F, Radich JP, Rousselot P, Saglio G, Saussele S, Schiffer C, Silver R, Simonsson B, Steegmann JL, Goldman JM, Hehlmann R. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood. 2013 Aug 8;122(6):872-84. doi: 10.1182/blood-2013-05-501569. Epub 2013 Jun 26. — View Citation

Danthala M, Gundeti S, Kuruva SP, Puligundla KC, Adusumilli P, Karnam AP, Bala S, Konatam ML, Maddali LS, Digumarti RR. Generic Imatinib in Chronic Myeloid Leukemia: Survival of the Cheapest. Clin Lymphoma Myeloma Leuk. 2017 Jul;17(7):457-462. doi: 10.1016/j.clml.2017.05.006. Epub 2017 May 10. — View Citation

Deininger MW, O'Brien SG, Ford JM, Druker BJ. Practical management of patients with chronic myeloid leukemia receiving imatinib. J Clin Oncol. 2003 Apr 15;21(8):1637-47. doi: 10.1200/JCO.2003.11.143. Epub 2003 Mar 13. — View Citation

Deininger MW, Shah NP, Altman JK, Berman E, Bhatia R, Bhatnagar B, DeAngelo DJ, Gotlib J, Hobbs G, Maness L, Mead M, Metheny L, Mohan S, Moore JO, Naqvi K, Oehler V, Pallera AM, Patnaik M, Pratz K, Pusic I, Rose MG, Smith BD, Snyder DS, Sweet KL, Talpaz M, Thompson J, Yang DT, Gregory KM, Sundar H. Chronic Myeloid Leukemia, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2020 Oct 1;18(10):1385-1415. doi: 10.6004/jnccn.2020.0047. — View Citation

Ercaliskan A, Seyhan Erdogan D, Eskazan AE. Current evidence on the efficacy and safety of generic imatinib in CML and the impact of generics on health care costs. Blood Adv. 2021 Sep 14;5(17):3344-3353. doi: 10.1182/bloodadvances.2021004194. — View Citation

Gemelli M, Elli EM, Elena C, Iurlo A, Intermesoli T, Maffioli M, Pungolino E, Carraro MC, D'Adda M, Lunghi F, Anghileri M, Polverelli N, Rossi M, Bacciocchi M, Bono E, Bucelli C, Passamonti F, Antolini L, Gambacorti-Passerini C. Use of generic imatinib as first-line treatment in patients with chronic myeloid leukemia (CML): the GIMS (Glivec to Imatinib Switch) study. Blood Res. 2020 Sep 30;55(3):139-145. doi: 10.5045/br.2020.2020130. — View Citation

Hochhaus A, Baccarani M, Silver RT, Schiffer C, Apperley JF, Cervantes F, Clark RE, Cortes JE, Deininger MW, Guilhot F, Hjorth-Hansen H, Hughes TP, Janssen JJWM, Kantarjian HM, Kim DW, Larson RA, Lipton JH, Mahon FX, Mayer J, Nicolini F, Niederwieser D, Pane F, Radich JP, Rea D, Richter J, Rosti G, Rousselot P, Saglio G, Saussele S, Soverini S, Steegmann JL, Turkina A, Zaritskey A, Hehlmann R. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020 Apr;34(4):966-984. doi: 10.1038/s41375-020-0776-2. Epub 2020 Mar 3. — View Citation

Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2016 update on diagnosis, therapy, and monitoring. Am J Hematol. 2016 Feb;91(2):252-65. doi: 10.1002/ajh.24275. — View Citation

Jiang H, Zhi LT, Hou M, Wang JX, Wu DP, Huang XJ. [Comparison of generic and original imatinib in the treatment of newly diagnosed patients with chronic myelogenous leukemia in chronic phase: a multicenter retrospective clinical study]. Zhonghua Xue Ye Xue Za Zhi. 2017 Jul 14;38(7):566-571. doi: 10.3760/cma.j.issn.0253-2727.2017.07.003. Chinese. — View Citation

Kantarjian H, O'Brien S, Jabbour E, Shan J, Ravandi F, Kadia T, Faderl S, Garcia-Manero G, Borthakur G, Cortes J. Impact of treatment end point definitions on perceived differences in long-term outcome with tyrosine kinase inhibitor therapy in chronic myeloid leukemia. J Clin Oncol. 2011 Aug 10;29(23):3173-8. doi: 10.1200/JCO.2010.33.4169. Epub 2011 Jul 11. — View Citation

O'Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ; IRIS Investigators. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2003 Mar 13;348(11):994-1004. doi: 10.1056/NEJMoa022457. — View Citation

* Note: There are 14 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of patients who achieve and maintain major molecular response (MMR) at 12 months	Proportion of patients who achieve and maintain major molecular response (MMR) at 12 months using RQ-PCR test (Appendix II) using Chi-square test. The MMR is defined as ration of BCR-ABL to ABL (or other housekeeping gene) = 0.1% on the international scale (MMR is equal to a 3-log reduction in the ratio of BCR-ABL1: ABL from a standardized median baseline value).	12 months
Secondary	the safety & tolerability of imatinib after 12 months	In both cohorts, the safety & tolerability of imatinib after 12 months of treatment will be assessed by: The number, type, severity and frequency of the adverse reactions particularly those described in the SmPC of the reference product.; Incidence of adverse events (AEs) & serious adverse events (SAEs).; AEs leading to permanent treatment discontinuation.; Clinically relevant changes in laboratory tests (according to laboratory reference ranges).	12 months
Secondary	Progression free survival (PFS) at 12 months		12 months
Secondary	Event free survival (EFS) at 12 months		12 months
Secondary	Survival without blastic phase (BP) at 12 months		12 months
Secondary	Overall survival (OS) at 12 months		12 months
Secondary	Complete cytogenetic response (CCyR) at 12 months		12 months
Secondary	Deep Molecular response (DMR) at 12 months		12 months
Secondary	Treatment compliance	Treatment compliance while on imatinib will be evaluated by identifying the frequency of not taking the medications as prescribed and the reason behind that based on the prescription pattern. The decision on non-compliance is based on the treating physician's judgment."	12 months